Look at it, 16 categories of medical insurance measures are introduced

On June 24, the Shaanxi Provincial Medical Security Bureau held a policy blowing meeting of the "Active Coperly responding to the impact of the impact on the impact of the epidemic affected to help market entities and service targets" (hereinafter referred to as "Several Measures"). The reporter learned from the conference that "Several Policy" is an active response to the impact of the new crown pneumonia, alleviating the difficulties faced by market entities and service targets, and prompting a series of policies and measures to formulate and introduced. A total of 16 specific policies: comprehensive guarantee policies, continuous improvement of medical insurance support for epidemic prevention and control policies, and continuous optimization of medical insurance agency services.

Support market entities to relieve difficulties -affected enterprises affected by the affected enterprise can "exempt and enjoy" to slowly pay employee medical insurance and maternity insurance

The "Several Policies" mentioned that enterprises that are unable to pay for medical insurance and maternity insurance premiums that are unable to pay medical insurance and maternity insurance premiums in full and unable to pay for medical insurance and maternity insurance premiums in full. The slow payment period does not exceed 3 months, and the enterprise shall take the initiative to make up in time after the expiration period expires. Do not collect late fees during the slow payment period, and will not affect the medical insurance benefits and personal medical insurance equity records.

The reporter learned that after the State Council's executive meeting determined the payment of the employee medical insurance units of small and medium -sized enterprises in the small, medium and micro enterprises, Shaanxi Province further optimized the process of slow payment. The tax department's filing "is simplified to" exempt and enjoy ". It does not require enterprises to provide application materials to the Medical Insurance Office to ensure that the policy is directly reached to the market.

"Several Policy" allows enterprises to make up for medical insurance business. For enterprises that are not affected by closed management (static management), companies that fail to handle insurance registration, transfer continuity, payment, replenishment, and employment retirement will be allowed within 3 months after the end of the closed management (static management). In order to meet the needs of the development of the new economy and the development of the new business, the restrictions on participating in the household registration of new employment forms such as logistics, takeaway, and freelance occupations, and convenient for new employment employees to participate in employee medical insurance. In addition, for the third batch of provincial -level supplements, medical insurance payment time continued to December 31, 2022, further promoting the stable development of market entities.

Strict implementation of comprehensive guarantees -the special funds for the new crown vaccine and vaccination costs 6.220 billion yuan

Continue to implement the "two guarantees" policies. Through the comprehensive guarantee of medical expenses for diagnosis patients, policies such as non -medical treatment and reduction of medical treatment in different places, medical expenses budget for patients with new crown pneumonia, and do not take up the total budget indicators of the hospital for the year. The treatment drugs and diagnosis and treatment items in the "New Coronary Virus Pneumonia Diagnosis and Treatment Plan" are temporarily incorporated into medical insurance payment to ensure that patients do not affect medical treatment due to expenses, and ensure that the treatment hospital does not have the impact of the payment policy. The reporter learned that in order to respond to the epidemic situation in the province at the beginning of the year, the Shaanxi Provincial Medical Security Bureau also guided Xi'an, Baoji, Yan'an and other cities to pre -allocated more than 97 million yuan in medical institutions to ensure the need for medical treatment.

Make a good guarantee for vaccine and vaccination costs. The new crown vaccine for free, vaccine and vaccination costs shall be shared by the accumulated balance of the coordinated fund and fiscal funds. At present, a total of 6.22 billion yuan of special funds for the new crown virus vaccine and vaccination costs can be used to achieve "money waiting for seedlings" and effectively ensure the smooth progress of the vaccination work of our province.

Effectively guarantee the treatment level of people in difficulties. Consolidating the guarantee of medical assistance and support, for the inpatient medical expenses of key people, orphans, or unattended children, after the basic medical insurance and major illness insurance are paid in accordance with the regulations, medical assistance will be paid in accordance with the regulations. 100%rescue, the proportion of low -protection objects, and the rescue of the poor and poverty -stricken people is not less than 70%. Others are not less than 50%of the rescue ratio of poverty alleviation in low -income or easy poverty alleviation. The monitoring objects are included in the scope of medical assistance, and the scope of medical assistance policy is not less than 50%. If the individual burden is still heavy within the policy scope after the triple system is paid, it is given tilt assistance.

Do a good job in preventing dynamics and early warnings from returning to poverty due to illness. For the cumulative medical expenses of the personal annual burden on the poverty alleviation population of the file, the cumulative annual burden of the person in the province's urban and rural residents is more than 10,000 yuan (10,000 yuan). For the cumulative medical expenses of individuals in rural residents, which exceeded the per capita disposable income line (26,000 yuan) in our province's annual per capita residents in our province, the scope of poverty monitoring of the medical insurance department due to illness. Family members of the minimum security marginal family and rural areas are easy to return to the poor, and the medical assistance application channels for patients with poverty and serious illness due to illness. Rescue to prevent poverty due to illness.

Continuously improve the prevention and control of medical insurance support -fixed -point pharmacies to purchase new crown antigen detection reagents can use medical insurance personal accounts to pay

Adjust the scope of medical insurance payment in time. The new coronary antigen detection test agent and corresponding test items and related medical service items are incorporated into the basic medical insurance medical service project directory. The relevant expenses incurred by the insured in the fixed -point medical institution shall be paid in accordance with the current regulations of the regional region, and the cost of purchasing the new coronary virus antigen detection reagent in a designated retail pharmacy can be paid using a personal account of medical insurance. Optimize the management of new medical service price projects. Accelerate the progress of the prices of new medical services, especially the new medical services that optimize the diagnosis and treatment plan of major diseases, respond to major epidemic conditions, or fill in major innovative projects that fill the diagnosis and treatment gap, and open up green channels. Normalized institutionalization to carry out procurement of drugs, and incorporate more drugs and medical consumables into the scope of procurement. The reporter sorted out and found that at present, our province has implemented the national organizational drug concentrated with the procurement of six batches of 7 rounds of 243 selection varieties, and completed the provincial organizations, leading provincial alliance organizations or participating in the six batches of 159 varieties of provincial alliance organizations. Task (including 24 varieties). Our province has implemented the selection of varieties in the procurement of national organizational medical consumables coronary stent and artificial joints. ), Foam dressing (52 varieties), pacemaker, coronary artery balloon expansion catheter, catheter guide wire selection results have been executed, participating in the Beijing -Tianjin -Hebei alliance's trauma medical consumables, matheliers and Sichuan Province Concentrated procurement of oral implants of the alliance. The new coronary virus nucleic acid and antigen test reagents are organized by the Guangdong Jizai Alliance. In the next step, medicines with large clinical use and high procurement amount of medical institutions will be included in the scope of collection, so that they should be selected and squeezed the prices of drug virtual high prices, so that patients can enjoy more and more collection systems. Reform dividends.

Optimize the procurement of the epidemic prevention and control pharmaceutical procurement, and add the new coronary virus infection pneumonia and pneumonia treatment drugs, detection reagents and other epidemics such as the new coronary virus pneumonia diagnosis and treatment plan. Sales in our province at any time to ensure that medical institutions are used. In addition, the Shaanxi Provincial Medical Security Bureau has made it to the latest that there is a need for medical institutions and the drug procurement platforms that the provincial pharmaceutical and device procurement platform, allowing medical institutions to purchase offline.

Since March this year, our province has lowered the prices of new coronary virus nucleic acid tests three times, and the prices of new coronal virus antigen detection are lowered. At present, the new coronary virus nucleic acid test single test is 16 yuan/person, the mixed examination 3.4 yuan/person, and the total cost of the new crown virus antigen test is 6 yuan per person. The "Several Measures" mentioned that in the next step, according to the work arrangements of the State Medical Insurance Bureau, combined with the situation of our province, the price of new crown virus nucleic acid and antigen detection items will continue to serve the prevention and control and testing of new crown pneumonia. Reduce the burden on the masses.

Continue to optimize the service of medical insurance and office -realize 5 kinds of outpatient slow special diseases across the province and the direct settlement area coverage in the province before the end of the year

In the medical insurance information system, the new crown pneumonia clinic settlement module is added, and the outpatient review cost of patients with new coronary pneumonia is included in the fund payment scope, and the outpatient clinic in the province is gradually realized. Category to promote the "cross -provincial generalization" of hospitalization and outpatient expenses across provinces. The reporter learned that in November last year, our province achieved the full coverage of outpatient expenses across provinces and different places in the province. At least one ordinary outpatient cost of each county has been achieved. At the same time, Yang Ling Demonstration Zone Hospital, as 5 kinds of outpatient disease -related treatment expenses, including hypertension, diabetes, malignant tumor outpatient chemotherapy, uremia dialysis, and organ transplantation of anti -exclusion therapy after the treatment. It was officially launched at the end of December last year. This year, our province will further increase its work, continue to promote the direct settlement of 5 clinics and special diseases in the province and the province, and achieve full coverage of the overall planning area by the end of the year.

For patients who cannot return to the insurance place due to the prevention and control of the epidemic, and have not handled the referral transfer, and the long -term medical application for medical treatment, the green channel for medical treatment for medical treatment is opened, and the filing procedures are simplified. Direct settlement. Open a green channel for medical insurance services. Implement the "no meeting" service, open online transfer continuity, different places for medical records and other businesses. For business that cannot be processed online, the insured unit is encouraged to submit application materials through fax and express mail. The qualified "Internet+" medical service costs are included in the scope of medical insurance payment to achieve online medical insurance settlement.

Improve the service level of medical insurance. Adhere to the principle of "non -necessary, no window", and take measures such as online handling, delay, simplified office, and shortage of capacity. The time limit for extension of matters is appropriately extended, the appointment system is implemented, and the masses are handled when the peaks are wrong. Further improve the direct settlement policy for hospitalization expenses across provinces to facilitate the record of the people's parties to record different places, and steadily improve the direct settlement rate of hospitalization expenses across provinces. Make full use of the traditional service methods that are familiar with groups such as the elderly, ensure the basic needs of special groups, and effectively play the role of traditional service methods.

Tip

Related ways to consult the medical insurance policy

Participants can inquire about medical insurance policies through the official website of Shaanxi Medical Insurance Bureau and Shaanxi Medical Insurance APP.At the same time, starting from May 17, the 12393 medical security 24 -hour service hotline will be available for trial operation, which can provide more convenient and intimate medical insurance consulting services for the people participating people.The hotline is dominated by intelligence, supplemented by artificial services, and cooperates with intelligence and artificial phase. It is unlimited and unlimited to provide intimate services.Text: Xi'an Newspaper All Media Reporter Ma Xiang

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