Implementation of Decree 75/2023/ND-CP on Health Insurance: Ministry of Health Guidelines
What is the responsibility of the Vietnam Social Security agency in implementing Decree 75/2023/ND-CP?
On November 7, 2023, the Ministry of Health issued Official Dispatch 7221/BYT-BH of 2023 to implement Decree 75/2023/ND-CP.
In Official Dispatch 7221/BYT-BH of 2023, the Ministry of Health requests Vietnam Social Security to implement the adjustment of benefit levels for health insurance participants according to Decree 75/2023/ND-CP as follows:
- Direct provincial and city social insurance agencies to cooperate with related agencies and units to prepare lists and issue health insurance cards for the subjects amended and supplemented in Decree 75/2023/ND-CP; adjust the benefit levels for health insurance participants as stipulated in Clause 5, Article 3 of Decree 146/2018/ND-CP to 100% as regulated in Point a, Clause 5, Article 1 of Decree 75/2023/ND-CP.
- Guide and organize the supplementary payment of medical examination and treatment costs at health facilities that exceeded the total payment from January 1, 2019, according to the provisions of Clause 8, Article 1 of Decree 75/2023/ND-CP, and report to the competent authorities as required.
- Advise, guide as per authority, train, and organize the implementation of provisions in Clause 9, Article 1 of Decree 75/2023/ND-CP on the preparation and allocation of estimates to provincial social insurance and promptly notify the projected medical examination and treatment costs to ensure prompt, appropriate distribution.
- Strengthen the inspection and complete the information technology system to receive, inspect, and promptly respond to medical facilities regarding health insurance examination and treatment data; ensure the accuracy, safety, confidentiality of information, and rights of the related parties; proactively review, detect, and send warning information promptly to health facilities about high medical examination and treatment costs compared to the average costs of the same grade, line, and specialty to allow the health institutions to check, verify, and adjust appropriately to use the health insurance fund economically and effectively.
How is the implementation of Decree 75/2023/ND-CP on health insurance guided by the Ministry of Health? (Image from the internet)
How is the responsibility of the provincial and city Departments of Health guided in Official Dispatch 7221/BYT-BH of 2023?
In Official Dispatch 7221/BYT-BH of 2023, the Ministry of Health requires the provincial and city Departments of Health as follows:
- Direct local health institutions to improve the quality of health insurance services, meet patient satisfaction, continuously tighten discipline in healthcare, procurement, bidding, strictly implement the laws on health insurance, medical examination, and treatment along with the provisions of Decree 75/2023/ND-CP; enhance inspection, control to prevent wasteful, negative, abusive, and exploitative acts related to the health insurance fund.
- Collaborate with the provincial and city social insurance to advise the provincial and city People's Committees in building, directing, and implementing fully and promptly the policies on health insurance relevant to the practical needs of the locality, support health insurance contribution levels, identify supported subjects and co-pay amounts for health insurance participants as stipulated in Clause 3, Article 1 of Decree 75/2023/ND-CP to maintain the achieved insurance participation rate and continuously cover the population not yet participating in health insurance.
- Enhance inspection, control, and urge the implementation of health insurance policies and laws to prevent wasteful, negative, abusive, and exploitative actions regarding the health insurance fund.
What responsibilities do hospitals under the Ministry of Health have in implementing Decree 75/2023/ND-CP?
In Official Dispatch 7221/BYT-BH of 2023, the Ministry of Health requires hospitals, institutes with hospital beds under the Ministry of Health, ministries, sectors, and health care facilities nationwide as follows:
- Directors of health facilities are responsible for directing, organizing the strict implementation of the laws on health insurance, medical examination and treatment, procurement, bidding, management, use of public assets, and relevant laws to ensure the prompt, sufficient supply of medicines, chemicals, medical supplies, effective and economical technical medical services, and thoroughly addressing the shortage of medicines and medical supplies.
- Proactively review, issue, and promptly update professional procedures, guidelines, and measures to prevent the abuse and exploitation of the health insurance fund as per authority; regularly organize checks, reviews, and verify increased health insurance examination and treatment costs at the facility according to the recommendations and warnings of the social insurance agency and appropriately adjust.
- Raise the sense of responsibility in serving health insurance patients, use the health insurance fund effectively, and strictly handle violations as per authority.
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