Fifteen days for an inpatient to be evicted is a health insurance bureau regulation

It is not a requirement of the Health Insurance Bureau that inpatients are evicted within 15 days, but there is a well-known unspoken rule in the health care system: the assessment data of the "inpatient bed turnover rate". Therefore, the general hospital will take 10 to 15 days for the patient to be discharged, fake discharge, or even go to the ** hospital around the hospital to come back to be hospitalized.

There is no such provision from the Health Insurance Agency.

During the two sessions of the Guangzhou Municipal People's Congress, a reporter followed Li Guoxiong, a deputy to the Guangzhou Municipal People's Congress, to the booth of the Municipal Health and Family Planning Commission to ask about the question of "being discharged from the hospital in 15 days". At that time, the relevant person in charge of the Guangzhou Municipal Health and Family Planning Commission said: "As a health and family planning department, we are very clear that there are no such regulations, and we are not allowed to operate like this.

The relevant person in charge of the Human Resources and Social Security Bureau also explained that there has never been a "medical insurance ceiling" in the policy, and the average fixed amount of medical insurance is for the average cost of the entire hospital, but it is not excluded that some hospitals privately average it to each patient.

According to the Notice on the Payment of Hospitalization Medical Expenses of Social Medical Insurance in Guangzhou by Disease Score issued by the Guangzhou Municipal Human Resources and Social Security Bureau, the Guangzhou Municipal Finance Bureau and the Guangzhou Municipal Health and Family Planning Commission, from January 1, 2018, the Municipal Medical Insurance Bureau and the designated hospitals will settle the inpatient medical expenses of the medical insurance participants according to the value of the disease.

Once the designated medical institution has decomposition hospitalization, nominal hospitalization, etc., the score of the current hospitalization will not be calculated, and the score will be deducted according to 3 times the score, so as to restrict the hospital to consciously abide by the rules.

Hello! Not really.

The medical insurance departments at all levels have never issued any medical insurance policies that limit the number of days of hospitalization of insured patients. Unreasonable discharge of patients from the hospital is a violation of medical insurance regulations. Medical insurance cannot arbitrarily interfere with clinical ways and means.

According to the statement on the official website of the National Health Insurance Administration, medical insurance departments at all levels have never issued any medical insurance policies that limit the number of days of hospitalization of insured patients. In fact, there are no relevant restrictions on medical insurance, and it cannot arbitrarily interfere with clinical methods and means.

To prevent over-treatment, the health department conducts an average length of stay in the hospital to reflect the efficiency of the hospital's service to inpatients. This restriction is based on the average situation of the entire hospital and not for individual patients.

Yes, the medical insurance company will not reimburse for more than 15 days. So the patient is asked to be discharged. Half a month later, you can start medical insurance reimbursement if you are readmitted to the hospital.

Call for people's livelihood policies and regulations to be put in place in one step. The reality is that the first to formulate and implement unreasonable or even interest-biased regulations, while implementing the slow adjustment, this adjustment process, may be a few years, but can also be more than ten or decades, just like the pension dual-track system, more than ten years of dual-track system has led to the retirement of retired employees of enterprises by the retired employees of the enterprise far behind.

Even if the dual-track system is abolished today, more than a decade later, what will happen? Those who are left behind will never catch up. If you think about it, isn't this true for other regulations?

Those who formulate biased regulations are to use the whole process of "formulating biased regulations, promoting implementation, social feedback, social influence, and slowly adjusting and changing" to encroach on the interests of vulnerable groups or grassroots ......This medical insurance is just one of them.

The medical insurance bureau does not have clear regulations on the number of hospitalizations and hospitalization time of insured persons per year, and it is an internal regulation of the hospital that the hospital must be discharged after 15 days, which is to decompose hospitalization and avoid the problem of medical insurance reimbursement. In the general medical insurance reimbursement, it is paid by the overall coordinator according to the reimbursement ratio of different levels of medical institutions, and individuals only need to pay the medical expenses that should be borne by themselves when they are hospitalized, and the rest is settled by the medical insurance center and the hospital. After the maximum payment limit of 80,000 yuan for basic medical insurance at the provincial level is exhausted, it will automatically enter the supplementary medical insurance payment for serious illnesses, and the reimbursement ratio for hospitalization will be uniformly increased to 90%, and the maximum reimbursement will be 250,000 yuan.

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