医保精细化管理
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中药饮片医保编码身份升级!道地药材、生产厂家一码掌握
Ren Min Ri Bao· 2026-01-10 00:06
中药饮片的医保编码迎来"身份升级"!为适配医保业务的新形势新要求,助力中医药产业高质量发展, 近日,国家医保局修订中药饮片医保编码规则,给每一味中药饮片都配上了新"医保身份证",这波操作 直接戳中百姓的用药需求! 中药饮片就是咱们去药房抓药时,那些经过清洗、切片、炮制的中药材"成品"。像补气养血的黄芪、当 归,助眠安神的炒酸枣仁,清热降火的金银花,都是常见的饮片品种。国家医保局推出的中药饮片医保 编码规则,给每味饮片分配了专属医保"身份标识"。 据介绍,这次修订不搞"大改大动",是在保留"中药饮片识别码、标准分类码、功效分类码、中药饮片 名称码"4大核心要素基础上,新增"道地药材标识码"和"中药饮片企业码"两个关键码段,填补"是否道 地、谁来生产"的信息空白,大幅提升透明度。新增道地药材标识码,如同给饮片贴了地理认证标签, 云南三七、四川川贝等道地品种一查便知;新增企业码实现生产责任精准锁定,厂家信息清晰可溯,既 倒逼企业压实主体责任,也为中药饮片集中采购落地筑牢根基。 国家医保局有关负责人表示,医保服务将更暖更贴心中药饮片的"医保身份证"升级背后,是医保管理的 不断精细化,更是对人民群众就医用药需求的贴心回 ...
国家医保局优化医用耗材分类 涉及血管介入支架等七类
Yang Guang Wang· 2025-09-14 00:43
Core Insights - The National Healthcare Security Administration (NHSA) has optimized the classification and generic names of seven categories of medical consumables, including vascular interventional stents, with full implementation of the related database expected by the end of September [1] Group 1: Medical Consumables Classification - The classification coding for medical consumables has been a challenging aspect of standardization in healthcare insurance [1] - The recent adjustments in classification coding aim to address long-standing issues of unclear categorization and complex management of medical consumables [1] - High-barrier technologies such as implantable cardiac rhythm management devices and artificial organs have been included in the new classification regulations, indicating a shift towards more detailed management in high-value areas [1] Group 2: Database and Future Plans - By August 2025, the medical consumables classification database is expected to publish 103,600 classification codes, covering 15,000 enterprises, 91,600 registration certificates, 140,900 products, and 13,379,600 specifications and models [1] - The NHSA plans to continue revising and optimizing the classification of other medical consumables, particularly allowing space for innovative products [1] - A temporary coding channel has been established under the "other" category in the medical consumables database to accommodate currently undefined innovative products [1]
北京将加强定点医药机构人员管理,实行“驾照式记分”
Xin Jing Bao· 2025-04-27 06:34
新京报讯(记者叶红梅)4月27日,记者从北京市医保局获悉,北京将对定点医药机构相关人员实行医保 支付资格管理,采取"驾照式记分"。 《实施细则》明确,对违法或违反医保服务协议的相关人员,在对定点医药机构作出行政处罚或协议处 理的基础上,根据行为性质和负有的责任程度等认定相关人员责任并记分。年度记分达到9分,未达12 分的,暂停医保支付资格1-6个月;年度记分累计12分的,终止医保支付资格1年;单次记12分的,终止 医保支付资格3年。 据介绍,医保支付资格管理制度的建立是医保管理向精细化延伸的标志性成果。对相关人员进行记分管 理,旨在警示教育医务工作者自觉遵守诊疗规范,主动约束手中的"一支笔",规范诊疗服务、促进行业 自律。医保部门与定点医药机构和医务工作者凝聚共识,在新形势下共建、共治、共享,形成合力,进 一步加强医保基金监管。 近日,北京市医疗保障局发布《关于印发 <北京市定点医药机构相关人员医保支付资格实施细则 试行 ="试行"> 的通知》(以下简称《实施细则》),对北京市定点医药机构相关人员实行医保支付资格管理。 《实施细则》将监管对象由定点医药机构延伸至医务工作者,从医保支付这一关键环节入手,对涉及医 ...