Four Departments: The proportion of reimbursement for outpatient and emergency expenses of insured patients for the new crown is not less than 70%

　　Chinanews.com, January 7th. On the 7th, the National Medical Insurance Administration, the Ministry of Finance, the National Health and Health Commission, and the National Bureau of Disease Control and Prevention issued the "Related Policies on Optimizing the Treatment Expenses of New Coronavirus Infected Patients after the Implementation of "Class B and B Controls"" announcement of".

　　The "Notice" proposes that the inpatient medical expenses incurred by patients with new coronavirus infection in all medical institutions that meet the new coronavirus infection diagnosis and treatment plan formulated by the health department shall implement the early-stage expense protection policy, which shall be covered by basic medical insurance, serious illness insurance, and medical assistance. After the payment is made according to the regulations, the financial subsidy will be provided for the part of the personal burden, the required funds will be paid by the local finance in advance, and the central finance will subsidize 60% of the actual expenses incurred.

The policy is calculated based on the patient's admission time and will be implemented until March 31, 2023.

　　The "Notice" clarifies that coordinated efforts will be made to promote the implementation of hierarchical diagnosis and treatment, guide patients to seek medical treatment at the grassroots level, and ensure smooth and orderly medical services.

Increase medical insurance support for grassroots medical institutions (first-level medical institutions and below) in rural areas and urban communities, and implement special guarantees for outpatient and emergency expenses for new coronavirus infections and suspected symptoms of insured patients in designated medical institutions of grassroots medical insurance .

Grass-roots medical institutions are encouraged to allocate enough drugs for the treatment of new coronavirus infection in the medical insurance drug catalog (including temporary additions by provinces). A minimum payment line and a cap line are set, and the reimbursement ratio is not less than 70%.

The specific regulations shall be determined by the local medical insurance department in consultation with the financial department based on research on the operation of the medical insurance fund, and will be implemented until March 31, 2023.

Outpatient and emergency expenses incurred by insured patients for the treatment of new coronavirus infection in other medical institutions shall be implemented in accordance with other medical insurance policies for Class B infectious diseases.

　　The "Notice" mentioned that the new coronavirus treatment drugs in the new coronavirus infection diagnosis and treatment plan will continue the temporary medical insurance payment policy, which will be implemented until March 31, 2023.

If some places consider temporarily expanding the list of medical insurance drugs due to insufficient supply of drugs, they can refer to the list of drugs for the treatment of new coronavirus infection identified by the provincial joint prevention and control mechanism, and the provincial medical insurance department will propose temporary inclusion in the local medical insurance drug list based on the operation of the medical insurance fund. The varieties, deadlines and reimbursement categories will be implemented after reporting to the National Medical Insurance Administration for record, and will be implemented until March 31, 2023.

　　The "Notice" also proposes to continue to do a good job in price negotiation or consultation, centralized procurement, online procurement, filing procurement, price monitoring, etc. for the treatment of patients with new coronavirus infection to reduce the cost of treatment of patients with new coronavirus infection.

Provincial medical insurance departments should combine the actual operation of medical insurance funds, coordinate and promote the implementation of policies, and scientifically determine the scope and level of protection, which can not only reasonably reduce the burden on the masses, but also ensure the safety and sustainability of medical insurance funds.

On this basis, if the medical insurance fund confirms that the income does not cover the overall planning area, the local finance can provide appropriate subsidies.

Promptly promote the transfer of funds in the province.

(China New Finance and Economics)

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