By Fineline Cube 
China’s National Healthcare Security Administration (NHSA) last week released the “Healthcare Security Law (draft proposal)”, aiming to promote the high-quality development of the country’s healthcare security system.
Establishment of Basic Medical Insurance System
The State shall establish and improve the basic medical insurance (BMI) system, which includes employee basic medical insurance and urban and rural resident basic medical insurance. Flexible employment personnel are encouraged to participate in Employee Basic Medical Insurance and pay premiums according to regulations.
Enhancement of Coverage and Benefits
The employee high-cost medical subsidy and resident critical illness insurance programs will provide additional coverage for excessive medical expenses incurred by employee BMI participants. Provincial-level healthcare security administrations, in conjunction with finance departments, will determine fundraising mechanisms, coverage scope, and benefit standards.
Financial Management and Fraud Prevention
Healthcare security funds, including BMI funds and medical assistance funds, must implement unified national financial and accounting systems and be used exclusively for designated purposes. The law prohibits any organization or individual from concealing, transferring, misappropriating, or embezzling funds. For fraudulent claims through deception or falsified documentation, the healthcare security administration will impose full repayment of defrauded amounts and a fine of 200% to 500% of the defrauded amount.
Penalties for Non-Compliance
For medical security agencies, responsible leaders and directly responsible personnel will be punished according to the law. Designated medical institutions may be ordered to suspend medical services related to the use of medical security funds for more than six months but less than one year until the medical security agency terminates the medical security service agreement. If the responsible leaders and directly responsible personnel have practicing certificates, their practicing certificates will be revoked by the relevant competent department in accordance with the law. For insured individuals, management and restraint measures such as suspending their online settlement of medical expenses for three to twelve months and limiting the scope of designated medical institutions where they can receive services will be implemented.-Fineline Info & Tech