The directive stated that, recently, through the inspection and examination, there was an abuse of using health services, fraud, profiteering of the health insurance fund, affecting the use of the fund and the rights of patients, the reputation of the health sector and the humane meaning of the health insurance policy.

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To promptly prevent acts of abuse, fraud and profiteering of health insurance funds, the Ministry of Health request Directors of Health Departments from central provinces and cities; Health heads of ministries and branches to intensify advisory work to perform the task of state management in health insurance, propaganda and education of policies and laws on health insurance. In particular, attention should be paid to the contents related to medical examination and treatment with health insurance under the provisions of the Health Insurance Law and Resolution No. 05/2019 / NQ-HDTP dated August 18, 2019 of the Council of Judges of the People's Court Supreme People on the Application of Articles 214, 215 and 216 of the Criminal Code ...

It is necessary to coordinate with the social insurance authorities of provinces and cities in directing the organization of inspection and examination of medical treatment service with health insurance; tendering, supplying, managing and using drugs, chemicals, medical supplies and paying expenses for medical examination and treatment with health insurance at clinics under their management; prevent and promptly detect acts of abuse, fraud, profiteering of health insurance funds, report to competent authorities to strictly handle violations of health insurance.

The Ministry of Health also requires that the directors of hospitals plan to examine, supervise and reorganize the medical examination and treatment with health insurance, especially the designation of medical services in order to detect, prevent abuse of inpatient indications, prescribe subclinical technical services, over-prescribe medication; create names for the technical service, the diagnostic name that is not the case, will be paid for a higher price. In addition, inspecting and supervising the work of making medical records, prescribing and distributing health insurance drugs, preventing the situation of making empty medical records, prescribing unconventional drugs, providing inadequate medicine for patients to misappropriate medicine and money from the health insurance fund.

At the same time, the price list of medical services approved by competent authorities must be publicized at the place of patient reception and payment. The price list must be clear, readable and conspicuous. Application of information technology will be strengthened, administrative procedures in medical examination and treatment will be reformed; categories and price lists of health services will be ensured to publicize.

The Ministry of Health assigns the Inspectorate of the Ministry of Health to act as the focal point in coordination with the Vietnam Social Security to organize both scheduled and unscheduled inspections on medical examination and treatment; and the management and use of the health insurance fund.

The Ministry of Health also requests Vietnam Social Insurance and the social insurance agencies of provinces and cities under the Central Authority to regularly notify the Ministry of Health, the Department of Health, the health management agencies of ministries and branches about cases of excessive use of medicines and supplies and unprescribed appointments for inpatient treatment so that the management agencies can promptly check and rectify those health facilities./.