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《关于做好长期护理保险支付管理工作的指导意见》的政策解读_我的网站

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一 | Russian President Vladimir Putin has underscored that the white-blue-and-red flag of the country “symbolizes our faith in our traditional values that we will never give up.” In an address on the occasion of National Flag Day, celebrated by Russia on August 22, he continued:,"Russia is a strong, independent world power. On the international stage, we are committed to pursuing only such policies that meet the vital interests of our Fatherland.",Putin added that the flag symbolizes faith in values such as “truth and justice, solidarity and mercy, and respect for Russia’s centuries-long uninterrupted history, the achievements and victories of our ancestors that inspire us to care for and defend our Motherland and never permit any foreign hegemony or diktat.”,© Sputnik / Evgeny Odinokov / Go to the photo bankRussian servicemen and the National Guard unfurled a 1,000-square-meter tricolor on National Flag Day near the Victory Museum in Moscow.Russian servicemen and the National Guard unfurled a 1,000-square-meter tricolor on National Flag Day near the Victory Museum in Moscow.© Sputnik / Evgeny Odinokov / Go to the photo bank,He added that starting from September 1, the beginning of the school year, all schools in Russia will begin each week with a ceremony of raising the flag and singing the national anthem.,Russia’s White-Blue-Red Tricolor,The Day of the State Flag was established on the basis of the Decree of the President of the Russian Federation dated August 20, 1994.,On this day in 1991, the Supreme Council of the Russian Soviet Federative Socialist Republic (RSFSR) adopted a resolution "On the Official Recognition and Use of the National Flag of the RSFSR." The move, just a few months before the official dissolution of the Soviet Union, brought back a design similar to the pre-revolutionary tricolor abolished in 1917.,Alternative View: Could USSR Have Avoided Dissolution, Overcome Crisis?17 August 2015, 13:47 GMT,The Soviet Union’s sickle-and-hammer flag was lowered on the night of December 25, 1991 and the Russian white-blue-red tricolor was raised in its place with the dissolution of the Soviet Union.,© Sputnik / Sergey Kuznecov / Go to the photo bankFlag of the Union of Soviet Socialist Republics. (File)Flag of the Union of Soviet Socialist Republics. (File)© Sputnik / Sergey Kuznecov / Go to the photo bank,However, the actual origins of the flag predate the post-Soviet Russian state by centuries.,The white-blue-red flag was hoisted for the very first time on the first Russian man-of-war Orel during the reign of Alexei Mikhailovich (1645-1676). On January 20, 1705, Peter the Great issued a decree ordering all merchant ships to fly the white-blue-red flag.,In the beginning, the white-blue-red flag’s use was limited to vessels. It was the geographical discoveries of Russian navigators that led to the flag being associated with dry land as well.,Until the 19th century, Russian sailors typically erected a memorial cross on shore during such ventures to mark land they were claiming for the country.,Yet when the Russian expedition of 1806 explored the coast of southern Sakhalin, it landed and raised two flags: St. Andrew's flag celebrated the merit of the Navy, the state white-blue-red flag – Russia’s new territorial acquisition. Thus, in 1883, the Russian flag was authorized to be used on dry land.,Officially, the white-blue-red flag was approved as the state flag of Russia only on the eve of the coronation of Tsar Nicholas II in 1896.,The three colors of the flag received an official interpretation, where red meant "sovereignty," blue, the color of the Mother of God - under whose heavenly protection Russia’s land was deemed to be, and white, the color of freedom and independence.。为深入贯彻落实党中央、国务院关于加快建立长期护理保险制度的重大决策部署，建立适配群众需求、符合长期护理保险特点与市场发展要求的支付管理机制，近日，国家医疗保障局印发了《关于做好长期护理保险支付管理工作的指导意见》(以下简称《指导意见》)，现对有关内容解读如下。

二 | 　　一、《指导意见》出台的背景是什么？　　加快建立长期护理保险制度，是党中央、国务院为应对人口老龄化、健全社会保障体系作出的重大决策部署。长期护理保险支付管理是保障参保人员享受优质服务、维护基金安全平稳运行的关键环节，对长期护理服务市场健康发展具有重要牵引作用。随着长期护理保险制度逐步发展，各地在前期探索中已初步形成符合本地实际的长期护理保险支付管理机制，但在支付范围、支付方式、支付标准管理等方面仍存在差异，一定程度上影响群众公平享受待遇，也难以有效引导长期护理服务市场规范发展。　　在总结各地试点经验的基础上，经商财政部，国家医疗保障局出台《指导意见》，对长期护理保险支付管理工作作出统一规范，进一步发挥长期护理保险基金战略购买作用，切实保障长期护理保险待遇享受人员基本照护需求，激励引导长期护理服务市场健康发展，提升长期护理保险基金使用效率，促进长期护理保险制度高质量发展。　　二、制定《指导意见》的总体考虑是什么？　　《指导意见》研究制定过程中，始终坚持以人民为中心的发展思想，以保障群众基本需求为出发点，注重与长期护理保险制度相适配，切实发挥长护险基金支付的牵引作用。

三 | 　　总体考虑：一是坚持保障基本。坚持尽力而为、量力而行，严格规范长期护理保险基金支付范围。

四 | 坚持以收定支、收支平衡，强化预算管理，确保长期护理保险基金安全高效运行。　　二是坚持科学易行。适应长期护理保险服务供给特点，按照科学合理、易行高效的原则，明确长期护理保险支付方式。评估服务以按人次付费为主，护理服务以按时长付费为主，区分不同服务类型合理确定时长付费单元。

五 | 　　三是坚持规范管理。

六 | 科学编制长期护理保险基金年度预算，加强预算绩效管理，建立基金运营监控和风险防范机制；加强服务质量评价，引导规范服务行为，推动长期护理服务市场良性有序竞争。　　三、《指导意见》的主要内容是什么？　　《指导意见》着眼于当前长期护理保险全面建制的整体形势，对长护支付管理的相关政策和核心要素进行了梳理明确，主要内容共分为七个部分，具体包括：　　第一部分为总体要求，明确了《指导意见》制定的重要意义、指导思想与总体原则。第二部分为明确支付范围，规定长期护理保险基金原则上按规定支付定点机构提供的评估费用、服务费用，以及依法依规引入社会力量参与经办管理服务产生的费用，并明确了上述三类费用支出的基本原则。第三部分为规范支付方式，明确评估服务以按人次付费为主，护理服务以按时长付费为主，同时区分居家、机构、社区三种不同服务类型，合理确定时长计费单元。第四部分为合理确定支付标准，要求综合考量长期护理保险基金支撑能力、参保人员基本保障需求与长期护理服务供给情况，合理确定护理服务、评估服务的支付标准并坚持动态调整。第五部分为严格基金管理和监督，明确了基金预算管理、支付费用审核拨付管理、基金监督管理等方面的要求，保障参保人员合法权益。第六部分为加强服务质量评价，要求建立健全定点长护服务机构服务质量评价机制和费用控制激励约束机制，将评价结果与费用支付、协议续签等挂钩，引导相关机构规范服务行为。第七部分为强化组织保障，明确了各级医疗保障部门的职责要求，设置政策过渡期，保障现有试点地区实现平稳过渡，并要求做好政策宣传解读工作，及时总结推广典型经验。　　四、《指导意见》对地方医保部门抓好工作落实有哪些要求？　　《指导意见》要求各地在总结试点经验的基础上，做好与现行长期护理保险支付管理工作的衔接，发挥长期护理保险基金支付的牵引作用，赋能长护相关行业、产业高质量发展。各统筹地区结合本地经济社会发展水平、基金承受能力等因素，科学制定护理服务支付标准并动态调整。要求原有试点地区应当利用3年左右时间逐步完成过渡，确保参保群众待遇稳定衔接。