Categories
Pages
-

SmartMedCN

Schlagwort: ‘Reimbursement’

NMPA: encouraging the reimbursement of payments incurred at designated retail pharmacies by medical insurance

February 17th, 2023 | by

On February 15th, the NMPA published a “Notification on Reimbursement of Payments incurred at Designated Retail Pharmacies by Medical Insurance companies.” The Notification states that the integrated fund will pay the costs incurred by insured persons when purchasing drugs that are included in the national reimbursement drug list at designated retail pharmacies based on prescriptions from designated medical institutions. The Notification clarifies that the implementation of the electronic prescription center should be accelerated by relying on the national unified health insurance information platform to achieve a smooth flow of electronic prescriptions from designated medical institutions to designated retail pharmacies. The designated medical institutions can issue long-term prescriptions for eligible patients for up to 12 weeks.

国家医保局:支持定点零售药店开通门诊统筹服务

来源:医药网  2023.02.17

2月15日,国家医保局印发《关于进一步做好定点零售药店纳入门诊统筹管理的通知》。《通知》明确参保人员凭定点医疗机构处方在定点零售药店购买医保目录内药品发生的费用可由统筹基金按规定支付。《通知》明确要依托全国统一的医保信息平台,加快医保电子处方中心落地应用,实现定点医疗机构电子处方顺畅流转到定点零售药店。定点医疗机构可为符合条件的患者开具长期处方,最长可开具12周。

Shandong: Using medical insurance to purchase drugs online

December 29th, 2021 | by

Recently, the first batch of designated pharmacy branches in Shandong began offering “Buying Drugs Through Medical Insurance” service in Alipay. An insured person can use Alipay to search for “Buying Drugs Through Medical Insurance,” select drugs or pharmacy branches marked “Available to Reimbursement,” and then pay for their drugs online using their medical insurance. Ele.me will deliver drugs in a short period of time following a successful payment.

外卖购药,可以刷医保卡啦!

来源:大众日报  2021.12.29

近期,山东省首批试点定点零售药店在支付宝开通“医保买药”服务。参保市民可通过支付宝搜索“医保买药”,选择有“医保支付”标识的品种或药店下单,在线医保支付。支付成功后,由“饿了么”平台提供即时配送服务。

“Dual-Channel Policy” for Medicines under National Medical Insurance Negotiation

May 11th, 2021 | by

Recently, the NMPA and the National Health Commission jointly issued the “Opinions on Establishing and Improving Dual-Channel Management Mechanisms for Medicines under National Medical Insurance Negotiation”. According to the “Opinions”, the reasonable usage of these reimbursed drugs, such as supply and clinical use, will be met through two channels, namely designated medical institutions and designated retail pharmacies, with drug payment covered by the medical insurance payment mechanism. Eligible designated retailed pharmacies should be connected to the Medical Insurance Information Platform and the Electronic Prescription Sharing Platform, and a compliant storage and distribution system should be established to ensure drug safety.

医保药品可“双通道”购买

来源:中华人民共和国中央人民政府  2021.05.11

近期,国家医保局会同国家卫健委出台了《关于建立完善国家医保谈判药品“双通道”管理机制的指导意见》。《意见》提出,将通过定点医疗机构和定点零售药店两个渠道满足医保谈判药品供应保障、临床使用等方面的合理需求,并同步纳入医保支付;符合纳入“双通道”管理的定点零售药店要与医保信息平台、电子处方流转平台等对接,并建立符合要求的储存、配送体系,确保药品质量安全。

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

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 NMPA: Internet hospitals can get reimbursement

January 3rd, 2021 | by

On January 11th, the NMPA issued the “Interim Measures for the Administration of Designated Pharmacy Chains regarding Basic Medical Insurance” and the “Interim Measures for the Administration of Designated Medical Institutions regarding Basic Medical Insurance”, which will be implemented from February 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 pharmacy chains can sell prescription 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。

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。

Pharmacy chains can only rise the price of drug in the reimbursement list by 15%

September 3rd, 2020 | by

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%

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。