Hubei announced the medical insurance payment standards for urban and rural residents, 350 yuan per person per year

Jimu Journalist Cao Yang

Correspondent Huang Shan

On August 24th, Jimu Journalists learned from the Hubei Provincial Medical Security Bureau that in 2022, the basic medical insurance participation payment of urban and rural residents in Hubei Province was officially launched. The personal payment standard is 350 yuan per person per year, and the per capita fiscal subsidy standard reaches not less than 610 yuan per person per year.

The "Notice on Doing the Basic Medical Guarantee Work of Urban and Rural Residents in 2022", the interpretation of relevant policies is as follows:

(1) Regarding reasonable improvement of fundraising standards. According to national requirements, it is clear that the per capita financial subsidy standard for urban and rural residents' basic medical insurance in 2022 will be added 30 yuan, reaching no less than 610 yuan per person per year, and a simultaneous increase of personal payment standards 30 yuan to reach 350 yuan per person per year. Continuing the insurance restrictions.

(2) Regarding consolidation and improvement of treatment. Overall the effectiveness of the comprehensive guarantee of basic medical insurance, major illness insurance and medical assistance. The first is to consolidate the treatment level of residents' medical insurance hospitalization and ensure that the fund payment ratio within the policy scope is stable at about 70%. The second is to steadily improve the functional protection function of residents' medical insurance clinics. In principle, the proportion of medical expenses in general outpatient policies is not less than 50%in principle, and the maximum payment limit of the year is not less than 350 yuan. Strengthen the function of major illness insurance, medical assistance outpatient security, and jointly reduce the burden of medical expenses for outpatient clinics.

(3) About the bottom line of the people's livelihood guarantee. The first is to continue to do a good job in medical assistance classification. Continue to implement the policy of funding for stable poverty alleviation. The second is to make a good job of rectifying the rectification and policy implementation, and clarify that the counties and cities in 2022 will unify the budget of supplementary medical insurance funds (or bottom guarantee funds) in the period of poverty alleviation. The third is to improve the long -term mechanism of preventing the poverty and poverty due to illness, strengthen departmental coordination, and jointly prevent the risk of returning to poverty due to illness.

(4) Regarding the unity of promoting system norms. It is necessary to resolutely implement the system of medical security treatment list. The first is to strictly implement the "Notice of the Provincial Department of Medical Security and Provincial Department of Finance on Printing and Distributing the Implementation Plan of Hubei Province's Implementation of the Implementation of the Medical Guarantee Listing Listing Listing Listing List" (E -Medical Paifa [2021] No. 63). The second is to gradually regulate policies such as the scope of slow disease diseases in basic medical insurance clinics in the province. The third is to comprehensively do basic medical insurance city -level overall planning.

(5) Regarding the management of medical insurance payment. The first is to strengthen the management of medical insurance and drug catalogs, and do a detailed negotiation of "dual channels" management. The second is to standardize the management of medical institution preparations, Chinese medicine slices and traditional Chinese medicine formulas. The third is to accelerate the reform of the DRG/DIP payment method, covering at least 50%of the regions in the jurisdiction. The fourth is to improve the designated management of medical institutions and retail pharmacies.

(6) Regarding strengthening the purchase and price management of centralized bands in drug consumables. The first is to implement the results of national organizations and inter -provincial alliance collection. At the end of 2022, the number of cumulative number of drugs in the national and provincial (including cross -provincial alliances) has not less than 350 drugs, and high -value medical consumables have accumulated more than 5 or more. The second is to enhance the function of improving the pharmaceutical collection platform and strengthen performance evaluation. The third is to guide the urging regions to do a good job of evaluation and dynamic adjustment of price adjustment in 2022. The fourth is to carry out medical price monitoring in accordance with regulations, and continue to promote the implementation of medical prices and recruitment credit evaluation systems.

(7) Analysis of strengthening fund supervision and operation. The first is to accelerate the construction and improvement of the medical insurance fund supervision system and law enforcement system. The second is to carry out special rectification of the province's designated medical institutions to use the medical insurance fund to further promote the special rectification of the "three fakes". The third is to improve the fund supervision linkage mechanism, improve the working system, and form a working pattern. The fourth is to do a good job of fund budget performance management, carry out the analysis of fund revenue and expenditure, and improve risk early warning, evaluation, resolution mechanism and plan.

(8) About the improvement of public management services for medical insurance. The first is to carry out special actions for the construction of management services for medical security and management services to improve the level of convenience services. The second is to adhere to intelligent online payment channels and traditional offline payment methods to innovate parallel to improve the level of payment facilitation. The third is to comprehensively implement the temporary measures for the transfer of basic medical insurance relations, and continue to do a good job of "cross -provincial generalization". The fourth is to continue to do medical expenses, new crown vaccines and vaccination costs for new crown pneumonia. Fifth, do a good job of direct settlement in different places, support the general outpatient clinic of urban and rural residents' medical insurance to coordinate direct settlement for medical treatment, and promote the direct settlement service of 5 kinds of outpatient slow special diseases across provinces.

(9) Regarding the promotion of standardization and information construction. It is necessary to continue to promote the deepening application of the national medical security information platform in Hubei Province, comprehensively deepen the maintenance application of business coding standards, establish a sound information system operation and maintenance management and security management system, and improve the level of medical insurance services and governance capabilities.

(10) Regarding the organization and implementation. From the aspects of compacking work responsibility, strengthening departmental coordination, and increasing publicity efforts, work requirements for relevant departments in various places to ensure that various policies and measures are effective, and continuous promotion of protection and improving people's livelihood.

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