国务院正式发文！职工医保将有这些大变化
<p></p><section data-source="bj.96weixin.com" style="max-width: 100%;font-family: -apple-system, system-ui, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;background-color: rgb(255, 255, 255);font-size: 16px;color: rgb(62, 62, 62);line-height: 25.6px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: 10px;margin-bottom: 10px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: -4px;padding: 10px;max-width: 100%;background-color: rgb(239, 239, 239);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><p style="max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;">22日，国务院办公厅发布《国务院办公厅关于建立健全职工基本医疗保险门诊共济保障机制的指导意见》。看要点梳理↓</p></section></section></section></section></section></section></section></section><p></p><ul class=" list-paddingleft-2" style="list-style-type: square;"><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">逐步将多发病、常见病的普通门诊费用纳入统筹基金支付范围。</span></p></li><li><p style="margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">普通门诊统筹覆盖职工医保全体参保人员，政策范围内支付比例从50%起步，待遇支付可适当向退休人员倾斜。</span></p></li><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">根据医保基金承受能力，逐步扩大由统筹基金支付的门诊慢特病病种范围，将部分治疗周期长、对健康损害大、费用负担重的疾病门诊费用纳入共济保障。</span></p></li><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">将符合条件的定点零售药店提供的用药保障服务纳入门诊保障范围，支持外配处方在定点零售药店结算和配药。</span></p></li><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;color: rgb(0, 122, 170);box-sizing: border-box !important;overflow-wrap: break-word !important;">探索将符合条件的“互联网+”医疗服务纳入保障范围。</span></strong></p></li></ul><p style="max-width: 100%; min-height: 1em; font-family: -apple-system, system-ui, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; letter-spacing: 0.544px; white-space: normal; background-color: rgb(255, 255, 255); text-align: center; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"></p><p style="margin-bottom: 20px; max-width: 100%; min-height: 1em; font-family: -apple-system, system-ui, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; letter-spacing: 0.544px; white-space: normal; background-color: rgb(255, 255, 255); text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 14px;color: rgb(136, 136, 136);box-sizing: border-box !important;overflow-wrap: break-word !important;">△2020年7月16日，浙江省舟山医院两位医生通过远程视频连线为海岛民众提供医疗服务。</span></p><ul class=" list-paddingleft-2" style="list-style-type: square;"><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">在职职工个人账户由个人缴纳的基本医疗保险费计入，计入标准原则上控制在本人参保缴费基数的2%，单位缴纳的基本医疗保险费全部计入统筹基金。</span></p></li><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">退休人员个人账户原则上由统筹基金按定额划入，划入额度逐步调整到统筹地区根据本意见实施改革当年基本养老金平均水平的2%左右。</span></p></li><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;color: rgb(0, 122, 170);box-sizing: border-box !important;overflow-wrap: break-word !important;">个人账户</span></strong><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">主要用于支付参保人员在定点医疗机构或定点零售药店发生的政策范围内自付费用，</span><strong style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;color: rgb(0, 122, 170);box-sizing: border-box !important;overflow-wrap: break-word !important;">可以用于支付参保人员本人及其配偶、父母、子女在定点医疗机构就医发生的由个人负担的医疗费用，</span></strong><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">以及在定点零售药店购买药品、医疗器械、医用耗材发生的由个人负担的费用。</span></p></li><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;"></span><strong style="max-width: 100%;font-family: mp-quote, -apple-system-font, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;color: rgb(0, 122, 170);box-sizing: border-box !important;overflow-wrap: break-word !important;">个人账户不得用于公共卫生费用、体育健身或养生保健消费等不属于基本医疗保险保障范围的支出。</span></strong></p></li></ul><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; font-family: -apple-system, system-ui, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; 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text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">严肃查处“挂床”住院、诱导住院等违法违规行为。</span></p></li><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">加快全国统一的医疗保障信息平台建设，推进门诊费用异地就医直接结算。</span></p></li><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">通过协同推动基层医疗服务体系建设等，引导参保人员在基层就医首诊。</span></p></li><li><p style="margin-top: 20px; margin-bottom: 20px; max-width: 100%; min-height: 1em; text-align: justify; line-height: 2em; box-sizing: border-box !important; overflow-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="max-width: 100%;font-size: 16px;color: rgb(0, 122, 170);box-sizing: border-box !important;overflow-wrap: break-word !important;">各省级人民政府要按照本意见要求，在2021年12月底前出台实施办法，</span></strong><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">指导各统筹地区推进落实，</span><span style="max-width: 100%;font-size: 16px;color: rgb(0, 122, 170);box-sizing: border-box !important;overflow-wrap: break-word !important;"><strong style="max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;">可设置3年左右的过渡期，</strong></span><span style="max-width: 100%;font-size: 16px;box-sizing: border-box !important;overflow-wrap: break-word !important;">逐步实现改革目标。</span></p></li></ul><p style="margin: 0cm 0cm 0.0001pt; 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