Gansu: The novel Coronavirus antigen testing service fee and newly added drugs are temporarily included in the coverage of medical insurance

2022-07-10 0 By

On March 23, the reporter learned from the Medical insurance Bureau of Gansu Province that Gansu province has issued a notice on the medical security work of epidemic prevention and control.The Circular has clarified the relevant medical insurance policies for the promotion and application of novel Coronavirus antigen testing, adjusted the COVID-19 treatment drugs covered by the medical insurance, allocated advance funds for treatment, implemented medical insurance for treatment costs, continued to ensure the cost of Novel Coronavirus vaccine, and made all-out efforts to ensure the procurement of epidemic prevention and control materials.To ensure that confirmed and suspected COVID-19 patients are not affected by the cost of medical treatment, and ensure that medical institutions are not affected by payment policies.Novel Coronavirus antigen testing service fee of RMB 5 / person-time is temporarily included in the new medical service price item of Novel Coronavirus antigen testing under provincial Medical Insurance. Novel Coronavirus antigen testing service fee of RMB 5 / person-time is included. Antigen testing reagents and sampling instruments are sold separately according to the zero error rate regulation.The total cost of “Test price item + test reagent (including sampling instrument)” shall not exceed 15 yuan per person.Medical institutions at all levels shall purchase Novel Coronavirus antigen detection reagents through Gansu Province Medical Consumables Sunshine Procurement Platform, and off-line procurement shall be prohibited.Novel Coronavirus antigen detection reagents and corresponding detection items shall be temporarily included in the list of basic medical insurance service items of Gansu Province according to the procedures, and relevant expenses incurred by insured personnel in designated medical institutions shall be paid according to the current regulations of the overall planning area, namely:The novel Coronavirus antigen test expenses incurred during hospitalization shall be settled and paid by the National Insurance Pooling Fund in accordance with category A and other inpatient medical expenses, and the novel Coronavirus antigen test expenses incurred in outpatient clinics shall be reimbursed in accordance with the current medical expense reimbursement regulations for general outpatient clinics in the coordinated areas.Insured personnel in the fixed point retail drugstore to buy the cost of testing reagents, can use personal accounts to pay.The newly added drugs in The Diagnosis and Treatment Protocol (Trial Ninth Edition) will be temporarily included in the payment scope of the Medical insurance Fund as Class A drugs;For medicines that have been called out and are not included in the basic medical insurance list, the medical insurance payment will be stopped on the release date of COVID-19 Diagnosis and Treatment Protocol (Trial Version 9).For newly added drugs that have not yet been connected to the Internet, a green channel will be opened to be directly connected to the Internet, allowing medical institutions to purchase offline drugs for emergency use before being connected to the Internet.The nematavir/ritonavir tablets added in the Plan shall be purchased by medical institutions according to the price agreed upon between enterprises and relevant departments, and the medical insurance department shall make payment according to the provisions.At the same time, special advances for COVID-19 treatment can be allocated to designated medical institutions for centralized treatment in accordance with the procedures, so as to reduce the pressure on medical institutions to make advance payments and fully support the smooth operation of designated medical institutions for centralized treatment.Cities and states that have not recovered the advance funds in 2021 shall retain or add special advance funds for medical insurance according to the development of the epidemic situation.We will continue to implement the policy of “treatment first, settlement later” for patients insured in other places, and urge designated medical institutions for centralized treatment to continue to implement the policy of “treatment first, settlement later” for both locally insured patients and those insured in other places.In cooperation with the financial department, the medical treatment expenses will be partially subsidized by individuals.Actively cooperate with The Medical Insurance Bureau of Gansu Province in the settlement of treatment costs for patients insured in other places of the province or within the province.Local governments should make every effort to ensure that medical supplies for epidemic prevention and control are available online, simplify the procedures for reporting medical supplies for epidemic prevention and control online, and help ensure the supply of treatment drugs, testing reagents, and prevention and control materials.Local medical security departments should strictly implement the novel Coronavirus vaccine special budget and timely and fully settle the vaccine vaccination costs with all levels of vaccination institutions.At the same time, we will strictly implement the policies of medical insurance settlement and reimbursement for long-term prescriptions and online diagnosis and treatment, and reduce the number of visits to medical institutions for prescriptions by insured patients.Source: China