近日，据国家医保局网站消息，为加强医保基金监管，保障医保基金安全，各地医保部门积极响应，对属地定点零售药店集中开展合规经营谈话提醒，旨在规范药店的经营销售和医保基金使用行为。这一举措是继国家医保局对一心堂药业集团股份有限公司有关负责人进行约谈后的重要跟进，旨在通过强化监管，提高药店的合规意识，确保医保基金的合理使用。
#### 云南、吉林、贵州、海南、新疆等省份的医保部门纷纷采取行动
– **云南省医疗保障局**对定点零售药店进行了约谈，通报了近年来医保部门查处的违法违规使用医保基金情况，并解读相关法律法规和政策文件，以增强药店的诚信合规意识。同时，印发了《云南省定点零售药店医保基金使用负面清单》，并组织全省所有医保定点零售药店开展常态化自查自纠，以避免再次发生违法违规使用医保基金的问题。
– **吉林省医疗保障局**对15家定点零售药店负责人进行了集中谈话提醒，要求药店树立依法经营意识，规范执行医保政策，利用其行业优势和网点分布，主动发现并报告异常购销和价格问题，同时作为医保政策的宣传“网点”，发挥正面作用，共同维护医保基金安全。
– **贵州省医疗保障局**召开警示教育会议，传达国家医保局的约谈情况，组织观看医保基金监管警示教育宣传视频，以提高药店的合规意识。同时，印发了《关于进一步加强定点零售药店监管工作的通知》，强调各地医保部门应加强对定点零售药店的监管力度，压实其基金使用主体责任。
– **海南省医疗保障局**印发了《关于加强定点零售药店监管工作的通知》，全省18个市县医保部门同步对定点零售药店进行了集中谈话提醒，引导药店加强制度建设、政策培训和执行，以及自查自纠，确保医保基金的合理使用。
– **新疆生产建设兵团医疗保障局**召开定点零售药店警示提醒会，传达国家医保局的部署要求，要求各药店进行自查自纠，主动退回违规使用的医保基金，加强药品耗材溯源码信息上传，增强工作人员的合规意识，共同维护医保基金安全。
### 结语
通过这一系列的约谈和提醒行动，各地医保部门旨在构建更加严密的医保基金监管体系，确保医保基金的使用符合法律法规，保护人民群众的医疗保障权益。这些举措不仅提高了药店的合规经营意识，也为维护医保基金的安全和有效使用提供了坚实的基础。
英语如下：
### Nationwide Medical Insurance Authorities Mobilize定点药店 for Conformity Talks, Strengthening Fund Usage Regulations
In recent developments, the National Medical Insurance Administration has initiated a series of compliance discussions with designated retail pharmacies across the country, aiming to tighten the reins on the use of medical insurance funds. This move follows closely on the heels of a conversation with the head of Yitianyantang Pharmaceutical Group Company, signaling the administration’s commitment to enhancing oversight and ensuring the rational use of medical insurance funds.
#### Action Taken by Medical Insurance Authorities in Multiple Provinces
– **Yunnan Province’s Medical Insurance Bureau** convened discussions with designated retail pharmacies, highlighting past instances of misuse of medical insurance funds and clarifying relevant laws, regulations, and policies. This was coupled with the distribution of a ‘Negative List of Medical Insurance Fund Usage for Designated Retail Pharmacies in Yunnan Province’, encouraging a regular self-inspection process to prevent future misuse.
– **Jilin Province’s Medical Insurance Bureau** gathered 15 pharmacy managers for a collective reminder session, emphasizing the importance of legal business practices and strict adherence to medical insurance policies. The pharmacies were also encouraged to play a proactive role in identifying and reporting unusual purchasing and pricing behaviors, serving as a beacon for medical insurance policy dissemination.
– **Guan Zhou’s Medical Insurance Bureau** organized an警示教育 meeting, sharing insights from the National Medical Insurance Administration’s previous conversation. This was complemented by the screening of a medical insurance fund management警示教育 video, aimed at heightening pharmacies’ awareness of compliance.
– **Hainan Province’s Medical Insurance Bureau** issued a notification for strengthened regulation of designated retail pharmacies, instructing all 18 county-level medical insurance bureaus to engage in compliance discussions. The focus was on enhancing regulatory efforts,压实 pharmacies’ responsibility for fund usage, and promoting the development of internal policies, training, and self-inspection processes.
– **The Medical Insurance Bureau of Xinjiang Production and Construction Corps** convened a meeting for designated retail pharmacies, echoing the National Medical Insurance Administration’s directives. The emphasis was on self-inspection, refunding misused medical insurance funds, and improving the traceability of drug and material information, with a special focus on strengthening staff compliance awareness.
### Conclusion
These series of compliance discussions and reminders are part of a concerted effort by the medical insurance authorities to build a more robust regulatory framework for medical insurance fund usage. The aim is to ensure that the funds are used in accordance with the law, safeguarding the interests of the public’s medical security. These initiatives not only elevate pharmacies’ awareness of compliance in their operations but also lay a solid foundation for maintaining the safety and effective use of medical insurance funds.
【来源】http://www.chinanews.com/life/2024/07-25/10257044.shtml
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