国家医保局:互联网医疗收费细则初稿已完成 即将纳入医保报销!

2019-08-02 Linan 新浪医药

7月31日,国家医保局公开了对十三届全国人大二次会议部分代表关于互联网医疗建议提案的答复,从信息中可以看到,互联网医疗收费细则正在制定,初稿已完成,并且即将纳入医保报销范围。相关数据显示,我国互联网医疗市场的规模到2020年有望突破900亿。此前,互联网医疗如何定价、纳入医保报销问题一直是行业发展中最大的阻力,如今在政策明确利好的形势下,预计互联网医疗产业这块蛋糕还将进一步做大。最迟两个月 细则就

7月31日,国家医保局公开了对十三届全国人大二次会议部分代表关于互联网医疗建议提案的答复,从信息中可以看到,互联网医疗收费细则正在制定,初稿已完成,并且即将纳入医保报销范围。

相关数据显示,我国互联网医疗市场的规模到2020年有望突破900亿。此前,互联网医疗如何定价、纳入医保报销问题一直是行业发展中最大的阻力,如今在政策明确利好的形势下,预计互联网医疗产业这块蛋糕还将进一步做大。

最迟两个月 细则就会面世

此前,国务院办公厅印发的《深化医药卫生体制改革2019年重点工作任务》中,明确提到由国家医保局操刀负责制定互联网诊疗收费和医保支付政策文件,并于今年9月底前完成。

7月31日,国家医保局对十三届全国人大二次会议第2056号建议的答复中表示互联网医疗收费细则正在制定,已经形成了初稿,等待征求各方面意见修改完善后正式发布。

这意味着最迟两个月时间,互联网医疗收费细则就会面世。

去年4月份,国务院办公厅印发《关于促进“互联网+医疗健康”发展的意见》,其中对互联网收费制度制定就提出了一定的要求,该《意见》明确要求进一步完善医保支付政策,建立费用分担机制,健全互联网诊疗收费政策,促进形成合理的利益分配机制,支持互联网医疗服务可持续发展。

而对于即将出台的互联网诊疗收费细则,医保局透露,将根据中央与地方在医疗服务价格管理上的权限,国家层面负责明确“互联网+”医疗服务立项原则、项目名称、服务内涵、计价单元、计价说明等的规范,指导各省做好医疗服务价格项目工作。各省负责根据医疗技术发展和本地区实际,按照国家规定的立项原则等,设立适用本地区的医疗服务价格项目,制定调整项目价格。这里面强调了各省市可以根据指导文件等,自行制定符合本地区的互联网医疗服务价格。

另外,从披露的信号可知实施方向将会是由市场决定、政府调节、社会共治相结合,政府鼓励互联网医疗多样化、创新发展,对于更好满足多层次医疗需求的新技术、新模式,政策上会给予更宽松的发展空间;而线上、线下医疗服务实行公平的价格和支付政策,费用公平负担,线上、线下协调发展会是重点。

纳入医保报销范畴,得过两道“关卡”

早在相关互联网医疗新规落地之前,国家卫健委医政医管局副局长焦雅辉就曾向记者表示,互联网诊疗接入医保,首先要解决的问题是“如何定价”。她提到,不管是属于基本医疗范畴,还是属于市场定价范畴,首先得有收费项目。并且,互联网诊疗服务若属于基本医疗服务范畴,医保要给予报销,不属于基本医疗服务范畴,要由患者负担。

可以看到,互联网医疗纳入医保报销,先需要明确自身服务的具体价值,然后还得考虑是否被纳入基本医疗服务范畴里面。

对于互联网医疗项目是否会纳入医保报销,国家医保局方面的表态是,国家层面对于医疗服务项目采取排除法管理,没有将互联网诊疗项目排除在外。在此基础上,各省制定具体支付的医疗服务项目范围。国家医保局支持各地医保部门根据基金承受能力,将符合条件的互联网诊疗项目纳入医保支付范围。

据了解,江苏、贵州、甘肃、四川等省份全省或部分地区目前已出台远程医疗价格、报销等政策,将符合条件的诊疗服务纳入医保支付范围。

查阅相关资料,去年10月份,江苏省物价局联合省卫计委等下发通知,对部分“互联网+”医疗服务项目制定试行价格。从列出的部分“互联网+”医疗服务项目试行价格可以观察到,仅从门诊费用来看,与线下医院诊疗费用价格相差不大。

公开信息显示,国家医保局正将配合卫生健康等相关部门协同推动“互联网+医疗健康”发展,尽快出台“互联网+”医疗服务价格和医保支付政策文件,指导督促各地落实到位。

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