Medical network - on February 6th February 4, which is the second working day holiday back, fujian health care began to enlarge recruit, issued by the health care management committee office of fujian province implementation of medical insurance payment settlement price based medicine joint limit sunlight procurement notice.
For health care do this pioneering department of fujian province, I believe you no longer feel strange. Last October 28, has just set up a month of health office of fujian province was issued by the health care management committee office of fujian province on a further blow to diddle medical insurance fund and the violation of patients' behavior notice, "the first fire" to the medical insurance fund, strong-arm reaction to diddle medical insurance fund.
As early as in April last year the national health work picturephone meeting, vice premier of the state council, reform of the state council leading group leader liu yandong, said will sum up the experiences of promoting sanming, promoting reform of the unity of miho, at the same time the drug procurement functions into health care sector, implement "mining".
Now, of fujian health office and through YaoXie joint limit sunlight procurement network announced a new round of drug bidding procurement rules. Drug purchase into the health care sector for the first time, but also in health care star zhan rich under the tender for the first time, believe that for the work of the provincial drug bid has very important significance.
See from the content of the rule, the following points worth attention:
One, the sword refers to the lowest price
Notification requirements, drug into YaoXie joint limit sunlight procurement platform competition condition is a procurement directory of drugs offer in principle is not higher than the lowest price for the label and the recent international procurement of fujian province.
And the net price for the country, such as net price above the provincial level of the minimum purchase price, the enterprise should take the initiative to report to the provincial platform and make the price adjustment, if not timely report, once discovered to verify, will be suspended on the net on pricing, force until cancelled netting not credit enterprise "blacklist". Net drugs such as found a production enterprise base agent, and the price is net price artificially high phenomenon, once verify will be removed from the network.
At the same time, the notice also made clear, encourages areas with quantity purchase, to encourage each district medical institutions on the platform, on the basis of the net price further negotiate with the enterprise to bring the negotiation, also is what we usually call "secondary bargaining", and bring the real price of bargaining negotiations is not released.
In addition, we also need to focus on the point, notice is clear, for competitive drugs, belong to the insurance reimbursement, medical institutions according to the medical insurance payment settlement price sales, medical insurance fund settlement reimbursement ratio according to the law. Higher than that of medical insurance payment settlement price part shall be borne by the medical establishment, below the medical insurance settlement price difference, belong to the medical institutions; Belong to the insurance reimbursement, medical institutions according to the highest price is not higher than the sales sales, the patients' out-of-pocket expense, more than the highest price sales part shall be borne by the medical institution.
Rival drug, and that is to say, for health insurance prices relative to the medical insurance payment settlement price pressure to the lower, the better for the hospital, after all the difference to hospital income. Predictably, that in every area of the "secondary bargaining", the hospital will certainly be very willing to bargain, and there is a low pressure and low much.
It seems that fujian from health care, for drug price control will be linked together, drug companies face a new round of price cuts are unavoidable.
Second, the four types of drug cool
According to the notice, in order to promote effective competition and clinical rational drug use, give attention to two or morethings will unite price sunshine purchasing drugs into non-competitive directory and competitive directory. As everybody knows, is of the pharmaceuticals listed in the catalogue of competitive, must through the grouping, facing the cruel price competition and, rather than competitive directory of drugs, only need to face negotiations. A dominant, which belong to the original, the FDA certification, through consistency evaluation, and only a register of varieties, the rest of the varieties were included in the competitive directory.
You medicine for junior partner to have a look, their varieties belong to do not belong to the above four kind of non-competitive varieties, is great, at least to avoid the peer vicious price competition, perhaps there's little room for negotiations with experts, we are looking forward to it.
Three, auxiliary medicine named
Explicitly mentioned in the notice auxiliary medication and nutritional medicine, this is the first time in the provincial tendering procurement documents. These drugs, most of them are our common adjuvant.
Notice also gives a clear definition to the auxiliary administration:
Adjuvant drugs: instructions on "auxiliary treatment" or the state development planning commission issued of clinical pathway and the Chinese medical association and so on a national level (category) to learn (association) will be released by the clinical guidelines mentioned, expert consensus of drugs used in the adjuvant treatment of disease.
Nutritional medicine: refers to the drug can replenish nutrients effect.
Notice, for the month of the pharmaceuticals listed in the key monitoring sales amount is more than 5 million yuan, and quarterly sales value of the top 10 auxiliary medication and nutritional medicine practice the ladder price. From exceed sales quota of the next month, more than 2% per (less than 2%, calculated at 2%), procurement prices fell by 0.5% to pay YaoKuan, reduce the purchase price is no longer the callback and adjust accordingly WangJia and medicare payment standard or benchmark.
, although now the provinces for auxiliary medicine there is no unified definition of auxiliary medication but fujian starting to explicitly defined, and the strict control in the purchasing process, it has very important significance for other provinces, this also is each drug firms must focus on one of the main reasons for this round of bidding in fujian.
Attached: the basis of the implementation of medical insurance payment settlement price of fujian province pharmaceutical joint limit sunlight procurement rules
Head: the examination and approval of jg accumulated rich people: Zhang Xuanhua make people: Lin waterford
According to the overall deployment of medical and health system reform in our province work to fully give play to the role of market mechanism, to squeeze drug prices artificially high space, in accordance with the "on-demand set, for use, remove the grey, price real" and "open and fair, fair competition, the honest code of honor, the entire regulation" principle, for the medical insurance fixed-point medical institutions at various levels and of the use of drugs (material), the implementation of medical insurance payment settlement price based joint procurement price sunshine, ensuring the supply of drugs (consumables) in place in time, clinical medicine (consumables) is safe and effective, our province is established drug joint limit sunlight procurement rules as follows (consumable price sunlight procurement rules shall be formulated separately) :
One, to set up the provincial sunlight procurement platform
(a) YaoXie joint limit sunlight procurement network of fujian province (website: www.fjyxcg.gov.cn, hereinafter referred to as the "provincial platform"), a nonprofit drug (consumables) is the provincial government set up sunlight procurement, supervision and management platform, for the drug (consumables) joint limit sunlight procurement activities to provide technical support. Strengthen platform sun open, oversight function such as early warning, complain inform against, joint limit sunshine purchase all announcement notice, the purchase price, the number of deals, such as procurement unit information released in time, the provincial platform to accept social supervision.
(2) all health care in our province the medical establishment that decide a dot, and participate in our province drug procurement activities (consumables) joint limit sun pharmaceutical production, circulation (distribution) enterprises and other relevant parties should be carried out according to the requirements on the provincial platform sunlight procurement.
Drugs (3) of the sunlight procurement is divided into: joint price special drug sunshine sunshine purchase, emergency procurement and other medicines procurement three sunshine.
1. Varieties within the joint limit sunlight procurement catalogue, the provincial platform "joint limit sunlight procurement" channel for purchasing.
2. Directory, in clinical treatment needs are not included in the purchase of drugs, the medical institution shall, according to the clinical application for examination and approval rules, the provincial platform "emergency medicine procurement sunshine special channel (i.e., the" green channel ") to purchase.
3. Special control shall belong to the state of toxic drugs for medical treatment, narcotic drugs, psychotropic drugs, radioactive drugs, medical treatment, use drug free treatment of infectious diseases and parasitic diseases, immune planning with vaccines, drugs, family planning, traditional Chinese medicine, Chinese medicine yinpian, and active pharmaceutical ingredients and the national fixed-point production of drugs, negotiations drugs according to the existing provisions of the state in the provincial platform in the "other medicines procurement sunshine" channel for purchasing.
Second, the preparation of pharmaceutical joint limit sunlight procurement directory
(a) in accordance with the "on-demand set, mining, remove the grey for use, price real" principle, based on the standard drug purchase 9 directory of fujian province, in combination with medical institutions in medicine and adjust the actual needs. Directory adjustment mainly borne by the provincial public hospitals, according to the division of professional committee is responsible for. Implement procurement directory selection GongKaiZhi real-name system and sunshine.
(2) to promote the effective competition and clinical rational drug use, give attention to two or morethings will unite price sunshine purchasing drugs into non-competitive directory and competitive directory. Non-competitive directory containing the original drug, through the FDA certification, and in Europe and the United States have a sales of generic drugs, as well as by consistent evaluation and exclusive production of generic drugs (registration) drugs; In addition to the varieties in competitive directory. At the same time, the joint limit medicine procurement sunshine purchase netting according to "four general" (that is, the "common name", "general dosage form", "general specification", "general packaging") and press "therapeutic drugs", "adjuvant drug" and "nutritional medicine" to distinguish the drug properties.
1. The original drug and verification according to the following conditions:
(1) overseas pharmaceutical research and development of the world's first listed company of imports to domestic drugs.
(2) overseas pharmaceutical research and development of the world's first listed company of semi-finished products to import to the territory, the repackaging of drugs shall be conducted by domestic pharmaceutical companies.
(3) outside the pharmaceutical research and development of the world's first listed company, by its in China have subordinate relations (wholly owned or holding joint venture) pharmaceutical enterprise production of drugs.
(4) overseas pharmaceutical research and development of the world's first listed company of raw materials imported to the territory, authorized patents by the subordinate relations of domestic pharmaceutical enterprise production of drugs.
(5) the domestic pharmaceutical companies for national first class new drug certificate of medicine production.
2. Certified by FDA drug review identified by method of the following:
Declare drugs in the FDA's website the NDA or ANDA database registration and in a valid state, and shall provide the following materials:
(1) declare drugs must provide the NDA or ANDA database registered screenshots and Chinese translation;
(2) since 2015, exports Europe and the United States export customs declaration and Chinese translation;
(3) exports Europe and the United States and for the use of domestic drug for the collinear production and quality of the same commitment.
3. The generic consistency evaluation and verification according to the following conditions:
According to the national food administration of drug safety about the implementation of the general office of the state council about to carry out the quality of generic drugs and curative effect evaluation of consistency on relevant matters of public announcement no. 106 (2016) requirements for generics consistency evaluation of drugs. Generics are regarded as through consistency evaluation of two things: 1. Use the same production line production in China listed and approed for sale in the European Union, the United States or Japan and has sales of the drug after approved by the audit shall be regarded as through; 2. Domestic drug manufacturing enterprises has been approed for sale in the European Union, the United States or Japan and has sales of generic drugs after the review as pass. The above declaration administration of drugs by state food and drug supervision, or China's food and drug verification research institute's website or certificate for audit as basis.
4. The therapeutic drug use
Refers to the state development planning commission issued of clinical pathway and the Chinese medical association and so on a national level (category) to learn (association) will be released by the clinical guidelines mentioned, expert consensus for the treatment of clinical symptoms of systemic disease drugs, declare drugs to provide the above information is proved that for review.
5. Adjuvant drug
Instructions on "auxiliary treatment" or the state development planning commission issued of clinical pathway and the Chinese medical association and so on a national level (category) to learn (association) will be released by the clinical guidelines mentioned, expert consensus of drugs used in the adjuvant treatment of disease.
6. Nutritional medicine
To replenish nutrients effect of drugs.
"Therapeutic drugs", "adjuvant drug" and "nutritional medicine" attribute of overlap, according to the former sequence attribute classification, involving health care reimbursement, according to health related provisions.
Three, enterprise to declare
(a) declare enterprise must ensure that meet our province joint limit the normal supply of sunlight procurement at least one cycle. Don't keep good faith, without justifiable reasons not on time delivery, shall be included in the not good faith enterprise "blacklist" published on provincial platform dealt with and report to relevant departments according to the relevant provisions of the state.
(2) the joint limit sunlight procurement only accept domestic drug manufacturing enterprises of approval documents (that is, the pharmaceutical production enterprise) and imported drugs total domestic agents (i.e., direct customs declaration enterprise) of the declaration.
(3) the domestic drug manufacturing enterprises (including packing) and imported drugs total domestic agents authorized only one natural person (should be the enterprise staff) as the authorized representative in the medicine joint limits the management of the procurement activities, and bear the corresponding legal responsibility.
(4) the joint purchasing price is not accepted by our province since 2015 on dishonest enterprise (list attached), and fujian ZhengBan [2015] no. 124 and fujian medical insurance office [2016] no. 8 involved in dishonest records and apply "blacklist" companies.
(5) shall provide truthful and fill in the information about it, all filings with the method of electronic documents to declare on the net, filing need to use a digital certificate with electronic stamp after the upload, filing for modification, shall, in accordance with the provisions of the public notice period through procurement platform, do not accept paper document. The public after the deadline, don't allow enterprises to modify its filing to supplement again.
(6), according to the specific requirements see the provincial platform for enterprise can through the digital certificate login platform understand joint purchasing price related information in a timely manner.
Four, network rules
(a) use of market mechanisms, bidding and negotiation in parallel, lets the enterprise competition fully.
1. The drugs enter YaoXie joint limit sunlight procurement platform competition condition is a procurement directory of drugs offer in principle is not higher than the lowest price for the label and the recent international procurement of fujian province.
2. For a non-competitive three rounds of the drugs on the platform of the man-machine dialogue and negotiation, in accordance with the negotiation results to determine whether the net;
(3) for a competitive drugs on the platform through three rounds of public bidding, after the competition, according to the price from low to high reserve several home network. Bargaining, sunlight procurement by the medical institutions themselves.
(2) group. According to the generic names, general dosage forms, specifications, general packaging general "four principles", grouping.
(3) the purchasing cycle. Joint limit sunlight procurement net period is 12 months. Provincial platform of network enterprise implement the performance evaluation and regularly publish the inspection result, continuation of the net to honest prior purchasing. To the dishonest enterprise revoked the net at any time, and blacklisted according to relevant regulations.
(4) the production and circulation system of corporate responsibility jointly. In violation of the health care management committee office of fujian province on a further blow to diddle medical insurance fund and the violation of patients' behavior notice (fujian medical insurance office [2016] no. 8) file spirit, have been found with gold sales, rebates, promotion and other illegal ACTS and not on time delivery, timely delivery, breach of contract manufacturing enterprise, enterprise in circulation (distribution), disqualified from the supply and distribution, at the same time blacklisting, reports the national health development planning commission and the healthcare reform office of the state council, and public reporting on the Internet.
(5) for production enterprise system quotation. To put an end to a medical representative for the influence of drugs price, the joint limit sunlight procurement only accept domestic drug (consumables) production enterprise of approval documents (that is, the pharmaceutical production enterprise) and import (consumables) total domestic drug agents (i.e., direct customs declaration enterprise) of the declaration.
(6) encourage bargaining negotiations. Joint limit sunlight procurement of drug screening price ceiling price for purchase of medical institutions, to encourage each district medical institutions in the platform the net price, on the basis of the further negotiate with the enterprise to bring the negotiation, bring the real price of bargaining negotiations is not released.
Five, the grouping method
According to the different method of drug of generic (injection, oral and external use) for grouping, including:
1. The "notice" to the original reimbursement directory "remarks" column "left" drug references 9 standard categorization as a group with competitive bids.
2. With potting plans or prefi lled syringes of insulin alone group, other drugs with additional devices (such as dosing device, syringe, with solvent, potting or prefi lled syringe, etc) constitute a combination of packaging, not distinguish between the bidding group alone.
3. Have the following special medication, can distinguish between different bidding group:
(1) belong to the indications and function of the attending different into different bidding groups.
(2) of children is suitable for dosage form specifications, the oral preparations for the treatment of mental disease, alzheimer's disease, the mouth of the avalanche piece and other clinical treatment must use special formulations, such as slow controlled release can be grouped separately.
(3) in peritoneal fluid osmosis bid and whether low calcium can be divided into different groups.
(4) the external preparation site to distinguish the different according to different groups.
(5) vitamins compound medicine in compound vitamin or compound vitamins and minerals, bid is divided into two groups.
(6) and amino acid injection according to the different components are divided into 3 aa, 9 aa, 15 aa group and other four bidding; Pediatric amino acid and 19 aa single bid for the same group.
(7) contrast agents bid according to the different concentration can be divided into different groups.
(8) sugar-free type and sugar type bid of proprietary Chinese medicine can be divided into different groups.
(9) proprietary Chinese medicine ingredient containing bezoar or musk varieties, according to the natural, cultivated in vitro or in vivo implantation, artificial bid is divided into three groups, must have the state food and drug supervision and administration bureau (total) production or approval documents are clearly marked on the manual.
Six, hanging net condition
(a) a non-competitive directory varieties through three rounds of man-machine dialogue and negotiation, in accordance with the negotiation results to determine whether the net.
1. Belong to the sole drug, in no more than the product on the basis of the lowest purchase price (shortage of some medicines to allow appropriate price adjustment), comprehensive reference surrounding countries and regions outside the purchase price, the customs ports and paid the benchmark for three rounds of the man-machine dialogue and negotiation, negotiation conditions, shall be the net and not satisfied, will not be net.
2. How to declare, on the basis of the lowest quotation, same group comprehensive reference surrounding countries and regions outside the purchase price, the customs ports and paid the benchmark for three rounds of the man-machine dialogue and negotiation, negotiation conditions, shall be the net and not satisfied, not hanging net.
3. Negotiation rules:
(1) negotiations, the man-machine dialogue, in terms of three rounds of price negotiation.
(2) declare drugs must truthfully provide Hong Kong, Macao and Taiwan and domestic provinces in our country the actual purchase price, the import pharmaceuticals customs ports and import of drug agents and related price data.
(3) to provide import agent contract and the customs ports:
1) belongs to the therapeutic drug use, into the medical insurance directory directly hanging nets, and less than the lowest drug procurement in accordance with the price, is not higher than 50% customs ports to determine medicare payments benchmark price negotiation, and according to negotiate drug prices drop to adjust to determine medicare payment benchmark price.
(2) belonging to the auxiliary and nutritional drugs, such as competitive directory with varieties of common name of the drug, in quotation is not higher than the lowest drug purchase price, and not on the basis of 50% above the customs ports, can hang net directly, if you don't accept the above offer requirements, by way of man-machine dialogue, through three rounds of price negotiation to determine whether the net; Such as competitive directory has the similar varieties of common name of the drug to competitive directory on the drug's highest offer reference price for negotiations, according to negotiate drug prices and reference price gap, and determined the medicare payment benchmark of determine whether screening.
(4) to not be able to provide import agent contract and the customs ports:
1) belongs to the therapeutic drug use, into the medical insurance directory net directly, and by no more than 80% of drug national minimum purchase price, 50% is not higher than the lowest quotation competing goods in the same group or competitive directory has the drug with the common name of varieties of highest the 130% that offer (incurred by the above data) to determine medicare payments benchmark price negotiation, and according to negotiate drug prices drop to adjust to determine medicare payments benchmark price.
(2) belonging to the auxiliary and nutritional medicine, said in an interview at the lowest price is not higher than drug purchase price, and 50% higher than the lowest quotation competing goods in the same group or competitive directory has the drug with varieties of common name of the highest bid (the above data taken) as the reference price negotiations, according to negotiate drug prices and reference price gap, and determined the medicare payment benchmark of determine whether screening.
(5) the above matters not be determined by negotiation expert group according to the condition of site specific collective research.
(2) competitive directory varieties according to the attributes of the drug and clinical treatment need, through three rounds of public bidding, after the competition, according to the price from low to high: keep several netting
1. Group drugs on the basis of this the reference price for a first round quotation, quotation in the first round in principle should not exceed their respective drugs nationwide provincial lowest purchase price at present, it need to adjust the price for cost reasons, quotation and shall not exceed the highest bid, otherwise out directly.
2. After the first round quotation, on the basis of enrollment situation, according to the quotation from low to high several into the second round bid quotation number and published the first round.
(3) into the second round of drug price shall not be higher than the first round of the product offer, after the second round quotation, according to the quotation from low to high into the third round of quotation and published several second round quotation list.
4. Enter the third round of drugs offer shall not be higher than that of the second round of this product, after the third round of quotation, depending on the attributes of the drug and clinical treatment need, according to the quantity of quotation from low to high determine screening.
Specific offer details see the platform for announcement.
(3) for the month of the pharmaceuticals listed in the key monitoring sales amount is more than 5 million yuan, and quarterly sales value of the top 10 auxiliary medication and nutritional medicine practice the ladder price. That is:
(1) the key monitoring drug sales amount is more than 5 million yuan per month, from exceed sales quota of the next month, more than 2% per (less than 2%, calculated at 2%), procurement paid YaoKuan prices fell by 0.5%, reduce the purchase price is no longer the callback and adjust accordingly WangJia and medicare payment standard or benchmark.
(2) the quarterly sales value of the top 10 auxiliary medication and nutritional medicine, such as the monthly average sales amount is more than 5 million yuan, since over the allowance of the next quarter, more than 2% per (less than 2%, calculated at 2%), procurement paid YaoKuan prices fell by 0.5%, reduce the purchase price is no longer the callback and adjust accordingly WangJia and medicare payment standard or benchmark.
(4) the net price for the country, such as the net price above the provincial level of the minimum purchase price, enterprises should take the initiative to report to the provincial platform and make the price adjustment, if not timely report, once found to verify, will be suspended on the net on pricing, force until cancelled netting not credit enterprise "blacklist". Net drugs such as found a production enterprise base agent, and the price is net price artificially high phenomenon, once verify will be removed from the network.
Seven, medicines procurement
(a) price sunshine purchase, after the confirmation of the net result for around a month transition period.
(2) the joint procurement price sun hung WangJia drugs for netting the highest purchase and sales price, encourage medical institutions to purchase a consortium or, for the unit with the area of joint limit sun drug procurement netting to purchasing with the amount of negotiation.
(3) the sanming joint drug price purchasing netting, each district, you can purchase through the platform at the provincial level.
Eight, distribution management
(a) sell drugs pharmaceutical production, circulation enterprises, shall be in accordance with the relevant provisions of the invoice management of the special invoices for value-added tax or VAT invoice (hereinafter generally referred to as the "invoice"), the project complete to fill in. Sell drugs also shall, in accordance with the drugs management quality management specification (drug GSP) asked the attached with the cargo of peers, purchase of the invoice (as well as the listing, similarly hereinafter), annul name shall be just and with goods flow direction in order, payment, amount is consistent.
(2) drug purchase adopt "production enterprise," unified distribution model, strictly implement the "two votes" and to "one vote". Among them, the production enterprise of approval documents (that is, the pharmaceutical production enterprise or direct customs declaration enterprise) to issue the invoices for the first ticket distribution enterprises, distribution companies drawn from medical institutions to check incoming freight invoice invoice for second votes. Base fluids "votes", grassroots medical institutions based fluids can implement the "two votes".
(3) to ensure that the entire province rural grassroots medical institutions at all levels to distribution in place, to encourage a collectivized (each district branch, subsidiary) distribution. In response to the outbreak of natural disasters, major, major events and the patient (rob) save the special circumstances, such as emergency purchasing drugs or national pharmaceutical reserve drugs, can special treatment.
(4) according to the administrative division of 11 distribution area (i.e., the provincial area, fuzhou area, xiamen area, zhangzhou area, quanzhou area, sanming area, putian, nanping area, longyan area, ningde area, pingtan area. Including sanming drug distribution in sanming joint price purchasing plan execution), a production enterprises in the same area enterprise can only specify one distribution distribution we all hang net of drugs.
(5) circulation of narcotic drugs and the psychotropic drugs of category I still according to the regulations of the state. Belong to national reserve distribution according to the relevant provisions of the drug at the provincial level.
Nine, payment and settlement
(a) the medical establishment that decide a dot on the platform payment of purchasing medicines at the provincial level, and hierarchical management by health departments at all levels in accordance with the principle of territorial unification and territorial distribution companies to sunshine and settlement, and payment before 15 drugs into the Treasury of the next month. Provincial health office electronic settlement center is responsible for provincial health care medical establishment that decide a dot of drug payment and settlement, the city divided into districts, pingtan comprehensive experimental area health care department (medical center) is responsible for drug payment of health medical establishment that decide a dot, and the type, quantity and price with the payment and settlement monitoring.
(2) the department of health and health care medical establishment that decide a dot settlement as follows:
1. For noncompetitive drugs, belongs to the medical insurance reimbursement, medical institutions according to the highest price is not higher than the sales sales, according to the medical insurance payment benchmark of medical insurance fund settlement (according to the generic drug reimbursement amount, through the reimbursement ratio regulation), more than medicare billing part shall be borne by the patient pays; Belong to the insurance reimbursement, sales, according to the highest price is not higher than the sales costs borne by patients with conceit.
2. For competitive drugs, belong to the insurance reimbursement, medical institutions according to the medical insurance payment settlement price sales, medical insurance fund settlement reimbursement ratio according to the law. Higher than that of medical insurance payment settlement price part shall be borne by the medical establishment, below the medical insurance settlement price difference, belong to the medical institutions; Belong to the insurance reimbursement, medical institutions according to the highest price is not higher than the sales sales, the patients' out-of-pocket expense, more than the highest price sales part shall be borne by the medical institution.
Four, bylaw
(a) from the date of release to implement these rules. In case of the country, the reform in fujian province relevant policy adjustment, these rules will be changed accordingly.
(2) these matters not released by the provincial health office timely supplement and correction announcements and related documents. |
