The branches of the Municipal Medical Insurance Bureau, the District Finance Bureau, the Health Bureau, and the Social Insurance Fund Administration:
Now, the Notice of Guangdong Provincial Health and Wellness Committee of Guangdong Provincial Department of Finance, Guangdong Provincial Health and Wellness Committee, Guangdong Provincial Health and Wellness Bureau, Ministry of Finance, National Health and Wellness Committee, and National Bureau of Disease Control on Optimizing the Relevant Policies of novel coronavirus's Medical Insurance for Infected Patients after the Implementation of Class B Management is forwarded to you, and the following opinions are put forward. Please implement them together.
First, the outpatient and emergency expenses incurred by the insured patients with infection and suspected symptoms in novel coronavirus in designated medical institutions with secondary and below medical insurance shall be specially guaranteed, and paid according to the following reimbursement rates: 90% in primary medical and health institutions, 90% in non-profit medical and health institutions with primary and below, 70% in secondary medical and health institutions, and 70% in other medical and health institutions with primary and below, which are not included in the annual maximum payment limit of the medical insurance general outpatient co-ordination fund. The drug list is implemented according to the relevant provisions of the state and province, and the diagnosis and treatment list and consumables list are implemented according to the general outpatient policy of our city. Belonging to the medical assistance object, enjoy the medical assistance treatment according to the regulations. Novel coronavirus infection outpatient and emergency expenses of tertiary medical institutions are implemented according to the general outpatient policy of basic medical insurance in our city. This policy will be implemented until March 3, 20231.
Second, novel coronavirus infected patients in all medical institutions, in line with the health department to develop novel coronavirus infection diagnosis and treatment program of hospitalization medical expenses, the implementation of the upfront cost protection policy, by the basic medical insurance, serious illness insurance, medical assistance, etc. in accordance with the provisions of payment, personal burden by financial subsidies, the required funds by the medical institutions at the same level of financial advance, the central government according to 60% of the actual cost to be subsidized. This policy is based on the patient's admission time and will be implemented until March 3, 20231day.
Third, the designated medical institutions that provide "internet plus" medical services provide mobile payment and settlement services for patients who have symptoms related to novel coronavirus infection and meet the family treatment guidelines for COVID-19-infected people. The medical insurance reimbursement standards are consistent with offline. Follow-up services for infection-related symptoms in novel coronavirus are still implemented according to the current Internet follow-up reimbursement policy.
Fourth, strengthen departmental coordination and linkage to ensure that policies are effective. All departments should improve their political positions and conscientiously perform their duties. The medical insurance department is responsible for the audit and settlement of related expenses and strengthen fund supervision. The financial department is responsible for timely disbursement of financial subsidies; The health department is responsible for guiding medical institutions to do a good job in the identification, information registration and data uploading of infected patients in novel coronavirus, and the disease control department is responsible for the information and data uploading of infected patients in novel coronavirus. Strengthen coordination and linkage to ensure the full implementation of the decision-making arrangements of the CPC Central Committee and the State Council.
Attachment: Notice of the National Health Insurance Bureau, the Ministry of Finance, the National Health and Wellness Commission and the National Bureau of Disease Control on Optimizing the Medical Insurance Policy for the Treatment Expenses of Infected Patients in novel coronavirus after the Implementation of Class B Management.
Foshan Medical Security Bureau Foshan Bureau of Finance
Foshan Municipal Health Bureau Foshan Social Insurance Fund Management Bureau
65438+202318 October