From next year!

On January 1, 2022, Zhejiang formally implemented the "Specified Evaluation Rules for Medical Insurance Designated Retail Pharmacies", making it more difficult to approve medical insurance designated pharmacies

New evaluation criteria for designated pharmacies, to be implemented on January 1, 2022

Recently, the Zhejiang Medical Insurance Bureau issued the "Detailed Rules for the Determination and Evaluation of Medical Security Designated Retail Pharmacies" (hereinafter referred to as the "Detailed Rules") to strengthen and standardize the determination of medical security for retail pharmacies, encourage and guide various retail pharmacies to participate in fair competition, and It will be officially implemented on January 1, 2022

Rules to determine the designated retail pharmacies for the process, including: the development plan, issued a notice to accept the application, review materials, organizational assessment, results of the public, contract preparation, agreement and so on

Regarding the application requirements for designated retail pharmacies, the detailed rules emphasize that pharmacies must officially operate at the registered address for at least 3 months and have at least one pharmacist who has obtained a licensed pharmacist qualification certificate or a professional technical qualification certificate in pharmacy, clinical pharmacy, and Chinese pharmacy, and The registered place is in the retail pharmacy, and the pharmacist must sign a labor contract of 1 year or more and within the contract period

In addition, if the relevant designated medical institutions of the same legal entity (investment subject) have been suspended, cancelled or terminated medical insurance agreements within 1 year due to violations of regulations, and are undergoing investigation and processing by the agency, applications for designated retail pharmacies will not be accepted

It is worth noting that the detailed rules have formulated the "Evaluation Form for Medical Security Designated Retail Pharmacies" (hereinafter referred to as the "Evaluation Form") to score retail pharmacies, and municipal agencies can make adjustments to local conditions based on the "Evaluation Form"

The total score of the evaluation index is 150 points, and 120 is divided into the qualified line

According to detailed information, designated pharmacies have a total of 26 evaluation items, including 10 basic indicators and 16 evaluation indicators

The evaluation index adopts a scoring system, and the total score of 16 evaluation indexes is 150 points.

It is worth mentioning that pharmacies with an area of ​​more than 120 square meters, those with a distance of more than 1,000 meters from similar designated retail pharmacies, and those that do not sell non-medicinal products can be used as additional points for evaluation indicators

Implementation of detailed rules makes it more and more difficult for designated pharmacies to approve

If the rules are implemented, what impact will the drug store have? Huang Changjiang, a senior practitioner of Zhejiang chain pharmacy, told Cyblan-pharmacy manager that once the rules are implemented, the management of designated pharmacies will be more challenging, and the supervision will definitely be stricter

"At the current pharmacy in my area, it is very difficult to complete the basic items and guarantee no deductions.

Huang Changjiang further mentioned that some local medical insurance pharmacies are becoming saturated, and the medical insurance bureaus are under heavy financial settlement pressure.

Regardless of what will happen after the implementation of the detailed rules, based on the current situation, medical insurance restrictions in some areas of Zhejiang have become stricter

"Our pharmacy has a medical insurance area and a non-medical insurance area.

In addition, during the epidemic prevention and control period, in order to curb medical insurance funds collateralization, designated pharmacies implement a drug purchase system.

It should be noted that, because the detailed rules allow prefecture-level cities to adjust relevant regulations according to local conditions, there will be differences in the management system of designated pharmacies between regions

Evaluation indicators, showing some trends in the development of the industry

On January 8, 2021, the National Medical Insurance Administration issued the "Interim Measures for the Management of Medical Security in Retail Pharmacies" to better protect the rights and interests of insured persons
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In response to a reporter’s question, the National Medical Insurance Bureau stated that the introduction of the "Interim Measures for the Administration of Medical Security in Retail Pharmacies" has made the power and responsibility relationships between medical insurance administrative departments, medical insurance agencies, and designated retail pharmacies clearer, and also clarified the relationship between the parties to the agreement.
Liability for breach of contract puts forward the specific circumstances of the suspension and cancellation of the agreement, which is equivalent to listing a "negative list", which is conducive to promoting the standardization and legalization of the designated management of retail pharmacies
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Senior medical expert Ma Wanqi also said that the release of the evaluation rules for designated pharmacies in Zhejiang is to implement the established national policies at the provincial level.
Its essence is the penetration of the medical insurance system reform into designated pharmacies, which can effectively rectify the chaos in the management of designated pharmacies.
It can also effectively improve the competitiveness of designated pharmacies
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Compared with the previous period, the application threshold, supervision and punishment level of designated pharmacies stipulated this time have been significantly improved
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"For policy changes, pharmacies must adapt as soon as possible and abandon the traditional bad habits of exploiting loopholes as soon as possible
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" Ma Wanqi reminded
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"The extra points of the evaluation indicators show some trends in the development of the industry.
The relevant departments currently adopt a moderately encouraging attitude
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" Ma Wanqi said that pharmacies need to return to service, and do their own thing, pay close attention to , Follow the new industry policy
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(At the request of the interviewer, "Huang Changjiang" in the text is a pseudonym
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