The Ministry of Health to guide the implementation of Decree 75/2023/ND-CP in Vietnam

On November 7, 2023, the Ministry of Health issued Official Dispatch 7221/BYT-BH on the implementation of Decree 75/2023/ND-CP.

The Ministry of Health to guide the implementation of Decree 75/2023/ND-CP in Vietnam

To implement the Decree promptly and effectively, the Ministry of Health requests that agencies and units within the scope of assigned functions and tasks focus on implementing the following contents:

(1) Organize to disseminate, thoroughly grasp, deploy, and urge the implementation of Decree 75/2023/ND-CP to relevant agencies and units under the scope of management and responsibility; Organize propaganda and widely disseminate regulations related to the rights and responsibilities of health insurance card holders so that people know and comply with the regulations.

(2) For Vietnam Social Insurance:

- Direct the Social Insurance of provinces and centrally-run cities to coordinate with relevant agencies and units to compile a list and issue health insurance cards to subjects that have been amended and supplemented in Decree 75/2023/ND-CP; Adjust the benefit level for health insurance participants specified in Clause 5, Article 3 of Decree 146/2018/ND-CP to 100% according to the provisions of Point a, Clause 5, Article 1 of Decree 75/2023/ND-CP;

- Guide and organize additional payment of medical examination and treatment costs covered by health insurance of medical examination and treatment facilities that exceed the total payment from January 1, 2019 according to the provisions of Clause 8 of Decree 75/2023/ND-CP, and report to competent authorities according to regulations.

- Advise and guide according to authority, train, and organize the implementation of regulations in Clause 9, Article 1 of Decree 75/2023/ND-CP on preparing and delivering estimates to the provincial social insurance and notifying the estimated amount of medical examination and treatment expenses covered by health insurance to medical examination and treatment facilities to ensure timely and in accordance with regulations.

- Strengthen the implementation of appraisal work and perfect the information technology system to meet the needs of receiving, assessing, and promptly responding to medical examination and treatment facilities about medical examination and treatment data covered by health insurance; ensure accuracy, safety, and security of information; and respect the rights of relevant parties;

Proactively review, detect, and promptly send warning information to medical examination and treatment facilities covered by health insurance regarding medical examination and treatment costs covered by health insurance that are higher than the average costs of medical examination and treatment facilities of the same class, same level, and same specialty so that medical examination and treatment facilities can inspect, verify, and make appropriate adjustments to economically and effectively use the health insurance fund.

(3) For Departments, Bureaus, Inspectorates, and Ministry Offices under the Ministry of Health:

- Organize reviews and promptly advise leaders of the Ministry of Health to develop, amend, and supplement legal regulations, professional and technical instructions on medical examination and treatment, health insurance, pharmacy, medical equipment and supplies, medical examination and treatment service prices, procurement, bidding, management, and use of public assets to ensure a complete, clear, and feasible legal corridor for medical examination and treatment activities covered by health insurance and the assessment of medical examination and treatment costs covered by health insurance.

- Strengthen inspection, examination, and urge the implementation of policies and laws on health insurance, and prevent wasteful, negative, abusive, and profiteering behavior with health insurance funds; Improve the quality of medical examinations and treatments covered by health insurance, meeting patient satisfaction.

(4) For Departments of Health of provinces and centrally run cities:

- Direct medical examination and treatment facilities in the area to improve the quality of medical examination and treatment covered by health insurance, meeting patient satisfaction, continue to tighten discipline in medical examination and treatment, procurement, and bidding, and strictly implement the provisions of the law on health insurance, medical examination and treatment, and regulations of Decree 75/2023/ND-CP; strengthen inspection and prevention of wasteful, negative, abusive, and profiteering acts of health insurance funds.

- Coordinate with the Social Insurance of provinces and centrally run cities to advise the People's Committees of provinces and centrally run cities in building, directing, organizing full and timely implementation of health insurance policies and mechanisms in accordance with local practical requirements, support health insurance premiums, and identify beneficiaries of support and the level of support and payment of medical examination and treatment costs covered by health insurance for health insurance participants according to the provisions of Clause 3, Article 1 of Decree 75/2023/ND-CP in order to maintain the health insurance participation rate that the province and city have achieved and continue to cover the population that has not yet participated in health insurance.

- Strengthen inspection and examination, urge the implementation of policies and laws on health insurance, and prevent wasteful, negative, abusive, and profiteering behavior with health insurance funds.

(5) For Hospitals and Institutes with beds under the Ministry of Health, Ministries, branches, and medical examination and treatment facilities nationwide:

- Directors of medical examination and treatment facilities are responsible for directing and organizing the strict implementation of legal regulations on health insurance, medical examination and treatment, procurement, bidding, management, and use of public assets and related laws to ensure timely and adequate supply of drugs, chemicals, medical supplies, and medical technical services with quality, efficiency, and savings, and to completely overcome the shortage of drugs and medical supplies.

- Proactively review, promulgate, and promptly update processes, professional guidance, and measures to prevent abuse and profiteering of health insurance funds according to authority; Regularly organize inspections, reviews, and verification of increased medical examination and treatment costs covered by health insurance at the facility according to the recommendations and warnings of the social insurance agency and make appropriate adjustments.

- Enhance the sense of responsibility to serve patients with health insurance, effectively use the four health insurance funds, and strictly handle violations according to authority.

More details can be found in Official Dispatch 7221/BYT-BH, dated November 7, 2023.

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