The basic medical insurance catalog is a list that stipulates the payment scope of the basic medical insurance fund to ensure that insured persons can enjoy necessary medical services. The catalog is classified according to the type of medical services, including medical items, drugs, medical equipment, diagnosis and treatment technology, etc. The catalog is dynamically adjusted. Insured persons can check their own reimbursement scope, and medical institutions can determine the reimbursement method based on the catalog. The formulation and implementation of the catalog improve the level of medical security and meet the basic medical needs of the people.
The basic medical insurance catalog refers to a list jointly formulated by the National Health Commission and the Ministry of Finance to stipulate the payment scope of the basic medical insurance fund. It mainly includes medical service items, drugs, medical equipment, diagnosis and treatment technology, etc. that can be paid by the basic medical insurance fund.
The basic medical insurance catalog is formulated to clarify the scope of use of basic medical insurance funds and ensure that insured persons can enjoy reasonable and necessary medical services. The items listed in the catalog have undergone professional evaluation and demonstration, and have certain medical necessity and economic rationality.
Basic medical insurance catalogs are usually classified according to different types of medical services, such as outpatient service, hospitalization, special diseases, etc. In the catalog, each item will have a specific code and description to facilitate inquiry and understanding by medical institutions and insured persons.
The formulation of the basic medical insurance catalog is a dynamic process and will be adjusted and updated according to the development of medical technology and changes in social needs. Insured persons can check the catalog to learn about the reimbursement scope of their medical insurance, and medical institutions can also determine the reimbursement methods and standards for medical services based on the catalog.
In short, the basic medical insurance catalog is an important part of the basic medical insurance system. Its formulation and implementation will help improve the level of medical security and protect the basic medical needs of the people.
The process of formulating and adjusting the basic medical insurance catalog refers to the process organized by relevant departments to formulate and adjust the payment scope and reimbursement standards of basic medical insurance in accordance with relevant national policies and regulations. First, relevant departments will collect and analyze information such as medical service demand, cost levels, and medical technology development to determine the items that need to be included in basic medical insurance. Then, based on this information, a preliminary draft of the medical insurance catalog is developed and publicly solicited comments. Next, relevant departments will organize expert reviews to revise and improve the draft. Finally, with government approval, the basic medical insurance catalog was officially released. During the implementation process, if the content of the catalog needs to be adjusted, the relevant departments will evaluate and adjust it based on the actual situation, and publish it after soliciting opinions again. The purpose of this procedure is to ensure the scientific nature, fairness and adaptability of the basic medical insurance catalog to protect the basic medical needs of the people.
Legal basis:
"Social Insurance Law of the People's Republic of China":
Chapter 3 Basic Medical Insurance
Art. Article 24 The state shall establish and improve a new rural cooperative medical system. The management measures for the new rural cooperative medical system shall be stipulated by the State Council.