Study On Supervision Of Urban Workers' Basic Medical Insurance Fund In Shanxi Province

With the rapid advancement of the universal medical insurance system and the continuous improvement of the medical security level,the risks faced by the medical insurance fund increase sharply,and the supervision of the medical insurance fund faces many new challenges.As an important social insurance fund,the basic medical insurance fund for urban workers is closely related to the interests of most people.Under the new situation,how to further strengthen the supervision of the basic medical insurance fund for urban workers becomes the key to the balance of income and expenditure of the whole medical insurance fund and the healthy operation of the medical insurance system.In this paper,the author uses the methods of literature analysis,field investigation,qualitative and quantitative analysis,and studies the current situation of the supervision of the basic medical insurance fund of the urban staff in Shanxi Province.It mainly expounds the following four aspects: the regulation and regulation of the supervision,the subject of the supervision and the duties,the content of the supervision and the way of supervision.Based on the interview with the fund supervision department of Yangquan Municipal Social Security Bureau,this paper discusses the problems existing in the supervision of the basic medical insurance fund for urban workers in Shanxi Province.In the actual process of supervision,there are many problems,such as the imperfect supervision law,the absence of the main body of supervision,and the weak internal supervision of medical insurance agencies,especially the supervision of the contents of the basic medical insurance fund for urban workers.If the supervision of the designated hospitals is not effective,the fund will be taken out;The supervision of personal account funds is not in place,resulting in unreasonable use of personal account funds,serious waste.In view of the problems in the supervision of basic medical insurance fund for urban workers in Shanxi Province,it can be optimized from four aspects.First of all,it is necessary to perfect the policies and regulations governing the basic medical insurance fund for urban workers,especially to increase the punishment for illegal acts such as embezzlement and deceiving the medical insurance fund,and secondly,to give full play to the role of the main body of supervision and to do a good job of audit supervision.Financial supervision and social supervision should,once again,strengthen supervision over the contents,explore ways to make full use of personal account money,avoid excessive waste,and reasonably control the expenditure of basic medical insurance expenses.Finally,we should rely on medical insurance big data.Introduction of third-party payment review mechanism,innovation of regulatory party Type,perfect Shanxi Province medical insurance information system construction.The regulation of the basic medical insurance fund of the urban staff is of great significance to the maintenance of the safety of the fund and the risk of avoiding the operation,and has great help to promote the sustainable development of the basic medical insurance system of the urban staff in Shanxi Province.