in order to further improve the new rural cooperative medical system, expand the beneficiaries of participating farmers, and reduce the medical burden of farmers suffering from chronic diseases, the Lincheng County New Rural Cooperative Medical Management Committee decided to formulate the management measures. I. Diseases and standards of special chronic diseases 1. Uremia: there are obvious clinical manifestations such as anemia, bad breath, itchy skin, severe nausea, vomiting, neurological complications, water and salt metabolism and obvious acid-base balance disorder; The results of functional examination were as follows: ① endogenous creatinine clearance rate < 1 ml/min; ② Serum creatinine > 442 mmol/L; ③ blood urea nitrogen > 2 mmol/l. 2, diabetes: accompanied by ketoacidosis, vascular disease, central nervous system damage and other complications. 3, intermediate and advanced cancer: there are various cancer histories, postoperative spread of cancer, postoperative chemotherapy of cancer. 4, chronic aplastic anemia: anemia, fatigue, bleeding and other symptoms, laboratory blood routine or bone marrow examination in line with the diagnostic criteria. 5, leukemia: anemia, fatigue, bleeding and other symptoms, laboratory blood routine or bone marrow examination meets the diagnostic criteria. 6. Active chronic hepatitis or liver cirrhosis: symptoms of digestive tract or indications such as bleeding, ascites, hepatosplenomegaly, etc., and liver function and B-ultrasound examination support the diagnosis. 7. Systemic lupus erythematosus: The clinical symptoms, signs and laboratory tests are consistent with the diagnosis. 8. Rheumatoid arthritis (incapacitated): The clinical symptoms, signs and laboratory tests are consistent with the diagnosis. 9. Ankylosing spondylitis: The clinical symptoms, signs, images and laboratory tests conform to the diagnosis. 1. Sequela of cerebrovascular disease: having serious neurological, mental and limb dysfunction. 11. Hypertension (phase III): one of the complications of heart, brain, kidney and eye. 12, cor pulmonale complicated with heart failure: clinical symptoms, signs and imaging, laboratory examination in line with the diagnosis. 13. Rheumatic heart disease complicated with heart failure: clinical symptoms, signs, images and laboratory tests are consistent with the diagnosis. 14, coronary heart disease complicated with heart failure: clinical symptoms, signs and imaging, laboratory examination in line with the diagnosis. 15. Children with cerebral palsy: often hospitalized or rehabilitated. 16. Mental disorders and nervous system diseases: the ability of independent behavior is limited, and the ability to work is partially or completely lost. 17. After organ transplantation: drugs must be taken all the year round. 18. Other special chronic diseases: other special chronic diseases identified by the county new rural cooperative medical management committee upon application by the county new rural cooperative medical management center. Ii. declaration of special chronic diseases 1. scope and information of declaration: all farmers who participate in the new rural cooperative medical system in our county and suffer from diseases that meet the scope and standards of special diseases determined by our county can declare. Participating farmers who declare special diseases should provide medical records, diagnosis certificates, inspection reports, pathological section reports, CT films and other medical information related to the disease in public hospitals at or above the county level. 2. Procedures for declaration and appraisal (1) Preliminary examination (conducted by designated medical institutions in the jurisdiction) Participating farmers apply to the township joint management office, which collates and conducts preliminary examination of the application materials, and summarizes the materials of applicants who meet the standards, together with their "cooperative medical certificate", and submits them to the county new rural cooperative medical management center. (2) Review (county new rural cooperative medical management center) The county new rural cooperative medical management center shall verify the medical records reported by the township joint management office in the first instance, and those who meet the evaluation conditions shall be organized by the county new rural cooperative medical management center for expert appraisal. Do not meet the conditions, be returned. (3) Identification (county new rural cooperative medical system special disease expert appraisal team) The county new rural cooperative medical system management center set up an appraisal team, whose members are composed of center personnel and medical experts, and are specifically responsible for the appraisal work. Once every six months, centralized identification was conducted, and identification was carried out by reviewing data, face-to-face diagnosis and reexamination at Lincheng County Hospital and Lincheng County Hospital of Traditional Chinese Medicine. (4) Establishing files: those who meet the requirements after identification shall be established by the county new rural cooperative medical management center for standardized management. Iii. Certification and verification of special chronic diseases 1. The county new rural cooperative medical management center will summarize the qualified personnel and issue the "Certificate of Special Chronic Diseases" for them, which proves a unified number. Special chronic diseases are valid in the current year after confirmation, and will be verified once a year thereafter. 2. From March to April every year, the township joint management offices shall review the eligibility for reimbursement of chronic diseases of patients with special chronic diseases under their jurisdiction, and report to the county new rural cooperative medical management center for approval. 3. Those who meet the requirements after examination will continue to enjoy the treatment of reimbursement of outpatient expenses for special chronic diseases. 4. Those who fail to participate in the annual audit within the time limit and have serious violations such as false reporting and impersonator shall be disqualified. IV. Management of medical treatment 1. Medical institutions: When patients with special chronic diseases are treated in the county, they can choose to see a doctor at any designated medical institutions in the county and township. The hospitals for medical treatment are Lincheng County People's Hospital, Lincheng County Chinese Medicine Hospital and eight township hospitals; Transferred to the outside of the county for medical treatment shall be approved by the referral team of the county new rural cooperative medical management center, and the hospital for medical treatment shall be a non-profit medical and health care institution of level 2 and above. 2. Non-reimbursement: Medical expenses incurred by patients with special chronic diseases in drug sales units and non-designated medical institutions will not be reimbursed, and those beyond the scope of reimbursement drug list and diagnosis and treatment items of the new rural cooperative medical system in Hebei Province will not be reimbursed. 3. Procedures for seeing a doctor: Patients with special chronic diseases should hold the Cooperative Medical Certificate or the Certificate for Seeing a Doctor with Special Chronic Diseases when they see a doctor in the county. The attending doctor should work according to the relevant regulations, carefully check the patient's identity, certificate, expiration date, etc., provide corresponding treatment according to the approved diseases, fill in the diagnosis and treatment process in detail, issue double prescriptions, and submit one copy to the patient for reimbursement after pricing; In medical institutions outside the county, patients should be required to provide copies of double prescriptions or priced prescriptions, or provide machine-made receipts with detailed records of drugs. Medicines and examination items prescribed by doctors for patients with special chronic diseases should meet the needs of the disease, and the dosage of a patient should generally not exceed 15 days. For uremia patients with renal dialysis, malignant tumor radiotherapy and chemotherapy, leukemia dialysis and severe mental illness who need to go through hospitalization procedures for multiple consecutive treatments, their medical expenses reimbursement shall be implemented with reference to hospitalization compensation scheme. 4, designated medical institutions in any of the following circumstances, to carry out informed criticism, and can be given economic penalties, if the circumstances are serious, cancel its designated qualification. (1) prescribing irrelevant drugs and inspection items for patients; (2) failing to provide quality services for patients with special diseases; (3) being complained by patients with special diseases for more than 3 times a month; (4) fraud, taking cooperative medical fund and other acts. 5, the designated medical institutions to accept doctors in any of the following circumstances, to cancel the qualification, and the corresponding economic penalties. (1) Prescription, favor prescription, hitchhiking medicine, etc. (2) engaging in various forms of flexibility for patients and using prescription rights for personal gain; (3) Violation of other provisions of the new rural cooperative medical system in the county. V. Reimbursement of medical expenses 1. Patients with special chronic diseases pay for medical treatment in medical institutions, and keep relevant medical records, prescriptions and receipts. 2, special chronic disease outpatient expenses reimbursement once every six months, the county new rural cooperative medical management center in June, December 1-1 to accept chronic disease patients to submit information and apply for reimbursement. The township joint management office is responsible for collecting outpatient medical records and examinations, medicines, treatment fee receipts and effective prescriptions of patients with special chronic diseases, and submitting them to the county new rural cooperative medical management center for reimbursement within the specified time. 3, special chronic disease outpatient expenses accumulated throughout the year, reimbursement deductible 5 yuan, reimbursement rate of 4%; For patients with uremia, renal dialysis, malignant tumor radiotherapy and chemotherapy, leukemia dialysis and severe mental illness, the reimbursement for continuous hospitalization expenses is 7% for township deductible line 5 yuan, 5% for county deductible line 5 yuan, and 4% for municipal and above deductible line 1 yuan. Each person will pay 6, yuan per year for the capping line.