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    Home > Medical News > Latest Medical News > International Health Commission: Regulations on price behavior management in medical institutions

    International Health Commission: Regulations on price behavior management in medical institutions

    • Last Update: 2020-01-03
    • Source: Internet
    • Author: User
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    On January 2, 2020, the State Health Commission and the State Administration of traditional Chinese medicine jointly issued the regulations on the management of internal price behavior of medical institutions (hereinafter referred to as the regulations) There are four parts and 78 chapters in the regulations, aiming to strengthen the management awareness of medical institutions and the responsibilities of internal price management departments Clarify the department setting, personnel management, responsibilities and tasks, management mechanism, etc The first part is general This paper mainly introduces the main purpose of the regulations, the scope of application of the regulations, and the connotation of the internal price behavior management of medical institutions The second part is organization, function and post responsibility Medical institutions are required to establish a price management committee composed of multiple departments, to clarify the setting of price management departments at all levels of medical institutions, the proportion and requirements of staffing, and to clarify the main functions (or responsibilities) of price management committee, price management department, full-time medical service price staff and part-time medical service price staff The third part proposes to improve the internal price behavior management system of medical institutions Medical institutions are required to establish the management system of medical service cost calculation and cost control, the management system of medical service price adjustment, the management system of new medical service price items, and the price publicity system The fourth part proposes to strengthen the supervision and inspection of medical institutions It is required that the local administrative departments of health and health at or above the county level (including the competent departments of traditional Chinese Medicine) should carry out quality control over price management of medical institutions, establish a system to investigate the responsibility of price management, and notify and deal with violations of price management regulations in accordance with relevant regulations Chapter I general provisions of regulations on the administration of internal price behavior of medical institutions Article 1 in order to standardize the charging behavior of medical institutions, strengthen the management of internal price behavior of medical institutions, promote the reform and development of health care, and safeguard the legitimate rights and interests of patients and medical institutions, in accordance with the price law of the people's Republic of China, the opinions of the State Council of the CPC Central Committee on deepening the reform of the medical and health system, and the opinions of the development and Reform Commission on printing and distributing reform drugs These Provisions are formulated in accordance with the relevant policies and regulations such as the notice of opinions on the price formation mechanism of products and medical services (fgjg [2009] No 2844) and the notice on printing and distributing opinions on promoting the price reform of medical services (fgjg [2016] No 1431), and in combination with the characteristics of the price management of medical services Article 2 These Provisions are applicable to all kinds of public medical institutions at all levels, and non-public medical institutions may refer to them Article 3 the internal price behavior management of traditional Chinese medicine treatment institutions in the present Provisions refers to the internal management of the price behavior of medical service items, drugs and medical consumables in the diagnosis and treatment activities of medical institutions Article 4 the main person in charge of a medical institution shall take the leadership responsibility for the internal management of its own price behavior The price management department of a medical institution shall be responsible for organizing the management of its own internal price behavior Article 5 in accordance with the relevant provisions of the state, the local health administrative departments at or above the county level (including the competent departments of traditional Chinese medicine, the same below) shall, in accordance with their duties, guide, assess and inspect the price management of the government operated medical institutions within their jurisdiction, while other public medical institutions shall be guided, assessed and inspected by the organizing units with reference to these provisions Article 6 a medical institution shall establish a medical institution price management system composed of the leader in charge of the medical institution, the medical management department, the price management department, the clinical department and the medical material procurement and supply department, so as to scientifically manage and reasonably monitor the medical service cost and improve the quality of price management A medical institution shall establish a price management committee The members of the committee shall be composed of the leaders in charge of the medical institution, the price management department and the heads of the financial, medical, nursing, medical insurance, information, pharmaceutical, material management, medical technology, quality control, equipment, discipline inspection and supervision and other functional departments, responsible for the leadership, organization and decision-making of the price management of the whole hospital Article 7 medical institutions should strengthen the construction of internal price management departments The third level medical institutions shall specify the departments responsible for internal price management, which shall be in the charge of the hospital leaders; the second level and below medical institutions shall specify the price management responsibilities in the relevant functional departments The third level medical institutions shall be equipped with 3-5 medical service price staff; the second level and below medical institutions shall be equipped with 1-3 medical service price staff Each medical institution may increase or decrease the number of personnel according to the size of the institution and the amount of medical services Each business department (Department) shall have part-time medical service price staff, and each department (department or ward) shall have at least one Article 8 basic requirements for full-time medical service price staff: (1) be able to correctly understand, master and implement the medical service price policy, and carry out price management according to law; (2) Master the basic knowledge of medical service price management, understand the health, accounting, economy, management and other related business knowledge, and be familiar with the connotation and main cost composition of medical service price items carried out by business departments; (3) have good communication and coordination ability, and be able to properly handle the consultation and complaints in the internal price management of the organization; (4) Adhere to the principle in work, do a good job in price policy publicity and interpretation according to the relevant provisions of medical service price management, guide clinical and medical technology departments to correctly implement the medical service price policy, check the implementation of each department, and correct the irregular charging behavior of medical institutions; (V) have primary and above professional titles, and receive professional training every year Article 9 the main functions of the price management committee of medical institutions are as follows: (1) conscientiously implement the relevant medical price policies and regulations, and realize standardized, scientific and institutionalized management; (2) study and formulate the price management system, business process, evaluation indicators, reward and punishment standards within the medical institutions, and be responsible for the organization and implementation; (3) Organize, implement and manage the whole process of declaration, adjustment, publicity, implementation, verification, assessment and evaluation of the price of medical institutions; (IV) hold the price management working meeting in time, guide and coordinate the relevant work progress according to the work deployment of relevant departments, and regulate the price management of medical institutions Article 10 the main functions (or responsibilities) of the price management department (or full-time medical service price staff) of a medical institution are: (1) to establish the concept of the rule of law, to conduct price management according to and in accordance with the price law of the people's Republic of China and relevant laws, regulations and policies, to master various policies of price management, to grasp standards, to strictly implement and operate them; (2) To carry out internal management of the price behavior of medical institutions, to be familiar with the connotation of each price item, to organize, coordinate and participate in the scientific and reasonable calculation of the cost of medical service items by relevant departments, and to put forward suggestions and measures for improving management, reducing costs and increasing efficiency; (3) Participate in the bidding purchase and price negotiation of drugs, medical equipment and medical consumables, as well as the demonstration and verification of charges of new technologies and new therapies before entering the medical institutions; (4) participate in the price negotiation of medical insurance fund payment projects and diseases; (5) Cost calculation and price review shall be carried out for new medical service price items and new diseases (including disease diagnosis related groups, hereinafter referred to as DRG) of medical institutions, price suggestions shall be put forward, and approval shall be submitted in accordance with specified procedures, and price adjustment of existing items shall be submitted for approval; (6) To calculate the cost of the approved price items of medical services and preparations of medical institutions that are subject to market adjustment price, put forward price suggestions, and submit them to the price management committee for discussion and determination before implementation and supervision; (7) Strictly implement the medical price policies and regulations, and timely adjust the price (including public price) standards of the price management system of medical institutions in accordance with the changes of the government's medical service price policies; (VIII) guide clinical and medical technology departments to correctly implement the medical price policies; (9) Regularly check the outpatient (emergency) and inpatient expenses, and feed the results back to the Department to correct the irregular charging behavior in time; (x) receive the consultation on the price management of medical services, handle the complaints related to the price of medical services, write a complaint analysis report against the effective complaints and put forward the rectification opinions; (11) Regularly investigate and organize relevant business departments to discuss the actual problems existing in the price management of medical institutions, and put forward suggestions; (12) guide and train part-time medical service price staff in price policy (business); (13) cooperate with relevant departments to carry out price inspection of medical services; (14) Complete the investigation and statistics of various medical service costs and prices assigned by the competent department, and provide real and reliable data for the adjustment of medical service price policies; (15) do well in other matters related to price management Article 11 the main responsibilities of part-time medical service price staff are: (1) to accept the training of medical service price knowledge, to be familiar with the medical service price policies and regulations, to publicize and implement the price management system of the institution; (2) to cooperate with the price management department of the institution to accept the price inspection of medical service by relevant departments; (3) Put forward suggestions for price management, apply to the price management department of the institution for new medical service price items and medical service price items to be eliminated, and provide basic information; (4) assist the price management department of the institution to do a good job in price management, publicity and medical service price policy interpretation of the undergraduate office; (5) Assist the price management department of the organization to deal with the price consultation and complaint of the medical service in the undergraduate department; (6) be responsible for the self inspection and self correction of the internal price behavior of the Department, timely correct the irregular charging behavior, and establish a long-term mechanism for internal inspection; (7) accept the regular assessment of the price management department of the organization Chapter IV Management System Article 12: medical institutions shall establish the management system of cost measurement and cost control of medical services, and establish and improve the cost measurement system of medical services on the basis of constantly improving the cost accounting of medical institutions and departments Medical institutions should closely monitor the changes in the cost and income structure of medical services, and take the initiative to put forward suggestions on adjusting the price of medical services to relevant departments According to the relevant regulations on the price management of medical service items, drugs and medical consumables, on the premise of ensuring the medical quality, a scientific management mechanism for cost control shall be established, and the charging behavior shall be scientifically standardized through the links of beforehand control, on-site control and feedback control Article 13 medical institutions shall establish a price adjustment management system for medical services, ensure strict implementation of the price policy for medical services, establish a smooth price adjustment notice process, and timely adjust or notify relevant departments to adjust the price of medical services Article 14 medical institutions shall establish a management system for new medical service price items, and carry out project approval and Price Declaration for new medical service price items in accordance with the provisions of the administrative measures for clinical application of medical technology (Order No 1 of the state health and Health Commission) and other relevant management norms, and adhere to the principle of technology admission (permission) first Standardize the internal audit process of new medical service price items The newly added medical service price items shall be submitted to the provincial level after being reviewed and demonstrated by the price management committee of medical institutions
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