CHINA Law and Practice Contributed by: Alan Zhou, Coco Fan, Kelly Cao and Stephanie Wang, Global Law Office
prescription, to avoid wasting medical resources or taking advantage of the BMI funds. Government policies may affect or guide a phy- sician’s prescription decisions. • The BMI funds indirectly require physicians to consider the BMI budget when prescrib- ing drugs and to use medical consumables reimbursed by the BMI funds. • Hospitals are required to prioritise drugs and medical consumables that are centrally procured. • Diagnosis-related group (DRG) payment methods and the big data diagnosis-inter- vention package (DIP) are aimed to be fully implemented and expanded to all medical institutions by the end of 2025 and will pres- sure hospitals to control medical expenses so may influence physicians’ prescription behav- iours. The NHSA is building an intelligent monitoring system for BMI fund supervision of the DRGs and DIP payment methods. • Local authorities of the NHSA, along with oth- er departments, conduct examinations of the
use of BMI funds through diverse inspections, such as daily supervision, special inspections, joint inspections, unannounced inspections and inspections based on whistle-blowing. The increasingly severe punitive measures imposed on designated medical institutions and drug retailers contracting with the agen- cies of the BMI, as well as the mechanism and rewards for reporting incompliant use of BMI funds, aim to restrain fraudulent activities in the use of BMI funds. The special rectifica- tion campaign to crack down on BMI fund fraud led by the NHSA focuses on acts of obtaining insurance benefits in a deceptive manner and monitors how the BMI funds are reimbursed on key drugs and medical con- sumables with top billing. A pharmacist will dispense prescription drugs according to a physician’s prescription. The examination of a prescription by an eligible phar- macist focuses on the appropriateness, rational- ity and correctness of a drug’s use, rather than economic considerations.
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