Kategorie: ‘Hospital News’
The NMPA: implementation of Diagnosis-Intervention Packet
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。
Hainan: supervising the drug procurement process
On October 10th, the Hainan Medical Insurance Bureau issued the “Plan on Supervising and Evaluating the Medical Price in Hainan Province.” The “Plan” clarifies that drugs included in the procurement list on the website of the centralised procurement platform of Hainan Province should be supervised, which means that monitoring and early warning systems will be implemented as drugs are published on or removed from the website as well as during the processes of drug procurement, distribution, use, and purchase. In addition, a centralised drug procurement assessment for medical institutions should be developed, in which will be evaluated particularly whether medical institutions have obeyed the purchase agreement and paid for the drugs with in 30 days, the rate of drug cost compared with the whole medical costs in medical institutions, the rate and purchasement of unselected drugs, and illegal purchase behavior.
医保局推药品采购全流程监测预警！严抓30天回款率
来源：医药网 2020.10.12
10月10日，海南省医疗保障局印发《海南省医药价格综合监管评价服务工作方案》（以下称《工作方案》）。《工作方案》明确，将在海南省医药集中采购平台挂网采购的药品纳入监测内容，对药品的挂网、撤网、采购、配送、使用和回款等全流程实施监测预警。 另外，应设置医疗机构的药品集中采购考核，其中对于协议完成率、30天汇款率、药占比、非中选产品采购量及金额占比、违规采购行为等进行了重点评分规定。
Coding rules for chinese traditional drugs
On September 25th, the NMPA issued the “Coding Rules of Chinese Traditional Drugs Included in the Reimbursement List and Pharmaceutical Preparations of Medical Institutions.” The code of Chinese traditional drugs consists of 10 digits and four sections. The first section represents Chinese traditional drugs. The second section represents different medical standards in different cities. The third section represents drug effects. The fourth section represents the name of drug. The code of pharmaceutical preparation of medical institutions consists of 16 digits and 4 sections. The first section represents pharmaceutical preparations. The second section represents different medical institutions in different cities. The third section represents medical institutions. The fourth section represents the sequence of pharmaceutical preparations in different medical institutions.
医保药品中药饮片和医疗机构制剂统一编码规则和方法
来源：医药网 2020.09.27
9月25日，国家医保局印发了《医保药品中药饮片和医疗机构制剂统一编码规则和方法》。中药饮片分为4个部分共10位。其中，第1部分是中药饮片识别码，第2部分是标准分类码，第3部分是功效分类码，第4部分是中药饮片名称码。医疗机构制剂编码分4个部分16位。其中，第1部分是医疗机构制剂识别码，第2部分是行政区划代码，第3部分是定点医疗机构顺序码，第4部分是医疗机构制剂顺序码。
The State Council: encouraging online drugs trade, prescription sharing and online medical consulting services
On September 21st, the State Council issued the “Opinions on Accelerating the Development of Consumption Created by New Forms of Bussiness”. The “Opinion” stipulates that a public service platform of online and e-commerce services should be established and improved to accelerate the integration of online and offline services; online medical services should be developed, which means scheduled appointments of consulting services, online medical consulting services, prescription sharing and online drugs trade will be promoted.
国务院力挺网络售药、处方流转、互联网医疗
来源：医药网 2020.09.23
9月21日，国务院办公厅印发《关于以新业态新模式引领新型消费加快发展的意见》（以下简称《意见》）。《意见》要求，应建立健全“互联网+服务”、电子商务公共服务平台，加快社会服务在线对接、线上线下深度融合；积极发展互联网健康医疗服务，大力推进分时段预约诊疗、互联网诊疗、电子处方流转、药品网络销售等服务。
Pharmacy chains can only rise the price of drug in the reimbursement list by 15%
On September 1st, the “Reform Project on Improving the Functions of the Centralised Drug Procurement Platform and Promoting a Full Coverage of Payment Requirement of Drugs on the Reimbursement List in Zhejiang Province” was implemented. The “Project” indicates that drugs included in the list of online transactions on the provincal procurement platform of drugs and medical equipments are included in the provincal drug reimbursement list. Designated public medical institutions and private medical institutions should fix the drug price that accords with the price on the drug reimbursement list while pharmacy chains can rise the price upto 15% based on the price on the list.
9月1日起执行：医保用药 药店只能加价15%
来源：医药网 2020.09.03
9月1日，《浙江省提升药品集中采购平台功能推进医保药品支付标准全覆盖改革方案》正式实施。《方案》明确，所有纳入该省药械采购平台在线交易的医保目录内药品均纳入医保支付范围。其中，定点公立医疗机构与民营医疗机构医保药品执行相同的支付标准，定点零售药店医保支付标准统一按医疗机构支付标准上浮15%。
Wuhan: implementing the centralised procurement of the intensive monitoring drugs
On August 6th, the Joint Procurement Office of Drugs and Medical Equipments in Wuhan issued the first “Price List of Intensive Monitoring Drugs” and implemented the centralised procurement of 30 sorts of intensive monitoring drugs, which will last one year and is aimed to regulate a rational drug pricing and guiding medical institutions to regulate medication to reduce the financial burden on patients.
武汉市启动30种重点监控药品集中议价采购
来源：医药网 2020.08.06
8月6日，武汉市药械联合采购办公室公布武汉市首批《重点监控合理用药药品议价目录》，并正式启动武汉市30种重点监控药品集中议价采购，周期为一年，旨在促进药价合理形成，引导医疗机构规范用药，切实减轻患者药费负担。
Reimbursing online medical consulting services
On July 21st, the General Office of the State Council issued the “Opinions on Optimizing the Business Environment to Better Serve the Market Participants”. The “Opinions” indicates that under the premise of ensuring the medical safety and quality, the range of the online medical consulting services should be extended and qualified online medical consulting services should be included in the reimbursement list. In addition, a national unified approval requirement for online medical consulting services should be formulated and announced.
国务院：进一步放宽互联网诊疗范围， 将符合条件的医疗服务纳入医保报销
来源：搜狐网 2020.07.23
7月21日，国务院办公厅发布《关于进一步优化营商环境更好服务市场主体的实施意见》（以下简称《意见》）。《意见》指出，在保证医疗安全和质量的前提下，应进一步放宽互联网诊疗范围，将符合条件的互联网医疗服务纳入医保报销范围，并制定公布全国统一的互联网医疗审批标准。
Hospitals in Guizhou should pay for drugs within 30 days
Recently, the Healthcare Security Administration of Guizhou Province issued the “Measures on Managing the Settlement of the Centralised Procurement of Drugs in Guizhou Province.” The “Measures” indicates that medical institutions should transfer the drug payment to the settlement account on time, which means that the time range between the day after the delivery of the medicines is qualified and the storage is confirmed and the day of transfer should be less than 30 days. In addition, the settlement of medical insurance expenses by designated medical institutions organised by medical insurance agencies in different levels should not exceed 25 working day from the date of submitting the application of reimbursement.
1365家医院30天必须回款
来源：新浪医药新闻 2020.07.15
近日，贵州省医保局发布《贵州省药品集中采购货款统一结算管理实施暂行办法（征求意见稿）》。《征求意见稿》提出，医疗机构应按时将结算采购货款划拨到结算账户，从药品交货验收合格、确认入库的次日开始计算，不得超过30天。同时，各级医保经办机构对定点医疗机构医疗保险费用的结算从申请提交之日起不超过25个工作日。
Prohibiting hospitals from designating drug delivery companies and pharmacies
On July 6th, the Health Commission of Gungxi and other seven departments jointly issued the “Notice on Strengthing the Medication Management in Medical Institutions to Promote Rational Use of Medicines”. The “Notice” clarifies that medical institutions supporting Prescription Sharing should establish a process and supervision system of Prescription Sharing and are prohibited from designating drug delivery companies and pharmacies to avoid monopolies organised by distribution companies and pharmacies; the shared prescriptions should be approved by medical institutions and included into the services of prescription management, supervision of medication, and guidance on rational use of medicines.
七部门：杜绝医药统方 严禁医院指定配送企业和药店
来源：医药网 2020.07.08
7月6日，广西自治区卫健委等七部门发布《关于进一步做好医疗机构药事管理促进合理用药工作的通知》（以下简称《通知》）。《通知》明确，开展处方外配的医疗机构应建立处方外配流程和监管制度，严禁指定药品配送企业和药店，避免配送企业和药店垄断药品销售；外配处方应经医疗机构审核，并纳入处方点评、用药监测和合理用药指导等药学服务范围。
Ningbo: medical insurance will not reimburse drugs that are not included in the “selected drugs”-list
On June 19th, the Ningbo Municipal Medical Insurance Bureau collects opinions from the whole society for the plan of centralized procurement of medicines and medical consumable materials in public medical institutions. The “Plan” stipulates that the medical insurance fund will not pay for medicines that are similar to the selected drugs but are not included in the list of selected drugs.
宁波集采新规：医保不报销非中选产品
来源：医药网 2020.06.17
6月19日，浙江省宁波市医保局向全社会征集公立医疗机构药品、医用耗材集中采购的工作方案。《方案》要求，公立医疗机构若采购中选产品目录以外的同类产品，医保基金不予支付。
