Issued by the National Health Insurance Administration: Supplies With Volume Purchase Program (with full text)

On December 22nd, the Medical Network established an advance payment mechanism, not less than 30% on December 17th, and the State Health Security Administration issued the Opinions of the State Organization for the Centralization of The Purchase and Use of Complementary Measures, which pointed out that the medical insurance departments in the integrated regions should establish an advance payment mechanism on the basis of the budget management of the total amount of the medical insurance fund.
the medical institution signs a purchase agreement with the selected enterprise, the medical insurance fund shall be paid to the medical institution in advance at not less than 30% of the amount agreed upon annually.
The state will fully implement the decision-making on centralized belt procurement of medical supplies and the management of high-value medical supplies, actively play the role of the medical security sector, improve support, guidance and safeguard measures, and promote the smooth implementation of the results of the national organization's crown stent centralized belt procurement (hereinafter referred to as "crown vein bracket collection"), and formulate this opinion.
centralized procurement, patients according to the selected price using the National Health Insurance Administration stressed: regulate the platform network and distribution work.
crown vein bracket collection selected products according to the selected price in the provincial pharmaceutical centralized procurement platform hanging network, medical institutions according to the selected price procurement, patients according to the selected price to use.
for the crown bracket other than the selected product, in accordance with the principle of matching performance and price, consider the reasonable price relationship with the selected product, guide and encourage the relevant enterprises to adjust the price to a reasonable level.
provincial health insurance departments should strictly implement the requirements of selected enterprises to choose their own products distribution enterprises.
to strengthen the supply and demand sides docking, to ensure that the selected enterprises and all agreed procurement medical institutions to establish a distribution relationship, timely distribution in place, to ensure the use.
be paid back in accordance with the provisions, the province's monitoring of the National Health Insurance Bureau stressed: the implementation of the health insurance fund advance policy.
the medical insurance departments of each co-ordination region shall estimate the agreed purchase amount of each selected product according to the selected price of the selected products, the purchase products and quantities agreed upon by each medical institution and the enterprise.
On the basis of the budget management of the total amount of the medical insurance fund, establish an advance payment mechanism, after the medical institution and the selected enterprise have signed a purchase agreement, the medical insurance fund shall advance to the medical institution at not less than 30% of the amount agreed upon annually, and require the medical institution and the enterprise to clear the purchase price in a timely manner, and the settlement time shall not exceed the end of the month after the delivery acceptance.
, on the premise of implementing the main responsibility of medical institutions for payment of payment, medical insurance agencies or purchasing agencies are encouraged to settle directly with enterprises.
provincial health insurance departments should monitor and supervise the implementation of the prepaid policy and the repayment of funds from medical institutions.
to the selected price as the payment standard, the full inclusion of health insurance payments the National Health Insurance Administration stressed: do a good job of health insurance payment policy convergence.
the selected products in the crown bracket collection to the winning price as the payment standard, the full amount into the scope of medical insurance payment, the health insurance fund in accordance with the prescribed proportion of payment.
crown stent other than the selected product belongs to the scope of payment of the medical insurance fund, all localities may reasonably set the high limit of the medical insurance payment standard according to the actual transaction price, and the patient uses the product that exceeds the high limit of the medical insurance payment standard, in principle, exceeds the part paid by the patient.
should take measures to gradually adjust the payment criteria over a two-year period so that they do not exceed the maximum selected price.
should consider the setting of the internet price, the proportion of out-of-patient payment and the high standard of medical insurance payment, so as to avoid the increase of the burden of patient expenses.
the balance of medical insurance funds, medical institutions retain the National Health Insurance Bureau stressed: improve the incentive and restraint mechanism for medical institutions.
Referring to the relevant provisions on the retention of medical insurance fund balances for centralized procurement of medicines by state organizations, the provincial medical insurance departments shall guide the overall regions to implement the single budget management of medical insurance funds for varieties within the scope of the collection of coronary stents, and the savings portion of medical insurance funds shall be retained by medical institutions according to the proportion of medical institutions that are not higher than those retained by the centralized procurement balance of drugs organized by the state organization.
To carry out areas that pay according to disease (disease group) and other means, under the premise of ensuring that the patient's out-of-payment part fully enjoys the effect of collecting and reducing prices, the first year may not lower the corresponding disease (disease group) medical insurance payment standards, and then adjust the medical insurance payment standards for diseases (disease groups) on a regular basis according to the rules.
incentives should be well connected to avoid duplication.
Special circumstances, according to the actual adjustment of surgical prices to accept coronary stent implant surgery of foreign patients accounted for a large proportion of related medical services project current prices significantly lower than the national median price and the price of surrounding provinces in the provinces, can be combined with local actual, appropriate adjustment of coronary stent implant surgery prices.
Other provinces, in accordance with the "Opinion on doing a good job in the current dynamic adjustment of the price of medical services" issued by the National Health Insurance Administration and other four departments (Medical Insurance Issue (2019) No. 79), speed up the establishment of a dynamic adjustment mechanism to optimize the price of medical services.
medical insurance departments should guide medical institutions to improve internal assessment methods, pass on incentive policies to medical personnel, and encourage rational and priority use of selected products.
supervision and implementation, to ensure that the completion of the procurement volume should strengthen supervision and implementation, to ensure that the medical institutions participating in the collection of crown stents in accordance with the purchase and sale contract to complete the purchase volume of the selected product agreement.
the purchase volume of the agreement, priority should still be given to the selection of varieties.
central procurement agencies around the country to increase the monitoring of online procurement, to put an end to medical institutions offline procurement and other irregular procurement phenomenon.
local medical insurance departments shall, in accordance with the requirements of "monthly monitoring and annual assessment", closely monitor the results of centralized procurement by fixed-point medical institutions and incorporate them into the agreement management assessment of fixed-point medical institutions.
if the purchase amount of the selected product is not completed in accordance with the contract during the procurement cycle, the balance retained funds and the amount of medical insurance expenses for the following year shall be deducted accordingly.
all regions should deeply understand the significance of centralized procurement and use of the crown vein bracket of national organizations, further enhance the sense of responsibility and mission, effectively strengthen organizational leadership, implement relevant supporting measures, and smoothly promote the implementation of the results of collection.
major problems in the implementation of the national health care system should be reported to the State Health Insurance Administration in a timely manner.
Attached full text: Opinions of the State Administration of Medical Security on the centralized procurement and use of supporting measures by the National Organization Crown Bracket Medical Insurance No. 51 Provinces, Autonomous Regions, Municipalities directly under the Central Government and Xinjiang Production and Construction Corps Medical Security Bureau: In order to implement the Party Central Committee and the State Council on the full implementation of medical supplies Centralized belt procurement and management of high-value medical supplies decision-making and deployment, proactive play the role of the medical security sector, improve support, guidance, safeguard measures, and promote the national organization of crown stent centralized belt procurement (hereinafter referred to as "crown vein bracket collection") in the selection of the results of the smooth implementation, the formulation of this opinion.
1. The overall requirement is to adhere to the people-centered, closely combine the characteristics of the production, procurement, distribution and use of the crown bracket, and the current medical security, pharmaceutical prices and tender procurement policies, play the strategic purchase role of the medical insurance fund, make full use of the platform hanging network, medical insurance fund advance payment, medical insurance payment, medical institutions incentive constraints and other supporting measures to promote the smooth implementation of the results of the crown stent collection, to achieve the people's benefits, medical institutions and medical personnel incentives and medical enterprises to develop the goal of high quality.
, the main supporting measures (1) to standardize the platform network and distribution work.
crown vein bracket collection selected products according to the selected price in the provincial pharmaceutical centralized procurement platform hanging network, medical institutions according to the selected price procurement, patients according to the selected price to use.
For the crown bracket other than the selected product, in accordance with the principle of matching performance and price, consider the reasonable price relationship with the selected product, guide and encourage the relevant enterprises to adjust the price to a reasonable level.
provincial health insurance departments should strictly implement the requirements of selected enterprises to choose their own products distribution enterprises.
to strengthen the supply and demand sides docking, to ensure that the selected enterprises and all agreed procurement medical institutions to establish a distribution relationship, timely distribution in place, to ensure the use.
(ii) implement the policy of advance payment of medical insurance funds.
the medical insurance departments of each co-ordination region shall estimate the agreed purchase amount of each selected product according to the selected price of the selected products, the purchase products and quantities agreed upon by each medical institution and the enterprise.
On the basis of the budget management of the total amount of the medical insurance fund, establish an advance payment mechanism, after the medical institution and the selected enterprise have signed a purchase agreement, the medical insurance fund shall advance to the medical institution at not less than 30% of the amount agreed upon annually, and require the medical institution and the enterprise to clear the purchase price in a timely manner, and the settlement time shall not exceed the end of the month after the delivery acceptance.
, on the premise of implementing the main responsibility of medical institutions for payment of payment, medical insurance agencies or purchasing agencies are encouraged to settle directly with enterprises.
provincial health insurance departments should monitor and supervise the implementation of the prepaid policy and the repayment of funds from medical institutions.
(iii) do a good job of health insurance payment policy convergence.
the selected products in the crown bracket collection to the winning price as the payment standard, the full amount into the scope of medical insurance payment, the health insurance fund in accordance with the prescribed proportion of payment.
crown stent other than the selected product belongs to the scope of payment of the medical insurance fund, all localities may reasonably set the high limit of the medical insurance payment standard according to the actual transaction price, and the patient uses the product that exceeds the high limit of the medical insurance payment standard, in principle, exceeds the part paid by the patient.
should take measures to gradually adjust the payment criteria over a two-year period so that they do not exceed the maximum selected price.
should consider the setting of the internet price, the proportion of out-of-patient payment and the high standard of medical insurance payment, so as to avoid the increase of the burden of patient expenses.
(4) improve the incentive and restraint mechanism for medical institutions.
Referring to the relevant provisions on the retention of medical insurance fund balances for centralized procurement of medicines by state organizations, the provincial medical insurance departments shall guide the overall regions to implement the single budget management of medical insurance funds for varieties within the scope of the collection of coronary stents, and the savings portion of medical insurance funds shall be retained by medical institutions according to the proportion of medical institutions that are not higher than those retained by the centralized procurement balance of drugs organized by the state organization.
To carry out areas that pay according to disease (disease group) and other means, under the premise of ensuring that the patient's out-of-payment part fully enjoys the effect of collecting and reducing prices, the first year may not lower the corresponding disease (disease group) medical insurance payment standards, and then adjust the medical insurance payment standards for diseases (disease groups) on a regular basis according to the rules.
incentives should be well connected to avoid duplication.
the proportion of foreign patients receiving coronary stent implant surgery is large, and the current price of related medical services is significantly lower than the national median price and the price of surrounding provinces in the provinces, the price of coronary stent implant surgery can be appropriately adjusted in the light of local reality.
Other provinces, in accordance with the "Opinion on doing a good job in the current dynamic adjustment of the price of medical services" issued by the National Health Insurance Administration and other four departments (Medical Insurance Issue (2019) No. 79), speed up the establishment of a dynamic adjustment mechanism to optimize the price of medical services.
medical insurance departments should guide medical institutions to improve internal assessment methods, pass on incentive policies to medical personnel, and encourage rational and priority use of selected products.
, supervision and implementation should strengthen supervision and implementation, to ensure that the medical institutions participating in the collection of crown-pulse brackets in accordance with the purchase and sale contract to complete the purchase volume of the selected product agreement.
the purchase volume of the agreement, priority should still be given to the selection of varieties.
central procurement agencies around the country to increase the monitoring of online procurement, to put an end to medical institutions offline procurement and other irregular procurement phenomenon.
health insurance departments in various regions shall, in accordance with the requirements of "monthly monitoring and annual assessment", closely monitor the implementation of centralized procurement results by fixed-point medical institutions and incorporate them into the agreement management assessment of fixed-point medical institutions.
if the purchase amount of the selected product is not completed in accordance with the contract during the procurement cycle, the balance retained funds and the amount of medical insurance expenses for the following year shall be deducted accordingly.
all regions should deeply understand the significance of centralized procurement and use of the crown vein bracket of national organizations, further enhance the sense of responsibility and mission, effectively strengthen organizational leadership, implement relevant supporting measures, and smoothly promote the implementation of the results of collection.
major problems in the implementation of the national health care system should be reported to the State Health Insurance Administration in a timely manner.
15, 2020