The selection criteria for dual-channel pharmacies are here!

Following Hebei, another province has introduced the selection criteria for dual-channel pharmacies

Dual-channel pharmacies, the selection criteria are coming

On November 23, the Jiangxi Provincial Medical Insurance Bureau issued the "Interim Measures for the Administration of Drugs for Dual Channel Negotiations in Jiangxi Province" (hereinafter referred to as the "Measures"), and it is clear that it will be implemented on December 1, 2021

The "Measures" pointed out that dual-channel drugs implement the "dual-channel three-fixed management" of designated medical institutions (hereinafter referred to as dual-channel medical institutions), designated responsible physicians (hereinafter referred to as responsible physicians), and designated retail pharmacies (hereinafter referred to as dual-channel pharmacies).

For the selection of retail pharmacies, according to the Measures, to apply for a dual-channel pharmacy, the following 12 conditions must be met:

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

Many provinces emphasize that at least 2 licensed pharmacists

Of course, Jiangxi Province is not the first province to introduce the selection rules for dual-channel pharmacies.

It should be noted that the two provinces have clearly stipulated the number of licensed pharmacists, with at least 2 full-time licensed pharmacists; they have been included in the management of designated retail pharmacies for more than 3 years (including 3 years).
In the past three years, there has been no violation of laws or regulations.
The behavior was notified by the market supervision and drug regulatory authorities, and did not violate the medical insurance service agreement of designated retail pharmacies
.

The difference is that the "Measures" of Jiangxi Province emphasizes that the "Pharmaceutical Business License" has a "biological product" business scope, while Hebei Province emphasizes the establishment of a special business area for negotiating drugs, with an area of ​​more than 40 square meters, including independent drug fields.
in warehousing, pharmaceutical sales, pharmaceutical care, patient care and rest
.

In accordance with the requirements of the National Medical Insurance Administration, the medical insurance departments of all regions must adhere to the principle of “openness, fairness, and justice”, determine the selection criteria and procedures, and ensure that the qualifications are compliant, the management practices, the reputation is good, the layout is reasonable, and the Designated retail pharmacies with retrospective conditions are included in the "dual channel" management, and they are proactively disclosed to the public in a timely manner
.

Compared with ordinary designated retail pharmacies, higher requirements are put forward for designated retail pharmacies that are included in the "dual channel" management
.
Specific requirements are as follows:

One is informatization
.
Designated retail pharmacies must interface with medical insurance information platforms, electronic prescription circulation platforms, etc.
, to ensure comprehensive, accurate, and timely communication of information on medicines and medical insurance payments
.

The second is drug management
.
Some negotiated drugs have special requirements for storage, and designated retail pharmacies need to establish a storage and distribution system that meets the requirements to ensure drug quality and safety
.
At the same time, professionals are equipped to guide patients in the rational use of drugs to ensure the safety of clinical drug use
.

The third is the supervision of medical insurance funds
.
Designated retail pharmacies should take more stringent measures to verify the identity of patients to ensure that "prescribed patients" and "actual medication patients" are consistent, plug the loopholes of "fraud insurance" and ensure fund security
.

8 cases, withdraw from management, no longer included in two years

In addition, the National Medical Insurance Bureau has also made it clear that it is necessary to establish a sound "dual channel" exit mechanism for designated retail pharmacies, moderate competition, and dynamic adjustments
.
It is reported that Hebei and Jiangxi both have clear regulations on this
.

Among them, Hebei Province emphasized that if one of the following circumstances exists in a designated retail pharmacy, the application for the selection of a "dual channel" designated retail pharmacy will not be accepted:

1.
Failure to perform administrative punishment responsibilities in accordance with the law;

2.
The license information is inconsistent;

3.
Applying for a fixed point by fraudulent or other improper means, and it has been less than 3 years since the date of discovery;

4.
The legal representative, the main person in charge or the actual controller has once caused the original designated retail pharmacy to be released from the medical insurance agreement due to serious violations of laws and regulations, and it has not been 5 years;

5.
The legal representative, main responsible person or actual controller is included in the list of dishonest persons;

6.
Hanging up the medical insurance fixed-point logo in advance or fraudulently using the medical insurance fixed-point qualification;

7.
Other non-acceptable circumstances stipulated by law
.

The "Measures" of Jiangxi Province mentioned that for dual-channel medical institutions that are not equipped for a long time or are insufficiently equipped, and the dual-channel drug reserves cannot reach the agreed number, resulting in the insured persons being unable to purchase drugs, the investigation has verified that the total number of drugs has reached 1 time per year.
Reminders should be made; if there are 2 accumulative times in the year, interviews and rectification within a time limit shall be conducted, and the integrity assessment score of the year shall be deducted at the same time; if accumulatively 3 times or more in the year, the dual-channel management shall be withdrawn and will not be included within two years
.

At the same time, dual-channel medical institutions that have one of the following circumstances shall withdraw from dual-channel management and cease to be included within two years:

1.
Forgery, alter or alter the bills and accounts of the dual-channel drug "purchase, sale, and deposit";

2.
Request or induce insured persons to purchase medicines at designated pharmacies, causing adverse social impact;

3.
Selling dual-channel medicines at a price that exceeds the payment standard for medical insurance in our province;

4.
The dual-channel pharmaceutical and medical insurance settlement business was not carried out in the previous year, or although the dual-channel pharmaceutical and medical insurance settlement business was carried out but the medical insurance settlement business was less than 10 persons;

5.
Provide false certification materials for insured persons to enjoy dual-channel drug and medical insurance benefits;

6.
Provide convenience for the insured persons to resell dual-channel drugs to obtain illegal benefits;

7.
Other violations of laws and regulations, or violations of medical insurance service agreements of designated medical institutions that cause loss of medical insurance funds or serious adverse social impacts;

8.
Other situations that should be withdrawn from dual-channel management stipulated by the overall planning area
.