Tianjin Municipal Medical Insurance Bureau recently issued the “Notice on the Implementation of the Beijing-Tianjin-Hebei “3+N” Pharmaceutical Purchasing Alliance for the Procurement and Use of Pacemakers and Coronary Drug Balloons Medical Consumables with Quantity”, clearly implementing With the purchase results of the quantity, the selected products will be used first, and the direct settlement policy of medical insurance will be implemented. The notice will be implemented from April 15, 2022.
At the beginning of this year, the Municipal Medical Insurance Bureau took the lead in organizing the Beijing-Tianjin-Hebei “3+N” alliance to successfully complete the centralized procurement of coronary drug balloons and pacemaker medical consumables. The average price of coronary drug balloons dropped from 23,000 yuan/piece to 6,000 yuan/piece, an average drop of 72.50%; the average price of pacemakers dropped from 48,000 yuan/piece to 24,000 yuan/piece, an average drop of 50% %.
The selected products of pacemaker medical consumables with volume linkage shall take the selected price as the payment standard and be included in the scope of medical insurance payment, and the medical insurance fund shall pay according to the prescribed proportion.
Among them, the highest medical insurance payment standard for non-compliant MRI/non-frequency-responsive pacemakers (the same below) is 17,980 yuan per set; non-compliant MRI/frequency-responsive pacemakers are 34,519 yuan per set; Whole-body compatible MRI/non-frequency-responsive pacemakers are 31,605 yuan per set; whole-body compatible MRI/frequency-responsive pacemakers are 37,791 yuan per set; other types of pacemakers (excluding single-chamber and triple-chamber pacemakers) For each set of 37791 yuan.
The selected products of coronary drug balloon medical consumables with volume linkage shall take the selected price as the payment standard and be included in the scope of medical insurance payment.
For the medical consumables that are not selected by the above-mentioned products, the sales price shall not be higher than the highest payment standard of medical insurance in the same category and similar function group, and the medical insurance fund shall pay according to the prescribed proportion; For products with the medical insurance payment standard, the medical insurance fund shall pay according to the specified proportion according to the highest medical insurance payment standard; if the sales are 2 times higher than the highest medical insurance payment standard (excluding 2 times), 110% of the highest medical insurance payment standard shall be used as the medical insurance payment standard for the consumables. , the individual burden of patients shall be implemented in accordance with the current regulations of our city.