Interpretation of the policy on optimizing medical coverage for patients with novel coronavirus infection after the implementation of the "Class B B" management

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In order to implement the Party Central Committee and the State Council’s decision and deployment, the smooth and orderly implementation of the new coronavirus infection “Class B B management”, the State Council to respond to the new coronavirus infection epidemic joint prevention and control mechanism comprehensive group has issued a “on the implementation of the new coronavirus infection” Class B B management The overall plan” and supporting programs. In order to do a good job of medical protection for patients with new coronavirus infection after the implementation of the “Category B B control”, the National Health Insurance Bureau, Ministry of Finance, National Health and Health Commission, and National Disease Control Bureau jointly issued the “About the implementation of the “Category B B control” after The relevant policies have been implemented since the implementation of the “Class B, B Control” policy for new coronavirus infection (referred to as “new coronavirus”), and the main contents are explained below.

I. Protection of inpatient treatment costs for patients with new coronavirus

In order to protect patients with neo-coronary disease from being affected by hospitalization costs, the document stipulates that patients with neo-coronary disease who are hospitalized will continue to be covered by the policy of “Category B, Tube A”, and the hospitalization costs of patients with neo-coronary disease will be fully covered. The inpatient medical expenses incurred by the newly crowned patients in all medical institutions in accordance with the diagnosis and treatment plan of the new coronavirus infection formulated by the health department will be paid by the basic medical insurance, major medical insurance and medical aid according to the regulations, and the part of the individual burden will be subsidized by the finance. The policy is calculated by the time of admission of new coronary patients, first implemented until March 31, 2023.

Second, on the new crown patients emergency outpatient treatment cost protection

In order to ensure that patients with new crown can receive timely medical services in the early stage of infection, the document requires the implementation of a special guarantee to improve the level of reimbursement for outpatient and emergency patients for the treatment of new crown in primary medical insurance designated medical institutions (secondary and lower medical institutions). The document calls for the implementation of a special guarantee to increase the level of reimbursement for emergency outpatient treatment of new coronavirus infection in primary health insurance designated medical institutions (level II and below). In principle, there is no starting line and no ceiling line for reimbursement of outpatient and emergency expenses related to the treatment of new coronavirus (within the scope of the medical insurance catalog), and the reimbursement rate is no less than 70%. The specific provisions shall be determined by the local medical insurance department in consultation with the financial department according to the operation of the medical insurance fund, and shall be implemented until March 31, 2023. Participating patients in other medical institutions in the new crown outpatient emergency treatment costs, in accordance with other Class B infectious diseases medical insurance reimbursement policy, the cost of medical care and drugs included in the scope of medical insurance, should be reported.

Third, about the new crown patients with drug security

In order to adapt to the current epidemic situation and meet the drug needs of patients with the new crown, it was decided to temporarily expand the medical insurance drug list and implement it first until March 31, 2023. The current version of the national medical insurance drug list has 660 kinds of drugs for the treatment of fever, cough and other symptoms of neo-crown, on this basis, the new coronavirus infection treatment plan contains the new crown treatment drugs also implement the temporary payment policy of medical insurance. The local health insurance departments that are still short of drugs can temporarily expand the medical insurance drug list with reference to the new coronavirus infection treatment drug list identified by the joint prevention and control mechanism of each province and the operation of the health insurance fund.

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IV. Online treatment for new coronavirus patients

To ensure that new coronary patients can get timely treatment, the document requires good “Internet +” medical insurance services, to help new coronary patients online treatment. The health departments around the world are required to promptly publish the list of medical institutions that provide “Internet+” medical services, and for the industry sector to permit the opening of the first Internet consultation service for new coronavirus infections, as required for new coronavirus patients with symptoms related to new coronavirus infections, in line with the “Home Treatment Guidelines for People with New Coronavirus Infections”. Provide medical insurance mobile payment settlement services, local medical insurance departments can be consistent with the principle of online and offline supporting the Internet first medical services pricing policy, reimbursement standards are consistent with offline. New crown-related symptoms follow-up services, still according to the current Internet reimbursement policy.

V. On reducing the cost of new crown treatment to enhance the ability to protect health insurance

The document requires the improvement of the price formation mechanism, continue to do a good job in the new crown patients treatment required drugs and other price negotiations or consultations, centralized procurement, listed procurement, record procurement, price monitoring and other work to reduce the cost of treatment of new crown patients. Provincial medical insurance departments should be combined with the actual operation of local medical insurance funds, co-ordinate the implementation of policies, scientific determination of the scope and level of protection, not only reasonably reduce the burden on the masses, but also to ensure the safety and sustainability of medical insurance funds. On this basis, the medical insurance fund does appear to be unable to cover the expenses of the co-ordinated areas, the local financial to give appropriate subsidies.

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Sixth, on the management of medical insurance services

The document requires optimization of the medical insurance handling process, to provide convenient medical insurance services. Continue to do a good job of medical insurance convenience services, the implementation of long-term prescription medical insurance payment policy, the implementation of medical insurance handling work routine matters online, urgent matters in a timely manner, special matters to facilitate the people, non-urgent matters postponed, to eliminate hidden problems to do. All localities will sign temporary special agreements with non-medical insurance designated medical institutions with the ability to treat new coronavirus patients to settle medical insurance fees, and guide all types of medical institutions to do a good job of collecting and uploading information related to diagnosis and settlement of new coronavirus infections and settlement of medical insurance fees. The company’s main goal is to promote the use of the new coronavirus, and to promote the use of the new coronavirus. The company’s main goal is to promote the use of the new coronavirus, and to promote the use of the new coronavirus, and to promote the use of the new coronavirus.

Seven, on the responsibilities of relevant departments

The implementation of the new coronavirus infection “B class B management”, is the Party Central Committee, the State Council in a comprehensive assessment of the virus variation, the epidemic situation and China’s prevention and control work based on major decisions made. The document requires the strengthening of departmental coordination and linkage, the relevant departments around the world to raise the political stance, and effectively perform their duties to ensure that the policy is effective. The medical insurance department is responsible for the audit and settlement of related costs and strengthening fund supervision; the finance department is responsible for the timely disbursement of financial assistance funds; the health and health department is responsible for guiding medical institutions to do a good job of identifying, registering and uploading information on patients with new crowns; the disease control department is responsible for uploading information and data on patients with new crowns. Strengthen coordination and linkage to ensure that the decision and deployment of the Party Central Committee and the State Council will be put in place without compromise.