COVID-19 antigen detection reagent and corresponding testing items are temporarily included in medical insurance.

2022-03-22

In March 21st, the office of the national health insurance agency issued the circular on "earnestly making the current epidemic prevention and control of medical security work". It is clear that the provincial health insurance departments should consider the epidemic prevention and control needs in accordance with the New Coronavirus pneumonia diagnosis and treatment plan (trial version ninth) (hereinafter referred to as the "treatment plan (trial version ninth)" and "New Coronavirus pneumonia prevention and control program (trial version ninth)". The payment capacity of the medical insurance fund in the region shall be adjusted and optimized in a timely manner in accordance with the principles of scientific accuracy, positive stability and controllable risk. Among them, COVID-19 antigen test reagents and corresponding testing items should be included in the basic medical insurance medical service directory in the province. The circular pointed out that COVID-19 antigen test reagents and corresponding testing items should be included in the basic medical insurance medical service directory in the province. The relevant expenses incurred by the insured in the designated grass-roots medical institutions shall be paid according to the current provisions of the overall planning area. The expenses of purchasing testing reagents in the designated retail pharmacies can be paid by personal accounts. The provincial medical insurance departments refer to the letter of the office of the national health insurance agency on the proposal to temporarily add New Coronavirus antigen detection items and related matters to the local medical insurance office (medical insurance Letter No. 2022] No. 11), and continuously regulate and optimize the price policy of public medical institutions to provide new crown antigen detection services. The centralized purchasing agencies in various places should do a good job of hanging the nets of COVID-19 antigen detection reagent, actively promote the purchase of hanging nets and rely on the national unified medical insurance information platform for information sharing. At the same time, we will strengthen measurement and monitoring, and jointly promote the work of price, procurement, payment and information system transformation. At the same time, the notice pointed out that the new crown treatment drugs included in the payment scope of medical insurance should be adjusted in time. For the newly added drugs in the diagnostic plan (trial version ninth), the provincial medical insurance departments refer to the relevant requirements of the Ministry of finance of the State Council on medical insurance and the medical insurance for New Coronavirus infected pneumonia (national medical insurance [2020] 5), and incorporate the temporary nature into the payment scope of the medical insurance fund of this province. For drugs transferred out of the diagnosis and treatment plan (trial version 9) and not included in the basic medical insurance catalogue, all provincial medical security departments shall stop medical insurance payment from the date of publication of the diagnosis and treatment plan (trial version 9). All provincial medical security departments shall do a good job in the network connection of new drugs. For drugs that have not been connected to the network, medical institutions are allowed to purchase offline for emergency use. The newly added nimatovir tablets / ritonavir tablets in the diagnosis and treatment plan (trial version 9) shall be purchased by the medical institution according to the price agreed between the enterprise and relevant departments, and the medical insurance department shall pay according to the regulations. The notice emphasized that the medical insurance departments at all levels should refine and improve the work measures according to the requirements of the Ministry of health insurance of the Ministry of finance of the State Council, the Ministry of finance of the State Council on medical insurance for New Coronavirus infected pneumonia (national medical insurance [2020] 5) and so on. Support the normal operation of medical institutions in areas with serious epidemic situation, and prepay part of the new crown treatment funds according to procedures when necessary. We should do a solid job in the protection of COVID-19 vaccine and vaccination fees, conscientiously implement the price policy of nucleic acid and antigen detection projects, implement the long-term reimbursement policy for long-term prescription and Internet diagnosis and treatment, ensure the implementation of the epidemic prevention and control medical insurance policy, reduce the number of insured patients to the medical institutions, and effectively reduce the risk of the spread of the epidemic. (outlook new era)

Edit:Yuanqi Tang    Responsible editor:Xiao Yu

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