Chapter I General Provisions

Article 1 In order to enhance the level of healthcare services in the free trade port, meet the diverse and personalized needs of the population, and accelerate the construction of Healthy Hainan, these Measures are formulated in accordance with the Opinions of the CPC Central Committee and the State Council on Deepening the Reform of Medical Insurance System, the requirements of the National Healthcare Security Administration on deepening medical service price reform, and the actual circumstances of our province.

Article 2 The special needs medical services provided by public healthcare institutions referred to in these Measures mean the medical services voluntarily chosen by patients that are carried out by public healthcare institutions while ensuring basic medical services, according to their existing facilities, physician teams, and characteristics, to meet the diverse and personalized needs of the population. Special needs medical services serve as a reasonable supplement to basic medical services and should reflect a supportive role for basic medical services.

Article 3 These Measures apply to the declaration conditions, approval procedures, project and price management, and supervision and management of special needs medical services provided by public healthcare institutions.

Article 4 The provision of special needs medical services by public healthcare institutions is subject to access management. Without the review and approval of the provincial medical security and health and wellness administrative departments, public healthcare institutions are not allowed to provide special needs medical services. All levels of medical security and health and wellness administrative departments shall be responsible for the daily supervision of special needs medical services within their respective jurisdictions.

Chapter II Application Conditions

Article 5 Under the premise of ensuring basic medical services, public healthcare institutions at the secondary level and above (inclusive of the secondary level) in our province may provide special needs medical services to meet the healthcare needs of different strata of the population.

Article 6 The provision of special needs medical services must ensure the adequate supply of resources for normal basic medical services and the majority of patient's healthcare needs and should have independent service areas or independent management.

Article 7 The scale of special needs services provided by public healthcare institutions shall be strictly controlled, with the proportion of special needs services not exceeding 10% of all medical services, including those provided by branch hospitals.

Article 8 Public healthcare institutions applying to provide special needs medical services must submit the following materials:

i. Application report;

ii. Application Form for Special Needs Medical Services Prices and Projects in Hainan Province;

iii. Financial statements of the public healthcare institution for the most recent year;

iv. Projections of the number of patients and income from special needs medical services;

v. Details of the staffing of hospital healthcare professionals, as well as the conditions for staffing and basic facilities for providing special needs medical services;

vi. Relevant measures and systems for standardizing the management of special needs medical services.

Article 9 Public healthcare institutions shall submit applications to the corresponding medical security and health and wellness departments according to their affiliations and be responsible for the authenticity of the submitted materials. Municipal and county-level medical security departments, in conjunction with health and wellness departments, shall be responsible for receiving and conducting preliminary reviews of applications from public healthcare institutions in their jurisdictions to provide special needs medical services. After preliminary review, they shall issue written review opinions along with the application materials to the provincial medical security and health and wellness departments for further review. The provincial medical security and health and wellness departments shall be responsible for receiving and reviewing applications from provincial public healthcare institutions to provide special needs medical services. Provincial public healthcare institutions and non-profit healthcare institutions under the jurisdiction of the Boao Lecheng International Medical Tourism Pilot Zone Administration may directly submit applications to the provincial medical security and health and wellness departments for review. After approval, healthcare institutions may commence providing special needs medical services.

Article 10 Applications will not be accepted if any of the following conditions apply:

i. Lack of independent service areas or independent management;

ii. Insufficient staffing of healthcare professionals to meet the requirements for providing basic medical services;

iii. Absence or inadequacy of special needs service standards, medical staff admission and exit review systems, medical staff outpatient regulations, price display, and fee list-related systems or measures;

iv. Violation of laws, regulations, and relevant provisions.

Article 11 For applications that meet the approval conditions after review, the provincial medical security and health and wellness administrative departments shall inform the healthcare institutions in writing and copy the notification to the municipal and county-level medical security and health and wellness departments.

Article 12 Special needs outpatient clinics must have separate diagnostic areas. The area for special needs outpatient clinics should be reasonably set. The overall environment of the special needs outpatient clinic area must be clean, comfortable, and convenient. It should be equipped with a dedicated consultation service desk, and it is recommended that auxiliary facilities such as wheelchairs, stretchers, air conditioning, sofas (or chairs), drinking water, and restrooms be provided. Independent diagnostic areas must ensure one-to-one consultations and be equipped with routine medical instruments and equipment to meet diagnostic needs.

Doctors selected to sit in special needs outpatient clinics must base their appointments on the volume of reservations and actual outpatient sessions in non-special needs outpatient clinics (i.e., general outpatient clinics, specialized/special disease outpatient clinics, expert outpatient clinics). They should be doctors with a large volume of reservations and actual outpatient sessions, high levels of diagnostic and therapeutic skills, high patient satisfaction with medical services, long-term experience in clinical medicine, and those who have held a senior technical qualification for over one year and been promoted to the position of associate professor or above. During special needs outpatient sessions, doctors must sit in the special needs outpatient clinic to meet patient needs. Special needs outpatient clinics and non-special needs outpatient clinics operate in a linked mechanism, where in-service experts must also attend non-special needs outpatient clinics. The ratio of special needs outpatient sessions to non-special needs outpatient sessions (half day for a session) for doctors with full professor titles may not exceed 2:1, and for associate professors may not exceed 1:1. Invited experts are not subject to these ratios.

Article 13 Special needs wards must have relatively independent areas. The number of beds in special needs wards must not exceed 10% of the total number of beds approved for the healthcare institution; if the actual number of open beds is less than the approved number, the number of beds in special needs wards must not exceed 10% of the actual number of beds. Special needs wards are configured as suites, single rooms, or double rooms, with suites having an area of no less than 25 square meters per suite, and single rooms and double rooms having an area of no less than 15 square meters per room. In addition to basic medical equipment, they must also have independent restrooms and bathing facilities, air conditioning, televisions, wardrobes, sofas, refrigerators, microwave ovens, and other related living service facilities.

Special needs wards implement a system of dedicated doctors and nurses, with patients selecting their doctors. According to the patient's condition, the relevant clinical departments are responsible for the daily examination of patients by doctors with the rank of associate professor or above (inclusive of associate professor). The attending doctor must meet the qualifications of a professional doctor and must obtain the patient's consent or be freely selected by the patient. The ratio of beds to nurses in the ward must not be lower than 1:1.5. Patients' examinations and treatments must be accompanied by dedicated healthcare professionals.

Article 14 For other special needs medical services provided by public healthcare institutions, in addition to meeting the basic conditions stipulated in these Measures, venues, facilities, and healthcare professionals must be arranged according to the characteristics and requirements of the special needs medical services being provided.

Chapter III Management of Special Needs Medical Service Projects and Prices

Article 15 Special needs medical service projects are managed through a list system. Public healthcare institutions must develop and publicly disclose a list of special needs service projects within the range of special needs medical service prices and projects prescribed, using the format attached to these Measures.

Article 16 Special needs service projects are selected from the existing basic medical service price project directory and market-regulated medical service price project directory in our province and should cover and expand upon the content of the service projects.

i. Projects listed as special needs services shall meet one of the following characteristics:

1. General medical service projects;

2. Projects belonging to clinical key specialties;

3. Projects whose primary function is not disease treatment, including but not limited to special needs outpatient clinics, special needs wards, special needs physical examinations, medical beauty, and other special needs medical service projects;

4. Medical imaging, ultrasonic examination, and laboratory testing projects related to equipment in the special needs service area of public healthcare institutions;

5. Projects whose technical labor component in the current price structure does not reach 60%;

6. Projects belonging to the current basic medical service projects that use new diagnostic methods, new equipment, and new consumables.

ii. Projects falling under the following categories are not included in special needs services:

1. Pre-hospital emergency, emergency, and intensive care scenarios;

2. Projects specified by the state and province as not subject to market-regulated pricing.

Article 17 Special needs medical service price standards. Special needs medical service prices are determined according to market supply and demand principles, implemented as market-regulated prices, and autonomously determined by healthcare institutions.

Article 18 Filing of special needs medical service prices. Special needs medical service projects and prices must be filed with the provincial medical security department and the provincial health and wellness department before implementation. Municipal and county-level institutions must also file with the municipal and county-level medical security bureaus and health and wellness commissions. The filed prices must be actual prices and cannot be changed arbitrarily within one year after determination. Any change in prices requires re-filing.

Article 19 Disclosure of special needs medical service prices. Special needs medical services are subject to an informed consent system, with patients voluntarily choosing to receive them. Special needs medical services must not be implied or forced upon patients. Special needs medical service prices must be marked, and healthcare institutions must publicly disclose the special needs medical service projects, price standards, and service standards in prominent locations in the service area at least ten working days in advance, accept public supervision, and explain the policies to patients.

Article 20 Fees for medical service projects provided in the special needs service area of public healthcare institutions are not covered by basic medical insurance and must be borne by patients themselves.

Chapter IV Supervision and Management

Article 21 Healthcare institutions must ensure the scale and quality of basic medical services, conduct special needs medical services in a standardized and orderly manner through internal optimization, and meet the multi-level medical service needs of society.

Article 22 Public healthcare institutions must strictly abide by national laws and regulations, strengthen internal management of special needs medical services, establish and improve relevant management systems and service processes, and ensure that the entire process of special needs medical services is traceable.

Article 23 The content of the special needs medical services shall strictly be adhered to when providing services and charging fees, ensuring that the services are efficient, of high quality, and commensurate with the price.

Article 24 All levels of medical security, health and wellness, and other administrative departments must strengthen supervision and management of the provision of special needs medical services and price management by public healthcare institutions according to their institutional functions. Regular or irregular inspections and evaluations of the configuration conditions, service content, and service volume of special needs medical services provided by public healthcare institutions must be conducted. For healthcare institutions that do not comply with relevant requirements upon inspection or evaluation, they must be ordered to make corrections within a specified period. If they fail to correct or continue to lack the conditions for provision after correction, they must cease providing special needs medical services. For actions such as arbitrarily expanding or adding special needs medical service projects, failing to file as required, or providing special needs medical services against the wishes of patients, all illegal acts must be investigated and punished according to law. The provincial health and wellness department shall include these matters in hospital evaluation, performance appraisal of public hospitals, institutional licensing, and other important inspection contents.

Chapter V Supplementary Provisions

Article 25 The relevant procedures for special needs medical services in Document Q.Y.B.G. (2019) No. 10 apply to these Measures. Where there are inconsistencies between these Measures and previous regulations, the provisions of these Measures shall prevail.

Article 26 These Measures are interpreted by the Medical Security Bureau of Hainan Province and the Health Commission of Hainan Province. 

Article 27 These Measures shall be implemented on a trial basis from the date of issuance.