The pilot program for direct settlement of work-related injuries for medical treatment in other places has arrived, who benefits? How to do it?-瞭望新时代网

The pilot program for direct settlement of work-related injuries for medical treatment in other places has arrived, who benefits? How to do it?

2024-02-04

According to a recent notice issued by the Ministry of Human Resources and Social Security and other three departments, starting from April 1st, provinces across the country will pilot the direct settlement of work injury insurance for cross provincial medical treatment. How to carry out the pilot program? Which groups are the main beneficiaries? How to apply for processing? According to the reporter's understanding, the human resources and social security departments of various provinces and Xinjiang Production and Construction Corps will select cities within 40% of the province to initiate pilot projects. Personnel in pilot cities with demand can directly settle the expenses for inter provincial and cross regional medical treatment, inpatient work injury rehabilitation, and auxiliary equipment configuration at medical institutions by holding social security cards or electronic social security cards. "This will greatly solve the pain points of work-related injuries such as" running errands "to reimburse medical expenses and advance payment for treatment." The head of work-related injury business at a large machinery manufacturing company in Tangshan, Hebei Province, told reporters that in the past, when employees suffered major work-related injuries, due to the complexity of the injuries, the injured often needed to go to first tier cities for treatment. Individuals or companies need to advance the expenses incurred for medical treatment in other places, and then review and manually reimburse them based on invoices. Sometimes, it may even take nearly a year for them to be credited to the account. After implementing direct settlement, employees can directly claim work-related injury insurance reimbursement payments with their social security cards. As of the end of 2023, the number of insured individuals in China's basic work-related injury insurance exceeded 300 million for the first time, reaching 302 million, an increase of 10.54 million compared to the same period last year. Carrying out settlement of medical treatment for work-related injuries in different locations will undoubtedly benefit insured individuals, especially in better safeguarding the rights and interests of workers in industries with relatively high work-related injury risks such as hazardous chemicals, mines, construction, transportation, and machinery manufacturing. With the increase of social mobility, the demand for settlement of work-related injuries for medical treatment in other places is constantly increasing. "In addition to working employees, there is also a group of 'old work-related injuries' who require long-term treatment. Many of them will follow their children to live in other provinces after retirement. With this policy, it will be more convenient for them to seek medical treatment," said the head of the medical insurance department at a second tier hospital in Shandong. So, how will the specific pilot be carried out? The relevant person in charge of the Work Injury Insurance Department of the Ministry of Human Resources and Social Security introduced that the pilot areas will follow the principle of gradual progress, first including hospitalization expenses, starting with long-term living (working) in other places and personnel who are transferred to other places for medical treatment, and giving priority to connecting areas with concentrated medical treatment in other places. The number of medical institutions with direct settlement agreements can be determined based on actual conditions in pilot areas, and one can be launched online through China Unicom. Each province should determine at least one protocol rehabilitation institution and one auxiliary device configuration institution, which can be gradually increased according to the progress. How can personnel in need apply for processing? During the pilot period, medical personnel seeking medical treatment in other places are limited to those who have lived or worked outside the insured province for six months or more, as well as work-related injury workers who need to be transferred to other provinces for medical treatment due to medical conditions. They must also complete work-related injury identification, work-related injury recurrence confirmation, work-related injury rehabilitation confirmation, or auxiliary equipment configuration confirmation. Before seeking medical treatment across provinces or regions, work-related injured employees must file a record with the local insurance agency and obtain approval after review. The specific procedures can be handled through national unified service entrances such as the National Social Insurance Public Service Platform, the Human Resources and Social Security Government Service Platform, the mobile 12333App, and the electronic social security card, or through the windows of the local insurance agency. In order to avoid employees changing their place of medical treatment too frequently and guide them to seek medical treatment in an orderly manner, the notice stipulates the participation in insurance during the pilot period

Edit：GuoGuo Responsible editor：FangZhiYou

Source：people.cn

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