By hannover-web.com On October 16, the National Healthcare Security Administration (NHSA) announced the release of guidelines aimed at standardizing the management of external prescriptions for reimbursed medications. The notice emphasizes the urgent need to advance the development of electronic prescription centers, connecting national healthcare agencies, designated medical institutions, and retail pharmacies to ensure the smooth flow of electronic prescriptions.
In the notice, the NHSA highlights significant progress made in recent years to enhance access to healthcare and medication for insured individuals. These efforts include establishing a cooperative medical insurance system for outpatient care, improving medication security for chronic diseases in urban and rural populations, and accelerating the construction of electronic prescription centers.
However, a recent special inspection revealed that some designated medical institutions and retail pharmacies are exhibiting poor management practices regarding external prescriptions, including fraudulent prescriptions and excessive medication dispensing. These issues not only violate the rights of insured individuals but also pose a risk to the stability of the healthcare fund, highlighting the necessity for stricter regulation of external prescription management. The NHSA urges local jurisdictions to analyze instances of fraud, like those reported in Harbin, and implement comprehensive oversight of the entire prescription process.
The guidelines outline several key points for improving management of external prescriptions for healthcare reimbursements:
1. **Standardize Prescription Services in Designated Medical Institutions:** Local healthcare departments must guide institutions on providing necessary medications per relevant agreements and requirements. If certain medications are unavailable but needed, external prescription services should be offered. Areas already utilizing the electronic prescription center must provide services through this platform, while those still relying on paper prescriptions require them to be signed by authorized personnel. All external prescriptions must be retained for at least two years.
2. **Enhance Management of Retail Pharmacies:** Retail pharmacies must meticulously check the authenticity and legality of prescriptions, ensuring that medications dispensed comply with regulations. In areas with electronic prescription centers, they should download prescriptions for dispensing. Pharmacies must retain paper prescriptions properly and submit them for periodic checks.
3. **Strengthen Prescription Flow Management:** Generally, prescriptions billed to the healthcare fund must originate from local designated medical institutions. Local health departments will ensure adherence to national service agreements regarding prescription management, with regular audits to identify illicit activities.
4. **Accelerate Implementation of Electronic Prescription Centers:** All regions are to use the unified healthcare information platform to facilitate electronic prescription flows, requiring designated pharmacies to transition to electronic prescriptions for dual-channel medications by January 1, 2025. Extensions for paper prescription usage may be allowed under certain circumstances.
5. **Conduct Special Governance on External Prescription Use:** Local healthcare departments are tasked with assessing external prescription management as part of fraud prevention efforts. By late 2024, there will be focused inspections on prescriptions related to outpatient chronic and special disease medications. Data analysis will ensure rigorous checks on prescriptions with high usage or unusually large quantities, addressing fraudulent cases promptly.
The NHSA urges all regions to recognize the significance of tightening prescription management, ensuring designated medical institutions and pharmacies comply with electronic prescription center protocols. Increased public awareness and transparency surrounding these regulations are essential to foster a cooperative environment among insured individuals. Any significant issues encountered must be promptly reported to the NHSA.
