Severely crack down on illegal activities such as fraud and insurance fraud in designated retail pharmacies

Zhao Chenxi, all-media reporter of the Rule of Law Daily

In order to better promote the reform of the medical insurance outpatient mutual aid guarantee mechanism for employees, the National Medical Security Administration recently issued the “Notice on Further Improving the Inclusion of Designated Retail Pharmacies in the Overall Management of Outpatient Clinics” (hereinafter referred to as the “Notice”), clarifying that medical insurance departments at all levels should take effective measures. Measures to encourage qualified designated retail pharmacies to voluntarily apply for the opening of outpatient coordinating services.

The “Notice” clarifies that designated retail pharmacies that apply for the opening of outpatient coordinating services should meet relevant requirements and be able to carry out outpatient coordinating and online direct settlement. The medical insurance department in the coordinating area should optimize the application conditions, improve the service process, and open outpatient coordinating services for eligible designated retail pharmacies in a timely manner.

In terms of strengthening the management of prescription circulation, the “Notice” clearly states that relying on the unified national medical insurance information platform, the implementation and application of the medical insurance electronic prescription center will be accelerated, so as to realize the smooth flow of electronic prescriptions from designated medical institutions to designated retail pharmacies. Designated medical institutions can issue long-term prescriptions for eligible patients for up to 12 weeks.

In addition, the “Notice” clearly needs to strengthen fund supervision, and through various methods such as daily supervision, intelligent review and monitoring, severely crack down on illegal activities such as fraud and insurance fraud in designated retail pharmacies.