The Government assigns the budget for health insurance examination and treatment in 2023

Patients come for medical examination and treatment at Xanh Pon General Hospital, Hanoi (illustrative photo)

Decision to assign the budget for medical examination and treatment under health insurance in 2023 to the Social Insurance of provinces and centrally run cities, the Social Insurance of the Ministry of National Defense and the Social Insurance of the People's Public Security, with a total of more than 114.5 trillion VND.

The Deputy Prime Minister requested the Social Insurance Management Council to be responsible for directing and supervising the implementation of the assigned health insurance medical examination and treatment expenditure estimates for 2023, ensuring compliance with regulations.

For medical examination and treatment expenses under health insurance in 2023 and previous years exceeding the annual budget assigned by the Prime Minister, Vietnam Social Security shall appraise and synthesize to ensure objective causes, and report to the Social Security Management Board for approval.

The Chairmen of the People's Committees of provinces and centrally run cities are responsible for directing the provincial Social Insurance to preside over and coordinate with the Department of Health and relevant agencies to effectively manage and use the Health Insurance Fund and estimate the costs of medical examination and treatment under health insurance assigned; strictly implement the regulations on advance payment and settlement of medical examination and treatment costs under health insurance according to the provisions of the Law on Health Insurance, Decree No. 146/2018/ND-CP of the Government detailing and guiding the implementation of a number of articles of the Law on Health Insurance and guiding documents.

Mobilize people to participate in health insurance

The Chairmen of the People's Committees of provinces and centrally-run cities shall direct the Department of Health to preside over and coordinate with the provincial Social Insurance and relevant agencies to strengthen consultation to help the provincial People's Committees carry out state management of health insurance through inspection, examination and handling of violations; and have solutions to prevent abuse and profiteering of the Health Insurance Fund.

Direct the Department of Finance to transfer sufficient and timely state budget funds to pay and support health insurance payments for subjects guaranteed by the state budget; participate in the management of health insurance funds according to regulations.

Direct medical examination and treatment facilities to perform medical examination and treatment, prescribe drugs and technical services in accordance with regulations and professional procedures issued by competent authorities; fully and promptly update information on medical examination and treatment under health insurance and transfer data to the Social Insurance agency according to regulations so that assessment and payment are accurate and timely...

The General Director of Vietnam Social Security is responsible for directing Vietnam Social Security to appraise the settlement of health insurance medical examination and treatment expenses in 2023 according to the provisions of the Law on Health Insurance. Submit to the Social Security Management Council for approval, including reporting: The amount of health insurance medical examination and treatment expenses exceeding the estimate assigned by the Prime Minister but within the scope of health insurance revenue for health insurance medical examination and treatment and prevention in 2023; the amount of health insurance medical examination and treatment expenses exceeding the health insurance revenue for health insurance medical examination and treatment and prevention in 2023.

On that basis, Vietnam Social Security will supplement the Social Security of provinces and units with the amount of medical examination and treatment expenses for health insurance exceeding the estimate assigned by the Prime Minister but within the scope of health insurance revenue for medical examination and treatment for health insurance and prevention in 2023.

Synthesize and submit to the Social Insurance Management Board for approval, send to the Ministry of Finance to submit to the Prime Minister for decision to supplement the provinces and units with the amount of health insurance medical examination and treatment expenses exceeding the health insurance revenue for health insurance medical examination and treatment and prevention in 2023 according to the provisions of Clause 4, Article 35 of the Law on Health Insurance as amended and supplemented, from the reserve fund surplus from previous years (if any).

In case the reserve fund is not enough to supplement the health insurance medical examination and treatment costs according to regulations, it is recommended to comply with the provisions of Clause 3, Article 35 of Decree No. 146/2018/ND-CP.

The General Director of Vietnam Social Security guides the documents, procedures, and organization of the implementation of the health insurance regime to ensure quickness, simplicity, and convenience for health insurance participants.

Direct and guide social insurance agencies of provinces and centrally run cities to advance, pay, and settle medical examination and treatment costs under health insurance in accordance with the provisions of the Law on Health Insurance and Decree No. 146/2018/ND-CP.

Ensure the quality of medical services

The Minister of Health is responsible for presiding over and coordinating with the Social Insurance agency and relevant agencies to submit to competent authorities amendments to regulations on payment methods for medical examination and treatment costs under health insurance in accordance with the law on medical examination and treatment under health insurance to effectively control costs, ensure the quality of medical services, and convenience for patients and medical examination and treatment facilities; and ensure good implementation of the budget assigned by the Prime Minister.

Preside over and coordinate with the Social Insurance agency and relevant agencies to strengthen inspection, examination and supervision of medical examination and treatment activities and payment of medical examination and treatment costs under health insurance to prevent abuse and profiteering of health insurance funds.

Direct medical examination and treatment facilities to provide adequate medicines, chemicals, medical supplies, and technical services within the scope of benefits for health insurance participants, promote the spirit of practicing thrift, and combat waste in testing, inpatient treatment, and service use, especially expensive technical services and medicines.

The Minister of National Defense and the Minister of Public Security are responsible for directing relevant units to implement the targets for developing health insurance participants and estimating expenditures for medical examination and treatment under health insurance in agencies and units under the management of the Ministry of National Defense and the Ministry of Public Security.

The Minister of Finance is responsible for balancing and arranging state budget resources to implement health insurance regimes and policies for subjects guaranteed by the state budget.

According to VNA