Sichuan issued implementation opinions to reduce the burden on such patients!

On the morning of July 21, the Sichuan Provincial Government Information Office held a press conference on "Implementation Opinions on Implementing Medical Insurance and Rescue System". Xiaobu learned from the press conference that recently, Sichuan issued the "Implementation Opinions on Implementation of Medical Insurance and Rescue System" (hereinafter referred to as "Implementation Opinions").

The overall goal of the "Implementation Opinions" is to focus on reducing the burden of medical expenses for the major diseases of the crowd, establish and improve the long -acting mechanism for preventing and resolving the poverty and poverty due to illness, and strengthen the comprehensive protection of basic medical insurance, major illness insurance, and medical assistance. Safe treatment standards, ensure the basic medical care of the people in difficulties, and not affect the basic life due to severe diseases, while avoiding excessive guarantee.

"Implementation Opinions" further reduces further

The burden of medical expenses for patients with difficulties and patients with major illnesses

What new rules?

This

Zhang Haifeng, a member of the Party Group and Deputy Director of the Sichuan Provincial Medical Insurance Bureau

Interpret

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In 2023, comprehensively realized medical assistance municipal -level overall planning

The "Implementation Opinions" states that in 2022, the medical assistance policy and the unified municipal level of the procedures of the office were selected. In 2023, comprehensively realized medical assistance municipal -level coordination.

Rescue target and rescue guarantee scope

Xiaobu learned that the "Implementation Opinions" unified the rescue objects into 6 types of patients, orphans, orphans, subsistence allowances, subsistence allowances, minimum -fidible family members, and patients with poverty -elites. The long -term mechanism of the risk of poverty and returning to the poor. According to Zhang Haifeng, the conditions for the identification of patients with poverty due to illness, and the Civil Affairs Department, together with the provincial medical security bureau and other relevant departments, in accordance with the principle of "basic insurance", comprehensively considers the economic conditions, medical expenses, and medical insurance payment.

In terms of the scope of rescue and guarantee, the "Implementation Opinions" proposes to adhere to the basic medical needs of rescue objects. The cost of long -term outpatient treatment. The rescue objects that have not referred to in accordance with the prescribed referral are not included in the scope of medical assistance in principle. Strict implementation of the medical security treatment list system, the drug, medical consumables, and diagnosis and treatment items paid by the medical assistance fund shall comply with the provisions of the basic medical insurance payment.

What guarantee policies are clarified?

"Implementation Opinions" refined

Triple protection policy

1

The individual payment part of the rescue target participates in the medical insurance of urban and rural residents shall be classified. According to the minimum payment standards determined by various coordinated areas, give full funding to the purse and orphans, and the funding of the subsistence allowances and the prevention of 75%of the monitoring of poverty -stricken return. Related policies and regulations for rural revitalization strategies.

Zhang Haifeng said that the "Implementation Opinions" fully canceled the payment standards for special insights, orphans, and subsistence allowances to prevent 5%of the per capita disposable income of residents in the preparation area of ​​the preparation area in the preparation area of ​​the poverty -stricken monitoring objects. The starting standard of members of the subsistence allowances is determined at 10%, and the starting standard of patients with poverty due to illness is determined at 25%. Within the policy scope of the rescue target, the individual's self -paying medical expenses exceed the part with the above payment standards, and the rescue of the annual rescue limit will be rescued in proportion. Rescue is rescuted to members of the subsistence allowances and patients with poverty due to illness and poverty due to illness of not less than 50%.

2

Give full play to the maintenance function of the main body of the medical insurance, and clarify the basic medical insurance treatment of the rescue objects uniformly enjoying fair and inclusiveness. In addition, consolidate the guarantee of medical assistance, and implement classification rescue and tilting assistance for the compliance medical expenses that rescue targets are paid after basic medical insurance and major illness insurance. Broaden the channels for comprehensive social assistance, and develop and strengthen charity assistance, medical mutual assistance and commercial health insurance.

"If the personal burden is still heavy after reimbursing through the triple system, it will be given tilt assistance." Zhang Haifeng said, "The annual rescue limit of medical assistance and the annual limit of tilt assistance shall be Scientific determination such as fund support capabilities to avoid excessive guarantee. "

3

Clarify the optimization service procedures. The "Implementation Opinions" proposes to build a unified medical security management system in the province, focusing on strengthening the construction capacity of medical insurance for rural areas, vigorously promoting service sinking, promoting the establishment of medical insurance service windows in townships (streets), equipped The personnel to fully implement the medical insurance service grid service management. Promote the "one -stop" service, "one window" processing of the medical assistance business, the settlement of "one single system", strengthen medical service management, and strictly supervise fund supervision.

Zhang Haifeng said that the "Implementation Opinions" comprehensively establishes a mechanism for application rescue mechanisms, unblocked the family members of the minimum security marginal family and preventing the target of poverty -relief monitoring, medical assistance application channels for patients with poverty and serious illness, promptly carry out identification work, dynamically adjust the identification information, enhance the timeliness of rescue time limit sex. Those who have been identified as the targets of special poverty, orphans, and minimum allowances will directly obtain medical assistance.

Chengdu Business Daily-Chengdu Published Reporter ｜ Peng Jing

Chengdu Published Edit | Tian Dou

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