提高门诊医保报销比例!国家医保局答复全国政协委员提案

2019-10-17 佚名 健康界

15日,国家医保局官网发文,答复徐凤芹等7位全国政协委员提出的“关于提高门诊医保报销比例,防止小病大养、小病不治拖成大病的提案”。关于“新增财政补助向门诊保障倾斜”,国家医保局称,今年国家医保局和财政部联合印发的《关于做好2019年城乡居民基本医疗保障工作的通知》(医保发〔2019〕30号),明确要求地方按规定足额安排财政补助资金并及时拨付到位,用好城乡居民医保年度筹资新增资金,在做好住院保障的基

15日,国家医保局官网发文,答复徐凤芹等7位全国政协委员提出的“关于提高门诊医保报销比例,防止小病大养、小病不治拖成大病的提案”。

关于“新增财政补助向门诊保障倾斜”,国家医保局称,今年国家医保局和财政部联合印发的《关于做好2019年城乡居民基本医疗保障工作的通知》(医保发〔2019〕30号),明确要求地方按规定足额安排财政补助资金并及时拨付到位,用好城乡居民医保年度筹资新增资金,在做好住院保障的基础上,加强居民医保门诊保障,重点保障群众负担较重的多发病、慢性病

关于“提高门诊就医报销比例”,国家医保局回复:“基本医保在保障住院大病支出的同时,保障范围逐步向门诊小病延伸。职工医保在通过个人账户保障门诊小病的基础上,部分地区结合个人账户改革,探索开展普通门诊统筹。居民医保普遍建立了普通门诊统筹,依托基层医疗机构,主要保障常见病、多发病门诊医疗费用,支付比例在50%左右。”

国家医保局称,提案反映的部分地方门诊待遇较低的情况确实存在,这主要是因为目前我国基本医保的筹资能力,与全面满足人民群众的医保需要之间仍有距离,特别是居民医保,2018年人均筹资水平不到700元,有限的资金在保障住院大病医疗费用的同时,很难支撑对门诊的充分保障。

为进一步完善门诊保障待遇,国家医保局结合现有的门诊保障政策,研究制定了完善居民医保高血压糖尿病门诊用药保障机制的具体方案,正在指导地方抓紧落实。对于加强早诊早治、扩大门诊就医报销范围等具体建议,国家医保局也将充分考虑。

关于“扩大门诊就医报销的疾病范围”,国家医保局称,各地根据国家要求,把一些病期长、医疗费用高的慢特病纳入了统筹基金支付范围,如对恶性肿瘤放化疗、尿毒症透析、器官移植术后抗排异治疗、糖尿病患者胰岛素治疗、重性精神病人药物维持治疗等特殊疾病治疗和门诊日间手术等,参照住院进行管理和支付,以减轻患者负担。

我国基本医疗保险实行属地管理,筹资及待遇水平与当地经济发展和医疗消费水平相适应,各地纳入统筹基金支付范围的病种范围和认定标准也有所不同,多的地方有六十余种,少的地方有十余种。国家医保局将积极指导地方规范慢特病门诊保障工作,提升门诊待遇保障水平。

国家医保局回复,7位全国政协委员反映的“小病大治”的问题,据分析,既有门诊保障尚不完善的原因,也有部分医疗机构管理不严,住院标准不规范等原因。国家医保局将积极完善相关政策,在做好住院大病保障的基础上完善门诊待遇,同时抓住关键环节加强管理。一是配合有关部门严格入院指征管理,堵住随意住院的漏洞;二是完善医保支付方式,建立更科学的补偿机制,把该留在基层的病人留在基层;三是强化医保基金监管,持续保持打击欺诈骗保的高压态势。

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