
A | 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。 一、明确支付范围 长护险基金可以报销这些费用:失能等级评定机构做失能评估的费用、定点养老护理机构提供的长期照护服务费,还有第三方机构帮忙经办管理的相关费用。 失能评估的费用,会根据实际情况,由基金和个人共同分担,防止大家随便申请、过度评估。

B | Washington, Oct 11 (UNI) The Chinese economy will post the lowest GDP growth in four decades in the current year, barring performance during the initial COVID-19 crisis in 2020, the International Monetary Fund (IMF) said on Tuesday.
"The revisions reflect the downgrade for growth in China, to 3.2 percent in 2022 (the lowest growth in more than four decades, excluding the initial COVID-19 crisis in 2020). COVID-19 outbreaks and lockdowns in multiple localities, as well as the worsening property market crisis, have held back economic activity in China, " the IMF said in its World Economic Outlook.
However, China’s growth is expected to rise to 4.4 percent in 2023, the report added.
COVID-19-related lockdowns have taken a significant toll on China’s economy, particularly in the second quarter of 2022, according to the reports. Particularly, the property sector, which represents the fifth part of the nation’s economy is rapidly weakening, it added.
"A worsening of China’s property sector crisis could spill over to the domestic banking sector and weigh heavily on the country’s growth, with negative cross-border effects," the IMF said.
UNI/SPUTNIK GNK。一般来说,参保人第一次失能评估合格,还有按规定定期复查评估的费用,长护险基金支付。

C | 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。同时分清基本医保和长护险的报销边界,两类保险原则上不能重复报销。 二、规范支付方式 评估服务主要按人头收费。护理服务主要按服务时长计费:居家护理一般按小时算钱;养老院机构护理按住院天数算;社区护理根据实际服务内容确定计费方式。 未来随着政策完善,国家还会统一摸索,对智能照护设备、辅助器具等,实行定额打包或者按单个项目付费。 三、合理确定支付标准 各地要结合基金财力、老人基本照护需求、当地护理行业收费水平,合理定报销标准,并且根据情况动态调整。护理报销标准按当地经济水平、平均工资、护理人员专业等级分档次设定。

D | 参保人一年里长护险基金最高报销额度,不超过当地上一年城乡居民人均可支配收入的50%。

E | 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。

F | 四、严格基金管理和监督 《指导意见》要求优化结算流程,用智能系统审核报销,加快打款速度。如果评估服务未按规定执行、评估通过率畸高畸低的,护理服务未按照护理服务计划执行、未达到服务项目目录要求,以及社会力量经办机构未按规定管理的,基金将按一定比例扣除直至拒付。长期护理保险基金支付不得由第三方社会力量代管代拨。

G | 长护险资金使用会纳入常态化检查,包括专项飞行检查、日常巡查、社会监督、智能监控,还会研究建立信用黑名单制度。同时实时监控评估机构、护理机构的收费,保障参保人的权益。 (总台央视记者 龙晓勤)。
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