Officially implemented from March 1st! There are new changes in the list of medical insurance drugs in Hebei Province

In order to further improve the level of drug protection for insured persons in Hebei Province and standardize the management of basic medical insurance, work injury insurance and maternity insurance drugs, the Hebei Provincial Medical Security Bureau and the Hebei Provincial Human Resources and Social Security Department have recently formulated and issued the Hebei Provincial Basic Medical Insurance, Industrial Injury Insurance and Maternity Insurance Drug Catalog (2020 edition) (hereinafter referred to as the "Drug Catalog").
3,097 drugs in the "Drug Catalog" and will be officially implemented from March 1.
it is understood that the "Drug Catalog" includes the national catalogue of drugs and Hebei Province temporarily retained additional drugs, a total of 3097 kinds of drugs.
among them, 1264 kinds of conventional medicines in the national catalogue, 1315 kinds of Chinese medicine, 221 kinds of drugs negotiated during the period of the national catalogue agreement, 167 kinds of supplemental drugs containing Western medicine and 130 kinds of Chinese medicine were retained in Hebei Province.
, there are 892 Chinese medicine tablets that the fund can pay for.
Drug Catalog is the standard for the payment of drug expenses by hebei Province's basic medical insurance, work injury insurance and maternity insurance funds.
in order to improve the efficiency of the use of the Fund, the Drug Catalog limits the scope of payment for some medicines.
relevant departments and institutions shall strictly implement the Drug Catalog, shall not make their own catalogues or increase the number of drugs in the catalogue by different methods, shall not restrict the commodity names of medicines, and shall not adjust the scope of payment of drugs and related regulations on their own.
the payment of drug expenses for work-related injury insurance is not limited to the scope of payment.
the same time, in accordance with the requirements of the state, we should speed up the digestion and transfer of supplemental drugs in Hebei Province, and promote the basic unification of the scope of medical insurance use in Hebei Province with the state.
, anti-TB drugs, anti-schistosomiasis drugs, etc., which are provided free of charge by the State and national public health projects, shall not be paid by the Fund if they are used by insured persons and are covered by public health payments.
the introduction, "Drug Catalog" of Western medicine and Traditional Chinese medicine sub-class A and B management, negotiating drugs in accordance with Class B management, Chinese medicine tablets in accordance with Class A management.
The expenses of negotiating medicines and Chinese medicine tablets during the period of the agreement shall be distinguished between Class A and B when the basic medical insurance is paid, and the payment of work injury insurance and maternity insurance shall be divided between Class A and B.
At the same time, Class A drugs, which do not set an individual out-of-payment ratio, shall be paid by the Basic Medical Insurance Fund in accordance with the provisions;
of class B drugs (excluding negotiated drugs during the agreement period) the proportion of individual out-of-payment was uniformly determined at 5% in the province.
the negotiation of drugs during the period of the agreement, the proportion of individual out-of-payment for the treatment of tumors in western medicine, the province's unified rate of out-of-payment of the remaining drugs of the individual out-of-payment ratio by the municipal medical security departments to determine, up to a maximum of 20%.
the transfer of the original conventional Class B drugs into the agreement period, the individual out-of-payment ratio shall be implemented in accordance with the conventional Class B drug policy.
addition, the Drug Catalog agreement period to negotiate the implementation of the national unified medical insurance payment standards, the agreement period may not be a second bargain.
medical insurance payment standards are marked with a "
the requirements, before February 25, 2021, the provincial drug centralized procurement department will negotiate drugs during the agreement period in the provincial drug centralized procurement platform directly online procurement.
drug with the generic name is listed during the period of the agreement, the listed price of the generic drug shall not be higher than the standard of payment for the same specification of medical insurance as determined in the negotiation, and the price of the same name shall be used as the standard for the payment of medical insurance.
specifications are different from those negotiated during the agreement period, the list price shall not be higher than the standard of medical insurance payment calculated according to the principle of differential price, and the price of the internet shall be used as the standard of payment for medical insurance.
departments at all levels shall, in cooperation with the relevant departments, guide the designated medical institutions to reasonably equip and use the drugs contained in the Drug Catalog.
designated medical institutions should generally use the drugs in the Drug Catalog.
departments at all levels should strengthen the agreement management of fixed-point medical institutions and incorporate the rational provision of medical institutions with the use of drugs in the Drug Catalog into the contents of the agreement.
health insurance departments at all levels should innovate their working methods and methods to promote the landing of the Drug Catalog by improving the policy of outpatient protection, opening the channel of fixed-point pharmacies for medical insurance, and rationally adjusting the total amount control.
fixed-point medical institutions shall not negotiate the provision and use of drugs during the agreement period on the grounds that the total amount of medical insurance is controlled, the quantity of drug catalogues of medical institutions is limited, and the proportion of drugs is affected.
The Drug Catalog has been in effect since March 1, 2021.
departments at all levels should speed up the adjustment and updating of the medical insurance information system in accordance with the 2020 edition of the catalogue, improve the settlement management methods, and ensure that the "drug catalogue" lands in a timely manner.
The Notice issued by the Hebei Provincial Medical Security Bureau and the Hebei Provincial Human Resources and Social Security Bureau will be repealed at the same time as of March 1, 2021.
, the 17 drugs negotiated for 2018 will still be paid for by the Fund as originally planned.
the source of the client