If a designated hospital fails to use drugs, diagnose and treat the participant as required, resulting in the loss or waste of secondary reimbursement funds, it shall not be eligible for secondary reimbursement settlement; for those failing to provide services for secondary reimbursement as required, in case of serious consequences, medical insurance department shall deal with them in accordance with relevant regulations.
If a staff member engaged in secondary reimbursement commits any of the following acts, he/she shall be disciplined; in case of serious consequences, he/she shall be subject to legal liabilities in accordance with the law:
1. Failing to accept the application for secondary reimbursement as required, or intentionally disapproving that the qualified applicants or approving the unqualified ones;
2. Dereliction of duties, practicing favoritism, or misappropriating, withholding, or defaulting on secondary reimbursement funds.
X. Supplementary Provisions
For the purpose of this Scheme, the "designated hospitals" herein refer to the designated hospitals as prescribed by Guangzhou social medical insurance or the hospitals in other places that meet the provisions of Guangzhou social medical Insurance for medical treatment in other places.
The "basic medical expenses" refer to the expenses that comply with the provisions of the state and the province on the scope of medication, the scope of diagnosis and treatment items and the scope of medical service facilities for basic medical insurance.
Class-I Special Diseases for Outpatient Treatment: including hypertension, diabetes, hyperlipidemia, coronary atherosclerotic heart disease, chronic heart failure (cardiac function above Grade III), cerebrovascular disease sequelae, bronchial asthma, chronic obstructive pulmonary disease, anticoagulant therapy after heart valve replacement surgery, rheumatoid arthritis, osteoarthritis, hypothyroidism, psoriasis, Wilson disease (copper metabolism disorder), lymphatic tuberculosis, amyotrophic lateral sclerosis, systemic lupus erythematosus, Parkinson's disease, Alzheimer's disease, epilepsy, chronic renal insufficiency (non-dialysis), chronic