By the end of 2022, Hebei's original transfer of Class B drugs will be all transferred out of Beijing, Tianjin and Hebei to achieve health insurance synergy.

Text . . . Fengqiu August 11, according to Hebei Daily reported that the Hebei Provincial Party Committee, the provincial government has issued "on deepening the implementation of the reform of the medical security system", proposed to speed up the construction of a coverage of the whole people, urban and rural integration, clear rights and responsibilities, to ensure a moderate and sustainable multi-level medical security system, do their best and do their best to promote the high-quality and coordinated development of medical security and medical services.
main objectives are: by 2025, the basic completion of treatment security, financing operation, medical insurance payments, fund supervision and other important mechanisms and medical services supply, health insurance management services and other key areas of reform tasks, medical security system more mature stereotypes.
to 2030, a medical security system with basic medical insurance as the main body and medical assistance as the base, supplementing medical insurance, commercial health insurance, charitable donations, and mutual medical assistance and common development will be fully established to achieve the goal of better safeguarding medical treatment.
March 5, 2020, the State issued the Implementation Opinions on Deepening the Reform of the Medical Security System, Hebei took the lead in following up on the reform of the provincial-level deepening of the medical insurance system.
31 articles, the specific content of which is as follows: First, the overall requirements (i) guiding ideology.
Fully implement the spirit of the Second, Third and Fourth Plenary Sessions of the 19th National Congress and the 19th Central Committee of the Communist Party of China, implement the 9th and 10th plenary sessions of the 9th Provincial Committee, adhere to the people's health as the center, speed up the construction of a multi-level medical security system covering the whole people, urban and rural areas, clear rights and responsibilities, guarantee moderate and sustainable, do our best and do our best to promote the coordinated development of high-quality medical security and medical services, promote the health of Hebei, and promote the people's sense of well-being and security.
(ii) the main objectives.
to 2025, the basic completion of treatment security, financing operation, medical insurance payment, fund supervision and other important mechanisms and medical services supply, health insurance management services and other key areas of reform tasks, medical security system more mature stereotypes.
to 2030, a medical security system with basic medical insurance as the main body and medical assistance as the base, supplementing medical insurance, commercial health insurance, charitable donations, and mutual medical assistance and common development will be fully established to achieve the goal of better safeguarding medical treatment.
, improve policy measures, improve fair and moderate treatment guarantee mechanism (iii) improve the basic medical insurance system.
adhere to and improve the basic medical insurance system and policy system covering the whole people and participating in accordance with the law, the classification and protection of workers and urban and rural residents, the treatment and payment are linked, and the funds are accounted for separately.
reasonably set the proportion of hospitalization reimbursement for different levels of medical institutions, appropriately raise the proportion of reimbursement for primary medical institutions, and the proportion of reimbursement within the policy of primary medical institutions for basic medical insurance shall not be less than 90% in principle.
the difference between the proportion of reimbursement within the policy scope of primary and secondary medical institutions for urban and rural residents and workers is not less than 10% and 3%, respectively, and the difference between the proportion of reimbursement within the policy of secondary and third-level medical institutions is not less than 15% and 5%, respectively.
improve the outpatient co-ordination system of common security and reform the personal accounts of basic medical insurance for employees.
(4) strictly implement the national list system of medical security treatment.
In accordance with the requirements of the national list system of medical security treatment, regulate the government's decision-making authority, strictly implement the basic system, basic policies, fund payment items and standards, without approval, all localities may not issue policies beyond the scope of the list authorization, to ensure the smooth flow of decrees.
(v) To improve the unified and standardized medical assistance system.
Establish a timely and accurate identification mechanism for aid objects with cross-sectoral, multi-level and information sharing, fully implement the policy of payment for the participation of key assistance objects, improve the policy of medical assistance for serious and serious diseases, and scientifically determine the scope of assistance according to the affordability of medical assistance funds.
to establish long-term mechanisms to prevent and defuse poverty as a result of disease.
by reducing medical costs, raising the annual medical assistance limit, and reasonably controlling the proportion of out-of-the-money expenses within the policy of the poor.
(vi) to establish a guarantee mechanism for the cost of medical treatment in major outbreaks.
in an emergency such as an outbreak, medical institutions should be treated first and charged later, and medical insurance may advance part of the funds for medical institutions that receive more patients.
implement the national special groups, specific diseases medical expenses exemption system, targeted exemption from the medical insurance directory, payment limits, drug use and other restrictive provisions.
use of medical security funds and public health service funds to increase the proportion of payments to primary health care institutions.
(7) to speed up the construction of a multi-level medical security system.
Strengthen the triple protection functions of basic medical insurance, major illness (large) insurance and medical assistance, improve the residents' medical insurance, large medical expenses subsidies for workers, medical assistance for civil servants and supplementary medical insurance for enterprises, and study and establish a multi-level medical security system in the light of the existing social assistance methods.
to speed up the development of commercial health insurance, enrich the supply of health insurance products, strengthen product design, sales, compensation and other key links of supervision, make full use of personal income tax policy.
encourages social charitable donations, mobilizes charitable medical assistance and supports the orderly development of mutual medical assistance.
to implement the national drug protection policy for rare diseases.
, strengthen the fund collection and management, improve the sound and sustainable fund-raising operation mechanism (8) in-depth implementation of the national insurance plan.
to further find out the bottom number of urban and rural insurance coverage, formulate the implementation plan of the universal insurance plan, and continuously improve the participation rate of basic medical insurance.
strengthen the responsibilities of the municipal and county Party committees and the government, enhance the awareness of the whole people to participate in insurance, and ensure that all insurance should be guaranteed.
(9) strengthen the collection of basic medical insurance funds.
employed persons to participate in basic medical insurance shall be paid jointly by employers and individuals.
non-employed persons to participate in basic medical insurance by individual contributions, the Government shall grant subsidies in accordance with the provisions.
establish a benchmark rate system for basic medical insurance, standardize the approved contribution base, reasonably determine the rate, and implement dynamic adjustment.
to increase financial investment in medical assistance, and play a complementary role in financing channels such as social donations.
(10) to do the basic medical insurance city-level co-ordination.
to achieve the municipal-level co-ordination of basic medical insurance for urban and rural residents by 2020 and the municipal-level co-ordination of basic medical insurance for workers by 2021, and to encourage the simultaneous implementation of basic medical insurance for urban and rural residents.
to promote vertical management of medical security departments below the municipal level in accordance with the unified deployment of the central and provincial governments.
promote provincial co-ordination in due course.
to steadily improve the level of medical assistance co-ordination, to achieve coordination with the basic medical insurance co-ordination level.
(11) strengthen the budget performance management of the health care fund.
scientifically prepare the budget of the medical security fund revenue and expenditure, and explore the development of cross-provincial fund budget with Beijing and Tianjin and other provinces (cities).
strengthen the fund's medium- and long-term actuarial and fund operation monitoring and analysis, implement the whole process of fund operation performance management, improve risk assessment, early warning mechanism.
, improve the efficiency of the fund, establish a well-functioning and efficient payment mechanism for medical insurance (12) to strengthen the management of the medical insurance catalogue.
improve the dynamic adjustment mechanism of the medical insurance catalogue, strictly implement the national medical insurance drug catalogue, and all localities shall not make their own catalogues or adjust the scope of payment for medical insurance drugs.
the end of 2022, the original increase in our province's Class B drugs all transferred out.
according to the affordability of the medical insurance fund, regulate the medical insurance diagnosis and treatment projects, medical supplies catalog.
(13) strengthen the management of agreements between medical insurance fixed-point pharmaceutical institutions.
revise and improve the agreement management methods of medical insurance fixed-point medical institutions, incorporate medical institutions with good technology, excellent service, low price and reasonable regional layout into the fixed-point medical insurance, and support the development of new service models such as "Internet plus medical care".
the proportion of drugs, medical treatment items and medical supplies used in the medical insurance catalogue of designated medical institutions.
to formulate measures for the implementation of the agreement by fixed-point pharmaceutical institutions and improve the exit mechanism for fixed-point pharmaceutical institutions.
(14th) to further promote the reform of health care payment methods.
to revise the budget method for the total amount of the health insurance fund.
to the close-knit medical association, in accordance with the medical association service object to implement the head packaging payment.
comprehensive consideration of drugs, medical supplies centralized belt procurement and other factors, scientific calculation of packaging payment standards, strengthen supervision and assessment, balance retention, reasonable overspend sharing.
to promote the reform of medical insurance payment methods by disease diagnosis, by disease type, by bed day, by head-to-head payment, etc.
the establishment of a prepaid work capital system, medical insurance agencies to the secondary and above not included in the medical association of fixed-point medical institutions and medical personnel in the township (town) health hospitals to allocate the work capital.
(15th) to deepen the coordinated development of medical security in Beijing, Tianjin and Fujian.
to comprehensively promote mutual recognition of Beijing-Tianjin-Hebei medical insurance fixed-point, reimbursement of medical expenses, mutual recognition of inspection and inspection results, and actively promote the inclusion of medical institutions in our province in the scope of Beijing-Tianjin medical insurance fixed-point.
。
Xiong'an New Area as an independent medical insurance co-ordination area to provide medical security for the orderly undertaking of Beijing non-capital functional personnel dredging.
, maintain the safety of the fund, improve the strict and strong fund supervision mechanism (16) to strengthen the fund supervision capacity-building.
strengthen the supervision and management of medical insurance funds, improve the efficiency of use, reform the regulatory system, improve law enforcement mechanisms to ensure the safety of funds.
the city and county party committee, the government's responsibility for territory and supervision, for the incompetent performance of their duties, in accordance with the rules and regulations in accordance with the law and serious accountability.
fund supervision into the prevention and resolution of major risks.
strengthen the construction of internal control institutions for medical insurance operations, and implement the responsibilities of agreement management, cost monitoring and auditing.
audit organs at all levels should strengthen audit supervision and include medical insurance funds, medical insurance agencies and regulatory agencies in the annual audit plan.
establish an internal audit system for health insurance funds.
(17) innovative fund supervision.
according to the National Medical Security Fund flight inspection method to study and develop our province's medical security fund flight inspection program.
strengthen process monitoring of medical behavior.
through the government to purchase services, and actively introduce third-party regulatory power to improve regulatory effectiveness.
establish an information disclosure system, strengthen social supervision, and improve the fraud insurance reporting reward system.
(18) to investigate fraud and insurance fraud in accordance with the law.
to formulate and improve the province's health insurance fund regulations.
establish a credit system for medical security.
improve the joint conference system for the supervision of medical insurance funds, make comprehensive use of agreements, administration, justice and other means, seriously investigate the fraud and fraud units and individuals responsible, and investigate criminal responsibility for suspected crimes in accordance with the law.
, deepen the "four-doctor linkage" and jointly promote the reform of the supply side of medical services (19) and actively promote the centralized procurement and use of medicines and medical supplies.
basis of medical insurance payment, the provincial drug centralized procurement platform is established, which is integrated into bidding, procurement, transaction, settlement and supervision.
the results of the centralized procurement of medicines by national organizations.
to carry out the centralized procurement of non-consistent evaluation drugs in our province in an orderly manner.
promote cooperation with Beijing, Tianjin and Beijing, "Sanming" procurement alliance.
the medical insurance fund balance shall be returned on an annually annual period for medicines in the medical insurance catalogue purchased centrally by the state and provincial organizations.
the direct settlement of medical insurance funds and pharmaceutical enterprises, and improve the coordination mechanism between medical insurance payment standards and centralized procurement prices.
(20) to improve the price formation mechanism of medicines and medical supplies.
to improve the drug, medical supplies hanging network policy, the establishment of market-oriented drugs, medical supplies price formation mechanism.
Establish an early warning mechanism for monitoring abnormal changes in drug prices, and adopt means such as inquiry and interview, public exposure and suspension of the Internet to promote the regulation of price management by operators and medical institutions.
(21) to improve the dynamic adjustment mechanism of medical service prices.
to gradually raise the price of medical services reflecting the value of technical services, reduce the proportion of equipment consumption high inspection and treatment prices of large-scale equipment.
to the country and the province well-known experts, pilot personalized, differentiated medical service price policy.
to the cost reduction, diagnosis and treatment effect of obvious medical services price items, the opening of a green channel for audit, other provinces have been announced and has obvious clinical advantages of the price of medical services projects actively included.
(22) to enhance the access to medical services.
strengthen the assessment of regional medical service capacity, rationally plan the distribution of various types of medical resources, promote the sharing and utilization of resources, accelerate the development of social medical treatment, and standardize the development of new service models such as "Internet and medical care".
promote the construction of close medical associations and improve the coverage of medical associations.
development of tele-medical services, and promote experts to sink high-quality medical resources at the grass-roots level.
to fully implement integrated rural management, solidly promote the signing of family doctor services, and continuously improve the quality of performance.
in principle, each administrative village has at least one village health room and one village doctor to ensure full coverage of basic public health services, basic medical services and health management in each administrative village.
strengthen the management of rural doctors' practice and the supervision of service quality, implement the 24-hour on-duty consultation system, and speed up the construction of medical call systems for the elderly, such as disabled and semi-disabled, widowed and lonely in rural areas.
efforts to deepen the reform of public hospitals and speed up the establishment of a modern hospital management system.
strengthen the configuration and use management of large-scale medical equipment in public hospitals to ensure that it is adapted to functional positioning and clinical service needs, and strictly control the abnormal over-staffing.
, pediatrics, geriatrics, psychiatric and other short boards of medical services.
to support the development and use of high-quality generic drugs and promote generic drug substitution by improving medical insurance payment standards and drug tendering and procurement mechanisms.
establish a four-level drug shortage monitoring and early warning mechanism and a provincial and municipal response mechanism.
(23) to improve the training and use of incentives for general practitioners.
the number of general professional enrollment strive to reach that year's standardized training of residents 20% of the total enrollment plan, increase targeted free training, on-the-job personnel continuing education and training efforts to improve the capacity of primary general medical services.
to promote the basic medical and health institutions general practitioners' salary level and the local county-level general hospital equivalent conditions of clinicians' salary level.
(24) regulate the medical institutions and medical personnel's medical treatment behavior.
implement the core system of medical quality and safety, and strengthen the evaluation of the rationality of diagnosis and treatment.
establish and improve the monitoring and evaluation of clinical drug use.