Recently, the Shanghai Medical Insurance Bureau and other departments jointly issued the Notice on Including Some Therapeutic Assisted Reproductive Technology Projects in the Payment Scope of Medical Insurance and Industrial Injury Insurance. Since June 1 of this year, 12 medical services such as "ovum retrieval" have been included in the payment scope of medical insurance.
According to the requirements of the national medical insurance department, Shanghai standardized the current assisted reproductive medical service projects and optimized and integrated them into 17 assisted reproductive medical service projects such as "ovum retrieval". Among them, 12 projects were included in the payment scope of Shanghai medical insurance, covering necessary medical assisted reproductive technologies such as egg retrieval, sperm retrieval, artificial insemination, embryo culture, embryo transfer, etc.
This policy will be implemented in 17 hospitals in Shanghai that have the qualification to carry out assisted reproductive technology and are designated medical insurance institutions, including Renji Hospital affiliated to Shanghai Jiaotong University Medical College, Shanghai Ninth People's Hospital, Ruijin Hospital, Shanghai First Maternal and Infant Health Hospital, etc.
The 12 projects are divided into Class A and Class B payment modes. Among them, Class A can be fully included in the scope of reimbursement, while Class B needs to be paid by individuals for 10% of the expenses first, and the rest is included in the scope of medical insurance fund payment.
According to the direct settlement policy for trans provincial and trans regional medical treatment, patients can enjoy the "policy of insured places and directory of medical treatment places". Non local insured persons who come to Shanghai to receive assisted reproductive technology treatment can also be reimbursed according to the 12 medical service items in the Shanghai medical insurance directory. The specific reimbursement proportion is based on the policy of the insured area.
The Shanghai Medical Insurance Bureau revealed that the implementation of the above policies will reduce the medical burden of patients, which is expected to reduce the burden of the insured by about 900 million yuan every year, bringing convenience to more people in Shanghai who are willing to have children to receive fair, accessible and affordable assisted reproductive treatment.
China's fertility rate continues to decline, while the incidence of infertility among couples of childbearing age is rising year by year. The Survey Report on the Current Situation of Infertility in China shows that there are more than 50 million infertile patients in China, and one in every eight couples is facing infertility.
Assisted reproduction is considered to be one of the most effective methods to treat infertility. Assisted reproduction technology refers to the technology that uses medical technology and methods to manually operate gametes, zygotes and embryos to achieve the purpose of pregnancy. It is divided into artificial insemination technology, in vitro fertilization embryo transfer technology and related derivative technology.
In recent years, assisted reproductive technology has developed rapidly in China. Data shows that the total number of cycles of assisted reproductive treatment in China each year exceeds 1 million, and the number of babies born exceeds 300000, accounting for about 3% of the total birth population.
"The average minimum treatment price of assisted reproduction exceeds the affordability of 60% of the families nationwide, and the high price makes it difficult to release some demand." According to the China Assisted Reproduction Research Report 2023 released by Zeping Macro.
In recent years, there has been no lack of calls to include assisted reproduction in medical insurance and reduce the economic pressure on patients to seek medical treatment. The signal released at the national level will appear in 2022.
In 2022, the National Health Insurance Bureau, the National Health Commission and other departments triggered the Guiding Opinions on Further Improving and Implementing Active Maternity Support Measures, which proposed to guide local governments to comprehensively consider the affordability of medical insurance (including maternity insurance) funds, relevant technical norms and other factors, and gradually include appropriate labor analgesia into the fund payment scope according to procedures.
Up to now, Beijing, Guangxi, Inner Mongolia, Gansu, Shandong and other provinces and cities have included assisted reproduction into medical insurance reimbursement, and Hunan, Zhejiang, Anhui and other places are also exploring to include assisted reproduction into medical insurance.
"Assisted reproduction is a very important aspect of reproductive support, which must be in accordance with laws and regulations, scientific and reasonable, which has strict procedures and medical standards. The National Health Insurance Bureau will also continue to help build a fertility friendly society, so that more people of childbearing age will receive medical insurance policy dividends." Recently, Zhang Ke, director of the National Health Insurance Bureau, pointed out in a survey in Beijing Maternity Hospital.
The relevant person in charge of the Shanghai medical insurance department said that he would continue to implement the national requirements, implement active fertility support policies and measures, improve the establishment of assisted reproductive medical services and the management of medical insurance payment, and strengthen the coordination of departments to promote the connection of basic medical insurance, maternity insurance and related economic and social policies, and jointly promote the long-term balanced development of the population.
Interface journalist | Huang Jingyuan
Interface News Editor | Peng Peng
