Proposal to review the removal of referral regulations and non-discriminatory medical examination routing in Vietnam

The Ministry of Health of Vietnam issued Official Dispatch 144/BYT-VPB1 in 2025 addressing the petition of the voters from Bac Lieu Province prior to the 8th Session of the 15th National Assembly.

Proposal to review the removal of referral regulations and non-discriminatory medical examination routing in Vietnam (Image from the internet)

Proposal to consider adding Cervical Cancer to the List of diseases covered by health insurance of Vietnam

Regarding the addition of healthcare services covered by health insurance, the Ministry of Health has acknowledged numerous opinions from voters to compile, research proposals aiming to expand health insurance benefits. This addition requires research into all related aspects, such as premium contributions, benefits, service management to prevent abuse and exploitation, as well as balancing perspectives on preventive services assured by the state budget and healthcare costs covered by the Health Insurance Fund.

In 2024, during the drafting of the Law on amendments and supplements of certain articles of the Law on Health Insurance, the Government of Vietnam presented a draft principle regulation to the National Assembly. It delegated the Government of Vietnam to specify the scope of health insurance benefits for services of diagnosis, risk evaluation, and preventive treatment of the progression of certain high prevalence diseases with significant health burdens and efficacy in early intervention and treatment, like cervical cancer, breast cancer, hepatitis B, C, diabetes, hypertension, etc., when there is scientific evidence of treatment efficacy and a full impact assessment ensuring the balance of the Health Insurance Fund. Adopting the opinions of National Assembly's Committees and related units, the addition of healthcare services covered by health insurance requires thorough research, the development of specialized guidelines, and preparation of necessary conditions as a basis for summarizing and proposing when amending the comprehensive Law on Health Insurance or, if necessary, piloting before legal stipulation.

Currently, cancer screening programs in the community, such as cervical and breast cancer screening through healthcare establishments, are in place. Particularly, there are free or low-cost screening programs for high-risk groups. Additionally, the Ministry of Health is actively promoting public awareness about the importance of screening for cancer prevention, particularly cervical cancer.

In Circular 39/2024/TT-BYT dated November 17, 2024, and Circular 35/2016/TT-BYT dated September 28, 2016, by the Ministry of Health, a list of medical technical services within the payment scope of the Health Insurance Fund was issued. The Ministry has added some technical services for early-stage diagnosis, which will contribute to improving access to treatment and the effectiveness of treating certain cancer diseases, thus increasing health insurance benefits for insured patients who unfortunately contract the disease.

Proposal to review the removal of referral regulations and non-discriminatory medical examination routing in Vietnam

Currently, the issuance of referral and transfer papers is very slow. In severe cases, patients have to wait for lengthy procedures, affecting their health status and treatment opportunities. We propose considering the abolition of referral regulations and non-differentiation of treatment levels.

On January 1, 2025, the Ministry of Health issued Circular 01/2025/TT-BYT detailing and guiding the implementation of certain provisions of the health insurance law, including (1) a list of 62 rare and serious diseases that do not require referral paperwork, allowing patients to still enjoy 100% of their health insurance benefits; and (2) regulations on initial health insurance registration and treatment, the referral of patients back to their initial health insurance treatment facilities.

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