|
No.
|
Type of violation
|
Violation
|
Penalty
|
|
1
|
Violations against regulations on paying health insurance
|
Individual liable for health insurance that fails to pay insurance
|
A warning or a fine of VND 50,000 - VND 100,000
|
|
Failing to pay compulsory health insurance for every employee liable for health insurance
|
VND 300,000 - VND 500,000
|
|
Failing to pay health insurance for every employee liable for health insurance
|
A fine of VND 500,000 - VND 30,000,000 depending on the number of employees that are omitted
|
|
Failing to pay health insurance in full
|
A fine of VND 300,000 - VND 35,000,000 depending on the number of employees that are omitted
|
|
2
|
Violations against regulations on including external people in the payroll to obtain health insurance
|
Illegally obtains insurance for other people for every illegal health insurance card has not been used
|
A fine of VND 500,000 - VND 1,000,000, determined based on every health insurance card
|
|
Illegally obtains insurance for other people for every illegal health insurance card that has been used
|
A fine of VND 1,000,000 - VND 2,000,000, determined based on every health insurance card
|
|
Every individual that obtains health insurance against the law in case the health insurance card is not used
|
A fine of VND 500,000 - VND 1,000,000, determined based on every person with a health insurance card
|
|
Every individual that obtains health insurance against the law in case the health insurance card is used
|
A fine of VND 1,000,000 - VND 2,000,000, determined based on every person with a health insurance card
|
|
3
|
Violations against regulations on incorrectly certify health insurance premium paid by policyholders; violations against regulations on extracting government budget to pay health insurance premium
|
Incorrectly certifying the health insurance premium paid by policyholders
|
A fine of VND 500,000 - VND 45,000,000 depending on the incorrect amount
|
|
Any entity that improperly extracts government budget to pay health insurance premium but does not cause a loss to the health insurance fund and does not affect the benefits of policyholders
|
A warning or a fine of VND 200,000 - VND 500,000
|
|
Any entity that improperly extracts government budget to pay health insurance premium and causes a loss to the health insurance fund or affects the benefits of policyholders
|
A fine of VND 1,000,000 - VND 2,000,000 depending on the incorrect amount
|
|
4
|
Violations against regulations on extracting government budget to pay health insurance after the procedure is completed
|
Any entity that fails to extracts government budget to pay health insurance within 30 days after the procedure is completed but does not cause a loss to the health insurance fund and does not affect the benefits of policyholders
|
A warning or a fine of VND 200,000 - VND 500,000
|
|
Any entity that fails to extracts government budget to pay health insurance within 30 days after the procedure is completed but and causes a loss to the health insurance fund or affects the benefits of policyholders
|
A fine of VND 1,000,000 - VND 20,000,000 depending on the incorrect amount
|
|
5
|
Violations against regulations on making and sending the list of health insurance policyholders
|
Making and sending the list of policyholders under one’s management behind schedule without affecting their benefits
|
A warning or a fine of VND 200,000 - VND 500,000
|
|
Making and sending an insufficient list of policyholders under one’s management behind schedule without affecting their benefits
|
|
Any entity that makes and sends the list of policyholders less than 10 working days behind schedule and affects their benefits
|
VND 500,000 - VND 700,000
|
|
Any entity that makes and sends the list of policyholders 10 working days or more behind schedule and affects their benefits
|
VND 700,000 - VND 1,000,000
|
|
Making and sending an insufficient list of policyholders that affects the benefits of policyholders
|
A fine of VND 300,000 - VND 10,000,000 depending on the minimum number of policyholders
|
|
6
|
Violations against regulations on issuance, reissuance, and replacement of health insurance cards
|
The health insurance card is issued, reissued, or replaced less than 10 working days behind schedules
|
A warning
|
|
The health insurance card is issued more than 10 working days behind schedule
|
A fine of VND 300,000 - VND 10,000,000 depending on the number of cards that are issued behind schedule
|
|
The health insurance card is reissued or replaced more than 10 working days behind schedule
|
A fine of VND 300,000 - VND 10,000,000 depending on the number of cards that are reissued or replaced behind schedule
|
|
7
|
Violations against regulations on issuance health insurance cards
|
The health insurance card is issued to an ineligible person, in case the card has not been used for medical examination and treatment
|
A fine of VND 1,000,000 - VND 2,000,000, determined based on each health insurance card
|
|
The health insurance card is issued to an ineligible person, in case the card has been used for medical examination and treatment
|
A fine of VND 3,000,000 - VND 5,000,000, determined based on each health insurance card
|
|
The benefits of the policyholder on the health insurance card are incorrect, in case the card has not been used for medical examination and treatment
|
A fine of VND 300,000 - VND 500,000, determined based on each health insurance card
|
|
The benefits of the policyholder on the health insurance card are incorrect, in case the card has been used for medical examination and treatment
|
A fine of VND 500,000 - VND 1,000,000, determined based on each health insurance card
|
|
The expiry date on the health insurance card is incorrect, in case the card has not been used for medical examination and treatment
|
A fine of VND 300,000 - VND 500,000, determined based on each health insurance card
|
|
The expiry date on the health insurance card is incorrect, in case the card has been used for medical examination and treatment
|
A fine of VND 500,000 - VND 1,000,000, determined based on each health insurance card
|
|
8
|
Violations against other regulations on using health insurance cards during medical examination and treatment
|
Falsifying the health insurance card, in case the act has not caused a loss to health insurance fund
|
VND 500,000 - VND 1,000,000
|
|
Falsifying the health insurance card, in case the act has caused a loss to health insurance fund
|
VND 1,000,000 - VND 2,000,000
|
|
Lending or borrowing the health insurance card, in case the act has not caused a loss to health insurance fund
|
VND 500,000 - VND 1,000,000
|
|
Lending or borrowing the health insurance card, in case the act has caused a loss to health insurance fund
|
VND 1,000,000 - VND 2,000,000
|
|
9
|
Infringements of the benefits of policyholders
|
The benefits infringed upon are assessed at below VND 1,000,000
|
A warning or a fine of VND 200,000 - VND 500,000
|
|
Infringing upon the benefits of the policyholders, if the benefits infringed upon are assessed at from VND 1,000,000 to below VND 5,000,000
|
VND 500,000 - VND 1,000,000
|
|
Infringing upon the benefits of the policyholders, if the benefits infringed upon are assessed at from VND 5,000,000 to below VND 10,000,000
|
VND 1,000,000 - VND 2,000,000
|
|
Infringing upon the benefits of the policyholders, if the benefits infringed upon are assessed at from VND 10,000,000 to below VND 15,000,000
|
VND 2,000,000 - VND 3,000,000
|
|
Infringing upon the benefits of the policyholders, if the benefits infringed upon are assessed at from VND 15,000,000 to below VND 20,000,000
|
VND 3,000,000 - VND 4,000,000
|
|
Infringing upon the benefits of the policyholders, if the benefits infringed upon are assessed at from VND 20,000,000 to below VND 40,000,000
|
VND 4,000,000 - VND 5,000,000
|
|
Infringing upon the benefits of the policyholders, if the benefits infringed upon are assessed at 40,000,000 VND or more
|
VND 5,000,000 - VND 6,000,000
|
|
10
|
Violations against other regulations on payment for medical cost covered by health insurance
|
Fixing incorrect prices, writing incorrect categories, units, or names of the services in the invoices for medical services covered by health insurance
|
A warning or a fine of VND 200,000 - VND 500,000 depending on the infringing amount
|
|
11
|
Violations against regulations on verification of health insurance card
|
Failure to verify health insurance in a transparent manner without affecting the policyholders’ benefits, the medical facility, and the health insurance fund
|
A warning or a fine of VND 200,000 - VND 500,000
|
|
Obstruction to health insurance verification without affecting the policyholders’ benefits, the medical facility, and the health insurance fund
|
|
Failing to verify health insurance in a transparent manner or obstructing the verification of health insurance and affecting the policyholders’ benefits
|
VND 500,000 - VND 1,000,000
|
|
12
|
Violations against other regulations on health insurance contracts
|
Unilaterally terminating the health insurance contract without affecting the benefits of the policyholder, the medical facility, and the health insurance fund
|
A warning or a fine of VND 200,000 - VND 500,000
|
|
Signing a health insurance contract with illegal contents without affecting the benefits of the policyholder, the medical facility, and the health insurance fund
|
|
Signing a health insurance contract beyond one’s competence without affecting the benefits of the policyholder, the medical facility, and the health insurance fund
|
|
Unilaterally terminating the health insurance contract in a way that infringes upon the benefits of policyholder, the medical facility, or the health insurance fund
|
A warning or a fine of VND 1,000,000 - VND 40,000,000 depending on the infringing amount
|
|
Signing a health insurance contract with illegal contents or beyond its competence in a way that infringes upon the benefits of the policyholders, the medical facility, or the health insurance fund
|
A warning or a fine of VND 1,000,000 - VND 40,000,000 depending on the infringing amount
|
|
13
|
Violations against other regulations on advance payment and payment for medical cost covered by health insurance
|
Making illegal advance payment or payment for the medical cost covered by health insurance to medical facilities
|
A warning or fine of from VND 200,000 - VND 500,000 depending on the infringing amount
|
|
Making advance payment or payment for the medical cost covered by health insurance to medical facilities behind schedule without affecting the benefits of such medical facilities and the policyholders
|
A warning or a fine of VND 200,000 - VND 500,000
|
|
Late advance payment or payment for the medical cost covered by health insurance
|
A warning or a fine of VND 5,000,000 - VND 20,000,000 depending on the duration behind schedule
|
|
14
|
Violations against regulations on using the health insurance fund
|
Using the health insurance fund against the law
|
A fine of VND 2,000,000 - VND 40,000,000 depending on the infringing amount
|
|
15
|
Offering benefits inconsistent with the health insurance card
|
Offering benefits inconsistent with the health insurance card
|
A warning or fine of from VND 200,000 - VND 6,000,000 depending on the infringing amount
|
|
16
|
Violations against regulations on health insurance
|
Obstruction of the medical examination and treatment covered by health insurance that does not affect the benefits of the policyholders or the medical facility
|
A warning or a fine of VND 200,000 - VND 500,000
|
|
Failure to comply with regulations of competent authorities that does not affect the benefits of the policyholders or the medical facility
|
|
Abuse of covered medical services such as excessive use of drugs, substances, supplies, and medical services that causes a loss of below VND 1,000,000 for the policyholders, the health insurance fund, and the medical facility
|
|
Obstruction of the medical examination and treatment covered by health insurance that affects the benefits of the policyholders or the medical facility
|
A fine of from VND 500,000 - VND 15,000,000 depending on the infringing amount
|
|
Failure to comply with regulations of competent authorities that affects the benefits of the policyholders, the medical facility, or the health insurance fund
|
A fine of from VND 1,000,000 - VND 40,000,000 depending on the infringing amount
|
|
Abuse of covered medical services such as excessive use of drugs, substances, supplies, and medical services that affects the benefits the policyholders, the health insurance fund, or the medical facility
|
A fine of from VND 500,000 - VND 40,000,000 depending on the infringing amount
|
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