UBND TINH TIEN GIANGsoLAO DONG - THlfONG BINHvA xA HQI -BAo HIEM xA HQI

S6: bJ~ ISLDTBXH-BHXHv Iv [(1soat the BHYT trung

nam 2010,2013,2014 va giai phapkhac phuc viec clip the trung

CQNG HOA xA HQI cnu NGHlA ~T NAMD{>cI~p - Ty' do - H~nh phuc

tu« Giang, ngay.JO thdng 6 ndm 2014

Kinh gui:

- Phong Lao dong Thuong binh va

Xa hoi cac huyen, thanh pho, thi xa;

- Ba o hiSm xa h o i cac huye n ,

thanh ph6, thi xa.

Th\!,C hien kSt luan cua KiSm toan Nha mroc khu VlJC IX narn 2013 va y kiSnchi dao cua UBND tinh Ti~n Giang v~ viec xu ly d6i voi s6 kinh phi diroc ngansach Nha mroc h6 tro do c~p trung the bao hiSm y tS (BHYT) narn 2011,2012va tiSp tuc ra soat xac dinh the trung nam 2010, 2013, 2014. Sa Lao dong -Thirong binh va Xa hQi (LDTB&XH) va Bao hiSm xa hQi (BHXH) tinh huangd~n viec thuc hien ra scat the BHYT trung va giai phap kh~c phuc khong dS c~ptrung the BHYT trong thai gian toi tren dia ban tinh, noi dung nhtr sau:

1. Ra soat giam th~ trimg 2010, 2013, 2014:

Can cir s6 lieu nghi trung the BHYT, BHXH tinh cung c~p danh sach dSPhong LDTB&XH huyen kSt hop voi c~p xa xac dinh chinh xac s6 the c~ptrung, Viec ra scat xac dinh the trung, thu hoi, giam the, l~p cac biSu ID~U baocao theo nQi dung huang d~n Lien nganh s6 143/LDTBXH-BHXH ngay 25thang 3 nam 2013 cua Sa LDTB&XH va BHXH tinh.

Thai gian ra soat the trung nam 2010, 2014 tong hop bao cao v~ SaLDTB&XH, BHXH tinh trurrc ngay 15/07/2014 dS tong hop bao cao v~ UBNDtinh, BHXH Viet Nam.

Rieng the trung nam 2013 BHXH huyen va Phong LDTB&XH huyen da ra.soat xong, d~ nghi hai don vi nay tiSp tuc phoi hop thu h6i the dirt diSm trongthang 6 nam 2014.

2. Xac djnh d6i tugng cfip the BHYT:

KS nr ngay 01/7/2014 tro di yeu c~u Phong LDTB&XH va BHXH huyenphoi hop chin chinh viec c~p the trung nhu sau:

2.1. Xac djnh thtr tl! U'U tien ciia cac nhorn d6i tuong cfip the BHYTnhu sau:

STT D6i turrng DO'n vi I~p danhsach

01 Can bQ xa da nghi viec huang tro c~p tir NSNN hang UBND xa,thang phuemg

02 Nguoi c6 cong voi each mang PhongL8TB&XH

03 Cuu chi~n binh PhongL8TB&XH

04 Nguoi tnrc ti~p tham gia khang chien chong My PhongL8TB&XH

05Dai bi€u Quoc hoi, HQi d6ng nhan dan dirong nhiem UBNDcacdp

VP 8BH8ND

06 Nguoi thuoc dien huong tro c~p bao tro xa hQi hang Phongthang L8TB&XH

07 Ngiroi ngheo, dan tQCthieu s6 sinh song & vung 8BKK PhongL8TB&XH

08 Thannhan cua ngiroi c6 cong voi each mang PhongL8TB&XH

09 Than nhan cua 1t,r6IUQ'ngvfi trang, co yeu

- Than nhan cua CAND Cong an tinh, cacdOll VI cong antnrc thuoc BQdong tren dia bantinh

- Than nhan cua nguoi lam cong tac co y~u VP Tinh uy

Tre em duoi 6 tu6i (thuc hien Quy trinh cap the theo UBND xa,10 Quyet dinh s6 49/2013/Q8-UBND ngay 16/12/2013 cua phuemg

UBND tinh Ti€n Giang)

11 Ngiroi thuoc hQ gia dinh can ngheo PhongL8TB&XH

- U6i tuong co trach nhiem cung c~p thong tin chinh xac, d~y dti vS nhanthan (ho ten, ngay, thang, nam sinh, gioi tinh, dia chi, ... ). Truong hop 01 ngiroid6ng thai thuoc nhieu d6i tuong diroc c~p the BHYT thi khi co quan lap danhsach co trach nhiem d6i chi~u ki~m tra va xac dinh theo thir nr iru tien tren vachi diroc dS nghi c~p 01 the BHYT.

2

- Truong hop nguoi lao dong dang lam viec thuoc d6i tirong tham giaBHYT b~t bU9C(kS ca nguoi hoat dong khong chuyen trach c~p xa, phirong, thitran) ma dong thai thuoc d6i tuong neu tren thi phai tham BHYT b~t bU9Ctainai cong tac,

2.2. Trach nhiem do'n vi rhuc hi~n:

* Phong Lao dQng Thurrng binh va X3 hQi huyen:

- Phong LDTB&XH chiu trach nhiern huang d~n UBND phuong, xa, thitr~n l~p diy du, chinh xac thong tin v~ nhan than cua d6i tirong (ho ten, ngaythang nam sinh, gioi tinh, dia chi: s6 nha, duong, t6, khu pho, ~p, phuong,xa, ... ) d6ng thai ra soat loai tnr nhirng tnrong hop mot nguoi trung nhi~u nhomd6i tuong dS chon d6i nrong cap the BHYT theo thir tir uu tien, Tong hop danhsach d~ nghi BHXH huyen c~p the BHYT cho d6i tuong.

- Phai hop UBND c~p xa, phirong, thi tran t6 chirc c~p phat the BHYT chocac nhorn d6i tuong kip thai truce khi the co gia tri sir dung. Huang d~n nguoigiao the BHYT yeu ciu d6i nrong khi nhan the kiSm tra thong tin ca nhan ghitren the; neu dung thong tin thi ky, ghi r6 ho ten, ngay thang nam nhan the vaodanh sach c~p the (can be)LDTB cdp xii co trach nhiem luu danh sach a6i tuongkY nhdn the ai phuc VI} viec kiim tra, a6i chiiu vd sau). Truong hop phat hienthe c~p trung, hoac d6i nrong dii chuyen di nai khac thi phai thu h6i lai the. Lapdanh sach kern the BHYT thu h6i bao cho ca quan quan ly d6i urong d~ nghigiam the.

- Kip thai chuyen ti~n dong BHYT hang thang theo quy dinh, thuongxuyen ra soat lap danh d~ nghi c~p the BHYT cho d6i tuong. Tranh dS xay ratinh trang d~ ngh] c~p trung the hoac cham d~ nghi c~p the, cham chuyen ti~nnhir thai gian qua.

* CO' quan Bao hi~m X3 hQi:

- Khi nhan danh sach va d~ nghi c~p the BHYT kern file dfr lieu (rn~uchu~n do BHXH huyen cung cap) do ca quan quan ly d6i tuong chuyen dSn,BHXH huyen (bo phan thu) chiu trach nhiern ra soat d6i tuong dang quan ly trenphan mem SMS. Cu thS: vao muc tim thong tin ca nhan kiSm tra cac thong tinnhir: Gioi tinh, s6 CMND, dia chi, ten cha me ... theo tung kh6i quan ly dS xacdinh co trung hay khong? NS'u nghi trung thi in ra danh sach d~ nghi ca quanquan ly kiSrn tra lai truce khi in the BHYT, nSu xac dinh trung d6i tuong thiphoi hop voi don vi lap bien ban khong c~p the BHYT.

- B9 phan s6 the cua BHXH huyen tiSp tuc kiSm tra, ra soat lai lin nfratruce kh'i in the cho d6i tuong.

- Hang quy, phong s6 the, b9 phan s6 the cua BHXH huyen xu~t dfr lieu diic~p the cho cac nhom d6i tuong neu a bang tren dS ra soat d6i tuong nghi trung(ho ten, nam sinh, dia chi ... ) va bao cao lanh dao cho y kiSn xu IY.

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- BHXH huyen thu h6i the BHYT trung (neu the con gia trj sfr dung) vati~n hanh giam ngaytren phan mem cac the BHYT bj trung, hru dfr lieu phuc vucong tac kiSm tra sau nay. .

- BHXH huyen thuong xuyen don d6c, nh~c nho Phong LBTB&XH huyenchuyen tien va cap the BHYT kip thai cho d6i tirong tham gia, han ch~ viecchuyen tien cham, lap danh sach cham anh huang d~n quyen loi cua ngiroi thuhuang BHYT.

Tren day la nhtrng n9i dung huang d~n thirc hien viec ra soat the trung nam2010, 2014, dong thai ch~n chinh tinh trang c~p the trung trong thai gian qua. Benghi Phong LBTB&XH va Bao hiSm xa hoi c~p huyen thuc hien ngay nhfrng n9idung tren. Trong qua trinh triSn khai thirc hien n~u con vuong m~c kip thai phananh ve Sa LBTB&XH, Bao hiSm xa hoi tinh dS duoc huang d~n them .I. -~

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sa LAO DONG - TBXHKT.GlAMDOC

.-:::::=~·n6GlAM DOC

NO'i nlt~n.~- Nhu tren;- UBND cac huyen, thanh ph6, thi xii;- Luu: VT(Sa LDTBXH, BHXH tinh).

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