BEIJING: China plans to develop a points-based credit system for healthcare professionals who are certified to process medical insurance funds to curb the misuse of funds and strengthen punishment for violators, according to a guideline released recently.
Similar to the nation’s point system for driver’s licenses, the new system will target relevant staff members at insurance-designated medical institutions as well as owners of pharmacies, according to the guideline jointly released by the National Healthcare Security Administration, the National Health Commission and the National Medical Products Administration on Sept 27.
Workers who are found to have engaged in dishonest or illegal behavior will have points assigned to them in the system deducted.
They can lose one to three points for minor offenses, while the most severe violations will result in a loss of 10 to 12 points.
Those who lose nine to 11 points in a year will see their insurance payment certifications suspended for one to six months, which also means that patients who use healthcare services and medications prescribed by them — except for first aid and emergency care services — will not be reimbursed for the amount they spent on these services. –The Daily Mail-China Daily news exchange item
