Health

Promoting the high-quality development of medical insurance and enhancing the health and well-being of the people - Relevant officials from the National Medical Insurance Administration respond to hot issues

2024-09-11   

How to better alleviate the burden of medicine for the public? How to make insurance more convenient and efficient? How to keep the "money bag" of medical insurance safe? At the "Promoting High Quality Development" series of themed press conferences held by the State Council Information Office on the 10th, relevant officials from the National Medical Insurance Administration responded to relevant hot issues. Reducing the burden of medical treatment on the public is closely related to medical security and reducing the burden of medical treatment on the public. We insist on deepening reforms and enhancing the health and well-being of the people Zhang Ke, Director of the National Healthcare Security Administration, introduced that the National Healthcare Security Administration has institutionalized and normalized the centralized procurement of drugs and consumables, and has carried out 9 batches of national organized drug centralized procurement and 4 batches of national organized high-value medical consumables centralized procurement. At the same time, it has guided and promoted local centralized procurement of varieties other than national centralized procurement. One of the benefits of centralized procurement is a reduction in the burden of medication on the public, as well as an improvement in the accessibility and quality of medication Yan Qinghui, Deputy Director of the National Healthcare Security Administration, introduced that for example, after centralized procurement, insulin prices have significantly decreased, and the proportion of third-generation insulin with better clinical performance has increased from 58% before centralized procurement to over 70%. The next step will continue to expand the coverage of centralized procurement, carry out new batches of national organized drugs and high-value medical consumables centralized procurement, and include high-value medical consumables such as cochlear implants in the scope of centralized procurement, "Yan Qinghui said. We also leverage the advantages of medical insurance 'group buying' to guide new drug prices back to reasonable levels Li Tao, Deputy Director of the National Healthcare Security Administration, said that the administration has integrated the medication needs of over 1.3 billion insured people to implement strategic purchases, improved the national drug negotiation and access mechanism, and set "civilian prices" for many "noble drugs". Since its establishment 6 years ago, the National Healthcare Security Administration has negotiated drugs to benefit 720 million insured patients, and combined with multiple factors such as negotiated price reductions and medical insurance reimbursements, it has reduced the burden on the public by over 700 billion yuan. Improve the quality of security connotation, consolidate and improve the level of inpatient security, carry out outpatient chronic and special disease security, and comprehensively establish the general outpatient coordination of staff medical insurance and the outpatient medication security mechanism for urban and rural residents with hypertension and diabetes... In recent years, the content of medical insurance has been constantly enriched and the quality has been constantly improved. Zhang Ke introduced that the National Healthcare Security Administration actively responds to the aging population and steadily promotes the pilot of the long-term care insurance system, which has covered 49 cities and 180 million people. At the same time, active measures to support childbirth have been implemented, and 20 provinces and the Xinjiang Production and Construction Corps have included assisted reproductive technology projects such as in vitro fertilization in the scope of medical insurance payments. Since the beginning of this year, the National Healthcare Security Administration has integrated the concept of "efficiently accomplishing one thing" into healthcare insurance work, making healthcare services more convenient and beneficial to the people. Yan Qinghui introduced that firstly, newborns have changed from "only participating in insurance after settling in" to "participating in insurance upon arrival". Through data sharing, medical insurance departments in various regions have realized that newborns can participate in insurance online with their birth medical certificates. The average time for insurance payment has been reduced from 28.7 working days at the beginning of the year to 6.4 working days. Newborns can be directly reimbursed for medical expenses upon discharge. Secondly, the personal account of employee medical insurance has changed from "personal exclusive" to "family shared". From January to July this year, the amount of family mutual assistance in individual accounts of employee medical insurance reached 22.7 billion yuan. It is expected that by the end of this year, various regions will achieve intra provincial mutual assistance in individual accounts, and from next year, we will explore and promote inter provincial mutual assistance. It is particularly important to emphasize that the number of outpatient chronic diseases directly settled across provinces has increased from 5 to 10 Yan Qinghui said that the plan is to have at least one medical institution in every county and district across the country that can provide cross provincial direct settlement for newly added diseases by the end of this year. In addition, a unified national medical insurance information platform makes medical insurance settlement more convenient. The daily settlement volume of the medical insurance information platform now exceeds 28 million people, and the average response time of the hospitalization expense settlement system is only 0.8 seconds, effectively reducing the waiting time for the public in hospitals. Li Tao introduced that a total of 1.17 billion people in China have activated their medical insurance codes, and the public can use their mobile phones or other electronic devices to activate the medical insurance codes without carrying physical cards for medical treatment and reimbursement. Strengthening the supervision of medical insurance funds: Recently, the National Healthcare Security Administration has reported multiple cases of fraud and insurance fraud. How will the medical insurance department strengthen the supervision of medical insurance funds and safeguard the "money bag" of medical insurance? As of now, a total of 432 designated medical institutions in 30 provinces have been inspected, and it is expected that the number of inspected institutions this year will exceed the total of the past 5 years Yan Qinghui said. It is reported that since the beginning of this year, the National Healthcare Security Administration has adhered to strict crackdown and investigation, continuously increased the intensity of flight inspections, and paid more attention to the role of big data. It has verified and recovered nearly 60 million yuan of medical insurance funds through the "glycated hemoglobin" screening clues, and recovered nearly 14 million yuan of medical insurance funds through the "restriction of gender based diagnosis and treatment, examination, and medication" screening clues, achieving a "precise strike" combining on-site inspections and big data. We adhere to the principle of balancing leniency and strictness, and make good use of self-examination and self correction Yan Qinghui said that as of now, designated medical institutions at all levels have returned about 3 billion yuan of medical insurance funds. It is reported that the National Healthcare Security Administration is exploring the establishment of a management method for medical insurance payment qualifications, adopting a method similar to "driver's license deduction" to score relevant responsible persons; Improve the working mechanism of social supervisors for medical insurance funds and better mobilize all sectors of society to participate in fund supervision. Yan Qinghui stated that the next step will be to conscientiously implement the decisions and arrangements of the Party Central Committee and the State Council, and never let the people's "medical money" and "life-saving money" turn into "Tang Sanzang meat". (New Society)

Edit:HAN ZHUOLING Responsible editor:CAICAI

Source:xinhuanet.com

Special statement: if the pictures and texts reproduced or quoted on this site infringe your legitimate rights and interests, please contact this site, and this site will correct and delete them in time. For copyright issues and website cooperation, please contact through outlook new era email:lwxsd@liaowanghn.com

Recommended Reading Change it

Links