Three departments： In 2022, 30 yuan will be added to the per capita financial subsidy standard for residents’ medical insurance participation.

CCTV News:According to the website of the National Medical Insurance Bureau on July 8, the National Medical Insurance Bureau, the Ministry of Finance and State Taxation Administration of The People’s Republic of China recently issued a notice on doing a good job in the basic medical security for urban and rural residents in 2022. In order to implement the decision-making arrangements of the CPC Central Committee and the State Council and the relevant task requirements of the Government Work Report in 2022, further deepen the reform of the medical security system, and promote the high-quality development of medical security to achieve new results, we are hereby notified as follows:

First, raise the financing standard reasonably.

In order to adapt to the increase in medical expenses and the demand for basic medical care, and ensure the medical insurance rights and interests of the insured, in 2022, we will continue to raise the financing standard of basic medical insurance for urban and rural residents (hereinafter referred to as "residents’ medical insurance"). Finance at all levels will continue to increase subsidies for residents’ medical insurance participation, and the per capita financial subsidy standard will be added to 30 yuan, reaching not less than 610 yuan per person per year, while the individual payment standard will be raised to 30 yuan, reaching 350 yuan per person per year. The central government will continue to provide subsidies to local governments in different grades according to regulations. The western and central regions will be subsidized according to the per capita financial subsidy standard of 80% and 60% respectively, and the eastern provinces will be subsidized according to a certain proportion respectively. Co-ordinate arrangements for urban and rural residents’ serious illness insurance (hereinafter referred to as "serious illness insurance") funds to ensure that the funding standards and treatment levels are not reduced. Explore the establishment of a dynamic financing mechanism linked to residents’ medical insurance financing standards and per capita disposable income, and further optimize the financing structure. Let go of the restrictions on the household registration of flexible employees such as employees with new employment forms. Earnestly implement the "Provisional Regulations on Residence Permit", which stipulates that those who hold residence permits to participate in local residents’ medical insurance should be subsidized according to the same standards as local residents.

Second, consolidate and improve the level of treatment

It is necessary to adhere to the principle of "fixed income and expenditure, balanced income and expenditure, and slight surplus", do our best and do what we can, give full play to the comprehensive security efficiency of the triple system of basic medical insurance, serious illness insurance and medical assistance, and scientifically and reasonably determine the level of basic medical insurance. Stabilize the level of residents’ medical insurance hospitalization treatment and ensure that the proportion of fund payment is stable at around 70% within the scope of the policy. We will improve outpatient safeguard measures, continue to ensure the use of drugs in outpatients with hypertension and diabetes, and improve the protection of chronic diseases and special diseases (hereinafter referred to as "chronic and special diseases in outpatients"). Strengthen the outpatient support function of serious illness insurance and medical assistance, explore the inclusion of high outpatient medical expenses within the policy scope in the calculation of compliance medical expenses of serious illness insurance, coordinate the use of outpatient and inpatient assistance funds, and share the annual assistance limit. Reasonably improve the level of medical insurance and maternity medical expenses for residents, effectively support the three-child birth policy, reduce the burden of maternity medical expenses, and promote the long-term balanced development of the population.

Third, earnestly grasp the bottom line of people’s livelihood security

It is necessary to consolidate and expand the achievements of medical security in getting rid of poverty, consolidate the function of medical assistance, and resolutely hold the bottom line of not returning to poverty on a large scale due to illness. We will continue to do a good job in medical assistance to the needy people to participate in the classified funding of individual contributions for residents’ medical insurance, fully subsidize the extremely poor people, and subsidize the low-income recipients and the poor people who return to poverty. Make overall plans to improve the efficiency of the use of medical assistance funds, make full use of the policies of subsidizing insurance and direct assistance, and ensure that all resources should be used and all resources should be saved. We will improve the long-term mechanism for preventing and resolving poverty caused by returning to poverty due to illness, and improve the working mechanisms such as dynamic monitoring of insurance participation, early warning of patients with high expenses, information sharing among departments, and collaborative risk disposal to ensure early detection, early prevention and early assistance of risks. We will improve the mechanism of applying for assistance, provide classified assistance to people in need who have been identified and approved by relevant departments, and timely implement the medical assistance policy. For the needy people who are still heavily burdened with personal expenses after the triple system guarantee, we should do a good job of connecting with temporary assistance and charitable assistance, accurately implement hierarchical and classified assistance, and work together to prevent the risk of poverty caused by returning to poverty due to illness.

Fourth, promote the unification of institutional norms

We must resolutely implement the medical insurance treatment list system, standardize the decision-making authority, promote the unification of system norms, and enhance the balance and coordination of the development of the medical insurance system. In strict accordance with the requirements of the "Three-year Action Plan for Implementing the Medical Security Treatment List System (2021-2023)", the institutional framework of all the overall planning areas will be unified by the end of 2022, and 40% of the overall planning areas will complete the clean-up of off-list policies. Adhere to the principle of steady and steady progress, establish first and then break, make overall plans for connecting funds and benefits, and promote functional integration. Promote the basic unification of the scope of medical insurance drugs in the country. Gradually standardize and unify policies such as the scope of chronic and special diseases in basic medical insurance clinics in the province. Strengthen overall planning and coordination, and steadily promote provincial-level overall planning in accordance with the direction of unified and standardized policies, balanced fund adjustment, improved hierarchical management, strengthened budget assessment, and improved management services. Employee medical insurance and resident medical insurance can be promoted in a classified and orderly manner. It is necessary to strictly implement the reporting system for major decisions, major issues and major issues, and implement new situations, new problems and major policy adjustments in a timely manner after reporting. The implementation of the medical insurance treatment list system in each province will be included in the relevant work performance appraisal.

Five, do a good job in medical insurance payment management

It is necessary to strengthen the management of medical insurance drug list, do a detailed "dual-channel" management of negotiated drugs, and strengthen the supply guarantee and landing monitoring of negotiated drugs. Do a good job in the pilot work of medical insurance payment standards and strengthen monitoring. By the end of June 2022, the digestion of the original self-supplemented drugs in each province will be completed. Standardize the medical insurance access management of ethnic medicines, preparations of medical institutions, Chinese herbal pieces and Chinese herbal formula granules. Improve the management of medical consumables and medical services in medical insurance. Continue to promote the reform of medical insurance payment methods, solidly implement the "Three-year Action Plan for the Reform of DRG/DIP Payment Methods", accelerate the reform of DRG/DIP payment methods, and cover at least 40% of the overall planning areas in the jurisdiction. Explore outpatient payment by head, promote the reform of TCM medical insurance payment methods, and explore TCM diseases to pay by disease score. We will improve the designated management of medical security in medical institutions and retail pharmacies, strengthen the medical insurance management of "internet plus" medical services, and smooth the links of follow-up, drug collection and distribution.

Six, strengthen the centralized procurement and price management of pharmaceutical consumables.

It is necessary to promote the centralized procurement of drugs and medical consumables in an all-round and multi-level way, and coordinate and carry out centralized procurement by national organizations and inter-provincial alliances. By the end of 2022, the number of national and provincial (or inter-provincial alliance) centralized drug varieties was not less than 350, and the number of high-value medical consumables reached more than 5. Do a good job in the implementation of centralized purchasing results and the continuation of the purchase agreement when it expires, and implement supporting policies such as prepayment of medical insurance funds, coordination of payment standards, and retention of balances. Improve and improve the functions of the centralized pharmaceutical collection platform, strengthen performance evaluation, improve the online collection rate of public medical institutions, and promote online settlement. We will steadily and orderly promote the deepening of the pilot reform of medical service prices, and guide and urge the overall planning areas to do a good job in price adjustment evaluation and dynamic adjustment in 2022. Start the medical price monitoring project, compile the medical price index, strengthen the normalization supervision of the prices of drugs and medical consumables, and continue to promote the implementation of the credit evaluation system for medical prices and recruitment.

Seven, strengthen the fund supervision and operation analysis.

It is necessary to speed up the construction and improvement of the medical insurance fund supervision system and law enforcement system, promote the establishment of an incentive and accountability mechanism, and incorporate the work of combating fraud and insurance fraud into the relevant work assessment. Continue to carry out special rectification actions to crack down on fraud and insurance fraud, and constantly expand the breadth and depth of special rectification actions. We will improve the supervision linkage mechanism led by the medical insurance department and involving multiple departments, improve the working systems of information sharing, coordinated law enforcement, joint defense linkage, execution linkage and discipline linkage, promote the coordinated use of comprehensive supervision results, and form a fund supervision work pattern of multiple investigations in one case, multiple cases in one case and joint management.

It is necessary to do a good job in fund budget performance management as required and improve revenue and expenditure budget management. Comprehensive aging population, chronic diseases and other disease spectrum changes, the application of new medical technology, the increase of medical expenses and other factors, to carry out the fund income and expenditure forecast analysis, improve the risk early warning, evaluation, resolution mechanism and plan, and effectively prevent and resolve the fund operation risks.

Eight, improve the medical insurance public management services.

It is necessary to enhance the public service capacity of primary medical security and strengthen the handling power of medical security. We will fully implement the list and operational norms of handling government affairs services, promote the standardization of medical security government services, and improve the level of medical insurance convenience services. Fully implement the basic medical insurance management procedures, strengthen source control and repeated insurance management, and promote "one thing to participate in insurance" at a time. Optimize the insurance payment service, adhere to the parallel innovation of intelligent online payment channels and traditional offline payment methods, and continuously improve the level of payment facilitation. We will fully implement the interim measures for the transfer and continuation of the basic medical insurance relationship, and continue to do a good job in the transfer and continuation of "inter-provincial communication". Actively participate in the promotion of the "one thing for birth" joint office. Continue to do a good job in the settlement and liquidation of COVID-19 patients’ medical expenses, COVID-19 vaccines and vaccination expenses. By the end of 2022, at least one designated medical institution with inter-provincial networking for general outpatient expenses will be opened in each county, and five inter-provincial direct settlement services for outpatient chronic and special diseases such as hypertension, diabetes, radiotherapy and chemotherapy for malignant tumors, uremia dialysis and anti-rejection treatment after organ transplantation will be opened in all co-ordination areas.

Nine, promote standardization and information construction

It is necessary to continue to deepen the application of the unified national medical insurance information platform and give full play to the platform’s effectiveness. Comprehensively deepen the maintenance and application of business coding standards, and establish an assessment mechanism for standard application. Establish a sound information system operation and maintenance management and security management system, and explore the establishment of information sharing mechanism. Give full play to the role of national integrated government service platform, commercial banks, government applications and other channels, and explore cooperation mechanisms in the fields of inter-provincial medical records and medical insurance electronic certificate activation application.

Ten, do a good job in organizing the implementation

It is necessary to further improve the political position, strengthen the responsibility, compact the work responsibility, ensure that all policies and measures for medical security for urban and rural residents are effective, and continue to promote security and improve people’s livelihood. Medical and social security departments at all levels should strengthen overall coordination, strengthen departmental coordination, do a good job in the implementation and management of residents’ medical insurance benefits, the financial department should arrange financial subsidies in full and allocate them in time according to regulations, the tax department should do a good job in the collection of individual contributions for residents’ medical insurance, facilitate the masses to pay, and strengthen work linkage and information communication among departments. It is necessary to further intensify policy propaganda, popularize the concepts of mutual assistance, responsibility sharing, joint construction and sharing in medical insurance, enhance people’s awareness of insurance payment, reasonably guide social expectations, and do a good job in coping with public opinion risks.

I hereby inform you.