Xinjiang: Medical insurance treatment list to make medical security more benefits


Xinjiang: Medical insurance treatment list to make medical security more benefits

Original title: The medical insurance treatment list allows medical security more benefits recently, Xinjiang released the "Implementation Opinions on Implementing the State Medical Assurance Treatment List System (hereinafter referred to as" Opinions "), and announce the" Xinjiang Uygur Autonomous Region Medical Guaranteed List (2021 Year Edition) "(hereinafter referred to as" List "), will be based on comprehensive construction of clear, safeguard moderation, and sustainable multi-level medical security system, gradually establish and improve the list of medical insurance treatment, fair and moderately protect the basic medical security of the people. rights and interests.

What is the advantage of insured? What role will be played on the management of medical insurance system? For related issues, the reporter interviewed the relevant person in charge of the Medical Saving Bureau of the Autonomous Region. The medical insurance treatment and national unified "list" include the basic system, basic policies, and the medical insurance fund payment, and the scope of the medical insurance fund payment. Within the basic system framework of the medical insurance, basic medical insurance, supplementary medical insurance and medical assistance. "List" stipulates that the system must not be new in the basic institutional framework, and the existing other forms of institutional arrangements should be gradually cleaned into the basic system framework.

According to the requirements of eliminating increments, standard stock requirements, the policies that exceed the "List" authorization will not be introduced.

What will I deal with the "List" policy not consistent with the "List"? In this regard, Fu Yongzhong, deputy director of the Treatment Security Department of the Medical Saving Bureau of the Autonomous Region, and the number of medical insurance institutions, and policy settings will be required in accordance with the "List" requirements before 2022.

At the same time, the advancement of the centralized resource support to the poverty of the essential medical insurance, supplement medical insurance and medical assistance, the three-dimensional system of normalization, and do a good job in the super conventional system in the medical insurance poverty alleviation field. Before the end of 2022, the national unified provisions, all over the country Local all kinds of poverty alleviation super conventional system arrangements were incorporated into the medical assistance system, and the relevant funds were unified and included in the Medical Assistance Fund. Xinjiang also returns into the three-system guarantee framework in the form of other local systems outside the list.

Policy measures that exceed the list of lists, divided into the supplementary medical insurance or medical assistance to ensure a smooth connection of the treatment. The proportion of large disease insurance payments is not less than 60% "List" also clarified the hospital treatment payment policy.

Among them: The hospitalization payment standards of employees medical insurance is not higher than 10% of the average wages of employees in the co-ordination area, and the specific standards are determined by the local actual situation. Different levels of medical institutions are properly opened. The residential disease insurance payment standard is not higher than 50% of the annual per capita disposable income of the co-ordination area. Among them, the low-income objects, and special difficulties will fully cancel the threshold, and low-income family members shall determine the per capita disposable income of low-income regions. The per capita disposable income is determined, and patients with severe diseases in the disease is determined at about 25%. Fu Yongzhong introduced that the proportion of payments, the cost of the policy range below the policy, the maximum payment limit, the proportion of the basic medical insurance, the general payment ratio, the medical insurance and urban and rural residents maintain a reasonable gap, different levels of medical institutions The gap. The proportion of the big disease insurance payment is also clearly defined not less than 60%. Medical assistance to low-inspiring objects, special difficult personnel can be assisted in accordance with the ratio of no less than 70%, and there is no less than 80% of South China, and other rescue objects will be slightly lower than the low-inspiring object. The specific proportion is coordinated Region is determined according to actual. Reduce the medical attention of slow disease patients "List" also stipulates the payment policy of outpatient treatment.

In terms of ordinary outpatients, the payment standards or more, the cost of the policy is not less than 50% of the residential medical insurance.

In terms of slow disease in the outpatient, it is incorporated into medical insurance reimbursement.

Malignant tumor clinic plastic chemotherapy, uremia dialysis, organ transplantation, anti-wear treatment, severe mental patient drug maintenance, diabetes insulin treatment, tuberculosis, daytime surgery, etc., can be referred to in hospital management and payment. Long-term clinic is required for long-term clinic in patients with chronic diseases or serious diseases, resulting in a high-risk cost that meets the rescue conditions. The outpatient annual assistance limit is determined by the people’s governments above the county level according to the local rescue target and the raising situation of rescue funds. In addition, Xinjiang also develops a large-sick insurance tilt policy for low-cost objects, trainees and returning poverty, stipulates that the major illness insurance payment standard is 50%, and the payment ratio is increased by 5 percentage points, and the maximum payment limit is canceled.

Fu Yongzhong said that Xinjiang will also explore the medical expenses of the policy-wide medical expenses. Through innovation mechanisms support and encourage commercial insurance institutions, encourage social forces such as charitable donations, and multi-channel reducing the cost burden of the people’s policy. (Zhao Min) (Editor: Yang Rui, Han Ting) Sharing let more people see.