The National Healthcare Security Administration (NHSA) has released a notification to medical insurance departments across the country, identifying issues related to unreasonable restrictions on medical insurance as reported by patients. The order calls for a deeper investigation and resolution of these issues.
Key Areas for Rectification
The notice highlights three broad areas that need to be addressed:
- In-Patient Medical Services: The notice underlines that poor quality budget management and adjustments in relation to global budgets for hospitals are leading to irregularities in treatment. This includes unwarranted restrictions on the number of days of hospitalization for patients and subsequent interruptions to hospital care.
- Outpatient Medical Services: The report identifies restrictions on the specific number of days or upper limit on the amount of medication prescribed under Basic Medical Insurance (BMI) coverage for insured patients. These restrictions can make it impossible or inconvenient for medical institutions to issue long-term prescriptions.
- Cost-Control Restrictions by Hospitals: The notice states that certain cost-control restrictions imposed by hospitals themselves, such as on the average cost of hospitalization and outpatient visits, drug prescribing, etc., may be misconstrued by patients as imposed by the Healthcare Security Administration bureaus.
Action Plan and Timeline
Regional HSA departments are ordered to carry out self-examination and self-correction by the end of December 2022, list relevant issues, and implement corrective measures as required. Before January 31, 2023, the provincial HSA departments will provide a summary report on the rectification of unreasonable restrictions on medical insurance. Before the end of February 2023, the NHSA will carry out a work supervision program to understand the actual situation of troubleshooting and rectification in various regions through various channels and summarize the work.-Fineline Info & Tech
