Schlagwort: ‘Reimbursement’
Zhejiang takes the lead in implementing DRGs payment
On July 18th, the Zhejiang Medical Insurance Bureau issued the “Opinions on Promoting the Reform of Basic Medical Insurance Payment Methods for Medical Communities in Zhejiang Province,” and plans to implement multiple and composite medical insurance payment methods under total budget management. For inpatient medical services, the payment is mainly based on the DRGs (Diagnosis-Related Groups) system. For long-term and chronic disease inpatient medical services, the “daily payment for each sickbed” will be gradually promoted. For outpatient medical services, the “per-head payment” will be implemented, which also combines the “Contracted Family Doctor Services”.
市场洗牌来了！浙江率先全面推行DRGs点数法付费
来源：医药网 2019.07.19
7月18日，浙江省医保局发布《关于推进全省县域医共体基本医疗保险支付方式改革的意见》，计划全面推行总额预算管理下的多元复合式医保支付方式；对住院医疗服务，主要按DRGs（疾病诊断相关分组）点数法付费；对长期、慢性病住院医疗服务，逐步推行按床日付费；对门诊医疗服务探索结合家庭医生签约服务，实行按人头付费。
Medical insurance designated pharmacies will be incorporated in provincial centralized drug procurement
On May 15th, the Shandong provincial drug purchasing website released a document of “Opinions on the trial implementation of centralized online drug procurement by private pharmaceutical institutions.” The “Opinion” stipulates that private hospitals and chain pharmacies which are managed by the Medical Insurance Protocol should purchase drugs online through the centralized procurement platform of Shandong province, with the total purchase amount not less than 60% of the original usage. The “Opinion” will be implemented on July 1st.
重磅！医保定点药店纳入省级药品集采
来源：新浪医药新闻 2019.05.17
5月15日，山东省药品采购网发布文件《关于民营医药机构试行网上药品集中采购的意见》（以下简称《意见》）。《意见》要求，医疗保险协议管理的民营医院、连锁零售药店，应通过山东省药品集中采购平台网上采购药品，采购总量不低于原使用量的60%。据悉，《意见》将于7月1日开始执行。
The pilot program of national organized centralized procurement and use of drugs is officially released
On January 17th, the General Office of the State Council officially issued the “Notification of National Organized Pivot Program for the Centralized Procurement and Use of Drugs.” The “Notification” clarified that the purchase way for each selected drug depends on the number of its production enterprises. The “Notification” stipulated that the advance payment should not be less than 30% of the purchase amount and the total purchase quantity should account for 60%-70% of the full annual drug use of public medical institutions. The centralized procurement this time will be implemented in early 2019 with one year.
国家药品集中采购和使用试点方案正式发布
来源：制药网 2019.01.18
核心提示：1月17日，国务院办公厅正式发布《国家组织药品集中采购和使用试点方案的通知》。《通知》明确，应根据每种药品入围的生产企业数量分别采取相应的集中采购方式。《通知》要求，预付金额不得低于采购金额的30%；采购总量应占公立医疗机构年度药品总用量的60%-70%。本次集中采购将于2019年初开始实施，周期为一年。
Anhui: the procurement and use of traditional Chinese medicine products is encouraged
Recently, the Anhui General Office of the People’s Government issued the “Implementation Opinion on improving the National Essential Medicine System”. The “Implementation Opinion” proposed that medical institutions should give priority to the procurement and use of essential drugs that pass the Quality Consistency Evaluation of drugs and are affordable. Some kind of High-priced and high-dose drugs should be purchased with defined quantities. The use of traditional Chinese medicine products is encouraged to support the development of Chinese medicine.
安徽发布基药新政：鼓励采购使用中药产品
来源：医药网 2019.01.14
核心提示：日前，安徽省人民政府办公厅出台《完善国家基本药物制度的实施意见》（以下简称《实施意见》）。《实施意见》提出，医疗机构应优先采购和使用通过一致性评价、价格适宜的基本药物；应对价格高、用量大的药品实施单品种带量采购；鼓励采购使用中药产品，支持中医药事业发展。
The first detailed document for “procurement of drugs(“4+7”)” is released
Recently, Dalian city issued the “Implementation of a National Organised Work plan for centralized Procurement and Use of drugs (consultation paper).” The “Paper” stipulated that public medical institutions should sign a contract with the pharmaceutical production enterprises for the procurement of drugs with defined purchasing quantities and settle the payment of drugs promptly. Medical institutions should run out the contract amount within one year under the premise of ensuring the priority use of the selected drugs. The staff in medical institutions which do not use the drugs as required will be treated seriously by the relevant provisions. The Paper also clarified that the quality and use of selected drugs should be intensively monitored.
“4+7”带量采购，头一份细则文件来了！
来源：制药网 2019.01.11
核心提示：日前，大连市发布《贯彻落实国家组织药品集中采购和使用工作方案（征求意见稿）》。意见稿要求，公立医疗机构与药品生产企业应签订带量采购合同并及时结算药款，在确保中选药品优先使用的前提下，一年内完成合同用量；不按规定使用药品的医务人员，按照相应条款严肃处理。意见稿明确，应重点监测中选药品的质量和使用情况。
Shanghai: Complementary Document for procurement of drugs is released(“4+7”)
On November 22nd, Shanghai Pharmaceutical Centralized Bidding and Purchasing Management Office published “Complementary Document for centralized procurement of drugs in 4 municipalities and 7 other big cities (in Shanghai area)”. The “Complementary Document” stipulates that all medical insurance designated medical institutions should give priority to purchasing and using selected drugs in centralized procurement in 4 municipalities and 7 other big cities and the usage amount should be equivalent to last year. Meanwhile, medical institutions can continue to purchase and use unselected drugs under the premise of ensuring the amount of selected drugs, but the amount should not exceed the selected variety after being converted into proportion.
上海：4+7带量采购补充文件发布
来源：制药站 2018.11.22
核心提示：11月22日，上海市医药集中招标采购事务管理所发布《4+7城市药品集中采购上海地区补充文件》（以下简称《补充文件》）。《补充文件》要求，所有医保定点医疗机构应优先采购和使用4+7城市集中采购中选药品，使用量应与上一年度水平相当。同时，医疗机构可以在保证中选用品用量的前提下，继续采购并使用未中选药品，但数量按比例关系折算后不得超过中选品种。
Anhui: The 2018 version of the medical insurance catalog is released
Recently, Anhui Human Resources and Social Security issued the “Medicine Catalogue of Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance in Anhui Province(2018 version)”, which will be implemented from July, 1st, 2018. The catalog includes 1481 western medicines and 1356 Chinese patent medicines. Anhui Human Resources and Social Security indicates that Anhui Province will use the unified “Drug Catalog” database. The drugs on the catalog will be coded according to the “Social Insurance Drug Classification Code”, which will be confirmed by the provincial medical insurance administrative department.
安徽：2018版医保目录出炉
来源：中国医药报 2018.05.29
核心提示：日前，安徽省人社厅发布《安徽省基本医疗保险、工伤保险和生育保险药品目录2018年版》，将于7月1日起执行。该目录包括西药1481个，中成药1356个。安徽省人社厅表示，安徽省将使用统一的《药品目录》数据库，并按照《社会保险药品分类代码》对目录药品进行对码，由省级医保行政部门进行确认。
Shenzheng social security cards can be used at 307 hospitals in Guangzhou
Recently, the direct settlement platform for hospitalizing in Guangdong was expanded again. On the 21st February, already 354 medical institutions participate, including 47 hospitals in Shenzheng and 307 hospitals in other regions in Guangdong. All participants of Shenzheng basic health insurance can directly use the social security card for reimbursement when hospitalizing in the province of Guangdong. Then it is not necessary to come back to Shenzhen for the reimbursement. (Source: people.cn)
广东307家医院可直接刷深圳社保卡
来源：人民网 2017-02-28
核心提示：广东省异地就医直接结算平台近期再次扩容。截至2月21日，已有354家医疗机构加入，包括深圳本地医院47家、市外异地医院307家。只要是参加深圳基本医疗保险的参保人，在省内异地住院时，均可在307家医院直接刷社保卡记账报销住院费用，不必返回深圳社保局报销。
New national reimbursement drug list comes out – changes in 376 varieties
On 23rd February, Ministry of Human Resources and Social Security published the new national reimbursement drug list (Version 2017) for the national basis health insurance, occupational insurance and maternity insurance. (Source: Chinamsr)
新版医保目录正式出台！376品种有变
来源：中国医药联盟 2017-02-24
核心提示：2月23日，人社部网站发布《关于印发<国家基本医疗保险、工伤保险和生育保险药品目录（2017年版）>的通知》，公布了2017年版国家基本医疗保险、工伤保险和生育保险药品目录。
Paying by insurance card is suspended at 19 pharmacies in Xi’an due to the fraud
Recently, the social security center of the Xi’an Human Resources and Social Security Bureau carried out the inspection at health-insurance-designated retail pharmacies. In the inspection, it has been found out that in some pharmacies, it was possible to buy household items paying by health insurance cards. According to relevant rules, 19 pharmacies with the fraud are punished with suspension of their businesses. (Source: cnwest.com)
西安市19家药店因违规被暂停医保卡刷卡业务
来源：西部网 2017-02-16
核心提示：近期,西安市人社局社保中心在对部分城镇职工基本医疗保险定点零售药店进行检查时,发现个别定点零售药店存在使用西安市医疗保险卡刷售生活用品等问题。根据相关规定,决定对存在违规行为的19家定点药店进行处罚,暂停执行定点医疗服务协议、暂停医保刷卡业务、扣除质量保证金、责令整改。