Adjustment of payment standards!Jilin province unified execution

A few days ago

Jilin Provincial Medical Security Bureau released

Notice on adjusting some of the disease collection standards

Adjust the payment standards for some diseases

The full text is as follows

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Notice on adjusting some of the disease collection standards

Ji Yi Baofa [2022] No. 19

Municipal (states) medical security bureau, Changbai Mountain Management Committee Medical Security Bureau, Meihekou Municipal Medical Security Bureau, Provincial Social Medical Insurance Administration:

In order to further optimize the management of paying in our province according to the disease, the collective demonstration of the experts, the "Notice on the Clear Conditional Conditioning Standards and Related Works of 122 Cultivating Cardiac Deforms" (Ji Medical Insurance [2020] No. 17, the following, below, below Some of the disease collection standards are adjusted in some of the "Circular 17"), and the relevant matters are notified as follows:

1. Dynamic adjustment of the payment standard

The Provincial Bureau in accordance with the "Notice on Further Doing a Better Cover of the Provincial Diseases" (Ji Yi Baofa [2020] No. 43), "Notice on Further Improve and Expand the Scope of Payment Payment on the Disease" 2021] No. 31) and other requirements, comprehensively consider factors such as the collection of drugs and medical consumables, the adjustment of the price of medical services, the revenue and expenditure of medical insurance funds, and the economic and social development, and combined with the actual situation of our province, some of the diseases and payment standards (in detail see attached).

2. Other requirements

(1) The medical insurance departments of various localities should accelerate the three -year action plan of DRG/DIP, and make a good connection, and timely transform the payment policy to DRG/DIP in accordance with the disease types.

(2) Each designated medical institution shall strictly implement the payment policy according to the disease type, and shall not include inconsistent cases that are not consistently incorporated into the scope of the disease management scope by reducing the admission standards, relaxation of surgical indications, upgrading diagnosis, and stringing diagnosis.

(3) The Provincial Social Medical Insurance Administration shall promptly do a good job in the connection between the information system adjustment and the payment standards to ensure that the payment of payment and payment is standardized and efficiently implemented in accordance with the disease types.

(4) This notice will be implemented uniformly from July 1, 2022, and the implementation scope is limited to three -level medical institutions. The disease that has not been settled in the early period "Circular 17" affected by the epidemic can be implemented from January 1, 2022 with reference to this standard.

Attachment: Dynamic adjustment of diseases and payment standards

Jilin Provincial Medical Security Bureau

June 29, 2022

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Source: Voice of Jilin

Produced: Ji Bao Media

Editor: Zhou Baihang

Edit: Fu Yaoyao

School review: Lu Wenjiu

© Study Jilin

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