New regulations on medical insurance reimbursement in Xiamen in 2023

Starting from 2023, Xiamen’s medical insurance will introduce new regulations: prohibiting combined charges, clarifying the list of designated hospitals, optimizing policies, etc., aiming to control medical expenses and improve medical insurance coverage.

According to the "Notice on Participation in Basic Medical Insurance for Urban Employees and Related Business Matters in 2023" issued by the official website of Xiamen Municipal Social Insurance Bureau, starting from January 1, 2023, Xiamen Municipal Medical Insurance will implement multiple policies. new regulations. First, combination charges will be prohibited, that is, multiple inspection items will not be charged as a whole. This move aims to control medical costs and reduce the burden on patients. Secondly, Xiamen Medical Insurance will also clarify the list of designated hospitals. Only those who receive treatment in designated hospitals can enjoy medical insurance benefits. This will help standardize the development of the medical industry and improve the quality and efficiency of medical services. In addition, Xiamen’s medical insurance will continue to optimize policies, such as adjusting outpatient quota standards, expanding the scope of medical insurance payment, and strengthening support for primary medical institutions, to increase medical insurance coverage and protect the health needs of the people. It should be noted that after the new regulations are implemented, they may have a certain impact on some medical institutions and patients. Therefore, the Xiamen Municipal Medical Insurance Department will strengthen publicity and training to ensure the smooth implementation of the new regulations.

What factors will Xiamen Medical Insurance consider when evaluating whether to include a designated hospital? When Xiamen Medical Insurance evaluates whether to include designated hospitals, it usually comprehensively considers factors such as medical service capabilities, medical quality, price levels, and hospital management levels. Specifically, it includes but is not limited to: the hospital's medical equipment, technical level and professional expertise; the hospital's service attitude and diagnosis and treatment effects; the hospital's charging standards and medical insurance payment ratio, etc.

Starting from 2023, Xiamen’s medical insurance will introduce a number of new regulations, prohibiting combined charges, clarifying the list of designated hospitals, optimizing policies, etc., aiming to control medical expenses, increase medical insurance coverage and standardize industry development. The medical insurance department will strengthen publicity and training to ensure the smooth implementation of the new regulations. When choosing a hospital, patients are advised to pay attention to the hospital's designated status to avoid unnecessary expenses.

Legal basis:

Article 28 of the "Social Insurance Law of the People's Republic of China" complies with the basic medical insurance drug catalog, diagnosis and treatment items, medical service facility standards, and emergency, The medical expenses for rescue shall be paid from the basic medical insurance fund in accordance with national regulations.