| Announcement of the Supreme People's Court of the People's Republic of China | | 中华人民共和国最高人民法院公告 |
| The Official Reply of the Supreme People's Court on Issues Concerning the Application of Law to the Conditions for Applying for Advance Payment from Basic Medical Insurance Funds, as adopted at the 1959th Session of the Adjudication Committee of the Supreme People's Court on November 24, 2025, is hereby issued with effect from February 1, 2026. | | 《最高人民法院关于基本医疗保险基金先行支付申请条件法律适用问题的批复》已于2025年11月24日由最高人民法院审判委员会第1959次会议通过，现予公布，自2026年2月1日起施行。 |
| Supreme People's Court | | 最高人民法院 |
| January 5, 2026 | | 2026年1月5日 |
| Official Reply of the Supreme People's Court on Issues Concerning the Application of Law to the Conditions for Applying for Advance Payment from Basic Medical Insurance Funds | | 最高人民法院关于基本医疗保险基金先行支付申请条件法律适用问题的批复 |
| (Adopted at the 1959th Session of the Adjudication Committee of the Supreme People's Court on November 24, 2025, with effect from February 1, 2026; SPC Interpretation No. 1 [2026]) | | （2025年11月24日最高人民法院审判委员会第1959次会议通过，自2026年2月1日起施行 法释〔2026〕1号） |
| The High People's Court of Anhui Province: | | 安徽省高级人民法院： |
| Your request for instructions regarding issues concerning the application of law to the conditions for applying for advance payment from basic medical insurance funds has been received. Upon deliberation, the following official reply is hereby made: | | 你院《关于基本医疗保险基金先行支付申请条件法律适用问题的请示》收悉。经研究，批复如下： |
| In accordance with Article 30 of the Social Insurance Law of the People's Republic of China and Articles 2 and 3 of the Interim Measures for the Advance Payment of Social Insurance Funds, where an individual enrolled in basic medical insurance (the “insured”) sustains injury or illness as a result of the tortious conduct of a third party, the portion of the medical expenses that shall be borne by such third party in accordance with the law shall, if the third party fails to make payment or cannot be identified, be paid in advance by the basic medical insurance fund. Where the insured submits a written application for advance payment to the social insurance agency administering the insured's coverage, the insured shall state the cause of the injury or illness and the circumstances under which the third party fails to pay the medical expenses or cannot be identified. Upon lawful examination, the social insurance agency shall, in accordance with the provisions governing payment from the basic medical insurance fund within the pooling region, make advance payment of the corresponding portion of the medical expenses. | | 根据《中华人民共和国社会保险法》第三十条和《社会保险基金先行支付暂行办法》第二条、第三条的规定，参加基本医疗保险的个人（以下简称参保人）由于第三人的侵权行为造成伤病，医疗费用依法应当由第三人负担的部分，第三人不支付或者无法确定第三人的，由基本医疗保险基金先行支付。参保人向参保地社会保险经办机构书面申请先行支付时，应告知造成其伤病的原因和第三人不支付医疗费用或者无法确定第三人的情况。社会保险经办机构依法审核后应当按照统筹地区基本医疗保险基金支付的规定先行支付相应部分的医疗费用。 |
| ．．．．．． | | ．．．．．． |
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