Speaking at the meeting, Deputy Minister of Health Do Xuan Tuyen emphasized the focus groups of issues that VSS and the MoH need to immediately join hands for settlement. In particular, the Deputy Minister especially noted the importance of coordination between the two sides in the process of inspecting and examining the implementation of health insurance policies and laws in medical examination and treatment. According to Tuyen, in the past years, in addition to the results achieved in the implementation of coordination regulations in implementing health insurance policies, there are still a number of outstanding shortcomings in the process of inspection and examination. In particular, when inspecting some medical facilities, there is no representative of the social insurance agency in the MoH's inspection teams, which leads to different opinions on the two sides, also, some violations related to the abuse of health insurance funds have not been thoroughly handled.

According to the Tuyen, one of the main reasons for the above situation lies in the fact that the coordination in inspection and examination of the medical care under health insurance between the MoH and the VSS, and between the Departments of Health and the social insurance agencies of provinces and cities are not yet maximized for higher efficiency. “In the coming time, the MoH and VSS should work more closely to strengthen inspection and examination and handle abuse violations of the health insurance fund. The action must be done urgently and strictly.”, emphasized Tuyen.

Deputy Minister of Health Do Xuan Tuyen delivered a speech at the meeting

VSS Deputy General Director Pham Luong Son agreed and commented: “From a sharing point of view, I hope that in the coming time, the MoH and VSS will cooperate more closely. The MoH's Inspection Team will have to include staff from the VSS and vice versa. The two agencies must hold the same spirit. The point of view is that, if the remedy is real, we must find a solution to pay. Also, we must be drastic and strict with individuals who abuse the health insurance fund.”

As for solutions to further improve the quality of inspection and examination of the implementation of health insurance policies and laws in health care, the VSS Deputy General Director emphasized: On September 3, 2020, the MoH and VSS had a regulation on coordination in the development and implementation of a legal policy on health insurance, which clearly stipulates that coordination in inspection, examination and handling of violations and complaints and denunciations on health insurance. In order to ensure better implementation of the regulations on coordination, the social insurance agency requested the MoH to provide and exchange information related to the inspection plan on health insurance in the localities.

Along with that, VSS suggested, before concluding the specialized inspection in the field of health insurance, the MoH Inspectorate invited the VSS to participate in exchanging the draft inspection results. Notify the social insurance agency of the inspection contents related to the contract signing, assessment and settlement of medical care expenses covered by health insurance. As for the data related to the cost of medical examination and treatment covered by health insurance when included in the conclusions, the inspector shall solicit the assessment from the agency responsible for the accuracy of the data (the social insurance agencies of provinces, cities and VSS as these data have been finalized).

Overview image of the meeting between the MoH and VSS on the inspection and examination of health insurance policies and laws in medical examination and treatment.

In addition, it is necessary to strengthen the implementation of the inspection, monitoring and handling of abusive behaviors and profiting from the health insurance fund. In fact, the situation of abuse and profiteering from the health insurance fund does not only apply for medical facilities but also for participants of health insurance by many different forms. Therefore, the inspection and supervision should be strengthened for both the social insurance agency and the health sector.

At the conclusion of the meeting, the Deputy Minister of Health continued to propose the close coordination between the MoH and the VSS in the inspection and examination of the implementation of the health insurance law policy in medical examination and treatment. From a constructive point of view, Deputy Minister Do Xuan Tuyen affirmed the ultimate goal is to improve the quality of health care for the people. Tuyen said that the MoH will issue a document to direct and assign the Department of Health Insurance (MoH) with the Department of Medical Services Administration (MoH) to request the health departments, medical facilities and social insurance agencies where the payment is made to urgently conduct a review, and the treatment facility must complete the dossiers. The Deputy Minister also requested VSS to coordinate with the MoH to review guiding documents, legal documents, and if necessary, issue a new or amended circular.

“It is recommended to have close coordination between the departments of the MoH and the VSS units. The inspectors of the two units should recognize the limitations in order to find solutions, and proactively and actively conduct more extreme coordination in the inspection and examination of the implementation of health insurance policies and laws in medical services”, emphasized Tuyen.