On November 14, 2024, Zhang Ke, secretary of the Party Leadership Group and director of the National Medical Insurance Bureau, went to Xicheng District, Beijing to investigate medical insurance work. He visited the Xicheng District Medical Insurance Bureau and the Medical Insurance Affairs Management Center to learn more about the total budget management of medical insurance funds, the settlement process with designated medical institutions, and the allocation of funds.

Zhang Ke said that the medical insurance department of Beijing should take the lead in trialing and innovating the settlement methods of medical insurance funds, and explore the construction of a scientific medical insurance settlement system based on direct settlement, instant settlement, and synchronous settlement. It is necessary to actively promote direct settlement and instant settlement between medical insurance and hospitals, pharmaceutical companies, and equipment and consumables manufacturers.

For a long time, the long collection cycle has imposed a heavy financial burden on pharmaceutical and medical equipment companies. According to the "Statistical Analysis Report on the Operation of the Pharmaceutical Distribution Industry in 2023" of the Ministry of Commerce, the average number of days for medical institutions to collect accounts receivable is 152 days, an increase of 2 days from 2022.

In recent years, the medical insurance department has made frequent efforts to accelerate the collection of drug and medical device funds, including the reform of the settlement system. At present, the direct settlement model of medical insurance has achieved significant results in many places.

According to the disclosure of the National Medical Insurance Administration, many places such as Tianjin, Shandong, Fujian, Jiangxi, Inner Mongolia, and Hunan have begun to promote the model of direct settlement between medical insurance funds and enterprises. The collection period in some areas has been shortened from 6 months to 30 days.

At present, direct settlement is accelerating across the country, and product coverage is also continuously expanding, from centralized procurement drugs to non-centrally purchased drugs.
During his investigation in Xicheng District, Beijing, Zhang Ke pointed out that in recent years, the Beijing Medical Insurance Department has conscientiously done a good job in medical insurance settlement, optimized work processes, strengthened audits and inspections, and took the lead in implementing total advance payment and instant settlement, effectively safeguarding the legitimate rights and interests of designated medical institutions.

The introduction of the advance payment system can effectively alleviate the capital turnover pressure of medical institutions, and the upstream and downstream accounts related to it are expected to improve.

Recently, the General Office of the National Medical Insurance Administration and the General Office of the Ministry of Finance issued the "Notice on Doing a Good Job in Prepayment of Medical Insurance Funds", requiring provincial medical insurance departments to guide the coordinated regions to organize and carry out prepayment of medical insurance funds and clarify the relevant processes.

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