Reimbursement of hospitalization expenses for patients with novel coronavirus

January 7, the National Health Protection Bureau website released "National Health Insurance Bureau Ministry of Finance National Health and Health Commission National Bureau of Disease Control on the implementation of the" Class B B tube "after the optimization of new coronavirus infected patients with treatment costs of medical insurance related policies", the full text of the notice is as follows:

January 7, the National Medical Protection Bureau website The interpretation of the policy of optimizing the medical insurance related to the treatment costs of patients with new coronavirus infections after the implementation of "Type B B tube" was released, and the full text of the interpretation is as follows:

The interpretation of the policy of optimizing the medical insurance related to the treatment costs of patients with new coronavirus infections after the implementation of "Type B B tube" was released on the website of the State Medical Insurance Bureau.

In order to implement the decision-making and deployment of the CPC Central Committee and the State Council, and to smoothly and orderly implement the new coronavirus infection "B type B tube", the State Council to deal with the new coronavirus infection epidemic joint prevention and joint control mechanism comprehensive group has issued the "on the implementation of the new coronavirus infection". The State Council's Comprehensive Group on Joint Prevention and Control Mechanisms for Novel Coronavirus Infections has successively issued the "Overall Program on the Implementation of Type B B Control" and supporting programs. In order to do a good job of medical protection for the treatment costs of patients with novel coronavirus infections after the implementation of "Type B B control" for novel coronavirus infections, the NHA, the Ministry of Finance, the NHSC, and the NCDC have jointly issued the "General Plan on the Implementation of Type B B Control" and its supporting programs. Optimize the new coronary virus infection patients treatment costs of medical insurance related policy notice", the relevant policies since the new coronary virus infection (referred to as "new coronary") implementation of the "Class B B tube" date of implementation, is now the main content of the following explanation.

First, on the new coronary patients hospitalization treatment cost protection

In order to protect the new coronary patients do not affect the treatment of hospitalization costs, the document provides for the continuation of the hospitalized new coronary patients "Category B, A" when the policy, the new coronary patients hospitalization costs are fully covered. The hospitalization medical expenses incurred by new coronary patients in all receiving medical institutions, which are in line with the new coronary virus infection diagnosis and treatment plan formulated by the health department, will be paid for by the basic medical insurance, major disease insurance and medical aid in accordance with the regulations, and the part of the individual's burden will be subsidized by the financial sector. The policy to the new coronary patients admitted to the hospital time calculation, the first implementation until March 31, 2023.

Second, on the new crown patients outpatient emergency treatment cost protection

In order to ensure that the new crown patients in the early stages of infection can receive timely medical services, the document requires the implementation of special guarantees to improve the level of reimbursement of outpatient emergency patients in the primary health insurance designated health care institutions (second-level and the following health care institutions) to treat the new crown. The document calls for the implementation of special guarantees to increase the level of reimbursement for new coronavirus treatment in primary health insurance designated medical institutions (second-tier and lower medical institutions) for insured patients with new coronavirus infections and suspected symptoms. Outpatient and emergency expenses related to the treatment of novel coronavirus infection (within the scope of the medical insurance catalog) incurred by the insured patients at the designated medical institutions of the primary medical insurance shall, in principle, be reimbursed at a rate of not less than 70% without any starting or ceiling line. The specific regulations will be determined by the local medical insurance departments and financial departments according to the operation of the medical insurance fund, and will be implemented until March 31, 2023 first. The insured patients in other medical institutions in the new crown outpatient emergency treatment costs, in accordance with other Class B infectious diseases health insurance reimbursement policy, the inclusion of medical insurance coverage and drug costs, should be reported as much as possible.

Third, on the new crown patients medication security

In order to adapt to the current situation of the epidemic, to meet the needs of the new crown patients medication, the decision to temporarily expand the health insurance drug list, the first implementation until March 31, 2023. The current version of the national health insurance drug catalog has 660 kinds of drugs for the treatment of fever, cough and other symptoms of the new crown, on this basis, the new coronary virus infection diagnosis and treatment program contains the new crown treatment drugs also implement the temporary payment policy of health insurance. The local medical insurance department of the drug is still insufficient to refer to the provincial joint prevention and control mechanism recognized by the new coronavirus infection treatment drug list, combined with the operation of the medical insurance fund, can temporarily expand the medical insurance drug list.

Fourth, on the new coronary patients online diagnosis and treatment

In order to ensure that the new coronary patients can be treated in a timely manner, the document requires a good "Internet +" health insurance services to help new coronary patients online diagnosis and treatment. Requirements of the local health department to timely publish the list of medical institutions to provide "Internet +" medical services, for the industry sector permitted for the new coronary virus infection to open the Internet first diagnosis service, according to the provisions for the emergence of the new coronary virus infection related symptoms, in line with the "new coronary virus infected home treatment guidelines" of the new coronary patient Provide medical insurance mobile payment and settlement services, and the medical insurance departments of various regions can support the pricing policy for medical services of the first Internet consultation in accordance with the principle of consistency between online and offline, and the reimbursement standard is consistent with that of offline. New crown-related symptoms of follow-up services, still in accordance with the current Internet follow-up reimbursement policy.

V. On reducing the cost of new crown treatment to enhance the ability to protect health insurance

The document requires the improvement of the price formation mechanism, continue to do a good job in the treatment of patients with new crowns, such as price negotiation or negotiation of medicines, centralized purchasing, purchasing on the network, the record of purchases, price monitoring, etc., to reduce the cost of treatment of patients with new crowns. Provincial medical insurance departments should combine the actual operation of the local medical insurance fund, promote the implementation of the policy in a coordinated manner, and scientifically determine the scope and level of protection, not only to reasonably reduce the burden on the public, but also to ensure the safety and sustainability of the medical insurance fund. On this basis, the medical insurance fund does appear to be unable to cover the expenses of the integrated area, can be given appropriate subsidies by the local financial. In due course to promote the provincial fund transfer.

Six, on the management of health insurance services

The document requires the optimization of the health insurance process, to provide convenient health insurance services. Continue to do a good job of health insurance services, the implementation of long-term prescription health insurance payment policy, the implementation of health insurance handling routine matters online, emergency matters in time to do, special matters to do, non-urgent matters to do the extension of the Office of the elimination of hidden problems at ease to do. According to the needs of each region, signing the "Temporary Special Agreement on Settlement of Medical Insurance Expenses for Medical Institutions Admitting and Treating Patients with New Coronavirus Infections" with non-Medicare designated medical institutions with new coronavirus treatment capacity, guiding various medical institutions to do a good job of collecting and uploading information related to diagnosis and settlement of new coronavirus infections, and settlement of medical insurance expenses. Give full play to the handling of power, promote the sinking of services, handling agencies at all levels to do a good job of participating in publicity and mobilization of handling services at the same time, in conjunction with the relevant departments to do a good job in rural areas, urban communities, health promotion, popularization of knowledge of the epidemic prevention and control, and improve the masses of self-protection awareness, and effectively do the management of health insurance management is not relaxed, health care management services are uninterrupted.

VII, on the responsibilities of the relevant departments

The implementation of the new coronavirus infection "B B tube", is the CPC Central Committee, the State Council in a comprehensive assessment of the virus mutation, the epidemic situation and the prevention and control of China's work on the basis of a major decision. The document requires the strengthening of departmental coordination and linkage, the relevant departments around the world to raise the political position, and effectively fulfill their responsibilities to ensure that the policy is effective. The medical insurance department is responsible for the audit of the relevant costs, settlement work, strengthen the supervision of the fund; the financial sector is responsible for the timely disbursement of financial subsidies; the health sector is responsible for guiding medical institutions to do a good job in the identification of patients with new crowns, registration and uploading of information; the CDC department is responsible for the uploading of new crowns of patients' information and data. Strengthen the coordination and linkage, to ensure that the Party Central Committee and the State Council decision-making and deployment in place without compromise.