National Health Commission Issues Guidelines on Online Payment Implementation for Public Hospitals

Health and Family Planning Commissions of all provinces, autonomous regions, municipalities directly under the Central Government, and the Xinjiang Production and Construction Corps:
To guide public hospitals in implementing online payment services and further improve patients’ healthcare experience, our Commission has formulated the “Guiding Opinions on Public Hospitals Implementing Online Payment Services.” This document is hereby issued to you for diligent study and implementation.

General Office of the National Health Commission
October 15, 2018

(Form of Information Disclosure: Voluntary Disclosure)

Guidance on the Implementation of Online Payment Services in Public Hospitals

With the in-depth advancement of healthcare system reforms, certain localities and public hospitals have actively leveraged network information technologies to explore online payment services, implement appointment-based diagnosis and treatment, and provide diverse payment options. These measures have shortened patients’ payment time, reduced queuing at service counters, and improved the overall medical experience for patients. In accordance with the requirements for establishing a modern hospital management system, further implementing the Action Plan for Improving Medical Services, and promoting the development of “Internet + Healthcare,” this Opinion is formulated to guide localities in further advancing online payment services.
I. General Requirements
(I) Work Objectives. Guided by Xi Jinping Thought on Socialism with Chinese Characteristics for a New Era, adhering to a people-centered approach, implementing the new development philosophy, and advancing the Healthy China Strategy, we will actively promote the adoption of online payment services in public hospitals. Regions with appropriate conditions may explore the establishment of regional shared online payment platforms. By providing more convenient payment and settlement services, we aim to optimize patient care processes, enhance operational efficiency, improve service quality, and continuously improve the healthcare experience for the public.
(II) Basic Principles.
Facilitating Public Access and Encouraging Innovation. We adhere to serving the public as the fundamental starting point and ultimate goal, maintain a problem-oriented approach, actively apply new concepts, technologies, and methods, innovate convenient payment and settlement mechanisms, and promote an enhanced healthcare experience for the public.
Coordinated Planning and Steady Implementation. Adopt a holistic approach with emphasis on overall design, taking into account the requirements for launching online payment services alongside existing financial management, medical insurance settlement administration, and integration with information systems. Begin with a streamlined approach, conduct pilot operations, gradually expand coverage, and ensure prudent and steady advancement.
Clarify Rights and Responsibilities, Standardize Operations. Public hospitals conducting online payment services must comply with hospital financial management systems and relevant regulations on online payments, clearly define the rights and responsibilities of all parties, improve rules and regulations, standardize work processes, and enhance operational mechanisms.
Strengthen supervision and prevent risks. Establish an effective risk prevention and control system, enhance internal oversight and checks, plug management loopholes, maintain strict control over key processes, strengthen technical safeguards, and ensure the bottom line of fund security.
II. Establishing a Scientific and Standardized Operational Mechanism for Online Payment Management
Conducting online payment operations involves numerous departments, multiple procedural steps, and high technical requirements. It is essential to establish a working mechanism characterized by leadership oversight, multi-party participation, clearly defined responsibilities and authorities, rigorous policies, clear processes, and effective monitoring, thereby ensuring that risks are controllable and operations run smoothly and efficiently.
(I) Strictly manage accounts and funds. The hospital’s finance department shall be uniformly responsible for the use and management of bank accounts for online payment settlement, effectively fulfill its responsibilities for fund custody management, strengthen account and fund management, and ensure fund security. Bank accounts used for settling online payment transactions must be opened in the name of the entity, and their opening and use shall comply with the relevant regulations on account management issued by the Ministry of Finance, the People’s Bank of China, and the National Health Commission.
(II) Standardize the management systems for reconciliation and settlement. Hospitals shall reconcile the accounts of online payment transactions on a daily basis. In the event of discrepancies, the causes shall be promptly identified and addressed to ensure consistency between the hospital’s information system and the bank settlement account balances. For unilateral entries, the hospital shall establish clear handling procedures, verify the authenticity of the transactions, and proceed with corresponding operational and accounting treatments only after confirming the final completion of the transactions.
(3) Strengthen the refund management system. The reasons for refunds arising during the provision of medical services by hospitals are complex; therefore, management should be enhanced by formulating administrative measures and approval processes for refunds related to online payment transactions. Where funds must be refunded due to transaction cancellation (reversal), failed transactions, or other reasons, the corresponding amounts shall be returned via the original payment channel.
(4) Establish a record-keeping management system. Hospitals shall maintain authentic and complete records of online payment transactions, account reconciliation documents, and other related materials, which may be archived in accordance with the requirements for accounting records.
(5) Improve the management system for information systems. In the construction of online payment information systems, hospitals must comply with the Cybersecurity Law of the People's Republic of China and the relevant requirements and technical standards issued by the National Health Commission. They must properly manage data security and interconnectivity between internal and external systems to ensure secure and stable data transmission between hospital information systems and payment platforms, as well as smooth connectivity between internal information systems and external networks. Hospitals shall formulate and refine corresponding information management policies and specific operational procedures, and reasonably assign operational permissions for each position. Information technology personnel are prohibited from modifying original data to ensure data authenticity. Hospitals shall establish emergency response mechanisms for online payment failures based on actual conditions, possess necessary disaster recovery capabilities, and safeguard data integrity.
(6) Improve the internal control system. When conducting online payment businesses, any functions, business processes, operational authorizations, and data validations involving fund management, material management, and income and expenditure must comply with the internal control requirements for public institutions. In terms of information system construction, ensure that incompatible duties such as software development, system operation, maintenance, and archive management are segregated. When formulating internal financial electronic information management systems and position responsibility systems for hospitals, establish clear channels for issue resolution.
III. Conduct thorough assessment and feasibility studies prior to launching online payment services
Entities launching online payment services must strictly enforce rigorous security assessments, qualification reviews, and contract execution protocols to prevent rash implementation and the creation of latent risks.
(1) Conduct a thorough feasibility study on the implementation of online payment services. Before fully launching online payment services, hospitals shall, in light of their actual circumstances, organize relevant experts and technical personnel to evaluate whether the information platforms provided by commercial banks or non-bank payment institutions (hereinafter referred to as “payment institutions”) can be integrated with the existing hospital information systems, assess whether the operation and maintenance of the hospital information systems and the level of security technology protection meet the required standards, and give full consideration to the hospital’s risk tolerance capacity.
(2) Strictly review the qualifications of cooperating institutions. Hospitals shall strictly review the qualifications of cooperating commercial banks or payment institutions and select them in accordance with relevant laws and regulations. When cooperating with payment institutions, hospitals shall verify the scope of business and validity period of their Payment Business License, and give priority to institutions with high qualifications, strong capabilities, and good reputation.
(3) Clarify relevant responsibilities. Hospitals shall attach importance to contract management for online payment services, and organize personnel from legal, information technology, finance and accounting, and medical affairs departments to participate in negotiations and contract execution for online payment services. They shall clearly define the rights, obligations, and liability for breach of contract with payment institutions and commercial banks regarding matters such as the establishment and modification of acquiring bank settlement accounts, fund settlement cycles, settlement fee standards, and handling of errors and disputes. In cases where public service windows on payment platforms are enabled, given that functions such as appointment registration, report inquiry, and online payment involve patient information and hospital operational data, hospitals shall require service providers to prohibit the disclosure of patients’ identity and diagnosis/treatment information to any third party in any form.
IV. Strengthening Operational Guidance and Supervisory Oversight
(1) Local authorities shall strengthen guidance on the implementation of online payment services by public hospitals, monitor the progress of such implementations, enhance supervision and inspection, and promote the establishment and improvement of risk prevention and control mechanisms.
(2) While providing diverse payment options, localities should actively study and implement measures for electronic medical billing receipts to ensure that the public can obtain them in a timely and convenient manner. Meanwhile, in promoting online payment services, due consideration must be given to the varying needs of patients, with necessary manual service counters established.
(3) All localities shall coordinate the integration of online payment systems with medical insurance settlement, organize and conduct pilot programs, summarize best practices, and advance implementation in a phased manner to facilitate public access.
(4) The transformation of traditional payment and settlement services will necessitate adjustments to existing roles and responsibilities. It is essential to engage in comprehensive planning, prepare for the transition, shift mindsets, enhance professional competencies, and adapt to new circumstances, tasks, and requirements, thereby better serving the development of the cause.
(5) Strictly handle, in accordance with laws and regulations, any violations of relevant provisions by public hospitals in the conduct of online payment services.