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On December 17, the National Health Security Administration issued “Opinions on National Organizations for Centralized Purchasing and Use of Support Measures for Coronary Stents.” The opinion is clear that the products selected in the centralized procurement of coronary stents are paid based on the selected price, and the total amount is included in the scope of payment of health insurance, and the health insurance fund is paid in accordance with the prescribed ratio. If coronary stents other than the selected products fall within the scope of payment of the health insurance fund, localities can reasonably set the upper limit of the health insurance payment standard based on the actual transaction price. The patient uses the product whose price exceeds the upper limit of the health insurance payment standard and, in principle, the patient pays the excess part.
It is understood that in November this year, the National Health Insurance Administration announced that the first centralized procurement of coronary stents will open. After this centralized acquisition, the price of the stent has dropped from an average price of around 13,000 yuan to about 700 yuan. Patients across the country are expected to use the selected products after the national centralized acquisition price reduction in January 2021.
The opinions issued on this occasion are intended to promote the correct implementation of the results of the centralized procurement of coronary stents. The main support measures include: standardization of the platform network and distribution works. Selected coronary stent central procurement products are listed on provincial-level pharmaceutical central procurement platforms at selected prices. Medical institutions purchase at selected prices and patients use them at selected prices. For coronary stents other than selected products, in accordance with the principle of performance and price matching, consider the reasonable price relationship with the selected products and guide and encourage related companies to adjust the price to a reasonable level.
Implement the prepayment policy for medical insurance funds. The health insurance department of each coordinating area will calculate the agreed purchase amount of each selected product based on the selected price of the selected product, the purchase product and the amount agreed by each medical institution and the company. Based on the total budgetary management of the health insurance fund, an advance payment mechanism is established. After the medical institution signs a purchase agreement with the selected company, the medical insurance fund is paid in advance to the medical institution at a rate not less than 30% of the agreed annual purchase amount, and the medical institution must resolve the agreement with the company in a timely manner. The compensation time shall not exceed the end of the month following acceptance of the delivery.
Do a good job converging your health insurance payment policies. The products selected in the centralized procurement of coronary stents are paid based on the selected price, and the total amount is included in the scope of the health insurance payment, and the health insurance fund is paid according to the prescribed ratio. If coronary stents other than the selected products fall within the scope of payment of the health insurance fund, localities can reasonably set the upper limit of the health insurance payment standard based on the actual transaction price. The patient uses the product whose price exceeds the upper limit of the health insurance payment standard and, in principle, the patient pays the excess part. Within two years, gradually adjust the payment standard so that it does not exceed the highest winning price. Online pricing, the patient’s own-pay ratio, and the upper limit of the health insurance payment standard should be considered broadly to avoid an increase in burden for patients.
Furthermore, for provinces with a large proportion of non-local patients undergoing coronary stent implantation and the current price of related medical services is significantly lower than the national average price and the price of neighboring provinces, Coronary stenting can be appropriately adjusted according to local conditions. price.
By Beiqing-Beijing Head Reporter Xie LiReturn to Sohu to see more
Editor:
Disclaimer: The opinions in this article only represent the author himself. Sohu is an information publishing platform. Sohu only provides information storage services.
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