B · Normal
[National Medical Insurance Administration: Special case discussion guarantees the enthusiasm and rationality of medical institutions in treating difficult and severe cases] On September 2, the National Medical Insurance Administration held a press conference to release the 3.0 version of the disease-based payment grouping plan and technical specifications. According to the relevant person in charge of the National Medical Insurance Administration, special case consultation is an important supporting mechanism for payment based on disease type. It focuses on supporting medical institutions to use new drugs and new technologies, and to treat difficult and complex severe diseases. Medical institutions independently apply to the medical insurance agency. After expert review and evaluation, reasonable compensation can be given to those who meet the conditions. According to the 3.0 version of the grouping plan, the number of special cases in the DRG payment coordination area shall not exceed 5% of the total discharged cases in the DRG; the number of special cases in the DIP payment coordination area shall be appropriately adjusted and optimized. From 2027, it may not exceed 1% of the total discharged cases in the DIP to better meet the actual operation requirements of medical institutions for difficult and severe cases.
🕐 2026-09-02 11:51

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