List of Medical Supplies Covered for Participants of Health Insurance

List of Medical Supplies Covered by Health Insurance Participants as Specified in Appendix 01 Issued with Circular 04/2017/TT-BYT

The list includes consumable medical supplies, artificial replacement medical supplies, replacement materials, implant materials, and specialized tools (hereinafter referred to as medical supplies). The list of medical supplies is the basis for the health insurance fund to pay for the medical supplies used for health insurance participants according to the law on health insurance.

Illustrative image (source: internet)

Circular 04/2017/TT-BYT stipulates that the formulation of the list of medical supplies used in medical examination and treatment facilities must be based on the List of medical supplies in Appendix 01 issued with this Circular; the need for medical examination and treatment; professional capacity, medical equipment; the list of medical technical services (hereinafter abbreviated as technical services) approved by competent authority; and the actual use of the previous year according to the principles of ensuring safety, reasonableness, effectiveness, meeting the needs of medical examination and treatment, and being suitable with the health insurance fund's payment ability; giving priority to domestically produced medical supplies with quality and reasonable prices.

After obtaining the results of selecting the contractor, the medical examination and treatment facility must send the social insurance agency the following documents as a basis for payment:

- A list of medical supplies not included in the cost of technical services, medical examination, hospital bed day, or packaged treatment by disease case used at the medical examination and treatment facility according to the form in Appendix 02 issued with this Circular (in paper and electronic excel format);- The decision on approving the plan to select the contractor and the decision on approving the results of selecting the contractor to supply medical supplies (in paper and electronic excel format).

Note, in the case of non-public medical examination and treatment facilities choosing to purchase medical supplies according to the provisions of Article 52 of the Law on Bidding, the medical examination and treatment facility must prepare a list of medical supplies not included in the cost of technical services, medical examination, hospital bed day, or packaged treatment by disease case used at that facility according to the form in Appendix 03 issued with this Circular and send it to the social insurance agency.

More details can be found in: Circular 04/2017/TT-BYT, effective from June 1, 2017.

Thu Ba

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