Beijing, October, three medical insurance reduced new politics

Yesterday, the Municipal Medicine Bureau issued three new issues, including six diseases such as heavy psychosis, including 6 diseases such as the municipal medical insurance outpatient; increased malignant tumor clinic treatment, kidney dialysis two outpatient clinic applicants reimbursement, while LuoshaSiye capsules and other nine valuable drug outpatient medications were paid according to fixed ratio, further alleviating the drug burden of the masses.

It is reported that the new policy will be officially implemented on October 1, which is suitable for people such as urban workers and urban and rural residents. Added 6 kinds of special diseases, more than 200 kinds of drugs can be reimbursed according to the hospitalization standard reimbursement, since October 1, this year, the city will be suitable for long-term clinic treatment, high heterogeneous mental disease, pulmonary hypertension Targeted treatment, Du Muocanic, C-type Nigen-seek disease, median allergic asthma biological preparation, idiopathic pulmonary fibrosis anti-fibrosis treatment of 6 diseases Incorporate in the range of special diseases of the medical insurance outpatient disease. After the above six diseases are incorporated into the range of special diseases in the outpatient disease, more than 200 drugs related to outpatient inspection, treatment and use of the patient can be reimbursed according to the prevention standards.

It is understood that the market is currently 20,000 yuan and 4,000 yuan, and after the above disease is incorporated in the scope of the outpatient, the insured personnel have inspected in the outpatient clinic, and the cost of related drugs can be in accordance with the hospital. The cost reimbursement ratio and the reimbursement cap are performed, 360 days a settlement cycle, the patient’s medical expense burden will greatly alleviate. Such as the "pirate-nanone oral common release dosage form" for idiopathic pulmonary fibrosis, the patient’s annual drug cost is about 80,000 yuan, after incorporating special disease reimbursement, retired employees will decrease to about 10,000 yuan per year.

The Municipal Medical Insurance Bureau said that the insured personnel who meet the special diseases in the new clinic need to be reviewed after the special disease-based medical institutions selected, and enjoy the special disease reimbursement treatment. Not filing is not performed or not in the design of medical expenses in the designated medical institution of special disease species, not included in the scope of special disease medical expenses. It is reported that, in this city, the city has treated malignant tumor clinic, renal dialysis, renal transplantation, renovation, hemophilia, regenerative disorder anemia, hepatic transplantation, anti-wear treatment, liver and kidney joint transplantation 11 kinds of diseases such as resection of treatment, anti-field treatment after cardiac transplantation, pulmonary implantation, and intraocular injection, intra-angle, intraocular injection, etc. Injection treatment, etc. Incorporate in the range of special diseases in medical insurance. After the inclusion of 6 diseases such as heavy psychosis, after the special disease of the outpatient disease, the medical insurance outpatient disease was expanded to 17 kinds. More than 120 kinds of drugs used to treat malignant tumors, renal dialysis include the second reduction of new and negative new politics for malignant tumors and kidney dialysis. It is understood that malignant tumor clinic treatment and kidney dialysis have been included in the scope of special diseases in this city, and their outpatient examination, treatment and related drugs can be reimbursed in accordance with special disease policy. This time, for the above two types of outpatient diseases, further increased reimbursement drug varieties, mainly according to the national medical insurance drug catalog, negotiating drug varieties, combined with the actual needs of clinical drug, will treat more than 70 kinds of cancer bone metastasis and intestinal nutrient agents. The drug is incorporated into a malignant tumor outpatient treatment of special disease drug reimbursement; more than 50 drugs such as dialysis replacement liquid is included in the use of special diseases for special diseases for kidney dialysis outpatient.

The proportion of 9 valuables reimbursement increases the third reduction of new politics, facing the valuable drugs used in outpatient treatment. It is understood that with the implementation of the national medical insurance drug catalog and drug negotiation dynamic mechanism, the valuables in the scope of medical insurance reimbursement is increasing, and some are suitable for long-term clinics, high-cost drugs, while suitable for a variety of disease treatment. In order to further reduce the burden of the masses, it is convenient for the treatment of the masses. This time, the city shall be reimbursed in accordance with the level of special diseases for urban workers and urban and rural residents.

It turned out that nine valuable drugs such as "Rosha Sustic His Capsule", Ada Tumi-Anti-Intracking, according to the proportion of ordinary outpatients, pay according to the fixed ratio, and the basic medical insurance fund of the urban workers pays by 80%, the basic medical insurance fund for urban and rural residents 70% payment, higher than the previously reimbursement ratio. At the same time, the medical insurance fund payment section is included in the hospitalization fee, and the top line will perform the hospitalization standard. It is reported that after the implementation of new reimbursement policies, the patient’s clinic treatment of drugs will be greatly reduced. "Roshaki Hook Capsule" used to treat chronic nephropathy causes anemia, urban and rural residents’ insured personnel shall reimburse the top line of 4,000 yuan according to the current outpatient reimbursement, and the annual personal burden is about 10,000 yuan, according to the new policy reimbursement, personal annual The burden will reduce approximately 6,600 yuan.

Whether the above three will have an impact on the medical insurance funds after the implementation of the new policy, the relevant person in charge said that it will make full use of medical insurance data, monitoring, statistics, and analysis of related drug costs, ensuring the reasonable medical needs of the insured personnel, and Prevent fraudulent, unreasonable use, and ensure the safety of medical insurance funds. Text / This reporter said that 224 drugs from October transferred from Beijing Medical Insurance Drug Catalog. (Reporter Ji Li) Yesterday, the Municipal Medical Insurance Bureau issued a news, from October 1, this year, phenylanin, soil Two24 non-state medical insurance drug catalog varieties such as maquin are called from the medical insurance drug catalog, and the cost that occurs after the adjustment will no longer be included in the city’s basic medical insurance, work injury insurance and maternity insurance payment range.

It is understood that the use of non-state medical insurance drug varieties in various local medical insurance catalogs in three years is the unified requirements of the country.

The drug from this city is mainly drugs that have been revoked by the national drug supervision departments and less clinical use, and there is a better alternative drug. "The first batch of calls, basically zero fees last year, will continue to adjust non-state medical drug varieties next year.

The relevant person in charge of the Municipal Medical Insurance Bureau said. The person in charge also emphasized that in order to protect the people’s medical needs, the personnel have been required to adjust the medical insurance drug catalog in a timely manner, ensuring that the relevant drugs have been adjusted from the clinical medication.