因为这件事，大批医保药店被曝光
<section powered-by="xiumi.us" style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; letter-spacing: 0.544px; text-align: justify; white-space: normal; background-color: rgb(255, 255, 255); visibility: visible; overflow-wrap: break-word !important;"><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; visibility: visible; overflow-wrap: break-word !important;">一批医保药店被查处！</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; visibility: visible; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; visibility: visible;"/></p></section><p></p><section powered-by="xiumi.us" style="margin: 10px 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; letter-spacing: 0.544px; white-space: normal; background-color: rgb(255, 255, 255); text-align: center; justify-content: center; display: flex; flex-flow: row nowrap; visibility: visible; overflow-wrap: break-word !important;"><section style="margin: 0px; padding: 0px 20px 3px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; display: inline-block; width: auto; vertical-align: top; border-style: solid; border-width: 1px; border-color: rgb(127, 127, 127); box-shadow: rgb(141, 122, 186) -3px 3px 0px; min-width: 10%; flex: 0 0 auto; height: auto; line-height: 1; letter-spacing: 0px; align-self: flex-start; visibility: visible;"><section powered-by="xiumi.us" style="margin: -10px 0px 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; visibility: visible;"><section style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; text-align: left; letter-spacing: 0px; line-height: 1; visibility: visible;"><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; visibility: visible; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; visibility: visible; overflow-wrap: break-word !important;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; visibility: visible;">多家医保药店被中止协议</strong></span></p></section></section></section></section><section powered-by="xiumi.us" style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; letter-spacing: 0.544px; text-align: justify; white-space: normal; background-color: rgb(255, 255, 255); visibility: visible; overflow-wrap: break-word !important;"><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; visibility: visible; overflow-wrap: break-word !important;">日前，据广东化州市医疗保障事业管理中心称，该中心在对全市定点零售药店开展日常巡查的过程中，发现化州市那务镇壶垌延龙堂大药房中垌分店等11家定点零售药店分别存在营业时间内执业药师不在岗、POS机医保消费不能按规定打印明细、未凭处方单售卖处方药、非药品用医保个人账户社会保障卡支付、坐堂医生为病人看病或打针、不配合检查等违反定点零售药店服务协议的情况。<br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; visibility: visible;"/></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; visibility: visible; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; visibility: visible;"/></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; visibility: visible; overflow-wrap: break-word !important;">根据《关于进一步完善基本医疗保险定点医药机构协议管理有关工作的通知》（茂医保〔2020〕77号）第八条第二项有关规定，自2022 年 9月 29日起中止11家定点零售药店服务协议。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; visibility: visible; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; visibility: visible;"/></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; visibility: visible; overflow-wrap: break-word !important;">除化州外，包括四川汉源县、浙江浦江县以及辽宁阜新蒙古族自治县医保局等地均对违反医保服务协议的药店进行曝光。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; visibility: visible; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; visibility: visible;"/></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; visibility: visible; overflow-wrap: break-word !important;">在汉源县通报的案例中，37家药店主要存在的违规内容有：<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; visibility: visible;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(122, 79, 214); visibility: visible;">使用医保凭证购买化妆品、生活用品、营养用品；无处方销售处方药；药品购销存比率不符规定；营业时间执业药师不在岗。</span></strong></p><p style="margin-top: 8px; margin-bottom: 8px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;"></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;">据了解，今年4月，汉源县医保局召开2022年医疗保障基金监管集中宣传月活动暨专项治理工作会议，安排部署了2022年医保基金监管专项治理工作。会议强调，要推进医保基金监管常态化、制度化、规范化、精细化，严厉打击欺诈骗保行为。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;"/></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;">在浦江县通报的18家定点药店，主要扣分项目有<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(122, 79, 214);">“价格公示部分未标价”“监控记录未保存”“中药配备率不足”“药师不在岗”</span></strong>等。而阜新蒙古族自治县的17家定点药店分别存在<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(122, 79, 214);">药师不在岗、无处方销售处方药、无法提供处方、处方未盖章、处方填写不全、他人代写处方</span></strong>等违反协议规定的行为。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"/></p></section><section powered-by="xiumi.us" style="margin: 10px 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; letter-spacing: 0.544px; white-space: normal; background-color: rgb(255, 255, 255); text-align: center; justify-content: center; display: flex; flex-flow: row nowrap; overflow-wrap: break-word !important;"><section style="margin: 0px; padding: 0px 20px 3px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; display: inline-block; width: auto; vertical-align: top; border-style: solid; border-width: 1px; border-color: rgb(127, 127, 127); box-shadow: rgb(141, 122, 186) -3px 3px 0px; min-width: 10%; flex: 0 0 auto; height: auto; line-height: 1; letter-spacing: 0px; align-self: flex-start;"><section powered-by="xiumi.us" style="margin: -10px 0px 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;"><section style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important; text-align: left; letter-spacing: 0px; line-height: 1;"><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;">多地医保药店迎监管新规</strong></span></p></section></section></section></section><section powered-by="xiumi.us" style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; color: rgb(34, 34, 34); font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; letter-spacing: 0.544px; text-align: justify; white-space: normal; background-color: rgb(255, 255, 255); overflow-wrap: break-word !important;"><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;">医保基金是人民群众的“看病钱”、“救命钱”，如何管好用好这笔钱关系到广大人民群众的切身利益。<br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;"/></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;"/></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;">在管理方面，<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(122, 79, 214);">广东医保局在《广东省零售药店医疗保障定点管理经办规程》中明确了17类解除医保服务协议的情况，</span></strong>包括以弄虚作假等不正当手段申请取得定点的；以伪造、变造医保药品“进、销、存”票据和账目、伪造处方或参保人员费用清单等方式，骗取医疗保障基金的；将非医保药品或其他商品串换成医保药品，倒卖医保药品或套取医疗保障基金的；为非定点零售药店、中止医保协议的定点零售药店或其他机构进行医保费用结算的；将医保结算设备转借或赠与他人，改变使用场地的；拒绝、阻挠或不配合经办机构开展现场检查、智能审核、绩效考核等，情节恶劣的；被发现重大信息发生变更但未办理变更的等。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;"/></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(122, 79, 214);">山东济南在《济南市医疗保障基金使用监督管理办法（征求意见稿）》提出，</span></strong>定点医药机构为参保人员提供医疗服务，应当核验医疗保障凭证并向参保人员如实出具费用单据和相关资料，不得将应当由医保基金支付的费用转由参保人员承担。定点医药机构不得以现金、优惠券、实物或提供其他非法利益的方式诱导参保人就医、购药。定点医药机构有违反医保政策规定和定点服务协议行为的，医疗保障经办机构可根据违规违约行为的性质和情节严重程度，分别或同时给予约谈、限期整改、暂停拨付、拒付违规费用、扣除履约保证金、核减总控指标额度、中止协议、解除协议等处理；定点医药机构及其相关责任人员有权进行陈述、申辩。</p><p style="margin-top: 8px; margin-bottom: 8px; padding: 0px; outline: 0px; max-width: 100%; clear: both; min-height: 1em; text-align: center; box-sizing: border-box !important; overflow-wrap: break-word !important;"></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;">此外，在对定点零售药店进行规范化管理方面，<strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important;"><span style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box !important; overflow-wrap: break-word !important; color: rgb(122, 79, 214);">河南新昌县则进行了医保定点零售药店“红黑榜”管理，</span></strong>其中“红榜”鼓励、“黑榜”惩戒，并将定期对社会公布“红黑榜”药店信息，接受全社会监督。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;"/></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;">据介绍，新昌县有医保定点零售药店91家，定点率91%，但高定点率在保障参保市民享受便利服务的同时，也给基金监管带来了压力。“红黑榜”管理办法的实施，让定点药店依法经营有了硬标准，让药店争先创优有了内生动力，也让社会监督有了新渠道，将形成监管合力。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;"/></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;">该管理试行办法制定了“红榜”“黑榜”相关标准，有5项行为将被列入“红榜”，8项行为则会被列入“黑榜”。“红黑榜”一年一评，动态管理，每年4月底向社会公布结果，对纳入“黑榜”的定点药店，除纳入社会信用奖惩系统外，还将作为重点检查对象，加密检查频次，两年内取消各类评先评优资格，同时纳入卫生健康、市场监管等部门联合惩戒对象。</p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; overflow-wrap: break-word !important;"><br style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;"/></p></section><section powered-by="xiumi.us" style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; font-family: system-ui, -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif; letter-spacing: 0.544px; text-align: justify; white-space: normal; background-color: rgb(255, 255, 255); color: rgb(137, 137, 137); font-size: 14px; overflow-wrap: break-word !important;"><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; text-align: center; overflow-wrap: break-word !important;"><strong style="margin: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; overflow-wrap: break-word !important;">来源</strong></p><p style="margin-top: 0px; margin-bottom: 0px; padding: 0px; outline: 0px; max-width: 100%; box-sizing: border-box; clear: both; min-height: 1em; text-align: center; overflow-wrap: break-word !important;">米内零售观察</p></section><p></p><p><br/></p><link rel="stylesheet" href="//www.dafuping.cn/source/plugin/wcn_editor/public/wcn_editor_fit.css?v134_uyy" id="wcn_editor_css"/>
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