国家医保局回复:医保卡个人账户只限刷医药费用

2019-08-16 佚名 药店经理人

由于医保资金监管形势愈发严峻,多地药店直接下架保健品,那么,药店到底能不能销售保健品呢?医保卡可以刷保健品吗?医保局回复来了..... 据胶东在线消息,近日有网友留言:最近媒体一直在报道打击爱欺诈骗保行为,我想问一下,药店到底允不允许卖保健品,允不允许个人刷医保卡购买保健品?


由于医保资金监管形势愈发严峻,多地药店直接下架保健品,那么,药店到底能不能销售保健品呢?医保卡可以刷保健品吗?医保局回复来了.....

据胶东在线消息,近日有网友留言:最近媒体一直在报道打击爱欺诈骗保行为,我想问一下,药店到底允不允许卖保健品,允不允许个人刷医保卡购买保健品?

关于这个问题,烟台市医保局基金监督管理和规划财务科科长王传浩,在民声访谈中进行了解答。

王传浩介绍,按照我市医疗保险《服务协议》的约定,零售药店是允许摆放、售卖保健用品的,但不允许刷医保卡购买。国家医疗保障局已有明确规定,个人刷医保卡购买日用品、保健品等非医疗用品的行为属于欺诈骗保行为。2019年以来,我市不断加大对零售药店刷卡购买保健品的查处力度,凡是发现、查实的,医保局都将严肃处理。

也就是说,按照规定烟台市零售药店是可以销售保健品的,但个人医保卡是明确禁刷保健品的。

而这一规定,也和很多地区对零售药店保健品销售的管理是一致的。

今年4月,石家庄市人民政府官网发布消息称:为加强医保基金监管,打击欺诈骗保行为,石家庄市医保局将进一步规范石家庄市医保定点零售药店药事服务行为,并制定该市医保定点零售药店药事服务行为八个“严禁”,明确指出严禁摆放和经营食品、日用百货、健身器材、化妆品、小家电等商品。

按照这一要求,石家庄市的零售药店保健食品不得在该市定点零售药店摆放和销售。

可以这么说,一直以来,保健品都在零售药店占据较大的销售份额,但由于医保基金监管压力的增大,加之部分药店用医保卡盗刷生活用品的存在,具有预防和保健功能的保健食品多地被禁刷,甚至一度在部分地区药店被迫下架。

但医保卡究竟能否拓宽刷卡范围,个人账户能否放活使用呢?相关人大代表就此问题向国家医保局提出相关建议。

国家医保局:只限刷医药费用

今年8月1日,国家医保局就仇冰玉、庹庆明两人大代表提出“拓宽、放活医保卡个人账户使用范围”的建议作了答复。

国家医保局郑重声明:个人账户只能用于支付在定点医疗机构或定点零售药店发生的,符合基本医疗保险药品目录、诊疗项目范围、医疗服务设施标准所规定项目范围内的医药费用,禁止用于医疗保障以外的其他消费支出。

对此,业内解读观点各异。

有观点认为:医保卡刷保健品,彻底没戏了。因为按照上述规定,医保卡个人账户里的钱只能用于符合基本医疗保险项目范围内的医药费用,使用医保卡个人账户刷保健品、营养品等非医疗商品会被禁止。

也有业内观点认为:由于医保个人账户目前正在向统筹账户过渡,所以医保卡刷保健品并不是完全没有希望,根据目前的属地管理政策,很多地区医保卡还可以刷保健品。因为保健品不同于生活用品,未来还是有希望被纳入医保刷卡范围。

以湖南株洲为例, 今年4月,湖南株洲市医疗保障局印发《关于推行医疗保障惠民便民利民二十条措施的通知》(以下简称《通知》)。

《通知》第16条“推进个人账户改革”指出:“支持在协议零售药店购买药品、医疗器械、医用材料、卫消字或卫杀字准字的消毒用品、国食健字的保健品的费用。”

那么,未来保健品市场究竟如何呢?医保卡个人账户禁刷保健品会在全国铺开吗?

根据中国医药物资协会医药零售研究中心观点,医保药店目前左右为难的原因,主要在于国家医保政策调整与各地执行部门对于参保城镇职工个人账户使用规定的不确定性。

也就是说,未来不管是保健品市场,还是医保药店,国家医保政策调整与各地政府医保部门对个人账户在药店的使用报销范围规定,直接决定了两者的走向。

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    2019-10-11 pcw115
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    2019-08-18 cathymary
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    2019-08-18 bshuang
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