Doi vdi mot so nhom doi tuong cd ty le tham gia BHYT thdp: Nhu khdi^ cac trudng hgc, hd gia dinh, cac doanh nghiep; Can tang cudng tuyen truyen sau rdng chinh sach, phap luat vd B H Y T [r]
Trang 1PHONG GD&DT THANH OAI
C O N G V A N D E N
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mi.5: J\\HJQ- m^P.N THANH OAT
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CONG HOA XA HOI CHU NGHIA VIET NAM
Boc lap - Tir do - Hanh phuc
Thanh Oai, ngay^.S thdng 9 nam 2016
KE HOACH Thu'c hien chi tieu Bao hiem y te toan dan giai doan 2016 - 2020
Thuc hien KI hoach so 185/KH- U B N D ngay 14 thang 10 nam 2015 cua UBND thanh ph6 Ha Noi ve thuc hien Quyet djnh s6 1584/QD- TTg ngay 14/9/2015 cua Thu tuong Chinh phu ve viec giao chi tieu thuc hien bao hiem y
te giai doan 2015- 2020 UBND huyen Thanh Oai xay dung ke hoach thuc hien chi tieu B H Y T giai doan 2016 - 2020 tren dia ban huyen nhu sau:
I MUG DICH YEU CAU:
-Tri6n khai thuc hien Ke hoach s6 185/KH- U B N D ngay 14 thang 10 nam 2015 cua U B N D Thanh pho Ha Noi ve viec giao chi tieu thuc hien bao hiem y te giai doan 2015- 2020, gop phin thuc hien thang Igi muc tieu De an, thuc hien 16 trinh tien toi bao hiem y te toan dan tren dia ban Thanh pho
- Triln khai Quyet dinh so 1584/QD- TTg ngay 14/9/2015 cua Thu tuong Chinh phu den tan ca sa, nhim thay doi nhan thuc cua moi ngudi dan va cac cap chinh quyen ve vai trd va trach nhiem doi vdi muc tieu bao hiem y te toan dan
- Cap uy Dang, chinh quyen cac cap, cac nganh yeu cau can bo, dang vien, cong chuc, vien chuc van dong gia dinh guang mau tham gia bao hiem y te (BHYT) theo quy dinh cua Phap luat
II CHI TIEU BAO PHU BAG HIEM Y TE CU THE Tl/NG NAM:
Nam 2016 Nam 2017 Nam 2018 Nam 2019 Nam 2020
HI NHIEM VU GIAI PHAP:
1 Nang cao nhan thu'c, vai trd trach nhicm cua cap uy, chinh quyen cac cap trong vice thuc hien chinh sach phap luat, cac chuang trinh, muc tieu, ke hoach ve BHYT giai doan 2016 - 2020 tren dja ban huyen:
- Cap uy Dang, chinh quyen cac ca quan, ban nganh, U B N D cac xa, thi tran, cac nha trudng, cac danh nghiep tang cudng su lanh dao, chi dao quyet liet, trien khai quan triet sau sac den doi ngu can bo chu chot, cac dang vien, doan vien, hoi vien cac hoi doan th6 va nhan dan trong cac dan vj, de nang cao nhan thuc, vai trd, trach nhiem cua tung ca nhan nghiem tuc thuc hien Nghi quyet so 21- NQ/TW ngay 22/11/2012 cua Bo chinh tri; Chuang trinh hanh dong s6 19-CTr/TU ngay 17/4/2013 cua Thanh liy Ha Noi; Chuang trinh hanh dong so 13-CTr/HU ngay 31/5/2013 ciia Huyen uy Thanh Oai "Ve tang cudng su lanh dao cua Dang doi vdi cong tac bao hiem xa hoi, bao hiem y te"; Quyet dinh so 1584/QD- TTg ngay 14/9/2015 cua Thu tudng Chinh phu, Ke hoach s6
185/KH-U B N D ngay 14 thang 10 nam 2015 cua 185/KH-UBND thanh pho Ha Noi v6 viec giao
Trang 2chi tieu thuc hien bao hiem y te giai doan 2015- 2020; Quyet dinh so
213/QD-U B N D ngay 04/02/2016 cua 213/QD-U B N D huyen ve giao chi tieu thuc hien bao h'lkm y
te giai doan 2016-2020 doi vai cac xa, thi tran va cac van ban chi dao thuc hien tren dia ban huyen Thanh Oai
Xac dinh chi tieu, ty le bao phu B H Y T la nhiem vu quan trong trong thuc hien chinh sach an sinh xa hoi, dam bao chan soc sue khoe cong dong va thuc hien muc tieu tien bo va cong bSng xa hoi
Thuc hien day du chuc nang quan ly nha nude ve B H Y T va dap ung nhu cau cua ngudi dan ve B H Y T thdng qua su Lanh dao, chi dao cua Huyen uy, HDND, U B N D huyen; Su lanh dao,chi dao cua Dang uy, HDND, UBND cac
xa, thi tran, cac nganh, hoi doan the Tiep tuc day manh cong tac thanh tra, kiem tra, xu ly vi pham vd B H Y T theo quy dinh cua Phap luat
2 Tan^ ty le bao phu BHYT:
2.7 Doi vdi nhom doi tuong dd dgt ty le 100%: Tap trung d doi tugng la
can bo vien chuc nha nude, chinh sach ngudi cd cong, chinh sach xa hoi, huu tri, tre em dudi 6 tudi dugc ngudn ngan sach nha nude ddng;
Giai phap: Tang cudng kiem tra sa soat, theo doi tang, giam, bd sung
nhung ngudi thudc dien bien che, ngudi dugc hudng che dd, chinh sach cua nha nude thuc hien tham gia B H Y T de duy tri thudng xuyen ty le dat 100%
2.2 Doi vdi mot so nhom doi tuong cd ty le tham gia BHYT thdp: Nhu
khdi^ cac trudng hgc, hd gia dinh, cac doanh nghiep; Can tang cudng tuyen truyen sau rdng chinh sach, phap luat vd BHYT den chu su dung lao ddng, ngudi lao ddng, cac phu huynh, cac em hgc sinh va nhan dan, td chuc mang ludi dai ly thu B H Y T bao dam chdt lugng, hieu qua, tao thuan Igi cho vice tham gia
B H Y T , tang cudng cdng tac thanh tra, kidm tra tinh hinh thuc hien chinh sach, phap luat ve B H Y T d cac dan vi, nha trudng, UBND cac xa, thi trin, cac doanh nghiep va can cd cac nhom giai phap sau:
a) Nhdm do ngudi lao ddng va ngudi su dung lao ddng ddng: Tap trung d
cac doanh nghiep
- Chi tieu phan dau: Den nam 2020 dat tren 90% sd ngudi lao ddng tham
gia B H Y T
- Gidiphdp:
+ Bao hiem xa hdi huyen phdi hgp vdi cac nganh lien quan ra soat dua het
sd doanh nghiep cd su dung lao ddng tren dia ban vao quan ly va tham gia
B H Y T
+ Cling cd cac ca sd y te nha nude, y te cac doanh nghiep, cac tram y te
xa, dap ung nhu cau cham soc sue khde cho ngudi lao ddng tai noi lam viec hoac nai cu tru
+ Dinh ky hang quy, ca quan B H X H huyen kjp thdi bao cao U B N D huyen
ve tinh hinh thuc hien B H Y T ciia cac doanh nghiep tren dia ban, dong thdi de xuat cac giai phap de chi dao thuc hien
b) Nhdm tham gia theo hd gia dinh:
- Chi tieu phan dau: Den nam 2020 dat tren 85% dan so tham gia B H Y T
- Gidiphdp cu the:
Trang 3+ UBND cac xa, thi tran: Huy dong moi ngudn lire cua dja phuang de hd trg cho ngudi dan c6 dieu kien kinh te Ichd khan tham gia B H Y T
Xay dung ke hoach, giao chi tieu phat trien ddi tugng hang nam cho cac nganh, hdi doan the, nhan vien dai ly thu cua xa, thi tran; giao nhiem vu cho cac can bd, dang vien, lam tdt cdng tac tuyen truyen van ddng nhan dan tham gia
B H Y T theo chi tieu, ke hoach da xay dung,
+ C a quan B H X H : Md rdng mang ludi dai ly thu, dam bao cho cac dai ly thu hoat ddng c6 hieu qua, tich cue tuyen truyen van ddng cac hd gia dinh tham gia B H Y T va thuc hien giam tru muc ddng theo quy dinh
Hudng dan ve chuyen mdn cho cac xa, thi tran, cac dai ly thu lap danh sach cua cac ddi tugng va hd gia dinh tham gia B H Y T theo quy dinh
c) Nhdm tham gia BHYT hgc sinh:
- Chi tieu phdn dau: Nam 2016 dat 100% sd hgc sinh tham gia B H Y T
- Gidiphdp:
' ' + Cac Nha trudng huy ddng mgi ngudn kinh phi de hd trg cho nhung em hgc sinh cd dieu kien kinh te khd khan (chua thudc dien hd ngheo) tham gia BHYT
Xay dung ke hoach phat trien B H Y T hgc sinh trong nam hgc 2016-2017 cua nha trudng; giao chi tieu cho cac Idp hgc, chi dao cac td chuc doan the, cac thay cd giao van ddng phu huynh, hgc sinh tham gia B H Y T theo ke hoach,chi tieu dugc giao
+ Ca quan B H X H : Thuc hien viec hd trg, hudng dan lap danh sach hgc sinh tham gia B H Y T ; Trich chuyen thu lao, kinh phi cham soc sue khde ban dau
ve thuc hien B H Y T hgc sinh cho cac nha tru'dng kip thdi dung quy dinh
3 Nang cao chat lugng kham, chua benh, bao dam quyen igi cho ngudi cd the BHYT:
Viec phat tridn doi tugng tham gia BPTYT ludn gan lien vdi viec cham soc sue khde cho ngudi tham gia BHYT De cung cd, nang cao chat lugng kham chua benh B H Y T dam bao quyen Igi cho ngudi cd the B H Y T , cac ca sd y te tren dia ban huyen can thuc hien mot sd giai phap sau:
- Nganh y td dky manh cai each thu tuc hanh chinh trong kham chua benh,
trong thanh toan chi phi kham chua benh, ung dung CNTT, giam thdi gian chd dgi, tao dieu kien thuan Igi cho ngudi benh khi den kham chua benh
- Cac CO sd kham chua benh tap trung nang cao nang luc chuyen mdn va y
due cho ddi ngu can bd vien chuc lam cdng tac y te Dam bao du ca sd thudc, chat lugng cua cac loai thudc chua benh, dau tu tang cudng ca sd vat chat trang thiet bi, cac ky thuat mdi de nang cao chat lugng dieu tri tai cac ca sd kham chua benh, nhat la y te tuyen xa, dam bao ngay cang dap ung vdi su hai long cua ngudi benh
- Cac ca quan, ban, nganh lien quan tang cudng cdng tac thanh tra, kiem tra, giam sat thuc hien chinh sach BHYT, cdng tac kham chua benh, bao dam day du quyen Igi cua ngudi tham gia B H Y T theo quy djnh cua phap luat
4 Day manh cdng tac tuyen truyen, pho bien ehi'nh sach phap luat veBHYT:
,.,|,
Trang 4- Bao hiem xa hoi huyen la dau moi chju trach nhiem chinh, phoi hgp vai cac nganh, Dai truyen thanh, phong van hoa thong tin, UBND cac xa, thi tran to chuc cac hoat dong tuyen truyen ve chinh sach bao hiem y te
- Doi mai noi dung, hinh thuc de nang cao nhan thuc, trach nhiem cua cap
uy Dang, chinh quyen, cac ca quan, to chuc, doan the va moi ngudi dan ve Y nghia, tam quan trgng cua B H Y T trong phat trien kinh te- xa hoi va dam bao an sinh xa hgi, ve nghTa vu cua moi ngudi dan trong tham gia B H Y T va thuc hien chinh sach B H Y T
- Day manh cong tac thong tin, tuyen truydn, tren cac phuang tien thong tin dai chung va doi thoai true tiep thong qua cac hgi nghi tuyen truyen de van dong rgng rai trong nhan dan, lam chuyen bien nhan thuc va nang cao hieu biet
ve trach nhiem, quyen Igi khi tham gia B H Y T
- Cong tac truyen thong, tuyen truyen: Can dugc tien hanh vdi tat ca cac nhom ddi tugng, bao gdm ca cac cap chinh quyen, doan the, trudng hgc, cac chi
bd dang, nhan dan tiep can day dii vdi cac thdng tin ve chinh sach bao hiem y te
va each thuc tham gia B H Y T
IV TO CHirC THU'C HIEN:
Cac cap, cac nganh, U B N D cac xa, thi tran, cac nha trudng, cac doanh nghiep can cu Kd hoach so 185/KH-UBND ngay 14/10/2015 cua UBND Thanh pho Ha Ndi; Quyet dinh so 213/QD-UBND ngay 04/02/2016 cua UBND huyen Thanh Oai ve viec giao chi tieu thuc hien bao hiem y te giai doan 2016-2020 va
ke hoach nay de td chuc thuc hien ddng thdi phdi hgp thuc hien mot sd nhiem
vu sau:
1 Bao hiem xa hdi huyen:
- Chii tri, phdi hgp vdi Phdng Y te, Phong Lao ddng- Thuang binh va xa hdi huyen, U B N D cac xa, thi tran, phan cdng can bd theo doi, tang cudng kiem tra, ddn ddc viec thuc hien chi tieu bao phii bao hiem y te, hang quy bao cao ket qua, tien dd thuc hien ve U B N D huyen de kip thdi chi dao
- Xay dung ke hoach, ndi dung tuyen truyen, phdi hgp vdi cac nganh, Dai truyen thanh huyen, phdng Van hoa thdng tin td chuc tdt cac hoat ddng tuyen truyen chinh sach B H Y T den mgi tang lap nhan dan tren dia ban huyen;
Su dung cd hieu qua ngudn kinh phi tuyen truyen dugc Bao hidm xa hdi Thanh phd phan bd
- Tiep tuc md rdng cac dai ly thu va tang cudng hudng dan, tap huan, cu
di dao tao cho nhan vien dai ly thu de dam bao dai ly boat ddng hieu qua
- Chu tri hudng dan cac dan vi, U B N D cac xa, thi trdn, nha trudng, doanh nghiep thuc hien lap danh sach hd gia dinh, hoc sinh, ngudi lao ddng cac ddi tugng,tham gia B H Y T
2 Phdng Y te:
Thuc hien tdt chuc nang quan ly nha nude ve y te, phoi hgp vdi B H X H huyen va cac nganh lien quan tang cudng kiem tra cac ca sd y te tren dia ban, dac biet la cac tram y te tuyen xa, thi tran ve ca sd vat chat, trang thiet bi ky thuat, thudc, vat tu y te, tinh than trach de phuc vu tdt viec kham chua benh, dam bao quyen Igi cho ngudi tham gia B H Y T dung quy djnh
3 Phong Lao dong thiiong binh xa hdi:
Trang 5- Thuc hien tot chuc nang quan ly nha nuoc ve lao dong, phoi hgp voi
B H X H huyen tham muu cho UBND huyen chi dao thanh tra, kiem tra, ra soat cac doanh nghiep, hgp tac xa, hg gia dinh kinh doanh ca the tren dia ban chua tham gia B H Y T nghiem tuc thuc hien tham gia B H Y T cho ngudi lao dong theo quy djnh ciia phap luat ve lao dong va Luat BHYT
- Chii dong phdi hgp voi B H X H huyen hudng dan U B N D cac xa, thi tran
ra soat va lap danh sach cac ddi tugng thudc nhdm ngudi cd cdng, chinh sach xa hdi, hd gia dinh ngheo, tre em dudi 6 tudi va hd gia dinh tham gia BHYT, thuc hien xac nhan danh sach chuyen ca quan B H X H huyen de phat hanh the B H Y T kip thdi cho cac ddi tugng Chuyen kinh phi do ngudn ngan sach nha nude ddng
B H Y T ciia cac doi tugng vao tai khoan thu ciia B H X H huyen theo quy dinh
4 Phdng Van hda va Thdng tin:
Xay dung ke hoach tuyen truyen dua cdng tac tuyen truyen chinh sach BHYT vao ke hoach cdng tac tuyen truyen thang, quy, nam, phdi hgp vdi
B H X H huyen xay dung cac bieu ngu, pan nd, ap phich phd bien sau, rdng den mgi ngudi dan ve chinh sach BHYT
5 Dai truyen thanh huyen:
Xay dimg ke hoach tuyen truyen, phdi hgp vdi Bao hiem xa hdi huyen, thdng nhat chuang trinh, ndi dung tuyen truyen, danh thdi lugng phat thanh thudng xuyen hang ngay, tuyen truyen phd bien chinh sach phap luat ve bao hiem y te den toan the nhan dan tren dia ban huyen
6.' Phong Tai chinh - ke hoach:
- Dam bao ngudn kinh phi thuc hien chinh sach B H Y T cho cac ddi tugng dugc nha nude ddng va ho trg muc ddng theo quy dinh
- Phdi hgp vdi cac nganh lien quan thuc hien kiem tra viec thu, quan ly, su dung ngudn kinh phi ddng va hd trg ddng B H Y T
7 Phdng Giao due va dao tao:
Chi dao quyet liet cac nha trudng tren dia ban trien khai thuc hien nghiem tuc cac quy dinh ciia phap luat ve B H Y T hgc sinh, xay dimg ke hoach, cd van ban chi dao giao chi tieu thuc hien cho cac nha trudng, dua ra cac giai phap cu the dd dam bao 100% hgc sinh tham gia bao hiem y te Dua chi tieu tham gia BHYT la mot tieu chi quan trgng trong viec xet thi dua khen thudng hang nam ddi vdi cac em hgc sinh, tap the va cac nha trudng hang nam
8 UBND cac xa, thi tran:
- U B N D cac xa, thi tran can cu vao Quyet dinh sd 213/QD-UBND ngay 04/02/2016 ciia UBND huyen Thanh Oai ve viec giao chi tieu thuc hien bao hidm y td giai doan 2016-2020, trinh HDND xa, thi trdn dua chi tidu ty Id dan so tham gia BITYT trong chi tidu phat tridn kinh td- xa hdi hang nam cua dia phuang, den tung Khoi phd, Thdn, Ban Kdt qua thuc hien chi tidu bao phu BHYT la mot chi tidu danh gia nhiem vu chinh tri, xet thi dua khen thudng cua dia phuang va la chi tidu quan trgng trong vide xet dat tidu chuan xay dung ndng thdn mdi
- Xay dung kd hoach va td chuc thuc hien dd dat chi tidu bao phu bao
hiem y td trdn dia ban Ydu chu can bd, dang vidn, cdng chuc, vidn chuc van
ddng ngudi than va gia dinh guang mau tham gia B H Y T
Trang 6- Huy dong cac to chuc hoi, doan the tham gia tich cue tuyen truyen, van dong nhan dan, tang ty le so ngudi tham gia BHYT hang nam
- Chiu trach nhiem trudc UBND huyen ve to chuc thirc hien chi tieu bao phu B H Y T hang nam dugc giao
9 De nghj UBMTQ huyen va cac to chuc doan the:
Phoi hgp vdi Bao hiem xa hgi huyen va cac nganh lien quan to chuc tuyen truyen, van dong doan vien, hgi vien, ngudi than va mgi ngudi dan tham gia thgc hien chinh sach phap luat ve B H Y T Phdi hgp vdi cac nganh thuc hien kiem tra, giam sat, danh gia ket qua viec thuc hien chi tieu ve BHYT
Uy ban nhan dan huyen Thanh Oai yeu cau cac cap, cac nganh, U B N D cac xa, thi tran nghiem tuc thuc hien ke hoach nay, dinh ky 6 thang bao cao ket qua thuc hien ke hoach ( gui B H X H huyen de tong hgp) ve UBND huyen, Giao
B H X H huyen, Phdng Y td, Phdng L D T B & X H , Van phdng UBND huyen theo ddi, ddn ddc kdt qua thuc hien kd hoach, hang nam dd xuat UBND huyen td
chuc hdi nghi, so kdt, tdng kdt vide thuc hien kd hoach nay./Lj'^
Nffinhan:
- TT Huy^n uy;
- TT HDND huyen;
- CT; PCT UBND huyen;
- UBMT to qu6c huyen;
- UBND cac xa, thj tran;
- Ph6ng:LDTBXH; YT; GDDT, TC-KH ;VHTT
- BHXH huyen; Dai TT huy?ii, HOI doan till
- Luu: VT, BHXH huy^n