New changes!A list

In order to ensure the safe, efficient and reasonable use of medical insurance funds, Beijing implements the dynamic management methods of medical security institutions. Municipal and district medical insurance agencies regularly conduct review, evaluation, and adjustment, and strengthen the supervision and management of medical insurance designated pharmaceutical institutions.

It is understood that from January to July this year, a total of 6 fixed-point pharmaceutical institutions in Haidian District resumed medical security service agreements, and three fixed-point pharmaceutical institutions stopped the medical security service agreement. In addition, there are two new medical institutions for new special disease services.

Fixed -point pharmaceutical institutions that resume the medical insurance service agreement

After review by the municipal and district medical insurance agencies, the above six fixed -point pharmaceutical institutions already have the conditions to undertake medical security tasks and resume the signing of basic medical security service agreements. The above -mentioned designated pharmaceutical institutions will implement the basic medical insurance regulations of Beijing, and effectively provide standardized, high -quality and convenient medical services for the people participating people. At present, except for the health service stations in Zhufangqian Street, Dongsheng Town, Haidian District, Beijing, the remaining five provides outpatient medical services to insured personnel in the army camps.

Stop the designated pharmaceutical institution of the medical insurance service agreement

After review by the municipal and district medical insurance agencies, the above three fixed -point pharmaceutical institutions suspended the medical security service agreement because they could not continue to provide services to insured personnel. After suspending the agreement, the above -mentioned designated pharmaceutical institutions will no longer undertake medical insurance tasks, and the basic medical insurance funds incurred by insured persons in the above -mentioned pharmaceutical institutions will not be paid.

The special disease of the outpatient clinic refers to the relatively stable condition and does not need to be hospitalized, but it needs to be treated in the outpatient clinic for a long time, and it is included in the chronic or severe diseases of the basic medical insurance fund payment range.

It is understood that at present, there are 17 types of special diseases in Beijing's outpatient clinics, including: malignant tumor outpatient treatment (for example, various types of cancer, leukemia, malignant lymphoma, etc.), kidney dialysis, kidney transplantation of anti -excretion treatment, hemophilia disease, hemophilia disease , Regenerative disorders, anti -rejection therapy after liver transplantation, anti -rejecting therapy after liver and kidney combined transplantation, anti -excretion therapy after cardiac transplantation, anti -rejection therapy after lung transplantation Eye injection treatment, severe psychiatric disease, pulmonary hypertension targeting, multi -drug tuberculosis, C -type Nippi disease, medium -sized allergic asthma biological agent therapy and special pulmonary fibrosis anti -fibrosis therapy.

In response to some diseases that need to be treated in outpatient treatment for a long time and have high medical expenses, Beijing has established a system for reimbursement system for outpatient special diseases. After approval of special diseases, patients can choose a designated hospital for special diseases for record. The medical expenses of special diseases for outpatients can be reimbursed by the medical insurance fund according to the hospitalization standard. Insurance patients can not only enjoy more convenient medical services, but also greatly alleviate personal economic burdens.

Newly opened designated medical institutions for special disease services

At present, a total of 31 scheduled medical institutions in Haidian District have the qualifications to carry out one or more special disease services. The types of diseased diseases include 16 special diseases other than anti -rejection therapy after cardiac transplantation.

The reporter learned from the District Medical Insurance Bureau that for the designated medical institutions that apply for special disease services, the district -level medical insurance agency shall be based on relevant documents. Practicing physicians and treatment equipment with corresponding qualifications to ensure that the medical institution has both special disease treatment conditions and medical insurance related management regulations.

Reporter: Guan Yiping

Edit: Luo Yuhan

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