-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
-
Cosmetic Ingredient
- Water Treatment Chemical
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
Medical security bureaus of districted cities and relevant designated medical institutions:
Standardize and improve the medical insurance payment management of traditional Chinese medicine pieces in our province, ensure the demand of the insured people in our province for the use of traditional Chinese medicine pieces, improve the scientific and refined management level of basic medical insurance Chinese medicine pieces, and improve the efficiency of the use of basic medical insurance funds, according to the "Jiangxi Provincial Party Committee Jiangxi Provincial People's Government on Deepening the Reform of the Medical Security System" (Ganfa [2021] No.
2) and "The General Office of the Jiangxi Provincial People's Government forwarded the Provincial Medical Insurance Bureau on medical insurance support for traditional Chinese medicine" Inheriting the spirit of the Notice on the Implementation of Innovative Development (Ganfu Hall Zi [2022] No.
73), in order to do a good job in the management of medical insurance payment for Chinese medicine tablets, the following notice is hereby issued on relevant matters:
2) and "The General Office of the Jiangxi Provincial People's Government forwarded the Provincial Medical Insurance Bureau on medical insurance support for traditional Chinese medicine" Inheriting the spirit of the Notice on the Implementation of Innovative Development (Ganfu Hall Zi [2022] No.
73), in order to do a good job in the management of medical insurance payment for Chinese medicine tablets, the following notice is hereby issued on relevant matters:
1.
Scope of declaration
Scope of declaration
According to the principle of steady progress and batch implementation, the different forms of concocted products such as raw (fresh), calcined, fried (bran stir-fried, scorched, burnt), hot (boiled), boiled, wine, salt, ginger, vinegar, honey and other forms of Chinese medicine pieces from the same source that have been paid by medical insurance in our province will be used as the scope of declaration, and then the scope of declaration will be expanded according to the affordability of
the medical insurance fund and the drug needs of the insured people.
The application of Chinese medicine pieces shall comply with the current standards or processing specifications
formulated by the national or provincial drug regulatory authorities.
the medical insurance fund and the drug needs of the insured people.
The application of Chinese medicine pieces shall comply with the current standards or processing specifications
formulated by the national or provincial drug regulatory authorities.
(1) 892 Chinese medicine pieces with different processing methods of the same name that have been included in the National Basic Medical Insurance, Work-related Injury Insurance and Maternity Insurance Drug Catalogue (2021) and are not included in the national catalogue "shall not be included in the scope of fund payment"
.
.
(2) Different processing methods of Chinese medicine pieces with the same name in the province that have been included in the scope of medical insurance payment in our province, and are not included in the national catalogue "shall not be included in the scope of fund payment"
.
.
2.
Standardize the declaration process
Standardize the declaration process
Chinese medicine pieces that apply for inclusion in the payment scope of medical insurance in our province shall be declared to the medical security department by designated medical institutions of level II or above with independent legal personality
.
In accordance with the principle of territorial management, the medical security bureaus of districted cities accept the application materials of designated medical institutions within their jurisdiction, and submit the declaration materials of traditional Chinese medicine tablets approved by the preliminary examination to the provincial medical security bureau
.
The Provincial Medical Security Bureau accepts the declaration materials
submitted by medical institutions directly in Chang Province and the Medical Security Bureau of districted cities.
Implement dynamic acceptance and dynamic review
.
.
In accordance with the principle of territorial management, the medical security bureaus of districted cities accept the application materials of designated medical institutions within their jurisdiction, and submit the declaration materials of traditional Chinese medicine tablets approved by the preliminary examination to the provincial medical security bureau
.
The Provincial Medical Security Bureau accepts the declaration materials
submitted by medical institutions directly in Chang Province and the Medical Security Bureau of districted cities.
Implement dynamic acceptance and dynamic review
.
Designated medical institutions applying for the inclusion of Chinese medicine tablets in the scope of medical insurance payment shall submit the following materials and affix their official seals:
(1) Declaration Form for Chinese Medicine Pieces of Jiangxi Provincial Basic Medical Insurance (Annex 1);
(2) Quality test report of Chinese medicine pieces;
(3) Materials for the safety and clinical value of Chinese medicine tablets: official professional journal literature, invention patents, etc.
, provincial and ministerial level and above award certification materials;
, provincial and ministerial level and above award certification materials;
(4) Economic materials for the declared project: changes in usage, total cost, unit price and magnitude in the past 3 years, and the trend of usage and total cost expected within 3 years; If it has been included in the payment scope of medical insurance in other provinces, corresponding supporting materials such as medical insurance payment types and standards must be provided; Our province's admission price, sales price, purchase and use quantity in the past 3 years and other relevant data materials; The declaration shall bear legal responsibility
for the authenticity and legality of the declaration materials.
for the authenticity and legality of the declaration materials.
3.
Organize review
Organize review
(1) Composition of expert personnel
Under the supervision of the discipline inspection department, the leading office of the Provincial Medical Security Bureau shall form an expert group
of experts from the expert pool of the Medical Security Bureau.
Experts should be selected both professionally and representatively, mainly from the fields of clinical Chinese medicine, Chinese herbal medicine, medical insurance management, etc.
, with deputy senior or above professional titles or personnel at the section level or above
.
The number of experts is not less than seven odd members, and experts with a direct interest in the project should actively recuse themselves and not participate in the demonstration
.
of experts from the expert pool of the Medical Security Bureau.
Experts should be selected both professionally and representatively, mainly from the fields of clinical Chinese medicine, Chinese herbal medicine, medical insurance management, etc.
, with deputy senior or above professional titles or personnel at the section level or above
.
The number of experts is not less than seven odd members, and experts with a direct interest in the project should actively recuse themselves and not participate in the demonstration
.
(2) A description of the situation of Chinese medicine tablets
The relevant person in charge of the application made a complaint to the expert review team on the economy, clinical application, treatment effect, medical cost and other relevant information of the declared Chinese medicine tablets
.
Experts ask medical institutions about relevant issues
.
.
Experts ask medical institutions about relevant issues
.
(3) Expert review and negotiation
The expert review team analyzed and evaluated the clinical application, treatment effect and economy of the Chinese medicine pieces and voted, and more than two-thirds of the experts voted in favor of "recommended inclusion" as passing expert demonstration
.
Based on the economic evaluation and cost of the Chinese medicine pieces and the affordability of the medical insurance fund, the expert review team put forward opinions and suggestions
for inclusion in the payment scope and treatment categories of basic medical insurance in Jiangxi Province.
For varieties of Chinese medicine pieces whose prices are obviously too high, after negotiating with the declaration, and preliminarily determining the medical insurance payment standards of the Chinese medicine pieces, opinions and suggestions
are put forward to include the payment scope and treatment categories of basic medical insurance in Jiangxi Province.
.
Based on the economic evaluation and cost of the Chinese medicine pieces and the affordability of the medical insurance fund, the expert review team put forward opinions and suggestions
for inclusion in the payment scope and treatment categories of basic medical insurance in Jiangxi Province.
For varieties of Chinese medicine pieces whose prices are obviously too high, after negotiating with the declaration, and preliminarily determining the medical insurance payment standards of the Chinese medicine pieces, opinions and suggestions
are put forward to include the payment scope and treatment categories of basic medical insurance in Jiangxi Province.
4.
Application of results
Application of results
(1) Report to the National Medical Security Administration
The Provincial Medical Security Bureau summarizes the opinions and suggestions of experts, and in accordance with the relevant requirements of the request for instructions and reporting system, submits the Chinese medicine pieces to be included in the payment scope of medical insurance in our province to the National Medical Security Administration for the record according to the procedures, and revises and improves
them according to the opinions put forward by the National Medical Security Administration.
them according to the opinions put forward by the National Medical Security Administration.
(2) Issuance and implementation
The Provincial Medical Security Bureau takes the lead in reporting the evaluation results to the National Health Insurance Administration for the record, and after approval, it will be announced to the public on the official website of the Provincial Medical Security Bureau for 15 working days
according to the procedure.
After the expiration of the publicity period, the executive documents
shall be officially issued in accordance with the relevant procedures.
according to the procedure.
After the expiration of the publicity period, the executive documents
shall be officially issued in accordance with the relevant procedures.
5.
Establish a normalized working mechanism for the inclusion of Chinese medicine pieces in medical institutions into the payment scope of medical insurance in our province
Establish a normalized working mechanism for the inclusion of Chinese medicine pieces in medical institutions into the payment scope of medical insurance in our province
(1) On the basis of adhering to the principle of expert review, establish a normalized working mechanism, and carry out dynamic acceptance, dynamic review, and dynamic adjustment
of the inclusion of Chinese medicine pieces in the payment scope of the provincial medical insurance fund.
of the inclusion of Chinese medicine pieces in the payment scope of the provincial medical insurance fund.
(2) If the price of Chinese medicine pieces is obviously too high, after consultation, it may be clearly included in the trial period of medical insurance payment (in principle, two years), and the medical insurance payment policy
can be further clarified later according to factors such as the actual needs of the insured people and price adjustments.
can be further clarified later according to factors such as the actual needs of the insured people and price adjustments.
Contact number: Medical Service Administration 0791-86313276
E-mail: ybjyyfwc@126.
com
com
Attachments: 1.
Jiangxi Provincial Basic Medical Insurance Declaration Form for Chinese Medicine Tablets
Jiangxi Provincial Basic Medical Insurance Declaration Form for Chinese Medicine Tablets
2.
Expert opinion form of traditional Chinese medicine pieces of Jiangxi Provincial Basic Medical Insurance
Expert opinion form of traditional Chinese medicine pieces of Jiangxi Provincial Basic Medical Insurance
Jiangxi Provincial Medical Security Bureau
November 30, 2022
