According to the provisions of the Notice of the National Health Insurance Bureau on Doing a Good Job in Medical Insurance, the classified payment of medical insurance will be implemented from June 5438+ 10/. According to the different items in the medical insurance catalogue, payments will be made in different categories, such as medicines, examinations and treatments. Specifically, medical insurance pays for drugs according to the principle of "three decisions" (determining the scope, amount and standard of payment), and pays for examination and treatment according to the diagnosis results, required resources, cost sharing and other factors. In addition, the new regulations also clarify that in terms of drug sales in hospitals, hospitals are prohibited from selling drugs beyond the scope of medical insurance funds to patients, and control fees for restricted drugs and high-value consumables. The medical insurance department will also actively promote the combination of diagnosis and treatment programs and payment standards to promote the rational allocation and effective utilization of medical resources.
What is the impact of the new regulations on patients? The new rules of classified payment may have the following effects on patients: First, the prices of medical services such as drugs, examinations and treatments will be more transparent and open, and patients can better understand the source and composition of their medical expenses; Second, the medical insurance department controls the charges of restricted drugs and high-value consumables, which can control the rise of drug prices to a certain extent and reduce the economic burden of patients; Third, the medical insurance payment standard is scientific and reasonable, which promotes the rational allocation of medical resources and improves the quality and efficiency of medical services.
Since 2023, medical insurance has been classified into drugs, examinations and treatments according to the different items in the medical insurance catalogue. In addition, the new regulations also prohibit hospitals from selling drugs beyond the scope of medical insurance fund payment to patients, and control fees for restricted drugs and high-value consumables. The implementation of the new regulations will help to improve the efficiency of medical services and reduce the economic burden of patients, which is another important measure for the reform of China's medical security system.
Legal basis:
Article 23 of the Civil Code of People's Republic of China (PRC) * * * Employees shall participate in the basic medical insurance for employees, and employers and employees shall pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.