药店买药，医保价反而更贵？医保局严查整治“阴阳价格”

Core Viewpoint - The National Healthcare Security Administration (NHSA) has classified the "yin-yang pricing" behavior of designated retail pharmacies as suspected price fraud, highlighting the issue of pharmacies charging higher prices to insured patients compared to uninsured ones [1][2]. Group 1: Regulatory Actions - The NHSA issued a notification requiring local healthcare departments to rigorously investigate and manage the "yin-yang pricing" issue, emphasizing the need for ongoing price management in designated pharmacies [1][4]. - The notification defines "yin-yang pricing" as a discriminatory pricing practice where pharmacies charge insured patients more than uninsured ones, violating agreements that prohibit unfair pricing [1][2]. - Local healthcare departments are encouraged to actively monitor and report instances of "yin-yang pricing," utilizing big data to identify high-volume and high-price differential drugs [2][4]. Group 2: Challenges in Regulation - The issue of "yin-yang pricing" arises partly due to the difficulty in price regulation, as the retail drug market is vast and prices fluctuate frequently, making comprehensive monitoring challenging [2]. - Many insured individuals are less sensitive to the funds in their personal medical accounts, leading them to accept higher prices when using insurance, which creates opportunities for pharmacies to exploit this behavior [2]. Group 3: Enforcement and Compliance - Pharmacies found to engage in "yin-yang pricing" may face penalties ranging from warnings to suspension of their insurance settlement qualifications or even termination of their service agreements [4]. - The NHSA mandates that pharmacies display clear pricing information to insured patients and prohibits discriminatory pricing practices [4]. - The introduction of measures aims to not only standardize pharmacy pricing behavior but also enhance the effectiveness of regulatory oversight through collaboration with market regulation departments [4].