The Ministry of Human Resources and Social Security, the Ministry of Finance, and the Health and Family Planning Commission recently jointly issued the "guidance on further doing a good job in the settlement of medical expenses for medical treatment in different places of basic medical insurance," revealing that direct settlement of hospitalization expenses for medical treatment in different places within prefectures, cities and provinces (autonomous regions and municipalities) will be basically realized next year.
The person in charge of the Medical Insurance Department of the Ministry of Human Resources and Social Security stated that the guidance puts forward the idea of promoting the settlement of medical insurance expenses in different places at different levels, and requires that the goal is to fully realize the direct settlement of medical expenses within the city, and achieve fund budgets, financing treatment policies, and medical treatment. The unification of management and the integration of information systems strive to achieve "no different places in the same city".
The document also puts forward corresponding work objectives. In 2014, it is necessary to basically realize the direct settlement of medical treatment in the municipal overall planning area, standardize and establish the provincial remote medical treatment settlement platform; in 2015, it will basically realize the direct settlement of hospitalization expenses in the municipal overall planning area and in different places in the province, and establish and improve the national and provincial remote medical treatment settlement platform; in 2016, it will fully realize the direct settlement of hospitalization medical expenses of retirees across provinces.
The document proposes that the key group for the direct settlement of medical expenses in different places across provinces is the resettlement of retirees in different places, which refers to the long-term retirees who have obtained the residence registration in accordance with the household registration policy, mainly the elderly who live with their children after retirement. They are generally old and have a heavy medical burden. They do not return to the insured place for a long time. The problems of "running errands" and "advance payment" in reimbursement for medical treatment in different places have the greatest impact on them. Therefore, the demand for direct settlement of medical expenses in different places is the most urgent. At the same time, the boundaries of this part of the population are relatively clear, which is also conducive to the steady start of cross-provincial medical work.
In the next step, combined with the advancement of the reform of the household registration and residence permit system, places with conditions can explore the inclusion of other inter-provincial residents in the direct settlement of hospitalization medical expenses on the basis of summing up experience.