The Medical Insurance Bureau Officially Released: the Management Task of High-value consumables Is Coming
Focus on consumables with a unit price of more than 2000 yuan |
Recently, the Jiangsu Provincial Medical Insurance Bureau issued the Reform Implementation Plan for Governing High-value Medical Consumables (hereinafter referred to as the Plan), announcing the governance tasks for high-value medical consumables.
The Plan requires that by 2025, the sunlight procurement system for high-value medical consumables will be basically complete, the alliance will carry out normalized procurement with volume, and the medical burden of the people will be further reduced.
The Plan defines the governance scope of high-value medical consumables, that is, the Class II and III of registration management and medical consumables with a unit price of more than 2000 yuan. These consumables are medical consumables with large clinical use, relatively high price and heavy burden on the masses.
The Plan will promote the construction of the province’s “one platform”, and realize the synchronization of the provincial platform with the information system of medical institutions and the medical insurance payment platform, as well as data sharing. The medical consumables used by public medical institutions are purchased and publicly traded on the provincial platform.
The Plan will establish a market-led price formation mechanism for medical consumables, and comprehensively carry out online purchases of medical consumables with conditional price limits. Online bargaining will be encouraged, substantial bargaining between medical institutions and pharmaceutical companies on the platform will be promoted and medical consortia or multiple medical institutions will be encouraged to jointly carry out sunshine bargaining procurement.
The supervision of bargaining behavior will be strengthened, and the red, yellow and blue monitoring of bargaining results will be implemented. It will be linked with the lowest online prices of provincial platforms across the country, so as to dynamically adjust the online prices of provincial platforms.
The medical consumables classification and coding standards of national medical insurance will be fully implemented, the application of coding in medical consumables procurement, record procurement, alliance procurement and other links will be in promotion.
In terms of volume-based procurement, the medical insurance fund plays a strategic role in purchasing, forming a provincial sunshine procurement alliance, and implementing alliance-based procurement of medical consumables with large clinical consumption, high procurement amount, wide use range and strong competitiveness.
The public medical institutions will submit special settlement accounts for sunshine procurement to the provincial platform as required. Direct settlement between medical insurance funds and pharmaceutical companies will be implemented.
The special account information of public medical institutions will be dynamically supervised, the purchase orders of medical consumables and settlement information will be compared and analyzed regularly, the payment settlement will be reminded and warned in time, and the long-term or malicious arrears of payment will be interviewed.
From extensive model to the intensive |
