Highlights of Prominent Documents in the Fields of Insurance, Health, and Labor

1. Guidelines on Implementing Certain Regulations on Maternity Policies

According to Official Dispatch 3432/LDTBXH-BHXH dated September 08, 2016, guiding the implementation of certain policies under the Law on Social Insurance (SI) 2014, some regulations on maternity policies (MSP) are implemented as follows:

- One-time allowance for childbirth in the case where only the father participates in Social Insurance is applied even if the mother is not eligible for MSP but the father meets the conditions according to Clause 2, Article 9 of Circular 59/2015/TT-BLDTBXH;- If only the father pays Social Insurance and the mother encounters risks after giving birth, the father is entitled to maternity leave until the child reaches 6 months of age according to Clause 6, Article 34 of the Law on Social Insurance, irrespective of the time of Social Insurance contribution;- Male employees entitled to maternity leave can take multiple leaves, but the total time must not exceed the provisions at Clause 2, Article 34 of the Law on Social Insurance;- The maximum period for convalescence and recovery after maternity at Clause 2, Article 41 of the Law on Social Insurance is calculated for 1 year, from January 01 to December 31 of the calendar year, including holidays, Tet, and weekly rest days.

2. Reduction of Documents Required for Occupational Accident and Disease Policies

The documents for occupational accident (OA) and industrial disease (ID) policies for individuals who have been treated and discharged from the hospital from July 01, 2016, are implemented according to Official Dispatch 3647/BHXH-CSXH dated September 21, 2016. Specifically:

- For OA policy documents: Remove the occupational accident investigation report and related documents in cases where traffic accidents are determined as OA, including the scene examination report, scene diagram of the traffic accident, and traffic accident report;- For ID policy documents: Remove the report on environmental measurement with harmful factors or the results of labor environment measurement or the excerpts of these documents;- Supplement the request for settlement of OA and ID policies with the content of the issuance date of the investigation report, examination report, environmental measurement results with harmful factors, and labor environment monitoring.

3. Payment for Emergency Medical Examination Under 4 Hours

According to Official Dispatch 7117/BYT-KH-TC guiding the implementation of Joint Circular 37/2015/TTLT-BYT-BTC, the payment for medical examination (ME) in cases where the patient enters the emergency department without going through the ME department is as follows:

- Treatment time < 4 hours: Payment for ME, medication, and technical services, no payment for inpatient bed treatment costs;- Treatment time ≥ 4 hours: Payment for inpatient bed treatment costs, medication, and technical services per regulations, no payment for ME.

Refer to the regulations on the payment of inpatient bed treatment costs and medical examination and treatment expenses at Official Dispatch 7117/BYT-KH-TC dated September 27, 2016.

4. Guidance on Payment for Health Insurance Drugs

This content is mentioned in Official Dispatch 7086/BYT-BH dated September 26, 2016, regarding payment for health insurance drugs (HI).

To resolve the payment for HI drugs while waiting for the Ministry of Health to amend and supplement Circular 40/2014/TT-BYT as follows:

- For drugs used up to the date of issuance of this Official Dispatch: Payment will be made if the drug is prescribed as per the indication in the registered drug dossier or according to the guidance of the Ministry of Health's treatment protocols or the hospital's treatment protocols;- For non-used drugs: Follow exactly the guidance in Circular 40/2014/TT-BYT, payment is only made for indications consistent with those registered in the approved dossiers.

5. List of Medical Technical Services Covered by Health Insurance Participants

From December 01, 2016, payment for medical technical services within the scope covered by health insurance participants (HI) shall be according to Circular 35/2016/TT-BYT.

The list of medical technical services covered by HI participants includes health examination, treatment, functional rehabilitation, regular prenatal examination, and childbirth services, comprising:

- Professional technical service list in health examination and treatment issued with Circular 43/2013/TT-BYT;- Classification list of surgeries, procedures issued with Circular 50/2014/TT-BYT;- Medical technical services approved by the Minister of Health for implementation at health examination and treatment facilities not yet included in Circular 43/2013/TT-BYT, Circular 50/2014/TT-BYT.

Refer to additional content on payment rates, payment conditions, and HI payment guidelines in Circular 35/2016/TT-BYT.

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