The reporter learned that clinicians according to the needs of clinical treatment, for the insured insured to provide more than the scope of the catalogue or health insurance limit policy of medical s |
|||
Medical Network November 7 November 5, Ningxia Human Society Hall issued a message, the human Social Hall in conjunction with the Department of Finance, Health Commission and other departments jointly issued the "Ningxia Basic medical insurance, industrial injury insurance and maternity insurance medical Consumables Payment Catalogue" (hereinafter referred to as the "medical Supplies catalogue"). The move is intended to regulate the management of medical consumables, curb waste and protect the basic medical rights and interests of insured insured. According to the introduction, "Medical consumables catalogue" involves 473 supplies specifications, applicable to the basic medical insurance in our district, industrial injury insurance and maternity insurance, is the basic medical insurance, industrial injury Insurance and Maternity insurance fund to pay the insured personnel medical consumables and strengthen the management of social insurance medical services policy basis and. Standard In the basic payment management, the catalogue in the basic medical insurance reimbursement, no longer set a specific proportion of payments, directly into the scope of the health care policy costs, in accordance with the basic medical insurance for urban workers in our district and the basic medical insurance for urban and rural residents at all levels of medical institutions corresponding to the reimbursement of treatment. In the claim of maternity insurance and industrial injury insurance, it is subordinate to the implementation of its relevant policy provisions. In terms of limited payment management, the use of blood vessel stents, balloons, guide wire, artificial joints and organs in the catalogue of medical consumables, such as consumption of disposable medical consumables, limits the policy of Medicare payment. In the course of the diagnosis and treatment service, clinicians use the cost of disposable medical consumables that occur in excess of the provisions of the limited Medicare payment policy, and the basic Medical Insurance Co-ordination fund is not paid, and the various supplementary insurance and the insured are jointly burdened according to the provisions. The payment method in the current Medicare payment policy is otherwise stipulated and is implemented according to the original policy. In the single-product limit management, the scope of the catalogue of Medicare payment for non-limited payment of other consumables, the price of a single product supplies more than 50,000 yuan, the highest payment standard for Medicare by 50,000 yuan (50,000 yuan within the cost by the basic medical Insurance Co-ordination fund and individuals to pay according to the provisions, Parts exceeding 50,000 yuan or more are paid in accordance with the provisions of individual self-payment or various types of supplementary insurance). |