On October 19th, 2023, the government issued Decree No. 75/2023/NĐ-CP, amending and supplementing certain provisions of Decree No. 146/2018/NĐ-CP dated October 17th, 2018, detailing and guiding the implementation of some articles of the Law on Health Insurance. One of the new points in Decree 75 concerns the establishment of health insurance expenditure budgets and the notification of estimated HI spending, as stipulated in Article 1, Clause 9, Point 2.

According to these provisions, the budgeting process demands responsibility from relevant agencies as follows: Based on the allocated budget from the Prime Minister, the VSS allocates health insurance spending budgets to the social security offices of the Ministry of National Defense, Public Security, and those of provinces and centrally-run cities within 90% of the national health insurance budget. Based on the proposed estimated spending by health care facilities for the year, provinces and centrally-run cities inform the health care facilities about the estimated health insurance spending. In cases where the estimated spending increases or decreases compared to the previously notified amount, the health care facilities must submit documents to the provincial social security office to adjust accordingly.

To implement these guidelines, earlier on December 1st, VSS' Deputy General Director Nguyen Duc Hoa chaired an online conference with the VSS to gather feedback from the Health Departments and healthcare facilities regarding the establishment, allocation of budgets, and the notification of estimated health insurance spending as per Decree No. 75/2023/NĐ-CP.

Overview of the meeting

The overall feedback from World Bank experts and representatives from Health Departments and HI healthcare facilities during and after the conference indicated that the HI policy implementation team specifically identified the problem that needed resolution in the budgeting and allocation process to health care facilities: ensuring fairness in cost among different disease groups in the same hospital rank, same healthcare level, and same specialty.

Furthermore, Decree 75 emphasizes VSS's responsibility in the inspection function: “Proactively review, detect, and promptly (integrated with appraisal rules); medication cost appraisal through the Drug Management Software; assessing the rationality of prescriptions through Monitoring Software. Additionally, the Center has developed over 120 annual appraisal topics, requiring local social security units to deploy them to screen for abnormal costs.

These serve as the foundation for the VSS to fulfill the requirements of Decree 75 regarding reviewing, detecting, and timely