Analysis on the Classification Codes and Limited Payment of the 2022 Medical Insurance Drug List in China
Objective To analyse the coding principles and limited payment conditions of the 2022 Medical Insurance Drug List,in order to facilitate timely understanding of the new rules for code classification and limited payment for medical insurance drugs by practitioners,and the differences between the new and old medical insurance catalogs.Methods Analyse the basic situation regarding the medical insurance drug codes,Number of drug varieties,the limited Payment of drugs.Compare the changes with the 2021 Medical Insurance Drug List.Results The 2022 Medical Insurance Drug List in China has a specific rule for the coding of medicine.The list includes a total of 670 drugs with limited payment,out of which 314 are restricted to single limited payment and 356 to multiple.In comparison to the Medical Insurance Drug List,the 2022 Medical Insurance Drug List has undergone several changes in its limited payment,with 124 being cancelled and 43 being modified.Conclusion The first six digits of Medicare drug reimbursement codes adopts the drug classification code in the medical insurance drug directory for easy management and use.The 2022 Medical Insurance Drug List will include more drugs,with limited payment for more standard management,gradually returning to the scope of the drug instructions approved by NMPA.There are some questions about the limited payment in the actual implementation process.It is recommended to consider the sustainable development of the fund comprehensively,combine clinical guidelines and the actual needs of patients,accelerate the adjustment and improvement of policies related to limited payment,and consider restoring the payment scope of more drugs to the scope of drug instructions.Strengthen the role of pharmacists as the main body of rational drug use in the process of medical insurance drug use.Use information technology and big data to enhance the efficiency of medical insurance supervision.
medical insurance drug listlimited paymentdrug classification codehospital health insurance managementhealth insurance fundrecommendations
万方数据
维普
