China.org.cn | October 11, 2024
Farmers' Daily:
At the beginning of this year, the NHSA released major tasks concerning the one-stop government services in medical insurance. Can you tell us about the current progress made with these tasks? Thank you.
Zhang Ke:
Let us invite Mr. Yan to answer the question.
Yan Qinghui:
Thank you for your question. Since this year, the NHSA has implemented guiding principles from the State Council's relevant documents and has emphasized the integration of one-stop government services principle in all aspects of health care security work, effectively handling every matter to provide heartwarming services for enterprises and residents. Currently, the time for handling major tasks has been shortened with streamlined procedures and flexible forms. The insured population, pharmaceutical companies and medical institutions are all experiencing an enhanced sense of fulfillment from medical insurance services.
On the one hand, insured residents are experiencing improved services. Newborns can now be enrolled in medical insurance immediately upon birth, rather than waiting for household registration. Previously, newborns' households had to be registered before newborns could be enrolled in medical insurance, and medical expenses had to be paid out-of-pocket and then reimbursed at medical insurance windows later. Now, through data sharing, local medical departments can enroll newborns in the medical insurance system with just a birth certificate. The average time needed for enrollment and payment has been reduced to 6.4 working days from 28.7 working days at the beginning of the year. Medical expenses can now be directly reimbursed upon newborns' discharge from the hospital. Individual medical insurance accounts for urban employees have changed from individual ownership to family sharing. Through an online application, employees can add their parents, children, spouses and other close relatives to their accounts for shared use of their personal account funds. Currently, local governments are advancing work in this regard. From January to July of this year, the amount of individual medical insurance accounts shared among family members reached 22.7 billion yuan. It is projected that by the end of this year, individual accounts will be able to be shared among family members within the provincial-level administrative area where insurance is registered, and efforts will be made next year to promote cross-provincial practice. Particularly, on-the-spot settlement of cross-provincial medical expenses of outpatient services now covers 10 kinds of chronic and special diseases from the previous five. Taking varying diseases across different regions into consideration and to better meet people's needs for convenient cross-region medical services, we have included five diseases, namely chronic obstructive pulmonary disease, viral hepatitis, coronary heart disease, rheumatoid arthritis and ankylosing spondylitis, on top of the previous five kinds of diseases. By the end of this year, every district and county across China is planned to have at least one medical institution capable of cross-provincial on-the-spot settlement of medical expenses for these new types of diseases. In addition, we have shortened the average claim period for employee maternity benefits to be within 10 working days.
Second, we have taken more solid measures in medical security to facilitate the development of the pharmaceutical industry. In order to effectively address the concerns of pharmaceutical companies on some time-consuming procedures, such as coding medicines and publishing online notifications of centrally procured drugs, we have canceled the public notification procedure during the medicine coding process, while accepting complaints and appeals on a regular basis, so as to reduce the turnaround time for coding medicines covered by medical insurance from one month to one week. We have guided localities to unify the tendering and procurement information systems as well as product information standards, formulating a standardized service directory. We have also streamlined the operational procedures for centrally procured medical products to go through online public notification, reducing the turnaround time for such applications to fewer than 15 working days. In order to relieve the financial burden on medical institutions, we have taken timely settlement of eligible medical expenses as a prerequisite while streamlining the whole process. As a result, more than 90% of regions under unified management nationwide have realized monthly settlement of medical bills. We have also continued to implement the pre-payment mechanism. Medical insurance funds are prepaid to designated medical institutions at the beginning of each year to facilitate their development, with appropriate preference given to institutions that ensure better implementation of medical insurance policies.
That is all from me. Thank you.