On January 9, 2023, the National Assembly issued the amended Law on Medical Examination and Treatment, effective from January 1, 2024 ("Law on Medical Examination and Treatment 2023"). This law introduces various mechanisms to enhance the quality of healthcare services provided by medical facilities and improve people's access to medical examination and treatment services ("MET").
To implement the Law on Medical Examination and Treatment 2023, on December 30, 2023, the Government issued Decree No. 96/2023/ND-CP detailing certain provisions of the Law ("Decree 96"). The following are some notable points updated by ATA Legal Services:
1. Specifics on Capital Mobilization and Socialization in MET Activities
To attract social resources in MET activities, the Law on Medical Examination and Treatment 2023 added forms of mobilizing resources for state-owned medical facilities. Decree 96 provides specific guidance on the following:
(i) Borrowing capital for infrastructure and medical equipment investment:
- Applicable to medical facilities classified as autonomous groups 1, 2, and 3 based on financial autonomy mechanisms for public entities.
- Before implementation, medical facilities report to higher management authorities for opinions on borrowing for investment. The report includes criteria such as project implementation time, feasibility of the borrowing plan, socio-economic efficiency of the project, etc.
(ii) Leasing and renting assets, and services:
- State-owned medical facilities can lease and rent assets such as infrastructure and medical equipment for specialized activities or provide requested medical examination and treatment services.
- Leasing clinical services, paraclinical services, non-medical services, pharmacy services, and managing the operation of medical facilities according to bidding laws and laws on managing and using public assets.
(iii) Deferred payment, installment payment, and borrowing of medical equipment:
- State-owned medical facilities decide on equipment purchases based on their standards and budget to buy medical equipment through these methods.
- Borrowing medical equipment follows civil mechanisms.
- The use of medical equipment under these methods is included in the MET service fee charged to patients or paid by the health insurance fund as regulated.
(iv) Accepting sponsorship and aid from domestic and foreign organizations, and individuals:
- Medical facilities can accept aid in the form of money, technical support, and material gifts through Official Development Assistance (ODA), preferential loans, non-refundable aid from international organizations, and foreign individuals for Vietnam.
- Medical facilities can accept sponsorship, gifts of money, property, vehicles, and materials from domestic and foreign organizations, and individuals according to regulations.
- During epidemics, medical facilities can accept support, sponsorship, and asset support for epidemic prevention from domestic and foreign individuals and organizations without applying standards or usage quotas.
2. Specific Regulations on MET Service Fees
Previously, the Law on Medical Examination and Treatment 2009 and Circular No. 13/2023/TT-BYT regulated the price framework and pricing methods for medical examination and treatment services provided by state-owned medical facilities only in terms of general MET service fees. However, Decree 96 stipulates detailed components of MET service fees for each service, including examination fees, daily treatment bed fees, and technical service fees in MET.
The Health Insurance Fund pays the MET service fee for requested medical examination and treatment services. Patients pay any remaining difference to the medical facility.
Private medical facilities participating in health insurance are paid MET fees based on the service fees applied to state-owned medical facilities approved by the provincial People's Council. The patient covers the remaining difference.
3. Principles and Funding Sources for Professional Liability Insurance in MET
a. Principles of Professional Liability Insurance in MET:
- Professional liability insurance in MET is used to cover compensation costs for damages arising from medical incidents during the insurance period and legal dispute costs related to those medical incidents, excluding incidents caused by patients.
- Insurance companies, foreign non-life insurance branches, and medical facilities proactively agree on insurance conditions, liability limits, and insurance premiums based on risk assessment of medical facilities and relevant factors as prescribed.
b. Funding Sources for Professional Liability Insurance in MET:
- For non-public facilities: covered by the facilities themselves.
- For public medical facilities: funded from the financial sources of public entities according to regulations.
Decree 96 takes effect from January 1, 2024.
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