医院的医疗服务数量与质量、收费项目与标准、医疗行为合理性以及对相关医保政策的正确把握,与医疗保险的效果、医疗保险基金支出有着直接关系,医保部门对医院的监管(以下称医保监管)无疑是医保部门管理工作的重中之重。医保监管目前有多种形式,包括医保政策对医疗服务范围、项目和结算(支付)办法等规定;医保部门与医院双方签订的服务协议;以分级管理为基础的医院考评。此外,最传统、最常 The quality and quantity of medical services, the items and standards of fees, the rationality of medical behaviors and the correct grasp of related medical insurance policies are directly related to the effect of medical insurance and the expenditure on medical insurance funds. The medical insurance departments’ supervision over the hospitals Regulation) is undoubtedly the top priority of the health care sector management. There are many forms of medical insurance supervision at present, including medical insurance policies on the scope of medical services, project and settlement (payment) and other provisions; medical insurance departments and hospitals signed service agreements; based on the classification management of hospital evaluation. In addition, the most traditional, most often