Core Points - The core viewpoint of the article is that the reform of the medical insurance fund's instant settlement system is expected to enhance the operational management mechanism of the medical insurance fund, thereby improving settlement efficiency [1] Group 1: Reform Objectives - The National Healthcare Security Administration has issued a notice to promote the instant settlement reform, requiring all coordinated areas to implement it by the end of 2025 [1] - By the end of 2026, it is expected that instant settlement funds will account for over 80% of the local medical insurance fund's monthly settlement funds [1] - The proportion of designated medical institutions with instant settlement capabilities is also targeted to reach 80% by the end of 2026 [1] Group 2: Mechanism Enhancements - The notice emphasizes the need to strengthen the construction of the instant settlement mechanism, including standardizing the fund disbursement mechanism and enhancing audit and supervision mechanisms [1] - A risk warning mechanism is to be established to ensure better management of the medical insurance fund [1] Group 3: Settlement Process Improvements - Provincial medical insurance departments are instructed to guide designated medical institutions to submit medical expense claims by the 10th of the following month [1] - Localities are encouraged to further standardize the instant settlement process and utilize information technology to enhance efficiency and reduce settlement cycles [1] - The goal is to disburse settlement funds within 20 working days after the claim submission deadline, aiming for completion by the end of the following month [1]

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]

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]

Core Viewpoint - The National Healthcare Security Administration (NHSA) is accelerating the implementation of instant settlement for medical insurance funds, aiming for nationwide coverage by the end of this year and over 80% of designated medical institutions by the end of next year, which will improve cash flow for medical institutions [1][2]. Group 1: Policy Implementation - The NHSA has issued a notice to promote the instant settlement reform, with a focus on expanding the coverage of regions, funds, and designated medical institutions [1][3]. - By the end of 2025, all regions are required to implement instant settlement, and by the end of 2026, 80% of local medical insurance fund monthly settlement funds should be covered by instant settlement [1][3]. Group 2: Impact on Medical Institutions - The reform aims to alleviate the long-standing issue of slow payment to medical institutions, which typically experience a 40 to 60-day wait for funds after patient discharge [2][3]. - Instant settlement will shorten the payment cycle, allowing medical institutions to have smoother cash flow and invest more in equipment upgrades and talent development, ultimately enhancing patient care [2][3]. Group 3: Operational Efficiency - The NHSA has initiated pilot programs for instant settlement, optimizing processes such as fund settlement list uploads and intelligent reviews to improve efficiency [3]. - The notice emphasizes the need for a standardized fund disbursement mechanism, requiring medical institutions to submit expense claims by the 10th of the following month, with funds disbursed within 20 working days [3].

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]

Core Viewpoint - The National Healthcare Security Administration has announced a plan to promote the reform of instant settlement of medical insurance funds, aiming for over 80% of designated medical institutions to offer instant settlement by the end of 2026 [1] Group 1: Policy Implementation - The initiative will include the promotion of instant settlement in secondary and higher-level designated medical institutions, encouraging primary and unclassified institutions to participate [1] - Eligible designated retail pharmacies will gradually be included in the instant settlement system [1]

Core Viewpoint - The article highlights the issue of "dual pricing" in pharmacies, where the price of a medication is higher when paid through health insurance compared to cash payments, leading to increased costs for insured individuals and undermining the integrity of the health insurance system [1][2][3] Group 1: Pricing Mechanism - The phenomenon of "dual pricing" results in insured individuals facing higher medication costs, transforming health insurance personal accounts into tools for paying inflated prices [2] - Pharmacies exploit the lack of sensitivity among insured individuals regarding their health insurance accounts, creating a dilemma where consumers feel they lose money regardless of their payment method [1][2] Group 2: Impact on Health Insurance System - The existence of price discrepancies diminishes public trust in the health insurance system, as individuals realize they cannot purchase medications at equivalent prices using their insurance [2] - The practice of "dual pricing" is seen as a means for pharmacies to extract funds from health insurance, potentially leading to fraudulent behaviors and significant leakage of health insurance funds [2] Group 3: Regulatory Recommendations - To address these issues, it is recommended that health insurance authorities establish a dynamic price monitoring mechanism and enhance daily management of designated pharmacies, including increased inspections and penalties for violations [2][3] - The implementation of immediate settlement reforms for health insurance funds is suggested to alleviate financial pressure on pharmacies, thereby reducing the incentive for "dual pricing" practices [3] - A graded management system for designated pharmacies should be established, linking compliance with pricing to health insurance payment limits, rewarding compliant operators while penalizing violators [3]

Group 1 - Fujian Quanzhou has launched an instant settlement model for basic medical insurance funds to improve settlement efficiency and alleviate financial pressure on designated medical institutions [1] - The instant settlement reform establishes an efficient mechanism of "daily payment + monthly settlement" by compressing the settlement cycle and increasing payment frequency [1] Group 2 - Shanghai Pharmaceuticals announced that its subsidiary in Thailand received approval from the Thai FDA for the registration of Pregabalin capsules, which are used to treat various types of neuropathic pain and as an adjunct therapy for epilepsy [3] - Gilead Sciences announced that the FDA approved its injectable HIV-1 capsid inhibitor Yeztugo for pre-exposure prophylaxis (PrEP) to reduce the risk of HIV infection in adults and adolescents weighing 35 kg or more [4] Group 3 - Haizheng Pharmaceutical plans to establish a joint venture for synthetic biology with its wholly-owned subsidiary, with a registered capital of 350 million yuan, aiming to support the professional and large-scale development of its synthetic biology business [6] - Nuo Vision announced a plan to repurchase shares worth between 5 million and 10 million yuan for employee stock ownership plans, with a repurchase price not exceeding 30 yuan per share [7] - Tiankang Biological's subsidiary Tiankang Pharmaceutical has completed the counseling acceptance for its public stock issuance and listing on the Beijing Stock Exchange [8] Group 4 - Baike Biological received approval from the National Medical Products Administration for clinical trials of its influenza virus split vaccine, which aims to provide new vaccination options for individuals aged 60 and above [10] - Dizhi Pharmaceutical announced the completion of patient enrollment for its global Phase III clinical study of its lung cancer targeted drug, which compares its drug with platinum-based chemotherapy for advanced non-small cell lung cancer [11] Group 5 - The FDA announced the launch of the "Commissioners National Priority Voucher" program to expedite new drug review times from approximately 10-12 months to 1-2 months for eligible companies [12] - Shengnuo Biological expects a net profit increase of 254% to 332% year-on-year for the first half of 2025, driven by strong performance in its peptide raw material business [12]

Core Viewpoint - The implementation of the instant settlement reform for medical insurance funds in China is set to significantly improve the financial operations of hospitals, enhance patient experiences, and promote the collaborative development of the healthcare, medical insurance, and pharmaceutical sectors. Group 1: Reform Overview - In 2024, a unified and improved prepayment system for medical insurance funds will be established at the national level, with a total prepayment scale of 72.3 billion yuan in the first quarter of 2025, addressing the funding pressure faced by hospitals [1] - The instant settlement reform aims to shift from a "post-payment" model to a timely payment system, alleviating the financial burden on hospitals and patients [1][2] - The National Medical Insurance Administration has set a goal for 80% of coordinated regions to achieve instant settlement by 2025, with full coverage expected by 2026 [2] Group 2: Implementation and Impact - As of March 2025, 24 provinces have implemented instant settlement, covering 246,700 designated medical institutions with a total payment amount of 165.7 billion yuan, effectively easing operational pressures on hospitals [2] - Innovative mechanisms in provinces like Anhui and Shandong have significantly reduced payment timelines, enhancing cash flow for medical institutions and improving the overall efficiency of the pharmaceutical industry [3] - The reform allows patients to avoid upfront payments for medical expenses, reducing the time and effort spent on reimbursement processes, thereby improving the overall healthcare experience [3]