To strengthen prevention of fraud and the profiteering of social insurance, unemployment insurance, and health insurance funds in Vietnam

To strengthen prevention of fraud and the profiteering of social insurance, unemployment insurance, and health insurance funds in Vietnam (Internet image) 

Regarding this issue, LawNet would like to answer as follows:

On September 14, 2023, Vietnam Social Insurance issued Official Dispatch 2853/BHXH-TTKT on strengthening leadership in implementing the law and preventing and combating fraud and profiteering from social insurance funds, unemployment insurance, and health insurance.

To Strengthen prevention of fraud and the profiteering of social insurance, unemployment insurance, and health insurance funds in Vietnam

To continue to limit acts of fraud and profiteering from social insurance (SI), unemployment insurance (UI), and health insurance funds, Vietnam Social Security requests the Ministry of Labor, War Invalids and Social Affairs, the Ministry of Health, and the People's Committees of provinces and centrally run cities to pay attention and direct some of the following contents:

(1) For the Ministry of Labor, War Invalids, and Social Affairs

- Direct the inspection of the Department of Labor, War Invalids, and Social Affairs to coordinate with the social insurance agency at the same level to continue paying attention and strengthening inspection work for units that are slow to pay social insurance, unemployment insurance, and health insurance, the construction of salary scales and payrolls, signing labor contracts, and determining compulsory social insurance payments at enterprises to serve as a basis for contributions and enjoyment of social insurance, unemployment insurance, and health insurance benefits for employees.

- Issue documents guiding and directing the Department of Labor, War Invalids, and Social Affairs to coordinate with Social Security in provinces and cities to review cases where employees receive unemployment benefits that coincide with their working time and pay social insurance and unemployment insurance to recover the unemployment insurance fund for the amount of benefits not in accordance with regulations; regularly and proactively coordinate and share data with the social insurance of provinces and cities to review and resolve the unemployment insurance regime, avoiding the situation of issuing decisions on unemployment insurance payments to the wrong subjects for the wrong amount.

(2) For the Ministry of Health

- Issue a document directing the Departments of Health of provinces and centrally-run cities to rectify medical treatment facilities in the area and strictly implement the medical examination and treatment process issued with Decision 1313/QD-BYT in 2023. to promptly detect and handle cases of borrowing someone else's health insurance card to go for medical treatment; check the patient's medical history to detect cases of multiple medical examinations in a short period of time for the purpose of profiteering.

- Direct the Health Sector Inspectorate to strengthen coordination with social insurance agencies at all levels to inspect and examine the organization of health insurance medical examination and treatment and the payment of health insurance medical examination and treatment costs;

- Direct the Department of Health to coordinate with Social Security of provinces and centrally run cities to consider and promptly suspend or terminate health insurance medical examination and treatment contracts with health insurance medical examination and treatment facilities that are determined to have violations due to health insurance fraud. 

(3) For the People's Committees of provinces and cities

- Direct relevant State management agencies to strengthen inspection and supervision of agencies, units, and businesses in the area in compliance with laws on social insurance, unemployment insurance, and health insurance; at the same time, grasp the "health" situation of the business to provide timely warnings.

- Direct Departments, Committees and Sectors to coordinate with the Provincial Social Insurance to promote propaganda and dissemination of laws on social insurance, unemployment insurance, and health insurance; orient local press agencies to proactively propagate and warn people and workers about the act of purchasing social insurance books so that people and workers are not enticed to sell social insurance books; and promptly detect and denounce violations.

- Direct the Department of Labor, War Invalids, and Social Affairs to strengthen coordination with the provincial social insurance agency to inspect and examine labor-employing units in the area, which focuses on inspecting and checking units with signs of violations in collecting payments and handling social insurance and unemployment insurance benefits.

- Direct the Department of Health to strengthen coordination with the provincial social insurance agency to inspect and examine health insurance medical treatment facilities, especially the issuance of certificates of leave to enjoy social insurance benefits.

- Improve the efficiency and effectiveness of inter-sectoral inspection and examination in the implementation of social insurance, unemployment insurance, and health insurance policies, especially the effectiveness of interdisciplinary inspection and examination of the implementation of health insurance policies at health insurance medical facilities; Strictly handle units, businesses, and individuals that violate the law on implementing social insurance, unemployment insurance, and health insurance regimes and policies according to the provisions of the law to promptly ensure the legitimate rights and interests of participants in social insurance, unemployment insurance, and health insurance.

- Direct the provincial police agency to regularly monitor and understand the implementation of policies and laws on social insurance and health insurance in the province; promptly investigate and take measures to prevent and handle violations, especially acts of fraud, profiteering, and evasion of paying social insurance, unemployment insurance, and health insurance.

More details can be found in Official Dispatch 2853/BHXH-TTKT, dated September 14, 2023.

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