2024-08-16
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Editor's Note: After the interview on May 24, 2024,Yixintang Pharmaceutical GroupImplementing nationalHealth InsuranceThe relevant requirements of the Bureau, in Yunnan ProvinceMedical Insurance BureauUnder the active guidance of the , we have earnestly carried out self-examination and self-correction of the use of medical insurance funds and comprehensive rectification, adopted a series of measures, and achieved phased results. The specific rectification situation of Yixintang is now released as follows.
Yixintang Pharmaceutical Group's rectification situation
On May 24, 2024, after being interviewed by the National Healthcare Security Administration, Yixintang conducted self-examination, self-correction and comprehensive rectification in accordance with the requirements. The progress is as follows:
First, we must recognize the problem and make immediate corrections. After the interview, Yixintang realized that maintaining the security of medical insurance funds is a common political responsibility entrusted to all parties by the Party Central Committee and the State Council. As a large chain drugstore, it must enhance its sense of responsibility and play a leading role in demonstration. It must strictly demand itself and manage itself. On the afternoon of the day of the interview, Yixintang held a telephone conference to convey the relevant requirements of the National Medical Insurance Administration, and set up a special working group headed by the chairman and president of the group to formulate and issue the "Special Work Plan for Self-inspection and Self-examination of the Use of Medical Insurance Funds of Yixintang Pharmaceutical Group Co., Ltd." and arrange for the deployment of self-inspection and rectification work.
Second, we will check the list and make comprehensive rectifications.Fixed pointNegative list of retail pharmacies using medical insurance funds, from whether there is "falsePrescribing medication, substitution of drugs, excessive prescription of drugs, conducting medical insurance settlement on behalf of other pharmacies, and daily management". The group's 9,179 directly-operated chain medical insurance designated pharmacies will conduct self-inspection and self-correction on the use of medical insurance funds from May 1, 2021 to May 30, 2024, and learn from the lessons to comprehensively investigate other issues in the use of medical insurance funds. More than 10.7 million yuan of medical insurance funds involved in violations have been returned.
The third is to strengthen training and raise awareness. Organize all store employees to carry out special studies on the importance of maintaining the safety of medical insurance funds to improve awareness of maintaining the safety of medical insurance funds. Invite the Yunnan Provincial Medical Insurance Bureau to come to the company to carry out special training, train 1,200 employees, and record live playback videos, organize store employees to watch and learn repeatedly, and a total of more than 80,000 people clicked to watch. Set up an online "Strict Fund Management, Adhere to Legal Operations" learning column, complete the first "Medical Insurance Fund Use Behavior Code" training test for the entire group, more than 31,000 people participated in the study, the pass rate of the test was more than 98%, and the test results were included in the performance appraisal of the month.
Fourth, cooperate with the pilot and improve the mechanism. Under the guidance of Yunnan Provincial Medical Insurance Bureau, Yixintang Yunnan Company carried out a pilot project on the application of drug traceability codes in stores in 16 cities and prefectures in Yunnan Province to prevent the secondary sale of returned drugs from the perspective of information technology.
Fifth, strengthen constraints and management. Re-examine and revise the internal medical insurance fund use management system, supplement and improve the requirements for the implementation of medical insurance management and personnel behavior norms in designated retail pharmacies; revise the "Medical Insurance Personnel Management System". Strengthen the synergy of the company's compliance management system, quality management system, and internal control system, improve the level of medical insurance compliance management, let every employee clearly realize that compliance operation is the lifeline of corporate development, and firmly establish compliance awareness.
In the next step, the National Healthcare Security Administration and provincial healthcare security departments will continue to strengthen the management and guidance of Yixintang’s use of medical insurance funds, promote Yixintang to continuously improve its systems, strengthen internal management, and standardize the rational use of medical insurance funds.