Carry out special treatment of oral implant medical service charges and consumables prices

According to the website of the National Medical Insurance Bureau, the National Medical Security Bureau issued the "Notice on Carrying out Special Governance of Oral Implant Medical Service Charges and Consumable Prices", which clearly states that oral implants will be collected, crowns will be auctioned and hung, and dental implant medical services will be regulated, for example, the whole process of price regulation and control of medical services in tertiary public hospitals is 4500 yuan
per tooth 。 Notice of the State Medical Security Bureau on Carrying out Special Governance of Oral Implant Medical Service Charges and Consumables Prices Medical Insurance Fa [2022] No.
27 Medical Security Bureau of Provinces, Autonomous Regions, Municipalities Directly Under the Central Government and Xinjiang Production and Construction Corps: In order to implement the decision-making and deployment of the Party Central Committee and the State Council, ensure that the people have access to high-quality, efficient and affordable toothless restoration services, meet the people's yearning for a better life, and promote the healthy and orderly development of the oral implant industry, in accordance with the joint issuance of the "Nine Ministries and Commissions" In 2022, the requirements of the "Key Points for Correcting Unhealthy Trends in the Field of Pharmaceutical Purchase and Sale and Medical Services" will be carried out, and special management of oral implant prices covering public and private medical institutions
will be carried out.
The relevant work requirements are hereby notified as follows: First, standardize the method of charging oral implant medical services and consumables (1) Orderly promote the "separation of technical consumption" of oral implant medical services
.
Public medical institutions provide oral implant medical services, mainly in the form
of "service items + special consumables" separately priced.
That is, the implant implant fee is calculated separately from the price of the implant consumable system; Crown insertion fees are calculated separately from the price of crown products; The cost of bone graft surgery is calculated separately from the price of bone meal and periosteum
.
For the current situation where consumables are combined into charging in medical service price items, when implementing "separation of technical consumption", the project price
should be reduced simultaneously in accordance with the method of deducting the average price of online procurement of relevant consumables.
(2) Improve the price formation mechanism
of dental crowns.
The Sichuan Provincial Medical Security Bureau organizes bidding for the clinical mainstream all-porcelain crown in the province, and hangs the net according to the transparent price of the sunshine formed by the competition, and the other materials refer to the price of the all-porcelain crown
.
The National Medical Security Bureau guides other provinces to implement price linkage
.
Public medical institutions are independently selected according to clinical needs and sold
according to the "zero difference rate" of the hanging net price.
The price of crowns produced by third-party factories includes the cost of returning to the factory during the implantation process and shall not be charged
to the patient.
Public medical institutions themselves processing and making dental crowns, adopt the "productization" price formation mechanism, based on material costs, processing services, etc.
, according to the appropriate cost recovery rate to determine the price and hang the net, and the price comparison relationship with the bidding net crown is maintained in a reasonable range, the crown production of the mold refinement, scanning design, printing cutting, sintering glazing, coloring and other specific operations as cost factors into the price of the crown of the implant, Patients are no longer charged additionally for specific steps as a price item
for medical services.
(3) Standardize and integrate oral implant price items
.
In accordance with the basic principle of "output orientation", integrate the price items of medical services involved in oral implants
.
Among them, the design, preparation and operation of the first stage implant surgery (implant implantation) and the second stage surgery (placing the healing abutment) are merged into the implant implant project; Crown insertion services, including stamping and retrieval, jaw position relationship recording and transfer, abutment and crown installation, commissioning and modification, etc.
, merged into implant crown insertion projects; Dental implants are supported by bone graft surgery, soft tissue repair, implant repair and removal services, and independent medical service price items
are set up.
For complex implant surgeries such as full arch restoration implants and craniomaxillofacial implants, the difference
in the price of medical services can be reflected.
In order to ensure the accuracy of missing teeth restoration, medical institutions use various examination methods such as medical imaging, digital technology, artificial intelligence, etc.
to build virtual 3D models, make lesion models or surgical guides, and set up corresponding medical service price items
according to service output.
Specific guidelines for the establishment of price projects for oral implant medical services are separately issued
by the National Medical Security Bureau.
Provincial medical security departments should issue documents to regulate the integration of regional price items
by the end of November 2022.
Second, strengthen the price control of medical services such as oral implants (4) Do a good job in price regulation around the whole process of dental implants
.
Medical security departments at all levels should focus on the medical service price of a single conventional implant, in accordance with the "diagnosis and examination + implant implantation + crown insertion" of the medical service price to implement the overall regulation (see the annex for details), the current three-level public medical institutions to complete the whole process of implantation, the overall price of medical services is generally higher than 4500 yuan per area, should take targeted measures, into the overall no more than 4500 yuan per new range, The regulatory targets of public medical institutions below level 3 are correspondingly reduced
with reference to the local policy of hierarchical pricing of medical services.
Encourage areas with the capacity to further adopt measures such as negotiation and consultation, cost supervision and review within the scope of regulatory objectives to reduce prices, and further expand the effect of regulation and control to benefit the masses
.
At present, the overall price of medical services has generally fallen below 4500 yuan per piece in areas, encouraging the maintenance of the current low price
.
Allow economically developed areas with high labor costs to relax the price control targets of medical services according to local realities, and the proportion of relaxation should not exceed 20%; Encourage local medical institutions with high success rates of oral implants to explore targeted and relaxed overall price control policies for oral implant medical services (see annex for details
).
Each provincial medical security department combined with the overall price regulation requirements of medical services, as well as the results of implant collection and crown bidding, combined to formulate and disclose the price control targets of the whole process of implant implants in their respective regions (including implants, crowns and medical services), and take targeted implementation measures
.
(5) Strengthen policy guidance on the price of oral medical services in public medical institutions
.
The cost of implant implantation, crown insertion and bone graft surgery, which has strong reactions from the masses and heavy costs, is mainly
reduced.
Among them, if the government guidance price of public medical institutions is significantly higher than the average price of private medical institutions in the region, it is necessary to adhere to the principle of public welfare, thematic demonstration, and key price reduction; Where there is a large difference between hospitals in the independent pricing of public medical institutions, it is necessary to urge medical institutions with high price order rankings and significantly higher than average to take the initiative to pull back, and give play to the reference and anchoring role
of public medical institutions' public welfare prices on the market.
Projects with high technical difficulty and high risk, such as full arch restoration implants, craniomaxillofacial implants, and complex bone grafts, allow for an appropriate gap
with the price of conventional implant surgery.
The price of medical services for other methods of missing teeth such as fixed dentures and removable dentures remains relatively stable, and medical institutions are encouraged to give priority to providing patients with appropriate missing teeth restoration services
.
Tooth extraction, periodontal cleaning, dental filling and other projects based on technical labor services, the historical price is low can be appropriately increased
.
In areas where the oral implant project of public medical institutions implements government guidance price management, the provincial medical security departments should reformulate and publish the government guidance price
by the end of December 2022.
In areas where independent pricing is implemented, the medical security department shall, in accordance with the price control targets of the whole process of medical services, organize each medical institution to re-announce the price within 1 month of the local release and implementation of the new price project, so as to promote the price level to match the hospital level, professional status, and functional positioning, and regularly release the average level
of the independent pricing of public medical institutions in the region.
(6) Strengthen the supervision and guidance of oral implant prices in
private medical institutions.
The price of services such as oral implants in private medical institutions shall be regulated by the market, and the pricing shall follow the principles of fairness and legality, honesty and credibility, and the consistency of quality and price, and compared with the public medical institutions in the region, formulate reasonable prices that conform to the laws of market competition and the expectations of the masses, take the initiative to publicize prices in obvious areas in accordance with regulations, and ensure the authenticity, timeliness and completeness
of the public information.
Private medical institutions should strictly regulate their own price behavior, and must not use false or misleading "subsidies" and "low prices" and other price means to induce fraudulent patients
.
For private medical institutions in the region with high collection and reporting rate, high utilization rate of selected products, active commitment to accept the whole process of price regulation, outstanding economic advantages of oral implant costs, and high evaluation rankings, the medical security departments at all levels will display the price and cost on the official website, provide guidance for patients to seek medical treatment, and publicly expose
the high price and the use of "introduction fee" and "benefit fee" to buy and sell customer sources.
Third, carefully organize the centralized procurement of implant dental consumables (7) Form an inter-provincial procurement alliance
for implant consumables.
The Sichuan Provincial Medical Security Bureau will take the lead in establishing an inter-provincial procurement alliance for implant dental consumables, and all provinces should participate
.
Dental implant consumables centralized procurement adhere to the basic principle of recruitment and procurement integration, volume and price linkage, in accordance with the general idea of government organization, alliance procurement, platform operation, with a complete set of implant system as a unit (including implants, repair abutments, as well as covering screws, healing abutments, transfer rods, substitutes and other accessories), fully consider the characteristics of dental implant consumables production, supply and clinical use, etc.
, to guide enterprises to compete fairly
.
The specific procurement plan shall be formulated and organized
by the Sichuan Provincial Medical Security Bureau in conjunction with the medical security departments of the alliance provinces.
(8) Extensively mobilize all types of medical institutions at all levels to participate
.
In principle, the number of medical institutions (including private ones) participating in this collection in each co-ordination area should account for more than 40% of the medical institutions carrying out dental implant services, or the proportion of the total reported demand in the region to the total actual use in the previous year should reach more than 50
。 Medical security departments at all levels shall extensively mobilize medical institutions with dental implant service capabilities within their jurisdiction, organize public medical institutions (including military medical institutions) to participate in the centralized procurement of implant consumables, fully mobilize private medical institutions to take the initiative to participate, and the provincial medical security departments where the headquarters of large dental medical service chain groups are located should take the initiative to coordinate the participation of various chain (holding and branch) medical institutions of their groups to participate in the centralized procurement of implants and the implementation of the results
of the selection 。 It is necessary to clarify the policy requirements, mass expectations and social responsibilities of medical institutions to medical institutions, analyze the changing trend of the post-harvest industry pattern and patient medical behavior, emphasize relevant supporting and regulatory measures, etc.
, and guide medical institutions to obtain development opportunities in the same frequency resonance with national advocacy and people's expectations
.
Where doctors of public medical institutions practice in multiple locations in private medical institutions and serve as responsible persons or business backbones, the public medical institutions should supervise their standardized participation in collection
.
Please confirm in writing whether you will participate in this collection
or not.
(9) Truthfully and accurately fill in the purchase demand for
implants.
The provincial medical security departments respectively organized the public and private medical institutions in the province to participate in the collection to fill in the procurement needs of implant consumables
.
The content of the report includes the actual purchase volume of this implant consumable in the previous year, the purchase demand, and the number of dental chairs that provide dental implant services
.
In principle, the demand for filling in is not less than the actual purchase volume of the previous year, and at the same time, the factors of growth in the demand for dental implants are forward-looking, so as to ensure that the quotation is accurate and reasonable, promote the better realization of the price exchange by quantity, and facilitate the selection of enterprises to ensure supply
。 The alliance area may disclose the results of the reporting of each medical institution in the region in an appropriate manner, accept social supervision, and implement a differentiated price policy for public medical institutions that carry out implant services but refuse to report the amount or the reporting rate is less than 80% of the actual use in the previous year, among which, in areas where implant implants and crown implant surgery implement government guidance price management, the actual fees of the above-mentioned public medical institutions shall not exceed 80% of the government guidance price; In areas where self-pricing management is implemented, the actual fees charged by the above-mentioned public medical institutions shall not exceed 80%
of the average self-pricing of public medical institutions in the region.
Fourth, the implementation of oral implant charges comprehensive treatment (10) explore the establishment of oral implant price abnormal warning system
.
All provincial-level medical security departments should establish a warning system for abnormal prices of oral implants in the prefecture and city, and include all types of medical institutions at all levels and types of medical institutions at all levels that have more price complaints and reports, prices that are significantly higher than the local average, refuse or passively participate in implant collection, fabricate facts to detract from the products that participate in centralized procurement and selected products, and do not cooperate with regulatory work to maintain inflated prices, and publish them
on the official website of the local medical security department every quarter.
Medical institutions that have entered the warning list many times during the year shall be centrally notified
by the provincial medical security department.
Where the circumstances are heinous, they are to be uniformly exposed
by the National Medical Security Bureau.
For medical institutions included in the list of abnormal price warnings, comprehensive use of monitoring and early warning, correspondence and interviews, reminders and warnings, cost investigations, information disclosure, public exposure and other regulatory means to promote the formation of a good market order
.
Where it is a public medical institution, it is prudent to treat the declaration matters proposed by them to adjust the price of medical services and the price of new medical services, and when necessary, adopt binding measures
.
(11) Carry out oral implant price investigation and inspection
by the province.
In the launch stage of special governance (August 2022), in accordance with the principle of "horizontal to edge, vertical to vertical, and full coverage", the investigation and registration of oral implant charges and medical service prices will be comprehensively carried out, laying a solid foundation
for standardizing projects and prices and implementing centralized procurement.
Clues to illegal charges discovered during the investigation and registration period shall be promptly investigated and corrected
.
In the implementation stage of special governance (December 2022 to March 2023), medical security departments at all levels focus on monitoring work, pay close attention to the price implementation of oral implant medical services at all levels and types of medical institutions and the actual procurement of consumables such as implants, as well as changes in key indicators such as implant consumables, dental implant surgery prices, and patient average costs, to ensure that the implementation of various governance measures is detailed, and the provincial medical security departments report to the National Medical Security Bureau
with the provincial form 。 In the "looking back" stage of special governance (deployed by the provinces to choose the appropriate time period in the second half of 2023), medical security departments at all levels, together with relevant departments, focus on medical institutions that rank high in the region, have more complaints and reports from the masses, refuse to participate in implant collection or conceal the reported amount, and find that medical institutions repeat charges, price fraud, false publicity and other illegal and irregular clues in the process of inspection, as well as unreasonable and irregular inspection and diagnosis and treatment behaviors in the process of providing oral implant medical services, and promptly report to the competent departments of the industry, Administrative law enforcement departments are notified
.
The National Medical Security Administration will organize supervision and cross-examination in
due course.
(XII) Earnestly perform the responsibility
of pharmaceutical price management in the whole industry.
Medical security departments at all levels should attach great importance to the special treatment of the price and consumables of dentistry and other missing dental restoration medical services, effectively perform the responsibility of pharmaceutical price management in the whole industry, organize special forces, and conscientiously promote the implementation of various measures to achieve full coverage of public and private medical institutions and form a long-term governance effect
。 It is necessary to implement the people-centered governing concept, strengthen the coordination and coordination of price regulation and control of dental implant medical services and centralized procurement of consumables, effectively reduce the inflated prices of dental implant medical services and consumables, reduce the burden of people's costs, and guide medical institutions to develop
healthily through orderly competition such as transparent prices, quality services, standardized management, and good reputation.
First, standardize the procurement of oral implant medical services and consumables charging methods Second, strengthen the price control of oral implants and other medical services Hospitals Third, carefully organize the centralized procurement of implant consumables Fourth, implement the comprehensive management of oral implant charges and health care