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In order to do a good job in the normalization of monitoring and assistance for low-income rural populations, further improve the accuracy and timeliness of assistance, and effectively prevent and resolve the risk of returning to poverty due to illness, the National Health Insurance Administration and relevant departments recently issued the Notice on Resolutely Guarding the Bottom Line of Preventing Large-scale Poverty Return, and Improving the
Long-term Mechanism for Preventing and Resolving Poverty Caused by Returning to Poverty due to Illness 。
The Notice refines specific requirements such as ensuring that due diligence should be guaranteed, steadily promoting policy convergence, strengthening risk early warning and monitoring, normalizing the implementation of comprehensive assistance, strengthening departmental work coordination and information sharing, and making overall arrangements
for guarding the bottom line of preventing large-scale return to poverty due to illness.
The Notice requires the overall implementation of the comprehensive protection of the triple system of basic medical insurance, serious illness medical insurance, and medical assistance, and the implementation of categorical assistance policies
according to their difficult status categories.
Where the cost burden is still heavy after being guaranteed by the triple system, clarify the responsibility
for departmental linkage assistance.
Local medical insurance departments promptly push the patient's cost burden information to the big data platform for poverty prevention monitoring at the same level, and relevant departments jointly implement development-based assistance or provide basic living assistance or temporary assistance according to regulations, and comprehensively use commercial insurance, charitable assistance, charitable donations, and other assistance measures to ensure the basic livelihood
of patients with high cost burdens among the people in difficulty.
Aiming at the bottom-line task of "due diligence", the Notice requires that the participation rate of low-income rural people and people who have been lifted out of poverty in various regions should not be less than 99%, and requires improving the accuracy of subsidized insurance policies, standardizing insurance management services, and promoting the convergence of
subsidy policies.
According to monitoring, since 2021, the participation rate of rural low-income population and poverty alleviation population has been stable at more than 99%, and it has basically been guaranteed as much as possible
.
Under the comprehensive guarantee of the triple system, the hospitalization reimbursement level of low-income rural people has smoothly transitioned, and the treatment should be fully enjoyed
.
The Notice clarifies that during the transition period, fixed subsidies will be given to people in difficulty who are included in the monitoring scope of poverty prevention due to illness; Guide areas seriously affected by the new crown pneumonia epidemic to provide temporary subsidies
through medical assistance to marginalized people who are unable to pay medical insurance premiums for urban and rural residents due to their difficult lives due to the epidemic.
Encourage local governments to explore helping low-income rural populations participate in insurance contributions through charitable assistance, public welfare donations, village collective economic income, or asset income from poverty alleviation projects, and take positive measures to increase the public's willingness to
participate in insurance.
To prevent patients from returning to poverty due to high medical expenses, it is necessary to improve the monitoring and early warning mechanism
for preventing and resolving poverty caused by illness.
The Notice requires that patients with high medical expense burdens should be monitored and warned to ensure early detection, early intervention and early resolution
of risks.
The Notice proposes to rely on the national unified medical insurance information platform to guide all localities to do a good job in monitoring patients with high cost burdens among rural low-income people and poverty alleviation populations, and encourage localities with the capacity to expand the scope of high cost burden monitoring targets to cover all insured persons
.
Clearly take the overall planning area as the basis, refer to a certain proportion of the per capita disposable income of local residents in the previous year, set monitoring thresholds by category, and timely discover and push risk information
by dynamically tracking patients' enjoyment of medical security benefits, personal expense burden, and utilization of medical services.
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