Guidelines on Health Insurance Payment for the Damage Rate of Medicinal Herbs

Accordingly, Circular 43 guides the payment of health insurance regarding the rate of loss of medicinal herbs as follows:

- The maximum loss rate of medicinal herbs in processing, preservation, and dispensing is used as a basis for traditional medicine examination and treatment facilities to calculate the service prices for medical examination and treatment and settle health insurance.- During the process of purchasing medicinal herbs, the purchase invoice must clearly state the condition of the medicinal herbs: unprocessed, preliminarily processed, or fully processed to be used as a basis for calculation and applying the appropriate list of loss rates in accordance with reality.- The healthcare facility shall create a list of traditional medicinal herbs according to the template and send it to the health insurance agency, simultaneously providing relevant documents regarding the recording and monitoring of the medicinal herb processing work of the previous year to establish the list of medicinal herbs in preparation, extraction at the healthcare facility.- Based on the condition of the medicinal herbs when purchased by the healthcare facility (unprocessed, preliminarily processed, fully processed) and the requirements for the use of the medicinal herbs (preliminary processing, full processing), the healthcare facility shall establish the post-processing loss rate of the medicinal herbs based on the data of the processing batches and lots at the unit.- The social insurance agency shall base the payment on the processing method, the medicinal herbs processing procedure, and the documents provided by the healthcare facility to settle the loss rate in accordance with reality but not exceeding the maximum loss rate stipulated.

See details in Circular 43/2017/TT-BYT, effective from January 01, 2018.

-Thao Uyen-

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