The National Health Insurance Bureau promotes reimbursable drug purchases in pharmacies

2023-02-20

A few days ago, the National Medical Security Bureau issued the Notice on Further Improving the Integration of Designated Retail Drug Stores into the Overall Management of Outpatients. The Notice pointed out that medical insurance departments at all levels should take effective measures to encourage qualified retail pharmacies to voluntarily apply for the opening of out-patient coordination services, and provide insurance personnel with out-patient coordination drug protection. The expenses incurred by the insured personnel in purchasing the drugs in the medical insurance catalogue at the designated retail drugstore with the prescription of the designated medical institution can be paid by the pooling fund according to the regulations. The Notice clearly states that the designated retail pharmacies applying for the opening of the outpatient coordination service should meet the requirements of medical insurance drug management, financial management, personnel management, and can carry out the direct settlement of the outpatient coordination network. The minimum payment standard, payment proportion and maximum payment limit of the outpatient plan of the designated retail drugstore can implement the same medical insurance treatment policy as that of the designated primary medical institutions in the planned area. The designated retail pharmacy can provide distribution services according to the needs of the insured, and the distribution fee is not included in the scope of medical insurance payment. The Notice proposed that the designated retail drugstore should follow the principles of fairness and legality, honesty and credibility, and quality and price consistency to provide the insured with drugs with appropriate prices, and should respect the market mechanism and adhere to the designated attribute. The policy supports fixed-point retail pharmacies to purchase drugs through the provincial drug procurement platform, and encourages voluntary participation in the centralized and volume procurement of drugs. According to the Notice, relying on the national unified medical insurance information platform, accelerate the implementation and application of the medical insurance electronic prescription center, and realize the smooth flow of electronic prescriptions from designated medical institutions to designated retail pharmacies. Designated medical institutions can issue long-term prescriptions for eligible patients for up to 12 weeks. The Notice also proposed to explore the establishment of the overall budget management of the outpatient service of the designated retail drugstore, and give full play to the incentive and restrictive role of the medical insurance fund. (Xinhua News Agency)

Edit:Ying Ying    Responsible editor:Jia Jia

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