The new coronavirus pneumonia diagnosis and treatment program and other provisions of the medical costs, included in the basic health insurance fund to pay the scope of payment, there is no starting line, reimbursement limit, reimbursement rate of uniform 70%.
The basic medical insurance integrated fund settlement service has been opened by the designated medical institutions, temporarily all the new crown infection outpatient settlement; unified use of "new crown outpatient (1102)" medical category, settlement of outpatient costs of the new crown infection. Details ↓ December 29, Anhui Provincial Bureau of Medical Protection, Anhui Provincial Department of Finance, Anhui Provincial Health Commission jointly issued an emergency notice on the new coronavirus infection outpatient treatment and protection work, aimed at going all out to protect the health of the prevention of serious illnesses, the maximum degree of protection of people's lives and health, and do a good job of basic medical insurance for employees, urban and rural residents, basic medical insurance. Participants in the new coronavirus infection (hereinafter referred to as "new coronavirus infection") outpatient treatment and protection work. The notice makes it clear that the outpatient treatment of new coronary infections is unified. Participants in the new crown infection in the integrated area of the general outpatient (emergency) clinic treatment, incurred in line with the new coronavirus pneumonia diagnosis and treatment program and other provisions of the medical costs, into the basic health insurance fund to pay the scope of the integrated fund, without a starting line, reimbursement limit, reimbursement rate of 70% uniformly. At the same time, the cancellation of the fixed-point organization settlement level restrictions. The integrated area has opened the basic health insurance integrated fund settlement service village health clinic (community health service station), township health center (community health service center), first-class hospitals, second-class hospitals, tertiary hospitals and other designated medical institutions, temporary all into the new crown infection outpatient coordinated settlement scope to support the insured persons to obtain outpatient treatment in a timely manner and to protect the treatment. For the settlement of outpatient costs of new crown infection, the notice pointed out that the Anhui Provincial Health Insurance Information Center to optimize the settlement system module of the Anhui Provincial Health Insurance Information Platform, the unified use of the "new crown outpatient (1102)" medical category, settlement of outpatient costs of new crown infection. Each designated medical institution has to select four diagnostic codes for new crown infection through the medical category of "new crown outpatient (1102)" for system settlement. Medical insurance settlement system according to the medical category, disease diagnosis automatically determine the treatment algorithm to realize the network instant settlement reimbursement. Participants in the temporary out of town, visiting relatives and other new crown infections in a different place, or in the temporary does not have the conditions of the network settlement of the designated medical institutions, or due to the transfer of the year to suspend the health insurance settlement system (downtime), or due to network failures and other factors that lead to the site can not be instantly settled, you can take the relevant outpatient expenses to the participant in the local health insurance agency to apply for manual reimbursement. The notice requires that the health insurance to pay the outpatient costs of the new crown infection, not included in the annual basic health insurance general outpatient co-ordination of the total budget scope, from the health insurance current reserved risk fund or the balance of the previous years in the fund, the implementation of a separate statistics, separate settlement. The coordinated areas should be timely settlement of the new crown infection outpatient treatment of the insured persons of the medical insurance funds. Another introduction, the "Notice" implementation period for the date of issuance to March 31, 2023. Hebei Sanhe issued a new coronavirus infected people's health insurance reimbursement policy understand the paper According to the news, Sanhe City Medical Security Bureau on December 11th issued a "new coronavirus infected people's health insurance reimbursement policy understand the paper", a clear employee health insurance outpatient co-ordination of the annual starting standard of 100 yuan, 45 years of age, the co-ordination fund payment ratio of 60%, the annual payment limit of 2,000 yuan; 45 years of age (inclusive), more than 45 years of age, the co-ordination fund payment ratio of 60%, annual payment limit of 2,000 yuan. Above 45 years old (including), the integrated fund payment ratio is 60%, the annual payment limit of 3000 yuan; retirees integrated fund payment ratio is 70%, the annual payment limit of 4000 yuan. Resident medical insurance outpatient reimbursement policy in a year, the insured person in the integrated area of urban and rural residents inpatient qualification of designated medical institutions outpatient medical, outpatient outpatient coordinated annual starting standard for 50 yuan, the integrated fund payment ratio of 50%, the annual payment limit of 60 yuan. 2023 January 1, the cancellation of outpatient outpatient starting line and increase the annual payment limit to 80 yuan / year. In addition, the employee and resident health insurance co-ordination area hospitalization reimbursement also has the corresponding provisions. Details ↓ Fujian Jinjiang: outpatient, hospitalization can be reimbursed According to Jinjiang News Network news, Jinjiang County, Fujian Province, after the infection of the new crown health insurance reimbursement matters issued a notice: outpatient, the insured person in the health insurance designated primary health care institutions, you can enjoy the general outpatient treatment. In the township health center (community health service center), the reimbursement rate of 70%, the maximum payment limit of 420 yuan; in the city's designated village medical institutions, the reimbursement rate of 50%, the maximum payment limit of 50 yuan (a single reimbursement limit of 10 yuan). Hospitalization, in the city outside the province designated medical institutions incurred medical costs of basic medical insurance in the city reimbursement of 80% of the amount of reimbursement, in the province outside the designated medical institutions incurred medical costs of basic medical insurance in the city reimbursement of 60% of the amount of reimbursement. Shandong: new crown symptoms online consultation into the health insurance reimbursement According to the Shandong Provincial Health Protection Bureau website on December 28, Shandong Provincial Health Protection Bureau, Shandong Provincial Health Health Committee recently jointly issued a "new coronavirus infections on the Internet health care service work notice", pointed out that the new crown related symptoms Internet consultation fee into the basic health insurance payment range, and offline The reimbursement policy is consistent. The medical insurance department should settle the payment of "Internet +" medical expenses in a timely manner, strengthen the intelligent audit, and promote the rational and standardized use of medical insurance funds. Beijing: Nematodevir tablets / ritonavir tablets and other 6 drugs temporarily included in the medical insurance In order to cope with the new situation of the epidemic, the Beijing Municipal Bureau of Medical Insurance, with the approval of the State Medical Insurance Bureau, will be cotrimoxazole capsule, cotrimoxazole oral solution, pediatric aminophenol xanthanamins particles, aminocarboxazole capsules, chlorphenesulfamethoxazole tablets, aminoglycosanilide oral solution, the six drugs temporarily included in the city's medical insurance, workers' compensation insurance reimbursement coverage, reimbursement ratio of the proportion of the total amount of the drug, and the amount of the drug, and the proportion of the reimbursement of the total amount of the drug. The reimbursement rate will be in accordance with Class A drugs. Since December 18, 2022, the implementation of the validity period until March 18, 2023. In addition, in order to increase the new crown infection may develop into a serious, critical care patients, recently, Nematodevir tablets / ritonavir tablets have been included in the Beijing health insurance drug reimbursement scope, Beijing community hospitals reimbursement rate of 90%. Shaanxi: 234 kinds of new crown medicines temporarily included in the medical insurance According to "health Shaanxi release" December 22 news, December 21, Shaanxi Provincial Medical Protection Bureau, Shaanxi Provincial Health Health Commission, the State Administration of Taxation Shaanxi Provincial Taxation Bureau of the three units jointly issued the "on the further do a good job in the prevention and control of the current epidemic", "medical security work notice", "on the prevention and control of the current epidemic," the State Administration of Taxation Shaanxi Provincial Taxation Bureau of the State Administration of Taxation. Notice of medical protection work", the confirmed and suspected patients will use "Shaanxi Provincial Health and Health Commission Shaanxi Provincial Administration of Traditional Chinese Medicine on the issuance of Shaanxi Province, the new coronavirus infection Chinese medicine prevention program (third edition) and treatment program (trial fourth edition) of the notice" (Shaanxi Wei Chinese medicine hair 〔2022〕 No. 53) in the recommendation of the 107 kinds of proprietary Chinese medicines and the Provincial Bureau of Pharmaceutical Supervision and Provincial Health and Health Commission to organize the experts selected on the new coronavirus disease Targeted, the therapeutic effect of two types of 127 kinds of drugs temporarily included in the scope of medical insurance payments, medical insurance payments to June 30, 2023, to protect the diagnosed and suspected patients with medication. Hubei: 36 kinds of new coronary drugs temporarily included in the health insurance Hubei Provincial Bureau of Medical Protection December 29 news, approved by the State Medical Protection Bureau, since December 29, 2022, pediatric aminophenol huangnanamin particles, cotrimoxazole syrup and other 36 kinds of new coronary viruses drugs temporarily included in the Hubei Provincial Medical Insurance reimbursement category, reimbursement rate in accordance with the implementation of Category A drugs. Yunnan: 41 drugs have been temporarily included in the health insurance Yunnan Provincial Health Protection Bureau December 30 news, "Yunnan Province, the new coronavirus infected people with medication catalog (trial first edition)" in the "Sang Ju Yin Qiao San" 41 drugs have been temporarily included in the scope of payment of health insurance, according to the management of Class A drugs, to further satisfy the public medical treatment! The new crown infection patients to reduce the burden of costs. Figure for Yunnan Province temporarily into the scope of medical insurance payment of medicines catalog Yunnan Provincial Medical Insurance Bureau for Figure Guangxi: 15 kinds of new crown medicines can brush medical insurance According to the news of Guangxi News Network, in order to further safeguard the masses of medication needs, autonomous region of the Medical Protection Bureau of the external sense of wind cholera particles and other 15 kinds of medicines are temporarily included in the region's basic medical insurance fund to pay for the scope of the drug, according to the reimbursement of medication category A, since December 22, implementation, effective from the beginning of the drug, the drug is not a drug. December 22 implementation, valid until March 22 next year.