Research On The Implementayion Framework Of Medical Insurance Fund Audit

The 19 th CPC National Congress proposed to "implement a healthy China strategy" and "improve the national health policy".At the same time,it is necessary to "deeply carry out poverty alleviation and tackling the hardship" to realize the medical treatment of the people’s diseases.In recent years,the people’s health awareness has been continuously enhanced,and the attention has been paid to medical insurance funds as their own “life-saving money”.The coverage of medical insurance in China has been continuously expanded,the level of reimbursement has been continuously improved,and the price of medicines has been lowered several times.However,the burden of personal medical expenses of the people has not been alleviated,and the problem of “difficult to see a doctor and expensive to see a doctor” has not been resolved.One of the important reasons is that the illegal operation of medical insurance funds and the lack of strict management have led to an endless stream of fraudulent use of medical insurance funds,which has greatly threatened the safety of medical insurance funds.As an important part of the party and state supervision system,state audit has the responsibility to safeguard the rights and interests of the people.Through the audit work of medical insurance funds,the national auditing agency reveals the problems and hidden risks in the operation of medical insurance funds,and puts forward corresponding suggestions,which is conducive to the continuous improvement of the medical insurance system and the safe operation of medical insurance funds,thus safeguarding the people.Fundamental rights.Therefore,it is of great theoretical and practical significance to study the dilemma and countermeasures faced by the implementation of medical insurance fund audit.First of all,this paper sorts out the relevant literatures of current domestic and international medical insurance fund audits,including medical insurance funds and medical insurance fund audits.Secondly,it clarifies the theoretical basis of this paper,including principal-agent theory,project management theory,national audit and state.Governance theory;once again,clearly put forward the implementation framework of medical insurance fund audit,and combined with the current implementation experience of medical insurance fund audit conducted by China’s audit institutions and the specific case of R provincial medical insurance fund audit implementation,pointing out the current medical insurance fund audit implementation Faced with complex audit object and content,insufficient performance auditing,inadequate use of audit results,lack of interdisciplinary composite auditing talents,and computer auditing technology to be improved;finally,draw conclusions and propose solutions to the dilemma of medical insurance fund audit implementation Suggestions for the countermeasures and further clarify the research direction.Most of the current literature studies on medical insurance fund audits are based on the necessity of auditing or unilateral research on the audit of a part of the operation of the medical insurance fund.The innovations of this paper are as follows: Firstly,the implementation framework of the medical insurance fund audit is put forward,and the various elements are elaborated in detail;secondly,the relevant information of the audit institution to carry out the audit of the medical insurance fund and the R provincial medical insurance fund are fully collected.The first-hand information of audit implementation,combined with the audit implementation framework for exemplification analysis,systematically analyzes the dilemma faced by medical insurance fund auditing and puts forward corresponding countermeasures,which provides certain support for the construction and improvement of the new era medical insurance fund auditing system reference.