Procedures for signing contracts on health insurance-covered medical care in Vietnam from July 16, 2024

Procedures for signing contracts on health insurance-covered medical care in Vietnam from July 16, 2024 (Internet image)

On July 16, 2024, the General Director of Vietnam Social Security announced 03 administrative procedures that have been revised and supplemented in the field of implementing health insurance policies under the jurisdiction of Vietnam Social Security as per Decision 1003/QD-BHXH, following Decree 75/2023/ND-CP, October 19, 2023, of the Government of Vietnam which revises and supplements several articles of Decree 146/2018/ND-CP, October 17, 2018, of the Government of Vietnam detailing and guiding the implementation of several provisions of Law on Health Insurance 2008.

Procedures for signing contracts on health insurance-covered medical care in Vietnam from July 16, 2024

Procedures for signing contracts on health insurance-covered medical care in Vietnam from July 16, 2024 are as follows:

(1) Implementation Sequence

Step 1. Prepare and submit dossiers:The medical examination and treatment facility prepares the contract signing dossier as per regulations and submits it to the Social Security agency.

Step 2. The Social Security agency receives, reviews the dossier per regulations.

Step 3. Sign the contract:- If the medical examination and treatment facility meets all conditions, the Social Security agency and the facility will sign the health insurance examination and treatment contract according to Form No. 7 Annex issued with Decree 75/2023/ND-CP.- If the medical examination and treatment facility does not meet conditions, the Social Security agency will issue a written response stating the reasons.

(2) Method of Implementation

- The medical examination and treatment facility submits the dossier online, directly at the Social Security agency, or via public postal service.- Organize a contract signing if the requirements are met.

(3) Dossier Components

* For the first-time signing facility or a facility that has terminated a contract:- Official Dispatch proposing the contract from the medical examination and treatment facility;- Copy of the operating license of the medical examination and treatment facility issued by the competent state authority;- Photocopy with the facility's stamp of the hospital rating decision by competent authorities (if any) or the decision on technical specialization level by competent authorities for non-public medical examination and treatment facilities;- List of drugs, chemicals, medical supplies, and medical technical services approved by competent authorities (in writing or electronic form);- List of registered practicing personnel at the medical examination and treatment facility with complete information as per Form No. 01 Annex II issued with Decree 96/2023/ND-CP, December 30, 2023, of the Government of Vietnam.

* For annual contract signing medical examination and treatment facilities:Photocopy with the facility's stamp of the decision on function addition, tasks, professional scope, and hospital rating by competent authorities (if any) or the decision on technical specialization level by competent authorities for non-public medical examination and treatment facilities.

(4) Processing Time: Within 30 days from the date the Social Security agency receives a complete and valid dossier.

(5) Target of Administrative Procedure Implementation: Medical examination and treatment facilities.

(6) Agencies Implementing Administrative Procedures: Provincial/District Social Security agencies with delegated authority.

(7) Result of Administrative Procedure Implementation: Health Insurance Examination and Treatment Contract.

(8) Requirements and Conditions for Administrative Procedure Implementation:

- Sign the health insurance examination and treatment contract according to Form No. 7 Annex attached to Decree 75/2023/ND-CP.- Effective period of the health insurance examination and treatment contract as stipulated in Clause 2, Article 18 Decree 146/2018/ND-CP.

More details can be found in Decision 1003/QD-BHXH, which comes into force in Vietnam from July 16, 2024.

Nguyen Ngoc Que Anh

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