Schlagwort: ‘Reimbursement’
The first detailed document for “procurement of drugs(“4+7”)” is released
Recently, Dalian city issued the “Implementation of a National Organised Work plan for centralized Procurement and Use of drugs (consultation paper).” The “Paper” stipulated that public medical institutions should sign a contract with the pharmaceutical production enterprises for the procurement of drugs with defined purchasing quantities and settle the payment of drugs promptly. Medical institutions should run out the contract amount within one year under the premise of ensuring the priority use of the selected drugs. The staff in medical institutions which do not use the drugs as required will be treated seriously by the relevant provisions. The Paper also clarified that the quality and use of selected drugs should be intensively monitored.
“4+7”带量采购，头一份细则文件来了！
来源：制药网 2019.01.11
核心提示：日前，大连市发布《贯彻落实国家组织药品集中采购和使用工作方案（征求意见稿）》。意见稿要求，公立医疗机构与药品生产企业应签订带量采购合同并及时结算药款，在确保中选药品优先使用的前提下，一年内完成合同用量；不按规定使用药品的医务人员，按照相应条款严肃处理。意见稿明确，应重点监测中选药品的质量和使用情况。
Shanghai: Complementary Document for procurement of drugs is released(“4+7”)
On November 22nd, Shanghai Pharmaceutical Centralized Bidding and Purchasing Management Office published “Complementary Document for centralized procurement of drugs in 4 municipalities and 7 other big cities (in Shanghai area)”. The “Complementary Document” stipulates that all medical insurance designated medical institutions should give priority to purchasing and using selected drugs in centralized procurement in 4 municipalities and 7 other big cities and the usage amount should be equivalent to last year. Meanwhile, medical institutions can continue to purchase and use unselected drugs under the premise of ensuring the amount of selected drugs, but the amount should not exceed the selected variety after being converted into proportion.
上海：4+7带量采购补充文件发布
来源：制药站 2018.11.22
核心提示：11月22日，上海市医药集中招标采购事务管理所发布《4+7城市药品集中采购上海地区补充文件》（以下简称《补充文件》）。《补充文件》要求，所有医保定点医疗机构应优先采购和使用4+7城市集中采购中选药品，使用量应与上一年度水平相当。同时，医疗机构可以在保证中选用品用量的前提下，继续采购并使用未中选药品，但数量按比例关系折算后不得超过中选品种。
Anhui: The 2018 version of the medical insurance catalog is released
Recently, Anhui Human Resources and Social Security issued the “Medicine Catalogue of Basic Medical Insurance, Work Injury Insurance, and Maternity Insurance in Anhui Province(2018 version)”, which will be implemented from July, 1st, 2018. The catalog includes 1481 western medicines and 1356 Chinese patent medicines. Anhui Human Resources and Social Security indicates that Anhui Province will use the unified “Drug Catalog” database. The drugs on the catalog will be coded according to the “Social Insurance Drug Classification Code”, which will be confirmed by the provincial medical insurance administrative department.
安徽：2018版医保目录出炉
来源：中国医药报 2018.05.29
核心提示：日前，安徽省人社厅发布《安徽省基本医疗保险、工伤保险和生育保险药品目录2018年版》，将于7月1日起执行。该目录包括西药1481个，中成药1356个。安徽省人社厅表示，安徽省将使用统一的《药品目录》数据库，并按照《社会保险药品分类代码》对目录药品进行对码，由省级医保行政部门进行确认。
Shenzheng social security cards can be used at 307 hospitals in Guangzhou
Recently, the direct settlement platform for hospitalizing in Guangdong was expanded again. On the 21st February, already 354 medical institutions participate, including 47 hospitals in Shenzheng and 307 hospitals in other regions in Guangdong. All participants of Shenzheng basic health insurance can directly use the social security card for reimbursement when hospitalizing in the province of Guangdong. Then it is not necessary to come back to Shenzhen for the reimbursement. (Source: people.cn)
广东307家医院可直接刷深圳社保卡
来源：人民网 2017-02-28
核心提示：广东省异地就医直接结算平台近期再次扩容。截至2月21日，已有354家医疗机构加入，包括深圳本地医院47家、市外异地医院307家。只要是参加深圳基本医疗保险的参保人，在省内异地住院时，均可在307家医院直接刷社保卡记账报销住院费用，不必返回深圳社保局报销。
New national reimbursement drug list comes out – changes in 376 varieties
On 23rd February, Ministry of Human Resources and Social Security published the new national reimbursement drug list (Version 2017) for the national basis health insurance, occupational insurance and maternity insurance. (Source: Chinamsr)
新版医保目录正式出台！376品种有变
来源：中国医药联盟 2017-02-24
核心提示：2月23日，人社部网站发布《关于印发<国家基本医疗保险、工伤保险和生育保险药品目录（2017年版）>的通知》，公布了2017年版国家基本医疗保险、工伤保险和生育保险药品目录。
Paying by insurance card is suspended at 19 pharmacies in Xi’an due to the fraud
Recently, the social security center of the Xi’an Human Resources and Social Security Bureau carried out the inspection at health-insurance-designated retail pharmacies. In the inspection, it has been found out that in some pharmacies, it was possible to buy household items paying by health insurance cards. According to relevant rules, 19 pharmacies with the fraud are punished with suspension of their businesses. (Source: cnwest.com)
西安市19家药店因违规被暂停医保卡刷卡业务
来源：西部网 2017-02-16
核心提示：近期,西安市人社局社保中心在对部分城镇职工基本医疗保险定点零售药店进行检查时,发现个别定点零售药店存在使用西安市医疗保险卡刷售生活用品等问题。根据相关规定,决定对存在违规行为的19家定点药店进行处罚,暂停执行定点医疗服务协议、暂停医保刷卡业务、扣除质量保证金、责令整改。
The State Council: accelerating to build up a direct settlement mechanism for hospitalizing in other regions
The State Council recently published the plan of deepening the health reform in the 13th Five-Year. The plan requires building up a national health insurance system, which can work efficiently. The direct settlement mechanism for hospitalizing in other regions should be accelerated to build up. The basic health insurance should be promoted to connect nationwide. The cooperation between the regions of participating health insurance and the regions of hospitalizing should be strengthened, so that people do not need to shuttle or pay in advance. (Source: China News)
国务院：加快建立异地就医直接结算机制
来源：中国新闻网 2017-01-10
核心提示：国务院近日印发《“十三五”深化医药卫生体制改革规划》。《规划》要求，建立高效运行的全民医疗保障制度，加快建立异地就医直接结算机制，推进基本医保全国联网和异地就医直接结算，加强参保地与就医地协作，方便群众结算，减少群众“跑腿”、“垫资”。
Unified management of physicians according to codes in Fujian
On 11th November, Fujian Medical Security Management Committee published an announcement about the unified management of physicians according to codes. At the moment the codes of local physicians are being collected by medical security agencies in Fujian. After a review, the codes will be recorded in the physician database for the whole province of Fujian. This work is planned to be done by 31th December. After all codes will be recorded in the database, every unreasonable medical expense can be traced to the physician, so that the overall process management of medical treatments of doctors becomes possible. (Source: the 21th Century Economic Report)
福建医师代码统一管理 不合理医药费用责任追踪到个人
来源：21世纪经济报道 2016-11-15
核心提示：福建省医疗保障管理委员会办公室于本月11日正式发布《关于做好全省统一医保医师代码管理的通知》。现阶段福建省内各设区市医保经办机构正采集、汇总和审核本地区医保医师代码，审核通过的代码将录入全省医保医师代码库。相关工作将于12月31日前后结束。所有代码入库后，将全面实现每一笔不合理医药费用追踪到个人，进而实现对医生医疗行为的“事前、事中、事后”全过程管理。
Health reform in Fujian: “Three in one”– to break the profit chain
Recently, Fujian Institutional Organization Commission published an announcement concerning the medical security management system in municipalities. All municipalities are required to integrate municipal medical security institutions including their functions. The establishment of medical security authority should speed up. The management system of medical security should be straightened up, and the management responsibilities should be gathered. It is said that before the end of November, municipal medical security authorities should be set up in Fujian, and take charge of the businesses of health insurance, medical assistance and etc. Those businesses used to pertain to Ministry of Human Resources and Social Security, Health and Family Planning Commission and other departments. (Source: The Time Weekly)
福建医改探路三医合一：拧成一股绳，斩断利益链
来源：时代周报 2016-11-8
核心提示：日前，福建省委机构编制委员会下发《关于设区市医保管理体制问题的意见》，要求各设区市整合市级医保机构和职能，加快成立市医疗保障管理局，理顺医疗保障管理体制，归拢管理职责。据悉，全省所有设区市本月底前将设立市级医疗保障管理局，统一管理原属于人社、卫计、物价和民政等部门管理的医疗保险、医疗救助等事务。
The health insurances for urban and rural residents will be integrated comprehensively in 2017
Recently, the General Office of the government of Henan Province published the implementation opinions about the integration of basic health insurance systems for urban and rural residents. From next year, a unified health insurance system for urban and rural residents will be implemented in Henan Province. More than 80 million rural residents will have the same health insurance treatment as 11 million urban residents. (Source: Xinhua News Agency)
2017年河南将全面实现城乡居民医保“并轨”
来源：新华社 2016-10-25
核心提示：近日，河南省政府办公厅日前下发《关于整合城乡居民基本医疗保险制度的实施意见》。从明年起，河南省将全面实施统一的城乡居民医保制度，全省8000多万农村居民将与1100多万城镇居民一样，平等享受城乡居民医疗保障待遇。