According to the Official Letter No. 1345/SYT-NYY of the Hanoi Department of Health, implementing the guidance of the HanoiPeople's Committee in Official Letter No. 653/UBND-KGVX dated March 14, 2023, on strengthening the management and control of health insurance costs in the area, the Hanoi Department of Health requests all healthcare facilities throughout the area to develop plans and effective solutions for managing and using health insurance costs. Monthly and quarterly, they should proactively analyze data, evaluate the situation of health insurance costs of the unit, and timely take measures to control costs, especially for unusual cost increases.

Particularly, it is necessary to review and ensure the full supply of medication, chemicals, infusions, medical supplies, technical services, etc. to serve healthcare for patients. Health insurance patients should not have to buy their own medicine and medical supplies within the scope of the benefits they are entitled to, in order to ensure their legitimate rights and interests.

At the same time, healthcare facilities must enhance the spirit of practicing thrift, preventing waste, and preventing abuse of health insurance benefits in the stages of patient admission for inpatient treatment, medical testing, technical services, treatment drugs, and pay attention to prescribing expensive medical services and drugs. They should not over-prescribe medications; write down technical services and diagnoses correctly to avoid overpayment. It is strictly prohibited to fabricate medical records, prescribe fake drugs, or provide incomplete medication to patients to embezzle drugs or the funds of the health insurance fund.

Official Dispatch No. 1345/SYT-NYY of Hanoi Department of Health on strengthening management and control of health care costs covered by health insurance. Photo: Internet

Moreover, healthcare facilities must improve the effectiveness of the Drug and Treatment Council and treatment activities; reinforce the activities of clinical pharmacy, control prescriptions, medication use, medical testing, technical services, and patient care procedures.

In addition, it is necessary to promote the application of information technology, reform administrative procedures in healthcare to improve the quality of healthcare services in general and health insurance services in particular, in accordance with the regulations in Article 6, Article 7, and Article 8 of Circular No. 48/2017/TT-BYT of the Ministry of Health. Healthcare facilities must seriously implement the directives of the People's Committee in Plan No. 54/KH-UBND; ensure that 100% of the health insurance healthcare facilities in the area have sufficient resources, personnel, and specialized procedures to implement health insurance activities using chip-embedded ID cards.

The Hanoi Department of Health also requests healthcare facilities to continue to widely disseminate and thoroughly implement Directive No. 10/CT-BYT dated September 9, 2019, Directive No. 25/CT-BYT dated December 21, 2020, and Plan No. 193/KH-UBND dated August 26, 2021 of the People's Committee in healthcare units to the entire leadership and healthcare staff.

Illustrative image (internet)

In the coming time, the Department of Health will coordinate with the municipal social security agency and relevant authorities to strengthen inspection, monitoring, and supervision of the implementation of professional regulations, technical procedures, and cost control of health insurance services at health insurance healthcare facilities. They will propose measures to handle violations of regulations on abuse and exploitation of health insurance funds if any healthcare facility is found to have violated these regulations.

According to the Hanoi social security office, as of the end of February 2023, Hanoi had over 7.66 million people participating in health insurance, an increase of 25,058 people compared to the previous month, reaching a coverage rate of 92.9% of the population. In February 2023 alone, Hanoi had 780,444 health insurance treatments with a cost of 1,162.8 billion dong. In the first two months of 2023, the entire city had 1,596,997 health insurance treatments with a cost of 2,446.9 billion dong (equivalent to 123.5% compared to the same period in 2022). On average, each outpatient health insurance treatment costs 544,768 dong (equivalent to 100.7% compared to January 2023), while the average cost of each inpatient health insurance treatment is 7,634,211 dong(equivalent to 94.2% compared to January 2023)./.