Notice on issues related to the payment of family planning surgery fees Sui Renshe Han [2010] No. 502 Relevant units: In order to implement the original Ministry of Labor and Social Security, the National Family Planning Commission, the Ministry of Finance, and the Ministry of Health According to the spirit of "Notice on Properly Solving the Problem of Family Planning Surgery Costs for Urban Employees" (Ministry of Labor and Social Security [1999] No. 32) and "Guangzhou City Population and Family Planning Management Measures" (Guangzhou Municipal People's Government Order No. 6) Regarding the relevant provisions of the Notice on Implementing the Free Provision of Contraceptive and Birth Control Technical Services to Couples of Childbearing Age who are Practicing Family Planning (Suji Shengfa [2003] No. 27, hereinafter referred to as the "Notice on Birth Control Technical Services"), the maternity insurance fund is now used to pay for family planning surgeries. The relevant issues regarding fees are notified as follows: 1. Type of surgery. After the insured employee gives birth as planned, the medical expenses incurred by the insertion (removal) of intrauterine devices, abortion, induction of labor, sterilization and recanalization due to the implementation of family planning shall be paid by the maternity insurance fund. The maternity insurance fund will not pay for expenses incurred by the insured unit in arrears or during the suspension of insurance. 2. Settlement standards and payment of fees. The surgical fee standards stipulated in the "Notice on Birth Control Technical Services" are used as the fixed quota standard (see Appendix 1), and are allocated by the social insurance agency to the insured units. The portion of medical expenses exceeding the quota shall be borne by the employer. If the medical expenses do not meet the quota standard, after review, any medical expenses that meet the requirements of maternity insurance will be paid according to the actual expenses. If the family planning and financial departments adjust the surgical fees, they will be implemented in accordance with the new regulations. 3. Medical treatment management (1) Medical treatment hospital. Insured employees must undergo surgery at designated medical institutions of Guangzhou Maternity Insurance or Basic Medical Insurance that are qualified to provide family planning surgery services. Employees who give birth in another place within the country and take maternity leave, or undergo family planning surgery at the location of their workplace branch in another place, should apply for the off-site surgery procedures according to the following procedures: 1. Fill out the "Guangzhou Employee Maternity Insurance Off-site Family Planning Surgery Application Form" before the operation ( See Appendix 2) in duplicate. 2. Go to the Guangzhou Municipal Medical Insurance Service Administration Bureau (hereinafter referred to as the "Municipal Medical Insurance Bureau") through your employer to complete the application procedures. 3. When an employee undergoes surgery in another place, the hospital performing the surgery will fill in the corresponding columns of the "Guangzhou Employee Maternity Insurance Off-site Family Planning Surgery Application Form". (2) Reimbursement procedures. After surgery, the insured person should apply to the Municipal Medical Insurance Bureau for reimbursement from the employer within 5 months. When applying, you must fill in two copies of the "Guangzhou Fertility Insurance Family Planning Surgery Expense Reimbursement Review Form" (see Attachment 3), and bring the following information of the insured employees: 1. Female employees provide the original and copy of the family planning service certificate; none Those with this certificate must provide the original and copy of the certificate from the unit or the neighborhood family planning agency where the household registration is located (employees of central and provincial units in Guangzhou and municipal and district units shall have certificates issued by their units, and employees of foreign-funded, private, private enterprises, individual businesses) Households and other persons must issue certificates from the family planning agency in the town or street where their household registration is located). Male employees need to provide a certificate from the family planning department of the unit or the street where their household registration is located. Male and female employees who perform recanalization surgery must provide the original and copy of the certificate of approval of the surgery by the family planning administrative department at or above the district (county) level. 2. Original and copy of outpatient medical records or discharge summary. 3. The original and copy of the hospital diagnosis certificate or sick leave recommendation (including the name of the operation). 4. The original special receipt or invoice for medical expenses printed by the finance and taxation department (the back must be signed by the reimburser). 5. The original detailed list of medical expenses printed by the hospital that matches the amount of the receipt (invoice) (or a manual record list with the seal of the medical institution). 6. Those undergoing out-of-town surgery must hold the approved "Guangzhou Employee Maternity Insurance Off-site Family Planning Surgery Application Form". After receiving the application materials, the Municipal Medical Insurance Bureau will complete the review within 60 days, and the social insurance agency will allocate medical expenses to the insured units, and then the insured units will pay the medical expenses to the employees. 4. This notice shall be implemented from the date of issuance and shall be valid for five years. After the validity period expires, it will be evaluated and revised based on the implementation status. "Notice on Issues Concerning the Payment of Family Planning Surgery Fees" (Suilao Shehan [2005] No. 784) shall be abolished from the date of implementation of this notice.