The Ministry of Health (Hanoi, Vietnam) shall apply the new statutory pay rate in payment of healthcare costs covered by health insurance

The Ministry of Health (Hanoi, Vietnam) shall apply the new statutory pay rate in payment of healthcare costs covered by healthinsurance (Internet image)

On July 1, 2024, the Ministry of Health (Hanoi, Vietnam) issued Official Dispatch 3687/BYT-BH regarding the application of the statutory pay rate as stipulated in Decree 73/2024/ND-CP in paying healthcare costs covered by health insurance.

The Ministry of Health (Hanoi, Vietnam) shall apply the new statutory pay rate in payment of healthcare costs covered by healthinsurance

Specifically, based on the regulations in Decree 73/2024/ND-CP, the Ministry of Health provides guidance on the payment for healthcare costs covered health insurance (HI) during the transition period from July 1, 2024, to December 31, 2024, as follows:

- Regarding the health insurance benefit rates as stipulated at point d, clause 1, Article 14 Decree 146/2018/ND-CP or in cases where patients are admitted to the hospital or begin their treatment regimen before July 1, 2024, but are discharged or complete their treatment on or after July 1, 2024:

- The cost for one healthcare session is less than 15% of the statutory pay rate, which is equivalent to less than 351,000 VND (Three hundred fifty-one thousand dong).

- Regarding direct payment rates as stipulated in Article 30 Decree 146/2018/ND-CP from July 1, 2024, or in cases where patients are admitted to the hospital or begin their treatment regimen before July 1, 2024, but are discharged or complete their treatment on or after July 1, 2024:

• In the case of outpatient treatment, payment according to actual costs within the scope of benefits and benefit rates as per regulations, but not exceeding 0.15 times the statutory pay rate at the time of treatment: equivalent to a maximum of 351,000 VND.

• In the case of inpatient treatment, payment according to actual costs within the scope of benefits and benefit rates as per regulations, but not exceeding 0.5 times the statutory pay rate at the time of discharge: equivalent to a maximum of 1,170,000 VND.

• In cases where patients seek inpatient treatment at provincial-level medical facilities and equivalent that do not have a health insurance contract (except in emergency cases), payment according to actual costs within the scope of benefits and benefit rates as per regulations, but not exceeding 1.0 times the statutory pay rate at the time of discharge: equivalent to a maximum of 2,340,000 VND.

• In cases where patients seek inpatient treatment at central-level medical facilities and equivalent that do not have a health insurance contract (except in emergency cases), payment according to actual costs within the scope of benefits and benefit rates as per regulations, but not exceeding 2.5 times the statutory pay rate at the time of discharge: equivalent to a maximum of 5,850,000 VND.

- The total payment for medical equipment costs per usage of technical services does not exceed 45 months of the statutory pay rate as stipulated at point b, clause 2, Article 3 Circular 04/2017/TT-BYT:

• For patients admitted from July 1, 2024: equivalent to not exceeding 105,300,000 VND.

• For patients admitted or who began their treatment regimen before July 1, 2024, but are discharged or complete their treatment on or after July 1, 2024, the total payment for medical equipment costs per usage of technical services is determined according to the completion time of the service and costs calculated at two different times:

++ Before July 1, 2024: Apply the statutory pay rate as stipulated in Decree 24/2023/ND-CP dated May 14, 2023, which regulates the statutory pay rate for officials and public employees and the armed forces, equivalent to not exceeding 81,000,000 VND.

++ From July 1, 2024: Apply the statutory pay rate as stipulated in Decree 73/2024/ND-CP dated June 30, 2024, of the Government, equivalent to not exceeding 105,300,000 VND.

- From July 1, 2024, and in cases where patients are admitted to the hospital or begin their treatment regimen before July 1, 2024, but are discharged or complete their treatment on or after July 1, 2024, if the co-payment for healthcare costs covered health insurance within the year exceeds 06 months of the statutory pay rate to determine exemption rights as stipulated at point e, clause 1, Article 14 Decree 146/2018/ND-CP, the amount is determined as follows:

(For cases where the co-payment from January 1, 2024, to before July 1, 2024, has already met or exceeded 6 months of the statutory pay rate, the benefit is as per point e, Clause 1, Article 14 Decree 146/2018/ND-CP and this formula does not apply)

Nguyen Ngoc Que Anh

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