Cupping costs are included in medical insurance, and it is to see how these places in Shanxi are implemented

Taiyuan: Enjoy the treatment of medical insurance clinics when the medical insurance settlement of traditional Chinese medicine ward

On September 4, a reporter from Shanxi Evening News learned from the Taiyuan Medical Insurance Center that Taiyuan City incorporated the cost of the appropriate technical outpatient treatment of traditional Chinese medicine into the scope of medical insurance payment. The expenses of outpatient treatment in line with the scope were reimbursed by the Basic Medical Coordinating Fund. This is another new measure and benefit the people in Taiyuan City after the policy of the traditional Chinese medicine ward, Taiyuan City strongly support the development of the development of TCM.

At present, the appropriate technologies of traditional Chinese medicine that reflect the characteristics of traditional Chinese medicine include 71 major categories including acupuncture, buried needle treatment, moxibustion, cupping, and massage. In the secondary and above medical insurance designated traditional Chinese medicine hospitals and other level or above designated hospitals with Chinese medicine as the main service items, the outpatient costs of 20 types of diseases are used to treat appropriate technology in traditional Chinese medicine. Pay line, and the rest are paid by individuals or personal account funds for employee medical insurance. Any basic medical insurance or basic medical insurance personnel in Taiyuan City can enjoy the treatment of suitable technical outpatient treatment of Chinese medicine. The overall payment amount is included in the annual fund payment limit.

The appropriate technology of traditional Chinese medicine treats the disease with reference to the outpatient slow special disease service model, and implements the design of designated medical institutions and the responsible physician identification management system. Insured personnel who have been diagnosed with Chinese medicine physicians after the secondary and above -level designated medical institutions, if they are treated with Chinese medicine physicians, they need to be treated in the outpatient clinic, and the corresponding medical insurance treatment is enjoyed in accordance with regulations. When the insured patients were included in the management of medical insurance settlement in the traditional Chinese medicine ward in Taiyuan City, they enjoyed the treatment of medical insurance clinics at different times.

At present, Shanxi Provincial Hospital of Traditional Chinese Medicine, Affiliated Hospital of Shanxi University of Traditional Chinese Medicine, Shanxi Provincial Traditional Chinese and Western Medicine Hospital, Shanxi Acupuncture Hospital, and Taiyuan Traditional Chinese Medicine Hospital have taken the lead in carrying out this service. When the conditions are mature, the fixed -point medical institutions of Chinese medicine appropriate technology can extend to the first -level medical institutions with the characteristics of traditional Chinese medicine and service capabilities and township health centers.

Datong: Only one type of traditional Chinese medicine appropriate technical outpatient treatment can be handled within the year

On September 1, a reporter from the Shanxi Evening News learned from the Datong Medical Insurance Bureau: From this month, the insured personnel use Chinese medicine hospitals and other second -level hospitals to use traditional Chinese medicine as the main service project to use Chinese medicine appropriate technical treatment for the main service items. The outpatient treatment cost of 20 diseases will be included in the scope of payment of medical insurance overall funds.

Insured personnel in Datong City adopt 71 categories of acupuncture, buried needle treatment, moxibustion, cupping, and obtaining 71 categories of traditional Chinese medicine for cervical spondylosis, lumbar disc herniation, osteoarthritis, low back pain (lumbar muscle strain, acute lumbar sprain sprains ）、肩周炎、脑梗恢复期、脑出血恢复期、前庭性眩晕、后循环缺血、椎基底动脉供血不足、短暂性脑缺血、面神经炎、紧张性头痛、睡眠障碍、慢性胃炎、 Neurological deafness, allergic rhinitis, urticaria, asthma, and irregular menstruation, the medical expenses incurred were included in the scope of the medical insurance fund payment, and the medical insurance overall fund was paid at 60 %. Fund payment. At the same time, the adoption of the appropriate technical outpatient treatment of traditional Chinese medicine is implemented in proportion and annual limit management.

In addition, the appropriate technology of traditional Chinese medicine in Datong City will refer to the outpatient slow special disease service model, and implement a designated service and responsible physician management system. Insured personnel are diagnosed by a Chinese medicine physician with a second -level and above medical institution and above the senior titles of the medical institution. If they meet the regulations, they will be included in the scope of the slow special disease service of the outpatient clinic and enjoy the corresponding medical insurance treatment in accordance with regulations. Insured personnel can only handle 1 type of Chinese medicine appropriate technical outpatient treatment.

Changzhi: The pilot work lasted for one year, whether it is extended to the perspective

Recently, the Changzhi Medical Security Bureau and the Changzhi City Health and Health Committee jointly issued a notice, and decided to carry out the pilot work of the payment scope of the medical insurance fund in the relevant designated medical institutions of Changzhi City.

The principles of the pilot in accordance with the principles of "first pilot, total management, summary experience, and steady promotion", and the 71 71 categories of traditional Chinese medicine appropriate technical outpatient treatment costs that have accurate efficacy and the characteristics of traditional Chinese medicine are included in the basic medical insurance and basic medical insurance of urban and rural residents in urban employees. Insurance coordinated fund payment scope.

The scope of the pilot medical institution is the Chinese Medicine Department of TCM Hospitals in the city second and above and other secondary hospitals. Under the premise of discovering problems, summarizing experience, and ensuring the security of the fund's income and expenditure, the policies are adjusted in a timely manner, and the scope of pilot medical institutions is gradually expanded.

The scope and payment standards of the pilot disease are 20 diseases including cervical spondylosis, periarthritis, and facial neuritis. The outpatient expenses of the appropriate technical treatment of Chinese medicine in the use of the above disease due to the above diseases are jointly borne by the insured patients and the overall fund. Among them, the payment ratio of the overall fund is 60%, and the management of a single and annual payment limit shall be implemented; the rest shall be paid by the use of cash or employee medical insurance account funds.

The pilot work is one year from September 1, 2022 to August 31, 2023. Changzhi Municipal Medical Insurance Bureau will determine whether to extend the pilot period according to the pilot situation.

The appropriate technology of traditional Chinese medicine to treat the disease refer to the outpatient slow special disease service model, and implement a designated service and responsible physician system. If the insured personally meets the qualified secondary and above medical institutions, the deputy senior professional titles of the medical institution or above are diagnosed as a specified disease type, and the hospital's medical insurance department will be reviewed and registered. Enjoy medical insurance treatment.

Writing: Shanxi Evening News all-media reporter Guo Bin Wu Jia Zhang Wenfu Editor: Shanxi Evening News Editor Cao Rui

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