The MOH is seeking public feedback on a draft circular amending and supplementing several provisions of Circular No. 01/2025/TT-BYT, which provides detailed regulations and guidance on the implementation of the Law on Health Insurance.

One of the notable proposals is to promote the use of electronic medical referral forms and follow-up appointment forms, aiming to reduce administrative procedures for patients and improve information  exchange between healthcare facilities.

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Under the draft, referral forms  can be  issued in either paper or electronic form. The validity period is proposed to be extended from 10 to 20 days from the date of signing.

Patient may use medical referral forms and follow-up appointment forms on the VNeID application, the health insurance review information system, digitally signed electronic documents, or paper documents bearing QR codes for information retrieval. The paper is displayed on healthcare facilities’ electronic health management applications,  as regulated, have the same validity as their paper counterparts.

For follow-up appointment forms, patients must visit the healthcare facility within three working days from the date specified on the paper. If they are unable to attend  on time, they may contact their doctor or treatment facility to arrange another appointment.

The draft also proposed creating an automatic appointment reminder function and  supporting relatives  in looking up appointment papers for children, older people and dependants through electronic applications.

Health insurance referral forms can be used for  20 days, while those with chronic diseases will be issued a one-year slip 

Another notable proposal is to issue a one-year referral slip valid for one year to patients with chronic diseases or those requiring long-term treatment, as specified by  the Ministry of Health.

If,during treatment, the healthcare facility identifies an additional disease also included in  the prescribed list, the patient does not need to  obtain another referral form.

The draft also  adds  a list of traditional medicine  diseases that can be diagnosed and treated at specialised-level facilities in traditional medicine and rehabilitation;  and revises certain disease lists, including those for diabetes, heart failure and hypertension.

Notably, stable epilepsy after the acute phase is proposed to be added to the list of chronic diseases to be managed and monitored at primary healthcare facilities.

The draft further proposes changes to patient referral among healthcare facilities. Accordingly, referral will be based on professional requirements and the receiving facility’s treatment capacity, rather than being determined by hospital raking  and the existing technical and professional referral hierarchy.

After stable treatment at primary or specialised healthcare facilities, patients with chronic diseases may be referred back to their original healthcare facilities for continued monitoring and management  

When reassessment of treatment outcomes is necessary, patients may return to the facility where they previously received treatment up to once every six months.

According to the Ministry of Health, referring stable patients back to local healthcare facilities has helped ease pressure on higher-level hospitals and facilitated long-term monitoring and treatment. However, lower-level facilities continue to face difficulties due to shortages of medicines, medical supplies, equipment and personnel.

In addition, information on diagnoses, medicines, treatment regimens and test results is not yet fully  shared between different of healthcare levels, affecting the monitoring and treatment of patients.

Proposal to expand eligibility for registration of primary health insurance-covered healthcare facilities

The draft also proposes expanding the groups eligible to register for primary health insurance-covered examination and treatment at certain healthcare facilities. These include retired military and public security personnel, as well as people with disabilities aged 70 and above who have permanent residence in the locality where the healthcare facility is located.  

According to the MOH, the organisation of health insurance-covered medical examination and treatment should be aligned with each facility’s actual capacity and patient care requirements, while ensuring that patients can receive appropriate ongoing care and monitoring at local healthcare facilities.

Local authorities will strengthen investment in healthcare infrastructure, equipment and human resources. Specialised-level healthcare facilities will strengthen professional support for basic-level and primary facilities, while focusing on developing advanced medical techniques and the treatment of complex diseases that lower-level facilities are not yet equipped to manage.

The proposed amendments and supplements to regulations on referral form, follow-up appointment form and patient referral procedures are expected to promote digital technology application in health insurance-covered medical examination and treatment, reduce administrative procedures, and improve connectivity and the effectiveness of patient management and treatment between different levels of healthcare./.