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为加强医疗保险医疗服务管理,遏制医疗费用偏高,克服浪费,确保医疗保险制度顺利运行,根据省有关文件精神及泉州市医保两年来的运行情况,市劳动保障局、财政局、卫生局于2002年底就医保医疗服务管理一些问题联合发出通知。通知要求定点医疗机构医生开药或提供诊疗项目,在病情确需,疗效、副作用基本相同的情况下,应优先使用目录内及价格较低的药品或治疗项目。出院不能附带诊疗项目。出院带药不超过7天药量。病情需要确需超过限额,需报医保中心备案。并根据上级关于“目录外费用比例控制在8%以内”的要求,范围外药品费及诊疗费占总药品费及总诊疗费比例的定额标准调整为三级医院10%,二级医院8%,一级医
In order to strengthen medical insurance medical service management, curb high medical costs, overcome waste, and ensure the smooth operation of the medical insurance system, according to the spirit of provincial documents and the operation of Quanzhou medical insurance for two years, the Municipal Labor and Social Security Bureau, the Finance Bureau, and the Health Bureau At the end of 2002, joint notifications were issued on certain issues concerning the management of medical insurance medical services. The notification requires doctors of designated medical institutions to prescribe medicines or provide medical treatment items. In cases where the condition is really needed, and the efficacy and side effects are basically the same, priority should be given to medicines or treatment items in the list and with lower prices. Discharge can not be accompanied by medical treatment items. Discharge with medication does not exceed 7 days. The condition needs to exceed the limit, and it must be reported to the medical insurance center for record. According to the requirements of superiors on the principle that “the proportion of out-of-catalogue expenses is controlled within 8%,” the quotas for the proportion of the total medical expenses and the total medical expenses outside the scope are adjusted to 10% for tertiary hospitals and secondary hospitals. 8%, First Class Medical