科技日报北京7月24日电 （记者张佳星）全国超过12.36亿人开通使用医保码，就医买药实现扫码结 算、刷脸结算；跨省异地就医直接结算人次从2020年的537万人次增加到2024年的2.38亿人次，增长44 倍……在7月28日国新办举行的新闻发布会上，国家医疗保障局局长章轲表示，"十四五"期间，全国医 疗保障系统积极推进科技赋能，全面建成全国统一医保信息平台，实现医保业务编码标准全国统一，显 著提升医保智能管理水平。 "今年以来，我们通过智能监管子系统拒付、追回医保基金3.3亿元。"国家医疗保障局副局长黄华 波表示，通过强化大数据技术应用，构建"异常住院""医保药品倒卖""重点药品监测"等大数据分析模 型，精准锁定违法违规行为，医保基金监督检查精度和力度得到大幅提高。医保智能监管系统令医保基 金使用违法违规行为得到早发现、早预警、早处置。 黄华波表示，国家医疗保障局将进一步推进"一人一档"全民参保数据库建设，动态更新参保人员参 保状况变化，挖掘数据潜力，赋能参保人员健康管理。 随着医保码、药品追溯码、移动支付、电子处方等信息手段的全面应用，群众就医购药更加便捷。 医保基金还通过真金白银的购买，为医药行业发展、医 ...

医疗保障是减轻群众就医负担、增进民生福祉、维护社会和谐稳定的重大制度安排。"十四五"时期，基 本医疗保险参保率稳定在95%左右，医保基金累计支出12.13万亿元，年均增速9.1%。 7月24日，国务院新闻办举行"高质量完成'十四五'规划"系列主题新闻发布会，介绍"十四五"时期深化医 保改革有关情况。 "'十四五'时期，在以习近平同志为核心的党中央坚强领导下，医疗保障系统坚持以人民为中心，开拓 创新、锐意进取，圆满完成了各项医保改革发展任务。"国家医疗保障局局长章轲说。 2021—2024年，近200亿人次享受就诊医保报销 "2021—2024年，近200亿人次享受就诊医保报销，2024年是2020年的1.6倍。"章轲介绍，2024年度，全 国基本医保参保人数达到13.27亿人。基本医保参保长效机制不断健全完善，医疗救助每年资助参保约 8000万人。职工和居民住院费用目录内基金支付比例分别稳定在80%和70%左右。 呵护"一小"。截至今年6月，2.53亿人参加生育保险，基金累计支出4383亿元，享受待遇9614.32万人 次；优化"出生一件事"，新生儿凭出生医学证明就可以参保；31个省份和新疆生产建设兵团都将辅 ...

Group 1 - The core viewpoint of the news is the introduction of reforms in the medical insurance system during the "14th Five-Year Plan" period, focusing on optimizing services to better meet the needs of the public [1][2][3] - The National Medical Insurance Bureau emphasizes the importance of using modern technologies such as big data, cloud computing, and artificial intelligence to create a unified and efficient medical insurance information platform [1] - The initiative includes the establishment of a five-level medical insurance service network, aiming to create a "15-minute medical insurance service circle" for citizens [1][2] Group 2 - The "standardized service" approach has led to the development of 23 coding standards and 37 technical specifications, streamlining the process for maternity benefits to be completed within 10 working days [2] - The "cross-regional service" has expanded direct settlement from hospitalization to outpatient services for chronic diseases, benefiting over 500 million people and reducing out-of-pocket expenses by over 550 billion yuan [2] - The "efficient service" includes a nationwide medical insurance platform with a response time in milliseconds, handling over 14.5 million daily settlements and enabling cross-province processing for high-frequency services [2]

Core Viewpoint - The Henan Provincial Medical Security Bureau has launched an innovative "One Code Payment" service, enhancing the efficiency of medical insurance reimbursement and payment processes for patients [1] Group 1 - The new service allows insured individuals to complete medical expense payments by scanning a single code, streamlining the reimbursement process [1] - This initiative addresses the inconvenience faced by patients who previously had to switch between various online platforms and perform multiple operations to access their medical insurance [1] - The implementation of this service is expected to alleviate long waiting times during peak medical service hours, thereby improving the overall healthcare experience for patients [1]