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口腔含漱液小编提示:全国统一医保目录、医保支付要来,医药准入、营销迎巨变!

发布日期:2019-09-10 作者: 点击:

口腔含漱液小编提示:今日(99日),国家医疗保障局公布了对政协十三届全国委员会第二次会议第3015号(医疗体育类327号)提案的答复,在答复中,国家医保局表示,将建立全国统一的医保目录和统一医保支付标准,并还将修订《国家基本医疗保险诊疗项目和医疗服务设施范围管理办法》,建立符合国情、基金可承受的基本医疗保险诊疗项目和医疗服务设施标准。同时,也正在开展药品、诊疗项目等的全国编码统一,为全国医保目录统一工作打下基础。

 

医保目录和医保支付统一,药品营销和准入将进入一个新时代!医保目录统一后,通过进入多省医保后进入全国医保路径没了,未来药企只需考虑一个问题:医保是否愿意跟你玩以及你是否愿意跟医保一起玩。医保药物还是自费药物,身份只能二选一。

 

口腔含漱液小编提示:诊疗服务和药品(耗材)等是医疗主要组成部分,在医保全国统一基础上,诊疗服务也将全国统一,诊疗服务的全国统一意味着诊疗服务的标准化,在大范围推广临床路径的基础上,按病种付费、总额预付等医保支付方式对行业影响力将开始体现,符合诊疗规范的部分医保报销,否则不报销,医院将一句病种的医保支付标准,合理决定药品、耗材和医疗服务分配比例。临床必要性将成为药品营销推广的核心所在,一旦非临床必须,要么,可能转到院外,成为患者自负部分,当然,即使院外品种也必须有充足临床理由,否则可能会面临患者,医院随即的处罚可能直接让你的销售画上句号。

 

附国家医保局答复函全文:


国家医疗保障局关于政协十三届全国委员会第二次会议

第3015号(医疗体育类327号)提案答复的函

医保函〔2019〕117号

ZHANGGUANGQIWEIYUAN:

456棋牌NINTICHUDEGUANYUWANSHANQUANGUOYIDIJIUYIZHIJIEJIESUANYOUGUANZHENGCEDETIANSHOUXI。JINGSHANGCAIZHENGBU,XIANDAFURUXIA:

456棋牌KUASHENGYIDIJIUYIZHIJIEJIESUANGONGZUOSHIZHONGYAODEMINSHENGGONGCHENG,LINGDAOZHONGSHI,QUNZHONGQIDAI,SHEHUIGUANZHU。ZHANGQIYILAI,YIDIJIUYI“PAOTUI”BAOXIAONAN、“DIANZHI”FUDANZHONGWENTIYIZHISHILIUDONGRENKOU、SUIQIANLAORENDETONGDIAN、DUDIANHENANDIANWENTI,YANZHONGYINGXIANGRENMINQUNZHONGHEQINGHELIDEKUASHENGJIUYIXUQIU。KAIZHANKUASHENGYIDIJIUYIFEIYONGZHIJIEJIESUAN,RANGSHUJUDUOPAOLU,QUNZHONGSHAOPAOTUI,WEIQUNZHONGTIGONGGENGJIABIANJIEGAOXIAODEFUWU,RANGYIBAOFUWUGENGJIARENXINGHUA,JIUSHILUOSHI“YIRENMINWEIZHONGXIN”FAZHANLINIANDEJUTITIXIAN,NENGGOUDALITISHENGRENMINQUNZHONGYILIAOBAOZHANGDEHUODEGAN、XINGFUGAN。

456棋牌KOUQIANGHANSHUYEXIAOBIANTISHI:MUQIAN,KUASHENGYIDIJIUYIZHIJIEJIESUANGONGZUOYIZAIQUANGUOQUANMIANKAIZHAN,SUOYOUSHENGFEN、SUOYOUTONGCHOUDIQU,GELEICANBAORENYUAN、ZHUYAOWAICHURENYUAN,ZHONGDIANYILIAOJIGOUDENGDOUNARUKUASHENGYIDIJIUYIZHIJIEJIESUANXITONG,XITONGYUNXINGPINGWEN,JIESUANRENCI、JIESUANZIJINWENBUSHANGSHENG,YUELAIYUEDUOQUNZHONGXIANGSHOUDAOZHIJIEJIESUANBIANLI。JIEZHI2019NIAN6YUEDI,KUASHENGYIDIJIUYIDINGDIANYILIAOJIGOUSHULIANGWEI18962JIA,QIZHONGERJIJIYIXIADINGDIANYILIAOJIGOU16297JIA,GUOJIAPINGTAIBEIANRENSHU431WAN。ZI2017NIAN1YUEKUASHENGYIDIJIUYIZHIJIEJIESUANGONGZUOQIDONGYILAI,LEIJISHIXIANKUASHENGYIDIJIUYIZHIJIEJIESUAN268WANRENCI,YILIAOFEIYONG644.1YIYUAN,JIJINZHIFU377.7YIYUAN,JIJINZHIFUBILI58.6%。QIZHONG2019NIAN1-6YUEFEN,LEIJISHIXIANZHIJIEJIESUAN115.4WANRENCI,YILIAOFEIYONG276.1YIYUAN,JIJINZHIFU161.2YIYUAN,JIJINZHIFUBILI58.4%,RIJUNZHIJIEJIESUAN6376RENCI。

一、关于开展异地就医门诊直接结算的建议

456棋牌KAOLVDAOQUANGUOGETONGCHOUQUMENZHENZHENGCEBUTONGYI,DAIYUBAOZHANGSHUIPINGCHAYIDA;YIBAOXINXIXITONGJIANSHESHUIPINGBUYI,YAOPIN、YIYONGHAOCAIDAIMABIAOZHUNBUTONGYI;MENZHENJIUYIJIESUANPINCIGAO、JIESUANLIANGDA,DANBIJIESUANJINJIAOXIAO,YIBAOXINXIXITONGCHENGZAINENGLIBUGOUDENGYUANYIN,DANGQIANKUASHENGYIDIJIUYIZHIJIEJIESUANZHUYAOJIEJUECANBAOQUNZHONGDEZHUYUANYILIAOFEIZHIJIEJIESUAN,KUASHENGMENZHENYIDIJIUYIZHIJIEJIESUANSHANGWEIZAIQUANGUOKAIZHAN。MUQIAN,ZHANGSANJIAODIQUSHANGHAI、JIANGSU、ZHEJIANG、ANHUISANSHENGYISHIYIYU2018NIAN9YUEKAIZHANMENZHENYIDIJIUYIZHIJIEJIESUANSHIDIANGONGZUO。2019NIAN6YUE22RI,JINGJINJIYILIAOBAOZHANGXIETONGFAZHANHEZUOXIEYIQIANSHUYISHIZAITIANJINJUXING,JINGJINJIMENZHENYIDIJIUYIZHIJIEJIESUANSHIDIANZHENGSHIQIDONG。XIAYIBU,WOMENJIANGJIAQIANGZHIDAO,GULIYOUTIAOJIANYOUYIYUANDEQUYUKEYITANSUOKAIZHANKUASHENGMENZHENYIDIJIUYIZHIJIEJIESUANSHIDIAN,TONGSHIYEJIANGJIAQIANGMENZHENYIDIJIUYIZHIJIEJIESUANDIAOYAN,ZONGJIESHIDIANDIQUDEJINGYAN,BUDUANMANZUCANBAOQUNZHONGDEYIDIJIUYIXUQIU。

二、关于统一医疗保险支付标准,循序渐进统一全国医保目录,减少异地就医待遇差的建议

456棋牌MUQIAN,JIBENYIBAOYAOPIN、ZHENLIAOXIANGMUMULU、YILIAOFUWUSHESHIBIAOZHUNBUTONGYI,ZHUYAOYOUYIXIAYUANYIN:YISHIZAISANDAMULUSHEJIZHICHU,YOUYUGEDIJINGJIFAZHANSHUIPING、YILIAOFUWUJISHU、JIJINYUNXINGQINGKUANGBUTONG,WEIDUIQUANGUOYIBAOMULUZUOTONGYIGUIDING。RUYUANLAODONGHESHEHUIBAOZHANGBUDENG7BUMENZHIDINGDE《CHENGZHENZHIGONGJIBENYILIAOBAOXIANYONGYAOFANWEIGUANLIZANXINGBANFA》(LAOSHEBUFA〔1999〕15HAO)GUIDING,GESHENG(QU、SHI)KEGENJUDANGDIJINGJISHUIPING、YILIAOXUQIUHEYONGYAOXIGUAN,SHIDANGJINXINGDIAOZHENG,ZENGJIAHEJIANSHAODEPINZHONGSHUZHIHEBUDECHAOGUOGUOJIAZHIDINGDE“YILEIMULU”YAOPINZONGSHUDE15%。DUIYUZHENLIAOXIANGMUJIYILIAOFUWUSHESHI,YUANLAODONGHESHEHUIBAOZHANGBUDENGBUWEICHUTAIDE《GUANYUYINFACHENGZHENZHIGONGJIBENYILIAOBAOXIANZHENLIAOXIANGMUGUANLI、YILIAOFUWUSHESHIFANWEIHEZHIFUBIAOZHUNYIJIANDETONGZHI》(LAOSHEBUFA〔1999〕22HAO)CAIYONGPAICHUFAFENBIEGUIDINGLEYIBAOBUYUZHIFUFEIYONGHEZHIFUBUFENFEIYONGDEFANWEI。ZAICIJICHUSHANGGESHENG(QU、SHI)GENJUYILIAOJISHUFAZHAN、JIJINYUNXINGDENGSHIJIQINGKUANG,CAIQUPAICHUFAHUOZHUNRUFAQUEDINGLEBENDIDEZHENLIAOXIANGMUHEYILIAOFUWUSHESHIXIANGMUMULU。ERSHIQUANGUOYAOPIN、ZHENLIAOXIANGMUJIYILIAOFUWUSHESHIBIANMABUTONGYI,MUQIANGESHENGFENMULUDAIMABUJIANRONG,YAOTONGYIQUANGUOYIBAOMULU,XIANYAOTONGYIBIANMAGUIZE,GESHENGFENSANDAMULUBIANMAYAOWANCHENGYUGUOJIATONGYIBIANMADEZHUANHUAN,GONGZUOLIANGDA。

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三、关于优化医保经办服务,简化备案手续的建议

KUASHENGYIDIJIUYIZHIJIEJIESUANGONGZUOCAIQUBEIANZHIGUANLI,ZHUYAOSHIWEILEYINDAOCANBAOQUNZHONGHELIYOUXUJIUYI,LUOSHIGUOJIAFENJIZHENLIAOYAOQIU,YINDAOJICENGSHOUZHEN、SHUANGXIANGZHUANZHEN,BIMIANBUFENJIUYIRENYUANQUANGUO“MANYOU”,TONGSHI,TONGGUOBEIANZHIGUANLIKEYITIQIANJIEJUEQUNZHONGYIDIJIUYIGUOCHENGZHONGSUOYONGZHENGJIAN、WANGLUODENGFANGMIANDEQIANZAIWENTI,XIAOCHUQUNZHONGYIDIJIUYISHIKENENGCHUXIANDEZHANGAI。

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456棋牌NINTICHUDETUIXINGYIYUANDUANBEIAN,ZHENZHENGSHIXIANBEIANFUWU“LINGPAOTUI、BUJIANMIAN”DEJIANYI,WOMENJIANGRENZHENYANJIU,ZAIXIABUGONGZUOTUIJINZHONGRENZHENKAOLV。TONGSHI,WOMENYEJIANGJINYIBUYOUHUAHEWANSHANYIDIJIUYIZHIJIEJIESUANBEIANGUANLIZHENGCE,JINZHUAGEXIANGZHENGCEDELUOSHILUODI,DATONG“ZUIHOUYIGONGLI”,WEICANBAORENTIGONGGENGFANGBIANKUAIJIEDEYIDIJIUYIZHIJIEJIESUANFUWU。

四、关于强化异地就医费用监管的建议

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456棋牌WEIQUEBAOYIBAOJIJINANQUAN,GUOJIAYIBAOJUZAIZUOHAOJIUYIDIGUANLIDETONGSHI,CONGYIXIAJIGEFANGMIANQIANGHUAYIDIJIUYIFEIYONGJIANGUAN:YISHIGUANCHELUOSHI《GUOJIAYILIAOBAOZHANGJUGUANYUZUOHAO2019NIANYILIAOBAOZHANGJIJINJIANGUANGONGZUODETONGZHI》(YIBAOFA〔2019〕14HAO)YAOQIU,TUIJINJIUYIDISHIXIANDINGDIANYILIAOJIGOUJIANDUJIANCHAQUANFUGAI、KAIZHANDAJIQIZHAPIANBAOZHUANXIANGZHILIGONGZUO、WANSHANQUNZHONGJUBAOJIANGLIZHIDU,ZUZHIDAJIQIZHAPIANBAO“FEIXINGJIANCHA”DENGGONGZUO,JIADADUIPIANBAOXINGWEIDEDAJILIDU。ERSHIYIGUOJIAYIDIJIUYIJIESUANXITONGSHUJUWEIJICHU,JIANSHETONGYIDEYIDIJIUYIZHINENGJIANKONGSHENHEXITONG,YITUOGUOJIAJIDIFANGYIBAOZHENGCE、LINCHUANGYONGYAOGUIFANDENGWANSHANZHINENGSHENHEGUIZEKU,DUIYIDIJIUYIFEIYONGSHIXIANJIESUANDANJUQUANMIANSHENHE,BINGJIEZHUDASHUJUWAJUEFENXIJISHUFAXIANQIZHAPIANBAOXINGWEI。MUQIANGAIXITONGJIANSHEDINGCENGSHEJIHEZHAOBIAOHUANJIEYIWANCHENG,YUJINIANNEIKESHANGXIANSHIYUNXING。SANSHITANSUOKAIZHANJIUYIDIYUCANBAODIXIETONGLIANCHAJIZHI,QIANGHUALIANGDISHUANGXIANGGOUTONGXIANGYING,TIGAOXINXIGONGXIANGSHUIPING,JIADADUIYIDIJIUYIGUOCHENGZHONGQIZHAPIANBAOXINGWEIDEZHILILIDU。

五、关于建立国家异地就医集中账户的建议

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456棋牌NINTICHUDEJIANLIGUOJIAYIDIJIUYIJIZHONGZHANGHUDEJIANYI,WOMENZHENGZAIYUXIANGGUANBUMENYANJIULUNZHENG。

456棋牌GANXIENINDUIGUOJIAYILIAOBAOZHANGGONGZUODELIJIEHEZHICHI。

GUOJIAYILIAOBAOZHANGJU

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456棋牌     【SHENGMING】BENWENWEIZHUANZAI,SHANDONGBEINUOYIYAOSHENGWUKEJIYOUXIANGONGSIBUDUIQIZHUNQUEXINGJIGUANDIANFUZE。RUSHEJIBANQUANWENTIQINGLIANXI0536-8261370,WOMENJIANGLIJICHULI,YIBAOZHANGGEFANGQUANYI。


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相关标签:口腔含漱液小编提示:全国统一医保目录、医保支付要来,医药准入、营销迎巨变!

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