Four departments, including the National Health Insurance Bureau, adjusted the medical insurance reimbursement policy for COVID-19 patients

2023-03-31

Four departments, including the National Health Insurance Bureau, the Ministry of Finance, the National Health Commission and the National Bureau of Disease Control and Prevention, jointly issued the Notice on Further Improving the Medical Expense Guarantee for COVID-19 Patients (hereinafter referred to as the "Notice") a few days ago, which clarifies the related matters of medical expense guarantee after April 1. The Notice made it clear that the medical insurance reimbursement policy for COVID-19 patients should be adjusted. The special guarantee policies such as full payment guarantee for hospitalization expenses and special guarantee for outpatient services will be converted into regular medical insurance policies. The medical insurance reimbursement policies of the insured patients who meet the requirements for COVID-19 medical expenses will be the same as those of other Class B infectious diseases. The medical insurance departments at all levels will timely settle the medical expenses of the patients who meet the requirements for COVID-19 infection. After the payment of basic medical insurance and serious illness insurance according to regulations, if the individual burden is still relatively heavy and meets the conditions for medical assistance, classified assistance will be provided according to regulations. The Notice requires that COVID-19 therapeutic drugs outside the medical insurance list in the eligible diagnosis and treatment plan be temporarily included in the medical insurance payment scope. The State Medical Insurance Bureau improved the price formation mechanism of COVID-19 therapeutic drugs and implemented classified management according to the price level. COVID-19 therapeutic drugs that are not included in the medical insurance catalogue in the national diagnosis and treatment scheme for COVID-19 infection can be temporarily included in the payment scope of the medical insurance fund, and the payment level can be appropriately reduced on the basis of Class B drugs in the catalogue, if they are included in the "Notice on Improving the Price Formation Mechanism of COVID-19 Therapeutic Drugs and Implementing Classified Management" category of "the treatment cost of course of treatment is less different from that of similar drugs in the medical insurance catalogue". The Notice will be implemented from April 1, 2023. Based on the time of admission or medical treatment of patients, the Notice on Optimizing the Medical Insurance Policies for novel coronavirus Infected Patients after the Implementation of "Class B Administration" (Yi Bao Fa [2023] No. 1) will be stopped simultaneously, and the relevant policies will be adjusted according to the development of the epidemic situation. (Liao Xinshe)

Edit:Ying Ying    Responsible editor:Shen Chen

Source:People.cn

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