Notice of the General Office of Nansha District People's Government of Guangzhou Municipality on Issuing the Medical Assistance Scheme for secondary reimbursement in Nansha District of Guangzhou Municipality

VIII. Supervision and Administration

Secondary reimbursement funds shall be subject to the special accounting management by the operators, and the special funds shall be used exclusively. The expenditure rate shall be calculated by every insurance year. If the actual expenditure rate is less than 100 percent in a given year, the remaining funds will be carried forward for accumulative use in the following year; if the annual expenditure rate is less than 60 percent of the funds raised in the current year, secondary reimbursement benefits for the participant in the current year shall be extended for another year; if the actual expenditure rate exceeds 100 percent (including accumulated surpluses), the excess amount shall be funded by the district, towns/street communities and the operators in a ratio of 1:1:1.

Bureau of civil affairs of Nansha district shall, within the contract year, deduct 10 percent of the operation and management expenses for each contract year as the performance deposit of the operators, entrust a third-party institution to supervise, evaluate and audit the implementation of the services, social effect, and the quality of management regarding secondary reimbursement. The third-party institution shall issue supervision, evaluation and audit report on the quality of medical assistance services in the previous year. At the end of the contract year, bureau of civil affairs of Nansha district shall, according to the supervision and evaluation results from the third-party institution, allocate 100 percent of the performance deposit to the contracted institution if the service quality is qualified; if the service quality is not qualified, the performance deposit shall be retained by the bureau.

The error rate of annual review of sporadic reimbursement cases by the operators shall not be higher than 1 percent of the total number of review cases, or 0.3 percent of the total amount of compensation paid.

IX. Legal Liabilities

If a participant defrauds secondary reimbursement funds by means of false reporting, concealment, forgery, etc., the third-party supervision institution shall suspend his/her eligibility for secondary reimbursement and order him/her to return the illegally obtained reimbursement funds; if the case constitutes a crime, the person shall be transferred to the judicial authority for criminal liabilities in accordance with the law.