Workers' Daily News (Reporter Wang Xin Fang Dafeng) Recently, Hunan and Hubei held a signing ceremony for the cooperation agreement on medical security interconnection, and determined the "List of Medical Security Interconnection Matters in Hunan and Hubei (the first batch)", which covers 9 aspects, such as insurance information inquiry, transfer and continuation of medical insurance relationship, mutual recognition of remote medical treatment areas, and remote medical treatment settlement.
According to the list of medical security interconnection items in Hunan and Hubei provinces, before the end of June this year, the two provinces will realize the deep integration of the official WeChat and mini programs of the medical insurance bureau, so that the insured can easily download and print the certificate of participation and inquire about the details of insurance payment.
It is worth mentioning that after the mutual recognition of remote medical treatment areas, the previous filing restrictions will be broken, and the reimbursement ratio will not be reduced.
According to the current regulations of Hunan, except for the emergency rescue personnel in other places, they are deemed to have been recorded, and the rest of the personnel who seek medical treatment across provinces must be filed according to the regulations. In addition, if the temporary out-of-town medical treatment personnel who are referred to other places and rescued by emergency in other places are directly settled for medical treatment in the place of filing, the payment ratio will be reduced by 5% on the basis of the reimbursement level of the same level of medical institutions in the insured place. For those who fail to go through the filing in accordance with the regulations, go out for medical treatment and return to the insured place for manual reimbursement, the payment ratio shall be reduced by 10% on the basis of the reimbursement level of the same level of medical institutions in the insured place.
The cooperation agreement on medical security interconnection between Hunan and Hubei signed this time is clear that the adjacent cities, prefectures or districts and counties (i.e., mutual recognition areas) of Hunan and Hubei take the lead in realizing that cross-provincial hospitalization is regarded as medical treatment in the overall planning area, and there is no need to go through the filing of medical treatment in other places, and the minimum payment standard, payment ratio and maximum payment limit of the medical insurance fund shall be implemented in accordance with the policy standards for local medical treatment stipulated by the insured place.
For example, if the insured is hospitalized in an inter-provincial mutual recognition area, the medical expenses within the policy are 10,000 yuan after deducting the minimum payment line, and the medical insurance can be overreported by 500 yuan or 1,000 yuan. This will bring a real sense of gain to the insured.
In addition, the two provinces will also expand the scope of outpatient chronic diseases with inter-provincial direct settlement. At present, the medical insurance department has included hypertension, diabetes, outpatient radiotherapy and chemotherapy for malignant tumors, uremia dialysis, and anti-rejection therapy after organ transplantation, which are five outpatient chronic diseases that are in high demand and widely carried out by the masses, into the scope of direct settlement. The cooperation agreement on medical security interconnection between Hunan and Hubei signed this time is clear, and 15 new outpatient chronic diseases such as liver cirrhosis, hemophilia, and Parkinson's disease will be included in the scope of direct settlement.
"After this matter is implemented, patients who are eligible for the treatment of '5+15' outpatient chronic diseases can be directly settled and reimbursed after seeking medical treatment and purchasing drugs in the networked designated medical institutions in Hunan and Hubei provinces." The relevant person in charge of the Hunan Provincial Medical Insurance Bureau introduced.
At present, part of the work of medical security interconnection between Hunan and Hubei provinces has been implemented, including insurance information inquiry, remote medical treatment settlement, etc. Some areas of the two provinces have realized the transfer and continuation of the medical insurance relationship, and fully launched the cross-provincial direct settlement of medical insurance business such as hospitalization, general outpatient clinics, and five outpatient chronic diseases.
Source: Workers' Daily
