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山東省醫療保障標準體系的首批標準，將于10月30日起實施。5項標準中，前2項是整個醫療保障工作的基礎標準，后3項是針對醫保經辦服務制定的專門標準。

　　省(sheng)醫(yi)保(bao)(bao)(bao)(bao)(bao)局(ju)黨組書記、局(ju)長(chang)張寧(ning)波(bo)介紹，《醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)第1部(bu)分(fen)：標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)》規(gui)定(ding)了(le)(le)醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)的(de)構(gou)建原則、標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)的(de)組成及標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)的(de)內容，是全省(sheng)醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)化(hua)建設的(de)規(gui)劃(hua)(hua)性(xing)(xing)(xing)(xing)(xing)(xing)、指導性(xing)(xing)(xing)(xing)(xing)(xing)文件，不(bu)僅(jin)能為(wei)山東省(sheng)推(tui)進(jin)醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)化(hua)建設提(ti)供規(gui)劃(hua)(hua)依據，也將(jiang)(jiang)為(wei)建立全國統一(yi)的(de)醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)提(ti)供有益探索。主要(yao)內容包括：系(xi)(xi)(xi)統設計(ji)了(le)(le)山東省(sheng)醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)框架，將(jiang)(jiang)醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)劃(hua)(hua)分(fen)為(wei)基礎共(gong)性(xing)(xing)(xing)(xing)(xing)(xing)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)子(zi)(zi)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)、公共(gong)服(fu)務標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)子(zi)(zi)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)、管理與(yu)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)子(zi)(zi)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)、監督與(yu)評價標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)子(zi)(zi)體(ti)(ti)(ti)(ti)系(xi)(xi)(xi)4個部(bu)分(fen)，確保(bao)(bao)(bao)(bao)(bao)了(le)(le)醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)的(de)系(xi)(xi)(xi)統性(xing)(xing)(xing)(xing)(xing)(xing)和協調性(xing)(xing)(xing)(xing)(xing)(xing)。對今后(hou)一(yi)個時(shi)期將(jiang)(jiang)要(yao)制定(ding)的(de)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)進(jin)行了(le)(le)統籌規(gui)劃(hua)(hua)，提(ti)出了(le)(le)88項地方標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)制定(ding)任務，提(ti)升了(le)(le)醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)化(hua)工(gong)作的(de)計(ji)劃(hua)(hua)性(xing)(xing)(xing)(xing)(xing)(xing)和針(zhen)對性(xing)(xing)(xing)(xing)(xing)(xing)。初步(bu)確定(ding)了(le)(le)醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)具體(ti)(ti)(ti)(ti)工(gong)作領域和事項標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)的(de)主體(ti)(ti)(ti)(ti)內容，保(bao)(bao)(bao)(bao)(bao)證了(le)(le)醫(yi)療(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)地方標(biao)(biao)(biao)(biao)(biao)(biao)準(zhun)(zhun)(zhun)(zhun)(zhun)制修(xiu)訂的(de)方向性(xing)(xing)(xing)(xing)(xing)(xing)和目的(de)性(xing)(xing)(xing)(xing)(xing)(xing)。

　　《醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)第2部(bu)分：術(shu)(shu)(shu)語(yu)(yu)(yu)》規(gui)(gui)定(ding)了(le)醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)領(ling)(ling)域的(de)(de)(de)基本術(shu)(shu)(shu)語(yu)(yu)(yu)及定(ding)義，將為全(quan)(quan)省(sheng)(sheng)醫(yi)(yi)(yi)保(bao)(bao)(bao)(bao)(bao)信息(xi)系(xi)統的(de)(de)(de)互聯、省(sheng)(sheng)和(he)各(ge)市之間數據的(de)(de)(de)交換、重點領(ling)(ling)域改革(ge)的(de)(de)(de)互動提供有力支撐。主要內容包括(kuo)對(dui)(dui)全(quan)(quan)國(guo)醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)術(shu)(shu)(shu)語(yu)(yu)(yu)進(jin)(jin)行(xing)(xing)了(le)全(quan)(quan)面梳理(li)(li)。結合現有醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)制度(du)和(he)醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)改革(ge)有關情況，對(dui)(dui)全(quan)(quan)國(guo)醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)領(ling)(ling)域涉及到(dao)的(de)(de)(de)專(zhuan)業術(shu)(shu)(shu)語(yu)(yu)(yu)進(jin)(jin)行(xing)(xing)了(le)全(quan)(quan)面梳理(li)(li)，確保(bao)(bao)(bao)(bao)(bao)術(shu)(shu)(shu)語(yu)(yu)(yu)界(jie)(jie)定(ding)不(bu)缺項、不(bu)失范。對(dui)(dui)全(quan)(quan)省(sheng)(sheng)醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)術(shu)(shu)(shu)語(yu)(yu)(yu)進(jin)(jin)行(xing)(xing)了(le)規(gui)(gui)范統一。長期(qi)以來，山東(dong)省(sheng)(sheng)16市醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)術(shu)(shu)(shu)語(yu)(yu)(yu)表述不(bu)一，特(te)別是(shi)(shi)醫(yi)(yi)(yi)保(bao)(bao)(bao)(bao)(bao)經(jing)辦服務(wu)事(shi)項的(de)(de)(de)名(ming)稱缺乏統一規(gui)(gui)范，群(qun)眾(zhong)常常被各(ge)種事(shi)項名(ming)稱所困擾。該標準在全(quan)(quan)省(sheng)(sheng)范圍內對(dui)(dui)醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)服務(wu)組織、參保(bao)(bao)(bao)(bao)(bao)管理(li)(li)、保(bao)(bao)(bao)(bao)(bao)險待遇、基金管理(li)(li)等13類術(shu)(shu)(shu)語(yu)(yu)(yu)進(jin)(jin)行(xing)(xing)了(le)統一，為重點領(ling)(ling)域改革(ge)的(de)(de)(de)整體推進(jin)(jin)奠定(ding)了(le)基礎，也徹底解(jie)決(jue)了(le)備受詬病(bing)的(de)(de)(de)“名(ming)稱之困”。對(dui)(dui)醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)特(te)定(ding)概念(nian)(nian)進(jin)(jin)行(xing)(xing)了(le)規(gui)(gui)范解(jie)釋(shi)。特(te)別是(shi)(shi)對(dui)(dui)醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)領(ling)(ling)域的(de)(de)(de)特(te)定(ding)概念(nian)(nian)進(jin)(jin)行(xing)(xing)了(le)釋(shi)義，既有利于全(quan)(quan)省(sheng)(sheng)醫(yi)(yi)(yi)保(bao)(bao)(bao)(bao)(bao)系(xi)統學習把握(wo)，也有利于提升社會各(ge)界(jie)(jie)對(dui)(dui)醫(yi)(yi)(yi)療(liao)(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)(zhang)(zhang)領(ling)(ling)域政策制度(du)的(de)(de)(de)理(li)(li)解(jie)。

　　《醫(yi)療保(bao)障經(jing)(jing)辦(ban)(ban)(ban)服(fu)(fu)務(wu)(wu)通則》提出(chu)了醫(yi)保(bao)經(jing)(jing)辦(ban)(ban)(ban)服(fu)(fu)務(wu)(wu)的(de)(de)基礎(chu)性、通用(yong)性、整(zheng)體(ti)性要(yao)(yao)求(qiu)，是全省醫(yi)保(bao)經(jing)(jing)辦(ban)(ban)(ban)服(fu)(fu)務(wu)(wu)的(de)(de)總(zong)體(ti)指南。主要(yao)(yao)內容包括確(que)立了證(zheng)明材(cai)料最(zui)(zui)少、辦(ban)(ban)(ban)事(shi)流(liu)程最(zui)(zui)簡、辦(ban)(ban)(ban)理時(shi)(shi)(shi)限最(zui)(zui)短、服(fu)(fu)務(wu)(wu)質量最(zui)(zui)優(you)的(de)(de)“四個(ge)最(zui)(zui)”和統一事(shi)項名稱(cheng)、統一申辦(ban)(ban)(ban)材(cai)料、統一經(jing)(jing)辦(ban)(ban)(ban)方式、統一經(jing)(jing)辦(ban)(ban)(ban)流(liu)程、統一辦(ban)(ban)(ban)理時(shi)(shi)(shi)限、統一服(fu)(fu)務(wu)(wu)標準(zhun)的(de)(de)“六(liu)統一”總(zong)體(ti)要(yao)(yao)求(qiu)，著(zhu)力打(da)造醫(yi)保(bao)經(jing)(jing)辦(ban)(ban)(ban)服(fu)(fu)務(wu)(wu)品牌。明確(que)了服(fu)(fu)務(wu)(wu)機構和服(fu)(fu)務(wu)(wu)人(ren)員、服(fu)(fu)務(wu)(wu)對象與(yu)方式、服(fu)(fu)務(wu)(wu)內容與(yu)要(yao)(yao)求(qiu)、服(fu)(fu)務(wu)(wu)監(jian)督(du)評價與(yu)改進等(deng)7方面的(de)(de)通用(yong)要(yao)(yao)求(qiu)，對醫(yi)保(bao)經(jing)(jing)辦(ban)(ban)(ban)大廳服(fu)(fu)務(wu)(wu)設施的(de)(de)配備，服(fu)(fu)務(wu)(wu)人(ren)員的(de)(de)儀容儀態、行為舉(ju)止、服(fu)(fu)務(wu)(wu)用(yong)語、工作紀律(lv)等(deng)進行了規范，為各(ge)級醫(yi)保(bao)部門(men)優(you)化經(jing)(jing)辦(ban)(ban)(ban)服(fu)(fu)務(wu)(wu)提供(gong)了基準(zhun)。規定了首問(wen)負責制(zhi)(zhi)(zhi)、容缺受理制(zhi)(zhi)(zhi)、限時(shi)(shi)(shi)辦(ban)(ban)(ban)結制(zhi)(zhi)(zhi)、導辦(ban)(ban)(ban)代辦(ban)(ban)(ban)制(zhi)(zhi)(zhi)、否(fou)定報備制(zhi)(zhi)(zhi)、AB角工作制(zhi)(zhi)(zhi)、延時(shi)(shi)(shi)服(fu)(fu)務(wu)(wu)制(zhi)(zhi)(zhi)等(deng)服(fu)(fu)務(wu)(wu)制(zhi)(zhi)(zhi)度(du)，為醫(yi)保(bao)經(jing)(jing)辦(ban)(ban)(ban)服(fu)(fu)務(wu)(wu)要(yao)(yao)求(qiu)的(de)(de)落實提供(gong)了保(bao)障。

　　《職工(gong)醫(yi)(yi)(yi)(yi)(yi)療(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)經(jing)辦(ban)(ban)(ban)(ban)(ban)服(fu)務(wu)(wu)規范》《城鄉居民(min)醫(yi)(yi)(yi)(yi)(yi)療(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)經(jing)辦(ban)(ban)(ban)(ban)(ban)服(fu)務(wu)(wu)規范》是針(zhen)對(dui)(dui)不(bu)同的(de)醫(yi)(yi)(yi)(yi)(yi)療(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)制度(du)和(he)醫(yi)(yi)(yi)(yi)(yi)療(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)服(fu)務(wu)(wu)對(dui)(dui)象制定的(de)兩項具體(ti)(ti)醫(yi)(yi)(yi)(yi)(yi)保(bao)(bao)(bao)(bao)(bao)經(jing)辦(ban)(ban)(ban)(ban)(ban)服(fu)務(wu)(wu)標準，是對(dui)(dui)醫(yi)(yi)(yi)(yi)(yi)療(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)經(jing)辦(ban)(ban)(ban)(ban)(ban)服(fu)務(wu)(wu)通則(ze)的(de)具體(ti)(ti)細化(hua)。主要(yao)內容包(bao)括(kuo)對(dui)(dui)職工(gong)和(he)居民(min)醫(yi)(yi)(yi)(yi)(yi)保(bao)(bao)(bao)(bao)(bao)領(ling)域的(de)服(fu)務(wu)(wu)事項名(ming)稱(cheng)、經(jing)辦(ban)(ban)(ban)(ban)(ban)方式(shi)、經(jing)辦(ban)(ban)(ban)(ban)(ban)流(liu)程、申辦(ban)(ban)(ban)(ban)(ban)材(cai)料、辦(ban)(ban)(ban)(ban)(ban)理(li)時(shi)限和(he)辦(ban)(ban)(ban)(ban)(ban)理(li)結(jie)果等提出明確要(yao)求(qiu)，實現了(le)全(quan)(quan)省(sheng)醫(yi)(yi)(yi)(yi)(yi)療(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)經(jing)辦(ban)(ban)(ban)(ban)(ban)服(fu)務(wu)(wu)的(de)“六(liu)統一”，全(quan)(quan)省(sheng)參(can)(can)保(bao)(bao)(bao)(bao)(bao)群眾在全(quan)(quan)省(sheng)任何(he)地方辦(ban)(ban)(ban)(ban)(ban)理(li)醫(yi)(yi)(yi)(yi)(yi)保(bao)(bao)(bao)(bao)(bao)業(ye)務(wu)(wu)將享受到同質化(hua)的(de)服(fu)務(wu)(wu)。對(dui)(dui)經(jing)辦(ban)(ban)(ban)(ban)(ban)服(fu)務(wu)(wu)流(liu)程進行(xing)了(le)再造，就(jiu)職工(gong)和(he)居民(min)醫(yi)(yi)(yi)(yi)(yi)保(bao)(bao)(bao)(bao)(bao)相(xiang)關的(de)參(can)(can)保(bao)(bao)(bao)(bao)(bao)登記、醫(yi)(yi)(yi)(yi)(yi)療(liao)(liao)保(bao)(bao)(bao)(bao)(bao)險關系轉(zhuan)移接續、參(can)(can)保(bao)(bao)(bao)(bao)(bao)繳(jiao)費信息(xi)查詢、參(can)(can)保(bao)(bao)(bao)(bao)(bao)地就(jiu)醫(yi)(yi)(yi)(yi)(yi)、異地就(jiu)醫(yi)(yi)(yi)(yi)(yi)、生育保(bao)(bao)(bao)(bao)(bao)險等服(fu)務(wu)(wu)要(yao)求(qiu)進行(xing)了(le)細化(hua)，推動了(le)經(jing)辦(ban)(ban)(ban)(ban)(ban)服(fu)務(wu)(wu)的(de)優化(hua)和(he)升(sheng)級(ji)，全(quan)(quan)省(sheng)醫(yi)(yi)(yi)(yi)(yi)保(bao)(bao)(bao)(bao)(bao)經(jing)辦(ban)(ban)(ban)(ban)(ban)事項的(de)辦(ban)(ban)(ban)(ban)(ban)事時(shi)限整(zheng)(zheng)體(ti)(ti)壓(ya)縮(suo)45.5%，辦(ban)(ban)(ban)(ban)(ban)事環節整(zheng)(zheng)體(ti)(ti)精簡16.4%，申辦(ban)(ban)(ban)(ban)(ban)材(cai)料整(zheng)(zheng)體(ti)(ti)縮(suo)減32.3%。對(dui)(dui)參(can)(can)保(bao)(bao)(bao)(bao)(bao)人員(yuan)、參(can)(can)保(bao)(bao)(bao)(bao)(bao)單位、醫(yi)(yi)(yi)(yi)(yi)保(bao)(bao)(bao)(bao)(bao)經(jing)辦(ban)(ban)(ban)(ban)(ban)機構、醫(yi)(yi)(yi)(yi)(yi)療(liao)(liao)機構等不(bu)同主體(ti)(ti)在服(fu)務(wu)(wu)事項辦(ban)(ban)(ban)(ban)(ban)理(li)過程中所擔任的(de)角色進行(xing)了(le)明確，有利于不(bu)同的(de)參(can)(can)與主體(ti)(ti)全(quan)(quan)面理(li)解(jie)醫(yi)(yi)(yi)(yi)(yi)療(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)服(fu)務(wu)(wu)，方便參(can)(can)保(bao)(bao)(bao)(bao)(bao)人員(yuan)更好的(de)享受醫(yi)(yi)(yi)(yi)(yi)療(liao)(liao)保(bao)(bao)(bao)(bao)(bao)障(zhang)待遇。