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The NMPA: implementation of Diagnosis-Intervention Packet

October 20th, 2020 | by

On October 19th, the NMPA issued the “Notice on the Pilot Work of the Regional Point-Based Medical Insurance Fund Allocation and the Diagnosis-Intervention Packet.” The “Notice” stipulates that medical institutions should change the costs of each medical services into points; the regional medical insurance bureaus should calculate the value of each point according to the amount of points provided by all medical institutions of each region and the budget of medical insurance funds to pay for those medical institutions (Diagnosis-Intervention Paket). The “Notice” indicates that a data center on the basis of the unified national medical insurance information coding list should be established, which can inspect the quality of medical insurance settlement checklists, medical insurance cost schedule etc.

国家医保局发布区域点数法总额预算和按病种分值付费试点工作方案

来源:HIT专家网  2020.10.20

10月19日国家医保局下发《国家医疗保障局办公室关于印发区域点数法总额预算和按病种分值付费试点工作方案的通知》(以下简称《通知》)。《通知》要求,医疗机构应将治疗项目等付费单元转化为一定点数;医保部门年底根据各医疗机构所提供服务的总点数以及地区医保基金支出预算得出每个点的实际价值,按照各医疗机构实际点数付费。《通知》指出,应打造数据中心,在全国统一的相关医保信息业务编码的基础上,开展医保结算清单、医保费用明细表等质量控制工作。

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