Reimbursement of hospitalization expenses of new rural cooperative medical system in 2020

In 2020, the scope of reimbursement for hospitalization of the new rural cooperative medical system includes the following contents: (1) Drug expenses: supplementary examination: 200 yuan for examination expenses such as electrocardiogram, X-ray, radiography, laboratory tests, physiotherapy, acupuncture, CT and nuclear magnetism; Surgical expenses (refer to the national standard, reimbursement exceeding 1000 yuan 1000 yuan). (2) The elderly over 60 years old are hospitalized in Xingta Town Health Center, and the daily treatment and nursing expenses are compensated 10 yuan, with the limit of 200 yuan.

In 2020, the reimbursement standard for hospitalization of the new rural cooperative medical system: (1) town hospitals will reimburse 60%; (2) 40% reimbursement for secondary hospitals; (3) 30% reimbursement for tertiary hospitals.

The compliance medical expenses above the deductible line of the new rural cooperative medical system are below 50,000 yuan (including 50,000 yuan), and the payment ratio is 50%; 50,000 yuan to 6,543,800 yuan (including 6,543,800 yuan), and the payment ratio is 55%; 654.38+100000 yuan, 60%. The proportion of payment is determined according to the level of medical expenses. In principle, the higher the medical expenses, the higher the proportion of payment, and try to reduce the burden of personal medical expenses.

Legal basis: Notice on opinions on establishing new rural cooperative medical system. fund management

Rural cooperative medical fund is a private social fund with voluntary contributions from farmers, collective support and government contribution. Management should be carried out in accordance with the principles of revenue and expenditure, balance of payments and openness, fairness and justice. Must be earmarked, special storage, shall not be misappropriated.

(a) the rural cooperative medical fund is managed by the rural cooperative medical management committee and its dispatched offices. Rural cooperative medical care agencies should set up special accounts for rural cooperative medical care funds in state-owned commercial banks recognized by the CMC to ensure the safety and integrity of funds, establish and improve the rules and regulations for the management of rural cooperative medical care funds, reasonably raise and timely review and pay rural cooperative medical care funds according to regulations.

(II) The individual contributions of farmers and the funds supported by rural collective economic organizations in the rural cooperative medical fund shall, in principle, be collected annually by the agency (personnel) established by the rural cooperative medical service agency in the township (town) or entrusted by relevant institutions and deposited in the special account of the rural cooperative medical fund; Local financial support funds are allocated to the special account of rural cooperative medical fund by local financial departments at all levels according to the actual number of people participating in the new rural cooperative medical system; The special funds for the central government to subsidize the new rural cooperative medical system in the central and western regions shall be approved by the Ministry of Finance according to the actual number of people participating in the new rural cooperative medical system in each region and the availability of funds, and allocated to the provincial finance. The central and local governments at all levels should ensure that the subsidy funds are allocated to the special account of rural cooperative medical care fund in time and in full, and gradually improve the allocation method of subsidy funds through the pilot project of new rural cooperative medical care, simplifying the procedures as much as possible and facilitating the operation. It is necessary to combine the reform and improvement of the financial treasury management system and gradually realize direct financial payment. The specific subsidy measures for new rural cooperative medical care funds shall be studied and formulated by the Ministry of Finance in consultation with relevant departments.

(three) the rural cooperative medical fund is mainly used to subsidize the large medical expenses or hospitalization expenses of farmers participating in the new rural cooperative medical system. Where conditions permit, a combination of large medical expenses subsidies and small medical expenses subsidies can be implemented, which not only improves the ability to resist risks, but also takes into account the interests of farmers. Arrange a routine physical examination for farmers who have participated in the new rural cooperative medical system and have not used the rural cooperative medical fund during the year. All provinces, autonomous regions and municipalities directly under the central government should formulate a list of basic drugs for reimbursement of rural cooperative medical care. Counties (cities) should scientifically and reasonably determine the payment scope, payment standard and amount of rural cooperative medical fund according to the total amount of funds raised and local conditions, and determine the specific inspection items and methods of routine physical examination to prevent the rural cooperative medical fund from overspending or excessive balance.

(four) to strengthen the supervision of rural cooperative medical fund. Rural cooperative medical institutions should regularly report to the rural cooperative medical management committee on the income and expenditure and use of rural cooperative medical funds; Take measures such as posting, regularly announce the specific income and expenditure and use of rural cooperative medical fund to the society, and ensure the participation, information and supervision rights of participating farmers. The people's government at the county level may, according to local conditions, set up a rural cooperative medical supervision committee composed of relevant government departments and farmers' representatives who participate in the cooperative medical system, and regularly inspect and supervise the use and management of rural cooperative medical funds. The rural cooperative medical management committee shall regularly report its work to the supervision committee and the people's congress at the same level, and take the initiative to accept supervision. The audit department shall regularly audit the income and expenditure and management of the rural cooperative medical fund.