The National Medical Insurance Administration issued the "Work Plan for the Development of the Catalog of Medical Service Items of National Basic Medical Insurance (First Batch)"
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)".
- Our country will formulate a national unified medical insurance medical service item catalog for the first time.
- The first batch covers 13 categories such as cardiovascular, respiratory, and ophthalmology.
AI-generated summary
Why It Matters
Our country previously lacked a unified catalog of medical insurance and medical service items across the country. There were differences in payment scope among provinces, and it was inconvenient to settle medical bills across provinces and in different places.
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)
What to Watch
AI outlook — possibilities, not facts
The catalog of national unified medical insurance medical service items will be the first to be used for settlement of medical treatment in different places across provinces.
Very likely · Within months
The catalog will be dynamically improved and adjusted according to actual clinical needs and fund affordability.
Likely · Within months
Open Questions
- When will the catalog be officially released and implemented?
- How do each province connect with the national catalog and arrange the transition period?
- How to establish a dynamic directory adjustment mechanism?
