The per capita financial subsidy standard for residents’ medical insurance was raised to 583 yuan per person per year, the range of special diseases was expanded to 58, the medical expenses of outpatient clinics in different places inside and outside the province were settled directly, 78900 medical assistance objects were subsidized to participate in basic medical insurance, and all 1044 village health stations in the city were connected to the medical insurance settlement network… In the past year, Huizhou Medical Security Bureau (hereinafter referred to as “Huizhou medical insurance bureau”) handed over a sincere answer.
Medical security is an important institutional arrangement for the party and the state to reduce the burden of medical treatment, improve people’s well-being and maintain social harmony and stability. In Huizhou, the number of people covered by basic medical insurance has reached 4.7741 million, and the coverage rate has remained above 95% for a long time. With such a foundation, how to build a higher quality universal medical insurance is an important proposition faced by Huizhou medical insurance bureau.
The recently held 2022 Huizhou medical security and clean government work conference proposed to promote multi-level security, standardized policies, refined management, convenient services and coordinated reform, strive to practice the national medical security planning roadmap of the 14th five year plan, strive to build a higher quality national medical insurance, and contribute to the construction of a happier first-class city in China.
The continuous release of medical insurance dividends is turning into concrete measures to make the people the most direct beneficiaries.
do a good job in prevention and control logistics
implement the “two guarantees” and guarantee the “two expenses”
Recently, the situation of covid-19 pneumonia epidemic prevention and control has continued to tighten. The epidemic situation is an order, and prevention and control is a responsibility. In the face of the “big test” of epidemic prevention and control, Huizhou Medical Insurance Bureau quickly took action, fully deployed and made every effort to do a good job in the “logistics” of epidemic prevention and control, implemented “ensuring that patients do not receive timely treatment due to cost problems, and ensuring that designated medical institutions do not affect treatment due to the provisions on the budget management of total medical insurance”, played the role of “ballast” and “pressure reducing valve” of medical insurance to stabilize the society, and won the interdiction war of epidemic prevention and control for Huizhou Provide solid support for the overall war.
Statistics show that in 2021 alone, Huizhou medical insurance bureau has released 577 million yuan of special funds to ensure free vaccination. In addition, the medical insurance fund spent 103 million yuan to ensure the detection of nucleic acids in the city. Implement the policy on the periodic reduction and exemption of enterprise social insurance premiums. 45000 enterprises that have paid medical premiums and meet the “exemption” and “reduction” policies are exempted from applying for a refund of 392187 million yuan, so that they should be refunded as much as possible. At the same time, Huizhou medical insurance bureau has actively done a good job in preventing and controlling the supply and stable price of drugs and consumables, and organized to participate in the centralized procurement of testing reagents and supporting consumables. Under the superposition effect of price reduction of centralized procurement and reduction of nucleic acid detection fee, at present, the number of single nucleic acid detection per person in Huizhou medical institutions is reduced to no more than 40 yuan and that of mixed detection is reduced to 8 yuan, which saves financial funds for normalized epidemic prevention and control.
Lai Rong, party secretary and director of Huizhou medical insurance bureau, said that the Bureau will carefully support the normalization of epidemic prevention and control, resolutely “follow the command and follow the order”, and implement the covid-19 epidemic normalization prevention and control measures to the letter. At the same time, we will give full play to the role of special epidemic protection policies, implement the “two guarantees”, ensure that the “two costs” of vaccination and nucleic acid testing are in place, further promote the centralized procurement of testing reagents and supporting consumables, and continue to do a good job in the prevention and control of drugs and consumables, and ensure the supply and stable price.
optimize medical insurance for convenience
promote the inter provincial direct settlement of medical expenses of special diseases
Huizhou insured Ms. Chen went to live abroad for a short time due to working reasons. Last year, she received emergency medical treatment due to the onset of acute appendicitis. Fortunately, with the help of Huizhou medical insurance agency, she quickly and successfully completed the registration of medical treatment in other places, so that her follow-up medical treatment expenses are free from worries.
The continuous optimization of medical insurance convenience services not only improves people’s medical experience, but also meets the needs of more people for medical treatment in different places, and weaves a medical security network.
It is reported that at present, Huizhou has realized the direct settlement of medical expenses of outpatient clinics in different places inside and outside the province, and the problem of people’s reimbursement of expenses of outpatient clinics in different places and online outpatient clinics has been solved. Service items such as birth registration, approval of accidental injury, application for special treatment (including purchased negotiation drugs) and so on were transferred to the hospital for handling, 10 service items sank below township streets, and 16 medical insurance handling items realized “inter provincial and intra provincial general handling”.
In 2022, Huizhou medical insurance bureau will also vigorously promote the inter provincial direct settlement of medical expenses of special diseases, optimize the filing service, improve the direct settlement of medical expenses of outpatient treatment outside the province and medical expenses of maternity insurance in other places within the province, strengthen the cooperative handling of sporadic reimbursement of medical treatment in other places within the province, promote the Wuxi Online Offline Communication Information Technology Co.Ltd(300959) integrated settlement of medical expenses of inpatients and outpatients, improve the direct settlement rate and reduce zero reporting.
Medical insurance is more convenient and the guarantee is more powerful. The improvement of convenience is inseparable from the support of information technology. Huizhou Medical Insurance Bureau official said that the national health insurance information platform will strengthen the functions of various businesses, support the national medical insurance information platform to promote the “Internet plus government services”, and promote the formation of a new pattern of medical insurance business, “one network, one office, one network”. At the same time, we will strengthen the promotion and application of medical insurance electronic vouchers, give full play to the advantages of the national medical insurance information platform and the “universal platform” and “universal media” of medical insurance electronic vouchers, further broaden the application scenarios of medical insurance electronic vouchers, and let the people enjoy more convenient and fast digital services.
woven security network
ensure that medical assistance objects are insured without omission
Revise the measures for the administration of specific diseases in the outpatient service of basic medical insurance and the notice on adjusting the relevant provisions on the overall planning of the outpatient service of basic medical insurance, issue the management documents of “double channel” and Mente pharmacy, constantly improve the medical security system and steadily improve the level of medical insurance treatment… In Huizhou, a medical security network covering the whole people is speeding up the organization.
In 2021, Huizhou Medical Insurance Bureau promoted and guided commercial insurance institutions to launch the “affordable medical insurance” project of urban customized inclusive commercial health insurance. In 2021, the number of insured people of “huimedicare” reached 650000, and 29700 people have been reimbursed for medical expenses of 61.89 million yuan. The maximum amount of individual reimbursement is 660000 yuan, which has an obvious “burden reducing” effect on patients with major diseases and rare diseases, enriching the level of medical security in Huizhou. In the future, Huizhou will continue to promote the integrated development of basic medical insurance and commercial health insurance, guide the undertaking institutions of “preferential medical insurance” to do a good job in the use and liquidation of premiums in time, urge the implementation of various guarantees, accelerate the realization of “one-stop” claim settlement, and give better play to the inclusive nature of “preferential medical insurance” and the role of reducing the burden of high medical expenses.
In order to help the overall rural revitalization, Huizhou medical insurance bureau has normalized the role of medical assistance mechanism, prevented “poverty caused by illness” and “return to poverty due to illness”, continuously consolidated the achievements of poverty eradication and effectively connected with the Rural Revitalization Strategy. According to statistics, Huizhou funded 78900 medical assistance objects to participate in basic medical insurance in 2021, and the medical assistance fund funded the insurance expenditure of 236736 million yuan; 466400 people were rescued, and the amount of medical assistance reached 115 million yuan. In addition, all 1044 village health stations in the city are connected to the medical insurance settlement network, ensuring that the relief objects and villagers enjoy medical insurance treatment at the door of their homes.
The relevant person in charge of Huizhou medical insurance bureau said that this year, we will continue to consolidate the responsibility of medical insurance for poverty alleviation, promote rural revitalization and contribute to common prosperity. Pay close attention to the objects included in the scope of medical assistance, ensure that there is no omission of subsidized insurance, implement medical expense assistance measures, give full play to the supporting role of medical assistance, strengthen supervision and inspection, and prevent large-scale and systematic poverty return due to the inadequate implementation of medical insurance assistance policies.
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Lai Rong, director of Huizhou medical insurance bureau: protect every “life-saving money” and “life-saving money”
[author] Liao Yuxian, Xiao Qi
[photography] Wang Changhui
