200,000 medical institutions and 390,000 retail pharmacies are included in designated medical insurance

  News from our newspaper (reporter Li Danqing) Recently, the National Medical Insurance Administration formulated the "Interim Measures for the Management of Medical Security at Medical Institutions" and "Interim Measures for the Management of Medical Security at Retail Pharmacies", and proposed that eligible medical institutions and retail pharmacies can sign medical insurance through application The agreement is included in the designated management of medical insurance, and the basic conditions and procedures for signing the agreement are clarified.

According to statistics, in 2019, about 200,000 medical institutions and 390,000 retail pharmacies nationwide were included in designated medical insurance sites, which basically met the medical and drug service needs of the insured.

  In order to improve the efficiency of the use of medical insurance funds and better protect the rights and interests of insured persons, the two measures propose that medical institutions that have obtained medical institution practice licenses or Chinese medicine clinic registration certificates, and military medical institutions that have been approved by the military authorities to serve the civilian population , And retail pharmacies that have obtained a drug business license can apply for medical insurance designated points.

  "Medical institutions and retail pharmacies need to meet several basic conditions to apply for inclusion in medical insurance designated sites, including the institution's operating time of not less than 3 months, a certain degree of business license qualifications, and service personnel." It is the basic condition for medical institutions and retail pharmacies to normally provide services to the insured.

  In order to make it easier for the insured persons to go to the doctor to purchase medicines, the two methods are clear, and the time limit for the completion of the evaluation by the medical insurance agency shall not exceed 3 months.

Medical insurance agencies negotiate with qualified medical institutions and retail pharmacies, and if an agreement is reached, both parties voluntarily sign a service agreement.

  For medical institutions and retail pharmacies, the inclusion of medical insurance designated points does not mean once and for all.

The two measures propose that medical insurance agencies or third-party agencies entrusted by them will carry out performance appraisals of designated medical institutions and strengthen the supervision of designated medical institutions and designated retail pharmacies.

The Measures also clearly define the circumstances of suspension and termination of the agreement.

  During the epidemic prevention and control period, in order to facilitate the return of patients with chronic diseases to obtain medicines, all localities actively support "Internet +" medical services.

So, how can Internet hospitals be included in designated management?

  Currently, Internet hospitals mainly have various forms such as physical medical institutions building their own information platforms, and physical medical institutions cooperating with third-party institutions to build information platforms.

The person in charge revealed that “Internet hospitals must rely on physical medical institutions to apply for practice licenses, sign agreements with physical medical institutions, and report to the overall planning regional medical insurance agency for the record, and the provision of services incurred in compliance with the required expenses shall be handled by the overall planning regional medical insurance agency. Settlement between institutions and designated medical institutions."

  In addition, the method proposed that "designated retail pharmacies can sell drugs with electronic prescriptions issued by designated medical institutions", which attracted many people's reverie: "Does this mean that prescription drugs can be sold online?"

  That’s right, the person in charge gave a clear answer. The current regulations regulate the mode that prescriptions that meet the regulations can be transferred to physical pharmacies for medicines or distributed by physical pharmacies. The circulation of prescriptions is not the same as prescription drugs sold online. The relevant policies of the country need to be studied and clarified by the competent department.

Li Danqing