Legal analysis: DRGs is a payment method commonly used in developed countries, which meets the needs of the interests of the government, patients, hospitals and other subjects, and helps to promote the balanced development of medical costs and quality of care, so it has become an important direction in the reform of the current stage of the health insurance payment mechanism.
Legal Basis: The Social Insurance Law of the People's Republic of China
Article 28: Medical expenses that are in accordance with the basic medical insurance drug list, diagnostic and therapeutic items, standards of medical service facilities, as well as those for emergency treatment and rescue, shall be paid out of the basic medical insurance fund in accordance with state regulations.
Article 29 The part of the medical expenses of the insured that should be paid by the basic medical insurance fund shall be settled directly by the social insurance administrative organization with the medical institutions and drug business units. The social insurance administrative department and the health administrative department shall establish a settlement system for medical expenses incurred in other places to facilitate the enjoyment of basic medical insurance by insured persons.