Traditional Culture Encyclopedia - Traditional culture - What do these three directories refer to?
What do these three directories refer to?
List of drugs for basic medical insurance: refers to the policy basis and standards for the basic medical insurance, industrial injury insurance and maternity insurance funds to pay the drug expenses of the insured and strengthen the management of medical services in medical insurance.
Catalogue of diagnosis and treatment items: When medical institutions designated by medical insurance provide medical services for the insured, the price department has set a charging standard for the diagnosis and treatment items, thus standardizing the diagnosis and treatment items of social basic medical insurance. In practice, it is determined by formulating basic medical insurance diagnosis and treatment items.
Standard of medical service facilities: In the process of providing hospitalization and other medical services, the necessary medical service facilities and environment should be selected as the coverage of medical insurance. In practice, it is determined by formulating the standard of basic medical insurance service facilities. In order to standardize the scope of medical service facilities and payment standards, various provinces and cities have also formulated corresponding measures to ensure the basic medical needs of the insured.
In order to ensure the insured workers' demand for basic medical drugs, reasonably control medical expenses, standardize the management of basic medical insurance drugs and diagnosis and treatment, and ensure the healthy operation of the basic medical insurance system, the state and the province have formulated the Catalogue of Basic Medical Insurance Drugs, the Catalogue of Medical Treatment Projects for Urban Workers and the Project Scope of Medical Service Facilities for Urban Workers, which are referred to as "three catalogues" for short.
Legal basis: Article 28 of the Social Insurance Law of People's Republic of China (PRC) conforms to the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards and emergency and rescue medical expenses, and shall be paid from the basic medical insurance fund in accordance with state regulations.
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