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核心提(ti)示：據(ju)國家醫保(bao)局網站(zhan)消(xiao)息，為(wei)確保(bao)廣大人民(min)群(qun)眾更加公平、公正、及時享受長(chang)期(qi)(qi)護理保(bao)險待遇，推動長(chang)期(qi)(qi)護理保(bao)險失能(neng)等級評估機構(gou)定點管

據國家醫保(bao)(bao)(bao)(bao)局網站(zhan)消息，為確保(bao)(bao)(bao)(bao)廣大人民群眾更加(jia)公(gong)平、公(gong)正、及(ji)時(shi)享受長(chang)期護(hu)理(li)(li)保(bao)(bao)(bao)(bao)險待遇，推動(dong)長(chang)期護(hu)理(li)(li)保(bao)(bao)(bao)(bao)險失能(neng)等級評估機(ji)構(gou)定(ding)點管(guan)理(li)(li)更加(jia)規范化(hua)(hua)、標準化(hua)(hua)、科學化(hua)(hua)，近日，國家醫保(bao)(bao)(bao)(bao)局印發(fa)(fa)了《長(chang)期護(hu)理(li)(li)保(bao)(bao)(bao)(bao)險失能(neng)等級評估機(ji)構(gou)定(ding)點管(guan)理(li)(li)辦(ban)(ban)法（試行）》（醫保(bao)(bao)(bao)(bao)發(fa)(fa)〔2024〕13號(hao)，以下簡稱《定(ding)點管(guan)理(li)(li)辦(ban)(ban)法》）。

 長期護(hu)理保險失能(neng)等級(ji)評(ping)估(gu)是長期護(hu)理保險制度機制的(de)重要組(zu)成部分(fen)，評(ping)估(gu)結論是待遇享受和基金支付的(de)重要依據。對評(ping)估(gu)主(zhu)體的(de)規(gui)(gui)范確(que)定(ding)和管(guan)理，是確(que)保評(ping)估(gu)工(gong)作(zuo)專業化、規(gui)(gui)范化的(de)關(guan)鍵(jian)環節(jie)。在梳理總結試點經驗基礎(chu)上，國家醫保局研究制定(ding)《定(ding)點管(guan)理辦法(fa)》，明確(que)長期護(hu)理保險失能(neng)等級(ji)評(ping)估(gu)機構定(ding)點管(guan)理具體要求，推(tui)進評(ping)估(gu)機構定(ding)點管(guan)理規(gui)(gui)范統一。

  《定(ding)(ding)(ding)點(dian)管(guan)(guan)理(li)(li)辦法》主(zhu)要對(dui)定(ding)(ding)(ding)點(dian)評(ping)(ping)(ping)估(gu)機(ji)構的確(que)(que)定(ding)(ding)(ding)、運(yun)行(xing)管(guan)(guan)理(li)(li)、監(jian)督(du)(du)(du)管(guan)(guan)理(li)(li)等(deng)方面(mian)作出規(gui)定(ding)(ding)(ding)。一是明確(que)(que)定(ding)(ding)(ding)點(dian)評(ping)(ping)(ping)估(gu)機(ji)構的申(shen)請條件和確(que)(que)定(ding)(ding)(ding)程(cheng)序。規(gui)定(ding)(ding)(ding)申(shen)請成為(wei)定(ding)(ding)(ding)點(dian)評(ping)(ping)(ping)估(gu)機(ji)構應(ying)具備(bei)的基本(ben)條件、確(que)(que)定(ding)(ding)(ding)程(cheng)序，以及不予受理(li)(li)定(ding)(ding)(ding)點(dian)申(shen)請的情形等(deng)。二是提出定(ding)(ding)(ding)點(dian)評(ping)(ping)(ping)估(gu)機(ji)構的運(yun)行(xing)管(guan)(guan)理(li)(li)要求(qiu)。要求(qiu)定(ding)(ding)(ding)點(dian)評(ping)(ping)(ping)估(gu)機(ji)構應(ying)加強(qiang)內(nei)(nei)部(bu)建設，明確(que)(que)提出建立健(jian)全內(nei)(nei)部(bu)質量控制(zhi)制(zhi)度(du)、人員管(guan)(guan)理(li)(li)制(zhi)度(du)、評(ping)(ping)(ping)估(gu)檔案管(guan)(guan)理(li)(li)制(zhi)度(du)、信(xin)息安(an)全管(guan)(guan)理(li)(li)制(zhi)度(du)等(deng)。三是規(gui)定(ding)(ding)(ding)對(dui)定(ding)(ding)(ding)點(dian)評(ping)(ping)(ping)估(gu)機(ji)構的監(jian)督(du)(du)(du)管(guan)(guan)理(li)(li)要求(qiu)。明確(que)(que)醫療保(bao)障部(bu)門對(dui)定(ding)(ding)(ding)點(dian)評(ping)(ping)(ping)估(gu)機(ji)構加強(qiang)監(jian)督(du)(du)(du)、考核(he)、日常管(guan)(guan)理(li)(li)，規(gui)定(ding)(ding)(ding)醫保(bao)行(xing)政部(bu)門和經(jing)辦機(ji)構監(jian)管(guan)(guan)職責和內(nei)(nei)容(rong)等(deng)。此外，明確(que)(que)依托(tuo)其他(ta)形式主(zhu)體實(shi)施(shi)評(ping)(ping)(ping)估(gu)的，對(dui)有(you)關機(ji)構的管(guan)(guan)理(li)(li)，參(can)照本(ben)辦法執行(xing)。

 下一步，國家醫保(bao)局(ju)將指導長(chang)期(qi)護理保(bao)險(xian)制度試點地區(qu)醫保(bao)部門做(zuo)好《定(ding)點管(guan)理辦法(fa)(fa)》試行，及(ji)時(shi)總結經驗做(zuo)法(fa)(fa)，不斷健全長(chang)期(qi)護理保(bao)險(xian)失能等級評(ping)估標(biao)準(zhun)體系和管(guan)理辦法(fa)(fa)，更好維(wei)護廣大參(can)保(bao)人(ren)合法(fa)(fa)權益(yi)。

來源：醫化網