Ministry of Health to request promotion of responsibility for managing and using the health insurance fund in Vietnam

Ministry of Health to request promotion of responsibility for managing and using the health insurance fund in Vietnam (Image from the internet)

On July 22, 2024, the Ministry of Health (Hanoi, Vietnam) issued Official Dispatch 4158/BYT-BH to enhance the responsibility for managing and using the health insurance fund in Vietnam.

Ministry of Health to request promotion of responsibility for managing and using the health insurance fund in Vietnam

To ensure the management and use of the health insurance fund in conformity with the law, the Ministry of Health (Hanoi, Vietnam) requests:

(1) Vietnam Social Security to

- Implement the notification of the estimated spending for medical examination and treatment facilities according to the provisions at point a, point b, clause 2, Article 36 of Decree 146/2018/ND-CP dated October 17, 2018 of the Government of Vietnam detailing and guiding some articles of the Law on Health Insurance 2008 (amended and supplemented in clause 9, Article 1 of Decree 75/2023/ND-CP).

- Direct social security agencies at provinces and centrally run cities to notify the increase in health insurance examination and treatment costs on the data reception portal of the health insurance verification information system to the Department of Health and medical examination and treatment facilities to alert them about high costs compared to the average costs of similarly categorized facilities.

- Compile and send notifications to the Ministry of Health of the list of medical examination and treatment facilities in each province with higher costs compared to the average costs of similarly categorized facilities for the Ministry of Health to promptly direct management and use of the health insurance fund effectively.

(2) Departments of Health of provinces and centrally run cities; Health departments of ministries and central authorities to

- Direct medical examination and treatment facilities in the area to comply with the legal provisions on medical examination and treatment, professional guidelines of the Ministry of Health, and regulations related to the provision of technical services to ensure quality, efficiency, and thrift; develop guidelines for diagnosis and treatment, including criteria for inpatient admission suitable to professional requirements, the facility conditions, and staff of the hospital.

Direct the arrangement and disposal of hospital beds appropriate to the scale, equipment, and current staff of the medical examination and treatment facility in conformity with the Law on Medical Examination and Treatment 2023 and guiding documents.

- Direct health insurance examination and treatment facilities and centralized procurement units of the province to strictly follow relevant regulations on procurement and bidding to ensure sufficient and timely supply of drugs, chemicals, and medical supplies within the scope covered for participants of health insurance as guided in Official Dispatch 3314/BYT-KH-TC dated June 17, 2024 of the Ministry of Health.

- Coordinate with provincial social security agencies to notify the increase in health insurance examination and treatment costs on the data reception portal of the health insurance verification information system to medical examination and treatment facilities to alert them about high costs compared to the average costs of similarly categorized facilities in conformity with Decree 75/2023/ND-CP dated October 19, 2023 of the Government of Vietnam amending and supplementing some articles of Decree 146/2018/ND-CP detailing and guiding some articles of the Law on Health Insurance 2008.

- Coordinate with provincial social security agencies to compile and send notifications to the Ministry of Health and Vietnam Social Security of the list of medical examination and treatment facilities with higher costs compared to the average costs of similarly categorized facilities for the Ministry of Health to promptly direct.

- Lead and coordinate with provincial social security agencies to conduct inspections of health insurance examination and treatment at medical examination and treatment facilities in the area to improve the quality of health insurance examination and treatment, effectively managing and using the health insurance fund.

(3) Hospitals, Institutes with hospital beds under the Ministry of Health, Vietnamese Private Hospital Association to 

- Organize the implementation of legal provisions on medical examination and treatment, professional guidelines of the Ministry of Health, legal regulations on medical examination and treatment procedures, and medical record management; develop guidelines for diagnosis and treatment, including criteria for inpatient admission suitable to professional requirements, facility conditions, and staff of the hospital; arrange and dispose of hospital beds appropriate to the scale, equipment, and current staff of the medical examination and treatment facility in conformity with the Law on Medical Examination and Treatment 2023 and guiding documents.

- Ensure adequate and timely supply of drugs, chemicals, and medical supplies to safeguard the legal rights of health insurance participants.

- Register information with social security agencies to be granted access accounts to the reception portal to regularly and promptly monitor warning signs of increased costs at medical examination and treatment facilities according to Official Dispatch 439/BHXH-GDDT dated February 22, 2024 of Vietnam Social Security on registering accounts to monitor information as per point c, clause 10, Article 1 of Decree 75/2023/ND-CP of the Government of Vietnam.

- Organize effective cost control for health insurance examination and treatment at hospitals according to the estimated spending notification stipulated in clause 9, Article 1 of Decree 75/2023/ND-CP amending and supplementing Decree 146/2018/ND-CP dated October 17, 2018 of the Government of Vietnam detailing and guiding some articles of the Law on Health Insurance 2008; contributing to the effective management and use of the health insurance fund.

Nguyen Ngoc Que Anh

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