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CONSUMER COUNCIL ORDINANCE

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CONSUMER COUNCIL ORDINANCE ——附加英文版

Hong Kong


 CONSUMER COUNCIL ORDINANCE
 (CHAPTER 216)
 CONTENTS
  
  ion
  I    PRELIMINARY
  hort title
  nterpretation
  II    INCORPORATION AND POWERS
  ncorporation of Consumer Council
  unctions of Council
  owers of Council
  embership of Council
  eetings of Council
  ommittees
  isclosure of member's interest
  Appointment of staff and advisers
  Documents of Council
  III    FINANCIAL
  Resources of Council
  Borrowing powers
  Investment of funds
  Estimates
  Accounts, audit and annual report
  IV    GENERAL
  Council not servant or agent of Crown
  Governor may give directions
  Protection of members of Council and committees
  Prohibition of exploitation of the Council's name for
advertisement
  oses
  Transitional provisions
  dule
 Whole document
  
  ncorporate the Consumer Council, to define its functions and 
powers,
  egative personal liability of members and employees for the 
Council's
  ts committees' acts or omissions, and for connected purposes.
  July 1977] L. N. 167 of 1977
 PART I PRELIMINARY
  
  hort title
  Ordinance may be cited as the Consumer Council Ordinance.
  nterpretation
  his Ordinance, unless the context otherwise requires--
  ncil" means the Consumer Council incorporated by section 3 (1);
  ancial year" means each period of 12 months ending with 31 March;
  ber" means a member of the Council.
 PART II INCORPORATION AND POWERS
  
  ncorporation of Consumer Council
  The Consumer Council existing at the commencement of this
Ordinance is
  by created a body corporate consisting of the persons who from
time to
  hold office as members of the Council.
  The Council shall have perpetual succession and a common 
seal and
  l be capable of suing and being sued and of doing and suffering 
all
  other acts and things as bodies corporate may lawfully do and
suffer.
  The Council shall continue to be known in the Chinese language
as.
  unctions of Council
  The functions of the Council are to protect and promote the 
interests
  onsumers of goods and services and purchasers, mortgagors and 
lessees
  mmovable property by--
  collecting, receiving and disseminating
  rmation concerning goods, services and immovable property;
  receiving and examining complaints by and giving advice to 
consumers
  oods and services and purchasers, mortgagors and lessees of 
immovable
  erty;
  taking such action as it thinks justified by information 
in its
  ession, including tendering advice to the Government or to any 
public
  cer;
  encouraging business and professional associations to
  blish codes of practice to regulate the activities of their
members;
  undertaking such other functions as the Council may adopt 
with the
  r approval of the Governor in Council.
  The Governor may be notice in writing to the Council 
declare any
  s, services or immovable property or class of goods, 
services or
  vable property to be outside the scope of the Council's 
functions
  r subsection (1).
  In subsection (1) and in section 5 (2) (c) "goods and services" 
does
  include goods and services which are--
  supplied by--
  the Government, the Urban Council or the Regional Council; or
(Amended
  f 1985 s. 60)
  a body mentioned in the Schedule; or
  made the subject of a declaration under subsection (2).
  The Governor in Council may, by order published in the Gazette, 
amend
  Schedule. (Amended 5 of 1992 s. 2)
  owers of Council
  The Council may do such things as are reasonably necessary to 
enable
  o carry out its functions.
  Without restricting the generality of subsection (1), the Council 
may
  arrying out its functions--
  acquire, hold and dispose of all kinds of property 
movable and
  vable and in any manner which it thinks fit;
  enter into any contract;
  undertake the testing and examination of goods and 
services and
  ection of immovable property; (Amended 5 of 1992s. 3)
  produce or distribute, by way of sale or otherwise, any 
publication
  h is of interest to consumers;
  do any thing which it may do under this ordinance in 
association or
  peration with any other person or sponsor any other person to do 
that
  g;
  charge for the use of any facility or service provided by the
Council;
  with the prior approval of the Governor, become a member 
of or
  liate to any international body concerned with consumer matters.
  
  embership of Council
  The Council shall consist of the following members--
  a Chairman who shall be appointed by the Governor for a 
term not
  eding 2 years;
  a Vice-Chairman who shall be appointed by the Governor for a term 
not
  eding 2 years; and (Replaced 28 of 1985 s. 2)
  not more than 20 other persons each of whom shall be appointed
by the
  rnor for a term not exceeding 2 years. (Replaced 28 of 1989 s.
2)
  The Chairman, Vice-Chairman and any other member 
appointed under
  ection (1) (c) may be reappointed upon expiry of their 
respective
  s of office. (Amended 28 of 1985 s. 2)
  The Chairman, Vice-Chairman and any other member 
appointed under
  ection (1) (c) may at any time-- (Amended 28 of 1985 s. 2)
  resign his office by notice to the Governor; or
  be removed therefrom by the Governor for permanent incapacity or
other
  icient cause, and upon such resignation or removal the term for 
which
  as appointed shall be deemed to have expired.
  Where the Chairman, Vice-Chairman or any other member appointed 
under
  ection (1) (c) is precluded by temporary incapacity or other 
cause
  exercising his functions as such for any period the 
Governor may
  int another person to act in place of the Chairman Vice-
Chairman or
  r member during such period with all such rights, powers, 
duties or
  ilities as if he had been appointed under subsection (1). (Amended 
28
  985s. 2)
  (Replaced 28 of 1985s. 2)
  Where any question arises under subsection (3) or (4) as to 
whether
  incapacity or cause exists or whether any incapacity is 
temporary or
  anent or any cause sufficient, the decision of the Governor 
thereon
  l be final.
  eetings of Council
  Meetings of the Council shall be held at such times and places
as the
  cil, the Chairman or in his absence, the Vice-Chairman may from 
time
  ime appoint.
  The following procedural provisions shall apply to
  y meeting of the Council and subject thereto the Council may 
regulate
  own procedure--
  at meetings of the Council 11 members shall form a quorum; 
(Replaced
  f 1989 s. 3. Amended 5 of 1992 s. 4)
  the Chairman or in his absence, the Vice-Chairman shall preside
or, if
  are absent or disqualified under section 9 (c), the members 
present
  l appoint one of their number to preside;
  every question shall be determined by a majority of votes 
of the
  ers present and voting thereon;
  in the event of an equality of votes the member presiding shall
have a
  ing vote in addition to his ordinary vote.
  nded 28 of 1985 s. 3)
  
  ommittees
  The Council may appoint committees and may delegate to 
them the
  cise and performance of any of its powers and functions except 
this
  r of delegation.
  Persons who are not members of the Council are
  ible for appointment to committees.
  Subject to the terms of any delegation by the 
Council, every
  ittee--
  may exercise and perform the delegated powers and functions
  the same effect as if it were the Council itself;
  shall be presumed to be acting in accordance with the terms of 
the
  gation in the absence of proof to the contrary;
  may regulate its own procedure.
  isclosure of member's interest
  member of the Council, or of any committee of the Council, 
has a
  ct or indirect commercial interest in any matter under discussion
at a
  ing of the Council or of the committee, being an interest greater
than
  which he has as a member of the general public, the 
following
  isions shall apply--
  he shall disclose the nature of his interest at the meeting;
  the disclosure shall be recorded in the minutes;
  where the disclosure is made by the member presiding, he shall 
vacate
  chair during the discussion;
  the member (including one who has vacated the chair under
paragraph
  shall, if so required by the member presiding, withdraw 
from the
  ing during the discussion and shall not in any case, 
except as
  rwise determined by the member presiding, vote on any 
resolution
  erning the matter or be counted for the purpose of establishing 
the
  tence of a quorum.
  Appointment of staff and advisers
  Subject to subsection (4), the Council shall appoint a person to 
hold
  office of Chief Executive. (Amended 28 of 1985 s. 4)
  The Council may appoint such other employees as it thinks 
fit and
  ect to subsection (4), determine all matters relating 
to their
  neratior and terms and conditions of appointment or employment.
  The Council may engage the services of technical and 
professional
  sers in such manner and on such terms and conditions as it thinks
fit.
  The Council shall obtain the prior approval of the Governor to--
  any appointment proposed to be made under subsection (1) and the
terms
  conditions thereof;
  the suspension or dismissal of the Chief Executive;
  the salary or salary scale (including allowances and other 
pecuniary
  fits) and conditions of employment applicable to the Chief 
Executive
  every other employee or class employee, and any variation
thereof.
  nded 28 of 1985 s. 4)
  No person shall be employed by the Council otherwise than on the
salar
  alary scale or on the conditions of employment applicable to that
pers
  oved by the Governor under subsection (4).
  
  Documents of Council
  The Council may make and execute all such documents as may 
expedient
  or conducive to the exercise and performance of its power 
functions
  duties.
  The fixing of the seal of the Council to any document
  l--
  be authorized by resolution of the Council; and
  be authenticated by the signatures of any 2 members 
authorize by
  lution of the Council, either generally or specially, to ao for 
that
  ose.
  Any document purporting to be duly executed under the seal 
of the
  cil shall, unless the contrary is proved, be considered to be 
duly
  uted.
  Any contract or instrument which if entered into or executed 
by a
  on not being a body corporate would not be required to be in the 
form
  deed may be entered into or executed on behalf of the Council by 
any
  on generally or specially authorized by the Council for that 
purpose.
 PART III FINANCIAL
  
  Resources of Council
  The Governor may, out of money appropriated for the purpose 
by the
  slative Council, authorize payment to the Consumer Council 
of such
  nts as he thinks fit.
  The resources of the Council shall consist
  
  all money received by the Council pursuant to subsection (1);
  money paid to the Council by way of donations, fees, 
subscriptions,
  and interest;
  all other money and property, including accumulations of 
income,
  ived by the Council for its purposes.
  Borrowing powers
  Council may, with the approval of the Financial Secretary, 
borrow or
  rwise raise money and charge all or any part of its 
property as
  rity therefor.
  Investment of funds
  money of the Council that is not immediately required 
shall be
  sted--
  on fixed deposit in any bank or savings bank approved by the
  ncial Secretary, either generally or in any particular case, for 
the
  ose; or
  in such other forms of investment as the Financial 
Secretary may
  ove.
  Estimates
  Council shall in each financial year adopt estimates of 
income and
  nditure for the ensuing financial year and, before a date 
to be
  inted by the Financial Secretary, send them to the Governor for 
his
  oval together with a programme of its proposed activities 
for the
  ing financial year.
  
  Accounts, audit and annual report
  The Council shall keep proper accounts and proper records in 
relation
  eto and shall within 3 months after the expiry of a financial year,
or
  further period as the Financial Secretary may allow, 
prepare a
  ement of the accounts of the Council, which statement shall
include an
  me and expenditure account and a balance sheet.
  The Council
  l, subject to subsection (3), appoint an auditor, who 
shall be
  tled to have access at any time to all books of account, vouchers 
and
  r financial records of the Council and to require such information
and
  anations relating thereto as he thinks fit.
  The Council shall obtain the prior approval of the Financial
Secretary
  ny appointment proposed to be made under subsection (2).
  The auditor shall, as soon as is practicable, audit the 
accounts
  ired by subsection (1) and shall submit a report thereon 
to the
  cil.
  The Council shall within 3 months after the receipt by it 
of the
  tor's report in respect of its accounts for a financial 
year, or
  in such further period as the Financial Secretary may allow,
furnish--
  a report on the affairs of the Council for that year;
  a copy of its accounts therefor; and
  the auditor's report on the accounts, to the Governor who shall 
cause
  same to be tabled in the Legislative Council.
 PART IV GENERAL
  
  Council not servant or agent of Crown
  Council is not a servant or agent of the Crown and does not enjoy 
any
  us, immunity or privilege of the Crown.
  Governor may give directions
  The Governor may, if he considers that the public 
interest so
  ires, give to the Council such directions as he thinks 
fit with
  ect to the exercise and performance by the Council of its 
powers,
  tions and duties under this Ordinance, either generally or 
in any
  icular case.
  The Council shall comply with any direction given to 
it under
  ection (1).
  Protection of members of Council and committees
  No member or employee of the Council or of any committee 
of the
  cil shall be personally liable for any act done or default made--
  by the Council; or
  by any committee of the Council, acting in good faith in the course
of
  operations of the Council or of the committee.
  The protection hereby conferred on members and employees 
of the
  cil or of a committee in respect of any act or default shall not 
in
  way affect any liability of the Council for that act or default.
  
  Prohibition of exploitation of the Council's name for 
advertisement
  oses
  No person shall, with a view to promoting or disparaging any
  s, services or immovable property or promoting the image 
of any
  on, publish or cause to be published any advertisement which 
either
  essly or by implication makes reference to--
  the Council;
  any committee, member, agent or employee of the Council;
  the Council's publication or finding of tests or surveys
conducted by
  n behalf of the Council; or
  any other information published by the Council, without 
written
  ent of the Council.
  Any person who contravenes subsection (1) commits an offence 
and is
  le to a fine of $ 100,000.
  For the purpose of subsection (1) "advertisement" may be 
constituted
  ny words, whether written or spoken, or any picture, drawing, 
visual
  e, figure or article--
  appearing in any publication; or
  brought to the notice of the public or any section of the public 
in
  other way. (Replaced 5 of 1992 s. 5)
  Transitional provisions
  All property of whatever kind and whether movable or immovable 
vested
  r belonging to the Consumer Council existing at the 
commencement of
  Ordinance shall as from that date vest in or belong to that 
Council
  ts corporate capacity without any further assurance.
  All obligations and liabilities of the said Consumer Council 
are as
  the commencement of this Ordinance the obligations and
liabilities of
  Council in its corporate capacity.
  Where anything has been commenced by or under the authority 
of the
  Consumer Council before the commencement of this Ordinance such
thing
  be carried on any completed by the Council in its corporate
capacity.
  Every person who immediately before the commencement of this
Ordinance
  s an appointment as Chairman, Executive Director or a member of 
the
  Consumer Council is, as from such commencement but subject to 
the
  s of his appointment, the Chairman, Executive Director, or a
member of
  Council, as the case may be, for the purposes of this Ordinance.
  Notwithstanding the definition of "financial year" in section 
2 the
  od between the commencement of this Ordinance and 31 March 1978 
shall
  eemed to be a financial year.
  No stamp duty shall be payable in respect of any transfer of 
property
  r this section.
 SCHEDULE
  
  Television Limited
  a Light and Power Company, Limited
  a Motor Bus Company, Limited
  Cross-Harbour Tunnel Company, Limited
  Marketing Organization
  Kong Air Cargo Terminals Limited
  Hong Kong and Yaumati Ferry Company Limited

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海南省城镇从业人员基本医疗保险条例实施细则

海南省人民政府


海南省城镇从业人员基本医疗保险条例实施细则

海南省政府令第224号


《海南省城镇从业人员基本医疗保险条例实施细则》已经2009年8月17日五届海南省人民政府第37次常务会议修订通过,现予以公布,自2009年1月1日起施行。

省 长 罗保铭
二○○九年九月二日



第一条 根据《海南省城镇从业人员基本医疗保险条例》(以下简称条例),制定本实施细则。

第二条 凡在本省行政区域内的城镇用人单位及其从业人员,无论采用何种形式支付和取得劳动报酬,均须按条例规定参加基本医疗保险,缴纳基本医疗保险费。能够提供本统筹地区以外社会保险经办机构出具的已参保的有效证明材料的人员除外。

灵活就业人员参加基本医疗保险以个人身份办理参保手续。

第三条 条例所称退休人员是指在本省退休(退职)并按月领取基本养老金(退休费)的人员。

第四条 在本省行政区域内设立的外国组织代表机构和香港、澳门、台湾地区组织代表机构及其所雇用的中方从业人员,应当按照条例的规定参加基本医疗保险。

在本省行政区域内用人单位从业的台湾、香港和澳门居民中的中国公民应当按照条例的规定参加基本医疗保险。

在本省行政区域内城镇用人单位从业的外国籍人员,不参加条例规定的基本医疗保险。国家另有规定的,从其规定。

第五条 参保登记和缴费登记按以下规定执行:

(一)下列单位在省社会保险经办机构办理基本医疗保险参保登记后,在海口地方税务机关办理缴费登记:

1.驻海口地区的中央、省直属机关、事业单位,在省级以上民政部门登记的民办非企业单位、社会团体,在省级以上工商行政管理部门登记注册的企业,招用无军籍从业人员的驻琼部队所属单位;

2.铁路、远洋运输等跨区域、生产流动性较大的企业,自愿申请在省社会保险经办机构参加基本医疗保险并经省社会保障行政部门批准的。

(二)洋浦经济开发区内的用人单位在洋浦社会保险经办机构办理基本医疗保险参保登记后,在洋浦经济开发区地方税务机关办理缴费登记。其基本医疗保险基金纳入省本级财政专户洋浦分户管理。

(三)其他用人单位在所在市、县、自治县社会保险经办机构办理基本医疗保险参保登记后,在当地地方税务机关办理缴费登记。

(四) 参加基本医疗保险的灵活就业人员在就业所在市、县、自治县社会保险经办机构办理基本医疗保险参保登记后,在当地地方税务机关办理缴费登记。

第六条 参保人视同缴费年限按下列规定执行:

(一)2001年7月1日前按照国家规定计算的连续工龄或者工作年限,视同缴费年限。

(二)跨统筹地区流动人员按管理权限到本省县级以上组织、人事劳动行政主管部门或由其授权的其他部门办理了正式调动手续的,其按条例规定参加基本医疗保险以前符合国家规定的工龄或工作年限视同缴费年限。

(三)退役军人按照国家规定参加城镇职工基本医疗保险的,其在军队服役年限视同缴费年限。

第七条 被判服刑、被劳动教养或受开除处分的人员,劳动教养、服刑期间或未再就业期间不缴纳基本医疗保险费,不享受基本医疗保险待遇;被判服刑、被劳动教养或受开除处分之前实际缴费年限和视同缴费年限予以承认。

第八条 已经参加两份或两份以上基本医疗保险的用人单位、参保人,重复获得的基本医疗保险统筹基金支付待遇,由社会保险经办机构予以追回。

第九条 用人单位及其从业人员补缴的基本医疗保险费按规定比例划入个人帐户后,其余部分划入统筹基金。

用人单位欠费期间其从业人员发生的医疗费用由用人单位支付,统筹基金不予支付。

第十条 在省本级参保的用人单位,单位缴纳基本医疗保险费的费率为本单位从业人员月工资总额的7%,从2010年1月1日起执行。2009年1月1日至2009年12月31日仍按本单位从业人员月工资总额的6%缴纳。

在省本级参加基本医疗保险的用人单位缴纳基本医疗保险费的费率标准,由省社会保障行政部门会同省财政部门在条例规定的幅度内,根据海口地区从业人员在岗职工年平均工资的变化情况和基本医疗保险基金的收支情况提出调整方案,报省政府批准后实行。

在本省其它统筹地区参加基本医疗保险的用人单位缴纳基本医疗保险费的费率标准,由统筹地区社会保障行政部门会同财政部门在条例规定的幅度内,根据本统筹地区从业人员在岗职工年平均工资的变化情况和基本医疗保险基金的收支情况提出调整方案,报统筹地区人民政府批准后实行。

第十一条 停保人员恢复缴费后,从恢复缴费的当月起连续缴费达到条例第二十四条第三款所规定的时间后,方可重新享受基本医疗保险统筹基金支付待遇,其间发生的医疗费用由用人单位支付。

第十二条 用人单位及其从业人员跨年度补缴,费率按办理补缴手续上年度所在统筹地区用人单位及其从业人员参加基本医疗保险的费率确定。缴费基数不得低于办理补缴手续的上年度所在统筹地区在岗职工的月平均工资。

第十三条 参保人员退休后由社会保险经办机构核定其缴费年限(含实际缴费年限和视同缴费年限)。

核定享受基本医疗保险待遇的缴费年限,以年为单位,累计计算。

第十四条 2009年1月1日前因用人单位欠缴基本医疗保险费而中断享受基本医疗保险待遇的退休人员和享受社会医疗补助的退休人员,从2009年1月1日起按其累计缴费年限享受相应的基本医疗保险待遇。

第十五条 2009年5月31日前从未参加基本医疗保险的退休人员,一次性缴纳基本医疗保险补偿费后,从缴费次月起按条例及本实施细则规定享受相应的基本医疗保险待遇。缴纳基本医疗保险补偿费的年限计入缴费年限。

第十六条 经参保所在地地方税务部门、社会保障行政部门和财政部门共同确认,确无能力缴纳基本医疗保险费的困难单位的从业人员,可以以个人身份参加基本医疗保险,也可经省人民政府同意后参加城镇居民基本医疗保险。

第十七条 在省本级参加基本医疗保险的,个人帐户资金的计入方式为:

(一)用人单位从业人员个人缴纳的基本医疗保险费全部计入本人个人帐户。

(二)统筹地区用人单位缴纳的基本医疗保险费计入个人帐户基金的比例由省社会保障行政部门会同省财政部门在条例规定的幅度内,按照条例的规定和基金收支情况提出具体比例,报省政府确定。

前款第(二)项规定的资金计入个人帐户时,按30周岁以下、30周岁至39周岁、40周岁至49周岁、50周岁至法定退休年龄、法定退休年龄至69周岁、70周岁以上等年龄段,核定资金计入额度。高年龄段参保人所获个人帐户资金应当多于低年龄段参保人。年度个人帐户资金分配方案,由省社会保障行政部门会同省财政部门制定,报省人民政府批准后执行。

其它统筹地区用人单位缴纳的基本医疗保险费计入个人帐户基金的比例由统筹地区社会保障行政部门会同财政部门在条例规定的幅度内,按照条例的规定和基金收支情况提出具体比例,报统筹地区人民政府确定。

第十八条 省社会保障行政部门会同省卫生行政部门制定基本医疗保险病种目录,分别列明应当由统筹基金支付医疗费的疾病、需批准后统筹基金方能支付医疗费的疾病和统筹基金不予支付医疗费的疾病。

第十九条 已经列明应当由统筹基金支付医疗费的疾病,由定点医疗机构自行纳入统筹基金支付范围。

需批准后统筹基金方能支付医疗费的疾病,由定点医疗机构按照省社会保障行政部门的有关规定,纳入统筹基金支付范围。

定点医疗机构拒绝将符合前款规定的疾病纳入统筹基金支付范围的,相关医疗费用应当由定点医疗机构承担。已经列明为统筹基金不予支付医疗费的疾病,医疗费用由个人承担。

第二十条 少数适宜门诊治疗的已列入统筹基金支付医疗费的疾病,由社会保险经办机构批准后,其门诊医疗费由社会保险经办机构纳入统筹基金支付范围。

可纳入统筹基金支付的门诊治疗疾病的病种,由省社会保障行政部门会同省卫生行政部门制定,具体支付标准由统筹地区社会保障行政部门会同财政部门根据统筹基金支付能力确定。

第二十一条 在省本级社会保险经办机构参加基本医疗保险的人员,享受统筹基金支付待遇按照下列标准执行:

(一)统筹基金起付标准。当年第一次享受统筹基金支付医疗费待遇时,从业人员的起付标准为800元;退休人员为600元。当年再次享受统筹基金支付医疗费待遇时,不再执行起付标准。

(二)统筹基金年累计最高支付限额为23万元。 

(三)从业人员在起付标准以上、最高支付限额以下医疗费的分担比例为:在一级或二级医疗机构就医的,统筹基金支付比例和个人自负比例分别是88%和12%;在三级医疗机构就医的,统筹基金支付比例和个人自负比例分别是85%和15%。

(四)退休人员由统筹基金支付90%,个人自负10%。

省本级基本医疗保险统筹基金年起付标准、年度最高支付限额和医疗费分担比例,由省社会保障行政部门会同省财政部门在条例规定的幅度内,根据海口地区从业人员在岗职工年平均工资的变化情况和基本医疗保险基金的收支情况提出调整方案,报省政府批准后执行。

其它统筹地区基本医疗保险统筹基金年起付标准、年度最高支付限额和医疗费分担比例,由统筹地区社会保障行政部门会同财政部门在条例规定的幅度内,根据统筹地区从业人员在岗职工年平均工资的变化情况和基本医疗保险基金的收支情况提出确定和调整方案,报统筹地区人民政府批准后执行。

第二十二条 人工器官、体内置放材料、一次性医用耗材,统筹基金实行限额支付,具体标准由省社会保障行政部门会同财政、发改和卫生等部门制定,报省政府批准。

第二十三条 采用高新技术医疗设备检查,必须符合由统筹基金支付医疗费的疾病的检查指征。对不符合检查指征,检查结果不属由统筹基金支付医疗费而定点医疗机构决定检查的疾病或符合检查指征但已有明确诊断而定点医疗机构决定重复检查的,检查费用由定点医疗机构支付;不符合检查指征,参保人要求检查,检查结果不属由统筹基金支付医疗费的疾病或符合检查指征但已明确诊断后而参保人要求重复检查的,检查费全部由本人自负。

第二十四条 因病情严重住监护病房(复苏室、ICU、CCU等)的,病情缓解后应当转入普通病房;应当转入普通病房而未转入的,按基本医疗保险普通病房标准计费,超过标准的部分,统筹基金不予支付。

第二十五条 参保人住院治疗过程跨自然年度的,以出院的时间确定结算年度。

第二十六条 根据病情应当出院,经定点医疗机构通知,无正当理由拒绝出院的,自定点医疗机构通知出院之日起一切费用由本人自负;应当出院而定点医疗机构未通知住院者出院的,医疗费用由定点医疗机构承担。

第二十七条 参保人出院带药量标准为:急性病不得超过3天,慢性病不得超过7天。超过上述标准的,超标准费用由定点医疗机构承担。

第二十八条 定点医疗机构在为参保人提供医疗服务时,应当严格执行医疗保险政策、医疗卫生规范及省级价格管理部门制定的医疗服务收费规定。对住院治疗的,定点医疗机构应当每天向其提供医疗服务收费明细清单,接受参保人监督。

第二十九条 定点医疗机构使用自费药品、诊疗项目,应当事先征得参保人书面同意;未征得同意或虽经同意但有证据证明其违背参保人真实意愿的,社会保险经办机构有权直接扣减定点医疗机构的结算费用,用以补偿参保人已自负的医疗费。

定点医疗机构使用自费药品、诊疗项目的费用,超过参保人本次就医全部医疗费的15%的,社会保险经办机构应当对用药情况进行审核,发现明显不合理的,可以扣减定点医疗机构结算费用。

第三十条 定点医疗机构有下列行为之一的,社会保险经办机构应当依照规定予以处理:

(一)拒收符合统筹基金支付条件的参保人住院治疗的;

(二)违背合理检查、合理用药、合理治疗规范的;

(三)迫使未达到出院条件的参保人出院的。

第三十一条 社会保险经办机构对定点医疗机构支付统筹基金采用总额预付制结算的,定点医疗机构因收治参保人而发生的符合统筹基金支付范围的医疗费用超出总额预付的部分,由统筹基金和定点医疗机构按规定比例分担。

总额预付制结算与考核办法由省社会保障行政部门会同省财政部门另行制定。

第三十二条 社会保障行政部门应当制定医疗保险医疗服务质量考核办法,切实维护参保人正当医疗权益。

第三十三条 基本医疗保险药品应当公开招标采购。

第三十四条 因交通事故支出的医疗费及其它依法应当由特定责任人承担医疗费的,统筹基金不予支付。

第三十五条 由于医疗事故所增加的医疗费用,由定点医疗机构支付。

第三十六条 在参保所在地外居住6个月以上的退休人员和公派3个月以上的从业人员,经参保所在地的社会保险经办机构办理报批手续后,其异地就医发生的医疗费用方可按条例规定支付。

第三十七条 参保人需转异地就诊的,应当由转出地定点医疗机构提出转诊建议,并经社会保险经办机构核准,其医疗费用按条例规定支付。未经核准的,医疗费用全部由本人自负。社会保险经办机构可以根据实际情况,将转诊医疗费用纳入建议转诊医院的总额预付标准或由建议转诊医院承担适当比例的转诊医疗费用。

依据病情应当转诊而定点医疗机构不予转诊贻误病情的,定点医疗机构应当承担责任。

出差、休假期间,参保人因急性病在异地就医的医疗费用,按条例规定办法支付;非急性病在异地就医的,医疗费用由本人自负。

第三十八条 个人帐户可以采用社会保障卡方式管理。具体管理办法由省社会保障行政部门另行制定。

采用其它方式管理个人帐户的统筹地区,社会保障行政部门及社会保险经办机构也应当加强对个人帐户管理工作的监督。

第三十九条 社会保障行政部门应当建立对社会保险经办机构和定点医疗机构实行社会公众评议的工作制度,督促社会保险经办机构改进医疗保险工作,督促定点医疗机构改进医疗保险服务。

第四十条 自2009年1月1日起,各统筹地区社会补充医疗保险基金帐户合并到基本医疗保险基金帐户。

第四十一条 本实施细则所称省本级包括洋浦经济开发区。

第四十二条 本实施细则具体应用中的问题,由省社会保障行政部门负责解释。

第四十三条 本实施细则自2009年1月1日起施行。2001年9月20日省人民政府发布的《海南省城镇从业人员基本医疗保险条例实施细则》同时废止。






最高人民法院关于在民事判决书中增加向当事人告知民事诉讼法第二百二十九条规定内容的通知

最高人民法院


最高人民法院关于在民事判决书中增加向当事人告知民事诉讼法第二百二十九条规定内容的通知

法〔2007〕 19号


  全国地方各级人民法院、各级军事法院、各铁路运输中级法院和基层法院、各海事法院,新疆生产建设兵团各级法院:
  根据《中共中央关于构建社会主义和谐社会若干重大问题的决定》有关“落实当事人权利义务告知制度”的要求,为使胜诉的当事人及时获得诉讼成果,促使败诉的当事人及时履行义务,经研究决定,在具有金钱给付内容的民事判决书中增加向当事人告知民事诉讼法第二百二十九条规定的内容。现将在民事判决书中具体表述方式通知如下:
  一、一审判决中具有金钱给付义务的,应当在所有判项之后另起一行写明:如果未按本判决指定的期间履行给付金钱义务,应当依照《中华人民共和国民事诉讼法》第二百二十九条之规定,加倍支付迟延履行期间的债务利息。
  二、二审判决作出改判的案件,无论一审判决是否写入了上述告知内容,均应在所有判项之后另起一行写明第一条的告知内容。
  三、如一审判决已经写明上述告知内容,二审维持原判的判决,可不再重复告知。
  特此通知。









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