J City C District Medical Insurance Fund Audit Case Study

The issue of people’s livelihood is one of the important links in building a harmonious society,General Secretary Xi said in the report of the 19 th National Congress of the Communist Party of China: "Strengthening the construction of the social security system and fully implementing the plan for universal participation in insurance." "Medical insurance is an important part of China’s social security system,the implementation of which protects the life and health of our citizens and the well-being of our families,and is an important measure to solve the situation of"difficult and expensive to see a doctor".With the continuous development of the national economy and people’s income,the amount of medical insurance funds is also increasing,the supervision of the medical insurance fund is becoming more and more important.Audit as a means to monitor the smooth operation of the national economy and society,to combat illegal crimes,should assume the responsibility of protecting the safety of the health insurance fund,to safeguard the realization of the people’s livelihood goals of the country.Compared with some developed countries in Europe and America,China’s medical insurance fund audit started a little later,there are legal and institutional deficiencies,the grass-roots government agencies easily ignore the importance of the audit of health insurance fund,in the implementation process there are various difficulties.Therefore,the relevant research on the audit of medical insurance fund,to improve the quality of audit work,improve audit methods,promote the improvement of the audit system is of great significance.Through the review and summary of relevant literature at home and abroad,it is found that when studying the audit of medical insurance fund,most of the literature is incorporated into the field of social security audit,and there are few literature studies that analyze the audit of medical insurance fund separately.Most of the research focus on the audit of health insurance funds focuses on the supervision of its management,payment and other processes,from different perspectives to analyze the problems faced by the audit of health insurance funds,regulatory channels and methods,bring benefits and so on,in the overall perspective of the health insurance fund audit process of the difficulties and difficulties of the literature is not much,and the current literature is mostly concentrated at the provincial and municipal levels of the macro-level,for the district and county and other grass-roots organs audit status of the discussion is still valuable,can do further research and analysis.This paper selects the medical insurance fund audit work in J City C as a case study,takes the theory of public entrustment responsibility,new public management and national audit as the theoretical basis,studies the audit of medical insurance fund as an independent object,combs its fund profile,systematically expounds the audit process,audit content and audit results.From this point of view,we find the difficulties existing in the audit work of the primary audit organs in carrying out the audit of the medical insurance fund,and make suggestions from the angles of improving the construction of the audit team,improving the level of audit informatization,public participation,strengthening the follow-up audit and perfecting the audit prevention mechanism,so as to help the future audit work.