Recently,
Anhui Provincial Medical Insurance Bureau issued
Notice on the pilot implementation of Basic medical insurance
"There is no place for serious illness in the province" protection policy
clarifies pilot diseases and pilot hospitals
This notice will be implemented from October 1, 2022
trial period 1 year
Main content of the "Notice"
clarifies pilot diseases. On the basis of fully soliciting opinions from provincial and municipal medical institutions, combined with feedback from prefectures, screened and determined that 7 diseases including renal failure, liver failure, pituitary adenoma , aortic dissection (type A), jugular foramen tumors, Parkinson's, large-area burns (multiple third-degree burns) and other seven diseases are pilot diseases for the "serious illnesses in the province have no different places" guarantee policy.
clearly pilot hospitals. In order to protect the rights and interests of insured people to see a doctor and take into account the regional layout of high-quality medical resources, five provincial hospitals, including First Affiliated Hospital of China University of Science and Technology ( Anhui Provincial Hospital ), First Affiliated Hospital of Anhui Medical University , Second Affiliated Hospital of Anhui Medical University , First Affiliated Hospital of Bengbu Medical College, First Affiliated Hospital of Anhui Southern Medical College (Yijishan Hospital) , and 5 provincial hospitals including pilot disease treatment hospitals.
clear benefits guarantee. Insured people suffer from the above seven pilot diseases, comply with the regulations on disease diagnosis and surgical operations, and are hospitalized in provincial hospitals under pilot, and will not be subject to the registration regulations for medical insurance referral and transfer, and the deductible and reimbursement ratio of the second-level and county-level medical institutions in the insured place shall be implemented. will not increase the hospitalization deductible, nor will the reimbursement ratio be reduced, and the medical expenses burden of patients with serious illnesses will be effectively reduced.
Policy innovation points
guide medical treatment in the province. adjusts the reimbursement policy to improve the reimbursement level of patients with serious illness seeking medical treatment in the province, further play the "leverage role" of medical insurance fund payment, guide patients with serious illness who are fully capable of treating in the province to seek medical treatment in the province, reduce the burden of patients' medical expenses, and actively support the construction of regional medical centers.
optimizes filing management. Insured people suffer from pilot diseases and do not need to go through the referral procedures when seeking medical treatment at a pilot provincial hospital. The pilot hospitals implement the "No different places for serious illnesses in the province" guarantee policy by uploading the "Disease Code" and "Treatment Method" fields, so as to achieve online instant settlement of insured patients when they are discharged.
implement dynamic adjustments. comprehensively considers the health needs of insured people, the development of new medical technology, and the operation safety of medical insurance funds, and dynamic adjustments to pilot diseases, pilot hospitals, and surgical operation methods. At the same time, strengthen supervision and management of pilot hospitals, strengthen control of medical expenses and out-of-medical insurance expenses, and effectively safeguard the medical insurance rights and interests of insured persons and the safety of medical insurance funds.
basic medical insurance "There is no place for serious illness in the province" to ensure pilot diseases
and the list of provincial third-level medical institutions
(first batch)
