四川医保新政1月1日起实施！最新答疑→
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关于推进基本医疗保险省级统筹的意见》
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<span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: #007aaa;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">从1月1日起</strong></span>
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<span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: #007aaa;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">四川开始实施基本医疗保险</strong></span>
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<span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: #007aaa;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">调剂金模式省级统筹</strong></span>
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<span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; font-size: 16px; color: #888888;">（以下简称医保省级统筹）</span>
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医保省级统筹后
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医保待遇什么时候能全省统一？
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省内跨市异地就医报销比例
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能否全省统一？
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医保电子凭证是否在全省的定点医院
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药店都可以刷？
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针对社会关心的热点问题
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省医保局一一进行了回应
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<span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; background-color: #007aaa; color: #ffffff;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">问：医保待遇政策什么时候能全省统一？</strong></span>
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<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: #007aaa;">回应：2024年起逐步规范统一</span></strong>
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目前，四川省各地经济社会发展水平、医保基金支撑能力、医疗资源配置等方面均不相同，各市（州）既往的医保待遇政策存在一定差异。实施医保省级统筹后，全省将逐步实现预算管理、基金调剂、参保筹资、待遇保障、支付机制、经办管理“六统一”。
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随着全省基本医疗保险实现预算管理、基金调剂的统一，<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">从2024年起，医疗保障部门将逐步规范统一全省职工医保、居民医保同一制度内参保人员住院、普通门诊、门诊慢特病、“两病”门诊用药等待遇保障政策。</strong>
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<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; background-color: #007aaa; color: #ffffff;">问：省内跨市异地就医报销比例会不会全省统一?</span></strong>
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<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: #007aaa;">回应：按照国家要求逐步统一异地就医待遇</span></strong>
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在全省基本医疗保险各项制度还未统一前，各市（州）仍存在政策差异。各地按照省医保局2022年底印发的《四川省医疗保障局 四川省财政厅关于进一步做好基本医疗保险异地就医直接结算工作的通知》执行异地就医经办管理服务。异地转诊人员和异地急诊抢救人员在备案地住院就医结算时，支付比例在参保地规定的本地住院就医支付比例基础上，降幅不超过10个百分点。非急诊且未转诊的其他临时外出就医人员，支付比例在参保地规定的本地住院就医支付比例基础上，降幅不超过20个百分点。
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下一步，省医保局将按照省政府要求，加快推进全省基本医疗保险待遇政策的规范统一，促进医保制度更加公平、更可持续，在此之前，省医保局将继续指导各级经办机构严格按照政策文件执行异地就医经办服务，<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">并按照国家要求逐步统一异地就医待遇。</strong>
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<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; background-color: #007aaa; color: #ffffff;">问：医保目录是否会全省统一？</span></strong>
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<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: #007aaa;">回应：全省医保药品目录已基本统一</span></strong>
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省级统筹实施后，医保目录是否全省统一，目录范围会扩大吗？对此，省医保局回应，根据《基本医疗保险用药管理暂行办法》，医保药品目录主要由国家制定和调整，<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">省级医保部门以国家医保药品目录为基础按规定将符合条件的民族药、医疗机构制剂、中药饮片纳入省级医保支付范围。</strong>
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目前，全省医保药品目录已基本统一，医保医疗服务项目和耗材目录由各统筹地区根据当地基金承受能力等制定和调整，暂未实现全省统一。国家和省已建立药品目录动态调整机制，目录范围逐年扩大，保障水平逐步提高，例如，现行2022版国家医保药品目录包括西药和中成药2967种，我省医疗机构制剂目录包括制剂2867种，还有基金准予支付的中药饮片、民族药等，能够满足广大参保人的基本用药需求。
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省医保局将进一步完善医保目录管理机制，及时做好国家医保药品目录落地工作，将更多符合条件的药品（民族药品、中药饮片、医疗机构制剂）、医疗服务项目、医用耗材纳入基本医疗保险支付范围，2025年底前基本实现全省基本医疗保险药品、医疗服务项目、医用耗材支付范围和支付类别统一。
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<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; background-color: #007aaa; color: #ffffff;">问：医保电子凭证在全省定点医药机构都可以刷吗？</span></strong>
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<span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: #007aaa;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">回应：可以</strong></span>
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根据国家医保局统一规划，<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;">医保部门不再为参保群众发放实体医保卡，全国统一使用医保电子凭证。</strong>为了便于参保群众记忆和使用，现在医保电子凭证简称为医保码。目前，全省定点医院和药店已全部接入医保电子凭证，全省参保群众可通过国家医保、四川医保等渠道，“刷”医保电子凭证享受医保服务。
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此外，为便于群众就医购药，医保各项业务依然支持使用实体社保卡办理。<br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"/>
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<span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; font-size: 12px; visibility: visible; color: #7f7f7f; box-sizing: border-box !important; overflow-wrap: break-word !important;" >来源丨川观新闻</span>
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</section> 伽玛刀 发表于 2024-1-4 15:22
新年新规落实方案正式执行
希望能得到更好的改善 新年新规落实方案正式执行 东改西改，改得我都不敢生病了。 希望医保卡能全国通用 规范医保资金使用 国家应该把医保的政策更加推出 国家把人民群众的医保金收回一部分明显是不合理的，有些城市就反应强烈，已经改过来了，但为什么要将老百姓的医保金拿回去一部分呢？这明显的是侵犯了公民的权益。 现在还没有说全民免费医保，就把公民的医保金拿回去一部分，真是百思不得其解？
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