More than 50,000 yuan of single-product supplies, the highest payment standard for Medicare is executed at 50,000 yuan, and the excess is paid by individual self-payment or various types of supplement
Medical Network November 8 reporter recently learned from the Ningxia Department of Human Resources and social Security, Ningxia's latest policy, the basic medical insurance, industrial injury insurance and maternity insurance medical supplies in the basic payment, limited payment and single product limit, and so on, made clear that the health care medical consumables single product reimbursement standard of up to 50,000 yuan.
The aim is to standardize the management of medical consumables for Medicare, curb waste and protect the basic medical rights and interests of insured insured. According to the latest issue of "Ningxia Hui Autonomous Region basic medical insurance, industrial injury insurance and maternity insurance medical Consumables Payment Catalogue", in the basic medical insurance reimbursement, no longer set a specific proportion of payments, directly into the scope of health care policy, According to the basic medical insurance for urban workers in Ningxia and the basic medical insurance for urban and rural residents in the medical institutions at all levels of the corresponding reimbursement treatment implementation.
Maternity insurance and work-related injury insurance claims are implemented in accordance with the relevant policy provisions. For the catalogue of vascular Stents, balloons, guide wire, artificial joints and organs, such as high value, easy to consume the use of disposable medical supplies, Ningxia also limited the insurance payment policy. For example, the puncture device in the endoscope material, the Medicare payment limit is that Medicare pays up to 3 units during a hospital stay, with a maximum payment Standard For each set of 1200 yuan.
If clinicians use disposable medical supplies that exceed the limited Medicare payment policy during the diagnosis and treatment process, the costs incurred cannot be covered by Medicare reimbursement. In addition, for other consumables in the catalogue that do not qualify for Medicare payments, the cost of a single product consumable within 50,000 yuan is paid by the basic Medicare Co-ordination Fund and individuals in accordance with the regulations;