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国家医保局印发长护险新规:原则上居家护理服务以小时为付费单元_我的网站

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A |     A Suo motu case has been registered against the management of Lulu Mall and the event organisers, a day after actress Nidhhi Agerwal was mobbed by a crowd during the launch of a song from her film The Raja Saab. The case was registered by the Kukatpally Housing Board (KPHB) police on Thursday, December 18, 2025.          KPHB Inspector S. Rajashekar Reddy said, "A case is being registered against the mall management and the event organisers for holding the programme without permission." Further investigation is underway.          Several photos and videos circulating on social media show the actress being jostled by an unruly crowd.     The incident took place on Wednesday evening as she was leaving the venue after attending the launch of the song Sahana Sahana in Hyderabad.          Vultures Disguised As Fans; Prabhas Starrer "The Raja Saab" Actress Nidhhi Agerwal, was literally gets Mobbed and Crushed by Fans at a Song Launch event in Hyderabad on Wednesday.#NidhhiAgerwal #Prabhas‌ #Hyderabad #TheRajaSaab #SahanaSahana pic.twitter.com/omOzynRQcj     — Surya Reddy (@jsuryareddy) December 17, 2025                    As Nidhhi exited the venue, she was mobbed by fans pushing forward to take selfies and photographs, creating a chaotic situation. Despite her bodyguard stepping in to assist, the actress appeared visibly uncomfortable as the crowd continued to press in.          Her personal security attempted to shield her and clear a path, but the situation remained difficult to control. After a struggle, she managed to get into her car but videos from the scene show Nidhhi looking visibly shaken and distressed. This incident has once again turned the spotlight on fans’ insensitive behaviour and invasion of personal space.               About Nidhhi Agerwal     Nidhhi is one of the most promising stars in Tollywood. After having debuted with Savyasachi, she made inroads into the Telugu film industry. She also forayed into Tamil and has three films to her name. One of her major releases this year was Pawan Kalyan-starrer Hari Hara Veera Mallu. She is now looking forward to the release of Prabhas-starrer The Raja Saab. The film will be released on January 9, 2026, coinciding with Sankranti.          Nidhhi is one of the most promising stars in Tollywood. After having debuted with Savyasachi, she made inroads into the Telugu film industry. She also forayed into Tamil and has three films to her name. One of her major releases this year was Pawan Kalyan-starrer Hari Hara Veera Mallu. She is now looking forward to the release of Prabhas-starrer The Raja Saab. The film will be released on January 9, 2026, coinciding with Sankranti.     Also Read: Nidhhi Agerwal Hits Back At A Netizen Trying To Question Her Film Choices。      来源:北京商报  8月26日,北京商报记者获悉,国家医疗保障局印发《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《意见》)。  在明确支付范围方面,《意见》提出,长期护理保险基金按规定支付失能等级定点评估机构提供的失能等级评估服务费用、定点长护服务机构提供的长期护理服务费用,以及依法依规引入的社会力量参与经办管理服务的费用等。  失能等级评估服务费用区分不同服务利用的情形,综合考虑评估结果等因素,由基金和个人承担,避免随意过度使用评估申请权。原则上参保人首次评估通过,以及按制度要求参加定期复评的服务费,由基金支付。其中,按制度要求参加定期复评包括按照《长期护理保险失能等级评估管理办法(试行)》规定,经办机构在参保人评估结果有效期届满前组织开展的重新评估,以及根据工作需求组织开展的复评等。  长期护理服务费用支付范围依据《国家长期护理保险服务项目目录》(以下简称《服务项目目录》)确定,符合《服务项目目录》的相关护理服务费用,由基金按规定支付。超出支付范围的护理服务费用由参保人员个人或其他渠道支付。明确区分基本医疗保险、长期护理保险支付范围和情形,两项制度原则上不得重复支付。  社会力量参与经办管理服务的相关费用,依协议约定从基金中支付,相关管理规定另行制定。

B |   在规范支付方式方面,《意见》提出,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,合理规范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计费单元,原则上居家护理服务以小时为付费单元;机构护理服务以床日为付费单元;社区护理服务根据提供服务具体情况确定付费单元。随着人口形势变化和制度发展,国家层面统一探索对纳入长期护理保险支付范围的智能化服务、支持性辅助器具等,采取按定额或按项目付费等方式。  在合理确定支付标准方面,《意见》提出,根据长期护理保险基金支撑能力、参保人基本保障需求、长护服务供给情况等,合理确定长期护理保险支付标准,并动态调整。  护理服务支付标准依据本地区经济发展水平、社会平均工资、相关行业费用水平、长期照护师等护理服务人员专业技能等分档设置。服务时长限额依据长期护理保险基金用于护理服务的年度支出预算、待遇享受人数、护理服务支付标准、支付比例等综合确定,并结合参保类型等予以调整。

C | 原则上单个项目服务时长不超过《服务项目目录》推荐的服务时长上限。参保人员基金年度最高支付限额不超过统筹地区上年度城乡居民人均可支配收入的50%。

D | 各地要统筹考虑居家、机构、社区等护理服务形式,做好按床日支付标准与按小时支付标准的比照衔接,鼓励使用居家和社区护理服务。

E | 各省级医保部门要加强统筹管理,指导省内各统筹地区间护理服务支付标准、支付时长等待遇水平相对统一,避免差异过大。  评估服务支付标准依据本地区社会经济发展水平、评估人员资质、评估成本等综合确定,鼓励有条件的省份统一省域内评估服务支付标准。  在严格基金管理和监督方面,《意见》提出,科学编制长期护理保险基金年度预算,加强预算绩效管理,做好基金会计核算,建立基金运行监控和风险防范机制。  按规定做好失能等级评估、护理服务、引入社会力量参与经办管理服务等各项费用审核拨付工作。完善资金拨付管理,强化定点评估机构、定点长护服务机构以及社会力量经办机构绩效考核。完善结算管理机制,规范基金结算清算,加强经办智能审核,切实提高审核拨付效率。对于评估服务未按规定执行,评估通过率畸高畸低的;护理服务未按照护理服务计划执行、未达到《服务项目目录》要求的;以及社会力量经办机构未按规定管理的,基金将按一定比例扣除直至拒付。

F | 长期护理保险基金支付不得由第三方社会力量代管代拨。  重点加强对长期护理保险失能等级评估行为、护理服务行为以及社会力量参与经办管理服务等的监管,逐步将长期护理保险基金使用纳入飞行检查、日常监管、社会监督、智能监管等常态化监管范围,探索将监管延伸到个人。研究探索适应长期护理保险特点的信用管理制度。加强对定点长护服务机构服务收费价格、评估机构评估收费价格的动态监测,保障参保人合法权益。责任编辑:曹睿潼。

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Published on:17:55:59


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