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报销药品目录明年各区“一个样”

2017-08-22 05:16:47   中国青年网

城镇居民医保和新农合正在整合统一

报销药品目录明年各区“一个样”

记者杨荣峰

网民:我年初在武钢二医院开药,向医生明确说明重症可报销药物,医生也表示可以报销。累计开药1000多元,结果都无法报销。医生弄错报销范围给我造成的损失,希望医院能够承担。

【记者探访】

误买1000多元不能报销的药

市民胡先生的父亲身患重病,需要长期吃药。今年3月开始,胡先生定期到武钢二医院为父亲开药。

3月20日,医生欲给胡先生的父亲开三七舒通胶囊,胡先生咨询医生,该药是否在新农合医保报销范围内,医生称该药可以报销。胡先生便放心地划价开药,随后又3次前往武钢二医院开药。这4次三七舒通胶囊的费用共计1035.81元。

近期,胡先生拿着4次开药的发票,前往化工区政务服务中心报销,但被新农合窗口工作人员告知,三七舒通胶囊不能报销。

胡先生很恼火,“自己家里条件本就不好,却被误导自费买了1000多元的药品”。为了弄清楚缘由,胡先生留言投诉。

【部门办理】

医院退还应该报销的费用

武钢二医院客服部相关负责人介绍,对于胡先生的遭遇,医院深感抱歉,愿意补偿胡先生的损失。4次三七舒通胶囊的费用共计1035.81元,其中诊疗费13.5元不能报销,农合报销比例是60%,报销金额应为613.39元。医院愿返还胡先生613.39元。胡先生已将购药发票交给医院,可在工作日到医院签字领取。

对于医生的疏漏,这位负责人介绍,目前,武汉市各区的新农合报销药品目录没有统一,虽然各区目录中大部分药品都一样,但少数药品却不相同。武钢二医院的病人来自武汉各个区域,对于同一种药,办理了蔡甸区新农合的病人可以报销,但办理了洪山区新农合的病人却不一定能报销。医生给胡先生开药时,记混了各区的药品目录,因此给胡先生造成了损失。

记者从市卫计委了解到,武汉市各区新农合报销药品目录确实存在“小小的不一样”。目前,新农合已经由卫计委完全移交给市人力资源与社会保障局,市人力资源与社会保障局将会对新农合和城镇居民基本医疗保险进行整合,报销药品目录也会得到统一。

记者从市人力资源与社会保障局证实,以往,各区的新农合均是由区里财政部门提供资金,各区在制定本区的新农合政策时,略有不同。各区新农合报销药品目录因此存在差别。目前,市人力资源与社会保障局正在对城镇居民基本医疗保险和新农合进行整合统一,预计到2018年1月1日,全市将实施统一的城乡居民医保制度,其中,报销药品目录执行全省统一标准,各区之间完全一样,不再有任何差别。

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