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"Yang" to see a doctor, take medicine, how to be reimbursed by medical insurance? Many places have made clear →

 Last Update: 2023-02-03
 Source: Internet
 Author: User

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With the optimization and adjustment of China's epidemic prevention and control measures, the official announced that from January 8, the new coronavirus infection will be implemented "Class B tube", and how to reimburse medical insurance for medical treatment and medicine after "Yang" has also become the focus of
attention.
Recently, many places have clarified reimbursement policies
.
Beijing: Temporary inclusion of various drugs such as "compound aminophenolamine capsules" into the scope of medical insurance reimbursement On December 17, 2022, the website of the Beijing Municipal Medical Security Bureau announced that in order to actively respond to the new coronavirus pneumonia epidemic, strengthen Beijing's security work, and ensure the drug needs of insured persons for the treatment of new coronavirus pneumonia, with the approval of the National Medical Security Administration, six drugs including compound aminophenol alamine capsules, compound aminophenol methyl oral liquid, pediatric aminophen xanthamine granules, ambuffin huangmin capsules, clofenxanthin tablets, and ambrobuterol oral solution were temporarily included in the reimbursement scope of Beijing medical insurance and work-related injury insurance
。 The reimbursement ratio shall be implemented
in accordance with Class A drugs.
The notice will be implemented from December 18, 2022 and will be valid until March 18
, 2023.
In addition, Beijing has also explicitly included epidemic prevention and control drugs such as nematevir tablets/ritonavir tablets, ambavirumab/romisivimab injection, intravenous COVID-19 human immunoglobulin, and Shufeng detoxification granules into the payment scope
of the medical insurance fund 。 Anhui: The reimbursement rate of outpatient expenses for new crown infection is unified at 70% According to the website of the Anhui Provincial Medical Security Bureau, on December 29, the Anhui Provincial Medical Security Bureau, the Anhui Provincial Department of Finance and the Anhui Provincial Health Commission jointly issued an urgent notice on doing a good job in the outpatient treatment and guarantee of new coronavirus infection, clarifying that the medical expenses incurred by the insured in accordance with the new coronavirus pneumonia diagnosis and treatment plan and other provisions incurred by the insured in the general outpatient (emergency) treatment in the coordinated area will be included in the payment scope of the basic medical insurance pooling fund, and there is no payment threshold or reimbursement limit, and the reimbursement ratio is unified at 70%
。 At the same time, the settlement level restriction
of designated institutions will be removed.
Designated medical institutions that have opened basic medical insurance pooling fund settlement services in the coordination area will be temporarily included in the scope of new crown infection outpatient pooling and settlement, and support insured personnel to obtain outpatient treatment and guarantee treatment
in a timely manner.
Regarding the settlement of outpatient expenses for new crown infection, the notice pointed out that the Anhui Provincial Medical Insurance Information Center optimized the settlement system module of the Anhui Provincial Medical Insurance Information Platform, and uniformly enabled the "new crown outpatient (1102)" medical category to settle the outpatient expenses
of new crown infection.
If the insured person is treated in a different place due to temporary outing, visiting relatives and other new crown infections, or is temporarily not eligible for online settlement, or needs to suspend the medical insurance settlement system (shutdown) due to New Year's Eve, or cannot settle the settlement on site immediately due to network failure, etc
.
, he can apply for manual reimbursement at the medical insurance agency in the place of participation with the relevant outpatient fee receipt 。 Shandong: Online consultation of new crown symptoms is included in medical insurance reimbursement consistent with offline reimbursement policy According to the website of the Shandong Provincial Medical Security Bureau on December 28, the Shandong Provincial Medical Security Bureau and the Shandong Provincial Health Commission jointly issued the Notice on Doing a Good Job in Internet Medical Security Services for Novel Coronavirus Infection, which clarifies that the Internet consultation fee for new crown-related symptoms is included in the payment scope of basic medical insurance, which is consistent
with the offline reimbursement policy.
At the same time, medical institutions are encouraged to provide 24-hour online consultation services to provide medical treatment, psychological counseling and medication guidance services
for children, pregnant women, the elderly, dialysis patients and patients with underlying diseases.
The notice requires that medical insurance departments should settle and pay "Internet +" medical expenses in a timely manner, strengthen intelligent review, and promote the rational and standardized use of
medical insurance funds 。 Henan: 14 medical institution preparations and 6 proprietary Chinese medicines were temporarily included in the medical insurance payment scope According to the news on the website of the Henan Provincial Medical Insurance Bureau on December 30, with the approval of the National Medical Security Administration, the Henan Provincial Medical Insurance Bureau and the Provincial Department of Human Resources and Social Security temporarily included 14 medical institution preparations such as Jinburdock Qingjian Epidemic Granules and 6 kinds of proprietary Chinese medicines such as bluestone granules used for the prevention and treatment of the new coronavirus into the payment scope of Henan Province's basic medical insurance and work-related injury insurance, with a payment period until March 31
, 2023.
Previously, on December 9, the Henan Provincial Medical Insurance Bureau issued a document to include the "Jiuwei Qingwei Drinking Granules" declared by Nanyang Hospital of Traditional Chinese Medicine into the payment scope of the Henan Provincial Medical Insurance Fund, which was managed according to Class B drugs, and clarified that the medical insurance fund was paid
in accordance with the scope of the adjustment approved by the drug regulatory department.
At the same time, in line with the principle of preserving capital and making small profits and giving benefits to the people, the Henan Provincial Medical Insurance Bureau and the Nanyang Municipal Medical Insurance Bureau carried out price negotiations to determine the medical insurance payment limit
.
After several rounds of negotiation, the price of preparations was reduced from 51.
41 yuan/box to 48 yuan/box, a decrease of 6.
6%, further reducing the burden of
drug costs on patients 。 Guangdong: Internet first diagnosis and antigen test Medical insurance provides policy support In December 2022, the Guangdong Provincial Medical Insurance Bureau issued the Notice on Further Improving the Payment of Medical Insurance for "Internet +" Medical Services for New Coronary Pneumonia, whereby the basic medical insurance fund will pay
the basic medical insurance fund for the first consultation at designated medical institutions (including Internet hospitals and medical institutions that carry out Internet diagnosis and treatment services) in designated medical institutions (including Internet hospitals and medical institutions that carry out Internet diagnosis and treatment services) and issue prescriptions.
Drug delivery service fees are not included in the medical insurance payment scope
.
According to the deployment of the National Health Insurance Administration, Guangdong Province will temporarily include the new coronavirus antigen detection reagents and corresponding test items in the catalog of medical consumables and diagnosis and treatment items of Guangdong Province
.
The medical insurance fund shall pay
the new coronavirus antigen test expenses incurred by insured patients in primary medical institutions.
In addition, the cost of purchasing new coronavirus antigen detection reagents at designated retail pharmacies can be paid by the insured person's personal account of employee medical insurance
.
The spouse, parents and children of the insured can use the personal account of the insured to purchase antigen detection reagents
at designated medical institutions.
Hubei: 36 new crown drugs are temporarily included in medical insurance According to the news of the Hubei Provincial Medical Security Bureau on December 29, 2022, with the approval of the National Medical Security Administration, from December 29, 2022, 36 new coronavirus drugs such as pediatric aminophenol xanamine granules and compound forcordine syrup will be temporarily included in the reimbursement scope of Hubei Provincial Medical Insurance, and the reimbursement ratio will be implemented in accordance with Class A drugs
。 In addition, in order to ensure the supply of antipyretic and analgesic, cough and cold medicines and other epidemic prevention and control drugs in medical institutions, strengthen the supply of new crown infection treatment drugs, and meet the needs of the public, since December 16, the Hubei Provincial Medical Insurance Bureau has opened a green channel
for emergency hanging of urgently needed drugs related to new crown infection.
Up to now, three batches of urgently needed drugs related to new crown infection have been carried out on the emergency network, and the network has been listed first and then reviewed, and the network should be hung up in batches to ensure the orderly procurement and supply
of medical institutions in the province.
The 3 batches of new crown infection-related drugs emergency listing list involves a total of 31 drugs, all of which are cold, fever, cough and other therapeutic drugs, including the antipyretic analgesic ibuprofen, pediatric lung clearing granules, ambroxol hydrochloride oral solution, dextromethorphan hydrobromide capsules, human immunoglobulin, etc
.
At the same time, the price of the drug-hung drug pediatric lung cleansing granules was adjusted, from the original 94.
8 yuan / box to 79 yuan / box
.
Yunnan: 41 drugs have been provisionally included in medical insurance On December 30, 2022, the Yunnan Provincial Medical Security Bureau issued a notice to temporarily include 41 drugs such as Sangju Yinqiao into the scope of medical insurance payment, and the medical insurance payment time limit is from January 1, 2023 to March 31
, 2023 according to the management of Class A drugs 。 Yunnan Province's list of drugs temporarily included in the scope of medical insurance payment Guangxi: 15 kinds of new crown drugs can be brushed with medical insurance The Medical Security Bureau of Guangxi Zhuang Autonomous Region recently issued the Notice of the Autonomous Region Medical Insurance Bureau on Temporarily Including 15 Drugs such as Exosensory Rheumatoid Granules into the Payment Scope of the Basic Medical Insurance Fund, which clarifies that with the approval of the National Medical Security Administration, 15 drugs such as exosensory rheumatoid granules will be temporarily included in the payment scope of the basic medical insurance fund and reimbursed
according to medical insurance Class A drugs 。 The Guangxi Zhuang Autonomous Region was temporarily included in the list of drugs covered by the basic medical insurance fund Shaanxi: 234 new crown drugs are temporarily included in medical insurance According to the website of the Shaanxi Provincial Medical Insurance Bureau, on December 21, 2022, the Shaanxi Provincial Medical Security Bureau, the Shaanxi Provincial Health Commission, and the Shaanxi Provincial Taxation Bureau of the State Administration of Taxation jointly issued the Notice on Further Doing a Good Job in the Current Epidemic Prevention and Control Medical Security, and confirmed and suspected patients will use the Shaanxi Provincial Health Commission Shaanxi Provincial Traditional Chinese Medicine The 107 proprietary Chinese medicines recommended in the Notice of the Administration on Printing and Distributing the Prevention Plan of Traditional Chinese Medicine for New Coronavirus Infection in Shaanxi Province (Third Edition) and Treatment Plan (Trial Fourth Edition) (Shaanwei Traditional Chinese Medicine Fa [2022] No.
53) and 127 drugs of two categories selected by experts organized by the Provincial Food and Drug Administration and the Provincial Health Commission to have strong pertinence to the new crown condition and obvious treatment effect are temporarily included in the medical insurance payment scope, and the medical insurance payment will be until June 30, 2023, guaranteeing the use
of drugs for confirmed and suspected patients.

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