Chongqing Workers Injured Workers Pneumoconiosis Hospitalization Cost Quota Management

In order to effectively protect the medical needs of workers suffering from pneumoconiosis, and to use the industrial injury insurance funds rationally and effectively, the Municipal Human Resources and Social Security Bureau and the Municipal Bureau of Finance jointly issued documents. From November 1, 2013, the accidental injury insurance was adjusted to co-ordinate management of pneumoconiosis of injured workers. Inpatient medical expenses settlement methods, the implementation of fixed settlement management.

First, the management of the medical expenses of hospitalized pneumoconiosis patients was adjusted according to the type of disease quota. The expenses of medicines and medical service items outside the scope of payment due to the need of using the work-related injury insurance fund must be included in the scope of fixed-quota settlement. Medical institutions must not collect fees from the employer or the injured person.

Second, if there are special circumstances such as lung lavage or emergency rescue, the medical institution shall report to the work-related injury insurance agency with which the service agreement was signed. After approval, the relevant medical expenses shall be paid by the work-related injury insurance fund.

Third, medical institutions must not limit the cost of inpatient medical treatment for workers with pneumoconiosis due to settlement standards. They must not arbitrarily shorten or extend hospitalization time to maximize the benefits of settlement. They must not reduce the quality of medical care, and must not refuse to accept or accept heavy patients.

China Labor Insurance Network