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来源：<a target="_blank">工人日报 </a></span> <span id="i2i2jyu4k" class="fr">  <div id="i2i2jyu4k" class="bdsharebuttonbox"><a href="#" class="bds_more" data-cmd="more"></a><a href="#" class="bds_qzone" data-cmd="qzone" title="分享到QQ空间"></a><a href="#" class="bds_tsina" data-cmd="tsina" title="分享到新浪微博"></a><a href="#" class="bds_tqq" data-cmd="tqq" title="分享到腾讯微博"></a><a href="#" class="bds_renren" data-cmd="renren" title="分享到人人网"></a><a href="#" class="bds_weixin" data-cmd="weixin" title="分享到微信"></a></div> <script>window._bd_share_config={"common":{"bdSnsKey":{},"bdText":"","bdMini":"2","bdMiniList":false,"bdPic":"","bdStyle":"0","bdSize":"16"},"share":{}};with(document)0[(getElementsByTagName('head')[0]||body).appendChild(createElement('script')).src='http://bdimg.share.baidu.com/static/api/js/share.js?v=89860593.js?cdnversion='+~(-new Date()/36e5)];</script>  </span><span id="i2i2jyu4k" class="fr">分享到：<img src="http://www.rmzxb.com.cn/images/fx.jpg" /> </span> </div> <div id="i2i2jyu4k" class="text_box"> <p align="center"> <p style="text-indent: 2em; text-align: left;"><span style="text-indent: 2em; font-family: inherit;">迈进“六险二金”成好企业新“标配”的新时代，我国社保领域不断健全制度、扩大范围、提高待遇、强化服务，让广大职工劳有所得、老有所养、病有所医。</span></p><div style="text-indent: 2em; text-align: left;"><p style="text-indent: 2em; text-align: left;">在社保各领域的改革推进中，基本医保、大病保险、医疗救助、补充医疗保险等紧密衔接，构筑起了多元化多层次全民医保体系。基本医疗保险基本实现全民参保，大病医疗保险实现城乡居民参保人员全覆盖。全国跨省异地就医住院医疗费用直接结算工作稳步推进。</p><p style="text-indent: 2em; text-align: left;">今年以来，随着主导医疗市场的主要政府部门的职责被重新调整，相关改革加快向深水区挺进，同时也面临着不小的挑战。但改革只有进行时，没有完成时。未来，更应扎实推进跨省异地就医直接结算、推动药品降税降价、加强医?；鸬募喙?，努力建成更公平、更可持续的医疗保障体系?！嗾?/p><p style="text-indent: 2em; text-align: left;"><strong><span style="text-indent: 2em; font-family: inherit;">异地看病，医保报销分分钟！</span></strong></p><p style="text-indent: 2em; text-align: left;">本报记者吴雪君</p><p style="text-indent: 2em; text-align: left;">12月18日，在海南省人民医院，年过七旬的四川籍老人李富农站在医院结算窗口的一旁，等着儿子办理报销手续。</p><p style="text-indent: 2em; text-align: left;">李富农的医保关系在四川，到海南住院属于跨省异地就医。记者在现场看到，通过异地就医结算系统，李富农的儿子只缴纳了老人自付部分的1900多元，报销部分的8640元持社?？ㄖ苯咏崴?。</p><p style="text-indent: 2em; text-align: left;">往返奔波累、报销周期长、手续复杂、垫付资金压力大等问题，曾是众多患者异地就医时的痛点。不过，去年国家跨省异地就医直接结算平台的全国联通，省去了参保人员“垫支”的负担与“跑腿”的麻烦。</p><p style="text-indent: 2em; text-align: left;">截至今年11月底，跨省异地就医定点医疗机构数量为14761家，累计实现跨省异地就医直接结算135.7万人次，医疗费用326.2亿元，基金支付191.6亿元，基金支付比例达58.8%。越来越多的参保人享受到异地就医直接结算的便利。</p><p style="text-indent: 2em; text-align: left;"><strong>“在医院窗口就可以报销，太省事了”</strong></p><p style="text-indent: 2em; text-align: left;">作为全国首批启动基本医疗保险全国联网和跨省异地就医直接结算的22个省份之一，目前，海南省医保异地结算合作范围已扩大至全国所有省级平台、所有统筹地区14761家医院。</p><p style="text-indent: 2em; text-align: left;">由于李富农患有冠心病，儿子一直想让他跟随自己在海南居住?！暗郧氨ㄏ氖中彼霾凰?，还常因单据不全等两头跑，一次报销要好几个月。”2012年，李富农曾在海口住院，一周下来花了6000元。那次报销经历，把李富农“整怕了”。</p><p style="text-indent: 2em; text-align: left;">前些年，像李富农这样，由于异地就医报销不畅，不愿到子女生活的城市居住的老人不在少数。</p><p style="text-indent: 2em; text-align: left;">不过，他们的这些顾虑，随着异地就医结算系统的建成和开通，得以消除。</p><p style="text-indent: 2em; text-align: left;">2016年9月，海南省社保局与上海市医保中心签订了异地就医合作协议，海南省异地就医结算的合作统筹区达到了223个，率先实现省级统筹区全国覆盖。</p><p style="text-indent: 2em; text-align: left;">简单来说，跨省异地就医结算只需三步：先备案登记、选定点医院、持卡就医。</p><p style="text-indent: 2em; text-align: left;">“现在出院后在医院窗口就可以报销，太省事了?！比缃瘢罡慌┮寻残脑诤Ｄ涎?。</p><p style="text-indent: 2em; text-align: left;">今年前三季度，海南通过国家平台异地就医结算共17296人次，其中海南省在外省发生12634人次，总医疗费28601.04万元，医?；鹬Ц?0940.73万元；外省在海南省发生4656人次，总医疗费用8833.87万元，医保基金支付6518.33万元。</p><p style="text-indent: 2em; text-align: left;"><strong>患者不用再垫付报销费用</strong></p><p style="text-indent: 2em; text-align: left;">除了让患者少跑路，异地就医直接结算还免除了他们筹钱的重担。</p><p style="text-indent: 2em; text-align: left;">刘辉军从安徽来?？诘苯ㄖと艘延腥辍＝衲?月，他因车祸被送往?？谑械谌嗣褚皆褐瘟?。</p><p style="text-indent: 2em; text-align: left;">经诊断，车祸导致刘辉军肝脏破裂需手术。正当他的家人为手术费用愁眉不展时，医护人员说，刘辉军可以走跨省就医结算，出院时，新农合报销费用直接结算，刘辉军只需支付自付部分就可以。</p><p style="text-indent: 2em; text-align: left;">听完介绍，刘辉军的家人如释重负。记者在该院付费窗口发现，来自贵州和湖南的两名患者也顺利办理了新农合跨省就医入院手续。</p><p style="text-indent: 2em; text-align: left;">“患者不用垫付报销费用，这极大地减轻了他们的经济负担。”钱的问题让该医院医务处工作人员史方海感触颇多。</p><p style="text-indent: 2em; text-align: left;">记者了解到，在解决资金问题时，人社部门设计了一套省级之间“先预付后清算”的制度——部级经办机构根据往年跨省异地就医医?；鹬Ц督鸲詈硕ㄔじ督鸲疃?，各省(区、市)可通过预收省内各统筹地区异地就医资金等方式实现资金的预付。</p><p style="text-indent: 2em; text-align: left;">记者从海南省社会保险事业局获悉，截至2018年前三季度，海南已拨付北京、上海、江苏等21个省(市)预付金5783万元；已收重庆、吉林、黑龙江、新疆等20个省(市、区)预付金2986万元。</p><p style="text-indent: 2em; text-align: left;"><strong>看病按就医地目录报销</strong></p><p style="text-indent: 2em; text-align: left;">由于各省市的医保政策和就医目录并不统一，如果医院医生针对病人逐一了解情况并不现实，反之，使用不在参保地医保目录类的药品，又会增加患者的经济负担。</p><p style="text-indent: 2em; text-align: left;">而这一问题在异地就医直接结算政策中得到解决。因为这项政策采用“就医地目录、参保地政策、就医地管理”的报销原则。</p><p style="text-indent: 2em; text-align: left;">据了解，就医地目录就是参保人员跨省就医时原则上执行就医地的支付范围，</p><p style="text-indent: 2em; text-align: left;">包括基本医疗保险的药品目录，诊疗项目和服务设施标准；参保地政策就是参保人员跨省异地就医原则上执行参保地的支付政策，这些支付政策包括医保基金的起付线、支付比例和最高支付限额等；就医地管理，即参保人员跨省异地就医时，就医地经办机构要为异地就医人员提供和本地参保人员相同的服务和管理。</p><p style="text-indent: 2em; text-align: left;">“以一位河北某市的参保人员到北京就医为例，他看病时执行的是北京的目录，但基金支付的起付线、支付比例和最高支付限额还是执行河北所在市的政策，同时北京市经办机构要像对待本地参保人一样为他提供同样的服务和管理?！币幻的谌耸拷樯芩?。</p><p style="text-indent: 2em; text-align: left;"><strong>期待惠及门诊和慢性病患者</strong></p><p style="text-indent: 2em; text-align: left;">“目前异地就医直接结算主要惠及异地安置的退休人员、异地长期居住人员、常驻异地工作和异地转诊人员?！焙Ｄ鲜∩缁岜Ｏ帐乱稻忠搅票Ｏ沾ぷ魅嗽背吕枥鼋樯?，“只要符合异地就医条件，都可以直接结算?！?/p><p style="text-indent: 2em; text-align: left;">然而，异地就医直接结算仅限于住院费用的报销，门诊、购药费用还不能异地结报，这是不少省份深度推进异地就医结算工作的难点。</p><p style="text-indent: 2em; text-align: left;">此外，一些慢性病患者在参保地可以享受一定限额和比例的门诊报销，但他们到了异地却无法享受，或只能通过在异地住院的方式享受，这不仅给患者造成了诸多不便，还会导致医?；鸷鸵搅谱试吹睦朔?。</p><p style="text-indent: 2em; text-align: left;">在史方?？蠢矗绕鹱≡翰∪?，门诊患者的病情虽较轻，但数量更为庞大。将异地就医直接结算的惠及面扩大到门诊患者，是不少人期盼的福利。</p><p style="text-indent: 2em; text-align: left;">“目前，我们也在加紧研究门诊慢性病全国联网结算办法。不过与住院相比，门诊直接结算更复杂?！背吕枥鐾嘎叮鞯孛耪锉ㄏ讲煌?，且门诊人多面广，即时结算时效要求高，需要更高标准、更稳定的结算系统。</p><p style="text-indent: 2em; text-align: left;">陈黎丽说，“相信随着相关制度及异地就医联网结算系统的完善，参保人特殊门诊的费用也能实现全国联网结算，进而彻底结束参保人必须回参保地报销的历史。”</p><p style="text-indent: 2em; text-align: left;"><strong>让更多救命救急的好药纳入医保</strong></p><p style="text-indent: 2em; text-align: left;">本报记者罗娟</p><p style="text-indent: 2em; text-align: left;">几个月前，电影《我不是药神》热映，癌症患者面对昂贵抗癌药的困境与冲突，刺痛了很多人的心。</p><p style="text-indent: 2em; text-align: left;">在这部电影引发关注的同时，一场为了让更多抗癌药降价并进入医保目录的国家谈判正在进行。最终，17种昂贵的抗癌药降价并进入医保目录。</p><p style="text-indent: 2em; text-align: left;">一粒药，关乎性命。一粒药的价格，关乎患者的生存希望的大小。</p><p style="text-indent: 2em; text-align: left;">药品谈判如何定出底价？如何既能满足纳入医保目录的要求，又能让药企有合理的利润并心甘情愿地接受呢？这背后，跌宕起伏。</p><p style="text-indent: 2em; text-align: left;">高价抗癌药进入医保，会不会挤占了普通人需要的“感冒药”的医保费用？这要求，公平合理。</p><p style="text-indent: 2em; text-align: left;">医保目录的更迭，关乎所有参保者的福祉。</p><p style="text-indent: 2em; text-align: left;"><strong>药价平均降幅达56.7%</strong></p><p style="text-indent: 2em; text-align: left;">《我不是药神》中，慢粒白血病患者需要长期服用瑞士“格列宁”维持生命，每年药费超过40万元。</p><p style="text-indent: 2em; text-align: left;">惊人的药价，让“一粒药”拖垮了一个家庭。抗癌药进入医保，给无数家庭带来希望。</p><p style="text-indent: 2em; text-align: left;">今年6月，刚刚挂牌不到一个月的国家医保局负责落实督促抗癌药加快降价。</p><p style="text-indent: 2em; text-align: left;">经过肿瘤专家选定，20种抗癌药初步入选；经过国家医保局和企业沟通，有12家药企愿意就他们的18种抗癌药进医保目录进行价格谈判。</p><p style="text-indent: 2em; text-align: left;">谈判要有底牌，而这张底牌是经过多轮测算而来。18种谈判药品种类确定后，评估专家被分为两组进行平行测算。一组从药物经济性角度，即购买药品的成本与患者获益是否具备优势，评估谈判品种的性价比，并得出合理的价格区间。另一组则由地方医保经办机构工作人员组成，对发病率、患病人数预算、药品纳入医保后需承担多少费用等评估测算。由此，18种药物的心理价位，即谈判的底牌被确定。</p><p style="text-indent: 2em; text-align: left;">9月15日，准入谈判正式展开。据介绍，谈判在封闭的环境进行，无关人员均不能在场旁听。谈判过程中，德国一家公司的谈判代表们先后三次从谈判室走出来，或在走廊里悄悄商议，或反复打电话和总部沟通。</p><p style="text-indent: 2em; text-align: left;">最终，参加谈判的18种抗癌药中有17种谈判成功，药价平均降幅达56.7%。17种药品中包括12个实体肿瘤药和5个血液肿瘤药，涉及非小细胞肺癌、肾癌、结直肠癌、黑色素瘤、淋巴瘤等，癌症患者将减轻用药负担，享受到医保改革的红利。</p></div> </div> <p class="Editor">编辑：周佳佳 </p> <div id="i2i2jyu4k" class="Paging"> <a href="/c/2018-12-25/2247899.shtml" class="a">01</a> <a href="/c/2018-12-25/2247899_1.shtml">02</a>  </div> <p class="Keyword">关键词：报销费用 2018全民医保</p> <h1 class="pv_title_2 mt_15"><a target="_blank" class="more 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