CCTV News: The National Health Insurance Administration and the Ministry of Finance recently jointly issued a notice, clarifying that by the end of this year, all provinces must include the direct settlement fees for hospitalizations in other places in the province in the medical treatment place to pay according to the disease type, including two forms: payment by disease group (DRG) and payment by disease type score (DIP). Insured persons will continue to enjoy benefits according to the medical insurance policy of the insured place. Simultaneously promote cross-regional consultation and cooperation and informatization construction, and medical institutions will fully implement refined payment management.
According to the notice, provincial medical insurance departments should establish and improve consultation and cooperation mechanisms between medical places and insured places, and guide coordinated areas to meet the medical needs of insured people and the development needs of medical institutions based on the affordability of medical insurance funds in the insured places and the homogeneous management requirements of medical insurance funds in the insured places, and to ensure the safety and sustainability of the funds.
The notice requires that the support for national and provincial informationization is enhanced, the information system is improved, and the application of national disease-based group (DRG) payment and disease-based score (DIP) payment functional modules should be accelerated, and the refined management of designated medical institutions should be guided and promoted. In addition, the National Medical Insurance Administration recently issued the "Regulations on Paying Medical Insurance by Disease Type (2025 Edition)" to promote the management of payment by disease type.
