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    Home > Medical News > Latest Medical News > Weigh! Release of 2019 edition of medical insurance catalogue, 150 drugs out of the market

    Weigh! Release of 2019 edition of medical insurance catalogue, 150 drugs out of the market

    • Last Update: 2019-08-21
    • Source: Internet
    • Author: User
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    On August 20, the National Health Insurance Bureau issued the 2019 edition of the national health insurance catalogue, which collected 2643 drugs, including 1322 Western medicines, 1321 traditional Chinese medicines (including 93 ethnic medicines), and 892 pieces of traditional Chinese medicine At the same time, 128 drugs to be negotiated were identified The new version of the medical insurance catalogue will be officially implemented from January 1, 2020 It is worth noting that 148 varieties of conventional access drugs have been added to the new version of the medical insurance catalogue, including 47 western drugs and 101 Chinese patent drugs; 128 drugs have been included in the scope of access to be negotiated, including 109 western drugs and 19 Chinese patent drugs; 150 varieties have been transferred out of the medical insurance catalogue, and all the key monitoring drugs in the national medical insurance catalogue have been transferred out (at the end of the paper, you can download the list of 2019 version of the national medical insurance catalog) the following is the original notice: Notice of the Ministry of human resources and social security of the National Medical Insurance Bureau on printing and distributing the national basic medical insurance, industrial injury insurance and maternity insurance drug catalog (CMF [2019] No 46) Medical Security Bureau, human resources and social security department (bureau) of all provinces, autonomous regions, municipalities directly under the central government and Xinjiang production and Construction Corps: In accordance with the decision-making and deployment of the CPC Central Committee and the State Council, in order to further improve the drug use guarantee level of the insured, standardize the drug use management of medical insurance, work injury insurance and maternity insurance, according to the requirements of the social insurance law of the people's Republic of China and relevant documents, and in accordance with the work plan for adjusting the national medical insurance drug catalog in 2019, the State Medical Insurance Bureau and the Ministry of human resources and social security organize experts The national basic medical insurance, work injury insurance and maternity insurance drug catalogue (hereinafter referred to as "drug catalogue") has been adjusted and formulated "Drug catalogue" is the standard for basic medical insurance, work injury insurance and maternity insurance fund to pay for drug expenses The catalogue of drugs is divided into five parts: ordinary medicine, western medicine, Chinese patent medicine, negotiation medicine and Chinese herbal pieces For example, it explains and explains the format, name, dosage form specification and limited payment scope of the drug catalogue; the western medicine part includes chemicals and biological products; the Chinese patent medicine part includes Chinese patent medicine and national medicine; the negotiation medicine part includes the medicine which is still in the negotiation agreement period; the Chinese herbal medicine part includes the medical insurance fund to pay And local governments are not allowed to adjust the range of slices included in the payment of medical insurance fund In order to improve the use efficiency of medical insurance fund, the drug catalogue limits the scope of medical insurance payment for some drugs Now we will print and distribute the drug catalog to you Please abide by it and notify the following matters: first, strictly manage the payment, strengthen the guidance and overall coordination of the provincial medical security departments and the human resources and social security departments, and gradually promote the unification of drug management policies for medical insurance, work injury insurance and maternity insurance within the province In principle, the medical security department shall establish a unified payment standard for the original research drugs and generic drugs through the consistency evaluation according to the price level of generic drugs through the consistency evaluation Under the guidance of the provincial medical security department, the medical security departments in each overall planning area shall, according to the affordability and management requirements of the medical insurance fund, formulate the corresponding payment methods for class A and class B drugs in the drug catalog For drugs with limited payment scope, detailed rules for examination and verification of payment shall be formulated, and the examination of clinical basis shall be strengthened In accordance with the requirements of the notice on printing and distributing the first batch of national key monitoring and rational use drugs catalogue (chemical and biological products) (GWB YH [2019] No 558) issued by the general office of the National Health Commission and the office of the State Administration of traditional Chinese medicine, the fund can only pay for the prescription of Chinese patent medicine and the prescription of decoction pieces of traditional Chinese Medicine issued by qualified doctors Each overall planning area should establish the doctor system of medical insurance agreement and strengthen the examination and approval management of doctors' prescription qualification 2、 It is clear that all localities with local authority shall strictly implement the drug catalog, and shall not make their own catalog or use alternative methods to add drugs in the catalog, nor adjust the limited payment scope of drugs in the catalog The class B drugs added according to the regulations in the original provincial drug catalogue shall be gradually digested within 3 years In the process of digestion, provinces should give priority to adjusting the payment scope of drugs included in the national key monitoring scope For the national drugs approved by the relevant departments of the state to be listed, the provincial medical security departments can take the lead, together with the human resources and social security departments, according to the local fund affordability and drug demand, and the corresponding expert review procedures can be included in the provincial (District, city) fund payment scope The adjustment of national drugs in each province shall be reported to the state health insurance bureau for the record and then made public to the public The Chinese Herbal Pieces in the catalogue of drugs are produced from the Chinese herbal pieces with national standards through expert review For other pieces of traditional Chinese medicine with national or local standards, the provincial medical security departments can take the lead, together with the human resources and social security departments, according to the local fund affordability and drug demand, and the corresponding expert review procedures can be included in the provincial (District, city) fund payment scope, but the non payment pieces specified in the catalog shall not be added For the therapeutic hospital preparations approved by the provincial drug supervision and administration department, the provincial medical security department can take the lead, work together with the human resources and social security department according to the local fund affordability and drug demand, and through the corresponding expert review procedure, formulate the hospital preparations catalogue which is included in the fund payment scope of the province (District, city), and limit it to specific medical machines according to the relevant regulations Construct use The payment management measures for Chinese Herbal Pieces in the drug catalog, national drugs adjusted by each province (District, city), Chinese herbal pieces and hospital preparations shall be formulated by the provincial medical security department 3、 Good implementation Each provincial medical security department shall timely include the drugs in the drug catalog into the scope of local centralized drug purchase according to the regulations, update and improve the information system drug database according to the use of drugs in the medical institutions and retail pharmacies within the jurisdiction, establish and improve the national unified drug database, and realize the unified management of coding of Western medicine, Chinese patent medicine, Chinese herbal pieces and hospital preparations 。 Each overall planning area shall improve the intelligent monitoring system in combination with the management provisions of the drug catalog and the prescription management methods, clinical technical operation specifications, clinical diagnosis and treatment guidelines and drug clinical application guidelines formulated by relevant departments, and incorporate the implementation and use of the drug catalog by designated medical institutions into the management and assessment scope of the designated service agreement 4、 The National Health Insurance Bureau of negotiated access drugs will negotiate the drugs to be negotiated determined by experts according to relevant procedures, and the agreed drugs will be included in the payment scope of health insurance fund, and the specific list and relevant requirements will be issued separately In the process of organizing and implementing the drug catalogue, all localities shall report major problems to the state health insurance bureau and the Ministry of human resources and social security in a timely manner This catalogue has been officially implemented since January 1, 2020, and the notice of the Ministry of human resources and social security on printing and distributing the catalogue of national basic medical insurance, work injury insurance and maternity insurance drugs (2017 version) (HR & s Department [2017] No 15) shall be repealed at the same time Appendix: 2019 medical insurance catalogue.rar
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