北京市人力資源和社會保障局 北京市財政局 北京市衛生健康委員會關于北京市全面開展工傷保險跨省異地就醫直接結算有關工作的通知

京人社工發〔2025〕5號

各區人(ren)力資(zi)(zi)源社會保(bao)障局(ju)、財政局(ju)、衛生健康委，北京(jing)經濟(ji)技術(shu)開發區社會事業局(ju)、人(ren)力資(zi)(zi)源和社會保(bao)障服務(wu)中心、財政國資(zi)(zi)局(ju)，各有關(guan)(guan)工(gong)傷保(bao)險協議機(ji)構，各相關(guan)(guan)單位(wei)和人(ren)員：

為貫徹落實《人(ren)力資源(yuan)社會保(bao)(bao)(bao)障部 財政部 國家衛(wei)生健康委關于(yu)全(quan)面開(kai)展工(gong)(gong)傷保(bao)(bao)(bao)險跨(kua)省(sheng)異(yi)地(di)(di)就(jiu)(jiu)醫直接(jie)(jie)結算工(gong)(gong)作(zuo)的通知》（人(ren)社部發〔2025〕17號）要(yao)求，加快推進(jin)本市工(gong)(gong)傷保(bao)(bao)(bao)險跨(kua)省(sheng)異(yi)地(di)(di)就(jiu)(jiu)醫直接(jie)(jie)結算工(gong)(gong)作(zuo)，不斷(duan)提升(sheng)經辦管理(li)服(fu)務水平，更好(hao)保(bao)(bao)(bao)障工(gong)(gong)傷職(zhi)工(gong)(gong)權益(yi)和就(jiu)(jiu)醫需(xu)求，結合本市實際(ji)，現就(jiu)(jiu)有關事項通知如下：

一、確定工作目標

 按照國家規定，本市全(quan)面開展工(gong)(gong)傷(shang)保(bao)險跨(kua)省異地(di)就(jiu)醫(yi)直接(jie)結(jie)算(suan)工(gong)(gong)作。依托全(quan)國工(gong)(gong)傷(shang)保(bao)險異地(di)就(jiu)醫(yi)結(jie)算(suan)信息系統（以下(xia)簡稱國家異地(di)就(jiu)醫(yi)系統），實現相(xiang)關(guan)工(gong)(gong)傷(shang)職工(gong)(gong)持社會保(bao)障卡(ka)（含電子社保(bao)卡(ka)，下(xia)同）直接(jie)結(jie)算(suan)跨(kua)省異地(di)就(jiu)醫(yi)住院工(gong)(gong)傷(shang)醫(yi)療(liao)費、住院工(gong)(gong)傷(shang)康復費和(he)輔助器具配置(zhi)費。通過不斷完善政策、健全(quan)系統功能、優化經辦服務，為(wei)工(gong)(gong)傷(shang)職工(gong)(gong)提供規范、高效、便捷的就(jiu)醫(yi)服務，并切(qie)實維護工(gong)(gong)傷(shang)保(bao)險基金安全(quan)。

二、鞏固本市工傷職工異(yi)地就醫直接結算規定

（一(yi)）異地就醫直(zhi)接(jie)(jie)結(jie)算人員(yuan)范圍。參加本市(shi)工傷(shang)(shang)保(bao)險并已完成工傷(shang)(shang)認(ren)定、工傷(shang)(shang)復發(fa)確認(ren)、工傷(shang)(shang)康復申請(qing)核準或(huo)輔助器具配置確認(ren)的(de)以下人員(yuan)，可申請(qing)辦理異地就醫住院(yuan)工傷(shang)(shang)醫療費(fei)、住院(yuan)工傷(shang)(shang)康復費(fei)和(he)輔助器具配置費(fei)直(zhi)接(jie)(jie)結(jie)算：

1.在(zai)本市以外居住（工作）半(ban)年及(ji)以上，并符(fu)合本市異地(di)就醫、康(kang)復、輔助器具配置(zhi)要(yao)求的工傷(shang)職工。

2.因本(ben)市(shi)工傷保險協(xie)議醫(yi)療機構(gou)(gou)、康復(fu)機構(gou)(gou)、輔助(zhu)器(qi)具配置機構(gou)(gou)（以(yi)下簡(jian)稱協(xie)議機構(gou)(gou)）的醫(yi)療技術(shu)和設備不能診治或配置，符合本(ben)市(shi)轉診轉院要求，需要轉診轉院到本(ben)市(shi)以(yi)外就醫(yi)的工傷職工。

（二）異(yi)(yi)(yi)地(di)(di)(di)(di)就(jiu)(jiu)醫直(zhi)(zhi)接(jie)(jie)結算(suan)備案(an)(an)。工(gong)(gong)(gong)傷(shang)職(zhi)(zhi)工(gong)(gong)(gong)可通過(guo)國(guo)家(jia)社(she)會(hui)保(bao)險公共服務(wu)平臺、人社(she)政務(wu)服務(wu)平臺、掌上12333 APP、電子社(she)保(bao)卡等全國(guo)統一線(xian)上服務(wu)渠道，或(huo)相(xiang)關(guan)區按職(zhi)(zhi)責(ze)承擔工(gong)(gong)(gong)傷(shang)保(bao)險經辦(ban)事(shi)務(wu)的(de)(de)工(gong)(gong)(gong)作(zuo)機(ji)構(gou)（以(yi)下簡稱經辦(ban)機(ji)構(gou)）窗口，申請辦(ban)理(li)(li)異(yi)(yi)(yi)地(di)(di)(di)(di)就(jiu)(jiu)醫直(zhi)(zhi)接(jie)(jie)結算(suan)備案(an)(an)。異(yi)(yi)(yi)地(di)(di)(di)(di)長(chang)期(qi)居住和(he)常駐異(yi)(yi)(yi)地(di)(di)(di)(di)工(gong)(gong)(gong)作(zuo)的(de)(de)工(gong)(gong)(gong)傷(shang)職(zhi)(zhi)工(gong)(gong)(gong)備案(an)(an)有(you)(you)效(xiao)(xiao)期(qi)為一年，異(yi)(yi)(yi)地(di)(di)(di)(di)轉(zhuan)診(zhen)轉(zhuan)院的(de)(de)工(gong)(gong)(gong)傷(shang)職(zhi)(zhi)工(gong)(gong)(gong)備案(an)(an)有(you)(you)效(xiao)(xiao)期(qi)為六個(ge)月。工(gong)(gong)(gong)傷(shang)職(zhi)(zhi)工(gong)(gong)(gong)在(zai)備案(an)(an)有(you)(you)效(xiao)(xiao)期(qi)內(nei)(nei)，可按規定(ding)在(zai)就(jiu)(jiu)醫地(di)(di)(di)(di)多次就(jiu)(jiu)診(zhen)并享受(shou)直(zhi)(zhi)接(jie)(jie)結算(suan)服務(wu)。備案(an)(an)有(you)(you)效(xiao)(xiao)期(qi)結束后仍有(you)(you)異(yi)(yi)(yi)地(di)(di)(di)(di)就(jiu)(jiu)醫直(zhi)(zhi)接(jie)(jie)結算(suan)需(xu)求的(de)(de)，需(xu)重新辦(ban)理(li)(li)備案(an)(an)。備案(an)(an)有(you)(you)效(xiao)(xiao)期(qi)內(nei)(nei)喪(sang)失待(dai)遇享受(shou)資(zi)格的(de)(de)，備案(an)(an)有(you)(you)效(xiao)(xiao)期(qi)終止。

（三(san)）異(yi)地(di)就(jiu)醫(yi)直接(jie)結算(suan)范圍和(he)待遇(yu)政(zheng)策。已辦理異(yi)地(di)就(jiu)醫(yi)直接(jie)結算(suan)備案的(de)(de)本(ben)(ben)市(shi)工(gong)(gong)傷(shang)職工(gong)(gong)，在就(jiu)醫(yi)地(di)可(ke)提供(gong)異(yi)地(di)就(jiu)醫(yi)直接(jie)結算(suan)服務(wu)的(de)(de)協議機構(gou)發生的(de)(de)符合規定的(de)(de)費用，納入本(ben)(ben)市(shi)工(gong)(gong)傷(shang)保(bao)險(xian)(xian)異(yi)地(di)就(jiu)醫(yi)直接(jie)結算(suan)范圍，涉(she)及(ji)第三(san)方責任(ren)的(de)(de)費用除外(wai)。其中，異(yi)地(di)就(jiu)醫(yi)直接(jie)結算(suan)的(de)(de)住(zhu)院工(gong)(gong)傷(shang)醫(yi)療費、住(zhu)院工(gong)(gong)傷(shang)康(kang)復費，執行(xing)就(jiu)醫(yi)地(di)工(gong)(gong)傷(shang)保(bao)險(xian)(xian)藥品(pin)目(mu)(mu)錄、診療項目(mu)(mu)目(mu)(mu)錄、住(zhu)院服務(wu)標準、康(kang)復服務(wu)項目(mu)(mu)等(deng)有關規定。輔(fu)(fu)助器(qi)(qi)具配置(zhi)執行(xing)本(ben)(ben)市(shi)工(gong)(gong)傷(shang)輔(fu)(fu)助器(qi)(qi)具配置(zhi)項目(mu)(mu)及(ji)費用限(xian)額標準，超出項目(mu)(mu)范圍的(de)(de)，工(gong)(gong)傷(shang)保(bao)險(xian)(xian)基金(jin)不(bu)予支(zhi)付(fu)；輔(fu)(fu)助器(qi)(qi)具配置(zhi)費低(di)于(yu)本(ben)(ben)市(shi)最(zui)(zui)高(gao)支(zhi)付(fu)限(xian)額的(de)(de)，按(an)實際(ji)配置(zhi)費支(zhi)付(fu)；高(gao)于(yu)本(ben)(ben)市(shi)最(zui)(zui)高(gao)支(zhi)付(fu)限(xian)額的(de)(de)，按(an)本(ben)(ben)市(shi)最(zui)(zui)高(gao)限(xian)額支(zhi)付(fu)。

工傷職工異(yi)地就醫的住(zhu)院伙(huo)食(shi)補助費和因異(yi)地轉診轉院發生的到本(ben)市以外就醫所(suo)需的交(jiao)通食(shi)宿費，不納入異(yi)地就醫直接(jie)結(jie)算范圍，由本(ben)市經辦(ban)機構按照本(ben)市工傷保險基(ji)金支出(chu)項目標準有關規定(ding)審核報銷。

異地(di)長期居住和(he)常駐異地(di)工(gong)作(zuo)的工(gong)傷職(zhi)工(gong)，在備案有效期內確需回本市就醫的，可(ke)在本市享受直接結算服務，執行本市政策。

三、推(tui)進異地來京就醫工傷職(zhi)工直(zhi)接結(jie)算工作

（一）逐步增(zeng)加上線協(xie)(xie)議(yi)(yi)機(ji)(ji)構(gou)(gou)數量(liang)。按照國家進度安排，結(jie)合本(ben)(ben)市(shi)實(shi)(shi)(shi)際及(ji)工(gong)(gong)(gong)傷(shang)職(zhi)工(gong)(gong)(gong)需求，逐步將符合條件的協(xie)(xie)議(yi)(yi)機(ji)(ji)構(gou)(gou)分階段(duan)納入跨(kua)省(sheng)異地(di)就醫(yi)(yi)(yi)直接(jie)結(jie)算(suan)協(xie)(xie)議(yi)(yi)機(ji)(ji)構(gou)(gou)范圍，為異地(di)來京就醫(yi)(yi)(yi)工(gong)(gong)(gong)傷(shang)職(zhi)工(gong)(gong)(gong)提(ti)供直接(jie)結(jie)算(suan)服務。至(zhi)2025年底，實(shi)(shi)(shi)現本(ben)(ben)市(shi)30%以上三級工(gong)(gong)(gong)傷(shang)保(bao)險(xian)協(xie)(xie)議(yi)(yi)醫(yi)(yi)(yi)療(liao)機(ji)(ji)構(gou)(gou)支(zhi)持跨(kua)省(sheng)直接(jie)結(jie)算(suan)；至(zhi)2026年底，實(shi)(shi)(shi)現本(ben)(ben)市(shi)50%以上三級工(gong)(gong)(gong)傷(shang)保(bao)險(xian)協(xie)(xie)議(yi)(yi)醫(yi)(yi)(yi)療(liao)機(ji)(ji)構(gou)(gou)，以及(ji)50%以上工(gong)(gong)(gong)傷(shang)保(bao)險(xian)協(xie)(xie)議(yi)(yi)康(kang)復和輔助器具配置(zhi)機(ji)(ji)構(gou)(gou)支(zhi)持跨(kua)省(sheng)直接(jie)結(jie)算(suan)；至(zhi)“十五五”期末(mo)，實(shi)(shi)(shi)現本(ben)(ben)市(shi)全(quan)部三級工(gong)(gong)(gong)傷(shang)保(bao)險(xian)協(xie)(xie)議(yi)(yi)醫(yi)(yi)(yi)療(liao)機(ji)(ji)構(gou)(gou)，以及(ji)全(quan)部工(gong)(gong)(gong)傷(shang)保(bao)險(xian)協(xie)(xie)議(yi)(yi)康(kang)復和輔助器具配置(zhi)機(ji)(ji)構(gou)(gou)均支(zhi)持跨(kua)省(sheng)直接(jie)結(jie)算(suan)。根(gen)據本(ben)(ben)市(shi)實(shi)(shi)(shi)際和工(gong)(gong)(gong)傷(shang)職(zhi)工(gong)(gong)(gong)就醫(yi)(yi)(yi)需求，穩妥推(tui)動(dong)更(geng)多(duo)職(zhi)業(ye)病、骨折、燒傷(shang)整形等專科協(xie)(xie)議(yi)(yi)機(ji)(ji)構(gou)(gou)支(zhi)持跨(kua)省(sheng)直接(jie)結(jie)算(suan)。

（二）落實(shi)就醫(yi)地(di)統(tong)一(yi)管理工(gong)(gong)(gong)作(zuo)要求。各(ge)級經辦機構(gou)要將異地(di)來京就醫(yi)工(gong)(gong)(gong)傷(shang)職工(gong)(gong)(gong)納入本市(shi)統(tong)一(yi)管理，執行國家和本市(shi)就醫(yi)規定(ding)和流程，為其提供(gong)與(yu)本市(shi)工(gong)(gong)(gong)傷(shang)職工(gong)(gong)(gong)相(xiang)同的服務和管理，嚴格按照國家和本市(shi)規定(ding)審核結算(suan)費用，同步做(zuo)好數據(ju)統(tong)計分(fen)析等工(gong)(gong)(gong)作(zuo)。市(shi)工(gong)(gong)(gong)傷(shang)保險事(shi)務管理中心（以下(xia)簡(jian)稱(cheng)市(shi)工(gong)(gong)(gong)傷(shang)中心）應將異地(di)就醫(yi)工(gong)(gong)(gong)作(zuo)納入本市(shi)協議管理范圍，結合實(shi)際完善協議內容，強(qiang)化基金支出管理，加(jia)強(qiang)對協議機構(gou)的監管。

（三(san)）規(gui)范(fan)協議機(ji)構(gou)服(fu)(fu)務行(xing)為。協議機(ji)構(gou)要嚴格(ge)履行(xing)協議內容(rong)，認真核對(dui)工(gong)(gong)(gong)傷(shang)(shang)職(zhi)工(gong)(gong)(gong)身份(fen)信(xin)息(xi)和(he)(he)備案信(xin)息(xi)，按規(gui)定及(ji)時、如實、準(zhun)確、完(wan)整傳輸工(gong)(gong)(gong)傷(shang)(shang)職(zhi)工(gong)(gong)(gong)就醫、結算及(ji)其他相關信(xin)息(xi)。協議機(ji)構(gou)應嚴格(ge)按照(zhao)國家和(he)(he)本市工(gong)(gong)(gong)傷(shang)(shang)保險等有(you)關規(gui)定提供醫療、康復、輔助器具配置服(fu)(fu)務，做到(dao)因傷(shang)(shang)施治，傷(shang)(shang)病分離(li)，合理(li)診療等，對(dui)治療非(fei)工(gong)(gong)(gong)傷(shang)(shang)所發(fa)生的費(fei)用，就醫中發(fa)生的超(chao)(chao)標準(zhun)、超(chao)(chao)目錄范(fan)圍和(he)(he)不符合診療常規(gui)的費(fei)用，及(ji)其他違反工(gong)(gong)(gong)傷(shang)(shang)保險有(you)關規(gui)定的費(fei)用，工(gong)(gong)(gong)傷(shang)(shang)保險基(ji)金不予支付。

四、提升異地(di)就(jiu)醫直(zhi)接結算經辦管理水平

（一）落實經(jing)(jing)(jing)(jing)(jing)辦職責(ze)(ze)(ze)。本(ben)市(shi)(shi)異(yi)(yi)地就(jiu)醫(yi)直接(jie)結(jie)算(suan)工(gong)(gong)作由市(shi)(shi)、區兩級經(jing)(jing)(jing)(jing)(jing)辦機(ji)構(gou)負責(ze)(ze)(ze)。市(shi)(shi)工(gong)(gong)傷(shang)中(zhong)心(xin)負責(ze)(ze)(ze)統一組織、指導協(xie)(xie)調全(quan)市(shi)(shi)經(jing)(jing)(jing)(jing)(jing)辦機(ji)構(gou)和協(xie)(xie)議(yi)機(ji)構(gou)開展相關(guan)工(gong)(gong)作，制定(ding)經(jing)(jing)(jing)(jing)(jing)辦細(xi)則(ze)，同(tong)時(shi)(shi)做好(hao)協(xie)(xie)議(yi)管(guan)(guan)理(li)(li)、備案管(guan)(guan)理(li)(li)、持卡就(jiu)醫(yi)和結(jie)算(suan)、費用監控、監督(du)檢(jian)查、數據統計分析(xi)、運行監管(guan)(guan)、政(zheng)策宣(xuan)傳培訓等工(gong)(gong)作。市(shi)(shi)人力(li)資源社會保障(zhang)局大(da)數據中(zhong)心(xin)（以下(xia)簡稱大(da)數據中(zhong)心(xin)）負責(ze)(ze)(ze)及時(shi)(shi)落實信(xin)息系統建設相關(guan)要(yao)(yao)求(qiu)，積極推(tui)進社會保障(zhang)卡應(ying)用。北京(jing)市(shi)(shi)社會保險(xian)基(ji)金管(guan)(guan)理(li)(li)中(zhong)心(xin)負責(ze)(ze)(ze)會同(tong)市(shi)(shi)工(gong)(gong)傷(shang)中(zhong)心(xin)按國家及本(ben)市(shi)(shi)要(yao)(yao)求(qiu)，做好(hao)異(yi)(yi)地就(jiu)醫(yi)資金管(guan)(guan)理(li)(li)工(gong)(gong)作。各(ge)區相關(guan)經(jing)(jing)(jing)(jing)(jing)辦機(ji)構(gou)具體(ti)負責(ze)(ze)(ze)本(ben)轄區工(gong)(gong)傷(shang)保險(xian)異(yi)(yi)地就(jiu)醫(yi)直接(jie)結(jie)算(suan)備案及信(xin)息上傳、協(xie)(xie)議(yi)管(guan)(guan)理(li)(li)、費用審核結(jie)算(suan)等具體(ti)經(jing)(jing)(jing)(jing)(jing)辦事務。各(ge)級經(jing)(jing)(jing)(jing)(jing)辦機(ji)構(gou)應(ying)認真落實國家和本(ben)市(shi)(shi)關(guan)于(yu)異(yi)(yi)地就(jiu)醫(yi)直接(jie)結(jie)算(suan)工(gong)(gong)作要(yao)(yao)求(qiu)，不斷提升經(jing)(jing)(jing)(jing)(jing)辦管(guan)(guan)理(li)(li)服務水平。

（二(er)）深化信息(xi)系統(tong)(tong)建(jian)設和應用。市工(gong)傷(shang)中心(xin)和大數(shu)據中心(xin)要(yao)按(an)照國(guo)家統(tong)(tong)一技術(shu)標準(zhun)和工(gong)作要(yao)求，組織(zhi)完(wan)善本(ben)市工(gong)傷(shang)保(bao)險(xian)業務(wu)系統(tong)(tong)，加強(qiang)與(yu)國(guo)家異(yi)(yi)地(di)就(jiu)醫(yi)系統(tong)(tong)的對接，積(ji)極穩妥組織(zhi)推(tui)動好本(ben)市協(xie)議機(ji)構(gou)的信息(xi)系統(tong)(tong)改造和對接，大力推(tui)進社(she)會保(bao)障卡的應用，不斷(duan)提(ti)升本(ben)市工(gong)傷(shang)保(bao)險(xian)聯網結算(suan)水平和信息(xi)化管(guan)理(li)能力。各級經辦機(ji)構(gou)和各協(xie)議機(ji)構(gou)要(yao)強(qiang)化業務(wu)協(xie)同，充分依托國(guo)家異(yi)(yi)地(di)就(jiu)醫(yi)系統(tong)(tong)，及時(shi)按(an)規(gui)定(ding)傳輸備案、就(jiu)醫(yi)、結算(suan)等信息(xi)，支(zhi)持資金(jin)定(ding)期清分，引導工(gong)傷(shang)職工(gong)合理(li)有(you)序就(jiu)醫(yi)。

（三(san)）強化風險(xian)防(fang)控(kong)。市工(gong)傷中(zhong)心(xin)應不斷完善(shan)異(yi)地(di)就(jiu)醫(yi)經辦管(guan)理機制，充分(fen)分(fen)析利用國(guo)家異(yi)地(di)就(jiu)醫(yi)系統等的(de)就(jiu)醫(yi)數據，科學有(you)(you)效(xiao)(xiao)做好基(ji)金(jin)(jin)安(an)(an)全管(guan)理和使用情(qing)況分(fen)析；要(yao)加(jia)強與異(yi)地(di)相關(guan)經辦機構的(de)溝通協調與配合，對金(jin)(jin)額大、頻(pin)次高(gao)、備案(an)期(qi)間兩(liang)地(di)雙向支出等費用加(jia)強監管(guan)和稽核；要(yao)強化本市工(gong)傷保險(xian)業務系統技防(fang)功能，結合實際不斷完善(shan)系統事中(zhong)管(guan)控(kong)規(gui)(gui)則，對協議機構的(de)協議履行情(qing)況持續組織開展日常、專(zhuan)項(xiang)、年(nian)度等監督檢查，不斷強化風險(xian)防(fang)控(kong)，有(you)(you)效(xiao)(xiao)防(fang)范各類違規(gui)(gui)、騙保行為發生(sheng)，確保基(ji)金(jin)(jin)安(an)(an)全。

五、相關工作要求

（一(yi)）加強(qiang)組(zu)織領導(dao)(dao)。異地就醫(yi)(yi)直接結算工(gong)作是落實國務(wu)院加快(kuai)推進政(zheng)務(wu)服(fu)務(wu)“跨(kua)省(sheng)通辦(ban)(ban)”工(gong)作要(yao)求(qiu)，提升人(ren)社信息(xi)化(hua)便民服(fu)務(wu)水平的重要(yao)舉措。人(ren)力資源(yuan)社會保障(zhang)部(bu)門要(yao)提高(gao)站位，強(qiang)化(hua)組(zu)織領導(dao)(dao)和統籌謀(mou)劃，會同財政(zheng)、衛生(sheng)健康等部(bu)門扎實組(zu)織實施。財政(zheng)部(bu)門要(yao)根據經辦(ban)(ban)機構請款，按(an)規(gui)定及(ji)時劃撥跨(kua)省(sheng)異地就醫(yi)(yi)資金，合(he)(he)理安(an)排工(gong)作經費(fei)，加強(qiang)與經辦(ban)(ban)機構對賬管理，確(que)(que)保賬賬相(xiang)符(fu)、賬款相(xiang)符(fu)，按(an)職責(ze)落實好資金管理相(xiang)關工(gong)作。衛生(sheng)健康部(bu)門要(yao)指導(dao)(dao)相(xiang)關醫(yi)(yi)療機構積(ji)極配(pei)合(he)(he)落實跨(kua)省(sheng)異地就醫(yi)(yi)各(ge)項任務(wu)，提高(gao)服(fu)務(wu)能力，保障(zhang)醫(yi)(yi)療質量和安(an)全。相(xiang)關部(bu)門要(yao)落實工(gong)作責(ze)任，密切協調配(pei)合(he)(he)，確(que)(que)保按(an)時完成目(mu)標任務(wu)。

（二）提(ti)升工(gong)(gong)作(zuo)保(bao)障能力。全面開(kai)展異地就(jiu)醫(yi)直接結算工(gong)(gong)作(zuo)，要(yao)服務(wu)好本市工(gong)(gong)傷(shang)(shang)職(zhi)(zhi)工(gong)(gong)異地就(jiu)醫(yi)需(xu)求，也(ye)要(yao)保(bao)障好持(chi)續增多的外埠工(gong)(gong)傷(shang)(shang)職(zhi)(zhi)工(gong)(gong)來京就(jiu)醫(yi)需(xu)求。各級人力資源社(she)會(hui)保(bao)障部(bu)(bu)門要(yao)根據管理和服務(wu)需(xu)要(yao)，及(ji)時(shi)加強(qiang)工(gong)(gong)傷(shang)(shang)保(bao)險機(ji)構(gou)和干部(bu)(bu)隊伍建設，結合業(ye)務(wu)需(xu)要(yao)合理配備專業(ye)干部(bu)(bu)，保(bao)障必要(yao)的專職(zhi)(zhi)工(gong)(gong)作(zuo)人員和辦(ban)公條件；要(yao)充分調動協議(yi)機(ji)構(gou)積極(ji)性，并(bing)加強(qiang)對協議(yi)機(ji)構(gou)工(gong)(gong)作(zuo)指(zhi)導，共同做好經辦(ban)工(gong)(gong)作(zuo)，不斷提(ti)高工(gong)(gong)作(zuo)質效，確保(bao)工(gong)(gong)傷(shang)(shang)保(bao)險基金安全。

（三）做好宣(xuan)(xuan)傳引導和(he)總(zong)(zong)結完(wan)善。各級(ji)(ji)經(jing)(jing)辦機構要強化為(wei)民(min)服務(wu)意識，多(duo)渠道開(kai)展宣(xuan)(xuan)傳和(he)經(jing)(jing)辦服務(wu)，落實對(dui)工(gong)傷職(zhi)工(gong)的(de)政策解讀(du)、就醫指引、信(xin)息查詢、經(jing)(jing)辦指南(nan)、投(tou)訴舉報處理(li)等服務(wu)措施。各級(ji)(ji)人(ren)力資源社會保(bao)障(zhang)部門(men)要密(mi)切關注運行情況，落實好維護(hu)基金(jin)安全各項工(gong)作要求(qiu)，創(chuang)新服務(wu)舉措，適時開(kai)展普(pu)通門(men)診跨省聯網直接結算(suan)。各級(ji)(ji)人(ren)力資源社會保(bao)障(zhang)、財政、衛生(sheng)健康等相關部門(men)要結合(he)職(zhi)責認真總(zong)(zong)結工(gong)作經(jing)(jing)驗成效，及時研究解決問題，完(wan)善工(gong)作措施，穩妥推進(jin)各項工(gong)作。

本(ben)通(tong)知自印發之日(ri)起(qi)施(shi)行(xing)，《關(guan)于本(ben)市開展工傷保險跨省異(yi)地就醫(yi)直(zhi)接結算試點工作的通(tong)知》（京人(ren)社工發〔2024〕5號）停止執行(xing)。

附(fu)件(jian)：北(bei)京市工(gong)傷保險跨省異地(di)就醫直接結算經辦細(xi)則

北京市(shi)人力資源和(he)社會保障局

北京市財政局

北(bei)京市衛(wei)生健康委員會

2025年7月21日

（此件主動(dong)公開）

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