In order to protect the legitimate rights and interests of insured persons, the National Healthcare Security Administration recently issued the "Measures for the Designated Management of Long term Care Insurance Nursing Service Institutions (Trial)" (hereinafter referred to as the "Measures"), further clarifying the specific requirements for the designated management of long-term care service institutions, emphasizing the principle of leniency and strict management. If designated institutions engage in fraudulent and insurance fraud, their service agreements will be terminated. Long term care insurance, known as the "sixth insurance" of social security, is a social insurance policy launched by the government specifically to provide basic living care and medical care services for disabled individuals who are unable to take care of themselves due to old age, illness, or disability. Since the pilot establishment of the long-term care insurance system in China in 2016, it has covered about 180 million people in 49 cities across the country, with a total of over 2.35 million people enjoying benefits. Long term care insurance has played an important role in reducing the economic burden on families of disabled individuals. Designated long-term care service institutions are the main providers of long-term care services for insured persons and are also the main recipients of long-term care insurance fund payments. Whether insured individuals can fairly obtain relevant service guarantees, and whether long-term care insurance can release full positive energy, all rely on the service behavior of these designated institutions. Currently, the degree of aging varies in different regions, and the supply capacity and level of long-term care services in some areas are insufficient and uneven. The standards for handling services and many other aspects are also not unified. It is common for some institutions and practitioners to engage in non-standard nursing services. Previously, there have been media reports on a case where nursing staff from a certain company fraudulently obtained medical insurance benefits by falsely reporting their work frequency and duration. This indicates the need to strengthen the management standards of designated institutions and guard against illegal activities that may interfere with the concept of 'elderly care'. Strengthening the designated management of long-term care service institutions is an inherent requirement for regulating their service behavior and safeguarding the legitimate rights and interests of insured persons. The Measures address the current development status of long-term care insurance, focusing on safeguarding the rights and interests of insured persons and coordinating support for the development of the elderly care industry. They clarify a series of requirements from multiple aspects such as the determination, operation and management of designated institutions, and service management. For designated service agencies, this will achieve both entry and exit, and internal management must be strengthened, fund use must be strictly enforced, and any illegal or irregular behavior must bear corresponding legal consequences. By regulating in-process and post event supervision, it will further force designated institutions to improve service quality, thereby better safeguarding the legitimate rights and interests of insured persons. Everyone will age, so that every elderly and disabled person can be treated with tenderness and fully protected by law. This is not only related to the quality of life, but also to the integrity of the rule of law. We look forward to the effective implementation of the 'Measures', guiding relevant service institutions to continuously strengthen self-management and industry self-discipline, using professionalism and warmth to enable more disabled elderly people to achieve' care for the elderly ', and demonstrating more livelihood care through the long-term care insurance system. (New Society)
Edit：Sun Jia Bin Responsible editor：Li Yi
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