Tag Archives: Medical institutions

Shanghai Publishes Medical Insurance Catalogue of Medical Consumables – Zero‑Margin Sales, Mandatory Sunshine Procurement and Class A/B Reimbursement From 6 November 2026

Shanghai, China – 02 Sep 2026 – The Shanghai Healthcare Security Administration and the Shanghai Municipal Health Commission have jointly issued the “Catalogue of Medical Consumables for Shanghai Medical Institutions’ Medical Insurance (2026 Edition)”, mandating that all catalogued consumables be procured through full‑volume online sunshine procurement and sold at zero margin, with reimbursement governed by a Class A / Class B classification – Class B items carrying a 20% upfront cash co‑payment by insured patients. The notice takes effect on 6 November 2026 and simultaneously abolishes Shanghai’s 2019 catalogue of separately chargeable single‑use medical devices.

Policy Milestone

ItemDetail
Issuing AgenciesShanghai Healthcare Security Administration; Shanghai Municipal Health Commission
DocumentCatalogue of Medical Consumables for Shanghai Medical Institutions’ Medical Insurance (2026 Edition) – issued 2 Sep 2026
Policy BasisNHSA and seven other departments’ Pilot Program for Deepening Medical Service Price Reform (Yi Bao Fa [2021] No. 41)
Catalogue StructureFormulated in units of the national medical insurance medical consumables classification; subject to dynamic adjustment
Procurement RuleCatalogued consumables: full‑volume online sunshine procurement + zero‑margin sales; compliance with municipal listing/price‑negotiation and insurance payment rules
Reimbursement ClassesClass A: paid per basic medical insurance rules. Class B: patient pays 20% cash upfront, remainder paid per basic medical insurance rules
Effective Date6 November 2026; prior inconsistent provisions superseded
Repealed DocumentNotice on Publishing the Catalogue of Single‑Use Medical Devices Eligible for Separate Charging (Hu Yi Bao Jia Cai [2019] No. 84)

Catalogue Framework & Billing Rules

  • Classification‑Based Design: The Shanghai catalogue is built unit‑by‑unit on the national medical insurance consumables classification system, ensuring alignment with national coding, and will be dynamically adjusted as the market and clinical practice evolve.
  • “Basic Consumables” Prohibition: When delivering care, medical institutions must provide consumables already included in the “basic consumables” component of medical service price items – they may not require patients to self‑procure such items or charge for them separately.
  • Sunshine Procurement & Zero Margin: All catalogued consumables must be purchased entirely online through transparent procurement channels and sold to patients at zero markup, following Shanghai’s rules on listing, price negotiation and insurance payment.
  • Class A/B Payment Mechanics: Class A consumables are reimbursed directly under Shanghai’s basic medical insurance regulations; Class B consumables require the insured patient to first bear 20% in cash, classified as a self‑pay share, with the remaining cost then reimbursed per standard rules.

Exemptions & Special Populations

  • Excluded Groups: The proportional Class B co‑payment rules apply to Shanghai basic medical insurance participants, except veteran Red Army soldiers, retired cadres and disabled veterans graded 1–6, who are exempt.
  • Mutual‑Aid Plan: Participants in the Shanghai Community Medical Mutual‑Aid Assistance Program follow the same rules by reference.
  • VBP Products: Payment methods for medical consumables covered by national, alliance‑level and Shanghai‑organized volume‑based procurement are governed by their respective existing regulations.

Market Impact & Outlook

  • End of Separate‑Charging Era for Listed Devices: Abolishing the 2019 separately chargeable single‑use device catalogue and replacing it with a unified insurance catalogue removes a legacy add‑on billing channel, tightening hospital revenue from consumables and shifting the margin burden entirely off patients for basic consumables.
  • Zero‑Margin Discipline: Mandatory zero‑margin sales plus full‑volume online sunshine procurement eliminate hospital mark‑up incentives on catalogued consumables, reinforcing the national “zero‑markup” consumables policy and pushing supplier competition onto listed prices.
  • Class B Co‑Pay Certainty: A uniform 20% upfront self‑pay ratio for Class B consumables gives manufacturers and hospitals a predictable reimbursement structure – but keeps cost‑sensitivity high for premium‑priced Class B products.
  • National Coding Convergence: Building the catalogue on the national classification deepens Shanghai’s alignment with NHSA‑led consumables governance, easing cross‑province comparability and future national catalogue integration.
  • Implementation Window: Hospitals and suppliers have roughly two months (to 6 November 2026) to remap billing systems, procurement workflows and product listings to the new catalogue.

Forward‑Looking Statements
This brief contains forward‑looking statements regarding the implementation of the Shanghai medical insurance medical consumables catalogue, including procurement compliance, reimbursement operations and dynamic catalogue adjustments. Actual outcomes may differ due to risks including implementation execution by medical institutions, supplier listing and pricing adjustments, and subsequent policy updates by national or municipal authorities.-China Health Reform Pulse

Policy Source: https://ybj.sh.gov.cn/qtwj/20260911/ea41e7ead0ff4f60b191f07967d71a5f.html

China Tightens Rules on Medical Formula Foods in Hospital Settings

Beijing, Aug 6, 2026 — China’s National Health Commission and State Administration for Market Regulation jointly issued guidelines to standardize the use of foods for special medical purposes (FSMP) in medical institutions, requiring hospitals to establish dedicated management departments, segregated sales zones, and strict clinical protocols while explicitly banning the products from being treated as drugs or prescribed via standard prescriptions.

Policy Snapshot

AttributeDetail
IssuersNational Health Commission General Office; State Administration for Market Regulation General Office
DocumentGuiding Opinions on Standardizing the Use of Formula Foods for Special Medical Purposes in Medical Institutions
File No.Guo Wei Ban Shi Pin Fa〔2026〕No. 11
ScopeAll medical institutions holding a Medical Institution Practice License or clinic filing certificate
Target productsFSMP products registered with the national market regulator
Effective dateAug 6, 2026

Key Provisions

  • Institutional governance — Hospitals must establish dedicated FSMP management departments or working groups, create dynamic institutional supply catalogs limited to nationally registered products, and implement centralized procurement, review, and exit mechanisms.
  • Clinical oversight — Only physicians or clinical nutrition technicians with specialized training may recommend FSMP use. Dietary counseling must be prioritized; FSMP is suggested only when dietary intervention proves insufficient. Patient or guardian consent is required, with full disclosure that the product is not a drug and whether alternatives exist.
  • Documentation — FSMP usage during hospitalization must be recorded in patient medical records, with periodic institutional reviews of usage appropriateness and rationality.
  • Dedicated sales zones — Hospitals must establish clearly marked “FSMP Sales Zone” areas, segregated from pharmaceuticals. Sales records—including patient information, product name, specification, and price—must be retained per medical record standards.
  • Prohibitions — FSMP cannot be sold or used as unregistered products; hospitals cannot coerce or induce patients to purchase FSMP from designated sources. The products are explicitly not drugs and cannot be issued via prescription; distribution and billing must be separated from pharmaceutical workflows.
  • Recall protocols — Hospitals must cooperate with manufacturers on recalls, immediately halting sales, sealing inventory, and posting prominent recall notices.

Market Impact Analysis

The guidelines create a comprehensive regulatory framework for a segment that has historically operated in a gray zone between food and pharmaceutical oversight. By mandating that only nationally registered FSMP products enter hospital supply chains, regulators are effectively culling unregistered or borderline nutritional products that have penetrated clinical settings through informal channels.

For FSMP manufacturers—particularly domestic firms with robust registration portfolios in infant formula, geriatric nutrition, and metabolic disorder segments—the rules legitimize hospital distribution while raising compliance barriers for unregistered competitors. The requirement for dedicated sales zones and separation from drug prescribing workflows may force hospitals to reconfigure pharmacy and nutrition departments, creating short-term operational disruption but long-term standardization.

The prohibition on prescription issuance and the mandate for informed consent shift clinical liability toward physicians and nutrition technicians, potentially increasing institutional exposure if usage documentation is incomplete. The billing separation requirement also complicates revenue recognition for hospitals that had previously bundled FSMP with pharmaceutical charges.

Forward-Looking Statement

Industry analysts expect provincial health commissions to issue localized implementation templates within 60 to 90 days, potentially adding province-specific training requirements for clinical nutrition technicians. The national FSMP registration backlog—already strained by post-2020 regulatory tightening—could face additional pressure as hospitals purge unregistered inventory and demand shifts toward compliant products. Companies with robust pipelines in disease-specific nutrition, including oncology support and diabetes management formulas, are positioned to capture market share as the hospital channel formalizes. The guidelines also set the stage for potential reimbursement negotiations, as standardized hospital use could eventually qualify FSMP for inclusion in basic medical insurance pilot programs, though no timeline has been announced.-China Health Reform Pulse

Policy Source: http://wjw.xinjiang.gov.cn/hfpc/zcwj4/202608/822374ba4e68488db6ff7052a272b5b5.shtml

China Issues National FSMP Guidelines for Hospital Formularies

Beijing, Aug. 26, 2026 – China’s National Health Commission and the State Administration for Market Regulation have jointly issued the first national guidelines governing the use of Foods for Special Medical Purposes (FSMP) in medical institutions, establishing a mandatory formulary system, standardized procurement and storage protocols, and dedicated sales areas, while giving local authorities flexibility to adapt implementation to regional conditions.

The Guiding Opinions on Standardizing the Use of Formula Foods for Special Medical Purposes in Medical Institutions, released following extensive research and provincial consultations, aim to advance clinical nutrition under the National Nutrition Plan (2017–2030) and strengthen patient nutritional support for those with restricted intake, metabolic disorders, or specific disease conditions.

Scope and Definitions

The guidelines apply to all types of medical institutions – defined as licensed diagnostic and treatment facilities – covering the entire lifecycle of FSMP within hospital premises: product selection, stocking, sale, and clinical use.

Core Provisions: Four Pillars

  1. Establish a formulary and management mechanism. Each institution must designate a dedicated FSMP management department or team, create and dynamically maintain a FSMP Supply Catalog (limited to nationally registered products), and implement systematic procedures for selection, review, procurement, utilization tracking, periodic evaluation, and delisting.
  2. Strengthen in-hospital controls across the supply chain. Institutions must enforce rigorous protocols for procurement (including incoming inspection and record‑keeping), warehousing, inventory management, sales, use tracking, and recall handling. Designated food safety personnel are required, and all physicians or clinical nutritionists involved in FSMP use must complete specialized training in clinical nutrition and FSMP management.
  3. Standardize clinical workflow. Clinicians must prioritize dietary counseling first; FSMP may be recommended only when dietary intervention is insufficient, based on clear clinical indications. Informed consent must be obtained, with explicit disclosure of the product’s nutritional (non‑drug) nature and available alternatives. Inpatient FSMP use must be documented in medical records, with periodic reviews of appropriateness and rationality conducted by the hospital’s FSMP team.
  4. Create independent, clearly marked sales areas. Institutions must establish designated FSMP sales zones or counters with conspicuous signage reading “Foods for Special Medical Purposes Sales Area (or Counter).” Sales records – including patient details, product specifications, and pricing – must be retained in alignment with medical record retention periods. Hospitals are also required to cooperate with manufacturers on product recalls by ceasing sales immediately and posting recall notices prominently.

Implementation and Regional Flexibility

The guidelines serve as a national framework, setting out core principles and common requirements. Recognizing significant inter‑provincial differences in economic development, healthcare resource availability, clinical nutrition capacity, and existing management practices, the document explicitly encourages local authorities to tailor implementation measures to their specific circumstances while adhering to the central tenets, ensuring effective and practical application to local clinical settings and patient needs.

Market Impact Analysis

The guidelines represent the first comprehensive national regulatory framework specifically addressing FSMP in clinical settings – closing a policy gap that previously left hospital use largely unregulated beyond general food safety and registration rules. For FSMP manufacturers, the mandatory formulary system reinforces the commercial value of national registration, as only registered products can secure a place on hospital catalogs. The requirement for dedicated sales areas and separate record‑keeping creates operational challenges for hospitals, necessitating investments in inventory systems, staff training, and IT integration to distinguish FSMP transactions from pharmaceutical and ordinary food channels.

The emphasis on clinical governance – including informed consent, medical record documentation, and periodic usage reviews – may temper utilization patterns, particularly for products with less robust evidence, while also protecting patients from inappropriate or coercive promotion. However, the guidelines remain silent on reimbursement and pricing, leaving cost‑related access issues to future policy evolution.

Forward-Looking Statement

The issuance of these guidelines signals the central government’s intent to formally integrate FSMP into the broader healthcare system, potentially paving the way for subsequent insurance coverage expansions and quality metrics. Provincial implementing rules are expected in the coming months, with pilot regions such as Sichuan – which already issued local FSMP management measures – likely to inform refinements. As China’s aging population and chronic disease burden grow, the formalization of FSMP as a regulated clinical tool may attract increased investment in product innovation and manufacturing capacity, particularly for condition‑specific formulations.-China Health Reform Pulse

Policy Source: https://www.nhc.gov.cn/sps/c100087/202608/342b9e4703d0465687d06e56de795311.shtml