NHSA and MoF Announce Medical Insurance Fund Prepayment Initiative to Aid Healthcare Institutions

The National Healthcare Security Administration (NHSA) and the Ministry of Finance (MoF) have jointly issued a notification regarding the implementation of a medical insurance fund prepayment initiative. This program is designed to provide financial relief to designated medical institutions by prepaying a portion of the medical insurance fund, thereby easing the burden of settling medical expenses in advance and enhancing the quality of medical services for insured individuals.

Purpose and Allocation of Prepayment Funds
The document specifies that the advance payment for basic medical insurance should be utilized exclusively for medical expenses, such as the procurement of drugs and medical consumables, and should not be diverted to non-medical expenses like infrastructure investment, daily operations, or debt repayment of medical institutions. Additionally, the special prepayment of the medical insurance fund for drugs and medical consumables involved in volume-based procurement (VBP) will adhere to existing regulations.

Implementation and Eligibility Criteria
Each provincial healthcare security department is responsible for guiding and coordinating the organization and implementation of medical insurance fund prepayment within their region. The prepayment of the employee medical insurance pooling fund can be implemented if the cumulative balance can cover no less than 12 months, while the figure is 6 months for the resident medical insurance fund. Regions that have incurred deficits in the previous year or are expected to have deficits using a 12-month rolling calculation method are ineligible for prepayment.

Application and Disbursement Process
Designated medical institutions can voluntarily apply for advance payment from the healthcare security department in the pooling area in early January each year. Following review by the healthcare security department and consultation with the finance department, the scope and scale of prepayment to medical institutions will be determined. In principle, prepaid funds will be disbursed to designated medical institutions before the end of the first quarter of each year, based on the average monthly expenditure of relevant medical insurance funds in the previous one to three years, with the basic scale of prepayment equating to one month’s amount.-Fineline Info & Tech