The National Medical Insurance Administration issued a plan for formulating a catalog of medical service items and will establish a national unified medical insurance catalog for the first time.
Quick Look
- The National Medical Insurance Administration issued the "Work Plan for the Development of the National Basic Medical Insurance Medical Service Item Catalog (First Batch)".
- For the first time, my country will formulate a national unified medical insurance medical service item catalog, covering 13 categories such as cardiovascular and respiratory.
- Adhering to the "basic protection" positioning, it will be the first to be used in inter-provincial and remote medical settlements to promote the standardization and efficiency of medical insurance payment.
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Why It Matters
In the past, my country's medical insurance catalog was formulated by each province, resulting in inconsistent payment standards and difficulties in settling medical bills across provinces.
Today (16th), the National Medical Insurance Administration officially issued the "Work Plan for the Development of the National Basic Medical Insurance Medical Service Item Catalog (First Batch)". For the first time, my country will formulate a national unified medical insurance medical service item catalog to further standardize the scope of medical insurance payment and improve the fairness of protection and the efficiency of fund use.
The plan is clear, adheres to the positioning of "maintaining the basics", comprehensively considers the affordability of local funds and actual clinical needs, and advances according to "category formulation and dynamic improvement". The first batch will cover 13 categories including cardiovascular, respiratory, ophthalmology, gynecology, radiotherapy, anesthesia, nursing, rehabilitation, oral implants, and assisted reproduction. After the catalog is implemented, it will be first used for settlement of medical treatment in different places across provinces, and then gradually be integrated with the payment scope of each province.
The plan defines the admission criteria, and only projects that are clinically necessary, safe and effective, affordable, and have controllable fund risks can be included; non-disease treatment projects such as beauty and health care, non-functional cosmetic surgery, and physical examinations, as well as projects with uncertain effects and high risks, will not be included. This move will promote more standardized and efficient medical insurance payments and better protect the people's rights and interests in medical treatment.
(CCTV reporters Yang Yang and Long Xiaoqin)
Open Questions
- What medical services are specifically included in the first batch of catalogs?
- When will the catalog be fully implemented in all provinces after it is formulated?
- How to measure the improvement in fund utilization efficiency after the implementation of the catalog?
