Supreme People's Court Issues Reply on the Application of Laws Regarding Eligibility Criteria for Advance Payments from Basic Medical Insurance Funds
On January 6, the Supreme People’s Court publicly issued the “Reply of the Supreme People’s Court on the Application of Laws Regarding the Eligibility Criteria for Advance Payment from the Basic Medical Insurance Fund,” which will take effect on February 1, 2026. The Reply clarifies that, pursuant to Article 30 of the Social Insurance Law of the People’s Republic of China and Articles 2 and 3 of the Interim Measures for Advance Payment from Social Insurance Funds, where an individual participating in basic medical insurance suffers injury or illness due to the tortious conduct of a third party, and the portion of medical expenses that should legally be borne by the third party remains unpaid or the third party cannot be identified, the basic medical insurance fund shall make an advance payment. When an insured person submits a written application for advance payment to the social insurance administration agency in their place of enrollment, they must provide details regarding the cause of their injury or illness, as well as the circumstances under which the third party has failed to pay the medical expenses or cannot be identified. After conducting a review in accordance with the law, the social insurance administration agency shall advance the corresponding portion of the medical expenses in accordance with the regulations governing payments from the basic medical insurance fund in the coordinated region. (Xinhua News Agency)
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