With the increasing social mobility, the settlement of work-related injury insurance for medical treatment in different places has become a hot issue for many injured employees. In order to solve this problem, the Ministry of Human Resources and Social Security and other three departments jointly issued a notice that from April 1, 2023, all provinces across the country will pilot the direct settlement of work-related injury insurance for cross-provincial and non-local medical treatment. The implementation of this policy marks that the work-related injury insurance service has entered a new stage, which has brought great convenience to the majority of work-related injury workers.
The pilot will cover 40% of the cities in all provinces across the country, and these cities will serve as the vanguard of the pilot trial to accumulate experience for the follow-up comprehensive promotion. In the pilot areas, hospitalization costs will be included in the pilot area on a gradual basis, and then gradually expanded to include other related expenses. The implementation of this policy will mainly benefit injured employees who work or live outside the home for a long time, as well as injured employees who need to be referred to hospitals due to medical conditions.
How exactly will this pilot policy be carried out? First of all, the pilot areas will determine the number of medical institutions with direct settlement agreements according to the actual situation, and give priority to connecting the areas where medical treatment is concentrated in other places. This means that injured workers will have more options when seeking medical treatment, and at the same time, they will be able to enjoy more convenient settlement services. Secondly, the pilot areas will settle expenses in strict accordance with the relevant provisions of work-related injury insurance to ensure that the rights and interests of injured employees are fully protected.
For the majority of injured employees, how to apply for direct settlement of cross-provincial and remote medical treatment? First of all, they need to file with the local agency of the insured place, and after review and approval. During the filing process, employees can handle it through various channels such as the national social insurance public service platform and the human resources and social security government service platform, which is convenient and fast. After the filing is successful, employees only need to hold their social security card or electronic social security card when seeking medical treatment, and they can directly settle the relevant expenses at the medical institution, without the need to advance funds** or reimburse them later.
How to apply for those who need it? The implementation of this policy will greatly solve the pain points such as "errand" reimbursement and advance funds when injured employees seek medical treatment in other places. In the past, when injured workers sought medical treatment in other places, they often needed individuals or enterprises to pay medical expenses in advance, and then review and manually reimburse them with invoices later, which was a cumbersome and time-consuming process. Now, with only one social security card, the expense settlement can be easily completed, which greatly reduces the economic burden and time cost of injured employees.
In addition to addressing the issue of reimbursement, this policy will also help protect the rights and interests of workers in industries with a relatively high risk of work-related injuries. According to statistics, by the end of 2023, the number of people insured by China's basic work-related injury insurance has reached 30.2 billion people, an increase of 10.54 million year-on-year. Among them, the risk of work-related injuries for workers in industries such as hazardous chemicals, mining, construction, transportation, and machinery manufacturing is relatively high. Carrying out a pilot project for the settlement of medical treatment in other places for work-related injuries will provide better medical security services for these employees and protect their health and rights and interests.
The implementation of this policy will also promote the rational allocation and effective use of medical resources. With the gradual expansion and comprehensive promotion of the pilot areas, more medical institutions will be included in the scope of direct billing to provide more high-quality medical services for workers injured at work. At the same time, through direct settlement of medical treatment across provinces and places, it will also help alleviate the shortage of medical resources in some areas and promote the balanced distribution of medical resources.
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