NHSA Issues Interim Measures for Disease-based Payment Management under Healthcare Security

Recently, the National Healthcare Security Administration (NHSA) has issued the Interim Measures for Disease-based Payment Management under Healthcare Security (the "Measures"), with effect on the date of issuance.

The Measures set out policies, key technologies, core elements, and supporting measures for disease-based payment, and mainly regulate three areas. (1) Total budget management, requiring reasonable expenditure budgeting as the basis for determining the total amount for disease-based payment, and emphasizing the rigidity of the total budget. (2) Formulation and adjustment of grouping plans, specifying the responsible entities, grouping framework, data and opinion support, and adjustment contents, with grouping plans to be adjusted in principle every two years. (3) Core elements and supporting measures, clarifying the meaning of weights, rates, and payment standards, requiring that their determination be fully discussed and agreed upon between healthcare security authorities and medical institutions. The Measures also regulate related supporting measures for healthcare security payment, such as special case negotiations, advance payments, opinion collection, negotiation and consultation, and publication of healthcare security data, to enhance the scientific basis of payment.



(Source: https://www.nhsa.gov.cn/art/2025/8/15/art_104_17573.html)

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