Deputy General Director Dao Viet Anh said that the VSS always prioritizes the rights and interests of health insurance participants.

Proposing and recommending amendments to health insurance policies and laws to develop participants towards completing the goal of universal health insurance

Over the past time, there has been the attention and direction of the Government, the Prime Minister and the close coordination of ministries and branches in guiding and organizing the implementation of the Law on Health Insurance, especially the state budget covering the health insurance cards for target groups, including ethnic minorities living in areas with difficult socio-economic conditions, helping ethnic minorities to access modernize health care services, reduce financial burden and contribute to increasing the population coverage rate participating in health insurance. As of December 31, 2021, the number of health insurance participants is 88.837 million, an increase of 794 thousand people (0.9%) compared to 2020; reaching the rate of about 91.01% of the population participating in health insurance, 0.01% higher than the target set in Resolution No. 01/NQ-CP dated January 1, 2021 of the Government.

Statistics have shown that the number of health insurance participants from 2017 to 2020 every year increases by more than 2 million people, an average increase of about 3% a year. However, since 2021, due to the impact of the Covid-19 pandemic and the policy of purchasing health insurance cards for people living in communes in Region III, Region II, Region I in ethnic minority areas and in mountainous areas in the 2021-2025 period according to Decision No. 861/QD-TTg dated June 4, 2021 of the Prime Minister and people living in poor districts, communes with special difficulties in the lowlands, coastal areas and islands in the period 2021-2025 according to Decision No. 353/2022/QD-TTg dated March 15, 2022 of the Prime Minister has reduced the number of people participating in health insurance. Among them, there are about 3.1 million people who did not receive health insurance cards from the state budget. Some localities have had a sharp decrease in the number of people participating in health insurance: down 225.5 thousand people in Dak Lak, including 194.6 thousand ethnic minorities; down 309.5 thousand people in Soc Trang, of which 200 thousand ethnic minorities; down 243.6 thousand participants in Tra Vinh, down 93.8 thousand ethnic minorities in Tra Vinh, etc.

Representative of the Department of Social Insurance Book and Health Insurance Card presented thematic topics at the Conference

In order to create conditions for people to reduce difficulties and maintain a sustainable health insurance policy, contributing to the achievement of the goal that by 2025, 98% of ethnic minorities will participate in health insurance according to Resolution No. 88/2019/QH14 on November 18, 2019 of the National Assembly approving the master plan for socio-economic development in ethnic minority and mountainous areas for the period of 2021-2030, the VSS had a written report to the Prime Minister. The Government, the Committee for Ethnic Minority Affairs, the Ministry of Planning and Investment reported to the Party Personnel Committee that the Government continued to have the policy of paying and supporting health insurance premiums for people escaping from poor districts, extremely difficult communes, coastal areas and islands in the 2021-2025 period and ethnic minority people escaping from difficult and especially difficult communes in the period 2021-2025 mentioned above.

The proposed content of the VSS has been directed by Permanent Deputy Prime Minister Pham Binh Minh in the conclusion notice No. 251/TB-VPCP dated September 22, 2021 of the Government Office.

Create conditions for patients with health insurance cards to easily access medicines and technical services during treatment

The list of pharmaco-chemical drugs, biological products, radioactive drugs and markers is promulgated together with the Circular No. 30/2018/TT-BYT dated October 30, 2018 of the Ministry of Health, promulgating the list and proportions and payment conditions for pharmaco-chemical drugs, biological products, radioactive drugs and markers within the scope of benefits of health insurance participants include 1,030 pharmaco-chemical drugs, biological products and 59 radioactive drugs and marker.

Representative of the Department of Health Insurance Implementation presented the topic at the Conference

The list of traditional medicines, herbal medicines and traditional medicine ingredients is issued together with the Circular No. 05/2015/TT-BYT dated March 17, 2015 of the Ministry of Health promulgating the list of traditional medicines, drugs from medicinal herbs and traditional medicine ingredients covered by the health insurance fund, including 349 traditional medicine herbs; 229 traditional medicines and herbal medicines with over 1,200 preparations.

Effectiveness from the Assessment Information System in the management of health insurance funds

In 2016, VSS has developed a health insurance assessment information system to connect and link data with health care facilities under the direction of the Prime Minister in Notice No. 102/TB-VPCP. On June 24, 2016, the Data Receipt Portal under the VSS' system was officially opened and connected with medical facilities. Since January 2017, the system has been completed and officially implemented electronic assessment. So far, it has brought a lot of efficiency in the management of the health insurance fund, including:

The Data Receipt Portal has been connected and linked data between the social security agency and 12,380 health care facilities from commune to central levels nationwide, supplemented with the function of granting temporary health insurance card codes, and looking up card information according to the social insurance code on the VssID application, the chip-mounted VNEID/CCCD application, the function of requesting a temporary code for medical supplies, etc. The Ministry of Health, Departments of Health of provinces and cities and leaders of health care providers are provided with an account to monitor and manage medical care and use the health insurance fund.

Representative of the Center for Medical Claim Review presented their topic at the Conference

Through the functions of the system, the VSS and the provincial social security agencies have detected and recovered many cases of improper payment to the health insurance fund.

The connection of data with professional software has also helped to timely detect many cases of health insurance fraud. For instance, in 2019 and 2020, 364 turns of patients have been discovered to use other people's health insurance cards for medical care covered by health insurance with the amount of 1.14 billion VND; 26 cases of medical staff used the information of the deceased person's health insurance card to falsely create 35 health insurance payment records with the amount of 34.26 million VND. The health-insurance-based health care monitoring software has been developed since August 2017, with a total of 115 functions, with 56 maps, and 19 charts updated with daily monitoring data nationwide. The information on the health care situation is publicly updated, helping the local social security agencies to have an overview and easily identify and quickly detect changes and developments in medical expenses at all medical facilities to promptly coordinate with them in controlling and using the health insurance fund effectively.

Advantages of the application "VssID- Digital Social Insurance"

With the agreement of the Ministry of Health, on November 25, 2020, the VSS has piloted using the image of the health insurance card on the VssID application to go for medical care using health insurance instead of a paper health insurance card. Accordingly, the participants of health insurance, who are issued with health insurance cards by 10 social security agencies of provinces and cities in the central region - Central Highlands (Ha Tinh, Quang Binh, Quang Tri, Thua Thien - Hue, Da Nang, Phu Yen, Binh Dinh, Quang Nam, Quang Ngai, Kon Tum), are allowed to use the image of the health insurance card on VssID to go for health care at the facilities that have signed the health insurance contract.

On May 31, 2021, the VSS issued Official Letter No. 1493/BHXH-CSYT on the use of the health insurance card image on the VssID application for medical examination and treatment. Accordingly, based on the opinion of the Ministry of Health in Official Letter No. 4316/BYT-BH dated May 27, 2021 on the use of the health insurance card image on the VssID application to go for medical treatment with health insurance, from June 1, 2021, patients with health insurance can use the image of the health insurance card on the VssID application to replace the paper one at health care facilities nationwide.

By the end of June 2022, nationwide, there were over 26.2 million individual electronic transaction accounts that have been registered and approved (used to log in to use the VssID application), of which 673,755 people were registered and 1,212,145 turns of use of health insurance cards on VssID application for medical treatment using health insurance were recorded.

It can be said that VssID - digital social insurance is a strong step forward in the digital transformation process of Vietnam's social insurance industry. With many convenient features, this application contributes to the implementation of the national digital strategy and the development of e-Government in the coming time./.