Beijing Business Daily (Reporter Li Xiumei) On December 15, the National Health Insurance Administration reported that in order to strengthen the management of long-term care insurance disability level assessment and protect the legitimate rights and interests of the insured, according to the "Guiding Opinions of the National Health Insurance Administration and the Ministry of Finance on Expanding the Pilot of the Long-term Care Insurance System", the National Health Insurance Bureau and the Ministry of Finance jointly formulated the "Management Measures for the Assessment of Long-term Care Insurance Disability Level (Trial)" (hereinafter referred to as the "Management Measures").
The "Management Measures" clarify the scope of application, the principles to be followed, and the responsibilities of medical insurance departments at all levels.
According to the "Administrative Measures", long-term care insurance disability level assessment institutions implement fixed-point management. Designated assessment institutions refer to institutions that are included in the designated management of long-term care insurance disability level assessment institutions in the overall planning area, and carry out disability level assessment of long-term care insurance participants in accordance with relevant provisions. Coordinate the signing of an assessment service agreement between the regional medical security agency and the designated assessment agency, and clarify the responsibilities, rights and obligations of both parties. Encourage and support the development of independent evaluation bodies. Where the conditions for implementation are not met for the time being, the assessment may be carried out by relying on medical institutions, labor ability appraisal institutions, commercial insurance institutions, and so forth. With the improvement of the system, the assessment form will be gradually transitioned to an independent assessment body.
The Administrative Measures stipulate that the appraisers include appraisers and appraisal experts. The assessor is responsible for collecting assessment information and assisting in the on-site assessment. The assessment expert is responsible for carrying out the on-site assessment and proposing the assessment conclusions;Undertake the re-evaluation work;Propose a care service plan based on the needs of nursing services.
Assessors must have a professional background in medicine, nursing, psychology, long-term care, elderly care services and management, and have been engaged in relevant professional work for more than 2 years (inclusive).Standardized training and assessment are requiredHave good professional ethics and conduct;They should also have intermediate or above professional titles in clinical medicine, nursing, psychiatry and psychology and more than 2 years (inclusive) of relevant work experience.
The national medical security administrative department, in consultation with the financial department, shall formulate a unified national disability level assessment standard, clarify the assessment scale, evaluation index, grade classification, etc., and adjust it in a timely manner. Explore the establishment of a cross-departmental mutual recognition mechanism for assessment results. The disability level assessment process mainly includes assessment application, acceptance and review, on-site assessment, conclusion, publicity and delivery.