National Health and Family Planning Commission Mandates Nationwide Cross-provincial NRCMS Reimbursement Implementation by End of June

On May 11, 2017, the National Health and Family Planning Commission convened an on-site promotional meeting in Beijing to advance the implementation of networked cross-regional settlement for the New Rural Cooperative Medical Scheme (NCMS) at hospitals directly affiliated with or administered by the Commission.

The main content of the meeting is as follows:Report on the progress of nationwide networked settlement for cross-regional medical care under the New Rural Cooperative Medical Scheme (NRCMS), summarize and exchange work experiences from selected provinces and designated medical institutions, and deploy the next steps for NRCMS cross-regional networked settlement.Comrade Ma Xiaowei, Deputy Director of the National Health and Family Planning Commission, attended the meeting and delivered an important speech.

Ma Xiaowei pointed out that the networked settlement of cross-regional medical expenses is an important component of deepening the reform of the medical and healthcare system, and an inherent requirement for establishing a modern hospital management system. Health and family planning departments in all provinces and designated medical institutions must fully recognize the importance of the networked settlement of cross-regional medical expenses under the New Rural Cooperative Medical Scheme (NRCMS) and complete the tasks on schedule.

Ma Xiaowei emphasized that hospitals affiliated with or administered by the National Health Commission should actively assume their leading role as the “national team” and concentrate their efforts on the following tasks:

1. Improve the organizational structure, strengthen internal management, clarify the division of responsibilities among relevant hospital departments, and assign accountability to individuals.

Second, information systems should be improved to achieve interconnectivity and information exchange with the provincial or national New Rural Cooperative Medical Scheme (NRCMS) information platform as soon as possible.

Third, improve rules and regulations and streamline internal management and service processes.

Fourth, improve the settlement mechanism and carry out corresponding financial accounting management work.

Fifth, accelerate work progress, implement backward scheduling, and formulate implementation plans based on actual conditions.Ensure that all medical institutions carry out cross-provincial medical expense settlement and reimbursement by the end of June.

Ma Xiaowei also called on the health and family planning departments of all provinces to collaborate closely in organizing and implementing the relevant work:

First, regulatory oversight must be strengthened. In provinces where the health and family planning departments are responsible for the overall management of the New Rural Cooperative Medical Scheme (NRCMS), now integrated into the Urban and Rural Resident Basic Medical Insurance, the provincial-level health and family planning departments shall continue to coordinate, guide, and supervise the implementation of cross-regional direct settlement for medical expenses. In provinces where the NRCMS is administered by other departments, the provincial-level health and family planning administrative departments shall designate specific offices with clear responsibilities to enhance coordination and management of designated medical institutions across provincial boundaries within their jurisdictions.

Second, strengthen coordination and standardize referral processes. On the basis of improving the tiered diagnosis and treatment system, promptly establish a sound referral system for cross-regional medical care under the New Rural Cooperative Medical Scheme (NRCMS) to ensure reasonable needs for cross-regional medical treatment are met.

Third, strengthen publicity and guide public expectations. Improve the awareness and compliance of enrolled patients regarding reimbursement policies for cross-regional medical treatment, guide the public to promptly and proactively complete relevant referral procedures, clarify misconceptions in a timely manner, and reasonably shape societal expectations.

Fourth, strengthen performance assessments and enforce strict rewards and penalties. Health and family planning administrative departments at all levels shall incorporate the reimbursement work for cross-regional medical care under the New Rural Cooperative Medical Scheme (NRCMS) into the target assessment framework for healthcare reform and the evaluation system for designated medical institutions. They shall establish and improve performance appraisal and accountability mechanisms, and hold accountable those regions and individuals that demonstrate inadequate progress in implementing these initiatives.