Guangdong Provincial Health Insurance Bureau Guangdong Provincial Department of Finance Guangdong Provincial Health and Health Commission forwarded the Supplementary Notice of the General Office of th

Guangdong Medical Insurance Mingdian [2020] No.2

At the local level, the Municipal Health Insurance Bureau, Finance Bureau and Health and Wellness Bureau (Committee) are listed:

　　Now, the Supplementary Notice of the Office of the National Medical Insurance Bureau, the General Office of the Ministry of Finance and the General Office of the National Health and Wellness Commission on Doing a Good Job in Medical Security of Pneumonia Epidemic in novel coronavirus (No.6 [2020] of the National Medical Insurance Bureau) is forwarded to you, and the following opinions are put forward in combination with the actual situation in our province. Please implement them together.

　　First, increase medical security.During the epidemic period, confirmed suspected and confirmed insured patients, hospitalization and outpatient expenses of drugs and medical services that meet the diagnosis and treatment plan of pneumonia infected in novel coronavirus formulated by the national and provincial health administrative departments were all temporarily included in the scope of medical insurance fund payment, and the hospitalization Qifubiaozhun was cancelled. After the medical expenses of patients are paid in accordance with the regulations, such as basic medical insurance, serious illness insurance and medical assistance, the personal burden will be subsidized by the finance. Among them, the funds needed for the personal burden of the diagnosed patients are paid in advance by the hospital, with the central financial subsidy of 60%, and the remaining 40% is paid in advance by the finance at the same level in the place where the patient is treated. At that time, the provincial finance will co-ordinate the funds above the provincial level and settle them in different files according to the relevant requirements of basic public health services; Confirmed suspected patients are paid in advance by the finance at the same level in the place where they seek medical treatment, and the provincial finance co-ordinates funds above the provincial level to give appropriate subsidies as appropriate.

　　Second, ensure timely and smooth settlement.It is confirmed that the medical expenses of suspected and diagnosed insured patients are not included in the total budget control index of medical institutions, and hospitalization and outpatient services are paid according to the project. The diagnosis code of pneumonia in novel coronavirus temporarily uses joint code, that is, the main code J12.800 plus the additional code B97.200. Municipalities’ medical insurance agencies can temporarily increase the amount of advance payment for the pneumonia treatment hospitals infected in novel coronavirus, take various measures to solve the problem of differences between temporary policy adjustment and medical insurance information system, and timely settle the medical expenses of insured patients in line with regulations. Conditional areas should promptly add two temporary medical insurance settlement directories of "drugs for diagnosis and treatment of pneumonia infected in novel coronavirus" and "projects for diagnosis and treatment of pneumonia infected in novel coronavirus" to the medical insurance information system for the use of hospital settlement. For patients who seek medical treatment in different places, they shall be treated first and then settled, and the reimbursement shall not be reduced. Medical insurance agencies should coordinate medical institutions, do a good job in recording the information of insured patients seeking medical treatment in different places and accounting for medical expenses, and the medical expenses for medical treatment in different places in the province shall be settled with medical institutions in time by the medical insurance agencies in the insured places; Inter-provincial medical treatment in different places shall be carried out in accordance with the relevant provisions of the state, and liquidation shall be organized in a unified way throughout the country after the epidemic ends. The part that should be paid by individuals shall be settled with medical institutions in a timely manner by financial departments at all levels.

　　Third, continue to do a good job in the procurement and price monitoring of drugs and medical consumables.Municipal medical insurance departments should keep information flowing with procurement platforms and medical institutions, and jointly do a good job in the procurement, supply and price monitoring of drugs and medical consumables related to epidemic prevention and control. Instruct medical institutions to issue orders directly to the procurement platform in time for drugs, medical consumables and in vitro diagnostic reagent products related to novel coronavirus. Drugs and medical consumables that are difficult to purchase can be independently purchased by medical institutions for emergency use. At the same time, we should pay close attention to the price and supply changes of related drugs and medical consumables, and report to the Provincial Medical Insurance Bureau in a timely manner if the procurement supply and price situation are abnormal.

　　Fourth, strengthen departmental communication and coordination.Municipal medical insurance, finance, health and health departments should strengthen information exchange and share relevant data such as the number of inpatients and outpatients of suspected and confirmed patients every day. Medical insurance, health and health departments do a good job in the statistical work of medical expenses of insured patients and non-insured patients respectively. Medical and health institutions at all levels should standardize the process of confirmation and diagnosis of suspected and confirmed patients, and establish relevant statistical ledgers. Since January 28, 2020, the system of "daily submission and zero report" of medical insurance fund payment information will continue to be implemented. Municipal medical insurance departments should submit the epidemic situation and medical insurance fund, medical assistance fund payment and prepayment to the provincial medical insurance center before 10:00 every day.

　　If the original documents are inconsistent with this notice, this notice shall prevail. Major problems and situations encountered by cities in their work, please report to the Provincial Medical Insurance Bureau, the Department of Finance and the Health and Wellness Committee in a timely manner.

Guangdong Provincial Medical Security Bureau　　

Guangdong Provincial Finance Department

Guangdong Provincial Health and Wellness Commission

January 30, 2020

　　Attachment:Supplementary Notice of the Office of the State Medical Insurance Bureau, the General Office of the Ministry of Finance and the General Office of the State Health and Wellness Commission on Doing a Good Job in Medical Security for Pneumonia Infected in novel coronavirus