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Accordingly, to ensure the interests of HI participants, effectively manage and use the HI fund for medical examination and treatment, and estimate costs for medical examination and treatment covered by the HI fund, VSS requires provincial and the above-mentioned agencies to implement key tasks as follows:

Social insurance agencies of the provinces actively coordinate with the local departments of Health, and Finance to advise the provincial/municipal People's Committees to issue documents to direct and supervise the implementation of expenditure estimates for medical examination and treatment covered by the HI fund as soon as the Prime Minister's decision on the estimate takes effect.

Healthcare facilities are urged to raise the spirit of thrift and waste combat as well as take measures to prevent abuse and profiteering of health insurance funds. Medical costs covered by the HI fund must be advanced and paid per the Law on Health Insurance and guiding documents. The directors of the provincial social insurance agencies are fully responsible before the law and the VSS General Director for the accuracy of data on medical expenses for medical treatment and settlement and for ensuring the settlement schedule.

The social security agencies regularly inspect the organisation and implementation of the contracts on medical examination and treatment services covered by the HI fund in 2023 following the provisions of the Government’s Decree No 146/2018/ND-CP dated October 17, 2018 detailing and guiding the implementation of several articles of the Law on Health Insurance; Guidance of Vietnam Social Insurance in Official Letter No 4076/BHXH-CSYT dated December 13, 2021, Official Letter No 3794/BHXH-CSYT dated December 12, 2022 and Process of health insurance assessment issued together with Decision No 3618 /QD-BHXH dated 12/12/2022 by the VSS General Director.

The social security agencies are also asked to strictly implement the direction in Official Dispatch No 1576/BHXH-CSYT dated June 14, 2022 on ensuring that medical facilities do not lack medicines and insured patients don’t have to pay for medicines that are covered by HI fund. They are asked to coordinate with the Department of Health to advise and propose to the Provincial People's Committee to expand the list of drugs to be bid on at the local level, giving priority to drugs that are widely used at many medical units and treatment levels as regulated in the Circular No 15/2020/TT-BYT dated August 10, 2020 of the Ministry of Health on promulgating the list of bidding drugs, the list of drugs with concentrated bidding, the list of drugs subject to the form of price negotiation. Costs of drugs at non-public medical facilities must be controlled including drug lists, drug prices, and drug use structure to ensure rationality and efficiency.

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Provincial social security agencies conduct assessments and pay for medical expenses according to the HI regime at medical facilities. Medical facilities are requested to fully supply medical equipment within the scope of payment of the HI fund for patients and take responsibility for the procurement of medical equipment in accordance with the provisions of the law on bidding. The agencies provide the local Bidding Council with the results of the public procurement of medical equipment. The bidding results are published on the website of the VSS for reference to serve the formulation of cost estimates. Problems relating to the price of medical equipment, in the selection and use of medical equipment must be reported for proper adjustments to enhance the efficiency of using HI funds.

Social insurance agencies of provinces strictly implement the HI assessment process that was issued under Decision 3618/QD-BHXH dated December 12, 2022 of the VSS General Director which notes: Coordinate with medical facilities to review, standardise and update the lists and data on the Health Insurance Assessment Information System, ensure compliance with current regulations and meet the electronic assessment in accordance with VSS General Director’s direction in Decision  No 3681/BHXH-GDĐT dated December 1, 2022 and Official Letter No 37/BHXH-GDDT dated January 6, 2023 providing detailed instructions on how to record a number of indicators in Form No 01/QTGD issued together with the HI Assessment Process.

Civil servants, public employees and workers in charge of HI assessment must work in accordance with regulations and take responsibility for the settlement data of health insurance costs of the provincial social insurance agency with health care facilities. Social security agencies are required to develop a plan to control medical costs covered by the HI fund in 2023 to ensure the management and use of the fund strictly follow regulations, economically and efficiently./.