The National Healthcare Security Administration (NHSA) has released a notification with a focus on enhancing the standards for managing Basic Medical Insurance (BMI) payments for medical consumables. The notice indicates a further push towards the adoption of national BMI product codes to ensure uniformity across the country.
Expanding BMI Payment Management Scope
The goal is to include disposable medical consumables that are not directly part of the medical service projects’ price structure within the scope of BMI payment management regulations. This will involve the gradual development of generic naming rules for different categories of medical consumables, which will serve as the basis for BMI payments and management.
Incorporating Essential and Affordable Medical Consumables
The initiative aims to incorporate medical consumables that are clinically necessary, safe, effective, and reasonably priced into the BMI payment scope. Medical consumables with low clinical value or those with costs exceeding the affordability of funds and patients, as well as non-therapeutic rehabilitation devices, will not be covered by BMI in principle.
Inclusion of NRDL Consumables and High-Value Products
Consumables listed in the National Reimbursement Drug List (NRDL) that comply with current payment policies related to the volume-based procurement (VBP) program will also be included. Authorities will explore the entry of exclusive or high-value products through negotiation and other means. The notification calls for the phasing out of segmented payments based solely on cost levels, replacing them with fixed or limited payments that fit all situations. Regions can set pre-payment ratios for higher-priced or costly medical consumables based on actual circumstances and are encouraged to achieve unified practices as soon as possible.
Unified Payment Standards and Provincial Compliance
Unified payment standards can be established for medical consumables with the same function and purpose, similar materials and features, clinical substitutability, and convergence in medical insurance management. Provinces are required to submit their medical consumables lists to the NHSA before implementation. Provincial healthcare security administrations are encouraged to establish unified consumables lists and payment standards within their alliance or region.-Fineline Info & Tech
