In terms of ensuring medical institutions to treat patients, some medical insurance funds are pre-allocated to designated medical institutions in advance.
According to the medical insurance service, agreement implementation and operation of designated medical institutions, all localities will allocate medical insurance funds for designated medical institutions for not less than 2 months in advance, and no kickbacks will be given in 2022; The medical expenses incurred by patients with pneumonia in novel coronavirus in designated medical institutions will be included in the scope of basic medical insurance, serious illness insurance and medical assistance, so as to further reduce the pressure of running errands for insured patients and designated medical institutions.
In terms of improving the accessibility of drugs for the masses: establishing a green procurement channel for epidemic prevention and control drug consumables.
For the drugs (medical consumables) involved in the "Diagnosis and Treatment Plan for Infected Pneumonia in novel coronavirus" formulated by the national health department, a green network channel will be implemented. In line with the policy of hanging the net in the sun, it will be hung with the newspaper and will be used by medical institutions for procurement at the first time. Establish a communication mechanism for key supply enterprises, monitor the procurement and supply of provincial platforms in real time, and ensure the timely distribution of drugs (medical consumables).
In the construction of national immune barrier: do a good job in ensuring the vaccine and vaccination costs in COVID-19.
Do a good job in ensuring the cost of vaccines and vaccination in COVID-19 on a regular basis, timely and fully distribute and prepay COVID-19 vaccine procurement funds, timely and efficiently settle the expenses, fully guarantee the frontline vaccination work, and help accelerate the vaccination work of the elderly in COVID-19.
In the aspect of strengthening medical insurance public service, three convenient measures have been defined, namely, online service, "long prescription" and "internet plus" medical service.
First, smooth all kinds of medical insurance service channels. In view of the new situation of epidemic prevention and control and people's medical insurance demand, we will fully rely on the national medical insurance information system, the Yangtze River Delta "One Network Office" platform, "Jiangsu Medical Insurance Cloud", the local government service platform, 12393 medical insurance service hotline and self-service all-in-one machine to promote all medical insurance services. Further unblock business channels, continue to sort out and simplify service processes, actively guide business through telephone, fax, email, commitment, vacancy tolerance, on-site service, etc., and make every effort to ensure that all kinds of clients such as insured units, insured personnel and designated medical institutions can enjoy efficient and convenient medical insurance services without leaving home.
Second, continue to implement the "long prescription" policy to ensure the drug demand of patients with chronic diseases. Support designated medical institutions to appropriately increase outpatient prescriptions for chronic diseases according to the actual situation of insured patients, and effectively reduce the number of prescriptions of insured people and the number of trips to hospitals. For patients with definite and stable conditions such as hypertension and diabetes, who need to take fixed drugs for a long time according to clinical norms, the single prescription can be relaxed to 3 months after the doctor's evaluation, which can effectively meet the basic drug demand of special groups such as the elderly and outpatients with chronic diseases.
The third is to fully implement the "internet plus" medical service medical insurance payment policy, and support people to seek medical treatment online at home. Encourage qualified designated medical institutions to provide "internet plus" medical services according to the prescribed procedures, and provide outpatient medical services with clear clinical paths, clear technical specifications and remarkable disease diagnosis and treatment effects for patients with common diseases and chronic diseases insured in this district and city. The medical service items of designated medical institutions "internet plus" and offline medical services implement the same catalogue, medical insurance payment categories and payment standards, and do a good job in the settlement and supervision of medical service fees with designated medical institutions "internet plus".