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公立医疗机构开展“互联网+医疗服务”,收费行为规范出台

2020-05-14 杨迪 人民网-人民健康网

为进一步发挥“互联网+医疗服务”在疫情防控中的优势作用,规范医疗机构“互联网+医疗服务”价格行为,维护患者与医疗机构的合法权益,做好财务管理工作,促进&

为进一步发挥“互联网+医疗服务”在疫情防控中的优势作用,规范医疗机构“互联网+医疗服务”价格行为,维护患者与医疗机构的合法权益,做好财务管理工作,促进“互联网+医疗服务”新模式的长远发展。国家卫生健康委、国家中医药管理局昨日共同发布《国家卫生健康委 国家中医药管理局关于做好公立医疗机构“互联网+医疗服务”项目技术规范及财务管理工作的通知》(以下简称“通知”)。

国家卫健委财务司在解读通知表示,通知的主要内容包括四个部分:第一部分提出“互联网+医疗服务”项目相关管理要求。明确了10项“互联网+医疗服务”项目,规范了医疗机构开展相关服务的收费行为。

第二部分提出“互联网+医疗服务”会计核算及财务管理要求。明确了不同主体在开展“互联网+医疗服务”过程中的利益分配关系、收入确认原则、财务处理及票据处理要求等。

第三部分提出开展“互联网+医疗服务”后的工作量统计要求。明确了邀请方和受邀方开展“互联网+医疗服务”后,医疗机构内部和整体区域范围内的工作量统计标准。

第四部分附件明确“互联网+医疗服务”项目技术规范内容,依据是《互联网诊疗管理办法(试行)》《互联网医院管理办法(试行)》及《远程医疗服务管理规范(试行)》中临床准入的相关技术要求。

通知全文如下:

关于做好公立医疗机构“互联网+医疗服务”项目技术规范及财务管理工作的通知

国卫财务函〔2020〕202号

各省、自治区、直辖市卫生健康委、中医药管理局,新疆生产建设兵团卫生健康委:

发展“互联网+医疗服务”(含远程医疗)是推进区域医疗资源整合共享、促进优质医疗资源下沉、降低患者就医成本的重要举措。为深入贯彻落实习近平总书记关于统筹做好疫情防控与经济社会发展各项工作的重要指示精神,根据《国务院关于积极推进“互联网+”行动的指导意见》(国发〔2015〕40号)、国家发展改革委等4部门《关于印发推进医疗服务价格改革意见的通知》(发改价格〔2016〕1431号)、《国务院办公厅关于促进“互联网+医疗健康”发展的意见》(国办发〔2018〕26号)有关要求,我们将进一步发挥“互联网+医疗服务”在疫情防控中的优势作用,规范医疗机构“互联网+医疗服务”价格行为,维护患者与医疗机构的合法权益,做好财务管理工作,促进“互联网+医疗服务”新模式的长远发展。现将有关事项通知如下:

一、规范“互联网+医疗服务”项目相关管理工作

(一)规范收费项目。省级卫生健康行政部门要按照全国统一的“互联网+医疗服务”项目技术规范(详见附件),向社会公布允许在本地区实施的项目技术规范。各级公立医疗机构(简称医疗机构,下同)按照属地原则,严格执行本地区允许实施的项目技术规范。在全国“互联网+医疗服务”项目技术规范外,医疗机构新增的“互联网+医疗服务”项目,须经省级卫生健康行政部门确认并公布,否则医疗机构不得申报价格和开展相关收费服务(特需医疗服务除外)。

(二)加强项目成本测算。省级卫生健康行政部门要研究制订医疗服务价格项目成本测算指导意见,建立健全成本测算管理办法,加强对医疗机构互联网价格项目成本测算工作的指导。医疗机构要加强项目成本测算能力建设,为“互联网+医疗服务”项目价格标准的制订和调整提供依据。

(三)规范收费行为。各地要加强医疗机构内部价格行为的监督管理。医疗机构作为提供“互联网+医疗服务”的责任主体,要进一步规范价格行为。医疗机构应当根据患者的病情,优先在本省域内组织开展“互联网+医疗服务”,并向患者说明项目内容、收费标准等情况,征得患者同意。“互联网+医疗服务”由接诊医疗机构(指互联网诊疗活动中向患者提供诊疗服务的医疗机构和远程医疗服务活动中的邀请方)向患者收取医疗服务费用。接诊医疗机构按照协议向其他参与的机构(指远程医疗服务活动中的受邀方或提供第三方平台的机构等)支付费用。医疗机构应当严格执行《医疗机构内部价格行为管理规定》(国卫财务发〔2019〕64号),落实价格公示制度,在医疗机构现场及网站的显着位置公示所开展的“互联网+医疗服务”价格项目名称、项目内涵、计价单位、价格、说明等内容,自觉接受社会监督。

二、明确“互联网+医疗服务”会计核算及财务管理

(一)确定分配关系。开展“互联网+医疗服务”过程中涉及的医疗机构应当在不增加患者整体费用的前提下,自行协商确定医疗收入分配比例,签署约定协议。开展“互联网+医疗服务”过程中涉及医疗机构与提供第三方平台机构之间合作的,属于市场主体之间的行为,应当按照相关法律法规,以协议的形式约定相关主体间的权利和义务。

(二)收入确认原则。根据国家统一的会计制度,由接诊医疗机构全额确认医疗收入。如果涉及受邀方,受邀方按照与接诊医疗机构的协议约定确认医疗收入;接诊医疗机构按照协议约定,将应支付给受邀方的款项,同步冲减医疗收入。

(三)账务处理要求。为满足“互联网+医疗服务”管理需要,明确区分线上、线下医疗服务收支管理,医疗机构在会计核算时,应当在应收、应付类科目以及收入、费用、预算收入和预算支出等科目下对“互联网+医疗服务”业务进行相关明细核算。

(四)收费票据管理。“互联网+医疗服务”由接诊医疗机构向患者收取费用,并向患者提供全额医疗收费票据和费用清单。远程医疗服务中,受邀方应当依据协议约定按照接诊医疗机构支付的金额开具医疗收费票据,作为接诊医疗机构冲减医疗收入的依据。

(五)定期结算制度。开展“互联网+医疗服务”时,医疗机构应当及时结算、及时记账。医疗机构间结算时间原则上不超过3个月。

三、统一医疗服务工作量统计口径

医疗机构统计“互联网+医疗服务”工作量时,对1个诊疗活动由1家医疗机构独立完成服务的情况,该医疗机构依据医嘱计1次工作量;对由接诊医疗机构(远程医疗服务活动中的邀请方)和受邀方共同完成服务的情况,双方可分别计1次工作量。行政部门在开展宏观数据统计时,应当依据实际诊疗人次只对受邀方工作量进行统计。

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