National Medical Insurance Administration: Carry out dental planting medical services and consumables for special governance
Author:Sichuan Observation Time:2022.08.18
Today, the State Medical Insurance Bureau announced the "Notice on the Price Governance of Oral Planting Medical Services and Consumption Price (Draft for Soliciting Opinions)".
The "Notice" emphasizes the long -term existence of problems such as irregular fees and heavy cost burdens in the field of oral planting. With the improvement of living standards and deepening population aging, it has become a pain point that plagues the people. In order to implement the decision -making and deployment of the Party Central Committee and the State Council, ensure that the people have obtained high -quality, efficient, and affordable teeth repair services, meet the people's longing for a better life, promote the healthy and orderly development of oral planting, and follow the joint joints of the nine ministries and commissions. The requirements of the "Key Points of the Equality of the Field of Medical Purchase and Sales and Medical Services in 2022" were issued, and the special treatment of oral planting medical services and consumables was carried out.
The "Notice" requires as follows:
1. Regulate the method of oral planting medical services and consumables
(1) Orderly pushed into the "skill separation" of oral planting medical services. Public medical institutions provide oral planting medical services, mainly using "service projects+special consumables" to separate pricing methods. That is, the prices of implant implantation fees are priced separately from the price of implant consumables; the crowns are priced separately from the price of crown products; When the current consumable merger is charged in the price of medical service projects, when "separation of skills" is implemented, the project price shall be reduced in accordance with the method of deducting the average price of online purchases of relevant consumables.
(2) Guide the dental crown to form a reasonable price. Dental -implanted crowns are carried out to purchase networks. Public medical institutions choose independently according to clinical needs and sell them according to the actual procurement price. The Sichuan Provincial Medical Security Bureau bids the clinical mainstream all -centered crown tissue in the province to form a reasonable market price through competition. Other materials refer to the price of the whole porcelain crown. The National Medical Security Bureau guides other provinces to implement price linkages, limited prices to hang the net, and promote the prices of crowns and transparency. For medical institutions to process and produce dental crowns by themselves, the medical institution is based on material cost, processing services, etc., and autonomously determines the price and hang the net according to the appropriate cost recovery rate. Essence
(3) Standardize the integration of oral planting price projects. In accordance with the basic principles of "output orientation", integrate medical service price projects involved in oral planting. Among them, the first phase of implantation (implant implantation) and the second phase of surgery (placed healing base platform) are merged into implant implantation; crown access service, including printing system, jaw position recording and transfer, and transfer, transfer, transfer, and transfer, and transfer, transfer, and transfer of mandibular position, transfer, transfer, and transfer, and transfer of mandibular position, transfer, transfer, and transfer, The base platform and crown installation, debugging and modification, etc., merge into the crown of the implant; the bone planting surgery, soft tissue repair, the repair and demolition of the implantation of dental implant facilities, and set up independent medical service price projects Essence For complex planting surgery such as whole tooth bow repair and maxillary sinus bone, differences can be reflected in medical service price projects. In order to ensure the accuracy of dental repair, medical institutions use various inspection methods such as medical images and digital technology, artificial intelligence and other to build virtual 3D models, make lesion models or surgery boards, and set up corresponding medical service price projects according to the service output Essence The specific guidelines for dental repair such as dental repair such as oral planting are issued separately by the National Medical Security Bureau.
2. Strengthen the price control of medical services such as oral planting
(4) Do a good job of price control around the entire dental implants process. The medical security departments of various places should focus on a single conventional planting, clarify the regulation and control goals of the entire process, guide the centralized band procurement, standardize medical service price projects, and strengthen the regulation of the price control of oral planting medical services.
(5) Strengthen policy guidance for medical service prices for public medical institutions. Oral planting projects such as implant implantation fees, crowns, and bone planting costs implement government guidance price management areas. While regulating price projects, the medical security department re -formally formulates government guidance.
(6) Persistently rising and falling, rationalizing the relationship between related medical services. The masses reflected the implant fees, crown crowns, and bone planting costs for implantation fees, crown crowns, and bone planting costs. Among them, the government's guidance price is significantly higher than the average price of private medical institutions in the region, and it is necessary Medical institutions with significantly higher levels of medical institutions are proactively adjusted. It is allowed to drive a proper gap with conventional dental implant surgery prices with high technical difficulty and high risk -level projects. The price of medical services that are lacking in fixed teeth and picking dental dental reimbursement maintain a reasonable relationship with oral planting, and encourages medical institutions to give priority to patients with suitable dental repair services for patients. Tooth extraction, Zhou Jiezhi, and tooth tonic are mainly technical and labor -based projects. The low historical prices can be appropriately increased.
(7) Strengthen the supervision and guidance of oral planting in private medical institutions. The service prices such as oral dental implants of private medical institutions shall be regulated by the service prices of dental implants. The pricing shall follow the principles of fairness and legality, honesty, and quality and price. Essence Private medical institutions should strictly regulate their own price behavior, and they must not deceive fraud patients with false subsidies or low -cost publicity. For private medical institutions with high dental implants, high use of high -quality product usage, high economic advantages of oral planting expenses, and high -quality economy advantages, and the top evaluation rankings will display the price and expenses on the official website by the medical security bureaus. Provide patients with medical guidelines. 3. Carefully organize and carry out centralized procurement of dental implants
(8) Establish inter -provincial procurement alliance for dental implants. The provincial provinces should participate in the provincial provincial provincial procurement alliance led by the Sichuan Provincial Medical Security Bureau, and all provinces should participate. The concentrated and volume procurement of dental implant consumables adheres to the basic principles of recruitment and consolidation, and the overall ideas of the government organization, alliance procurement, and platform operations, and fully consider the characteristics of dental implantation consumables production, supply and clinical use, and guide the guidance Enterprise fair competition. The specific procurement plan is formulated and organized by the Sichuan Provincial Medical Security Bureau in conjunction with the provincial medical security departments. The centralized procurement is based on a complete set of implant systems, including implants, repair base platforms, and accessories covering screws, healing base platforms, metastasis rods, alternatives.
(9) Wide extensive mobilization of various medical institutions at all levels to participate. In principle, the proportion of the number of medical institutions (including private) to participate in the collection of the collection of this collection should reach more than 40%of the proportion of dental implants, or the total number of demand for submission of the region in this area accounts for the proportion of the actual use of the previous year More than 50%. In various regions, medical institutions with dental implants service capabilities in the jurisdictions are extensively mobilized. All public medical institutions (including military medical institutions) are organized to participate in centralized procurement of dental implants, and private medical institutions will be mobilized to participate in the medical institutions. Looking forward to the social responsibility of medical institutions, analyzes the trend of changes in the industry pattern and patient medical behavior, emphasize related supporting and regulatory measures, etc., and guide medical institutions Essence Public medical institutions doctors practice multi -point practice in private medical institutions and as the person in charge or business backbone. The public medical institution shall urge them to regulate the participation in the collection. Medical institutions need to reply in writing or not to participate in this collection.
(10) Fill in the demand for implant procurement accurately. The provinces organize the province's public and private medical institutions to fill in the procurement needs of dental implants. The contents of the report include the actual procurement and procurement demand for dental implant consumables in the unit. In principle, the demand for reporting shall not be lower than the actual procurement volume of the previous year. At the same time, the factors for the growth of dental implant demand should be considered to ensure the accurate and reasonable reporting volume, and to promote the better realization of the amount of price exchange, and to facilitate the supply of the selected enterprises to ensure the supply. Differentiated price policies for public medical institutions that carry out dental implant services but refuse to report or report less than 80%of the previous year. In the region, the actual charges of the above -mentioned public medical institutions shall not exceed 80%of the government's guidance price; areas that implement independent pricing management, the actual charges of the above -mentioned public medical institutions shall not exceed 80%of the average level of autonomous pricing in public medical institutions in the region.
4. Comprehensive treatment of oral planting charges
(11) Exploring the establishment of an abnormal warning system for the establishment of oral planting. The medical security departments of various places should establish the price abnormal warning system for oral planting in the units and cities, and report the price complaints more than the local average level, refusing or negatively participating in dental implants, various medical institutions, various medical institutions. The list of abnormal warnings of the price is publicly reported publicly on the official website of the local medical security bureau every quarter. During the year, the medical institutions that entered the warning list many times were reported by the provincial medical security department; if the circumstances were bad, the National Medical Security Bureau was uniformly exposed. For medical institutions that are included in the list of abnormal price warnings, supervision methods such as monitoring early warning, inquiry and interviews, reminders, warnings, cost investigation, information disclosure, and public exposure are used to promote the formation of good market order; Restrictions are taken in the aspects of adjusting medical services prices and accepting new medical service price projects.
(12) Special investigation and inspection of oral planting prices. During the launching phase of the special governance (August 2022), in accordance with the principle of "horizontal to the edge, vertical to the end, and full coverage", comprehensively conducts oral planting charges and medical services price surveys and registration, and laid for standardized projects and prices and implementation of centralized band procurement procurement. Solid foundation. The illegal charging clues found during the investigation and registration period will be investigated and correct in time. All localities should attach great importance to the price and special governance of dental repair medical services such as oral planting, effectively fulfill the responsibilities of the medical service price management of the entire industry, organize special forces, conscientiously promote the implementation of various measures, and achieve full coverage of public and private medical institutions. It is necessary to implement the people -centered governance concept, strengthen the coordination of dental implants medical services and consumables, and effectively reduce dental implants medical services and high prices of consumables, and reduce the burden on the people's costs.
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