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国家卫计委:6月底前开展新农合跨省就医结报

2017-05-13 13:56:14   

原标题:卫计委:6月底前开展新农合异地就医联网结报工作

国家卫计委要求,2017年6月底前,各省份均要开展跨省就医患者转诊和结报工作。定点医疗机构尤其是委管(属)医院要设定指定窗口,开始为规范转诊患者提供直接结报服务。

国家卫计委5月11日在北京召开委属(管)医院新农合异地就医联网结报工作现场推进会,并通报了此前全国新农合异地就医联网结报工作进展情况。国家卫计委要求,2017年6月底前,各省份均要开展跨省就医患者转诊和结报工作。

此前,国家卫计委办公厅在4月12日发布《关于加快推进城乡居民基本医疗保险(新型农村合作医疗)跨省就医联网结报工作的通知》,要求各地卫生计生委和定点医疗机构要成立领导小组,负责异地就医结报工作的组织领导、统筹规划、综合协调、宏观管理等工作。

根据国家卫计委在会上公布的最新数据显示,新农合异地就医联网工程已联通8个省份,(辽宁、吉林、安徽、海南、四川、贵州、陕西、甘肃)136家医疗机构,正式签约定点医疗机构290家。截至5月11日,共有17家医疗机构开始提供跨省就医联网结报服务,其中部委属(管)医院4家,已提供800余例跨省就医即时结报服务。吉林、海南、四川、贵州、陕西五个省份已实现转入患者和转出患者双向结算。

(现场展示国家新型农村合作医疗跨省就医即时结报系统。摄影:夏志诚)

国家卫计委副主任马晓伟在会议上指出,目前,跨省就医异地结算联网工作中主要存在的问题有三个。第一,部分医疗机构在参与联网结报的积极性,主动性不高,联通接口改造较慢,医保、信息、财务等部门之间的写作机制有待加强。第二,部分省份尚未建立省级结算账户,缺乏规范的转诊流程,个别身份尚未统一跨省就医结报政策;第三,宣传工作不到位,各级定点医疗机构以及患者对政策的知晓度不高。

马晓伟要求,各地在完善分级诊疗制度的基础上,要尽快健全新农合异地就医转诊制度,保障合情合理的异地就医需求。提高参合患者对异地就医结报政策的知晓率和依从度,引导群众及时、主动地办理相关的转诊手续,及时澄清认识误区,合理引导社会预期。同时,各地卫生计生行政部门要将新农合异地就医结报工作纳入医改目标考核和定点医疗机构考核评价体系,建立健全的绩效考核和问责机制,严肃问责工作推进不力的地区和个人。

国家卫计委基层卫生司司长李滔强调,2017年5月底前,各省份新农合信息平台、定点医疗机构信息系统和国家新农合信息平台要实现互联互通。2017年6月底前,各省份均要开展跨省就医患者转诊和结报工作。定点医疗机构尤其是委预算管理医院要设定指定窗口,开始为规范转诊患者提供直接结报服务。2017年7月起,国家卫计委将定期对各省异地就医结报工作进行实地考察和相关考核。

来源:界面新闻

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