Local medical insurance catalogue will be cancelled! A large number of varieties no longer enjoy medical insurance reimbursement

[policies and regulations of pharmaceutical network] on July 23, the State Medical Security Bureau issued the opinions on establishing the management system of medical security treatment list (Draft for comments) (hereinafter referred to as the "draft for comments") It is mentioned in the opinion draft that the State formulates the directory of national basic medical insurance drugs in a unified way, and all localities shall strictly follow the directory of national basic medical insurance drugs In principle, they shall not make their own directory or use flexible methods to add drugs in the directory According to the requirements of eliminating increment and standardizing stock, all localities shall not, in principle, issue policies and measures beyond the scope of authorization of the list In principle, it is required to complete the clearing and standardization within three years and link up with national policies This also means that the local medical insurance catalogue will be cancelled soon, and the local medical insurance catalogue designated by the state will be used after cleaning up within three years This news is undoubtedly a big blow to the product enterprises not listed in the national health insurance catalogue However, the author noted that the special policy measures such as local disease security and the inclusion of Tibetan medicine, Mongolian medicine, Uygur Medicine and other ethnic medicine in the medical insurance drug catalog, as well as the major policy adjustments such as the overall planning of basic medical insurance at the provincial level, should be promoted according to the regulations after reporting to the administrative department of medical security under the State Council and the Ministry of finance According to the previous regulations of the Ministry of human resources and social security, class a drugs will not be adjusted any more, and provinces (districts, cities) can issue the local directory of drugs for basic medical insurance, work injury insurance and maternity insurance The adjusted quantity of class B drugs (including transfer in, transfer out and restricted payment scope) shall not exceed 15% of the quantity of class B drugs in the country, i.e 291 kinds The main reason why local governments are allowed to supplement the medical insurance catalogue is that the economic development level of each province, especially the balance level of the medical insurance fund, is greatly different, and the medical insurance bearing capacity is different For example, the medical insurance for urban employees in Zhejiang, Shanghai, Guangdong and other places can be used for three years, while the eastern three provinces, Beijing and Hainan are almost all in deficit According to industry statistics, as of March 15, 23 provinces and cities, such as Shandong, Shaanxi and Sichuan, have published the new provincial medical insurance catalog; Shanxi Province has just announced the adjustment plan; seven provinces and cities, such as Beijing, Zhejiang and Guangdong, have not yet published the provincial catalog but directly implemented the national version According to the data of minenet, a total of 46 varieties have entered the supplementary catalogue of drug catalogue in 11 and above 23 provinces Among them, there are more than 15 provincial supplement catalogues for brain glycoside and carnosine, cefoperazone and tazobactam, oxiracetam, Shenxiong glucose and mannan peptide, and more than 11 and less than 15 provincial supplement catalogues for other varieties For these 46 kinds of production enterprises, only efforts to enter the national health insurance catalog can prevent the risk of medical insurance cancellation In addition, according to the opinion draft, in terms of payment items, the basic medical insurance is required to be implemented in accordance with the national basic medical insurance drug catalog, the scope of basic medical insurance diagnosis and treatment projects and medical service facilities and the corresponding standards Supplementary medical insurance shall be implemented according to the expense scope within the policy scope According to the payment standard, the basic medical insurance payment standard for the medical insurance drugs, medical service items and facilities provided by the designated medical institutions Each overall planning area may, in accordance with national regulations, formulate medical insurance payment standards for drugs, medical service items and facilities and for various payment methods If the State formulates payment standards in a unified way, the provisions of the State shall prevail.