Strictly regulate the use and charging of "surgical robots", Hunan Medical Insurance Notice is here!

Author:Hunan Daily Time:2022.09.23

The reporter learned from the Hunan Provincial Medical Security Bureau today that the "Notice on Regulating the use and charging behavior of standardized operating robot auxiliary operating systems" (hereinafter referred to as the "Notice") has been officially introduced. The medical insurance payment policy and standardized charging behavior were initially explained, and it was implemented from now on.

It is reported that this "Notice" aims to further standardize the use of surgical robot auxiliary operating systems and medical services charges, encourage the clinical application of innovative universal technology, give full play to the positive role of reducing the quality and efficiency, and guide the reasonable application of medical institutions Surgical robotics to ensure that medical services and charging are consistent.

The "Notice" pointed out that the "surgical robot" includes various types of auxiliary operation equipment, platforms, systems, or tools in various names. Medical institutions shall, in accordance with the scope of the application of the equipment registration certificate and the indicator of the clinical surgery, reasonably use the surgical robot auxiliary operating system, and shall not be over -range and overwhelmed.

The "Notice" states that medical institutions use "surgical robots" to assist orthopedics, head and neck surgery, thoracic surgery, cardiac surgery, general surgery, urological surgery, vascular surgery, gynecological surgery operation, and uniformly use the "addition" as the "addition" of surgical prices to charge In accordance with the benchmark price of the surgical items, a certain proportion is added. Other consumables consumed during the use of surgical robots. According to the actual function of the "surgical robot", classification and collection are implemented. Specific requirements are as follows:

The surgical robot auxiliary operating system only exerts the surgical planning function, including but not limited to the application of various digital, visual or intelligent innovative universal technologies such as artificial intelligence, augmented reality, hybrid reality, holographic image, naked eye 3D, etc. Preoperative simulation, etc., the auxiliary operation value is reflected in the surgical price, and no separate charges are set. For remote provision of inter -hospital surgery planning services, charges are charged according to the remote consultation of a single discipline, and no additional collection.

If the surgical robot auxiliary operating system only has and exerts the navigation positioning function, each surgery will be closed by 40%, and the core surgery price is more than 5,000 yuan per case, and the additional standards are capped at 2,000 yuan each time.

Surgical robot auxiliary operating system belongs to the "auxiliary surgical equipment and auxiliary surgical system using robot technology" (referred to as RA equipment/system, including but not limited to surgical equipment control systems such as "Da Vinci Surgical Robot"), according to the corresponding surgical items performed according to the corresponding surgical items Add. Surgical robot auxiliary operating systems who only complete or participate in the core operation steps (including remote surgery operations) of the surgical target under the control of medical staff will be closed; All core operation steps (including remote surgery operations) of surgical targets will be closed by 300%.

The "Notice" pointed out that if the above -mentioned increasing situation occurs at the same time, the charges with the highest proportion of the incremental increasing collection shall not be charged with each other. It is worth noting that the increase in fees for surgical robot auxiliary operating systems will not be incorporated into the scope of the payment of the medical insurance fund, and the procedures are adjusted according to factors such as medical service project guarantee demand, fund revenue and expenditure conditions, and bearing capacity.