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    Home > Medical News > Latest Medical News > Chongqing Health Insurance Bureau: Drug transaction procurement implementation rules came!

    Chongqing Health Insurance Bureau: Drug transaction procurement implementation rules came!

    • Last Update: 2020-08-08
    • Source: Internet
    • Author: User
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    Introduction: Negotiating procurement is not included during the transition period for centralized band procurement and drugs that do not meet the conditions for centralized band procurement.
    Chongqing Municipal Drug Transaction Procurement Implementation Opinion (Trial) (Draft for Comments) In accordance with the "Opinion of the State Council of the CPC Central Committee on Deepening the Reform of the Medical Security System" (Zhongfa (2020) No. 5) and other documents, in order to implement the CPC Central Committee, the State Council on the promotion of centralized procurement of drugs and deepen the reform of the medical and health system decision-making, combined with the actual situation, now on the procurement of drug transactions in our city put forward the following implementation advice.
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    (ii) The basic principle - adhere to the market-led mechanism for drug price formation, better play the role of government guidance, and promote fair and orderly competition among drug transaction procurement subjects.
    - adhere to the rules and regulations, strictly implement the relevant policy provisions, to ensure that procurement procedures are standardized, open and transparent, the whole process to accept the supervision of all parties.
    - adhere to the whole process of supervision, to ensure quality, ensure supply, ensure use, ensure repayment, and effectively reduce the burden on the masses and enterprises.
    (iii) the goal of work - the full implementation of a unified platform for drug procurement.
    the city's public medical institutions and military medical institutions in Chongqing are used in medicine procurement through the Chongqing drug transaction procurement platform (hereinafter referred to as the platform).
    gradually promote the non-public medical institutions and pharmacies and other medical insurance funds to pay all the drugs through the platform procurement, public transactions, should be harvested.
    - the full implementation of centralized drug procurement.
    deepen the reform of the drug centralized-belt procurement system, carry out the purchase of drug concentration, price-to-price linkage, volume-for-price, and reduce the price of inflated drugs.
    - establish a platform for bidding, purchasing, trading, clearing and supervising integrated municipal transactions.
    strengthen information technology support, promote information sharing on drug procurement, use and payment, strengthen the supervision of the whole process of drug transaction procurement, prevent fraud in medical insurance funds through big data analysis, and prevent corruption in drug transaction procurement.
    - improve the mechanism of the mechanism of financing the payment of medical insurance and the price of centralized procurement of medicines.
    play the strategic role of medical insurance fund purchase, promote direct settlement between medical insurance fund and pharmaceutical enterprises, improve the standard system of medical insurance payment, and realize the coordination between the standard of medical insurance payment and the centralized purchase price of medicine.
    . 2. The main task (i) to establish a bidding, procurement, transaction, settlement, supervision and integration of municipal transaction procurement platform in accordance with the relevant requirements of the construction of a platform for one province and one province, based on medical insurance payments, to promote the construction of our city's drug trading procurement platform.
    fully implement the national unified platform information standards, medical insurance drug classification and coding standards, realize the effective compatibility and convergence of the platform, pharmaceutical enterprises, medical insurance fixed-point pharmaceutical institutions, medical insurance agencies and other links, and actively promote the interconnection of information such as prescription, medical insurance settlement, medical service supervision, drug traceability, budget management, tax supervision, and other functions of platform scientific management, statistical analysis and decision-making support, monitoring and coordination, information sharing and coordination, public service, etc.
    (2) Improve the mechanism for the formation of classified procurement drug prices to adhere to the overall direction of market regulation of drug prices, strengthen the management of medical insurance drugs, improve the mechanism for the formation of prices of classified and purchased drugs, and form reasonable drug prices through bidding, bargaining, linking the lowest prices nationwide, etc.
    1. Centralized band purchases.
    fully implement the provisions of the state-organized drug centralized band procurement, and actively promote regional alliance sourcing, normalization of our city's medical insurance drug centralized volume procurement work.
    to carry out centralized purchase of medical insurance drugs with high clinical use, high purchase amount, full competition and more medical insurance funds, to form prices through market competition, and to carry out supply-stable purchase of specialty drugs for some alternatives, insufficient production power of enterprises, unstable market supply, emergency rescue drugs, women's and children's and infectious diseases specialty drugs.
    centralized volume procurement catalog, by the municipal health insurance department in conjunction with the relevant units to determine, and gradually expand to the medical insurance catalog of all varieties.
    implement the budget management of medical insurance funds for medicines included in the centralized volume procurement catalogue.
    medical institutions shall not bargain again in accordance with the selected price of centralized band procurement.
    2. Bargaining purchases.
    negotiated procurement is not included in the centralized volume procurement period and drugs that do not meet the conditions for centralized band procurement.
    , which belongs to the medical insurance catalogue drugs, in accordance with the principle of "medical insurance department organization, joint medical institution implementation, broad participation of the community", the municipal medical insurance department will work with the relevant departments to formulate a bargaining directory, organize medical institutions in batches to bargain, medical institutions at all levels according to the result of bargaining, procurement, may not bargain again;
    platform to provide the city's medical institutions procurement transaction price-related information, explore the establishment of a third-party drug evaluation system for medical institutions to choose cost-effective drugs to provide reference. The transaction price of the self-negotiated drug of the
    medical institution shall not be higher than the price of the platform-hanging net.
    3. Limit-price network procurement.
    in addition to the centralized volume procurement and bargaining drugs organized by the state and our municipal medical insurance department, enterprises shall submit information such as the declared price as required, and declare that the price of the hanging network is not higher than the lowest hanging net price now implemented by other provincial procurement platforms of the product;
    the generic drug negotiated by the State while in the negotiation effective agreement period, declare that the price of the hook-up network is not higher than the medical insurance payment standard determined by the state negotiations and the lowest online price currently implemented by other provincial procurement platforms throughout the country; Higher than the corresponding original research drug in other provincial levels of the country is now implemented the lowest hanging net price and the product of other provincial levels of the country is now implemented the lowest hanging net price;
    principle, with the production enterprisegeneral dosage form hanging net drug preparation specifications shall not exceed 3.
    strengthen the price management of the hook-up network, and carry out regular price dynamic adjustment.
    4. Record purchases.
    the clinically necessary, not on the platform and the network of drugs without substitutes, to adopt the "prior record, monitoring in the matter, after-the-fact notification" of the regulatory approach, medical institutions to fulfill the relevant filing procedures, through the platform record procurement system for procurement and settlement.
    establish an early warning mechanism for drug filing and procurement, and set up an early warning line of 5% of the total purchase amount of drug record purchase for medical institutions.
    conduct regular supervision and inspection of the record editing of pharmaceuticals and inform the relevant situation.
    5. Other purchases.
    the state negotiates drugs, the state-designated production of drugs, the municipal fixed-point procurement of drugs directly in accordance with the established price simply linked to the net, medical institutions directly procurement, may not bargain again.
    in addition to centralized volume procurement and centralized bargaining, the shortage of drugs, by the enterprise independent quotation, directly linked to the network, medical institutions independent procurement.
    emergency protection drugs such as major epidemic prevention and control, according to the relevant policies of the state and our city to attach to the network procurement.
    of narcotic drugs, psychotropic drugs, free drugs for the prevention and control of infectious diseases and parasites, vaccines from the National Immunization Programme, family planning drugs and tablets of Chinese medicine, and purchased through the platform in accordance with the existing provisions of the State.
    (3) Strengthen the drug supply guarantee mechanism to strengthen drug transaction delivery and distribution and supply guarantee, and pharmaceutical production enterprises, as the first responsible person for drug quality and supply, independently select the distribution of drugs by operating enterprises with distribution capacity and good reputation.
    the strict implementation of the "two-vote system" provisions for drug distribution.
    drug distribution enterprises shall distribute medicines in a timely manner in accordance with the online order demand and contractual agreements of medical institutions to ensure the demand for drug use in medical institutions at all levels.
    actively coordinate the procurement and distribution of drug use in primary medical institutions.
    relying on the platform to establish the drug information full intelligent traceability system, to achieve drug flow to pharmaceutical institutions to store information and price information sources can be found, go to traceable, responsibility can be investigated.
    (4) Grasp the settlement of drug purchase prices in accordance with the state requirements for the settlement of the purchase price, medical institutions through the platform and enterprises timely settlement of the purchase price, in strict accordance with the time agreed in the contract to pay the purchase price, from the delivery acceptance to payment shall not exceed 30 days.
    the medical insurance advance payment system for the purchase of drugs with a band amount, that is, on the basis of the total budget of the medical insurance fund, the medical insurance department shall advance to the medical insurance fixed-point medical institutions at no less than 50% of the purchase amount of the centralized drug purchase.
    to the centralized purchase of drugs, the pilot medical insurance fund and pharmaceutical enterprises direct settlement of the purchase price, and gradually expand to all centralized production of drugs, reduce the transaction costs of enterprises.
    (v) promote the synergy between medical insurance payment and drug procurement 1. Do a good job of health insurance payment standards and procurement prices linked.
    the centralized purchase of selected drugs to the winning price as the standard of medical insurance payment, non-winning drugs and the price gap between the winning drugs, can be in accordance with the "progressive, classification guidance" principle, gradual adjustment of payment standards, in 2 to 3 years with the standard of payment of the selected drugs converge, patients use the price is higher than the payment standard of drugs, the above-paid part of the patient pay;
    the state negotiates the standard of medical insurance payment negotiated by the state for the implementation of drugs, the state fixed-point production of drugs at the national unified procurement price for the standard of medical insurance payment.
    for medical insurance drugs that have not yet been included in centralized procurement and new entry into the market, the national minimum price of the product regulations of the variety of goods linked to the enterprise during the transitional period, as the limit for the payment of medical insurance for drugs, and where the purchase price of medical institutions is lower than the lowest price in the country, shall be settled at the actual price.
    all types of medical insurance fixed-point pharmaceutical institutions at all levels of the same drug according to the same standard of payment.
    in principle, the standard of payment of medical insurance drugs and procurement prices are linked to convergence, according to the purchase price timely dynamic adjustment.
    2. Improve the incentive and restraint mechanism of medical insurance.
    deepen the reform of the payment method of medical insurance, and establish the incentive and risk sharing mechanism of "retention of balance and reasonable overspending sharing" between the medical insurance department and medical institutions.
    in accordance with the unified deployment of the State, the inclusion of the state and our city organizations of drug centralized drug procurement, the implementation of the policy of retention of medical insurance funds balance, do a good job in the collection of drug medical insurance funds budget management, fixed-point medical institutions assessment, balance retention funds approved and settlement, improve the enthusiasm of medical institutions and medical personnel to participate in the reform, improve the efficiency of the use of health insurance funds.
    specific measures for the retention of the balance of medical insurance funds and the implementation of the measures shall be formulated separately.
    the system of reserve funds for the purchase of drugs with a band, incorporatethe the procurement and use of selected drugs into the management content of the fixed-point agreement of medical insurance and the system of total budget appraisal indicators, reduce the budget amount of the total medical insurance fund for the following year, for the medical insurance fixed-point pharmaceutical institutions that have seriously lagged behind the progress of the work and the quantity of outstanding contract procurement.
    (vi) Strengthen comprehensive supervision and management 1. Strengthen the supervision of drug transaction procurement.
    improve the regulatory mechanism for the normalization of drug prices, comprehensively use monitoring and early warning, correspondence interviews, reminders, cost investigations, credit evaluation, information disclosure and other means to strengthen the monitoring and supervision of drug price anomalies, and accept the supervision of all parties.
    implement abnormal monitoring of drug supply guarantee, punish pharmaceutical enterprises for not timely distribution and inadequate distribution, and carry out early warning and analysis of shortage drugs.
    to continuously purchase drugs with high prices in the same-purpose network group, strengthen monitoring and supervision, according to the actual situation may be handled by correspondence, interviews, notification and other means.
    strengthen real-time monitoring of purchased drug payments, regularly announce the payment of drug payments throughout the city in an appropriate manner, and punish medical institutions that fail to pay for medicines on time without good reason.
    to carry out the normal supervision of the implementation of the "two-vote system".
    make full use of the big data of drug transaction procurement, carry out drug transactions, procurement, use, reimbursement analysis, and provide data support for policy formulation, industrial development, fund supervision, etc.
    2. Strengthen the application of credit evaluation of pharmaceutical prices and tender procurement.
    establish a credit evaluation system based on quantitative scoring, dynamic adjustment and open and transparent credit evaluation according to the procurement of drug transactions.
    according to the nature of the pharmaceutical enterprise's breach of trust, circumstances, limitation sonofness and scope of influence and other factors, the pharmaceutical enterprises tender procurement failure, commercial bribery and other circumstances as general, medium, serious, especially serious four times.
    , which respectively assessed as "general breach of trust" "moderate breach of trust" "serious breach of trust" and "particularly serious breach of trust", shall be subject to graded punishment, progressive step by step, respectively, to give written reminders, automatic warning of risks, suspension of some or all of the enterprise's drug online bidding and distribution qualifications and other disciplinary measures, and supervise pharmaceutical enterprises to fulfill compliance with the procurement rules of drug transactions, integrity management obligations. the credit repair of the
    of the breach of trust shall be carried out in accordance with the relevant provisions of the State.
    3. Strengthen the code of conduct for the procurement of drug transactions.
    all districts, autonomous counties (hereinafter referred to as the districts and counties) drug procurement institutions, medical institutions in the procurement of drugs shall not limit the operation, purchase or use of certain production and distribution enterprises to provide goods and services;
    pharmaceutical enterprises shall not provide false information, shall not illegally trade or settle off-line, shall not illegally adopt unfair competition means such as commercial bribery, shall not provide counterfeit and inferior products in violation of the law, and shall not violate the rules on good faith performance.
    found a public exposure together, the relevant departments to verify the matter to be dealt with in accordance with the law.
    . (i) Strengthen organizational leadership in safeguard measures (i).
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