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Recently, the Henan Provincial Medical Security Bureau issued the "Work Plan for New Designated Medical Institutions in Henan Province (Trial Implementation)" (hereinafter referred to as the "Plan") to standardize the access of
designated medical institutions.
designated medical institutions.
The "Plan" mentions that pharmacies apply for fixed-point qualifications, and the operating area of "non-medical insurance swipe card" must be within 20%; The store area is less than 100 square meters, and points are directly deducted
.
.
It is becoming more and more difficult for retail pharmacies to apply for medical insurance designated pharmacy qualifications?
01 Henan Medical Insurance Bureau: "Non-medical insurance card" area is less than 20%
The "Plan" divides the assessment work of designated pharmacies into two forms of assessment, written and on-site, covering a total of 9 types of inspection items, involving whether the written materials are consistent with the actual situation, practicing pharmacist qualification certificates and labor contracts, and drug purchase, sale and inventory management
.
.
It is worth noting that the "Plan" puts forward requirements for the operating area of non-medical insurance drugs such as health care products, and no more than 20% becomes a red line
.
In other words, after the pharmacy successfully applies for a designated pharmacy, the sales area of non-medical insurance card products such as health care products can be retained, but the area must be strictly controlled
.
.
In other words, after the pharmacy successfully applies for a designated pharmacy, the sales area of non-medical insurance card products such as health care products can be retained, but the area must be strictly controlled
.
In addition, the "Plan" also stipulates the situation of "one-vote veto", in the above-mentioned assessment content, if the written materials declared by the pharmacy are inconsistent with the original on-site inspection, one vote is vetoed; If it does not meet the standard, one vote will veto (if one vote is rejected, the original and copy of the relevant materials shall be photographed for future reference).
On the whole, the newly released evaluation standards for designated pharmacies do put forward higher requirements
for the operating capacity and store layout of pharmacies.
for the operating capacity and store layout of pharmacies.
02 Many places have issued documents that the application conditions for designated pharmacies are more stringent
When minai retail observation combed through the information, it was found that in addition to Henan, the application conditions for designated pharmacies in other provinces were also becoming more stringent
.
.
Previously, the Zhejiang Provincial Medical Security Bureau issued the "Detailed Rules for the Determination and Evaluation of Designated Retail Pharmacies for Medical Security" (hereinafter referred to as the "Detailed Rules") to strengthen and standardize the determination of medical security designated points in retail pharmacies, encourage and guide all types of retail pharmacies to participate in fair competition, and officially implemented
on January 1, 2022.
on January 1, 2022.
Among them, the evaluation rules for designated pharmacies have triggered discussions in the industry, emphasizing that pharmacies need to be formally operating at their registered address for at least 3 months; At least 1 pharmacist who has obtained a practicing pharmacist qualification certificate or has a professional and technical qualification certificate in pharmacy, clinical pharmacy, or Traditional Chinese medicine, and the place of registration is in the retail pharmacy, and the pharmacist must sign a labor contract for 1 year or more and within the contract period; At least 2 full-time (part-time) medical insurance managers who are familiar with the provisions of medical security laws and regulations and related systems are responsible for managing medical insurance expenses and signing a labor contract for 1 year or more and during the contract period
.
.
In addition, the detailed rules also mention that if the relevant designated medical institution of the same legal entity (investment entity) has been suspended, terminated or terminated due to violations within one year and is being investigated and handled by the handling agency, the application of
the designated retail pharmacy will not be accepted.
the designated retail pharmacy will not be accepted.
It is evident that the trend of strict requirements for pharmacies in the new evaluation rules has emerged
.
.
In January this year, the Guangxi Medical Insurance Bureau issued the "Interim Measures for the Designated Management of Medical Security in Retail Pharmacies in Guangxi" (hereinafter referred to as the "Measures"), which was officially implemented
from February 1.
from February 1.
It is mentioned that the application for medical insurance designated pharmacies needs to meet 8 necessary conditions, and all 12 assessments must be qualified
.
If any one of the conditions does not meet the requirements, the assessment result is unqualified
.
If the rectification is still not in line with the requirements after 3 months, the pharmacy shall not apply
again within 1 year.
.
If any one of the conditions does not meet the requirements, the assessment result is unqualified
.
If the rectification is still not in line with the requirements after 3 months, the pharmacy shall not apply
again within 1 year.
The Measures stipulate that pharmacies applying for medical security must meet 8 conditions at the same time, such as officially operating at a registered address for at least 3 months; At least 1 pharmacist who has obtained a practicing pharmacist qualification certificate or has a professional and technical qualification certificate in pharmacy, clinical pharmacy, or traditional Chinese medicine; The business area of retail pharmacies in accordance with the regulations of the co-ordination area.
On this basis, the Guangxi Medical Insurance Bureau designed the "Rules for the Assessment of The Access of Designated Retail Pharmacies", which involves a total of 12 assessment contents, and if any subdivision of the assessment rules is no/none, the item is unqualified and the assessment results are unqualified
.
.
In recent years, the medical insurance reform has been deepening in the industry, bringing more uncertainty to the future development of medical insurance designated pharmacies
.
At the beginning of 2021, the "Interim Measures for the Management of Medical Security Designated Points in Retail Pharmacies" deliberated and approved by the National Medical Insurance Bureau was officially announced
.
Since then, all provinces, municipalities and autonomous regions have taken this as a model, combined with the actual local situation, formulated local designated pharmacy management measures or rules, and also brought new changes
to the application and management of local designated pharmacies.
.
At the beginning of 2021, the "Interim Measures for the Management of Medical Security Designated Points in Retail Pharmacies" deliberated and approved by the National Medical Insurance Bureau was officially announced
.
Since then, all provinces, municipalities and autonomous regions have taken this as a model, combined with the actual local situation, formulated local designated pharmacy management measures or rules, and also brought new changes
to the application and management of local designated pharmacies.
Some insiders said that the most direct change brought about by the "Measures" is that the penalties are heavier and the cost of violations is higher
.
The introduction of the new interim management measures has also tightened a string
for the managers of designated pharmacies in various places.
.
The introduction of the new interim management measures has also tightened a string
for the managers of designated pharmacies in various places.
03 Doing the opposite? A group of pharmacies voluntarily withdrew from medical insurance
Nowadays, more and more people began to pay attention to medical insurance, the number of insured users is also rising, in daily life to buy drugs, people will also give priority to the medical insurance designated pharmacies for consumption, so that the medical insurance drugs in the pharmacy can not only achieve higher turnover, but also can drive non-medical insurance drugs and non-drug sales, it can be said that becoming a medical insurance designated pharmacy has more advantages
than ordinary pharmacies.
than ordinary pharmacies.
And to become a medical insurance designated pharmacy, it must meet certain conditions, and the regulatory authorities have invisibly endorsed the trust of the designated pharmacy, indicating that the pharmacy is more trustworthy and is also conducive to increasing the source of
customers.
Therefore, in the industry, the qualification of Medicare designated pharmacies has always been the level
that retail pharmacies continue to strive to achieve.
customers.
Therefore, in the industry, the qualification of Medicare designated pharmacies has always been the level
that retail pharmacies continue to strive to achieve.
However, the situation seems to be a little different now, and a number of pharmacies
have recently emerged in the industry that have voluntarily withdrawn from medical insurance.
have recently emerged in the industry that have voluntarily withdrawn from medical insurance.
In early August, the Huizhou Municipal Medical Insurance Bureau in Guangdong Province issued a public announcement to terminate the service agreement
for 109 medical insurance designated retail pharmacies, including Zhengkang Pharmacy in Zhongkai High-tech Zone, Huizhou City.
Among them, chain pharmacies account for less than one-third, and most of the rest are single pharmacies
.
The announcement did not explain the specific reasons for the termination of the agreement, but after combing, it was found that a large number of single pharmacies that were still in business among the 109 pharmacies also terminated the medical insurance agreement
.
for 109 medical insurance designated retail pharmacies, including Zhengkang Pharmacy in Zhongkai High-tech Zone, Huizhou City.
Among them, chain pharmacies account for less than one-third, and most of the rest are single pharmacies
.
The announcement did not explain the specific reasons for the termination of the agreement, but after combing, it was found that a large number of single pharmacies that were still in business among the 109 pharmacies also terminated the medical insurance agreement
.
Recently, Yiwu Medical Security Center agreed to terminate the medical security service agreements
of 6 retail pharmacies upon application by retail pharmacies in accordance with the provisions of the Interim Measures for the Management of Designated Medical Security of Retail Pharmacies and the Agreement on Medical Security Services of Designated Retail Pharmacies of Jinhua City.
of 6 retail pharmacies upon application by retail pharmacies in accordance with the provisions of the Interim Measures for the Management of Designated Medical Security of Retail Pharmacies and the Agreement on Medical Security Services of Designated Retail Pharmacies of Jinhua City.
In addition to the above-mentioned areas, in mid-April, the Dongguan Municipal Medical Security Bureau in Guangdong Province issued a notice
to terminate the medical insurance agreements of seven retail pharmacies.
The notice shows that the reason why the seven retail pharmacies applied for the termination of the medical insurance agreement was due to business adjustments
.
to terminate the medical insurance agreements of seven retail pharmacies.
The notice shows that the reason why the seven retail pharmacies applied for the termination of the medical insurance agreement was due to business adjustments
.
All indications show that the "surrender wave" in the industry has spread to many places
.
.
Pharmacies take the initiative to withdraw from medical insurance, mainly for three reasons, on the one hand, the "non-drug" business restrictions, which is also the most important reason, such as Henan's "non-medical insurance card" area of designated pharmacies proposed a red line limit of 20%, which will also "dissuade" some pharmacies
.
In the past, pharmacies mainly relied on medical insurance drugs to maintain profitability, and thus drove the sales of "non-drugs", but now the restrictions on "non-drugs" have been significantly tightened, and pharmacy operators feel that they are "unprofitable", and there are not a few
who choose to take the initiative to "surrender".
.
In the past, pharmacies mainly relied on medical insurance drugs to maintain profitability, and thus drove the sales of "non-drugs", but now the restrictions on "non-drugs" have been significantly tightened, and pharmacy operators feel that they are "unprofitable", and there are not a few
who choose to take the initiative to "surrender".
On the other hand, the landing of "zero difference rate" has further compressed the profit space of pharmacies; In addition, according to industry insiders, the delay in medical insurance settlement is also one of the influencing factors
.
Generally speaking, the allocation of medical insurance payments needs to go through a series of approval procedures, the arrival time is often later than the time period required for the flow of funds, pharmacies want to use funds to purchase goods, but the money has not arrived, then the pharmacy will fall into the dilemma
of "moving".
.
Generally speaking, the allocation of medical insurance payments needs to go through a series of approval procedures, the arrival time is often later than the time period required for the flow of funds, pharmacies want to use funds to purchase goods, but the money has not arrived, then the pharmacy will fall into the dilemma
of "moving".
In the future, under the background of pharmaceutical reform and intensified market competition, small and medium-sized chains and single pharmacies are destined to face more challenges, and a large number of pharmacies with poor strength will eventually face elimination
.
It should be clear that the management of medical insurance designated pharmacies has always been dynamic, there is in and out is the norm, and pharmacies that remain in medical insurance are still the mainstream
.
.
It should be clear that the management of medical insurance designated pharmacies has always been dynamic, there is in and out is the norm, and pharmacies that remain in medical insurance are still the mainstream
.
Recently, the Henan Provincial Medical Security Bureau issued the "Work Plan for New Designated Medical Institutions in Henan Province (Trial Implementation)" (hereinafter referred to as the "Plan") to standardize the access of
designated medical institutions.
designated medical institutions.
The "Plan" mentions that pharmacies apply for fixed-point qualifications, and the operating area of "non-medical insurance swipe card" must be within 20%; The store area is less than 100 square meters, and points are directly deducted
.
.
It is becoming more and more difficult for retail pharmacies to apply for medical insurance designated pharmacy qualifications?
01 Henan Medical Insurance Bureau: "Non-medical insurance card" area is less than 20%
01 Henan Medical Insurance Bureau: "Non-medical insurance card" area is less than 20% The "Plan" divides the assessment work of designated pharmacies into two forms of assessment, written and on-site, covering a total of 9 types of inspection items, involving whether the written materials are consistent with the actual situation, practicing pharmacist qualification certificates and labor contracts, and drug purchase, sale and inventory management
.
Pharmaceuticals.
It is worth noting that the "Plan" puts forward requirements for the operating area of non-medical insurance drugs such as health care products, and no more than 20% becomes a red line
.
In other words, after the pharmacy successfully applies for a designated pharmacy, the sales area of non-medical insurance card products such as health care products can be retained, but the area must be strictly controlled
.
Health care products health products pharmacies pharmacies.
In other words, after the pharmacy successfully applies for a designated pharmacy, the sales area of non-medical insurance card products such as health care products can be retained, but the area must be strictly controlled
.
In addition, the "Plan" also stipulates the situation of "one-vote veto", in the above-mentioned assessment content, if the written materials declared by the pharmacy are inconsistent with the original on-site inspection, one vote is vetoed; If it does not meet the standard, one vote will veto (if one vote is rejected, the original and copy of the relevant materials shall be photographed for future reference).
On the whole, the newly released evaluation standards for designated pharmacies do put forward higher requirements
for the operating capacity and store layout of pharmacies.
for the operating capacity and store layout of pharmacies.
02 Many places have issued documents that the application conditions for designated pharmacies are more stringent
02 Many places have issued documents that the application conditions for designated pharmacies are more stringent When minai retail observation combed through the information, it was found that in addition to Henan, the application conditions for designated pharmacies in other provinces were also becoming more stringent
.
.
Previously, the Zhejiang Provincial Medical Security Bureau issued the "Detailed Rules for the Determination and Evaluation of Designated Retail Pharmacies for Medical Security" (hereinafter referred to as the "Detailed Rules") to strengthen and standardize the determination of medical security designated points in retail pharmacies, encourage and guide all types of retail pharmacies to participate in fair competition, and officially implemented
on January 1, 2022.
on January 1, 2022.
Among them, the evaluation rules for designated pharmacies have triggered discussions in the industry, emphasizing that pharmacies need to be formally operating at their registered address for at least 3 months; At least 1 pharmacist who has obtained a practicing pharmacist qualification certificate or has a professional and technical qualification certificate in pharmacy, clinical pharmacy, or Traditional Chinese medicine, and the place of registration is in the retail pharmacy, and the pharmacist must sign a labor contract for 1 year or more and within the contract period; At least 2 full-time (part-time) medical insurance managers who are familiar with the provisions of medical security laws and regulations and related systems are responsible for managing medical insurance expenses and signing a labor contract for 1 year or more and during the contract period
.
Regulations.
In addition, the detailed rules also mention that if the relevant designated medical institution of the same legal entity (investment entity) has been suspended, terminated or terminated due to violations within one year and is being investigated and handled by the handling agency, the application of
the designated retail pharmacy will not be accepted.
Medicinethe designated retail pharmacy will not be accepted.
It is evident that the trend of strict requirements for pharmacies in the new evaluation rules has emerged
.
.
In January this year, the Guangxi Medical Insurance Bureau issued the "Interim Measures for the Designated Management of Medical Security in Retail Pharmacies in Guangxi" (hereinafter referred to as the "Measures"), which was officially implemented
from February 1.
from February 1.
It is mentioned that the application for medical insurance designated pharmacies needs to meet 8 necessary conditions, and all 12 assessments must be qualified
.
If any one of the conditions does not meet the requirements, the assessment result is unqualified
.
If the rectification is still not in line with the requirements after 3 months, the pharmacy shall not apply
again within 1 year.
.
If any one of the conditions does not meet the requirements, the assessment result is unqualified
.
If the rectification is still not in line with the requirements after 3 months, the pharmacy shall not apply
again within 1 year.
The Measures stipulate that pharmacies applying for medical security must meet 8 conditions at the same time, such as officially operating at a registered address for at least 3 months; At least 1 pharmacist who has obtained a practicing pharmacist qualification certificate or has a professional and technical qualification certificate in pharmacy, clinical pharmacy, or traditional Chinese medicine; The business area of retail pharmacies in accordance with the regulations of the co-ordination area.
On this basis, the Guangxi Medical Insurance Bureau designed the "Rules for the Assessment of The Access of Designated Retail Pharmacies", which involves a total of 12 assessment contents, and if any subdivision of the assessment rules is no/none, the item is unqualified and the assessment results are unqualified
.
.
In recent years, the medical insurance reform has been deepening in the industry, bringing more uncertainty to the future development of medical insurance designated pharmacies
.
At the beginning of 2021, the "Interim Measures for the Management of Medical Security Designated Points in Retail Pharmacies" deliberated and approved by the National Medical Insurance Bureau was officially announced
.
Since then, all provinces, municipalities and autonomous regions have taken this as a model, combined with the actual local situation, formulated local designated pharmacy management measures or rules, and also brought new changes
to the application and management of local designated pharmacies.
.
At the beginning of 2021, the "Interim Measures for the Management of Medical Security Designated Points in Retail Pharmacies" deliberated and approved by the National Medical Insurance Bureau was officially announced
.
Since then, all provinces, municipalities and autonomous regions have taken this as a model, combined with the actual local situation, formulated local designated pharmacy management measures or rules, and also brought new changes
to the application and management of local designated pharmacies.
Some insiders said that the most direct change brought about by the "Measures" is that the penalties are heavier and the cost of violations is higher
.
The introduction of the new interim management measures has also tightened a string
for the managers of designated pharmacies in various places.
.
The introduction of the new interim management measures has also tightened a string
for the managers of designated pharmacies in various places.
03 Doing the opposite? A group of pharmacies voluntarily withdrew from medical insurance
03 Doing the opposite? A group of pharmacies voluntarily withdrew from medical insurance Nowadays, more and more people began to pay attention to medical insurance, the number of insured users is also rising, in daily life to buy drugs, people will also give priority to the medical insurance designated pharmacies for consumption, so that the medical insurance drugs in the pharmacy can not only achieve higher turnover, but also can drive non-medical insurance drugs and non-drug sales, it can be said that becoming a medical insurance designated pharmacy has more advantages
than ordinary pharmacies.
than ordinary pharmacies.
And to become a medical insurance designated pharmacy, it must meet certain conditions, and the regulatory authorities have invisibly endorsed the trust of the designated pharmacy, indicating that the pharmacy is more trustworthy and is also conducive to increasing the source of
customers.
Therefore, in the industry, the qualification of Medicare designated pharmacies has always been the level
that retail pharmacies continue to strive to achieve.
customers.
Therefore, in the industry, the qualification of Medicare designated pharmacies has always been the level
that retail pharmacies continue to strive to achieve.
However, the situation seems to be a little different now, and a number of pharmacies
have recently emerged in the industry that have voluntarily withdrawn from medical insurance.
have recently emerged in the industry that have voluntarily withdrawn from medical insurance.
In early August, the Huizhou Municipal Medical Insurance Bureau in Guangdong Province issued a public announcement to terminate the service agreement
for 109 medical insurance designated retail pharmacies, including Zhengkang Pharmacy in Zhongkai High-tech Zone, Huizhou City.
Among them, chain pharmacies account for less than one-third, and most of the rest are single pharmacies
.
The announcement did not explain the specific reasons for the termination of the agreement, but after combing, it was found that a large number of single pharmacies that were still in business among the 109 pharmacies also terminated the medical insurance agreement
.
for 109 medical insurance designated retail pharmacies, including Zhengkang Pharmacy in Zhongkai High-tech Zone, Huizhou City.
Among them, chain pharmacies account for less than one-third, and most of the rest are single pharmacies
.
The announcement did not explain the specific reasons for the termination of the agreement, but after combing, it was found that a large number of single pharmacies that were still in business among the 109 pharmacies also terminated the medical insurance agreement
.
Recently, Yiwu Medical Security Center agreed to terminate the medical security service agreements
of 6 retail pharmacies upon application by retail pharmacies in accordance with the provisions of the Interim Measures for the Management of Designated Medical Security of Retail Pharmacies and the Agreement on Medical Security Services of Designated Retail Pharmacies of Jinhua City.
of 6 retail pharmacies upon application by retail pharmacies in accordance with the provisions of the Interim Measures for the Management of Designated Medical Security of Retail Pharmacies and the Agreement on Medical Security Services of Designated Retail Pharmacies of Jinhua City.
In addition to the above-mentioned areas, in mid-April, the Dongguan Municipal Medical Security Bureau in Guangdong Province issued a notice
to terminate the medical insurance agreements of seven retail pharmacies.
The notice shows that the reason why the seven retail pharmacies applied for the termination of the medical insurance agreement was due to business adjustments
.
to terminate the medical insurance agreements of seven retail pharmacies.
The notice shows that the reason why the seven retail pharmacies applied for the termination of the medical insurance agreement was due to business adjustments
.
All indications show that the "surrender wave" in the industry has spread to many places
.
.
Pharmacies take the initiative to withdraw from medical insurance, mainly for three reasons, on the one hand, the "non-drug" business restrictions, which is also the most important reason, such as Henan's "non-medical insurance card" area of designated pharmacies proposed a red line limit of 20%, which will also "dissuade" some pharmacies
.
In the past, pharmacies mainly relied on medical insurance drugs to maintain profitability, and thus drove the sales of "non-drugs", but now the restrictions on "non-drugs" have been significantly tightened, and pharmacy operators feel that they are "unprofitable", and there are not a few
who choose to take the initiative to "surrender".
.
In the past, pharmacies mainly relied on medical insurance drugs to maintain profitability, and thus drove the sales of "non-drugs", but now the restrictions on "non-drugs" have been significantly tightened, and pharmacy operators feel that they are "unprofitable", and there are not a few
who choose to take the initiative to "surrender".
On the other hand, the landing of "zero difference rate" has further compressed the profit space of pharmacies; In addition, according to industry insiders, the delay in medical insurance settlement is also one of the influencing factors
.
Generally speaking, the allocation of medical insurance payments needs to go through a series of approval procedures, the arrival time is often later than the time period required for the flow of funds, pharmacies want to use funds to purchase goods, but the money has not arrived, then the pharmacy will fall into the dilemma
of "moving".
.
Generally speaking, the allocation of medical insurance payments needs to go through a series of approval procedures, the arrival time is often later than the time period required for the flow of funds, pharmacies want to use funds to purchase goods, but the money has not arrived, then the pharmacy will fall into the dilemma
of "moving".
In the future, under the background of pharmaceutical reform and intensified market competition, small and medium-sized chains and single pharmacies are destined to face more challenges, and a large number of pharmacies with poor strength will eventually face elimination
.
It should be clear that the management of medical insurance designated pharmacies has always been dynamic, there is in and out is the norm, and pharmacies that remain in medical insurance are still the mainstream
.
.
It should be clear that the management of medical insurance designated pharmacies has always been dynamic, there is in and out is the norm, and pharmacies that remain in medical insurance are still the mainstream
.
