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Schlagwort: ‘Health Reform’

Medical Reform involving all urban employees

April 23rd, 2021 | by

Recently, the State Council issued the “Opinions on Improving the Mutual-Aid Mechanism for Covering Outpatient Bills in the Employed Medical Insurance System.” According to the “Opinion”, employees’ medical insurance premiums paid by their employers should be consolidated into a fund that can cover outpatient bills to improve the Mutual-Aid Mechanism. The “Opinion” clarifies that individual insurance accounts can be used to pay for the medical cost incurred by the insured person, his or her spouse, parent and children at designated medical institutions, as well as the cost incurred by the insured person for the purchase of drugs, medical equipment and medical devices at designated retailed pharmacies.

涉及3亿多参保人,这项医保改革有哪些重点?

来源:医药网  2021.04.23 

日前,国务院办公厅印发《关于建立健全职工基本医疗保险门诊共济保障机制的指导意见》。《意见》提出,将单位缴纳的医疗保险费全部计入统筹基金,并将门诊费用纳入统筹基金支付范围,健全门诊共济保障机制。 《意见》明确,个人账户可以用于支付参保人员本人及其配偶、父母、子女在定点医疗机构就医发生的由个人负担的医疗费用,以及在定点零售药店购买药品、医疗器械及医用耗材发生的由个人负担的费用

Hainan Free Trade Port: implementing online sales of prescription drugs

April 20th, 2021 | by

On April 8th, the National Development and Reform Commission issued the “Opinions on Supporting the Special Measures to Expand Market Access in the Hainan Free Trade Port.” The “Opinion” indicates that an e-prescription center be contracted in Lecheng to support the online sale of prescription drugs that are not expressly regulated under the national drug administration law. The e-prescription center should be connected to internet hospitals, prescription systems of Hainan medical institutions, various prescription drugs sales platforms, health insurance information platforms, payment and claims processing institutions, and commercial insurance institutions, thereby realizing an “Integrated Online Platform”  for the collection of prescription-related information, prescription drugs purchasing, information security certification, and medical insurance claims processing.

海南自贸港:处方药网售落地

来源:医药网  2021.04.20

4月8日,国家发改委发布《关于支持海南自由贸易港建设放宽市场准入若干特别措施的意见》。《意见》指出,要在乐城先行区建立海南电子处方中心,对于在国内上市销售的处方药,除国家药品管理法明确实行特殊管理的药品外,全部允许依托电子处方中心进行互联网销售,不再另行审批。海南电子处方中心对接互联网医院、海南医疗机构处方系统、各类处方药销售平台、医保信息平台与支付结算机构、商业类保险机构,实现处方相关信息统一归集及处方药购买、信息安全认证、医保结算等事项“一网通办”。

Shandong: Online medical insurance payment + medication home delivery service

January 20th, 2021 | by

On 18th January, the Shandong Medical Insurance Bureau issued the interpretation of the “Notice on Insisting on the Innovation of Traditional and Intelligent Medical Services and Implementing the Twelve Measures of Convenient Medical Services for the Elderly. ” The “Notice” stipulates that the “online consultation”, “online prescription renewal”, “online medical insurance payment” and “medication home delivery service” should be realized with the help of the provincial online medical insurance service platform and internet hospitals.

医保局1号文力推线上医保结算+线下送药上门 年内全面落地

来源:医药网  2021.01.20

1月18日,山东医保局官网挂出《关于坚持传统服务与智能化服务创新并行推行老年人医疗保障便捷服务十二条措施的通知》的政策解读。《通知》要求,应依托省互联网医保大健康服务平台、互联网医院等“互联网+医保”服务新模式,实现复诊“线上问诊““线上续方”“线上医保结算”“线下送药上门”服务

The State Council: Normalize and Institutionalize the Centralized Procurement of Drugs

January 18th, 2021 | by

On 15th January, the State Council indicated that the implementation of Centrailised Procurement of Drugs (with target quantity) should be normalized and insitutionalized to lessen the burden on the masses; the drugs on the National Reimbursement Drug List that are in high demand and need large procurement amounts will be included in the fourth batch of the centralized procurement. At the same time, the Shanghai Sunshine Medical Procurement All-In-One company officially anounced the launch of the fourth batch of the National Centralized Procurement of Drugs.

国常会提出集采常态化制度化要求!第四批国采23日开标

来源:医药网  2021.01.18

1月15日,国务院常务会议指出,应进一步常态化制度化实施推进药品集中带量采购改革,以减轻群众就医负担;基本医保药品目录内用量大、采购金额高的药品将被纳入第四批集中采购。与此同时,上海阳光医药采购网正式官宣启动开展第四批国家组织药品集中采购和使用工作。

The NMPA: Internet Hospitals Can Get Reimbursement

January 3rd, 2021 | by

On January 11th, the NMPA issued the “Interim Measures for the Administration of Designated Retail Pharmacies regarding Basic Medical Insurance” and the “Interim Measures for the Administration of Designated Medical Institutions regarding Basic Medical Insurance”, which will be implemented from Feburary 1st, 2021. These two measures stipulate that local medial insurance agencies can pay the service cost produced by internet hospitals by paying to the designated medical institutions they rely on. Moreover, the two measures indicate that designated retail pharmacies can sell presciption drugs to patients when they have electronic prescriptions issued by designed medical institutions.

国家医保局:互联网医院可报销 网售处方药仍待明确

来源医药网  2021.01.13

1月11日,国家医保局正式对外发布《零售药店医疗保障定点管理暂行办法》和《医疗机构医疗保障定点管理暂行办法》并均将于2021年2月1日起施行。“两定办法”规定,互联网医院提供服务产生的相关费用可由其依托的定点医疗机构与当地医保经办机构结算。此外,“两定办法”提出,医保定点零售药店可凭医保定点医疗机构开具的电子处方销售药品。

New policies by online medical services and consultancies

December 11th, 2020 | by

On December 10th, the National Health Commission, the NMPA and the National Administration of Traditional Chinese Medicine jointly issued the “Notice on Implementing Five Services of Online Healthcare Services.” The “Notice” stipulates that medical institutions are encouraged to share patients’ medical information such as their electronic medical records, examination results and medical images and to promote the online checking and reasonable use of electronic medical records; promoting the residents’ electronic health code to replace the registration card in each medical insurance organization to make medical institutions share their medical information with each other and thus to realize a universal code in the healthcare industry.

三部门发文 “互联网+”医疗迎来新拐点

来源:医药网  2020.12.11

12月10日,国家卫健委、国家医保局、国家中医药局联合发布《关于深入推进“互联网+医疗健康”“五个一”服务行动的通知》。《通知》强调,在符合医疗机构质量控制和患者知情同意的前提下,应推动医疗机构间电子病历、检查检验结果、医学影像资料等医疗健康信息调阅共享,并推进电子健康档案在线查询和规范使用;推动居民电子健康码代替医疗卫生机构就诊卡,解决医疗健康服务信息在医院之间互不通用的问题,逐步实现卫生健康行业内的一码通用。

Unified reimbursement rate of online and offline medical consultations

November 4th, 2020 | by

Recently, the NMPA issued the “Guidelines on Promoting the Medical Insurance Payment of Online Medial consultation services.” The “Guidelines” clarifies that medical entities can help eligible online medical institutions that rely on them to be included in medical insurance, and the reimbursement rate for online and offline medical institutions is the same. The “Guideline” indicates that the payment of consultations and drugs for patients that need further consultations is also included in the medical insurance, which should be paid according to the regulations in different cities.

国家医保局“互联网+”医保支付采取线上线下一致

来源医药网  2020.11.04

日前,国家医疗保障局印发《关于积极推进“互联网+”医疗服务医保支付工作的指导意见》。《意见》明确,符合条件的互联网医疗机构可以通过其依托的实体医疗机构,自愿“签约”纳入医保定点范围,“互联网+”医保支付将采取线上、线下一致的报销政策。《意见》提出,医保参保人在本统筹地区“互联网+”定点医疗机构复诊并开具处方发生的诊察费和药品费,可以按照当地医保规定支付。

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。

Reimbursing online medical consulting services

July 23rd, 2020 | by

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,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。

Implementing online medical insurance settlement of prescriptions

May 21st, 2020 | by

On May 20th, the “Opinion on Settling the Price and Medical Insurance Payment of ‘Internet+’ Medical Services” issued by the Healthcare Security Administration of Chongqing province came into effect. The “Opinion” stipulates that for the pilot program of the “Internet+” medical insurance services for common and chronic diseases, doctors can issue electronic prescriptions after online consultations and settle up the medication costs online through medical insurance, and it is allowed to deliver medicines to patients in many ways.

 

线上处方医保支付落地!处方流转迎来新机遇!

来源:医药网  2020.05.21

5月20日,重庆市医疗保障局《关于“互联网+”医疗服务价格和医保支付政策的实施意见》开始实施。《意见》提出,对于正在试点的常见病、慢性病“互联网+”医保服务,患者通过网上问诊后,可由医生开出电子处方,医保在线结算,并且允许通过多种方式为患者进行配送。