今年底前所有统筹地区均需开展即时结算

Core Viewpoint - The reform of the medical insurance fund's instant settlement is expected to optimize the management mechanism of the medical insurance fund, enhancing settlement efficiency [1] Group 1: Reform Objectives - The National Healthcare Security Administration has issued a notice requiring all coordinated areas to implement instant settlement by the end of 2025 [1] - By the end of 2026, instant settlement funds should account for over 80% of the local medical insurance fund's monthly settlement funds [1] - The proportion of medical institutions with instant settlement capabilities should reach 80% by the end of 2026 [1] Group 2: Mechanism Enhancements - The notice emphasizes strengthening the construction of the instant settlement mechanism, including standardizing fund disbursement, enhancing review processes, and improving assessment and supervision mechanisms [1] - Each provincial medical insurance department is tasked with guiding local medical institutions to submit medical expenses by the 10th of the following month [1] - Localities are encouraged to streamline the instant settlement process using information technology to reduce the settlement cycle [1] Group 3: Efficiency Improvements - The goal is to disburse settlement funds within 20 working days after the submission deadline, aiming for completion by the end of the following month [1] - There is a focus on shortening the review cycle for special case applications to further enhance the efficiency of medical insurance fund disbursement [1] - Localities can determine the instant settlement disbursement ratio based on the annual medical insurance fund budget and historical expenditure [1]