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    Home > Medical News > Latest Medical News > Announcement on Soliciting Opinions and suggestions of the notice on establishing medical security mechanism for rare diseases in Zhejiang Province (Draft for comments)

    Announcement on Soliciting Opinions and suggestions of the notice on establishing medical security mechanism for rare diseases in Zhejiang Province (Draft for comments)

    • Last Update: 2019-11-07
    • Source: Internet
    • Author: User
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    In order to further improve the work of medical security for rare diseases in Zhejiang Province and help the people resolve the risk of huge medical expenses, the Bureau has drafted and formulated the notice on establishing medical security mechanism for rare diseases in Zhejiang Province (Draft for comments), which is now open to the public for comments If you have any modification opinions or suggestions, please feed back to the medical service management office of the Provincial Medical Security Bureau by email, fax, letter and other forms before November 14, 2019 (Thursday) Email: 36111001@qq.com Tel: 0571-87050377 Fax: 0571-87050375 contact address: Medical Service Management Office of Zhejiang Medical Security Bureau (213 Baogu Road, Xihu District, Hangzhou 310007) attachment of Zhejiang Medical Security Bureau on November 6, 2019 is as follows: Zhejiang Provincial Medical Security Bureau Zhejiang Provincial Department of Finance Zhejiang provincial health and Health Commission Zhejiang Provincial Department of civil affairs and other four departments notice on the establishment of medical security mechanism for rare diseases in Zhejiang Province (Draft for comments) city, county (city, district) Medical Security Bureau, Finance Bureau, health and Health Commission (bureau), Civil Affairs Bureau: In order to further improve the work of medical security for rare diseases in Zhejiang Province, help the people to resolve the risk of huge medical expenses, and effectively solve the problem of poverty caused by illness and returning to poverty due to illness, with the consent of the provincial government, the relevant issues concerning the establishment of medical security for rare diseases in Zhejiang Province are hereby notified as follows: 1 Objects of security Patients who have participated in the basic medical insurance of Zhejiang Province and obtained the household registration of our province for more than 5 years; or patients who have participated in the basic medical insurance of our province and whose age is less than 5 years, but whose parents have obtained the household registration of our province for more than 5 years 2、 At the level of overall planning, the medical insurance for rare diseases shall be carried out at the provincial level, with unified policy system, funding standard and treatment level, and the funds shall be collected and paid in a unified way 3、 The fund-raising mechanism is to establish the fund for rare diseases protection, and the fund source is to transfer the fund for serious diseases insurance and appropriate subsidy from provincial finance At present, according to the standard of 2 yuan per person per year for basic medical insurance participants in the whole province, each overall planning area will transfer directly from the serious illness insurance fund of each region before the end of January of each year according to the number of participants at the end of last year, and then submit it to Zhejiang Medical Security Bureau for centralized management According to the operation of the medical insurance fund for rare diseases, it should be adjusted in time The medical insurance fund for rare diseases shall be managed in a special financial account and accounted for independently 4、 According to the national catalogue of rare diseases, the dynamic adjustment mechanism of special drugs for rare diseases shall be established For the drugs listed on the domestic market with definite curative effect and urgent treatment, which are not included in the list of drugs for basic medical insurance and serious illness insurance, according to the principle of "expert argumentation, price negotiation and dynamic adjustment", and in combination with the economic and social development level of our province, the balance of medical insurance fund for rare diseases and other situations, special negotiation for special drugs for rare diseases is launched regularly Special drugs for serious illness insurance in our province, which are used to treat Gaucher's disease and phenylketonuria, will be directly transferred into the scope of medical insurance for rare diseases, and will no longer enjoy the treatment of serious illness insurance Local government departments should do a good job in policy convergence 5、 The expenses of special drugs for patients with rare diseases whose treatment level is included in the scope of security shall be resolved by medical security, medical assistance and charity assistance (1) Medical insurance for rare diseases The medical insurance for rare diseases shall be settled in accordance with the natural year, and the insured shall be reimbursed in sections and capped with individual burden in case of drug expenses incurred in one settlement year The reimbursement proportion of RMB 0-300000 is 80%; the reimbursement proportion of RMB 300000-700000 is 90%; the full amount of expenses above RMB 700000 will be reimbursed (2) Medical assistance For the remaining special drug expenses after medical insurance for rare diseases, the people's Government of the insured area shall provide medical assistance to the personnel who meet the medical assistance conditions according to the regulations, of which the proportion of the assistance for the extremely poor support personnel is 100%, the proportion of the assistance for the members of the family with the lowest living guarantee is 70%, the proportion of the assistance for the members of the family with the lowest living guarantee is 60%, the proportion of the assistance for the poor due to illness is 50%, and the maximum payment limit is 50% The amount is 100000 yuan (3) Charity help For those who still have difficulties after medical aid, the remaining medical expenses shall be assisted by charitable organizations such as the Provincial Charity Federation in the form of charity 6、 Management service (1) disease diagnosis Patients who meet the requirements of rare disease medical objects in Zhejiang Province must go to the First Affiliated Hospital of Zhejiang University Medical College, the Second Affiliated Hospital of Zhejiang University Medical College, Shao Yifu Hospital Affiliated to Zhejiang University Medical College, children's Hospital Affiliated to Zhejiang University Medical College, the Second Affiliated Hospital of Wenzhou Medical University and people's Hospital of Zhejiang Province for diagnosis; they must be rechecked before December 31 every year For the insured who meet the scope of insurance, the hospital shall issue the diagnosis certificate and register it with the provincial medical insurance agency (2) Fixed point treatment The Provincial Medical Security Bureau will set up a designated hospital for disease treatment together with the provincial health and Health Commission according to the rare diseases within the coverage, and require each designated hospital to designate 1-2 clinical experts with senior titles as responsible doctors to provide medical services for patients The responsible physician shall be responsible for the medical service of each stage of patient treatment During the reception, the identity of the patient shall be carefully verified, so that the person, certificate and card are consistent, the treatment shall be reasonable, the condition, prescription time, measurement and other information shall be recorded in detail, and the information shall be submitted to the provincial medical insurance bureau on a regular basis Patients should receive medical and technical services such as infusion of specific drugs on the spot in designated hospitals, and should not be taken to other hospitals for use or transferred to others for use (3) Cost guarantee After the patients are treated in the designated hospital, they only need to pay their own part, and other expenses are settled by the medical insurance agency and the hospital Special drugs for rare diseases are not included in the total amount management of the hospital, and are not included in the drug proportion assessment 7、 Safeguard measures the departments of medical security, finance, health and civil affairs at all levels should attach great importance to the work of medical security for rare diseases, establish the coordination mechanism of departments, and do the relevant work according to the division of labor The medical security department shall earnestly perform the responsibilities of the leading department, and work together with relevant departments to make policies, organize coordination, guide supervision, accounting, financial accounting, and supervise the implementation of agreements The health department shall designate designated hospitals for diagnosis and treatment in time, strengthen the supervision of medical institutions and medical service behaviors, and guide medical institutions to do a good job in diagnosis, treatment and information management The financial department should do a good job in the allocation and supervision of the fund for the medical insurance of rare diseases The civil affairs department should build and share a strong rescue information platform, and accurately identify the rescue object according to the verification of the applicant's family population, income, property and expenditure Local people's governments should take the patients with rare diseases who are included in the scope of guarantee as the special difficult groups who are poor due to illness, and formulate and issue the mechanism of supporting and supporting We will encourage social charities to raise funds for the relief of rare diseases, set up projects for the relief of rare diseases, and pool social forces to care for and help patients in need This notice will be formally implemented from January 1, 2020 The original notice of Zhejiang Provincial Department of human resources and social security on strengthening medical security for rare diseases issued by Zhejiang provincial health and Family Planning Commission of Zhejiang Provincial Department of civil affairs and Zhejiang Provincial Department of Finance (zhrssf [2015] No 126) will not be implemented at the same time Penicillin is the reprinted content of yaozhi.com, and the copyright belongs to the original author The purpose of reprinting is to transmit more information, which does not represent the view of this platform If the content of the work, copyright and other issues are involved, please contact our website message, we will delete the content in the first time.
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