Enhanced inspections shall be conducted to prevent abuse and misappropriation of the Health Insurance Fund. Compliance with occupational registration regulations within the units shall be strictly enforced. Timely data transmission to the Health Insurance Assessment Portal must be ensured.

"The Department of Health encourages units to enhance innovative and creative activities in prescription monitoring, adherence to treatment protocols, and the detection of acts of misappropriation of the Health Insurance Fund... Especially the application of machine learning and artificial intelligence to proactively detect and prevent such acts," the letter states.

People going for medical examination and treatment using health insurance in Ho Chi Minh City

Regarding the issuance of Certificates of Retirement and Social Insurance Benefits, Health Examination Certificates, and Driver's Health Certificates, the Department of Health requires hospitals to review and strengthen procedures to ensure the proper issuance of these documents according to current regulations.

Furthermore, hospitals must cooperate closely with the Department of Health Inspectorate and the HCMC Social Insurance Inspectorate in conducting inspections and audits related to health examination activities and the issuance of retirement and social insurance benefit certificates.

In relation to the rights of participants in health insurance, the Department of Health requires hospitals to proactively establish plans for selecting contractors at least three months before the expiration of the ongoing contracting package. Additionally, hospitals must have a medication reserve plan in place to ensure a continuous supply of medications for healthcare services without disruption.

"Hospitals should proceed with contractor selection immediately upon approval of the contractor selection plan by the Department of Health. Hospitals must pay utmost attention to safeguarding the rights of health insurance participants during healthcare services, ensuring that no situations arise where insured patients have to purchase medications externally..." stated the head of the Department of Health in the official letter.

The recently issued official letter from the Department of Health addresses various topics related to health insurance services, as the HCMC Social Security Office organized a conference on the assessment of health insurance services for the first six months of the year on July 1st. During the conference, in addition to providing essential data, the HCMC Social Security Office discussed numerous experiences in addressing shortcomings to enhance the quality of health insurance services and ensure compliance with payment regulations.

Illustrative image (internet)

At the conference, the Director of the Department of Health proposed the idea of organizing a competition to recognize and honor individuals involved in health insurance services within the city. In the recently issued official letter, the Department of Health provided detailed information about the competition to hospitals. Specifically, within the first six months of 2024, the Department of Health, in coordination with the HCMC Social Security Officee, will organize a competition titled "Excellent Managers in Health Insurance Services."

Participants in the competition will include heads and deputy heads of relevant departments in hospitals involved in health insurance services, such as General Planning, Finance and Accounting, Information Technology, Quality Management, and Nursing. "The Department of Health requests all hospitals, both public and private, within the area to fully participate and prepare well for the competition," the official letter states. It is noted that the award ceremony for the competition will take place on July 1st, 2024, in commemoration of Vietnam Health Insurance Day.

According to US Department of Labor,  Rights of Health Insurance Participants is Employees participating in retirement and health benefit plans have several important rights under the Employee Retirement Income Security Act. Among them are the right to: disclosure of important plan information a timely and fair process for benefit claims, elect to temporarily continue group health coverage after losing coverage, and recover benefits due under the plan.

It is important for employees and their families to know their benefit rights to make their benefits work for them.