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视频丨国家医保局出台指导意见 统一规范长护险支付管理_我的网站

一 |     　　国家医疗保障局近日印发《关于做好长期护理保险支付管理工作的指导意见》，明确长期护理保险支付范围、支付方式、支付标准以及基金监管和风险防范机制。　　长期护理保险基金按规定支付定点失能等级评估机构提供的失能等级评估服务费用、定点长护服务机构提供的长期护理服务费用，以及社会力量参与经办管理服务的费用等。　　失能等级评估服务费用由基金和个人承担，避免随意过度使用评估申请权。参保人首次失能评估合格的，按规定开展的定期复查评估费用，由长护险基金按规定支付。　　在国家规定的长护险服务清单里的护理项目，基金按规定报销；超出清单的服务，需要个人自费。    New Delhi, Oct 10 (UNI) The Central Bureau of Investigation (CBI) arrested one more person, a liquor businessman, in an ongoing probe related to alleged irregularities in framing and implementation of the New Excise Policy of Delhi government that now is withdrawn, the officials said on Monday.

Businessman Abhishek Boinpally was arrested by in a case related to alleged irregularities in new excise policy of Delhi government, the CBI said.

It is the second arrest in the New Delhi Excise Policy case after Aam Aadmi Party (AAP) leader Vijay Nair was arrested. Nair is former CEO of Mumbai-based Only Much Louder.

Boinpally is said to be an associate of Arun Ramchandra Pillai, who is one of the 15 persons named in the FIR.

The CBI has alleged that irregularities were committed while modifying the Excise Policy.

The probe agency has alleged that undue favours were extended to licence holders; licence fee was waived or reduced; and L-1 licence was extended without competent authority’s approval.

It said that beneficiaries diverted the "illegal" gains to the accused public servants and made false entries in their books of accounts to conceal the money trail.

Accused public servants named in the case are Delhi Deputy Chief Minister Manish Sisodia, the then Excise Commissioner Arva Gopi Krishna, Deputy Commissioner Anand Tiwari and Assistant Commissioner Pankaj Bhatnagar among others.

The Delhi Excise Department allegedly decided to refund the Earnest Money Deposit of about Rs 30 crore to a successful tenderer against the existing rules. Waiver on tendered licence fee was allowed due to Covid-19 from December 28, 2021, to January 27, 2022, apparentlyly causing a loss of Rs 144.36 crore to the exchequer.

A few months ago, CBI had conducted a search of the bank locker of Sisodia at Ghaziabad in the same case. It also raided and held a search operation for around 14 hours at his residence.

UNI CM SY ING。同时分清基本医保和长护险的报销边界，同一服务项目不得重复享受两项保险待遇。

二 | 　　规范长期护理保险支付方式，失能等级评估服务主要按人头付费。护理服务主要按服务时长计费，居家护理一般按小时计费；机构护理服务以床日为付费单元。　　今后，国家层面将探索对纳入长期护理保险支付范围的智能化护理服务、支持性辅助器具等项目，采取按定额或按项目付费等方式。

三 | 　　护理服务报销标准结合当地经济发展水平、职工平均工资、失能等级及护理服务类型等分档设定。参保人年度长护险基金最高支付额度，不超过当地上一年度城乡居民人均可支配收入的50%。各地要统筹考虑居家、机构、社区等护理服务形式，鼓励使用居家和社区护理服务。　　各地医保部门将加强基金监管，将长护险基金使用纳入飞行检查等常态化监管范围，探索建立长期护理保险信用管理制度。动态监测评估机构、护理机构的服务收费价格，保障参保人权益。责任编辑：曹睿潼。

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Published on:00:37:29