Medical Insurance Fund Usage Supervision Regulations Implementation Rules to Take Effect in April These Behaviors Will Be Penalized

The National Healthcare Security Administration today announced the “Implementation Rules for the Supervision and Administration of the Use of Medical Security Funds” (hereinafter referred to as the “Implementation Rules”), which will take effect from April 1, 2026. The “Regulations on the Supervision and Administration of the Use of Medical Security Funds” have been in effect since 2021. Based on practical work, the National Healthcare Security Administration has formulated these implementation rules to precisely crack down on fraudulent activities across the entire chain, such as drug resale and return, insurance fraud through drug switching, and false medical claims. According to the Implementation Rules, designated medical institutions and their staff who persuade, falsely advertise, reduce fees, or provide additional goods (services) to guide others to impersonate or falsely seek medical treatment or purchase drugs; organize others to use insurance fraudulently to buy medicines or medical consumables, and then illegally purchase or sell them, will be punished for “assisting others in impersonating or falsely seeking medical treatment or purchasing drugs.” Penalties include fines of more than twice but less than five times the amount fraudulently obtained, and suspension of the relevant responsible departments of the medical institutions involved in the use of the medical insurance fund for more than 6 months but less than 1 year. (CCTV News)