Guidance on Payment for HIV Antiretroviral Drugs between Healthcare Facilities and Social Insurance Agencies

Accordingly, the payment and settlement of costs for HIV antiretroviral drugs between medical facilities and the Social Insurance agency are guided by Circular 28 as follows:

- Vietnam Social Security transfers funds to the contracting unit to purchase the quantity of HIV antiretroviral drugs as stipulated in the Framework Agreement and any adjustments in demand if necessary. Vietnam Social Security advances 80% of the quarterly funds according to the contract to the contracting unit.- Periodically, along with the time of submitting the settlement report on medical examination and treatment expenses covered by health insurance, medical facilities prepare a Report on the statistics of HIV antiretroviral drug costs provided to patients and send it to the social insurance agency where the health insurance examination and treatment contract is signed (hereinafter referred to as the contracting social insurance agency). The report must specify the cost of HIV antiretroviral drugs paid by the health insurance fund and the co-payment cost of HIV antiretroviral drugs of patients participating in treatment with health insurance cards (hereinafter referred to as supported costs);- The contracting social insurance agency is responsible for notifying the medical facilities of the assessment results and the settlement amount of HIV antiretroviral drug costs along with the time of assessment and the announcement of assessment results and the settlement amount of health insurance medical examination and treatment costs.- The contracting social insurance agency aggregates the costs of HIV antiretroviral drugs paid by the health insurance fund into the settlement of health insurance medical examination and treatment costs of the medical facility. Each quarter, the medical facility aggregates the co-payment costs of HIV antiretroviral drugs of patients participating in treatment with health insurance cards to serve as a basis for payment to the Social Insurance agency.- The provincial social insurance agency aggregates the quarterly and annual settlement of HIV antiretroviral drug costs (detailed by each medical facility in the area and reflects the detailed costs of HIV antiretroviral drugs paid by the health insurance fund, and the co-payment costs of HIV antiretroviral drugs of patients participating in treatment with health insurance cards). It notifies the provincial HIV/AIDS prevention and control authority, the contracting unit, and the Department of HIV/AIDS Prevention and Control. It also aggregates the costs of HIV antiretroviral drugs paid by the health insurance fund into the settlement of health insurance medical examination and treatment costs of the province.- The contracting unit reports on the implementation of the HIV antiretroviral drug purchase contract as guided by Vietnam Social Security.

See details in Circular 28/2017/TT-BYT, effective from August 15, 2017.

-Thao Uyen-

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