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央广网沈阳8月11日消息(记者徐志强)记者日前在锦州市新农合管理中心了解到,为完善锦州市新农合制度,切实保障慢性病患者的基本医疗,减轻参合人员的负担,实现城乡居民公平享有基本医疗保险权益,锦州市新农合今年开始首次实行门诊特慢病补偿待遇。只要符合条件的新农合特慢病参保者在定点医疗机构门诊就诊,可享受一定数额的药费报销。
据了解,锦州市按逐级转诊的有关规定,在省、市、县级定点医疗机构实行新农合门诊特慢病补偿制度。将恶性肿瘤放化疗、尿毒症透析(腹透和血透)、冠心病(心绞痛型、心肌梗塞型)、高血压(Ⅲ期)、糖尿病(具有合并症及并发症)、结核病、慢性病毒性肝炎(抗病毒治疗)、血友病、类风湿性关节炎及强直性脊柱炎、系统红斑狼疮、儿童苯丙酮尿症、再生障碍性贫血病种纳入新农合门诊特慢病补偿范围。
在新农合门诊特慢病报销比例、补偿标准方面,恶性肿瘤门诊放化疗、尿毒症透析(腹透和血透)、血友病、再生障碍性贫血、各种器官和组织移植术后门诊排异治疗的门诊治疗费用,按省、市、县级相应级别定点医院住院补偿标准报销。对患有结核病、精神病、法定传染病的参合农民在市、县两级定点专科医疗机构就诊的,其门诊医药费按50%补偿比例报销,补偿封顶线2000元。
按照要求,各县(市)区卫计局将指定1—2家县级公立医院为特慢病的鉴定医院,患者需提供3年内的相关病例资料或到特慢病鉴定医院进行鉴定。各县(市)区新农合管理中心根据鉴定医院的鉴定结果,对已鉴定为特慢病的患者在其《新农合就诊手册》首页上加盖“特慢病管理专用章”并注明病种,特慢病患者需携带加盖“特慢病管理专用章”的就诊手册就诊,可享受特慢病相关补偿政策。特慢病复查周期为3年,经复查后确定为特慢病的可继续享受特慢病相关补偿政策。
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