Guizhou issued a document clarifying the level of reimbursement for new crown treatment costs

"Guizhou Medical Insurance" WeChat public account news on January 8, according to the National Health Insurance Administration, the Ministry of Finance, the National Health Commission, and the National Disease Control Administration's "Notice on Optimizing the Relevant Policies for Medical Security for Treatment Costs of Patients with Novel Coronavirus Infection after the Implementation of "Class B and B Management" (Medical Insurance Fa [2023] No.
1), the Guizhou Provincial Medical Security Bureau, the Guizhou Provincial Department of Finance and the Guizhou Provincial Health Commission issued a notice to implement "Class B tube" for Guizhou Province After the treatment cost of patients infected with the new coronavirus, the relevant policies of medical security will be optimized and adjusted
.

 

1.
Increase the level of reimbursement for medical treatment at the grassroots level

 

The inpatient medical expenses incurred by insured patients with novel coronavirus infection in the province in all admitted medical institutions that comply with the diagnosis and treatment plan for new coronavirus infection formulated by the health department shall be paid by basic medical insurance, serious illness insurance, medical assistance, etc.
according to regulations, and the personal burden will be subsidized by the treasury
.
The medical expenses of non-insured patients are borne by the treasury
.
The policy is calculated based on the time of patient admission and will be implemented until March 31
, 2023.

 

Increase the support of medical insurance to primary medical institutions (secondary and below) such as rural areas and urban communities, and implement special protection for outpatient emergency expenses of patients with novel coronavirus infection and suspected symptoms insured in the province that occur in designated medical institutions of primary medical insurance, with no starting and maximum payment lines, and a reimbursement rate of 70%
within the scope of the policy.
The payment amount of the medical insurance fund shall not be included in the outpatient pooled payment limit of basic medical insurance, and will not be included in the annual ceiling of basic medical insurance
.
This policy is calculated based on the patient's visit time and will be implemented until March 31
, 2023.
The emergency treatment expenses of new coronavirus infection outpatient treatment incurred by insured patients in other medical institutions in the province shall be implemented
in accordance with the current medical insurance policy.

 

2.
Expand the scope of the medical insurance drug list

 

When insured patients with novel coronavirus infection are treated in designated medical institutions in Guizhou Province (including medical institutions that have signed temporary special agreements), on the basis of the "National Basic Medical Insurance, Work-related Injury Insurance and Maternity Insurance Drug Catalog" and the current medical institution preparations, Chinese medicine tablets and Chinese medicine formula granules catalogue in Guizhou Province, it is expanded to all drugs in the "Novel Coronavirus Infection Diagnosis and Treatment Plan (Trial Version 10)" issued by the National Health Commission and the "Guizhou Province Provisional Medical Insurance Drug List for the Prevention and Treatment of Novel Coronavirus Infection"
。

 

3.
Expand the scope of designated medical institutions

 

Temporarily expand the scope of designated medical institutions to provide high-quality medical insurance services
for insured patients infected with new coronavirus infection.
For medical institutions that are not included in the three-level treatment system of the "Guizhou Province Novel Coronavirus Infection "Class B and B Management" Implementation Plan", a green channel for access is established, the assessment procedure is simplified, and the treatment settlement
is carried out immediately after signing the "Interim Special Agreement on Medical Insurance Fee Settlement of Medical Institutions Admitted to Novel Coronavirus Infection Patients" with the medical insurance handling institution.

 

4.
Do a good job in ensuring medical treatment in different places

 

The hospitalization expenses of patients insured outside the province for medical treatment in different places shall be settled
in accordance with the treatment policy of the place of participation.
The hospitalization expenses of insured patients with new coronavirus infection in the province are directly settled
in accordance with the treatment policy of this notice.

 

Outpatient expenses for patients with novel coronavirus infection who are insured outside the province for medical treatment in different places across provinces, and those who seek medical treatment at designated medical institutions with tertiary medical insurance shall be settled directly in accordance with the current medical insurance policy, and no special protection will be implemented; Self-pay settlement for medical treatment at designated medical institutions of secondary medical insurance and below will be manually reimbursed back to the place of participation
.
Outpatient expenses for insured patients with new coronavirus infection in the province are directly settled
in accordance with the treatment policy of this notice.

 

5.
Continue to carry out prepayment of medical insurance funds

 

In order to support designated medical institutions in further responding to the novel coronavirus infection, designated medical institutions that really need it can apply to the local medical insurance agency for pre-allocating special medical insurance funds
for treatment in accordance with the requirements of the Notice of the Guizhou Provincial Medical Security Bureau on Further Strengthening the Medical Security Work in Response to the Novel Coronavirus Pneumonia Epidemic (Qian Medical Insurance Fa [2020] No.
9).

 

6.
Provide convenient medical insurance services

 

Continue to do a good job in medical insurance convenience services, implement long-term prescription medical insurance payment policies, implement online handling of routine matters in medical insurance handling work, timely handling of urgent matters, convenient handling of special matters, postponement of non-urgent matters, and elimination of hidden dangers and peace
of mind.
Local medical insurance handling institutions should guide all types of medical institutions to do a good job in the collection and upload of information related to the diagnosis and settlement of new coronavirus infection, and the settlement of medical insurance fees
.
While giving full play to the handling strength, promoting the sinking of services, and doing a good job in handling services such as insurance participation publicity and mobilization, we should cooperate with relevant departments to do a good job in health publicity in rural areas and urban communities, popularize epidemic prevention and control knowledge, improve the public's awareness of self-protection, and effectively ensure that medical insurance handling management is not relaxed and medical insurance handling services are uninterrupted
.
The medical expenses of patients infected with the new coronavirus should be budgeted separately by local medical insurance handling institutions, which are not included in the total budget indicators of the admitted medical institutions, and the inpatient or outpatient expenses are temporarily not included in the DRG/DIP payment
.

 

7.
Strengthen the supervision of medical insurance funds

 

The optimization and adjustment of the medical security policy is to implement the requirements of the overall plan of "Category B and B Management" "health care and prevention of severe diseases" to ensure that the people smoothly pass the peak period
of infection.
All localities should strengthen the supervision and management of medical insurance funds, make full use of medical insurance intelligent monitoring, on-site inspections and other means to strengthen the management of medical insurance fund expenditures of designated medical institutions, and prevent medical institutions from fraudulently obtaining medical insurance funds, such as false medical treatment and false opening of diagnosis and treatment projects
.
It is necessary to fully promote designated medical institutions to implement the main responsibility for the use of funds, rationally use medical insurance funds, and standardize medical service behavior
.
It is necessary to combine the actual operation of the medical insurance fund, make overall plans to promote the implementation of policies, scientifically determine the scope and level of protection, not only reasonably reduce the burden on the masses, but also ensure the safety and sustainability
of the medical insurance fund.

 

8.
Strengthen departmental coordination and linkage

 

All relevant departments should improve their political standing and earnestly perform their duties, and the medical insurance department should be responsible for the review and settlement of relevant expenses, and strengthen fund supervision; The financial department is responsible for the timely allocation of financial subsidy funds; The health department is responsible for guiding medical institutions to do a good job in identifying, registering and uploading information of patients infected with the new coronavirus; The disease control department is responsible for uploading information and data for patients infected with the new coronavirus
.
Strengthen coordination and linkage to ensure that the decision-making and deployment of the Party Central Committee and the State Council are implemented to the letter
.

 

If the original medical security policies and handling procedures for patients with novel coronavirus pneumonia in Guizhou Province are inconsistent with this notice, they shall be implemented
in accordance with this notice.
This notice shall take effect
on the date of the implementation of the "Class B tube" of the new coronavirus infection.