Guidelines for Payment of Medicines, Supplies, and Medical Products Purchased from the State Budget for Healthcare Services Covered by Health Insurance

18/10/2023 02:57 PM


The Ministry of Health requires healthcare facilities to only receive payments from the Health Insurance Agency and collect the amount co-paid by patients with a Health Insurance card for medicines, supplies, and medical products within the specified list, rates, and conditions as per the entitlements of individuals holding a health insurance card, following the applicable regulations.

Recently, the Ministry of Health issued a communication to the Provincial Departments of Health, centrally-governed cities, hospitals with beds under the Ministry of Health, and healthcare departments of other ministries, instructing them to implement Resolution No. 129/NQ-CP related to Health Insurance. According to the Ministry of Health, the Government has issued Resolution No. 129/NQ-CP regarding the transfer of medicines, supplies, and medical products purchased from the state budget for Covid-19 prevention and control to the revenue source of healthcare services.

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Prior to September 21, 2023, the Ministry of Health issued Official Letter No. 6037/BYT-KHTC on the implementation of Government Resolution No. 129/NQ-CP. To clarify the application concerning Health Insurance, the Ministry of Health provides guidance to healthcare facilities on the settlement of accounts for medicines, supplies, and medical products purchased from the state budget for Covid-19 prevention and control when used for healthcare services for patients with a Health Insurance card.

Accordingly, healthcare facilities will only be reimbursed by the social security agency and will collect the co-payment amount from patients with a Health Insurance card for medicines, supplies, and medical products within the specified list, rates, and conditions as stipulated by the laws on Health Insurance. The payment rates for medicines, supplies, and medical products, as well as the timing of their application, will be carried out in accordance with the instructions in Official Letter No. 6037/BYT-KHTC issued by the Ministry of Health.

Healthcare facilities are responsible for consolidating the costs of medicines, supplies, and medical products within the payment scope of the Health Insurance Fund into a comprehensive table for monthly reimbursement requests for healthcare services covered by BHYT. They are also required to compile quarterly reports on settling healthcare expenses and submit them to the social security agency for payment and settlement according to the regulations outlined in Article 32, Clause 2 of the Health Insurance Law. The amount received from the health insurance fund, as well as the co-payment amount from patients with a health insurance card, is to be remitted to the State Treasury in accordance with the regulations.

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The Ministry of Health urges the Provincial Departments of Health, centrally-governed cities, hospitals with beds under the Ministry of Health, and healthcare departments of other ministries to coordinate with the social security agencies in executing the payment, settlement, and remittance of the received amounts in accordance with regulations. Simultaneously, they are instructed to ensure the rights and benefits of Health Insurance participants.

Government Resolution No. 129/NQ-CP dated August 18, 2023, allows healthcare facilities to use medicines, supplies, and medical products purchased from the state budget for Covid-19 prevention and control but not yet utilized, to serve healthcare activities, minimizing waste. The resolution assigns the Ministry of Health and People's Committees of provinces and centrally-governed cities to instruct healthcare facilities to actively review the quantity of unused medicines, supplies, and medical products purchased from the state budget, prioritizing their use for epidemic prevention and control activities. It also guides healthcare facilities to coordinate with the social security agencies in implementing proper payment and settlement procedures and remitting the received amounts to the State Treasury.

Simultaneously, the resolution directs the Provincial Departments of Health and relevant authorities to inspect and supervise the implementation related to pricing, settlement, ensuring compliance with legal regulations, effectiveness, and preventing negative occurrences, losses, and waste. The Vietnam Social Security instructs the social security agencies of provinces and centrally-governed cities to coordinate with the Departments of Health and healthcare facilities to implement this resolution./.

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