List of Healthcare Facilities Terminating Health Insurance Contracts in Q3 2023? Which Cases Will Terminate Health Insurance Contracts?
List of Health Insurance Medical Examination and Treatment Facilities Terminating Contracts in Q3/2023
Based on Section 2 Official Dispatch 5797/BHXH-TST in 2023, Ho Chi Minh City Social Insurance announces changes in information for health insurance medical examination and treatment facilities (HI) in other provinces/cities in Q3/2023.
The list of health insurance medical examination and treatment facilities in other provinces/cities terminating contracts in Q3/2023 includes:
| No. | Province | Facility Code | Facility Name | Notes || --- | --- | --- | --- | --- || 1 | Thanh Hoa | 38282 | Thanh Hoa Transportation General Clinic | Not Accepting || 2 | Hai Phong | 31015 | Military Medical Sub-Institute 7 under Military Hospital 7 - Logistics Department, Military Zone 3 | Not Accepting || 3 | Ha Noi | 01055 | Construction Hospital under Ministry of Construction | Not Accepting |
List of Health Insurance Medical Examination and Treatment Facilities Terminating Contracts in Q3/2023? Which cases will terminate health insurance medical examination and treatment contracts? (Image from Internet)
Which cases will terminate health insurance medical examination and treatment contracts?
Based on the provisions of Article 23 Decree 146/2018/ND-CP, the cases for terminating health insurance medical examination and treatment contracts are as follows:
- The medical examination and treatment facility ceases operations, dissolves, goes bankrupt, or has its Operating License revoked.
- Both parties mutually agree to terminate the health insurance medical examination and treatment contract according to legal regulations.
- During the execution of the health insurance medical examination and treatment contract, the social insurance agency or any organization, entity, or individual discovers that the medical examination and treatment facility has violated the health insurance medical examination and treatment contract, particularly notifying the Department of Health for facilities under its jurisdiction or the Ministry of Health for facilities under its jurisdiction, or the health management agency of ministries and central authorities for facilities under their jurisdiction.
- During the execution of the health insurance medical examination and treatment contract, any organization, entity, or individual discovers that the social insurance agency has violated the health insurance medical examination and treatment contract, notifying the managing agency.
Regulations on signing health insurance medical examination and treatment contracts with medical examination and treatment facilities
Based on the provisions of Article 18 Decree 146/2018/ND-CP regarding signing health insurance medical examination and treatment contracts with medical examination and treatment facilities:
- For first-time contract signings:
+ The medical examination and treatment facility submits 01 dossier set according to regulations to the social insurance agency;
+ Within 30 days from receipt of the complete, valid dossier (as indicated on the incoming official dispatch stamp), the social insurance agency must complete the dossier review and contract signing. If the contract is not agreed upon, a written response with clear reasons must be issued.
- The effective duration of the health insurance medical examination and treatment contract:
+ The contract duration is from January 01 to December 31 of the year, not exceeding 36 months;
+ For the first contract signing, the contract duration is from the signing date to December 31 of the expiry year, not exceeding 36 months;
+ For annual contract signing, the medical examination and treatment facility and the social insurance agency finalize the next year's contract before December 31 of that year.
10 days before the contract expires, if the medical examination and treatment facility and the social insurance agency agree to extend the contract by an appendix, that appendix holds legal value unless otherwise agreed.
- The examination and treatment costs for insured individuals receiving treatment before January 01 but discharged on or after January 01 are executed as follows:
+ If the facility continues to sign the health insurance medical examination and treatment contract, the cost is accounted for in the subsequent year's examination and treatment expenses;
+ If the facility does not continue the contract, the cost is accounted for in that year's examination and treatment expenses.
- The health insurance medical examination and treatment contract must clearly stipulate the method of payment for health insurance examination and treatment costs, compatible with the facility's conditions.
- Both parties are responsible for safeguarding the rights of patients holding health insurance, as per legal regulations, ensuring no disruptions in providing medical examination and treatment for insured patients.
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