China's Healthcare Authority Issues Rules on Long-Term Care Insurance Payments

China's National Healthcare Security Administration has released new guiding opinions to regulate reimbursement and payment management for the country's long-term care insurance system. The policy sets out standardized criteria for reimbursement scopes, payment settlements, and supervision of designated care institutions. Accompanied by official policy interpretations, the measure seeks to guarantee reliable coverage for individuals with severe physical and cognitive impairments while ensuring the long-term sustainability of social insurance funds amid China's rapid demographic aging.

The release of payment management guidelines establishes a standardized regulatory baseline across regions for reimbursing long-term care services. By clarifying eligibility criteria, payment boundaries, and settlement mechanisms, the framework aims to ensure that disabled beneficiaries receive entitled support while preventing fund mismanagement and structural deficits.

China's National Healthcare Security Administration (NHSA) has issued comprehensive guiding opinions aimed at regulating the reimbursement and payment management of long-term care insurance (LTCI), according to official statements and policy interpretations released through state media. The newly released document, titled 'Guiding Opinions on Doing a Good Job in Long-Term Care Insurance Payment Management,' establishes unified principles to govern how insurance funds cover long-term care services for disabled individuals. Alongside the release of the guidance, the administration published detailed policy interpretations explaining the regulatory requirements, settlement frameworks, and oversight standards intended to guide local healthcare security authorities. The regulatory initiative focuses on standardizing the scope of reimbursable care services, defining clear settlement parameters between insurance authorities and designated care providers, and strengthening the supervision of funds. By setting clear boundaries for eligible expenses and payment mechanisms, the NHSA aims to ensure that beneficiaries with severe disabilities or cognitive impairments receive consistent and adequate financial support while curbing improper fund usage. China has been piloting long-term care insurance since 2016 to address the growing care needs of an aging population. Over the years, the program expanded across dozens of cities, providing essential coverage for daily living assistance and basic medical nursing. However, differing local implementation practices, variations in reimbursement scopes, and inconsistent fund supervision standards highlighted the need for central regulatory alignment. Under the new guidelines, local health security departments are expected to align regional payment rules with the national framework. The policy emphasizes standardized supervision of designated care institutions to guarantee service quality and maintain fund solvency over the long term. As local jurisdictions prepare specific operational plans, the framework is set to anchor China's ongoing transition toward a mature, institutionalized nationwide long-term care insurance system.