Pilot varieties of medical insurance payment standards: 24 in Guizhou and 29 in Jiangxi...

According to industry rumors, the National Medical Insurance Bureau has officially launched the pilot work of medical insurance payment standards.
In principle, drug payment standards are determined based on their generic names, and uniform payment standards are implemented within the same province.
Formulate payment standards and make dynamic adjustments.
At present, many provinces have announced the payment standards for pilot drug and medical insurance
.
Xinjiang: 21, Guizhou: 24, Jiangxi: 29 Improve the implementation of the pilot drug payment standards in the administrative region, and speed up the progress of the formulation of payment standards.
In principle, it will be officially implemented from January 1, 2022
.
Previously, on December 29, 2021, the Xinjiang Medical Insurance Bureau issued a document clarifying that 21 pilots of drug and medical insurance payment standards will be officially launched on January 1, 2022, and the pilot period is tentatively set for two years
.
Recently, Guizhou and Jiangxi have also successively issued documents to carry out pilot medical insurance payment standards.
Among them, 6 drugs without purchase records in Guizhou in 2020 have not formulated medical insurance payment standards for the time being.
Jiangxi announced the medical insurance payment standards for 29 pilot drugs such as erecoxib tablets
.
Guizhou: There are no purchase records for 6 drugs in 2020, and no medical insurance payment standards will be formulated.
The pilot program of the medical insurance payment standard was officially launched on March 1.
Among the 30 drugs stipulated by the state, 6 drugs have no purchase records in Guizhou Province in 2020.
This time, the medical insurance payment standard will not be formulated
.
Among them, if the pilot drug belongs to the state negotiated drug during the agreement period, its medical insurance payment standard shall follow the state negotiated price
.
If the national negotiated drug has a generic drug on the market during the agreement period, the payment standard shall be re-determined according to the online price level of the generic drug in Guizhou Province
.
For pilot drugs that have been included in the national or provincial centralized procurement scope, their medical insurance payment standards shall be at the selected price
.
The medical insurance payment standards for non-selected drugs under the same generic name for centralized procurement of drugs at the national or provincial level shall be formulated separately
.
In addition, comprehensively considering factors such as the national medical insurance drug access negotiation, the changes in the results of centralized procurement of drugs at the national or provincial level, the actual supply and use of drugs, etc.
, the medical insurance payment standards for the pilot drugs are dynamically adjusted
.
Insured patients use drugs whose price is not higher than the medical insurance payment standard, and the patients and the medical insurance fund shall share according to the policy regulations based on the actual sales price
.
Patients use medicines with a price higher than the medical insurance payment standard, the part exceeding the medical insurance payment standard shall be borne by the patient, and the part within the medical insurance payment standard shall be shared by the patient and the medical insurance fund according to the policy
.
Jiangxi: 29 varieties included in the pilot program On January 6, 2022, the Jiangxi Provincial Medical Insurance Bureau also announced the "First Batch of Pilot List of Medical Insurance Drug Payment Standards in Jiangxi Province", involving a total of 29 varieties
.