Hebei: Incorporate suitable Chinese medicine and traditional Chinese medicine medical service projects into medical insurance

Recently, the Provincial Medical Security Bureau and the Provincial Administration of Traditional Chinese Medicine jointly issued the "Several Measures on Medical Insurance Supporting the Innovation and Development of TCM inheritance and Innovation" (hereinafter referred to as "Several Measures"), and proposed to include suitable Chinese medicine and traditional Chinese medicine medical service projects into the scope of medical insurance payment scope Essence

Incorporate the eligible Chinese medicine and medicine institutions into the medical preservation point

According to the "Several Measures", Hebei Province will include Chinese medicine and traditional Chinese medicine drinks that are included in the national medical insurance directory into the scope of medical insurance payment. The positive role of traditional Chinese medicine in major epidemic prevention will be temporarily incorporated into the scope of medical insurance payment in accordance with the codenum of epidemic diagnosis and treatment. According to the affordability of the medical insurance fund, other national or provincial traditional Chinese medicine films that meet the conditions are included in the scope of medical insurance payment.

At the same time, in accordance with the needs of clinical medication and the ability to withstand the medical insurance fund, the auctive hospitals approved by the provincial drug supervision and management department are included in the scope of medical insurance payment, and a dynamic adjustment mechanism is established. The designated medical institutions are purchased and used on the provincial pharmaceutical centralized procurement platform, and the traditional Chinese medicine formula particles corresponding to the national and provincial quality standards in the medical insurance directory are included in the scope of medical insurance payment.

In terms of traditional Chinese medicine medical service projects, the "Several Measures" proposes that according to the ability of the medical insurance fund to withstand the accurate efficacy and the advantages of traditional Chinese medicine, the appropriate technology of traditional Chinese medicine is included in the scope of medical insurance payment, and a dynamic adjustment mechanism is established. Incorporate the eligible Chinese medicine (including the combination of traditional Chinese and western medicine), and the Chinese medicine retail pharmacy into the management of fixed -point agreement, the primary medical and health institutions and rehabilitation hospitals, the Anning therapy center, the nursing home, etc. of the primary medical and health institutions provided by the qualified Chinese medicine services are included in The designated management of medical insurance will incorporate qualified designated Chinese medicine medical institutions into the scope of direct settlement of medical treatment in different places. The designated "Internet+" traditional Chinese medicine medical service projects corresponding to offline medical insurance medical service projects provided by the designated Chinese medicine medical institutions of Internet diagnosis and treatment services are included in the scope of medical insurance payment.

Regularly carry out the price adjustment evaluation of medical service projects

In terms of price management of traditional Chinese medicine services, the "Several Measures" proposes that the traditional Chinese medicine technologies that originated from ancient classics, are still widely used, and have accurate curative effects and have an innovative and economic advantage to open up green channels. Regularly carry out the evaluation of price adjustment of medical service projects, prioritize the income of traditional Chinese medicine medical service projects with obvious functional effects, wide acceptance of patients, outstanding characteristics, reflecting the value of labor service, long -term application history, and obviously deviating price and price deviations. Public medical institutions purchased Chinese medicine films from regular channels, and sold in strict accordance with the actual purchase price of not more than 25%. Non -drinking Chinese medicines are sold in strict accordance with the actual purchase price. The tight county medical communities led by traditional Chinese medicine medical institutions are appropriately tilted in the total budget.

Promote the reform of traditional Chinese medicine and medical insurance payment. Traditional Chinese medicine medical institutions may not be paid for groups (DRG) according to the diagnosis of disease diagnosis. For places that have been paid by DRG and the scores of the disease, the coefficients and points of traditional Chinese medicine medical institutions and traditional Chinese medicine diseases are appropriately improved. Service characteristics and advantages. To implement the payment policy of the same standards of the Chinese Medicine Hospital as the same standards of the comprehensive hospitals, the medical insurance reimbursement line of traditional Chinese medicine medical institutions is comparable to that of local comprehensive hospitals.

Support Chinese medicine continuous service at the grassroots level. Gradually incorporate the prescribed outpatient Chinese medicine services provided by the designated medical institutions at the grassroots level into the scope of the general outpatient and outpatient slow special disease protection scope. In the qualified grass -roots medical and health institutions, they carry out the first payment of people, encourage family doctors to provide Chinese medicine services, and encourage Chinese medicine doctors and conditional Chinese medicine clinics to form a team to conduct family doctors' contract services. (Hebei Daily reporter Lu Ruoxi)

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