China News Service, December 23. According to news from the website of the National Medical Insurance Bureau on the 23rd, recently, the National Medical Insurance Bureau issued the "Notice on Comprehensive Investigation and Cancellation of Unreasonable Restrictions on Medical Insurance" (hereinafter referred to as the "Notice").
The relevant person in charge of the Medical Service Management Department said in response to a reporter's question that according to the feedback from the masses and the previous research, this investigation focused on the five issues that the masses are most concerned about.
The five questions can be grouped into three categories:
One is inpatient medical services.
Whether there is any unscientific and irregular control of the annual total budget/total amount of designated medical institutions by medical insurance and the lack of a reasonable adjustment mechanism, and whether there are specific restrictions on the number of days a patient is hospitalized, which leads to shirking patients and splitting up hospitalization, etc.
The second is outpatient medical services.
Whether there is a specific number of days or an upper limit on the amount of medication prescribed by medical insurance for insured patients, making it impossible or inconvenient for medical institutions to issue long-term prescriptions.
The third is the refinement of medical insurance assessment management.
Is there any medical insurance that directly uses the management indicators of relevant departments as the management indicators of the medical insurance department, such as the average cost of hospitalization and outpatient visits, the proportion of medicines, etc., causing medical institutions and insured personnel to mistake it for the management regulations of the medical insurance department.
According to the relevant person in charge of the Medical Service Management Department, according to the deployment of the "Notice", the investigation work will be carried out in three stages.
First, before the end of December 2022, the medical insurance department in the coordinating area will carry out self-examination and self-correction, form a list of problems, and implement rectification measures one by one according to the specific situation.
The second is that before January 31, 2023, the provincial medical insurance department will summarize the situation in the whole province and form a rectification report for the province's investigation and cancellation of reasonable restrictions on medical insurance.
The third is that before the end of February 2023, the National Medical Insurance Bureau will carry out work supervision and scheduling, understand the actual situation of investigations and rectifications in various places through various channels, and summarize the work.
Praise and affirm areas that have achieved outstanding results, and criticize areas that fail to solve practical problems and go through the motions.
(China New Finance and Economics)