The agency has worked with the ministry to formulate, amend and supplement legal policies on health insurance.

It has also provided data on health care and medical expenses, summarised advantages and disadvantages and submitted appropriate amendments in the process of implementing the Law on Medical Examination and Treatment, the Law on Bidding (for bidding for drugs and medical supplies and equipment), and the Decree amending Decree No 146/2018/ND-CP on guiding a number of measures to implement the Law on Health Insurance.

Opportunities have been expanded for health-insurance participants to access healthcare services

It worked with the health ministry as well as other relevant ministries and sectors to propose the National Assembly and the Government to promulgate many policies to remove difficulties and obstacles in procurement, bidding, management and using medicines, medical supplies and equipment.

The policies include Resolution No 80/2023/NQ-QH15 dated January 9, 2023, of the National Assembly, on allowing the extension of the drug registration certificate until the end of 2024; Decree No 07/2023/ND-CP dated March 3, 2023, on resolving some problems in medical equipment management; Resolution No 144/NQ-CP dated November 5, 2022, and Resolution No 30/NQ-CP dated March 4, 2023, of the Government on solving problems in the payment of medical expenses covered by the health insurance fund, ensuring the supply of drugs, medical supplies and equipment for medical examination and treatment covered by the health insurance fund.

Monitoring medical-expense payment by the health insurance

During the COVID-19 pandemic, the agency assisted the health ministry in issuing many guiding documents on implementing medical examination and treatment, payment of medical expenses covered by the health insurance fund in accordance with the pandemic situation, creating favourable conditions for health insurance participants and medical facilities, increasing the time to provide outpatient medicine for chronic diseases to three months, solving problems in the payment of medical expenses for health insurance participants, who contracted COVID-19 with underlying diseases.

The agency has made an important contribution to helping the health ministry monitor and supervise the payment of medical expenses for health insurance participants, ensuring the effective use of the health insurance fund.

Viet Nam Social Security and the Ministry of Health coordinate to effectively implement health insurance policies

Through the connection of medical treatment data of nearly 13,000 medical facilities in the country, and the application of an electronic assessment system, the management and monitoring of medical expenses, covered by the health insurance fund, have achieved many results.

Errors in bidding have been reduced year after year thanks to the participation of medical facilities in Drug Procurement Councils from central to local levels. In recent years, drug prices have decreased and there is no high disparity between localities.

The agency has discovered that many operating licenses of medical facilities and practising certificates of medical staff were issued in contravention of regulations (medical staff who are not eligible are still granted practising certificates or medical staff still examine or treat patients without practising certificates).

Thanks to sharing daily data to the health insurance assessment portal of medical facilities, it helps to minimise the abuse of health insurance funds by both medical staff and patients.

Administrative reform, overcoming drug shortage

Because of the coordination between the agency and the health ministry, chip-based identity cards have been used for medical examination and treatment, covered by the health insurance fund, to save time for health-insurance participants when they go to medical facilities for examination and treatment.

The application of biometrics at medical facilities has been initially launched to ensure the interests of the people, save costs for managerial agencies, and prevent waste and profiteering of the health insurance fund.

The operation of VssID – a digital social insurance application, has helped people know the history of their medical treatment, creating a premise for building electronic health books.

Since the middle of last year, there has been a shortage of drugs and medical supplies at many medical facilities across the country, the agency has promptly directed local social insurance offices to work closely with the health sector to overcome difficulties and problems and ensure the adequate supply of drugs and medical supplies for medical examination and treatment, covered by the health insurance fund.

Chip-based identity cards are used to serve medical examinations, covered by the health insurance fund

Especially after the Government issued Resolution No 144/NQ-CP dated 5/11/2022 on the guarantee of drugs, medical equipment and payment of medical costs, covered by the health insurance fund, many difficulties have been removed. By the fourth quarter of last year, the shortage of drugs and medical supplies had basically been fixed in all localities.

The agency has worked with relevant ministries and sectors to propose mechanisms and policies to remove difficulties and obstacles in using medical equipment and paying for technical services performed by the equipment. Then, on March 4, 2023, the Government issued Resolution No 30/NQ-CP amending Clause 4 of Resolution 144/NQ-CP dated November 5, 2022 of the Government, to fix the situation.

In December 2022, the agency provided sufficient funding for the exceeding amount of the estimate of medical examination and treatment in 2021, covered by the health insurance fund, for five provinces of Ha Tinh, Ninh Binh, Phu Tho, Thai Nguyen and Thanh Hoa.

The amount was submitted to the Prime Minister for additional approval.

With the goal of putting the legitimate rights and interests of the health-insurance participants first, the agency and the health ministry have reached a consensus in developing and implementing policies and laws on health insurance.

The two sides will continue coordinating in amending the Law on Health Insurance to better ensure the interests of health insurance participants.