Notice of Beijing on Optimizing the Relevant Policies of Medical Insurance for the Treatment Expenses of Infected Patients in novel coronavirus

Medical Insurance Bureaus, Finance Bureaus, Health and Wellness Committees of all districts, Social Affairs Bureau and Financial Audit Bureau of Beijing Economic and Technological Development Zone, and relevant designated medical institutions:

In order to conscientiously implement the decision-making arrangements of the CPC Central Committee, the State Council, the Municipal Party Committee and the Municipal Government, According to the requirements of the Notice of the National Bureau of Medical Insurance, the Ministry of Finance, the National Health and Wellness Commission and the National Bureau of Disease Control and Prevention on Optimizing the Relevant Policies of Medical Insurance for the Treatment Expenses of Infected Patients in novel coronavirus after the Implementation of "Class B Management", it is decided to optimize and adjust the relevant policies of medical insurance in this city in order to ensure the people to get through the peak period of infection smoothly. The relevant matters are hereby notified as follows:

1. Optimize the medical insurance payment policy, Improve the level of reimbursement for medical treatment at the grass-roots level

The hospitalization medical expenses incurred by infected patients in novel coronavirus in all medical institutions that conform to the novel coronavirus infection diagnosis and treatment plan formulated by the health department shall be paid by the basic medical insurance, serious illness insurance and medical assistance according to the regulations, and the personal burden shall be subsidized by the financial department, and the required funds shall be paid in advance by the financial department, and the central government shall subsidize 6% of the actual expenses. This policy is based on the time of admission of patients and will be implemented until March 31, 223.

Cooperate to promote graded diagnosis and treatment, guide patients to seek medical treatment at the grass-roots level, and ensure smooth and orderly medical services. According to the actual situation of this Municipality, we will increase the support for bringing village clinics and community health service institutions in rural areas into the designated medical institutions for medical insurance in this Municipality, and sign an agreement on temporary designated medical institutions with interested village clinics and community health service institutions in rural areas. Encourage medical institutions to equip themselves with novel coronavirus infection treatment drugs in the medical insurance drug list. The insured patients in the city's secondary and below designated medical institutions in novel coronavirus infection and 11 kinds of suspected symptoms of outpatient and emergency expenses to implement special protection, no deductible and capping line, the reimbursement rate is 9%, the first implementation until March 31, 223.

due to the increased expenses paid by the medical insurance fund due to the adjustment of reimbursement ratio, the medical insurance department automatically made up the difference through the information system in April according to the information of the insured patients uploaded by the medical institutions, and directly allocated the difference-making expenses to the entrusted bank account bound by the insured, and the insured did not need to declare.

The outpatient and emergency expenses for novel coronavirus infection treatment of insured patients in other medical institutions shall be implemented according to the medical insurance policies for other Class B infectious diseases.

second, implement the temporary medical insurance drug list to meet patients' drug demand

According to the novel coronavirus Infection Diagnosis and Treatment Plan issued by the National Health and Wellness Commission and the State Administration of Traditional Chinese Medicine, the temporary medical insurance payment policy for novel coronavirus treatment drugs in the plan will be extended until March 31, 223. With the consent of the State Medical Insurance Bureau, the drugs identified by the joint prevention and control mechanism in this Municipality for treating novel coronavirus infection will be temporarily included in the list of medical insurance drugs in this Municipality, and will be implemented first until March 31, 223.

Third, do a good job in "internet plus" medical insurance service to help patients make online diagnosis and treatment.

The health administrative department should promptly announce the list of medical institutions that provide Internet diagnosis and treatment services, and provide mobile payment and settlement services for patients with symptoms related to novel coronavirus infection and meeting the Guidelines for Home Treatment of Covid-19 Infected Persons according to regulations. The medical insurance department should support the price policy of Internet first-visit medical services according to the principle of online and offline consistency, and the reimbursement standards and standards. The follow-up service for infection-related symptoms in novel coronavirus is still implemented according to the current reimbursement policy for follow-up visits on the Internet.

Fourth, improve the price formation mechanism, and enhance the ability of medical insurance

Continue to do a good job in price negotiation or consultation, centralized procurement, online procurement, filing procurement, price monitoring, etc. of drugs needed for the treatment of infected patients in novel coronavirus, so as to reduce the treatment cost of infected patients in novel coronavirus. Combined with the actual operation of the medical insurance fund, the medical insurance department promotes the implementation of the policy as a whole and scientifically determines the scope and level of protection, which not only reasonably reduces the burden on the masses, but also ensures the safety and sustainability of the medical insurance fund. On this basis, the medical insurance fund does not meet the expenditure, and the financial department will give appropriate subsidies.

V. Optimize the medical insurance handling process and provide convenient medical insurance services

Continue to provide convenient medical insurance services, implement the long-term prescription medical insurance payment policy, and implement the routine medical insurance handling work online, timely handle emergency matters, handle special matters privately, postpone non-urgent matters, and eliminate hidden dangers with confidence. According to the needs, and belong to the municipal health department to determine the scope of medical institutions that provide Covid-19 infected patients with the ability to treat novel coronavirus infection, non-medical insurance designated medical institutions signed the Temporary Special Agreement on the Settlement of Medical Insurance Expenses of novel coronavirus Infected Patients, guiding all kinds of medical institutions to do a good job in the collection and uploading of information related to novel coronavirus infection diagnosis and settlement, and the settlement of medical insurance expenses. Give full play to the handling power and promote the sinking of services. Agencies at all levels should cooperate with relevant departments to do a good job in health promotion in rural areas and urban communities, popularize knowledge of epidemic prevention and control, raise people's awareness of self-protection, and earnestly ensure that medical insurance management is not loose and medical insurance handling services are uninterrupted. All designated medical institutions should diagnose the new coronavirus infection and 11 kinds of suspected symptoms, accurately express the diagnosis information and upload it in time.

VI. Strengthening coordination and linkage among departments to ensure effective policies

The implementation of "Class B and B management" for novel coronavirus infection is an important decision made by the CPC Central Committee and the State Council on the basis of comprehensive evaluation of virus variation, epidemic situation and prevention and control work in China. All relevant departments should improve their political stance and earnestly 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 uploading of infected patients in novel coronavirus; The CDC is responsible for uploading information and data of infected patients in novel coronavirus. Strengthen coordination and linkage to ensure that the decision-making and deployment of the CPC Central Committee and the State Council are fully implemented.

This notice shall come into force as of the date of implementation of "Class B Management" for novel coronavirus infection.

Beijing Municipal Health Insurance Bureau

Beijing Municipal Finance Bureau

Beijing Municipal Health and Wellness Committee

January 7, 223

Attachment: 11 suspected symptoms.