Schlagwort: ‘Reimbursement’
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。
The “One Invoice Policy” will be implemented
On March 5th, the State Council issued a document on reforming the medical and health care system. The document indicates that a regional and a national allied procurement system should be implemented to realize an orderly drug supply system with reasonable prices and competition; medical insurance agencies should deal with the settlement payment directly with manufacturers or pharmaceutical companies. Besides, provincial centralized procurement platforms that are based on medical insurance payment should be established, which combines bidding, procurement, trading, settlement, and supervision.
国务院：推行一票制 经销商结款方式要变了
来源：医药网 2020.03.09
3月5日，国务院官网发布医疗保障制度改革文件。文件提出，将推进构建区域型、全国性联盟采购机制，形成竞争充分、价格合理、规范有序的供应保障体系；推进由医保经办机构直接与药品生产或流通企业结算货款；应以医保支付为基础，建立招标、采购、交易、结算、监督一体化的省级招标采购平台。
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。
97 negotiations targeted drugs will be published on the internet (National Negotiation)
On December 16th, the NHSA and the National Health Commission jointly issued the “Notification on Ensuring the Usage and Supply of Drugs that are Targeted in the National Negotiation.” The “Notification” stipulated that provincial healthcare security administrations should publish the 97 negotiations targeted drugs on their centralized procurement platform and their new reimbursement drug lists. Besides, healthcare departments should regulate the usage and supply of these drugs and instruct medical institutions to reserve and use them properly according to functions, clinical requirements, and healing effects.
两部门发文：97个国家谈判药品按时直接挂网
来源：医药网 2019.12.18
12月16日，国家医保局、国家卫健委联合发布《关于做好2019年国家医保谈判药品落地工作的通知》。《通知》要求，各省级医保部门应在规定时限内将97个谈判药品在省级药品集中采购平台上直接挂网，并保证新版目录及时落地。此外，各地医保和卫生部门应对谈判药品的配备及使用等方面提出具体要求，并指导各定点医疗机构根据功能定位、临床需求、和诊疗能力等即时配备、合理使用。
The National Medical Insurance Bureau issued new regulations
On August 30th, the National Medical Insurance Bureau issued the “Guidelines of Improving the price management of the ‘Internet+’ Medical Services and the Policies of Medical Insurance Payment.” The “Guidelines” proposed that the price management of the “Internet+” medical services should be included in the policy system of general medical services to realise a unified regulation. The eligible “Internet+” medial services will be regulated under proper medical insurance payment policies in accordance with the principle of online and offline consistency, and its management of medical insurance agreement(Every citizen contracts with a specific hospital) and the settlement process should be improved.
国家医保局公布新规，影响所有医药人
来源：医药网 2019.09.02
8月30日，国家医保局发布《关于完善“互联网+”医疗服务价格和医保支付政策的指导意见》（以下简称《指导意见》）。《指导意见》提出，应将“互联网+”医疗服务价格纳入先行医疗服务价格的政策体系统一管理；符合条件的“互联网+”医疗服务，按照线上线下公平的原则配套医保支付政策，并根据服务特点完善协议管理、结算流程。
The Xi’an Municipal Government launches the submission of increased purchase of selected drugs(“4+7”)
On August 6th, the Xi’an Municipal Government issued the “Notification on Launching the Submission of Increased Purchase of Selected Drugs in Xi’an from the ‘Office of the Leading Group for the Implementation of Centralized Drug Procurement and Pilot Work’”. It is decided to increase the purchase of selected drugs in Xi’an because its procurement exceeds expectations. Besides, the deferred payment of the increased procurement should be paid in time.
“4+7″采购量完成超预期，启动中选药品增加采购量报送
来源：医药网 2019.08.07
8月6日，西安市发布《落实国家组织药品集中采购和试点工作领导小组办公室关于启动西安地区中选药品增加采购量报送工作的通知》。因西安地区”4+7″准备采购量完成情况已经超过预期，经研究，决定启动西安地区中选药品增加采购量报送工作。同时，对于增加的采购量，应确保及时回款。
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。
Medical insurance designated pharmacies will be incorporated in provincial centralized drug procurement
On May 15th, the Shandong provincial drug purchasing website released a document of “Opinions on the trial implementation of centralized online drug procurement by private pharmaceutical institutions.” The “Opinion” stipulates that private hospitals and chain pharmacies which are managed by the Medical Insurance Protocol should purchase drugs online through the centralized procurement platform of Shandong province, with the total purchase amount not less than 60% of the original usage. The “Opinion” will be implemented on July 1st.
重磅！医保定点药店纳入省级药品集采
来源：新浪医药新闻 2019.05.17
5月15日，山东省药品采购网发布文件《关于民营医药机构试行网上药品集中采购的意见》（以下简称《意见》）。《意见》要求，医疗保险协议管理的民营医院、连锁零售药店，应通过山东省药品集中采购平台网上采购药品，采购总量不低于原使用量的60%。据悉，《意见》将于7月1日开始执行。
The pilot program of national organized centralized procurement and use of drugs is officially released
On January 17th, the General Office of the State Council officially issued the “Notification of National Organized Pivot Program for the Centralized Procurement and Use of Drugs.” The “Notification” clarified that the purchase way for each selected drug depends on the number of its production enterprises. The “Notification” stipulated that the advance payment should not be less than 30% of the purchase amount and the total purchase quantity should account for 60%-70% of the full annual drug use of public medical institutions. The centralized procurement this time will be implemented in early 2019 with one year.
国家药品集中采购和使用试点方案正式发布
来源：制药网 2019.01.18
核心提示：1月17日，国务院办公厅正式发布《国家组织药品集中采购和使用试点方案的通知》。《通知》明确，应根据每种药品入围的生产企业数量分别采取相应的集中采购方式。《通知》要求，预付金额不得低于采购金额的30%；采购总量应占公立医疗机构年度药品总用量的60%-70%。本次集中采购将于2019年初开始实施，周期为一年。
Anhui: the procurement and use of traditional Chinese medicine products is encouraged
Recently, the Anhui General Office of the People’s Government issued the “Implementation Opinion on improving the National Essential Medicine System”. The “Implementation Opinion” proposed that medical institutions should give priority to the procurement and use of essential drugs that pass the Quality Consistency Evaluation of drugs and are affordable. Some kind of High-priced and high-dose drugs should be purchased with defined quantities. The use of traditional Chinese medicine products is encouraged to support the development of Chinese medicine.
安徽发布基药新政：鼓励采购使用中药产品
来源：医药网 2019.01.14
核心提示：日前，安徽省人民政府办公厅出台《完善国家基本药物制度的实施意见》（以下简称《实施意见》）。《实施意见》提出，医疗机构应优先采购和使用通过一致性评价、价格适宜的基本药物；应对价格高、用量大的药品实施单品种带量采购；鼓励采购使用中药产品，支持中医药事业发展。