In Hanoi, on July 30, the delegation of the VSS, led by Deputy General Director Le Hung Son, had a meeting with Bach Mai Hospital. At the meeting, Son said that in the spirit of the direction of the Government and the Prime Minister on implementing solutions for socio-economic development, including removing difficulties for businesses and medical facilities, in the coming time, the VSS will have a meeting with the Department of Health and medical facilities of some localities. Therefore, the General Director of VSS sent a delegation to directly grasp the situation at Bach Mai Hospital to be able to offer the most optimal solutions.

Overview image of the meeting

At the meeting, Mr. Vu Van Hong, Deputy Director in charge of Bach Mai Hospital's economy shared that, in the 2 years affected by the Covid-19 epidemic, Bach Mai Hospital - a fully-piloted autonomy unit faced various difficulties, especially in the financial field. The payment of medical care costs covered by health insurance is still one of the long-standing problems with huge challenges.

Mr. Vu Van Hong delivered a speech at the meeting

According to the report of Bach Mai Hospital, currently, there are a number of problems in paying the hospital's medical care costs covered by health insurance in the period 2017-2020. In particular, the contents that have been paid after the conclusion of the Ministry of Health or after the hospital worked with the leaders of the social security agency but have not been paid in the previous period account for about nearly 4 billion VND. The content of refusal to pay includes 13 categories, mainly related to technical services.

For some unresolved problems, Bach Mai Hospital offered 9 items with about 26 billion VND yet to be paid. In particular, the expense that exceeds the total payment in 2020 is nearly 21.8 billion VND. Regarding the amount of more than 3.1 billion VND that was refused payment during the period of 2016-2017 (for the content of Oarm surgery), the Hospital affirmed and committed that All the above technical services have been performed for patients covered by health insurance during the pilot period, waiting for the official approval decision and in accordance with professional requirements, without abuse, without collecting any costs from the patient that are in the scope of support from the health insurance fund. In addition, Bach Mai Hospital also mentioned four shortcomings on mechanisms and policies with the proposed payment amount of more than 1.1 billion dong.

Director of Hanoi Social Security Office - Nguyen Duc Hoa

In addition, Bach Mai Hospital proposed to the VSS a number of contents, including coordination with the Ministry of Health to propose the Government to abolish Article 24 of Decree No. 146/ND-CP; substitute submissions are allowed before the 15th of the following month; consider paying when the equipment group has been recorded in hospital's fixed assets for machines put into use from 2018 or earlier but with incomplete machine records.

At the meeting, Mr. Nguyen Duc Hoa - Director of Hanoi Social Security Office said that the contents mentioned at today's meeting are very important and require quick resolution. According to Hoa, over the past time, the Hanoi Social Security Office and Bach Mai Hospital have had a lot of working sessions to resolve, but due to policy problems, most of these contents have existed for a long time ago.

Regarding the issue of payment and settlement of outstanding medical care costs covered by health insurance in the period of 2020-2021, Mr. Duong Tuan Duc - Director of the Center for Medical Claim Review (VSS) emphasized, Article 32 of the Law on Health Insurance stipulates that the time of settlement is monthly or quarterly. Therefore, the Hanoi Social Security Office has properly implemented the payment and settlement of medical and health insurance costs for Bach Mai Hospital. As for the retroactive cost proposals of Bach Mai Hospital, Mr. Duong Tuan Duc said that it is necessary to study and discuss them in more depth, since this is under the authority of higher management agencies.

Director of Center for Medical Claim Review (VSS) Duong Tuan Duc

Meanwhile, according to Mr. Le Van Phuc - Director of the Department of Health Insurance Implementation (VSS), over the past time, the number of payments and settlements of Bach Mai Hospital in the period of 2019-2021 has decreased significantly, greatly affecting the operation of Bach Mai Hospital, which is mainly attributed to the impact of the Covid-19 epidemic. Following this, the Hanoi Social Security Office has provided great support in coordination work to help the hospital resolve difficulties in paying health care costs covered by health insurance.

Deputy General Director Le Hung Son sympathized with the current difficulties of Bach Mai Hospital

According to Deputy General Director Le Hung Son, recently, the Hanoi Social Security Office has been very active in removing difficulties for Bach Mai Hospital, however, there are contents that are not under its authority, so they are not yet resolved. For the submission of data to the receiving portal of the Health Insurance Assessment Information System (VSS), Deputy General Director Le Hung Son requested the Center for Medical Claim Review to directly step in and coordinate closely with the hospital to fix this content.

Deputy General Director Le Hung Son also suggested that the two sides continue to research and flexibly apply solutions on how to solve and find the optimal solution, aiming to maximize benefits for patients with health insurance. For some unpaid amounts due to classification difficulties, it is necessary to have a group to classify and separate components for payment, and make payments that can be done immediately.

Assoc. Dao Xuan Co - Director of Bach Mai Hospital received ideas at the meeting

Acquiring opinions and solutions from the VSS' delegations, Assoc. Dao Xuan Co - Director of Bach Mai Hospital sent his thanks to the heads of VSS and Hanoi Social Security Office in the past time for caring and helping the hospital in difficult times. At the same time, he hoped that the VSS will continue to accompany Bach Mai Hospital in health care under health insurance for people, as well as support the development of IT applications in effective management of health care costs covered by health insurance./.