Schlagwort: ‘Hospital Management’
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。
Implementing online medical insurance settlement of prescriptions
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。
Zhejiang: restricting the medication costs
On May 11th, the Medical Insurance Bureau of Zhejiang Province issued the “Regulations of DRGs Payment on Hospitalization Expenses of Basic Medical Insurance in Zhejiang Province and Hangzhou.” The “Regulation” clarifies that designated medical institutions can retain 85% of the settlement balance of medical insurance fund while they should pay 85% of the overspending. Moreover, the “Regulation” stipulates that designated medical institutions should restrict the cost of drugs, materials, and diagnosis and treatment services that are paid by inpatients on their own, which should be within 15% of their medical cost.
浙江医保新政策：医院要砍品种了 严控药费
来源：医药网 2020.05.14
5月11日，浙江省医保局印发《浙江省省级及杭州市基本医疗保险住院费用DRGs点数付费实施细则（试行）》。《细则》明确，2020年度医保基金年度结算结余部分的85%由定点医疗机构留用；超支部分的85%由定点医疗机构分担。《细则》要求，定点医疗机构应合理控制住院病人自费的药物、材料和诊疗项目费用，个人政策范围外费用比例原则上应控制在15%以内。
Hospitals and pharmacies should pay the drug cost within 30 working days
On May 12th, the NMPA issued the “Notification on Issuing the List of National Medical Security Management Services.” The “Notification” stipulates that medical institutions including hospitals and pharmacy chains should pay the drug cost for distributors and manufacturers within 30 working days.
国家医保局：定点医院、药店费用结算时限不超过30个工作日
来源：医药网 2020.05.13
5月12日，国家医保局发布《关于印发全国医疗保障经办政务服务事项清单的通知》。《通知》明确，定点医疗机构（含医疗机构、零售药店）费用结算办理时间应不超过30个工作日。
Deepening the reform of the medical and health care system
On February 25th, the State Council issued the “Opinions on Deepening the Reform of the Medical and Health Care System.” The “Opinion” stipulates that medical institutions should improve the management of drug reimbursement lists, medical service protocols, and medicare settlement or increase the efficiency of medicare payment. Besides, the use of medical insurance funds should be strictly supervised, and insurance fraud will be dealt with according to legislation. In addition, the reform of centralized drug procurement should be deepened, and a pricing system that depends on the market should be established. Moreover, medical institutions should improve their service capacity and standardize new medical services, such as consulting over the internet.
关于深化医疗保障制度改革的意见
来源：医药网 2020.03.06
2月25日，国务院发布《关于深化医疗保障制度改革的意见》。《意见》要求，应完善医保目录、协议、结算管理，提升医保支付效率；完善医保基金监管，依法追究欺诈骗保行为；深化药品集中带量采购制度改革，并建立以市场为主导的药品价格形成机制；增强医疗服务能力，规范“互联网+医疗”等新服务模式发展。
Price management in medical institutions
On January 2nd, the National Health Commission issued the “Standard of Price Management in Medical Institutions,” which will come into effect as the date of promulgation. The “Standard” indicates that medical institutions should establish a price management system that is consisted of several departments. Besides, the “Standard” stipulates that medical institutions should make several staffs supervise the medical costs and adjust unreasonable charges. Besides, medical institutions should establish a system that can analyze and manage the medical service cost and make the costs of common medical services public.
国家卫健委：医疗机构内部价格行为管理规定
来源：医药网 2020.01.06
1月2日，国家卫健委发布《医疗机构内部价格行为管理规定》，并将自发布之日起施行。《规定》提出，各医疗机构应到建立由多部门组成的价格管理体系。《规定》要求，医疗机构应配备一定数量医疗服务价格工作人员，用于定期检查患者花费，纠正医院不规范收费；各医疗机构应建立医疗服务成本测算和成本控制管理制度，同时公示常用医疗服务项目的价格。
A national drug use supervision platform is launched
The National Health Commission announced that a national drug use supervision platform is launched, which can provide data to support healthcare administrations to supervise and analyse the drug use. 8840 medical institutions have registered on the platform.
国家药品使用监测平台上线运行 8000多家医院已登陆
来源：医药网 2019.12.11
国家卫健委统计信息中心今日发布消息，国家药品使用监测平台正式上线运行。目前，已有8840家医疗卫生机构完成系统登录。卫健委表示，“国家药品使用监测平台”将为各级卫生健康药政管理部门开展药品配备使用情况监测分析提供数据支撑。
Supervising drug use in public hospitals in Inner Mongolia
On November 18th, the office of the Inner Mongolia Health Commission issued the “Notification on Implementing the Test and Analysis of Drug Use in Public Health Institutions.” The “Notification” stipulates that Inner Mongolia will select all the Tertiary, 50% of the Secondary, and 10% of the Primary medical insurance to analyse the drug use according to the stipulation of the National Health Commission. Therefore, the safety, effectiveness, and property rights of drug use will be comprehensively evaluated.
内蒙古卫健委发文：监测公立医院药品使用
来源：医药网 2019.11.21
11月18日，内蒙古自治区卫健委办公室发布《关于开展公立医疗卫生机构药品使用检测分析工作的通知》（以下简称《通知》）。《通知》提出，内蒙古将按照国家卫建委的相关要求，选取所有三级公立医疗卫生机构、50%二级公立医疗卫生机构以及10%基层公立医疗机构开展药品使用监测分析，由此对药品临床使用的安全性、有效性、经济性等开展综合评价。
Standardising DRG (Diagnosis Related Groups) payment
On October 23rd, the National Medical Insurance Bureau issued the “Notification on Technical Specifications and Grouping Plans of Pilot Works of DRG Payment” including the “Technical Specifications of DRG Grouping and Payment” and “Grouping Plans of DRG(CHS-DRG) Payment.” The “Notification” stipulated that because the CHS-DRG covers nearly all treatments of diseases, it will become the only standard for DRG payment implemented by the National Medical Insurance. In addition, pilot cities of DRG payment should execute the “Grouping Plan” and formulate local subdivided DRGs according to the unified guidelines of grouping and the actual situation of each city.
国家医保局发文 DRG付费标准正式走向统一
来源： 医药网 2019.10.25
10月23日，国家医保局正式公布《关于疾病诊断相关分组（DRG）付费国家试点技术规范和分组方案的通知》，包含《国家医疗保障DRG分组与付费技术规范》和《国家医疗保障DRG（CHS-DRG）分组方案》。《通知》指出，CHS-DRG可基本实现疾病治疗全覆盖，将成为全国医保部门实行DRG付费的唯一标准；各试点城市应严格执行《分组方案》，按照统一的分组操作指南，并结合各地实际情况制定本地的细分DRG分组。
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。