New medical policy of Pingdingshan in 2023

Pingdingshan's new medical policy in 2023 is as follows:

1. Expanded the scope of medical personnel in different provinces. Before the reform, there were four types of personnel: resettling retirees in different places; Living in a different place for a long time; Living in different places; Referral of medical staff from different places.

2. The validity period of medical records in different provinces and places is different. After the inter-provincial resident population is registered and put on record, the record is valid for a long time, and the number of visits is not limited.

3. It is clear that the inter-provincial reimbursement policy for temporary medical personnel can be lower than the reimbursement level of medical institutions at the same level in the insured area. In principle, the payment proportion of off-site referral personnel and off-site emergency rescue personnel shall not be reduced by 10 percentage point, and the payment proportion of non-emergency and non-referral other inter-provincial temporary visits shall not be reduced by 20 percentage points.

Conditions for applying for medical treatment in different places:

Insured persons who meet one of the following conditions may apply for medical treatment in different places:

1. Insured retirees who leave the insured place and live in different places for a long time across the overall planning area and obtain household registration according to the household registration management regulations;

2. The insured who has worked and lived in a different place for more than 3 months (including 3 months) for a long time;

3. The insured who has been on business trip, studying, visiting relatives and taking vacations for less than 3 months and needs treatment for sudden illness;

4. Insured persons who need to be hospitalized outside the overall planning area due to the limitation of medical technical conditions in the overall planning area.

Insured persons who meet the requirements of medical treatment in different places should apply to the Municipal Social Security Bureau for medical treatment in different places and choose 3 or less designated medical institutions in different places for outpatient treatment and hospitalization in designated medical institutions outside the insured place. Provide the following materials in the transfer window:

1, resettle in different places, fill in the Registration Form for Medical Treatment in Different Places of Basic Medical Insurance and provide proof of residence registration;

2, working or living in different places, fill in the "basic medical insurance for medical treatment in different places for the record registration form", and provide the work certificate issued by the insured unit or the residence certificate issued by the community neighborhood Committee;

3, remote emergency, should be within 3 working days after admission, by the insured himself or entrust others to submit paper materials to the Municipal Social Security Bureau;

4, referral, need to provide the designated medical institutions designated by the insured issued by the "basic medical insurance as a whole diagnosis and treatment audit form".

To sum up, with the continuous improvement of medical conditions, regional clinics have been unable to treat serious diseases and need to be transferred for treatment.

Legal basis:

Article 23 of People's Republic of China (PRC) Social Insurance Law

Employees should participate in the basic medical insurance for employees, and employers and employees should pay the basic medical insurance premiums in accordance with state regulations. Individual industrial and commercial households without employees, part-time employees who have not participated in the basic medical insurance for employees and other flexible employees can participate in the basic medical insurance for employees, and individuals pay the basic medical insurance premium in accordance with state regulations.