九江社会 发表于 2023-11-14 10:47:21

全部纳入医保支付!江西下月起执行

<section data-role="outer" label="edit by 135editor"><p style="letter-spacing: 0.578px;white-space: normal;"><br/></p><section data-role="outer" label="edit by 135editor" style="letter-spacing: 0.578px;white-space: normal;"><section data-source="bj.96weixin.com" data-mpa-powered-by="yiban.io"><section><section><section><section><section><section><section><section data-role="outer" label="edit by 135editor"><section data-role="outer" label="edit by 135editor"><section data-role="outer" label="edit by 135editor"><section data-role="paragraph"><section data-role="outer" label="edit by 135editor"><section><section><section data-role="outer" label="edit by 135editor"><section data-role="outer" label="edit by 135editor"><section><section><section><section><section><section><section><section data-role="outer" label="edit by 135editor"><section data-role="outer" label="edit by 135editor"><section data-mpa-powered-by="yiban.io"><section><section data-width="100%"><section><section><section data-autoskip="1"><p style="text-align:center;outline: 0px;"><span style="font-size:18px;">11月13日</span></p><p style="text-align:center;outline: 0px;"><span style="font-size:18px;">记者从省医保局获悉</span></p><p style="text-align:center;outline: 0px;"><span style="outline: 0px;font-size: 20px;"><strong style="outline: 0px;"><span style="outline: 0px;color: #c00000;">4369项医疗服务项目</span></strong></span></p><p style="text-align:center;outline: 0px;"><span style="outline: 0px;font-size: 20px;"><strong style="outline: 0px;"><span style="outline: 0px;color: rgb(192, 0, 0);">纳入江西医保支付范围</span></strong></span></p><p style="text-align:center;outline: 0px;"><span style="font-size:18px;">其中甲类3009项</span></p><p style="text-align:center;outline: 0px;"><span style="font-size:18px;">乙类1360项</span></p><section data-role="outer" label="edit by 135editor" style="outline: 0px;"><section data-tools="135编辑器" data-id="135404" style="outline: 0px;"><section style="margin: 10px auto;padding: 10px 5px 10px 13px;outline: 0px;display: flex;flex-direction: column;"><section style="margin-bottom: -14px;margin-left: -15px;outline: 0px;width: 70px;z-index: 9;"><svg xmlns="http://www.w3.org/2000/svg" viewbox="0 0 116.281 72.97" style="display: block;"><path data-name="形状 5" style="fill: none;stroke: #ffd083;stroke-width: 4px;fill-rule: evenodd;" d="M19,936c39.787,2.739,14.917,61.315,54,65m38-29c2.082-11.478,11.56-16.829,20-12" transform="translate(-16.719 -934)"></path></svg></section><section style="outline: 0px;background-color: #5fa1f2;transform: rotate(3deg);-webkit-transform: rotate(3deg);-moz-transform: rotate(3deg);-o-transform: rotate(3deg);"><section style="padding: 10px 10px 10px 26px;outline: 0px;background-color: rgb(246, 246, 246);transform: rotate(-3deg);"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 14px;color: #333333;background-color: transparent;"><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;margin-top: 20px;"><span style="outline: 0px;font-size: 18px;">普通门诊、主任、副<span style="outline: 0px;letter-spacing: 0.578px;">主任、</span></span></p><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;"><span style="outline: 0px;letter-spacing: 0.034em;font-size: 18px;">专家、特殊专家门诊诊查费、</span></p><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;"><span style="outline: 0px;letter-spacing: 0.034em;font-size: 18px;">重症监护、新生儿护理、大抢救、</span></p><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;"><span style="outline: 0px;letter-spacing: 0.034em;font-size: 18px;">中抢救、小抢救、雾化吸入、</span></p><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;"><span style="outline: 0px;letter-spacing: 0.034em;font-size: 18px;">造瘘护理、洗胃、</span></p><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;"><span style="outline: 0px;letter-spacing: 0.034em;font-size: 18px;">磁共振心脏功能检查、</span></p><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;"><span style="outline: 0px;letter-spacing: 0.034em;font-size: 18px;">红外线乳腺检查、B超常规检查、</span></p><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;"><span style="outline: 0px;letter-spacing: 0.034em;font-size: 18px;">心脏彩色多普勒超声、血浆氨测定</span></p><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;"><span style="outline: 0px;letter-spacing: 0.034em;font-size: 18px;">甲状腺激素抑制显像、胃液常规检查、</span></p><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;"><span style="outline: 0px;letter-spacing: 0.034em;font-size: 18px;">各种穿刺液常规检查、微量元素测定等</span></p><p style="text-align:center;outline: 0px;letter-spacing: 0.578px;text-wrap: wrap;margin-bottom: 20px;"><span style="outline: 0px;color: #021eaa;font-size: 18px;"><strong style="outline: 0px;"><span style="outline: 0px;letter-spacing: 0.034em;">均纳入我省医保支付范围</span></strong></span></p></section></section></section></section></section></section><p style="text-align:center;outline: 0px;"></p><p style="text-align:center;outline: 0px;"><span style="outline: 0px;color: rgb(0, 0, 0);text-align: justify;caret-color: rgb(255, 0, 0);font-size: 18px;letter-spacing: 0px;font-family: 微软雅黑, sans-serif;">《江西省基本医疗保险医疗服务项目支付管理目录(2023年)》</span></p><p style="text-align:center;outline: 0px;"><span style="outline: 0px;color: rgb(127, 127, 127);font-size: 18px;letter-spacing: 0px;">(以下简称目录)</span></p><p style="text-align:center;outline: 0px;"><span style="outline: 0px;color: rgb(0, 0, 0);text-align: justify;caret-color: rgb(255, 0, 0);font-size: 18px;letter-spacing: 0px;font-family: 微软雅黑, sans-serif;">自<strong style="outline: 0px;"><span style="outline: 0px;color: rgb(192, 0, 0);letter-spacing: 0px;">12月1日零时起</span></strong></span></p><p style="text-align:center;outline: 0px;"><span style="outline: 0px;color: rgb(0, 0, 0);text-align: justify;caret-color: rgb(255, 0, 0);font-size: 18px;letter-spacing: 0px;font-family: 微软雅黑, sans-serif;">正式执行</span></p><section data-role="title" data-tools="135编辑器" data-id="135251" style="outline: 0px;"><section style="margin: 10px auto;outline: 0px;display: flex;justify-content: center;"><section style="outline: 0px;transform-style: preserve-3d;"><section style="margin-bottom: -10px;padding-right: 1em;padding-left: 1em;outline: 0px;display: flex;justify-content: space-between;transform: translateZ(7px);"><section style="outline: 0px;height: 15px;width: 6px;background-color: rgb(255, 226, 63);border-radius: 6px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="outline: 0px;height: 15px;width: 6px;background-color: rgb(255, 226, 63);border-radius: 6px;overflow: hidden;"><br style="outline: 0px;"/></section></section><section style="padding: 5px;outline: 0px;background-color: rgb(255, 247, 230);border-radius: 6px;transform: translateZ(1px);"><section style="padding: 5px 10px;outline: 0px;background-color: rgb(94, 168, 142);border-radius: 6px;"><p style="text-align:center;outline: 0px;font-size: 16px;color: #ffffff;"><span style="font-size:18px;"><strong data-brushtype="text" style="outline: 0px;">国家区域医疗中心建设</strong></span></p><p style="text-align:center;outline: 0px;font-size: 16px;color: #ffffff;"><span style="font-size:18px;"><strong data-brushtype="text" style="outline: 0px;">引进医疗服务项目纳入医保</strong></span></p></section></section></section></section></section><p style="outline: 0px;"><span style="font-size:18px;">&nbsp;&nbsp;</span></p><section data-role="title" data-tools="135编辑器" data-id="135244" style="outline: 0px;"><section style="margin: 10px auto;outline: 0px;"><section style="margin-right: 5px;margin-bottom: -5px;outline: 0px;display: flex;justify-content: flex-end;transform: translateZ(7px);-webkit-transform: translateZ(7px);-moz-transform: translateZ(7px);-o-transform: translateZ(7px);"><section style="outline: 0px;width: 24px;"><svg data-name="组 33" xmlns="http://www.w3.org/2000/svg" viewbox="0 0 39.969 18.907" style="display: block;"><g><path data-name="形状 1" style="fill: none;stroke: #ffe23f;stroke-linecap: round;stroke-linejoin: round;stroke-width: 5px;fill-rule: evenodd;" d="M423.491,482.043L415.5,488.59l7.993,7.363" transform="translate(-413 -479.531)"></path></g><g><path data-name="形状 1" style="fill: none;stroke: #ffe23f;stroke-linecap: round;stroke-linejoin: round;stroke-width: 5px;fill-rule: evenodd;" d="M436.481,482.043l-7.994,6.547,7.994,7.363" transform="translate(-413 -479.531)"></path></g><g><path data-name="形状 1" style="fill: none;stroke: #ffe23f;stroke-linecap: round;stroke-linejoin: round;stroke-width: 5px;fill-rule: evenodd;" d="M450.471,482.043l-7.994,6.547,7.994,7.363" transform="translate(-413 -479.531)"></path></g></svg></section></section><section style="padding: 20px 13px 10px;outline: 0px;background-color: rgb(255, 251, 242);border-radius: 6px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 14px;color: #333333;background-color: transparent;"><p style="max-inline-size: 100%;cursor: text;color: rgb(0, 0, 0);font-size: 17px;caret-color: rgb(255, 0, 0);text-indent: 2.1666em;font-family: 微软雅黑, sans-serif;outline: none 0px !important;"><span style="font-size: 18px;letter-spacing: 0px;">据悉,目录建立了医疗服务项目支付管理目录动态调整机制。支持全省定点医疗机构将质量安全可靠、临床价值高、参保群众急需的等反映医疗技术水平更新进步的医疗服务项目按程序申报纳入我省医保支付范围,实行动态受理、动态评审。</span></p><p style="max-inline-size: 100%;cursor: text;color: rgb(0, 0, 0);font-size: 17px;caret-color: rgb(255, 0, 0);text-indent: 2.1666em;font-family: 微软雅黑, sans-serif;outline: none 0px !important;"><span style="font-size: 18px;letter-spacing: 0px;">同时,将192个新增申报医疗服务项目动态评审纳入了医保支付范围,<span style="max-inline-size: 100%;cursor: text;color: rgb(192, 0, 0);letter-spacing: 0px;outline: none 0px !important;"><strong style="max-inline-size: 100%;cursor: text;outline: none 0px !important;">如“电子耳蜗植入术”“肢体肿瘤切除重建翻修术”等</strong>。</span>此外,支持国家区域医疗中心建设引进医疗服务项目纳入医保支付范围。已将我省7家国家区域医疗中心帮扶的<strong style="max-inline-size: 100%;cursor: text;outline: none 0px !important;"><span style="max-inline-size: 100%;cursor: text;color: rgb(192, 0, 0);letter-spacing: 0px;outline: none 0px !important;">心血管科、呼吸科、神经科、肿瘤科、中医科等10个临床科室涉及的1652项医疗服务项目纳入我省医保支付范围</span></strong>,其中甲类996项,乙类656项。</span></p><p style="max-inline-size: 100%;cursor: text;color: rgb(0, 0, 0);font-size: 17px;caret-color: rgb(255, 0, 0);text-indent: 2.1666em;font-family: 微软雅黑, sans-serif;outline: none 0px !important;"><span style="font-size: 18px;letter-spacing: 0px;">同时,优化医疗服务项目支付类别。为体现医务人员技术劳务价值,支持中医药传承创新发展,我省今年对赣州和在昌省直医疗机构调价的155个手术类项目、84个治疗类项目和23个中医类项目,共计262个医疗服务项目,由乙类支付调整为甲类支付。</span></p></section><section data-width="100%" style="margin-top: 8px;outline: 0px;width: 651px;border-top: 1px solid rgb(96, 191, 140);height: 1px;overflow: hidden;"><br style="outline: 0px;"/></section></section></section></section><section data-role="title" data-tools="135编辑器" data-id="135251" style="outline: 0px;"><section style="margin: 10px auto;outline: 0px;display: flex;justify-content: center;"><section style="outline: 0px;transform-style: preserve-3d;"><section style="margin-bottom: -10px;padding-right: 1em;padding-left: 1em;outline: 0px;display: flex;justify-content: space-between;transform: translateZ(7px);"><section style="outline: 0px;height: 15px;width: 6px;background-color: rgb(255, 226, 63);border-radius: 6px;overflow: hidden;"><br style="outline: 0px;"/></section><section style="outline: 0px;height: 15px;width: 6px;background-color: rgb(255, 226, 63);border-radius: 6px;overflow: hidden;"><br style="outline: 0px;"/></section></section><section style="padding: 5px;outline: 0px;background-color: rgb(255, 247, 230);border-radius: 6px;transform: translateZ(1px);"><section style="padding: 5px 10px;outline: 0px;background-color: rgb(94, 168, 142);border-radius: 6px;"><p style="text-align:center;outline: 0px;font-size: 16px;color: #ffffff;"><span style="font-size:18px;"><strong data-brushtype="text" style="outline: 0px;">各种美容、非功能性整容等</strong></span></p><p style="text-align:center;outline: 0px;font-size: 16px;color: #ffffff;"><span style="font-size:18px;"><strong data-brushtype="text" style="outline: 0px;">医保均不予支付</strong></span></p></section></section></section></section></section><p style="outline: 0px;"><span style="font-size:18px;">&nbsp;&nbsp;</span></p><section data-role="title" data-tools="135编辑器" data-id="135244" style="outline: 0px;"><section style="margin: 10px auto;outline: 0px;"><section style="margin-right: 5px;margin-bottom: -5px;outline: 0px;display: flex;justify-content: flex-end;transform: translateZ(7px);-webkit-transform: translateZ(7px);-moz-transform: translateZ(7px);-o-transform: translateZ(7px);"><section style="outline: 0px;width: 24px;"><svg data-name="组 33" xmlns="http://www.w3.org/2000/svg" viewbox="0 0 39.969 18.907" style="display: block;"><g><path data-name="形状 1" style="fill: none;stroke: #ffe23f;stroke-linecap: round;stroke-linejoin: round;stroke-width: 5px;fill-rule: evenodd;" d="M423.491,482.043L415.5,488.59l7.993,7.363" transform="translate(-413 -479.531)"></path></g><g><path data-name="形状 1" style="fill: none;stroke: #ffe23f;stroke-linecap: round;stroke-linejoin: round;stroke-width: 5px;fill-rule: evenodd;" d="M436.481,482.043l-7.994,6.547,7.994,7.363" transform="translate(-413 -479.531)"></path></g><g><path data-name="形状 1" style="fill: none;stroke: #ffe23f;stroke-linecap: round;stroke-linejoin: round;stroke-width: 5px;fill-rule: evenodd;" d="M450.471,482.043l-7.994,6.547,7.994,7.363" transform="translate(-413 -479.531)"></path></g></svg></section></section><section style="padding: 20px 13px 10px;outline: 0px;background-color: rgb(255, 251, 242);border-radius: 6px;"><section data-autoskip="1" style="outline: 0px;line-height: 1.75em;letter-spacing: 1.5px;font-size: 14px;color: #333333;background-color: transparent;"><p style="max-inline-size: 100%;cursor: text;color: rgb(0, 0, 0);font-size: 17px;caret-color: rgb(255, 0, 0);text-indent: 2.1666em;font-family: 微软雅黑, sans-serif;outline: none 0px !important;"><span style="font-size: 18px;letter-spacing: 0px;">我省在医疗服务项目支付管理目录调整上坚持“尽力而为、量力而行”,在全国较早将医疗服务项目支付管理目录更新到2023年版。我省牢牢把握“保基本”的功能定位。医保医疗服务项目的准入、调整、退出始终坚持对参保群众看病就医急需的医疗服务项目“应纳尽纳”,对一些非临床诊疗必需、效果不确定的医疗服务项目以及属于特需的医疗服务项目,<strong style="max-inline-size: 100%;cursor: text;outline: none 0px !important;"><span style="max-inline-size: 100%;cursor: text;color: rgb(192, 0, 0);outline: none 0px !important;">如各种美容、非功能性整容、矫形手术、减肥、增胖、增高、健康体检等,我省医保均不予支付。</span></strong><br style="box-sizing: content-box;max-inline-size: 100%;list-style-type: none;font-size: 16px;white-space: pre-wrap;background-color: #ffffff;outline: none !important;font-family: 宋体;"/>&nbsp;&nbsp;</span></p><p style="max-inline-size: 100%;cursor: text;color: rgb(0, 0, 0);font-size: 17px;caret-color: rgb(255, 0, 0);text-indent: 2.1666em;font-family: 微软雅黑, sans-serif;outline: none 0px !important;"><span style="font-size: 18px;letter-spacing: 0px;">同时,做好医保基金支付管理风险预判。利用医保信息平台大数据支持,及时做好政策调整基金影响测算。经测算,我省今年新增纳入医保支付范围医疗服务项目、支付类别由乙类调整为甲类医疗服务项目和部分价格调整同步协同医保支付的医疗服务项目,预计医保基金每年增加支出共约9.64亿元,属于安全可控范围。</span></p><p style="max-inline-size: 100%;cursor: text;color: rgb(0, 0, 0);font-size: 17px;caret-color: rgb(255, 0, 0);text-indent: 2.1666em;font-family: 微软雅黑, sans-serif;outline: none 0px !important;"><span style="font-size: 18px;letter-spacing: 0px;">此外,做到医疗服务项目目录和支付管理目录政策衔接协同。医保医疗服务项目支付管理与价格管理实行政策衔接,针对部分已淘汰落后、参保群众使用较少的医疗服务项目,经医疗服务项目价格管理按规定废止后,同步调出我省医保支付范围。</span></p><p style="max-inline-size: 100%;cursor: text;color: rgb(0, 0, 0);font-size: 17px;caret-color: rgb(255, 0, 0);text-indent: 2.1666em;font-family: 微软雅黑, sans-serif;outline: none 0px !important;"><span style="font-size: 18px;letter-spacing: 0px;">同时,我省将对费用高、用量大的医疗服务项目进行重点监控和分析,确保基金安全。完善智能监控系统,采取措施促进定点医疗机构合理检查、合理治疗,不断完善医疗服务项目费用审核办法,严格医疗服务项目费用支付管理,将定点医疗机构执行使用情况纳入定点服务协议管理和考核范围。</span></p></section><section data-width="100%" style="margin-top: 8px;outline: 0px;width: 651px;border-top: 1px solid rgb(96, 191, 140);height: 1px;overflow: hidden;"><br style="outline: 0px;letter-spacing: 0.544px;text-wrap: wrap;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;"/></section></section></section></section><p style="margin-top: 15px;margin-bottom: 15px;outline: 0px;letter-spacing: 0.544px;text-wrap: wrap;background-color: rgb(255, 255, 255);text-indent: 2em;line-height: 1.75em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;"><span style="font-size:18px;"><strong style="outline: 0px;"><span style="outline: 0px;color: rgb(255, 255, 255);background-color: rgb(255, 0, 0);">温馨提醒:</span></strong></span></p><p style="margin-top: 15px;margin-bottom: 15px;outline: 0px;letter-spacing: 0.544px;text-wrap: wrap;background-color: rgb(255, 255, 255);text-indent: 2em;line-height: 1.75em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;"><span style="font-size: 18px;letter-spacing: 0px;">参保群众如何知悉医疗服务项目是否属于江西医保支付范围?登录江西省医疗保障局门户网址(网址:http://ybj.jiangxi.gov.cn/),在“政策法规”栏目找到《江西省医疗保障局关于印发〈江西省基本医疗保险医疗服务项目支付管理目录(2023年)〉的通知》(赣医保字〔2023〕32号),打开附件《江西省基本医疗保险医疗服务项目支付管理目录(2023年)》,根据相关医疗服务项目的名称或编码等查询对应的医保支付政策。定点医疗机构为参保群众提供了目录范围内医疗服务,我省医保可按规定进行支付。</span></p><p style="text-align:center;margin-top: 15px;margin-bottom: 15px;outline: 0px;letter-spacing: 0.544px;text-indent: 0em;text-wrap: wrap;background-color: rgb(255, 255, 255);line-height: 1.75em;font-family: system-ui, -apple-system, BlinkMacSystemFont, Arial, sans-serif;"><br style="outline: 0px;border-width: 0px;border-style: initial;border-color: initial;line-height: 20px;"/><span style="outline: 0px;color: #7f7f7f;font-size: 14px;">▲江西省基本医疗保险医疗服务项目支付管理目录(2023年)</span></p></section></section></section></section></section></section><section><br/></section></section><section data-role="outer" label="edit by 135editor" style="letter-spacing: 0.578px;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Arial, sans-serif;"><section style="outline: 0px;text-align: center;"></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section></section><section data-role="outer" label="edit by 135editor" style="letter-spacing: 0.578px;"><section data-role="paragraph"><section data-role="outer" label="edit by 135editor"><section><section data-role="outer" label="edit by 135editor"><section><section data-role="outer" label="edit by 135editor"><section data-role="paragraph"><section data-role="paragraph"><section data-role="outer" label="Powered by 135editor.com"><section data-role="paragraph"><section 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运动 发表于 2023-11-14 10:51:24

原本就应该的,有异议吗?
页: [1]
查看完整版本: 全部纳入医保支付!江西下月起执行