Core Insights - The reform of the medical insurance fund's instant settlement is aimed at optimizing the management mechanism of the fund and improving settlement efficiency [1] - The National Healthcare Security Administration has issued a notice requiring all coordinated areas to implement instant settlement by the end of 2025, with a target of 80% of local medical insurance fund monthly settlement funds being instant by the end of 2026 [1] Summary by Sections - Instant Settlement Mechanism: The notice emphasizes the need to strengthen the construction of the instant settlement mechanism, including standardizing the fund allocation mechanism, enhancing review processes, and improving supervision and risk warning mechanisms [1] - Fund Allocation Standards: Provincial healthcare departments are instructed to guide medical institutions to submit medical expenses by the 10th of the following month, aiming to streamline the instant settlement process and reduce the settlement cycle [1] - Efficiency Goals: The goal is to ensure that settlement funds are paid within 20 working days after the submission deadline, with an aim to complete payments by the end of the following month [1] - Special Case Review: There is a focus on shortening the review cycle for special case applications to further enhance the efficiency of fund disbursement [1] - Budget Considerations: Local areas are encouraged to determine the instant settlement disbursement ratio based on the current year's budget and past expenditure [1]
国家医保局印发通知 今年底前所有统筹地区均需开展即时结算
Ren Min Ri Bao·2025-10-27 22:26