New health insurance regulations for jining: medical institutions in traditional Chinese medicine have lowered the standard by 100 yuan

Jining evening news.2018-01-09

A few days ago, our city print "the method of basic medical insurance of the resident of jining city", from January 1, 2018 come into force. In a year, residents' basic medical insurance, serious illness insurance, using specific highest pay limitation to be 650000 yuan, the basic medical insurance pay highest pay limitation to be 150000 yuan, a serious illness insurance pay highest pay limitation to be 300000 yuan, use the provincial regulations specific treatment of a serious illness insurance highest pay limitation to be 200000 yuan.

The identified as object of ginseng to keep staff, for poverty alleviation in a year, highest pay limitation to 500000 yuan, a serious illness insurance residents basic medical insurance, serious illness insurance, using specific highest pay limitation to be 850000 yuan.

The treatment of resident medical insurance includes basic medical treatment insurance treatment, big disease insurance treatment and national, province regulation medical insurance treatment. Basic medical insurance treatment includes hospitalization medical treatment, outpatient chronic medical treatment treatment, personal account medical treatment, childbirth medical treatment and unresponsible person accidental injury medical treatment, etc.

We will improve the reimbursement treatment for traditional Chinese medicine and traditional Chinese medicine.

Primary medical institutions are hospitalized.

The basic medical insurance fund pays a standard of 200 yuan.

Secondary medical institutions are hospitalized.

The basic medical insurance fund pays a standard of 500 yuan.

Tertiary institutions are hospitalized.

The basic medical insurance fund pays a standard of 1000 yuan.

TCM medical institutions are hospitalized.

Both the hospitalization of TCM medical institutions and the reimbursement treatment of pure Chinese medicine treatment have been improved.

The starting pay standard for medical treatment is reduced by 100 yuan.

The standard of hospitalization for pure Chinese medicine was reduced by 100 yuan.

The agreement management community health service center shall refer to the management of primary medical institutions; The undecided level of private agreement management medical institutions, the implementation of secondary medical institutions to pay the standard.

Adult residents policy within the scope of medical treatment, hospitalization occurs over fu biao to the highest pay limitation the following parts, the first, second and tertiary medical institutions fund payment proportion were 80%, 70% and 55% respectively.

In medical institutions, the proportion of hospitalization expenses incurred in the use of traditional Chinese medicine, TCM diagnosis and treatment techniques and approved therapeutic Chinese medicine preparations increased by 10%.

The proportion of medical expenses incurred in hospitalization with pure Chinese medicine is 90%.

Medical expenses incurred by students and other minors are increased by 5% on the basis of the proportion of adult residents.

If the insured person is transferred to the hospital for emergency treatment, the outpatient medical expenses of the day will be observed in the hospital.

Outpatient chronic diseases increased to 51.

Chronic disease outpatient from 47 to 51 species, class a disease to seven, b disease to 44 species, new diseases: galactosemia, glaucoma, ankylosing spondylitis, xerosis four b disease.

In one year, the basic medical insurance fund for residents will pay a standard of 500 yuan, which is calculated separately from the standard of hospitalization. There is no standard for the treatment of uremia and hemophilia.

The proportion of the basic medical insurance fund for class a patients is 70%, and the proportion of the medical institutions of class b is 65%, 55% and 45% respectively.

According to the regulation, in one year, the basic medical insurance fund of class a disease is the highest pay limit is 70 thousand yuan, the highest payment limit of class b disease is 5000 yuan. If there are two or more types of chronic diseases, the maximum payment limit is 150,000 yuan. If there are two or more types of chronic diseases, the maximum payment limit is 6000 yuan; At the same time, patients with chronic diseases of class a and class b shall pay a maximum amount of 75,000 yuan for the proportion of class a disease.

In accordance with the principle of local management and convenience, the insured persons choose to participate in an agreement to manage medical institutions. In principle, the diagnosis of chronic diseases in outpatients should be evaluated once a quarter, and the disease can be identified at any time.