200,000 medical institutions and 390,000 retail pharmacies have been included in designated medical insurance sites

Report from this newspaper (Reporter Li Danqing) Recently, National Medical Insurance Administration formulated the”Interim Measures for the Management of Medical Security at Medical Institutions” and the”Interim Measures for the Management of Medical Security at Retail Pharmacies”, and proposed that qualified medical institutions and retail pharmacies can sign through application The medical insurance agreement is included in the designated management of medical insurance, and the basic conditions and procedures for signing the agreement are clarified. According to statistics, in 2019, about 200,000 medical institutions and 390,000 retail pharmacies nationwide were included in the designated medical insurance sites, which basically met the medical and drug service needs of the insured.

In order to improve the efficiency of the use of medical insurance funds and better protect the rights and interests of insured persons, two measures have been proposed. Medical institutions that have obtained medical institution practice licenses or Chinese medicine clinic registration certificates shall be promising with the approval of the military authorities Military medical institutions with civilian service qualifications and retail pharmacies that have obtained drug business licenses can apply for designated medical insurance.

“Medical institutions and retail pharmacies need to meet several basic conditions to apply for inclusion in medical insurance designated points, including the operation time of the institution shall not be less than 3 months, and have certain business license qualifications and service personnel.” National Medical Insurance The relevant person in charge of the bureau believes that this is the basic condition for medical institutions and retail pharmacies to provide services to the insured persons.

In order to facilitate the insured persons to seek medical treatment and purchase drugs, the two methods are clear, and the time limit for the completion of the evaluation by the medical insurance agency shall not exceed 3 months. Medical insurance agencies negotiate with qualified medical institutions and retail pharmacies, and if an agreement is reached, both parties voluntarily sign a service agreement.

For medical institutions and retail pharmacies, including medical insurance fixed points does not mean once and for all. The two measures propose that medical insurance agencies or third-party agencies entrusted by them will carry out performance appraisal of designated medical institutions and strengthen the supervision of designated medical institutions and designated retail pharmacies. The Measures also clearly define the circumstances of suspension and cancellation of the agreement.

During the epidemic prevention and control period, in order to facilitate the return of patients with chronic diseases to obtain medicines, all localities actively support”Internet +” medical services. So, how can Internet hospital be included in designated management?

Currently, Internet hospitals mainly have various forms such as physical medical institutions building their own information platforms, and physical medical institutions cooperating with third-party institutions to build information platforms. The person in charge revealed that “Internet hospitals must rely on physical medical institutions to apply for practice licenses, sign agreements with physical medical institutions, and report to the overall planning regional medical insurance agency for the record, and the provision of services incurred in compliance with the required expenses shall be handled by the overall planning regional medical insurance agency. Institutions and designated medical institutions settle accounts.”

In addition, the “designated retail pharmacies can sell drugs with electronic prescriptions issued by designated medical institutions”, which has attracted many people’s reverie:”This is Doesn’t it mean that prescription drugs can be sold online?”

Yes, this person in charge gave a clear answer. The current regulations stipulate that prescriptions that meet the regulations can be transferred to physical pharmacies or be picked up by physical pharmacies. The distribution model and circulation of prescriptions are not the same as prescription drugs sold online. The relevant policies for prescription drugs sold online need to be clarified by the competent authority.

Li Danqing

Source:Workers Daily