Legal basis: People's Republic of China (PRC) Basic Medical Care and Health Promotion Law.
Article 83 The state establishes a multi-level medical security system with basic medical insurance as the main body, supplemented by commercial health insurance, medical assistance, mutual medical care for employees and medical charity services. The state encourages the development of commercial health insurance to meet the diverse health protection needs of the people. The state improves the medical assistance system to ensure that eligible people in need get basic medical services.
Eighty-fifth basic medical insurance fund payment scope shall be formulated by the competent department of medical security in the State Council, and listen to the opinions of the competent department of health and health, the competent department of traditional Chinese medicine, the drug supervision and administration department and the financial department in the State Council. The people's governments of provinces, autonomous regions and municipalities directly under the Central Government may, in accordance with the relevant provisions of the state, supplement and determine the specific items and standards paid by the basic medical insurance fund within their respective administrative areas, and report them to the competent medical security department of the State Council for the record. The competent department of medical security in the State Council should carry out evidence-based medicine and economic evaluation on the basic medical insurance drug list, diagnosis and treatment items, medical service facilities standards, etc. included in the scope of payment, and should listen to the opinions of the competent department of health and health in the State Council, the competent department of traditional Chinese medicine, the drug supervision and administration department, the financial department and other relevant parties. The evaluation results should be used as the basis for adjusting the payment scope of the basic medical insurance fund.