国务院:进一步放宽互联网诊疗范围,将符合条件的“互联网+”医疗服务纳入保障范围

2021-04-25 网络 网络

国家医保局待遇保障司负责人樊卫东通报了符合条件的‘互联网+’医疗服务也可以纳入基本医疗保障。

4月22日,国新办举行建立健全职工基本医疗保险门诊共济保障机制国务院政策例行吹风会,国家医保局待遇保障司负责人樊卫东通报了符合条件的‘互联网+’医疗服务也可以纳入基本医疗保障范围”政策。

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国务院办公厅印发《关于建立健全职工基本医疗保险门诊共济保障机制的指导意见》其中提出,不断健全门诊共济保障机制,逐步由病种保障向费用保障过渡。将符合条件的定点零售药店提供的用药保障服务纳入门诊保障范围,支持外配处方在定点零售药店结算和配药,充分发挥定点零售药店便民、可及的作用。探索将符合条件的“互联网+”医疗服务纳入保障范围。

根据医保基金承受能力,逐步扩大由统筹基金支付的门诊慢特病病种范围,将部分治疗周期长、对健康损害大、费用负担重的疾病门诊费用纳入共济保障,对部分适合在门诊开展、比住院更经济方便的特殊治疗,可参照住院待遇进行管理

不断健全门诊共济保障机制,逐步由病种保障向费用保障过渡。将符合条件的定点零售药店提供的用药保障服务纳入门诊保障范围,支持外配处方在定点零售药店结算和配药,充分发挥定点零售药店便民、可及的作用。探索将符合条件的“互联网+”医疗服务纳入保障范围。

除了原来个人账户继续可以用于药店购药之外,主要明确了三方面的支持措施:

  第一,把符合条件的零售药店纳入统筹基金结算范围。参保人在定点医疗机构门诊就诊后可凭医疗机构开具的外配处方到药店购药,所发生的符合规定的费用与医疗机构享受同等报销待遇。

  第二,拓宽了个人账户使用范围,实行家庭共济。原来个人账户在药店只能用于购买相关合规药品,现在在定点药店购买医疗器械、医用耗材的费用也可由个人账户支付。

  第三,符合条件的“互联网+”医疗服务也可纳入基本医疗保障范围。对符合条件的网上医药服务,基金也按规定给予支付。

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