echemi logo
Product
  • Product
  • Supplier
  • Inquiry
    Home > Medical News > Medical World News > This type of pharmacy requires a 3-year medical insurance qualification with a licensed pharmacist!

    This type of pharmacy requires a 3-year medical insurance qualification with a licensed pharmacist!

    • Last Update: 2022-05-19
    • Source: Internet
    • Author: User
    Search more information of high quality chemicals, good prices and reliable suppliers, visit www.echemi.com
    Recently, Hebei issued a notice "Notice on Incorporating Eligible Designated Retail Pharmacies into the Scope of Outpatient Overall Protection (Draft for Comment)" (hereinafter referred to as the "Draft for Comments").
    Retail pharmacies are selected and determined to be designated pharmacies for outpatient co-ordination and security (hereinafter referred to as co-ordination pharmacies)
    .
    Those that have been included in the "dual-channel" management can also be included in the outpatient co-ordination The "Draft" proposes that on the basis of the pilot, the eligible designated retail pharmacies will be selected and identified as the designated pharmacies for outpatient co-ordination guarantees, and the outpatient co-ordination fees will be directly settled
    .
    Outpatient overall security The drug insurance services provided by designated pharmacies are included in the general outpatient clinic and outpatient clinics for chronic diseases, special diseases and other outpatient overall insurance coverage
    .
    The designated retail pharmacies that have been included in the "dual-channel" management in the early stage can also be included in the scope of designated pharmacies for outpatient co-ordination
    .
    Outpatient overall protection The designated pharmacies should have a complete medical insurance settlement system and an invoicing system, realize electronic prescription circulation, and upload medical insurance settlement fees and invoicing data in a true, comprehensive, accurate and real-time manner
    .
    According to the requirements of "Network Security Access Specifications for Medical Security Core Business Areas", use dedicated lines or VPDN to access, and the access uplink bandwidth is not less than 4MB/S
    .
    Eligible designated retail pharmacies can voluntarily apply to the medical insurance agency in the overall planning area
    .
    Pharmacies applying to be included in the outpatient co-ordination must also have the following qualifications: 3 years or more (including 3 years) of designated medical insurance within the co-ordination area, and no reports of criticism, deductions for major violations of medical insurance regulations, suspension of medical insurance or termination of medical insurance agreements in the past 3 years; and No complaints and reports
    .
    At the same time, the designated retail pharmacy should have a year-end assessment score of over 90 points in the previous year; to set up an outpatient coordinating drug management post, there should be at least one licensed pharmacist, and the registered place should be in the designated retail pharmacy to ensure that there are pharmacists on duty during business hours to provide prescription review.
    , allocation and rational drug use guidance and other services
    .
    In terms of electronic prescriptions, the "Draft" proposes that the medical insurance departments of all coordinating districts should urgently supervise and guide designated medical institutions and designated retail pharmacies within their jurisdictions to speed up the interface of the settlement system of their institutions and the transformation of in-hospital prescription circulation, so as to realize direct connection with the national unified medical insurance information platform and electronic prescriptions are transferred to designated pharmacies for outpatient co-ordination and security
    .
    The insured personnel complete the medical insurance settlement through the social security card or medical insurance electronic certificate according to the payment information issued by the designated pharmacy for the outpatient co-ordination guarantee
    .
    Can you taste the "policy dividend"? It is worth noting that the "Draft" requires each co-ordination area to identify at least 2 designated medical institutions and 1 designated pharmacy for outpatient co-ordination and security as pilots, and to realize direct credit card settlement in pilot pharmacies before the end of June , which also means that Hebei Province will expand the scope of medical insurance outpatient pharmacies, and qualified pharmacies are expected to enjoy this bonus
    .
    In May last year, the General Office of the State Council issued the "Guiding Opinions on Establishing and Improving the Outpatient Mutual Assistance Mechanism of Basic Medical Insurance for Employees".
    At the briefing held on the same day, the person in charge of the National Medical Insurance Bureau stated that eligible retail pharmacies should be included in the overall fund.
    the settlement range
    .
    This is the statement and clear arrangement of the medical insurance executives on the sharing of outpatient mutual aid dividends by pharmacies under the background of prescription outflow after the reform of individual accounts reduces the inclusion of individual accounts and establishes the outpatient mutual aid mechanism
    .
    For designated medical insurance pharmacies, the reform of the outpatient mutual aid security mechanism is a rare business opportunity
    .
    The full implementation and implementation of this mechanism will bring a considerable increase in the consumption of medical insurance drugs for designated pharmacies, which is mainly reflected in: First, the eligible retail pharmacies are included in the settlement scope of the overall fund, which is equivalent to continuing to use the personal account for The pharmacy has opened up a steady stream of long-term living water; the second is to broaden the benefit and scope of the personal medical insurance account, and the personal account can pay the insured person himself, his spouse, parents, and children to buy drugs and medical equipment in designated pharmacies .
    The expenses incurred by medical consumables that are borne by individuals have revitalized the fund pool of personal accounts; the third is to pay for qualified online medical services according to regulations, opening up the "internet + pharmacy" medical insurance payment "medium obstruction"
    .
    Through the outpatient mutual aid security mechanism, pharmacies can share the "policy dividends" brought about by the outflow of prescriptions, but the dividends are not "available to everyone", and the high threshold and strict access standards also test the strength of pharmacies
    .
    Taking Hebei's "Draft" as an example, designated pharmacies should have a complete medical insurance settlement system and an invoicing system for outpatient co-ordination, realize electronic prescription circulation, and upload medical insurance settlement fees and invoicing and storage in a true, comprehensive, accurate and real-time manner.
    data
    .
    The differentiation of pharmacies may be accelerated.
    It is true that the reform of “personal accounts” of medical insurance has given pharmacies the hope of accepting the outflow of prescriptions.
    When the situation occurs, pharmacies should reduce the degree of dependence on the sales of medical insurance drugs, try to "open source", and prepare in advance
    .
    Judging from a number of reforms such as "individual account" and "dual-channel" management, these measures may accelerate the differentiation of retail pharmacies
    .
    Taking pharmacies to undertake centralized procurement of drugs as an example, many places have explored the form of "centralized drug counters".
    Most of the drugs on the shelves are chronic disease drugs and commonly used drugs to meet the daily drug needs of ordinary people; while "dual channels" solve relatively high prices, "Niche" categories - drugs with high clinical value, urgent demand, high cost, and low substitution
    .
    In other words, pharmacies that can obtain "dual-channel" qualifications must have the ability to operate these drugs
    .
    For chain pharmacies, the "dual channel" is expected to bring an increase in innovative drugs, so it is considered an important way and opportunity to undertake the outflow of prescriptions
    .
    Despite this, the outflow of prescriptions still fell short of industry expectations, and the crux is that the channels for outflow of prescriptions are not smooth
    .
    Therefore, from 2018 to 2021, all localities will vigorously promote the construction of prescription circulation platforms, which will benefit from chains that are large-scale, professional, and highly compliant
    .
    At the same time, regulatory authorities in many places are also promoting the transformation of some social pharmacies into "community health convenience stores"
    .
    Taking Guangdong as an example, the province's drug regulatory innovation promotes the integration of pharmacies and convenience stores, supports and encourages the cross-border integration of large chain convenience store headquarters and drug retail chain enterprises under the management of the same group, and develops large chain convenience stores throughout the province.
    For the pilot work of comprehensive reform of Class B non-prescription drugs, at present, there are two combinations of Meiyijia and Chunyuelin Pharmacy and China Resources Vanguard and Guangdong Dexinhang Pharmacy.
    From the first pilot site of Meiyijia, the flow is still objective.
    This model makes up for the time difference between non-business hours of traditional pharmacies, lays a good foundation for the subsequent rollout of non-prescription drug sales of Class B, and accelerates the transformation of traditional pharmacies into community health convenience stores
    .
    This article is an English version of an article which is originally in the Chinese language on echemi.com and is provided for information purposes only. This website makes no representation or warranty of any kind, either expressed or implied, as to the accuracy, completeness ownership or reliability of the article or any translations thereof. If you have any concerns or complaints relating to the article, please send an email, providing a detailed description of the concern or complaint, to service@echemi.com. A staff member will contact you within 5 working days. Once verified, infringing content will be removed immediately.

    Contact Us

    The source of this page with content of products and services is from Internet, which doesn't represent ECHEMI's opinion. If you have any queries, please write to service@echemi.com. It will be replied within 5 days.

    Moreover, if you find any instances of plagiarism from the page, please send email to service@echemi.com with relevant evidence.