2
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111100006883506060
北京市人力资源和社会保障局
辅助器具配置协议机构的申请
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1111000068835060602002014007011
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市人力资源社会保障局
110000000000
北京市人力资源和社会保障局
北京市政务服务中心:法定工作日: 上午: 08:30 - 12:00; 下午: 12:00 - 17:30; (延时服务时间: 周六上午08:30 - 12:30; )
北京市政务服务中心:北京市丰台区西三环南路1号(六里桥西南角)综合窗口
工伤保险辅助器具配置机构应当具备以下条件：
（一）依法成立的组织，持有工商行政部门颁发的有效的《营业执照》，并连续三年参加相关部门年审并年审合格；
（二）具有民政部门颁发的有效的《假肢和矫形器（辅助器具）生产装配企业资格认定证书》；
（三）具有2名以上从事假肢配置专业技术工作超过三年的专业技术人员及1名以上从事矫形器配置专业技术工作超过三年的专业技术人员；
（四）具有辅助器具专业评估、适配制作、康复训练及质量检验等业务领域的设备和工具、专业人员及管理人员，并提供专业服务；
（五）场地功能齐全，布局合理，假肢取模室、修模室、接受腔制作成型室、打模室、装配室、功能训练室六室分设；
（六）具备良好的工伤职工住宿条件，住宿床位在20张以上；
（七）遵守国家有关法律法规，内部管理制度完善，服务规范，有严格的质量监控措施和售后服务体系；
（八）配置的辅助器具符合相关国家标准或者行业标准；
（九）近三年未出现报送虚假申请材料或利用不正当手段报送申请材料的行为；
（十）近五年未出现骗取工伤保险基金支出的行为。
工伤职工配置制氧机机构应具备前款第（一）、（七）、（八）、（九）、（十）项规定的条件。
工伤保险辅助器具配置机构及工伤职工配置制氧机机构为工伤职工配置的辅助器具属于医疗器械的，应具有食品药品监督管理部门核发的有效的医疗器械备案凭证或注册证、医疗器械经营备案凭证或许可证等相关证件。（来源：《北京市实施<工伤保险辅助器具配置管理办法>的意见》京人社工发﹝2018﹞158号）
本市行政区域内依法设立的辅助器具配置机构，符合本市协议机构设置规划，申请签订服务协议的，应向经办机构递交《北京市工伤保险辅助器具配置机构申请书》，并提供以下材料：
（一）民政部门颁发的有效的《假肢和矫形器（辅助器具）生产装配企业资格认定证书》原件；
（二）《实施意见》第五条第三项规定的假肢配置和矫形器配置专业技术人员相关资料；
（三）《实施意见》第五条第四项规定的设备和工具的清单和权属情况，专业人员相关资料；
（四）《实施意见》第五条第五项、第六项规定的场地权属性质、使用情况和功能说明；
（五）机构内部管理制度、质量监控措施和售后服务体系相关材料；
申请成为工伤职工配置制氧机机构，应提供前款第（五）项规定的材料。
辅助器具配置机构为工伤职工配置的辅助器具属于医疗器械的，应提供食品药品监督管理部门核发的有效的医疗器械备案凭证或注册证、医疗器械经营备案凭证或许可证等相关证件的原件。（来源：《关于印发<北京市工伤保险辅助器具配置机构评估确定办法（试行）>的通知》京人社工发〔2018〕169号）
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