国家医保局：逐步缩短异地就医费用清算周期

Core Viewpoint - The National Healthcare Security Administration (NHSA) has released a three-year action plan aimed at improving the efficiency of medical insurance fund settlement, with a goal to streamline the settlement process for medical expenses, particularly for cross-regional medical services [1][2]. Group 1: Action Plan Overview - The action plan encourages localities to explore the inclusion of critical illness insurance funds and medical assistance funds in the expedited settlement process, aiming to shorten the settlement cycle for cross-regional medical expenses [1]. - By 2028, the plan aims to complete the previous year's settlement by the end of March each year, with settlement funds accounting for approximately 3% of the annual medical insurance fund disbursement [1][2]. Group 2: Phased Implementation - In the initial phase, all coordinating regions are required to complete the 2025 settlement by the end of May 2026, with pilot regions finishing by the end of March 2026, adjusting the settlement fund proportion to around 5% [1]. - In the acceleration phase, all regions must complete the 2026 settlement by the end of April 2027, with pilot regions finishing by the end of March 2027, and the settlement fund proportion adjusted to between 3% and 5% [1]. - The comprehensive implementation phase requires all regions to complete the 2027 settlement by the end of March 2028, maintaining the settlement fund proportion at around 3% [2]. Group 3: Key Focus Areas - The plan emphasizes the importance of key aspects such as scheme formulation, data preparation, comprehensive assessment, amount calculation, and approval for disbursement in the settlement process [2]. - For regions implementing quarterly settlements, certain processes may be simplified while ensuring that all aspects of annual settlements are executed [2].