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人社部:异地就医将不用“跑腿”报销

2016-06-01 02:18:26   新京报

原标题:异地就医将不用“跑腿”报销

新京报讯(记者吴为)昨日,人社部社会保险事业管理中心副主任黄华波接受媒体访谈时表示,异地就医必须解决老百姓看病垫资和跑腿报销的问题。黄华波介绍,包含国家结算平台系统在内的“金保二期”项目6月起将得到第一笔项目资金。通过部省两级信息对接,未来老百姓异地就医将有望既不用垫资又不必来回跑腿报销。

异地就医所有报销有望实现后台运算

异地医保一方面是先行垫资的问题,另一方面,即使实现了异地就医,群众看完病也需要来回奔波跑报销程序。对于垫资的问题,黄华波表示,目前医保基本实现地市级统筹,30个省份实现了省内异地就医联网,27个省份住院费用直接结算已经没有问题。

黄华波认为,异地就医报销时间长,一是外出看大病,另一方面监管力量跟不上。“看大病住院费多,单据会很长,十页几十页都有。审外地的单子,每一个都特别厚。”黄华波说。

黄华波介绍,将通过建立参保人员数据库解决这一问题。“我们的网络以后部省两级对接,参保人员在参保地进行简单备案。备案以后我们关键是要建立数据库,把这个信息通过省的平台、部平台再传回到就医地,这样参保人员就可以持社会保障卡到就医地医院看病了。”黄华波说。

据黄华波介绍,为建立省部两级系统,实现信息对接,人社部已经对包括国家结算平台系统在内的“金保二期”项目进行立项,6月将可能拿到第一笔项目资金并启动开发。

“未来参保人在参保地备案以后在就医地就刷卡结算,把自己付的付了就完了,所有的工作全是后台运算,包括省级平台、部级平台,部和参保地进行结算、监察都是后台做。”黄华波说。

建异地居住人员数据库完善分级诊疗

人社部明确表示,到2017年基本实现符合转诊条件的参保人员异地就医住院费用直接结算的目标。那么,异地就医的支付和结算便捷了后,会不会出现各地居民都跑到大城市、大医院看病的问题,从而加剧“一号难求”现象?

对此,黄华波表示,如果解决了垫资的问题以后会刺激外出的就医,未来将通过完善分级诊疗制度,控制风险。

“去年国办也下发一个关于分级诊疗的文件,有了很好的基础。这个事情要解决关键还是分级诊疗的工作要做起来,我们几个部门也在全力以赴地推。”黄华波表示。

人社部透露,该部目前正在会同相关部门研究进一步完善周转金、分级诊疗制度,包括加强医疗服务监管等政策。

“我们先是重点解决异地安置的退休人员住院费用,要把这一部分保住;2017年解决符合转诊条件的住院费用的结算,转诊条件到时候可能是要和分级诊疗结合起来了。”对于如何确定符合分级诊疗的要求并锁定相关人群,黄华波表示,未来将建立异地居住人员的数据库,锁定各方面的服务。

责任编辑:孙启浩 cn037
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