医保特殊药品目录调整通知
<section style="margin:10px 0px;"><section style="display: inline-block; width: 100%; vertical-align: top; border-width: 0px; box-shadow: rgb(0, 0, 0) 0px 0px 0px; box-sizing: border-box;" data-width="100%"><section style="margin-top: 10px; margin-bottom: 10px;"><section style="border-width: 1px; border-style: solid; border-color: rgb(232, 73, 63); border-radius: 5px; box-sizing: border-box;"><section><section style="width: 5px; height: 5px; border-bottom: 1px solid rgb(232, 73, 63); border-right: 1px solid rgb(232, 73, 63); float: left; border-top-color: rgb(232, 73, 63); border-left-color: rgb(232, 73, 63); box-sizing: border-box;"></section><section style="width: 5px; height: 5px; border-bottom: 1px solid rgb(232, 73, 63); border-left: 1px solid rgb(232, 73, 63); float: right; border-top-color: rgb(232, 73, 63); border-right-color: rgb(232, 73, 63); box-sizing: border-box;"></section><section style="clear: both;"></section></section><section style="padding-right: 4px; padding-left: 4px; box-sizing: border-box;"><section style="width: 100%; border-width: 1px; border-style: solid; border-color: rgb(232, 73, 63); margin-top: -1px; margin-bottom: -1px; padding-top: 10px; padding-bottom: 10px; box-sizing: border-box;" data-width="100%"><section><section style="font-size: 14px; line-height: 1.8; letter-spacing: 2px; padding-right: 10px; padding-left: 10px; box-sizing: border-box;"><p style="white-space: normal;"></p><section style="text-align: center;justify-content: center;display: flex;flex-flow: row;margin: 0px 0px 15px;box-sizing: border-box;"><section style="display: inline-block;width: 100%;vertical-align: top;align-self: flex-start;flex: 0 0 auto;height: auto;padding: 10px;background-color: rgba(160, 160, 160, 0.07);border-style: solid;border-width: 1px;border-color: rgb(13, 105, 201);border-radius: 5px;overflow: hidden;box-sizing: border-box;"><section style="text-align: justify;font-size: 15px;letter-spacing: 2px;line-height: 2;box-sizing: border-box;"><p style="text-indent: 2.2667em; text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;">医保特殊药品，是指国家为减轻参保患者就医负担，对部分药品进行特殊管理并纳入医保报销范围的药品，简称“特药”，具有价格昂贵、用药人群特定、用药指征明确、限定用量等特征。</p></section><section style="text-align: justify;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><br style="box-sizing: border-box;"/></p></section><section style="text-align: left;justify-content: flex-start;display: flex;flex-flow: row;margin: 10px 0px;box-sizing: border-box;"><section style="display: inline-block;vertical-align: middle;width: auto;align-self: center;flex: 0 0 auto;min-width: 5%;max-width: 100%;height: auto;line-height: 0;padding: 0px 5px 0px 0px;box-sizing: border-box;"><section style="transform: perspective(0px);-webkit-transform: perspective(0px);-moz-transform: perspective(0px);-o-transform: perspective(0px);transform-style: flat;box-sizing: border-box;"><section style="text-align: center;margin: 0px;transform: rotateY(180deg);-webkit-transform: rotateY(180deg);-moz-transform: rotateY(180deg);-o-transform: rotateY(180deg);line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;width: 21px;height: auto;box-sizing: border-box;"><svg width="100%" xmlns="http://www.w3.org/2000/svg" viewbox="0 0 288.279 254.107" style="max-width: 100%;width: 100%;box-sizing: border-box;"><g style="box-sizing: border-box;"><g style="box-sizing: border-box;"><path d="M288.279,254.107,68.215,127.054,288.279,0ZM80.3,127.054,282.236,243.643V10.465Z" fill="rgb(62,62,62)" style="box-sizing: border-box;"></path><polygon points="0 124.499 211.001 246.32 211.001 2.677 0 124.499" fill="rgb(97,163,246)" style="box-sizing: border-box;"></polygon></g></g></svg></section></section></section></section><section style="display: inline-block;vertical-align: middle;width: auto;align-self: center;flex: 0 0 auto;min-width: 5%;max-width: 100%;height: auto;padding: 3px 20px;background-image: linear-gradient(45deg, rgb(72, 213, 244) 0%, rgb(110, 94, 247) 100%);box-sizing: border-box;"><section style="font-size: 15px;text-align: justify;color: rgb(255, 255, 255);letter-spacing: 2px;line-height: 1.5;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><strong style="box-sizing: border-box;">一、支付规定</strong></p></section></section></section><section style="text-align: justify;font-size: 15px;line-height: 2;letter-spacing: 2px;box-sizing: border-box;"><p style="text-indent: 2.2667em; text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;">1、特药实行单独支付管理规定，不单设起付标准和支付限额，不受门诊慢特病病种限额限制，分别计入基本医疗保险、补充医疗保险、医疗救助年度统筹基金支付限额。</p><p style="text-indent: 2.2667em; text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;">2、参保人员在住院、门诊和特殊药品定点零售药店发生的特药费用，由个人先行自付15%，剩余85%纳入统筹基金支付范围。<strong style="box-sizing: border-box;">职工医保支付比例为83%</strong>，<strong style="box-sizing: border-box;">居民医保支付比例为60%</strong>。</p></section><section style="text-align: justify;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><br style="box-sizing: border-box;"/></p></section><section style="text-align: left;justify-content: flex-start;display: flex;flex-flow: row;margin: 10px 0px;box-sizing: border-box;"><section style="display: inline-block;vertical-align: middle;width: auto;align-self: center;flex: 0 0 auto;min-width: 5%;max-width: 100%;height: auto;line-height: 0;padding: 0px 5px 0px 0px;box-sizing: border-box;"><section style="transform: perspective(0px);-webkit-transform: perspective(0px);-moz-transform: perspective(0px);-o-transform: perspective(0px);transform-style: flat;box-sizing: border-box;"><section style="text-align: center;margin: 0px;transform: rotateY(180deg);-webkit-transform: rotateY(180deg);-moz-transform: rotateY(180deg);-o-transform: rotateY(180deg);line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;width: 21px;height: auto;box-sizing: border-box;"><svg width="100%" xmlns="http://www.w3.org/2000/svg" viewbox="0 0 288.279 254.107" style="max-width: 100%;width: 100%;box-sizing: border-box;"><g style="box-sizing: border-box;"><g style="box-sizing: border-box;"><path d="M288.279,254.107,68.215,127.054,288.279,0ZM80.3,127.054,282.236,243.643V10.465Z" fill="rgb(62,62,62)" style="box-sizing: border-box;"></path><polygon points="0 124.499 211.001 246.32 211.001 2.677 0 124.499" fill="rgb(97,163,246)" style="box-sizing: border-box;"></polygon></g></g></svg></section></section></section></section><section style="display: inline-block;vertical-align: middle;width: auto;align-self: center;flex: 0 0 auto;min-width: 5%;max-width: 100%;height: auto;padding: 3px 20px;background-image: linear-gradient(45deg, rgb(72, 213, 244) 0%, rgb(110, 94, 247) 100%);box-sizing: border-box;"><section style="text-align: justify;color: rgb(255, 255, 255);letter-spacing: 2px;line-height: 1.5;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><strong style="box-sizing: border-box;"><span style="font-size: 15px;box-sizing: border-box;">二、鉴定流程</span></strong></p></section></section></section><section style="text-align: justify;font-size: 15px;line-height: 2;letter-spacing: 2px;box-sizing: border-box;"><p style="text-indent: 2.2667em; text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;">1、门诊使用特药需先申请备案，备案成功后从审批通过之日起享受待遇，一个自然年度为一个备案周期。</p><p style="text-indent: 2.2667em; text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;">2、申请特药所需鉴定资料：诊断证明、病历复印件、影像学报告、病理检测报告、基因检测报告等。</p><p style="text-indent: 2.2667em; text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;">3、门诊特殊药品申请鉴定流程：</p></section><section style="justify-content: center;display: flex;flex-flow: row;margin: 10px 0px;box-sizing: border-box;"><section style="display: inline-block;width: auto;vertical-align: top;align-self: flex-start;flex: 0 0 auto;background-color: rgb(235, 159, 137);min-width: 5%;max-width: 100%;height: auto;padding: 8px 12px;box-sizing: border-box;"><section style="margin: 0px;box-sizing: border-box;"><section style="text-align: justify;color: rgb(255, 255, 255);letter-spacing: 2px;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><span style="font-size: 15px;box-sizing: border-box;">持鉴定资料在门诊5-7号窗口领取申请表</span></p></section></section></section></section><section style="margin: 1px 0% 10px;line-height: 0.8;box-sizing: border-box;"><section style="width: 0px;display: inline-block;border-top: 0.8em solid rgb(199, 38, 38);border-left: 0.7em solid transparent !important;border-right: 0.7em solid transparent !important;box-sizing: border-box;"><svg viewbox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section><section style="justify-content: center;display: flex;flex-flow: row;margin: 0px 0px 10px;box-sizing: border-box;"><section style="display: inline-block;width: auto;vertical-align: top;align-self: flex-start;flex: 0 0 auto;background-color: rgb(235, 159, 137);min-width: 5%;max-width: 100%;height: auto;padding: 8px 12px;box-sizing: border-box;"><section style="margin: 0px;box-sizing: border-box;"><section style="text-align: justify;color: rgb(255, 255, 255);letter-spacing: 2px;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><span style="font-size: 15px;box-sizing: border-box;">门诊挂特药医师专家号鉴定</span></p></section></section></section></section><section style="margin: 1px 0% 10px;line-height: 0.8;box-sizing: border-box;"><section style="width: 0px;display: inline-block;border-top: 0.8em solid rgb(199, 38, 38);border-left: 0.7em solid transparent !important;border-right: 0.7em solid transparent !important;box-sizing: border-box;"><svg viewbox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section><section style="justify-content: center;display: flex;flex-flow: row;margin: 0px 0px 10px;box-sizing: border-box;"><section style="display: inline-block;width: auto;vertical-align: top;align-self: flex-start;flex: 0 0 auto;background-color: rgb(235, 159, 137);min-width: 5%;max-width: 100%;height: auto;padding: 8px 12px;box-sizing: border-box;"><section style="margin: 0px;box-sizing: border-box;"><section style="text-align: justify;color: rgb(255, 255, 255);letter-spacing: 2px;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><span style="font-size: 15px;box-sizing: border-box;">门诊5-7号窗口审核盖章</span></p></section></section></section></section><section style="margin: 1px 0% 10px;line-height: 0.8;box-sizing: border-box;"><section style="width: 0px;display: inline-block;border-top: 0.8em solid rgb(199, 38, 38);border-left: 0.7em solid transparent !important;border-right: 0.7em solid transparent !important;box-sizing: border-box;"><svg viewbox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section><section style="justify-content: center;display: flex;flex-flow: row;margin: 0px 0px 10px;box-sizing: border-box;"><section style="display: inline-block;width: auto;vertical-align: top;align-self: flex-start;flex: 0 0 auto;background-color: rgb(235, 159, 137);min-width: 5%;max-width: 100%;height: auto;padding: 8px 12px;box-sizing: border-box;"><section style="margin: 0px;box-sizing: border-box;"><section style="text-align: justify;color: rgb(255, 255, 255);letter-spacing: 2px;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><span style="font-size: 15px;box-sizing: border-box;">医保局10楼审核盖章</span></p></section></section></section></section><section style="margin: 1px 0% 10px;line-height: 0.8;box-sizing: border-box;"><section style="width: 0px;display: inline-block;border-top: 0.8em solid rgb(199, 38, 38);border-left: 0.7em solid transparent !important;border-right: 0.7em solid transparent !important;box-sizing: border-box;"><svg viewbox="0 0 1 1" style="float:left;line-height:0;width:0;vertical-align:top;"></svg></section></section><section style="justify-content: center;display: flex;flex-flow: row;margin: 0px 0px 10px;box-sizing: border-box;"><section style="display: inline-block;width: auto;vertical-align: top;align-self: flex-start;flex: 0 0 auto;background-color: rgb(235, 159, 137);min-width: 5%;max-width: 100%;height: auto;padding: 8px 12px;box-sizing: border-box;"><section style="margin: 0px;box-sizing: border-box;"><section style="text-align: justify;color: rgb(255, 255, 255);letter-spacing: 2px;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><span style="font-size: 15px;box-sizing: border-box;">门诊5-7号窗口信息备案</span></p></section></section></section></section><section style="text-align: justify;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><br style="box-sizing: border-box;"/></p></section><section style="text-align: left;justify-content: flex-start;display: flex;flex-flow: row;margin: 10px 0px;box-sizing: border-box;"><section style="display: inline-block;vertical-align: middle;width: auto;align-self: center;flex: 0 0 auto;min-width: 5%;max-width: 100%;height: auto;line-height: 0;padding: 0px 5px 0px 0px;box-sizing: border-box;"><section style="transform: perspective(0px);-webkit-transform: perspective(0px);-moz-transform: perspective(0px);-o-transform: perspective(0px);transform-style: flat;box-sizing: border-box;"><section style="text-align: center;margin: 0px;transform: rotateY(180deg);-webkit-transform: rotateY(180deg);-moz-transform: rotateY(180deg);-o-transform: rotateY(180deg);line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;width: 21px;height: auto;box-sizing: border-box;"><svg width="100%" xmlns="http://www.w3.org/2000/svg" viewbox="0 0 288.279 254.107" style="max-width: 100%;width: 100%;box-sizing: border-box;"><g style="box-sizing: border-box;"><g style="box-sizing: border-box;"><path d="M288.279,254.107,68.215,127.054,288.279,0ZM80.3,127.054,282.236,243.643V10.465Z" fill="rgb(62,62,62)" style="box-sizing: border-box;"></path><polygon points="0 124.499 211.001 246.32 211.001 2.677 0 124.499" fill="rgb(97,163,246)" style="box-sizing: border-box;"></polygon></g></g></svg></section></section></section></section><section style="display: inline-block;vertical-align: middle;width: auto;align-self: center;flex: 0 0 auto;min-width: 5%;max-width: 100%;height: auto;padding: 3px 20px;background-image: linear-gradient(45deg, rgb(72, 213, 244) 0%, rgb(110, 94, 247) 100%);box-sizing: border-box;"><section style="font-size: 15px;text-align: justify;color: rgb(255, 255, 255);letter-spacing: 2px;line-height: 1.5;box-sizing: border-box;"><p style="text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;"><strong style="box-sizing: border-box;">三、特药报销须知</strong></p></section></section></section><section style="text-align: justify;font-size: 15px;line-height: 2;letter-spacing: 2px;box-sizing: border-box;"><p style="text-indent: 2.2667em; margin-top: 0px; text-wrap-mode: wrap; padding: 0px; box-sizing: border-box;">1、门诊特药报销需提供发票、处方、《渭南市医疗保险特殊药品门诊使用申请表》、身份证、医保电子凭证、职工医保卡。</p><p style="text-indent: 2.2667em; margin-top: 0px; text-wrap-mode: wrap; padding: 0px; box-sizing: border-box;">备注：①门诊特殊药品处方需单独开具，不应与慢病药品、普通药品开在同一张处方上；②住院患者使用特药（不包括外购特药），不需填写《申请表》，可根据特药适用范围合理用药。</p><p style="text-indent: 2.2667em; margin-top: 0px; text-wrap-mode: wrap; padding: 0px; box-sizing: border-box;">2、参保人员未办理特药申请鉴定手续且在统筹区外使用特药的，其鉴定申请批准之日前90天内的特药费用可按规定纳入基金支付。(统筹区外特药费用在参保地医保部门报销）。</p><p style="text-indent: 2.2667em; text-wrap-mode: wrap; margin-top: 0px; margin-bottom: 0px; padding: 0px; box-sizing: border-box;">附：最新医保特殊药品目录（见下）</p></section></section></section><p></p><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><p></p><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: 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center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: center;margin-top: 10px;margin-bottom: 10px;line-height: 0;box-sizing: border-box;"><section style="max-width: 100%;vertical-align: middle;display: inline-block;line-height: 0;box-sizing: border-box;"></section></section><section style="text-align: 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