Recently, the Jilin Provincial Medical Security Bureau issued a notice on adjusting the collection and payment standards for some diseases. The full text of the adjustment to the collection and payment standards for some diseases is as follows ↓↓↓Notice on adjusting the collectio

A few days ago

Jilin Provincial Medical Security Bureau issued

Notice on Adjusting the Collection and Payment Standards for Some Diseases

Adjusted the Collection and Payment Standards for Some Diseases

The full text is as follows

↓↓↓

Notice on Adjusting the Collection and Payment Standards for Some Diseases

Jiji Medical Insurance Development [2022] No. 19

Municipal (state) medical security bureaus, Changbai Mountain Management Committee Medical Security Bureau, Meihekou Municipal Medical Security Bureau, Provincial Social Medical Insurance Administration Bureau:

In order to further optimize the province’s disease-based Collection and payment management, after collective discussion by experts, the "Notice on Clarifying the Collection and Payment Standards and Related Work for 122 Diseases including Congenital Heart Malformations" (Ji Medical Insurance Fa [2020] No. 17, hereinafter referred to as "Document No. 17") The collection and payment standards for some types of diseases have been adjusted. The relevant matters are hereby notified as follows:

1. Dynamically adjust the collection and payment standards

The provincial bureau is based on the "Notice on Further Improving the Collection and Payment by Disease Type in Our Province" (Jiji Medical Insurance Issuer [2020] No. 43), the "Notice on Further Improving and Expanding the Scope of Collection and Payment by Disease Type" (Jiyi Medical Insurance Fa [2021] No. 31) and other requirements, comprehensively consider the centralized procurement of drugs and medical consumables, medical service price adjustments, medical insurance Based on factors such as fund revenue and expenditure, economic and social development, and combined with the actual conditions of our province, the collection and payment standards for some diseases have been dynamically adjusted (see the attachment for details).

2. Other requirements

(1) Medical insurance departments in various places should accelerate the implementation of the DRG/DIP three-year action plan, and make overall arrangements and transitions to DRG/DIP payment from the disease-based payment policy in a timely manner.

(2) Each designated medical institution should strictly implement the policy of charging and paying according to disease type, and shall not include unqualified cases in the management scope of charging and payment according to disease type by lowering admission standards, relaxing surgical indications, upgrading diagnosis, cross-diagnosis, etc.

(3) The Provincial Social Medical Insurance Administration should promptly adjust the information system and connect the collection and payment standards to ensure that the adjustment of collection and payment according to disease types is standardized and implemented efficiently.

(4) This notice will be implemented uniformly across the province from July 1, 2022, and the scope of implementation is limited to third-level medical institutions. For diseases that have not been settled in the "Document No. 17" in the early stage affected by the epidemic, this standard can be implemented from January 1, 2022.

Attachment: Dynamically adjusted disease collection and payment standards (click on the text to view the attachment)

Jilin Provincial Medical Security Bureau

June 29, 2022

Article source: Reprinted · Jilin Provincial Medical Security Bureau website Changchun

Review: Huainan

Producer: Wang Lin Hao Feng

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