At present, the novel coronavirus pneumonia epidemic situation is grim and complicated, and epidemic prevention and control are at a critical stage. In order to serve the current epidemic prevention and control needs, the office of the state health insurance agency issued the notice on effectively carrying out the current epidemic prevention and control medical security work (hereinafter referred to as the "notice"). Temporary inclusion of COVID-19 antigen detection reagent into health insurance Recently, the New Coronavirus pneumonia diagnosis and treatment plan (trial version ninth) requires additional antigen detection as a supplement to further improve the early detection ability of cases. In response to this, the circular pointed out that COVID-19 antigen detection reagents and corresponding testing items should be included in the basic medical insurance medical service directory of the province temporarily. 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. Adjust the new crown treatment drugs included in the payment scope of medical insurance The New Coronavirus pneumonia diagnosis and treatment plan (trial version ninth) has written two specific anti COVID-19 drugs approved by the State Administration of drug administration, namely PF-07321332/ Ritonavir Tablets (Paxlovid) and domestic monoclonal antibody (Alba monoclonal antibody / romicwell monoclonal antibody injection). In this regard, the notice requires that the new crown treatment drugs included in the payment scope of medical insurance 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. (outlook new era)
Edit：Yuanqi Tang Responsible editor：Xiao Yu
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