政府示范
合同预览图

安徽省工伤康复服务合同(2011年)

24次浏览 0次下载 共1页 发布日期:2011-11-23
免费模版
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.1//EN" "http://www.w3.org/TR/xhtml11/DTD/xhtml11.dtd"><html xmlns="http://www.w3.org/1999/xhtml"><head><meta http-equiv="Content-Type" content="application/xhtml+xml; charset=utf-8" /><title></title><style type="text/css">body{ font-family:'Times New Roman'; font-size:1em; } ul, ol{ margin-top: 0; margin-bottom: 0; } ins{color:#2E97D3;} del{color:#FF0000;} .Normal{page-break-inside:auto;page-break-after:auto;page-break-before:auto;margin-top:0.0pt;margin-bottom:0.0pt;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;font-size:12.0pt;font-family:'Times New Roman';mso-fareast-font-family:Calibri;mso-bidi-font-family:'Times New Roman';} .Heading-1{text-align:center;page-break-inside:avoid;page-break-after:auto;page-break-before:auto;margin-top:14.0pt;margin-bottom:14.0pt;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;color:#000000;font-size:18.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;} .Heading-2{text-align:center;page-break-inside:avoid;page-break-after:auto;page-break-before:auto;margin-top:14.0pt;margin-bottom:14.0pt;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;color:#000000;font-size:14.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;} .Default-Paragraph-Font{font-family:'Times New Roman';mso-fareast-font-family:Calibri;mso-bidi-font-family:'Times New Roman';} .Normal-Table{} .Normal--Web-{text-align:left;page-break-inside:auto;page-break-after:auto;page-break-before:auto;margin-left:0.0pt;text-indent:0.0pt;border-top-style: none;border-left-style: none;border-right-style: none;border-bottom-style: none;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;} .Table-Normal{} </style></head><body style="pagewidth:595.35pt;pageheight:841.95pt;"><div class="Section0"><div style="min-height:72pt" /> <p class="Heading-1"><span style="color:#000000;font-size:18.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">工伤康复服务协议范本</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">甲方:社会保险经办机构</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">&nbsp;</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">乙方:工伤康复机构</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">为规范工伤康复管理,完善工伤康复服务,促进工伤康复对象(以下简称康复对象)重新回归社会和重返工作岗位,根据《工伤保险条例》、《安徽省实施&lt;工伤保险条例&gt;办法》、《安徽省工伤康复管理暂行办法》和《安徽省工伤职工康复费用结算办法(试行)》等有关规定,甲方确定乙方为工伤康复服务机构,经双方协商,签订如下协议。</span></p> <p class="Heading-2"><span style="color:#000000;font-size:14.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">第一章  总则</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第一条 甲乙双方应认真执行《安徽省工伤康复管理暂行办法》和《安徽省工伤职工康复费用结算办法(试行)》及统筹地区有关政策规定,相互配合,共同做好工伤康复服务管理工作。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第二条 甲方有义务向乙方提供工伤保险康复的相关政策规定,提供康复对象相关的基本信息,并协助乙方做好工伤康复服务工作。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第三条 乙方应确定专门机构配备专(兼)职管理人员,负责工伤康复服务的管理工作,并制定相应的管理制度。乙方有义务及时向医务人员和康复对象宣传、解释工伤康复有关政策。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第四条 甲方有责任对乙方为工伤职工提供康复服务的情况进行监督检查。乙方有责任向甲方提供准确的与工伤康复有关的资料和数据信息等,甲方需查看工伤职工康复档案及有关资料或询问当事人等,乙方应予以配合。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Heading-2"><span style="color:#000000;font-size:14.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">第二章  康复管理</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第五条 乙方应认真核查工伤职工康复治疗申请的基本信息,发现与康复对象身份不相符合时予以拒绝并及时通知甲方。乙方要严格执行工伤康复标准,不得推诿、拖延、拒绝收治符合康复条件的康复对象。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第六条 乙方应严格执行《安徽省工伤职工康复费用结算办法(试行)》的相关规定,为康复对象提供优质的服务。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第七条 乙方使用超出“支付范围”外的项目时,须履行告知义务,并经康复对象及家属、或康复对象单位签字确认后方可使用。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第八条 康复对象在康复期间,因病情需要到院外购药、检查或购置辅助器具的,乙方需提供详细清单,经甲方审批签章同意后,其费用由乙方垫付,符合工伤保险规定的费用纳入工伤保险基金结算。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第九条 乙方应在康复对象接受康复治疗后3-5日完成康复前期评价,中期评价每月一次,后期评价在康复终结前7日内完成。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第十条 乙方要建立康复对象康复服务明细记录制度,详细记录康复项目、项目实施次数、康复时间、康复费用和康复效果等原始记录。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第十一条 乙方应严格按照《安徽省工伤康复管理暂行办法》第十二条规定执行,康复医疗期满后,应及时办理康复终结手续,不得故意延长康复时间。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第十二条 康复对象因伤情需要转院(异地)康复治疗的,由乙方开具转诊单,工伤职工单位同意并报甲方批准后,方可转院(异地)进行工伤康复。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第十三条 康复对象在康复期间受到意外伤害的,由康复机构承担责任。</span></p> <p class="Heading-2"><span style="color:#000000;font-size:14.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">第三章  档案管理</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第十四条 乙方应在康复对象接受康复治疗的当日起建立康复档案。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">康复档案内容包括:康复计划、康复治疗处方、康复实施人、康复实施时间、康复次数、康复执行单(经本人签字的)、康复前期评价、康复中期评价和康复后期评价及康复期间其他相关材料。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第十五条 乙方应做好康复对象在康复期间的档案收集、分类、整理、立卷、归案、确保归档材料的完整,不得篡改伪造。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第十六条 乙方对康复对象的康复档案要妥善保管、有序存放,并能及时提供给甲方查阅。</span></p> <p class="Heading-2"><span style="color:#000000;font-size:14.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">第四章  费用结算</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第十七条 甲乙双方按照《安徽省工伤职工康复费用结算办法(试行)》共同协商的结算方式、标准、范围、期限和程序等进行结算。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">康复对象康复期间,由参保单位或康复对象预付一定资金作为支付康复对象在康复期间使用“支付范围”外的费用。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第十八条 康复职工康复期间采取先记账后结算的方式。康复对象康复终结后,由乙方按照《安徽省工伤职工康复费用结算办法(试行)》第十条规定向甲方申报审核结算康复费用。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第十九条 甲方收到乙方材料后,严格按照《安徽省工伤职工康复费用结算办法(试行)》第十一条规定及时办结。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第二十条 乙方有违反《安徽省工伤康复管理暂行办法》第二十四条和《安徽省工伤职工康复费用结算办法(试行)》第八条规定之一的,所发生的费用工伤保险基金不予支付。</span></p> <p class="Heading-2"><span style="color:#000000;font-size:14.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">第五章  附  则</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第二十一条 甲方对乙方的工伤康复服务质量和管理情况采取定期检查和不定期抽查,对违反规定的,视情节给予通报、限期整改或暂停工伤康复费用结算。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">甲方对乙方的工伤康复服务质量和管理情况进行定期的考核,考核不合格的,终止工伤康复服务协议关系,情节严重,建议社会保险行政管理部门取消工伤康复协议医疗机构资格。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第二十二条 本协议一经签订,双方应严格遵守,认真履行,不得随意修改或变更。本协议未尽事项,应依据相应的法律、法规办理。法律、法规无明文规定的,须由甲乙双方协商签订补充协议,补充协议与本协议具有同等法律效力。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">本协议执行过程中如发生矛盾和争议,可由甲乙双方或主管部门协商解决,协商解决不了的,双方可终止协议。甲乙双方无论以何种理由终止协议,必须提前30日通知对方。</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">&nbsp;</span><a id="_GoBack" /></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第二十三条 协议履行期间,国家法律、法规和省有关工伤保险政策调整时,与本协议条款内容有抵触的,甲乙双方应按照新政策执行。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第二十四条 本协议有效期自</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">年</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">月</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">日起至</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">年</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">月</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">日止。协议期满前1个月内,甲乙双方可以续签本协议。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">第二十五条 本协议一式二份,甲乙双方各执一份,具有同等效力。</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">甲方(签章):</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">                  </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">法人代表(签字):   </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">年</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">月</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">日</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">&nbsp;</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">&nbsp;             </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;"> </span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;font-weight:bold;">乙方(签章):</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">法人代表(签字):</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">&nbsp;</span></p> <p class="Normal--Web-"><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">年</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">月</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;text-decoration: underline;">    </span><span style="color:#000000;font-size:12.0pt;font-family:Calibri;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">日 </span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">&nbsp;</span><span style="color:#000000;font-size:12.0pt;font-family:Simsun;mso-fareast-font-family:Calibri;mso-bidi-font-family:Simsun;">&nbsp; </span></p> </div></body></html>

最新合同