Xinhua News Agency, Beijing, October 16 (Reporter Xu Penghang) The reporter learned from the National Health Insurance Bureau that the recent special flight inspection organized by the National Health Insurance Bureau found that some designated medical institutions and designated retail pharmacies have extensive management of prescriptions for medical insurance drugs, and false prescriptions and excessive prescriptions have occurred frequently. On the 16th, the National Health Insurance Administration issued the "Notice of the Office of the National Medical Security Administration on Standardizing the Management of Prescriptions for Prescriptions for Medical Insurance Drugs" to further standardize the management of prescriptions for medical insurance drugs.
According to the notice, in the co-ordination areas where the medical insurance electronic prescription center has been launched, the designated medical institutions should provide prescription dispensing services through the electronic prescription center. Support the printing of electronic prescriptions into paper prescriptions, so that the elderly and other insured persons in need can go to designated retail pharmacies to purchase drugs with paper prescriptions. In areas where the medical insurance electronic prescription center has not yet been launched, the paper prescription issued by the designated medical institution must be signed by the medical insurance physician of the hospital and stamped with the special seal for external prescriptions.
The notice makes it clear that when designated retail pharmacies adjust the prescription for the insured, they should carefully check the authenticity, legality and standardization of the prescription, approve the prescription drug information, expiration date, etc., as well as the information of the insured.
In principle, the drugs sold by designated retail pharmacies with the prescriptions of the designated medical institutions in the overall planning area can be included in the payment scope of the medical insurance pooling fund if they meet the requirements, and the external prescriptions of medical institutions outside the overall planning area are not accepted for the time being.
The notice requires that the construction of electronic prescription centers be accelerated. From January 1, 2025, designated retail pharmacies equipped with "dual-channel" drugs will be required to circulate "dual-channel" drug prescriptions through the electronic prescription center, and paper prescriptions will no longer be accepted. If it is necessary to extend the use time of paper prescriptions under special circumstances, the overall planning area shall report to the provincial medical insurance department for approval and file with the National Health Insurance Bureau, and the extension time shall not exceed 3 months.
The notice proposes to focus on the special management of the use of medical insurance prescriptions. By the end of December 2024, special inspections will be carried out for outpatient chronic diseases and special diseases, prescription drugs for the outpatient "two diseases" medication mechanism for urban and rural residents, and other prescription drugs with high amounts, large costs, and high risks of fraud and insurance fraud.
Source: Xinhuanet