Shandong rural children's three categories of diseases enter medical insurance to start pilot projects
once the child suffers from severe leukemia, such as leukemia, a huge amount of medical expenses often makes the ordinary family in crisis. Today, the reporter learned from the health department of Shandong province that our province will carry out a pilot project to improve the medical security level of the major diseases of rural children. This year, the pilot area will be 0 to 14 years old (14 years old) of children with congenital heart disease, acute leukemia and simple cleft lip, which will be gradually included in the scope of major diseases.
our province first selected 6 counties (cities and districts) and other counties (cities and districts) in Laoshan District, Qingdao. At the same time, they also asked the cities to choose at least 1 counties (cities and districts) to carry out pilot projects. In 2011, more than 50% of the counties (cities and districts) were expanded to be pushed open in the whole province in 2012, so as to make effective treatment for children with leukemia, congenital heart disease and simple cleft lip in the province. On this basis, our province will expand the disease to 2015, and strive to make effective treatment for the rural children suffering from serious diseases in the whole province.
in terms of cost reimbursement, our province will standardize the diagnosis and treatment plan based on the pilot diseases, and reasonably calculate the cost limits for the diagnosis and treatment of related diseases. The new rural cooperative medical scheme and the medical relief fund, on the basis of the limited cost, implement payment by disease, and the expenses beyond the limit in principle shall be borne by the designated hospitals.
the cost of diagnosis and treatment within the limit of congenital heart disease and acute leukemia, the NCMS is compensated according to the proportion of 70%, and the medical assistance is compensated according to the proportion of 20%, and the conditional regional medical assistance can increase the proportion of compensation. For the simple diagnosis and treatment of the cleft lip, the NCMS should be compensated by no less than 70%. The participating patients are entitled to the prescribed compensation in the corresponding designated medical institutions in the province. Before the introduction of the cost limit for related diseases in the province, the new rural cooperative medical system and medical assistance should be compensated for the above proportion.