The National Healthcare Security Administration continues to promote the reform of the diversified and composite medical insurance payment method based on payment by disease. In order to continuously improve policy design and promote deeper and more practical reforms, the National Healthcare Security Administration recently issued the "Interim Measures for the Management of Payment by Disease for Medical Security". The basic structure of the "Measures" consists of eight chapters and 39 articles, which clarify the policies, key technologies, core elements, and supporting measures related to payment by disease, and highlight three aspects of standardization: firstly, standardize the management of total budget, require reasonable preparation of expenditure budget, and determine the total payment by disease based on this, emphasizing the rigidity of total budget. The second is to standardize the formulation and adjustment of grouping schemes. Clearly define the formulation subject, grouping framework, data and opinion support, adjustment content, etc. of the grouping scheme, and generally require the grouping scheme to be adjusted every two years. The third is to standardize core elements and supporting measures. Clarifying the connotations of weights, rates, payment standards, etc., it is required that the medical insurance department fully negotiate with medical institutions to reach a consensus on the core elements. Standardize supporting measures related to medical insurance payment, including special case negotiation, advance payment, opinion collection, negotiation and consultation, and medical insurance data release, to improve the scientific level of medical insurance payment. The Measures also specify that the requirements for payment by disease will be included in the agreement management, strengthen the monitoring and evaluation of reform effectiveness, strengthen fund supervision, improve the construction of medical insurance information platforms, and enhance the standardization level of payment by disease. The grouping scheme is an important technical support for the reform of payment by disease, which is related to the scientificity and rationality of medical insurance payment. Designated medical institutions are very concerned about it. The "Measures" chapter provides detailed instructions on the formulation and adjustment of disease grouping schemes, in order to stabilize the expectations of local medical insurance departments and medical institutions for grouping optimization. One is to clarify that the National Healthcare Security Administration is the main body responsible for formulating and adjusting grouping schemes. Since the launch of the pilot reform of payment by disease in 2019, the National Healthcare Security Administration has formulated a unified national technical standard for disease payment, issued the national version of the DRG grouping scheme and DIP disease database, requiring that the core grouping of DRG payment regions be consistent with the national version, and the disease grouping rules of DIP payment regions be consistent with the national version, with the aim of achieving unified technical standards and norms at the national level, and making disease categories comparable and analyzable between regions. At the same time, localities can localize DRG sub groups and take into account local realities. The second is to clarify the basic framework of the grouping scheme. The Measures clarify the grouping framework from a policy perspective. DRG grouping includes three levels: main diagnostic categories, core groups, and sub groups. DIP disease database includes core diseases and comprehensive diseases. Core diseases are the main payment units, and the number of cases below the critical value is converged again to form comprehensive diseases as a supplement to the core disease payment units. The third is to clarify the procedures for formulating and adjusting grouping schemes. The objective historical cost data and feedback from medical institutions are important supports for adjusting the grouping scheme. The National Healthcare Security Administration relies on a unified national medical insurance information platform to collect data and form basic data for disease grouping. At the same time, it establishes a feedback mechanism for opinion collection, regularly collects opinions and suggestions from relevant parties on grouping schemes, and timely absorbs valuable references into the new grouping, making the grouping results more closely related to clinical practice. Fourthly, the adjustment content and cycle have been clarified. DRG grouping scheme adjustment, while maintaining the relative stability of the main diagnostic categories, focuses on adjusting the core grouping and sub grouping. DIP disease database adjustment, focusing on core diseases and comprehensive diseases. In principle, the grouping scheme should be adjusted every two years.