Our hospital on the adjustment of the new rural cooperative medical care

Compensation Program

According to the document spirit of Liaohuifa [2011] No. 6 “Notice on Adjusting the Compensation Program of New Rural Cooperative Medical Program”, the hospital's new rural cooperative medical compensation program in 2011 is notified as follows:

I. Diagnostic and therapeutic items to be included in the reimbursement

1. Diagnostic and therapeutic equipment and medical materials

Pacemakers, artificial joints, artificial larynx, artificial femoral head, pediatric cochlear implants, pediatric cochlear implant materials, vascular stents and other internal replacement of artificial organs, internal materials, the first 30% of domestic personal out-of-pocket, the first 60% of imported personal out-of-pocket, and the rest of the cost of the New Farmers' Cooperative Medical Care Fund into the scope of reimbursement.

2、Treatment items

Individuals will pay 30% for the following items, and the rest of the expenses will be included in the scope of compensation of the New Agricultural Cooperative Fund.

① stereotactic radiotherapy device (γ-knife, X-knife, photon knife).

② liver, kidney, heart valves, cornea, skin, blood vessels, bone, bone marrow transplantation, heart bypass and cardiac catheterization balloon dilatation.

③Heart laser perforation, anti-tumor cellular immunotherapy, fast neutron therapy, catheter angiography therapy items.

Starting and Capping Lines

1、New rural cooperative inpatient hospitalization starting line is 500 yuan, the annual hospitalization compensation ceiling line is 80,000 yuan.

2. For outpatient compensation of chronic diseases and other special diseases, there is no starting line, the reimbursement rate is 50%, and the cap line is RMB 8,000 per person per year.

Reimbursement Ratio

Participating farmers are reimbursed for the hospitalized medical expenses incurred in our hospital according to the following ratios after removing the non-coordinated expenses and the starting line:

1、The proportion of reimbursement is 45% for those within 100,000 yuan (including 100,000 yuan) and 70% for those above 100,000 yuan.

2. The compensation ratio for the cost of medicines in the national and provincial basic drug catalogs, traditional Chinese medicine tablets and Chinese medicine appropriate technology promoted by the Provincial Department of Health: 55% for those within 100,000 yuan (including 100,000 yuan), and 80% for those above 100,000 yuan.

Hospitalization Compensation for Accidental Injuries

All accidental injuries (including trauma, poisoning and other unnatural diseases) are not subject to immediate settlement (i.e., not reimbursed in the hospital), but the hospital is required to provide the original invoice of the medical expenses for the current traumatic injury hospitalization, an itemized list of the hospitalization expenses, and a copy of the medical record (stamped with the seal of the hospital where the patient was treated). Trauma patients belonging to a single disease must still be charged according to the single disease limit.

V. Improving the level of protection for major diseases

Comprehensively promote rural children's leukemia, congenital heart disease and other major diseases medical insurance, and gradually serious mental illness, breast cancer, cervical cancer, end-stage renal disease, hemophilia and so on into the pilot scope of the hospitalization costs of the New Rural Cooperative reimbursement ratio of 70% or more; will be included in the chronic diseases such as psychiatric illnesses and other special illnesses into the scope of chronic disease reimbursement.

VI. This program shall be implemented from April 1, 2011 onwards.

                           Liaocheng Second People's Hospital

      New Agricultural Cooperation Management Office

                       2011-03-26