Here comes the detailed rules of 4 + 7 volume purchase: complete the contract volume in one year and collect the payment within 30 days

A few days ago, as one of the "4 + 7" cities, Dalian's "implementation of the work plan for centralized procurement and use of drugs organized by the state (Draft for comments)" (hereinafter referred to as "Dalian draft for comments") The detailed rules for the purchase and use of selected drugs have emerged The details are as follows: Dalian implements the work plan for centralized purchase and use of drugs organized by the state (Draft for comments), I guiding ideology, II Basic principles (omitted), III main tasks (I) to implement the annual purchase volume of selected drugs, I to clarify the responsibility of the main procurement body All public medical institutions in the city are the main purchasers of selected drugs (hereinafter referred to as "selected drugs") in the pilot drug centralized procurement organized by the state Public medical institutions shall sign volume purchase and sale contracts with production enterprises or pharmaceutical trading enterprises designated by production enterprises, and ensure that the contract volume is completed within one year In the implementation cycle of centralized procurement results, public medical institutions shall give priority to procurement, use the selected varieties of centralized procurement, and ensure the completion of the agreed procurement volume On the basis of giving priority to the use of selected drugs in the centralized procurement, public medical institutions can purchase appropriate amount of non selected drugs with the same price according to the relevant provisions of Liaoning Province on the centralized procurement management of drugs Public medical institutions, as the first person in charge of drug payment settlement, should guarantee to collect the payment in time within 30 days from the warehousing of drugs, so as to reduce the transaction cost of drug enterprises Public hospitals should strengthen clinical risk assessment, plan formulation and material reserve, strengthen the publicity and training of doctors and pharmacists, and explain patients well We should give full play to the role of clinical pharmacists, strengthen the examination and evaluation of prescriptions, and further strengthen the examination of rational use of drugs (responsible department: Municipal Health and Family Planning Commission) 2 Unblock hospital procurement channels The public medical institutions shall unblock the channels for the selected drugs to enter the hospital, ensure that the selected drugs enter the hospital and are used preferentially, and shall not influence the supply and rational use of the selected drugs on the grounds of the total cost, "drug proportion", the number of basic drug varieties in the hospital, the review of the pharmaceutical Committee and the account opening of drug distributors (responsible department: Municipal Health and Family Planning Commission) 3 Implement the procurement task with quantity Focus on the use of selected drugs in the hospital terminal, the use of drugs into the public hospital assessment indicators, the use of selected drugs and drug payment settlement for monitoring, monitoring and assessment, the development of medication guidelines; medical personnel for policy advocacy, rational use of drugs, and communication skills with patients, public opinion guidance training (responsible department: Municipal Health and Family Planning Commission) (II) ensure the quality and supply of selected drugs 4 Do a good job in the quality assurance of the selected drugs, increase the frequency of sampling inspection, clarify the quality problem information reporting system, include the relevant varieties in the annual key sampling plan, design the quality inspection plan specifically for the centralized purchase of the selected drugs, establish the quality disposal mechanism and emergency plan of the pilot drugs, strengthen the adverse drug reaction report and monitoring, and ensure the quality stability of the selected drugs 。 (responsible department: SFDA) 5 Implement drug use monitoring We will strengthen the monitoring of the use of selected drugs, find out and give early warning of the shortage of selected drugs in a timely manner, and report the situation of insufficient and untimely supply to the leading group of national and provincial pilot work as soon as possible (responsible department: Municipal Health and Family Planning Commission) (3) ensure timely payment collection; 6 Implement the pre allocation system of medical insurance fund The medical insurance fund prepays 50% of the purchase amount of the designated medical institutions, and actively explores a new operation mode of medical insurance fund prepaying directly to enterprises (responsible department: Municipal Bureau of human resources and social security) 7 Monitor the collection of medical institutions As the first person in charge of drug payment settlement, medical institutions should settle accounts with enterprises in time according to the provisions of the contract to reduce the transaction costs of enterprises We should urge medical institutions to settle accounts with enterprises in time in accordance with the contract, strictly check the problem of failing to settle drug payments in time, and take punishment measures such as interview and notification to the medical institutions and the persons in charge who fail to collect funds in time as required (responsible departments: Municipal Health and Family Planning Commission, municipal human resources and Social Security Bureau) (IV) implement relevant supporting policies 8 Clear payment standards In principle, for the reference preparations under the same general name and generic drugs passing the consistency evaluation, the medical insurance fund shall be settled according to the unified payment standard, and implemented in all medical institutions in the pilot city If there is a large difference between the drugs used by patients and the payment standard, the payment standard can be adjusted gradually and in place within 3 years We should speed up the formulation and promulgation of payment standard policies for pilot varieties, and make clear the schedule and roadmap for the adjustment of payment standards If a patient uses drugs higher than the payment standard, the part exceeding the payment standard shall be paid by the patient; if the price of the drugs used by the patient is lower than the payment standard, the actual price shall be paid On the basis of ensuring the quality and supply, guide the public medical institutions and patients to form reasonable medication habits (responsible department: Municipal Bureau of human resources and social security) 9 The balance of medical insurance fund is retained We will deepen the reform of the way of payment for medical insurance, establish a mechanism of "surplus retention and reasonable over expenditure sharing", ensure that public medical institutions use drugs with appropriate prices selected in the centralized procurement, and reduce the operating costs of public medical institutions For the part of reducing the expenditure of medical insurance fund due to standardized use of selected varieties and completed use, the total budget of medical insurance in the current year will not be reduced, and the balance will be left to medical institutions For those who pay by disease or DRGs, the disease quota will not be reduced According to the requirements of "two permits" (allowing medical institutions to break through the current wage control level of public institutions, allowing medical service income to deduct costs and withdraw various funds according to regulations, which are mainly used for personnel reward), public medical institutions can make overall plans for personnel salary expenditure and mobilize the enthusiasm of medical personnel (responsible departments: Municipal Human Resources and Social Security Bureau, municipal health and Family Planning Commission, Municipal Finance Bureau) (V) strengthen supervision and management 10 Strengthen supervision of medical institutions Encourage the use of selected drugs, and punish public medical institutions that do not purchase and use drugs according to regulations in the total amount index of medical insurance, grade evaluation of medical institutions, fixed-point qualification of medical insurance, evaluation and review of national and local key specialties, and objective assessment of heads of medical institutions Medical personnel who do not use drugs according to regulations shall be seriously dealt with in accordance with the corresponding provisions of the prescription management measures and the hospital prescription evaluation management standard (Trial) (responsible department: Municipal Health and Family Planning Commission, municipal human resources and Social Security Bureau) 11 Carry out the monitoring of the purchase and use of selected drugs Through the provincial drug centralized procurement platform to monitor the drug procurement of public medical institutions, through the medical insurance information system to control the use of selected drugs in designated medical institutions, especially the use rate and use amount, play the "one platform, one system" function, and give warnings and checks for low use (responsible department: Municipal Health and Family Planning Commission, municipal human resources and Social Security Bureau) 12 Implement the management of medical insurance agreement Strictly implement the requirements for designated medical institutions to complete the quantity of drugs purchased with volume, and incorporate the relevant requirements into the management of medical insurance agreement and into the daily assessment management of designated medical institutions For the designated medical institutions that fail to complete the purchase and use amount as required, the corresponding medical insurance settlement quota shall be deducted as the case may be, and special medical insurance interview shall be conducted for the doctors whose prescriptions of the selected drugs have declined significantly (responsible department: Municipal Bureau of human resources and social security) IV work arrangement (I) establish an organization to establish a leading group for implementing the centralized procurement and use of drugs organized by the state in Dalian, with the deputy mayor in charge as the group leader, and the main leaders of the municipal health and family Planning Commission, Municipal Bureau of human resources and social security, municipal food and drug administration, municipal development and Reform Commission, Municipal Finance Bureau, Municipal Publicity Department and other departments as members To be responsible for overall planning, coordination and promotion of the pilot work, and timely study and solve major problems in the process of pilot promotion The leading group has an office, and the director of the office is concurrently held by the main leader of the health and Family Planning Commission (after the establishment of the Municipal Health Insurance Bureau, the main leader of the Municipal Health Insurance Bureau concurrently holds the post) (III) formulate relevant supporting policies and relevant departments according to their responsibilities to formulate specific measures for supporting the scheme, such as medical insurance payment, assessment management, drug quality supervision, revolving fund prepayment management, etc (deadline: before January 2019) (IV) comprehensively organize and implement the pilot work of centralized drug procurement organized by the state Meanwhile, the payment standard of medical insurance shall be implemented, and the pilot work of centralized drug purchase organized by the State shall be analyzed and evaluated in due time (start time: March 1, 2019) v safeguard measures (I) to improve the awareness of centralized drug purchase is a major measure to deepen medical reform and solve the problem of difficult and expensive medical treatment All units should improve their political positions As the first person in charge, the main leaders should personally lead, plan, deploy and promote the pilot work According to the relevant requirements of the state and the province, the specific work plan shall be formulated, the responsibility of compaction shall be layer by layer, and the implementation shall be carefully organized to ensure that the annual task of the pilot work is completed on time and with high quality （2） Close cooperation with the pilot work of centralized drug procurement requires close cooperation of multiple departments to ensure the effective implementation of the pilot work Under the unified leadership of the leading group, all departments should closely cooperate, communicate in a timely manner, form a joint force, earnestly implement the relevant national and provincial work requirements, and ensure the smooth implementation of the pilot work （3） Strengthen publicity, strengthen public opinion monitoring and positive publicity, strengthen publicity and policy interpretation of the significance, main tasks and policy measures of the pilot work, reasonably guide the expectations of the masses, respond to social concerns, and create a good atmosphere for reform Strengthen the publicity and training of doctors and pharmacists, and explain the possible adjustment of drug use in the centralized purchase of drugs by the state.