China News Service, January 4th (Shao Wanyun, Zhongxin Finance and Economics) With the optimization and adjustment of my country's epidemic prevention and control measures, the official announced that the new coronavirus infection will be implemented on January 8th. How to reimburse medical insurance for seeing a doctor and taking medicine has also become the focus of attention.
Recently, reimbursement policies have been clarified in many places.
Beijing: Temporarily include multiple drugs such as "Compound Amphenamine Capsules" in the scope of medical insurance reimbursement
Picture from the website of Beijing Municipal Bureau of Medical Security
The website of the Beijing Municipal Medical Security Bureau released a message on December 17, 2022. In order to actively respond to the new coronavirus pneumonia epidemic, strengthen the security work in Beijing, and ensure the medical needs of the insured for the treatment of the new coronavirus pneumonia, with the approval of the National Medical Security Bureau, Six medicines, Compound Anfen Alkane Capsules, Compound Anfen Jiama Oral Liquid, Pediatric Anphen Huang Na Min Granules, An Ka Huang Min Capsules, Chlorphen Huang Min Tablets, and Ambroterol Oral Solution, were temporarily included in Beijing Medical Insurance, industrial injury insurance drug reimbursement scope.
The reimbursement ratio is implemented in accordance with Class A drugs.
The notice will be implemented from December 18, 2022 and will be valid until March 18, 2023.
In addition, Beijing has made it clear that Naimatevir Tablets/Ritonavir Tablets, Ambavirumab/Romisvirumab Injection, Intravenous COVID-19 Human Immunoglobulin, Shufengjiedu Granules, etc. Controlled drugs are temporarily included in the scope of medical insurance fund payment.
Anhui: The reimbursement rate for outpatient expenses for new crown infection is unified at 70%
According to the website of the Anhui Provincial Medical Security Bureau, on December 29, the Anhui Provincial Medical Security Bureau, the Anhui Provincial Department of Finance, and the Anhui Provincial Health and Health Commission jointly issued an urgent notice on the guarantee of outpatient treatment of new coronavirus infection, clarifying the insurance When a person infected with a new crown is treated in a general outpatient (emergency) clinic within the overall planning area, the medical expenses that meet the new crown virus pneumonia diagnosis and treatment plan and other regulations are included in the payment scope of the basic medical insurance overall planning fund, and there is no minimum payment line, reimbursement limit, and reimbursement ratio. Unified is 70%.
At the same time, the settlement level restrictions on designated institutions will be cancelled.
The designated medical institutions that have opened the basic medical insurance pooling fund settlement service in the overall planning area will be temporarily included in the overall settlement of the new crown infection outpatient service, and support the insured personnel to obtain outpatient treatment and security benefits in a timely manner.
Regarding the settlement of outpatient expenses for new crown infection, the notice pointed out that the Anhui Provincial Medical Insurance Information Center optimized the settlement system module of the Anhui Provincial Medical Insurance Information Platform, and uniformly enabled the "New Crown Outpatient Clinic (1102)" medical category to settle outpatient expenses for new crown infection.
The insured person seeks medical treatment in a different place due to the new crown infection such as going out temporarily or visiting relatives, or seeks medical treatment in a designated medical institution that does not have the conditions for online settlement, or the medical insurance settlement system needs to be suspended (downtime) due to the New Year's carryover, or cannot be paid due to network failures, etc. For real-time on-site settlement, you can apply for manual reimbursement at the local medical insurance agency with the relevant outpatient fee bills.
Shandong: Online consultation of new crown symptoms included in medical insurance reimbursement is consistent with offline reimbursement policy
According to news from the website of the Shandong Provincial Medical Security Bureau on December 28, the Shandong Provincial Medical Security Bureau and the Shandong Provincial Health and Health Commission jointly issued the "Notice on Doing a Good Job in Internet Medical Security Services for New Coronavirus Infection", which clarifies the Internet diagnosis of new crown-related symptoms The fee is included in the scope of basic medical insurance payment, which is consistent with the offline reimbursement policy.
The picture is from the website of Shandong Provincial Medical Security Bureau
At the same time, medical institutions are encouraged to provide 24-hour online consultation services to provide medical treatment, psychological consultation, and medication guidance services for children, pregnant women, the elderly, dialysis patients, and patients with underlying diseases.
The notice requires that the medical insurance department should settle and pay "Internet +" medical expenses in a timely manner, strengthen intelligent audits, and promote the rational and standardized use of medical insurance funds.
Henan: 14 kinds of medical institution preparations and 6 kinds of Chinese patent medicines are temporarily included in the scope of medical insurance payment
According to news from the Henan Provincial Medical Insurance Bureau website on December 30, with the approval of the National Medical Insurance Bureau, the Henan Provincial Medical Insurance Bureau and the Provincial Department of Human Resources and Social Security will use 14 medical institution preparations such as Jindao Qingye Granules for the prevention and treatment of the new crown virus and Six kinds of Chinese patent medicines such as Qingshi Granules are temporarily included in the payment scope of basic medical insurance and work-related injury insurance in Henan Province, and the payment period is until March 31, 2023.
Previously, on December 9, the Henan Provincial Medical Insurance Bureau issued a document to include the "Jiuwei Qingwenyin Granules" declared by Nanyang Hospital of Traditional Chinese Medicine into the payment scope of the Henan Provincial Medical Insurance Fund and manage it as a Class B drug, and clarified that the medical insurance fund is subject to drug supervision. Management approves scope payments for transfers.
At the same time, in line with the principle of maintaining capital and making small profits and benefiting the people, the Henan Provincial Medical Insurance Bureau and the Nanyang Municipal Medical Insurance Bureau conducted bargaining negotiations to determine the medical insurance payment limit.
After several rounds of price negotiations, the price of the preparation dropped from 51.41 yuan/box to 48 yuan/box, a decrease of 6.6%, which further reduced the burden of drug costs for patients.
Guangdong: Policy support for Internet first diagnosis and antigen detection medical insurance
In December 2022, the Guangdong Provincial Medical Insurance Bureau issued the "Notice on Further Improving the Payment of Medical Insurance for "Internet +" Medical Services for New Coronary Pneumonia". The basic medical insurance fund shall pay for the medical examination fee and drug fee that meet the regulations for the first consultation and prescription.
The cost of drug delivery service is not included in the scope of medical insurance payment.
The picture is from the website of Guangdong Medical Insurance Bureau
According to the deployment of the National Medical Insurance Administration, Guangdong Province will temporarily include the new coronavirus antigen detection reagents and corresponding detection items in the Guangdong Provincial Medical Insurance Medical Consumables Catalog and Diagnosis and Treatment Items Catalog.
The medical insurance fund will pay the cost of the new coronavirus antigen test incurred by insured patients in primary medical institutions according to regulations.
In addition, the cost of purchasing new coronavirus antigen detection reagents at designated retail pharmacies by the insured can be paid using the personal account of the employee's medical insurance.
The spouse, parents, and children of the insured can use the personal account of the insured to purchase antigen detection reagents at designated medical institutions.
Hubei: 36 new crown drugs temporarily included in medical insurance
According to the news from the Hubei Provincial Medical Security Bureau on December 29, 2022, with the approval of the National Medical Security Bureau, starting from December 29, 2022, 36 kinds of new coronavirus drugs such as Pediatric Amphenol Huang Namin Granules and Compound Phorcodine Syrup Temporarily included in the reimbursement category of medical insurance in Hubei Province, the reimbursement ratio is implemented in accordance with Class A drugs.
In addition, in order to ensure the supply of antipyretic and analgesic, cough and cold medicines and other epidemic prevention and control drugs in medical institutions, strengthen the guarantee of supply of drugs for the treatment of new crown infection, and meet the needs of the masses, since December 16, the Hubei Provincial Medical Insurance Bureau has opened the urgent need related to new crown infection. Green channel for drug emergency hanging nets.
Up to now, three batches of urgently needed medicines related to the new crown infection have been carried out in emergency nets. The nets are first netted and then audited. The nets are netted in batches, and all should be listed to ensure the orderly procurement and supply of medical institutions in the province.
The 3 batches of COVID-19 infection-related drug emergency online lists involve a total of 31 drugs, all of which are cold, fever, cough and other treatment drugs, including the antipyretic and analgesic drugs ibuprofen, Xiaoer Qingfei Granules, and ambroxol hydrochloride that are urgently needed by the public Oral solution, dextromethorphan hydrobromide capsules, human immunoglobulin, etc.
At the same time, the price of Xiaoer Qingfei Granules, a drug linked to the net, was adjusted, from 94.8 yuan per box to 79 yuan per box.
Yunnan: 41 drugs have been temporarily included in medical insurance
The Yunnan Provincial Medical Security Bureau issued a notice on December 30, 2022, temporarily including 41 drugs such as Sangju Yinqiao Powder into the scope of medical insurance payment, and managed them as Class A drugs. The time limit for medical insurance payment is from January 1, 2023 to March 2023 March 31.
The list of medicines temporarily included in the scope of medical insurance payment in Yunnan Province
Guangxi: 15 kinds of new crown drugs can be used for medical insurance
The Medical Security Bureau of Guangxi Zhuang Autonomous Region recently issued the "Notice of the Autonomous Region Medical Insurance Bureau on Temporarily Including 15 Drugs Including Exogenous Fengsha Granules into the Payment Scope of the Basic Medical Insurance Fund". 15 drugs are temporarily included in the payment scope of the basic medical insurance fund and reimbursed as Class A drugs in medical insurance.
Guangxi Zhuang Autonomous Region temporarily included in the list of drugs covered by the basic medical insurance fund
Shaanxi: 234 new crown drugs temporarily included in medical insurance
According to the website of the Shaanxi Provincial Medical Insurance Bureau, on December 21, 2022, the Shaanxi Provincial Medical Security Bureau, the Shaanxi Provincial Health and Health Commission, and the Shaanxi Provincial Taxation Bureau of the State Administration of Taxation jointly issued the "About Further Improving the Current Epidemic Prevention and Control Medical Security Work" "Notice" will be used for confirmed and suspected patients. The 107 kinds of Chinese patent medicines recommended in (Shaanwei Zhongzhongfa [2022] No. 53) and the two types of 127 kinds of medicines selected by experts organized by the Provincial Food and Drug Administration and the Provincial Health and Health Commission are highly targeted and have obvious therapeutic effects on the new crown disease. Included in the scope of medical insurance payment, medical insurance payment until June 30, 2023, to ensure the medication of confirmed and suspected patients.
(use up)