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Zhejiang Healthcare Security Administration
Date:2020-08-18 11:12

Institutional functions:

(1) Implementing laws and regulations, and policies and provisions on healthcare security like medical insurance, maternity insurance, and medical assistance, and formulating policies, local laws, and draft regulations, plans and standards related to healthcare security.

(2) Organizing the formulation of financing and treatment policies on healthcare security, improving the balancing mechanism for dynamic adjustment and regional adjustment, coordinating urban and rural healthcare security treatment standards, establishing and improving the treatment adjustment mechanism compatible with the financing level, establishing a unified healthcare security system across the province, and organizing the formulation and implementation of reform plans for the long-term medical insurance system.

(3) Organizing the formulation and implementation of measures for the regulation of the healthcare security fund, establishing and improving the prevention and control mechanisms for the safety of healthcare security fund, promoting the reform of the payment methods of the healthcare security fund, and undertaking work related to the regulation of the provincial healthcare security fund.

(4) Organizing the formulation of policies on medical insurance catalogs, payment standards and charges related to medicines, medical consumables, medical service items, and medical service facilities, establishing dynamic adjustment mechanisms, and formulating and implementing negotiation rules for medical insurance catalog access; establishing pricing information monitoring and information release systems.

(5) Formulating and supervising the implementation of bidding and procurement policies for drugs and medical consumables, and guiding and supervising the construction and maintenance of the bidding and procurement platforms for drugs and medical consumables.

(6) Formulating and implementing agreements for designated medical institution and measures for payment management, establishing and improving the healthcare security credit evaluation system and the information disclosure system, regulating medical services and medical expenses covered by the medical insurance, and investigating and dealing with violations of laws and regulations in the healthcare security field according to law.

(7) Being responsible for healthcare security management, and the establishment of public service systems and information; organizing the formulation of and improving policies on regulation of medical treatment received not in one’s native place and expense settlement; establishing and improving the transfer and continuation system for healthcare security.

(8) Completing other tasks assigned by the Provincial Party Committee and the Provincial Government.

(9) Transforming functions. Deepening the reform of “Maximum One Visit Service Procedure” in medical security, improving the unified basic medical insurance system and the critical illness insurance system for urban and rural residents, promoting the coordinated reform in medical care, medical insurance and medicine, promoting the unified “smart medical insurance” across the province, establishing and improving the multi-level healthcare security system covering all people and coordinating urban and rural areas, strengthening the linkage between medical insurance and policies on tiered diagnosis and treatment, pricing, fee control, and contracted services, giving play to the leverage of medical insurance, promoting the establishment of a market-dominating social medical pricing formation mechanism, continuously improving healthcare security to better meet the people's medical needs, and further improving the performance of the use of medical insurance funds to ensure that medical insurance funds are accessible and sustainable.

(10) Division of responsibilities with Health Commission of Zhejiang Province. Health Commission of Zhejiang Province and Healthcare Security Administration of Zhejiang Province and other departments strengthen the linkage between systems and policies in respect of medical care, medical insurance and medicine, establish communication and consultation mechanisms, promote the coordinated reform in these respects and the construction of the county medical and health service communities, and accelerate the advancement of interconnection between medical insurance and medical treatment and medical data to improve the efficiency of medical resource utilization and the standard of healthcare security.


Address: No. 51-1, Miduqiao Road, Gongshu District, Hangzhou

Public Telephone: 87051472

Complaint Hotline: 87051410

Website address: http://ybj.zj.gov.cn

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