Open Governance
Pilot Program of Direct Settlement of Personal Health Insurance Accounts in Yunnan, Guizhou, Sichuan, Tibet, and Chongqing This Year

This year, Sichuan Province will launch a pilot program of cross-provincial direct health insurance account settlement with Yunnan Province, Guizhou Province, Tibet, and Chongqing Municipality. That means that in the future, in eligible medical facilities within the scope of the pilot program, people can get medical treatment or buy medicine with their health insurance accounts. The reporter learned the news at the annual summary and operation analysis meeting of Sichuan Province on seeking medical treatment outside places of registered residence.

As of late 2018, 1,132,300 medical treatments outside places of registered residence had been filed in Sichuan Province. To further facilitate people with health insurance in seeking medical treatment outside places of registered residence, Sichuan Province will push for the work in multiple fronts. One of these efforts is cross-provincial direct settlement of health insurance accounts in southwest China. "With the vicinity among Sichuan, Yunnan, Guizhou, Tibet and Chongqing, frequent population flow happens among these regions, hence the urgent demand for cross-provincial direct settlement of health insurance accounts." According to source of Sichuan Provincial Medical Security Bureau, the Bureau has made plans for relevant works, and all regions in the province are making preparations in line with their actual conditions.

Besides cross-provincial direct settlement, the Bureau will continue to improve cross-regional direct settlement of health insurance accounts within Sichuan Province. On October 1, 2018, 21 municipalities (prefectures) in Sichuan Province launched cross-regional direct settlement of health insurance accounts within Sichuan Province. For people with health insurance, they do not need to get registered or filed for seeking medical treatment in places outside places of registered residence, and can use their social security cards for direct settlement in hospitals and drugstores available for cross-regional direct settlement; relevant fees would be deducted directly from their health insurance accounts. As of late last year, 880 medical institutions were available for direct settlement for general clinic, together with 2,777 networked drugstores. In Sichuan Province, 22 regions under unified planning now offer direct settlement for cross-regional general clinic and medicine purchased in drugstores within the province. In the future, efforts will be made to ensure that the practice prevail in all retail pharmacies of all regions and counties of Sichuan Province.

Sichuan Province will expand the scope of institutions available for the practice. As of late last year, 1,230 networked hospitals were available for cross-regional direct settlement for general hospitalization within the province, together with 756 networked drugstores available for cross-provincial direct settlement. Going forward, designated retail pharmacies, out-patient departments, and clinics with sound system, normative management, quality service, and good reputation will be included into the scope of cross-regional direct settlement. By late this year, over 85% grade-III designated hospitals, over 50% grade-II designated hospitals, and 10% of other designated hospitals would be included into national settlement system for cross-regional medical treatment. To address problems of people with health insurance, such as huge pressure of single payment for advance expenditure for medicine in cross-regional use and long period of reimbursement, this year Sichuan Province will establish "Sichuan Provincial Direct Settlement Management System for Special Medicine and Cross-regional Medical Treatment", aiming to realize information sharing and networked direct settlement of medicine in single payment.

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