On October 19, 2023, the Government issued Decree 75/2023/ND-CP ("Decree 75") amending and supplementing a number of articles of Decree 146/2018/ND-CP ("Decree 146") dated October 17, 2018, detailing and guiding measures to implement a number of articles of the Law on Health Insurance ("Health Insurance”). Decree 75 provides new provisions related to the rights and obligations of health insurance participants and health insurance examination and treatment establishments as follows:
1. Changing of subjects to be paid health insurance by the state budget
a. To supplement beneficiaries who are paid 100% of expenses by the health insurance fund within the scope of entitlement when going to medical examination and treatment as prescribed, including:
- The people of the revolutionary safe communes and zones in the anti-French and anti-American resistance are currently permanently residing in the revolutionary safe communes and zones in the anti-French and anti-American resistance have been updated in the National Database on Population, Databases of residences that are not subject to regulation;
- Participants in resistance and defense of the Fatherland as prescribed.
b. To amend the basis for determining the subjects of poor households to be paid health insurance by the state budget according to Decree 07/2021/ND-CP and related amended and supplemented documents.
The regulations mentioned above have been applied from October 19, 2023.
2. Changing of subjects supported by the state budget for health insurance contributions
a. To amend the basis for determining persons belonging to near-poor households and people belonging to households engaged in agriculture, forestry, fishery and salt farming with average living standards supported by the state budget for health insurance contributions. Accordingly, these subjects will be determined according to Decree 07/2021/ND-CP and related amended and supplemented documents. This regulation have been applied from October 19, 2023.
b. To supplement beneficiaries supported by the state budget are ethnic minorities living in communes in Region II, Region III and extremely disadvantaged villages in ethnic minority and mountainous areas in the period 2016-2020 which are no longer on the list of communes in Region II, Area III, extremely disadvantaged villages in ethnic minority and mountainous areas in the period of 2021-2025 according to the decision of the Prime Minister. According to Decree 75, this beneficiary will be paid 95% of the costs within the scope of entitlement when going to medical examination and treatment as prescribed. The state budget supports this object for a period of 36 (thirty-six) months from November 1, 2023.
3. Amending and supplementing regulations on documents to be presented when going to medical examination and treatment to use health insurance
In line with the orientation and practice of digital transformation in Vietnam, Decree 75 adds documents that can be provided when health insurance participants go for medical examination and treatment as follows:
a. A citizen ID can be presented instead of a health insurance card.
b. In case of presenting a health insurance card without a photo, additional documents with electronic identification level 2 as prescribed can be presented instead of presenting a hard copy.
4. Amending and supplementing several principles of payment of medical examination and treatment expenses between the social insurance agency and medical examination and treatment establishments:
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Decree 146 |
Decree 75 |
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The price of medical examination and treatment services for health insurance is uniformly applied to hospitals of the same class nationwide. |
The cost of medical examination services, the cost of bed-day services, and the cost of technical and laboratory services used for patients within the scope of entitlement and the entitlement level of the health insurance participant shall be paid according to the actual quantity used for the patient and the price according to current regulations. |
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Costs of drugs, chemicals, and medical supplies not included in the price of medical examination and treatment services shall be paid according to the purchase price under the law on bidding. |
Costs of drugs, chemicals, and medical supplies that have not been included in the price of health insurance examination and treatment services or used in technical services that have not yet been issued health insurance examination and treatment prices have been used for patients within the scope of entitlement and the entitlement level of health insurance participants shall be paid according to the actual quantity used and the purchase price according to regulations definition of the law on bidding. |
Decree 75 takes effect from December 3, 2023, except for the earlier regulations. Health insurance participants who enter medical examination and treatment establishments for treatment first, but are discharged from the hospital from the effective date of Decree 75, shall be paid by the health insurance fund within the scope of entitlement and entitlement level as prescribed.
Comment: