国家医疗保障局：全面推进医保基金即时结算改革扩面提质

Core Viewpoint - The National Healthcare Security Administration has announced a comprehensive initiative to advance the reform of instant settlement of medical insurance funds, aiming for nationwide implementation by the end of 2025 [1] Group 1: Reform Objectives - All provincial healthcare departments are required to focus on expanding the coverage of instant settlement reforms across regions, fund scope, and designated medical institutions [1] - By the end of 2026, instant settlement funds should account for over 80% of the monthly settlement funds of local medical insurance funds [1] Group 2: Coverage and Scope - The settlement funds will cover employee medical insurance funds (including maternity insurance) and urban-rural resident medical insurance funds [1] - Regions with conditions may explore including critical illness insurance funds and medical assistance funds in the scope of instant settlement [1] - The funds will cover various medical expenses, including outpatient services, outpatient chronic disease treatment, hospitalization, maternity, and pharmacy purchases [1] Group 3: Future Exploration - There is a gradual exploration of including cross-regional medical expenses in the instant settlement scope [1]