"The hospital information system has been successfully switched, and patients can go to the medical insurance consultation window in the lobby on the first floor of the hospital to get the latest information." Nie, director of the Medical Insurance Office of Chang Gung Memorial Hospital in Tsinghua, Beijing, said that in order to let patients enjoy the latest medical insurance reimbursement policy, the hospital procurement department timely obtained the drugs involved in the medical insurance catalogue on the drug sunshine procurement platform to check the price change information; The price department and pharmacy department updated the drug price and medical insurance treatment level according to the price change, and everything worked normally.
This adjustment will increase the use of 9 kinds of outpatient special diseases, * * * involving 125 kinds of drugs, reducing the burden of patients.
Among them, the category of reimbursement drugs for special disease treatment in aplastic anemia outpatient department increased the most.
There are 37 kinds of drugs used to treat gastric acid-related diseases, antiemetic drugs and anti-nausea drugs, drugs used to treat functional gastrointestinal diseases, analgesics and so on.
22 kinds of drugs for reimbursement of special diseases in renal dialysis outpatient department, including diabetes drugs, peripheral vasodilators and peritoneal dialysate;
After liver transplantation, kidney transplantation and combined liver and kidney transplantation, 19 kinds of anti-rejection outpatient special disease reimbursement drugs were added, including anti-anemia drugs and systemic antiviral drugs.
What is a special outpatient disease?
The so-called outpatient special diseases are diseases that require long-term outpatient treatment after surgery, which makes the outpatient medical expenses higher. After going through the formalities of filing special diseases, the outpatient department can enjoy the proportion of hospitalization reimbursement when carrying out relevant outpatient treatment in the selected designated medical institutions, and only charge a deductible within 360 days, which greatly reduces the burden of outpatient medical treatment for insured persons suffering from special diseases.
In recent years, Beijing has continuously improved the outpatient special disease policy, and the number of outpatient special diseases has increased from the initial three to 1 1 species. This time, the scope of drug reimbursement was adjusted, and * * * involved nine of them. The scope of drug reimbursement for "multiple sclerosis" and "intraocular injection therapy for macular degeneration" has not been adjusted yet, and "multiple sclerosis" has been included in the scope of drug reimbursement for outpatient special diseases. "Intraocular injection therapy for macular degeneration" is limited to "Kangpeixin Eye Injection" and "Leizumab Injection" which are included in the reimbursement scope for special diseases in outpatient department.
It is reported that through the adjustment of outpatient special disease policy, the burden of medical expenses for seriously ill patients can be reduced by about 350 million yuan every year. Taking Herceptin, a targeted drug for the treatment of breast cancer, as an example, the personal burden of retirees is reduced to 1 10,000 yuan after it is included in outpatient special disease reimbursement.
How to go through the formalities for outpatient special diseases?
According to Beijing Medical Insurance Center, at present, the filing process of special diseases is simplified. Insured persons suffering from special diseases only need to fill in the declaration form in the designated hospital for special diseases, and after being signed by the doctor, they should go through the filing formalities with the social security card at the medical insurance office of the hospital. After completing the filing, you can go to the hospital for treatment, and you don't need to go through the formalities at the unit or agency.
125 drug list
Special diseases in renal dialysis outpatient department