Proposal to pay for patients with health insurance who have to buy medicine outside

Delegate Tran Chi Cuong proposed to study and supplement regulations on payment for health insurance patients who have to buy medicine and medical supplies from outside, when medical examination and treatment facilities do not have medicine and medical supplies.

Hospital lacks medicine, patients have to buy medicine outside

On the afternoon of October 31, the National Assembly discussed in the hall the draft Law amending and supplementing a number of articles of the Law on Health Insurance (HI).

Commenting on the draft law, delegate Tran Chi Cuong ( Da Nang City delegation) said that although the draft Law has added regulations on payment in case of adjustment between health insurance examination and treatment facilities and paraclinical service costs in clauses 4 and 5.

However, the delegate said that the fact that patients with health insurance have to buy medicine and medical supplies from outside, and when the hospital does not have them, how will they be paid is a practical issue that many voters are concerned about today.

Delegate Tran Chi Cuong (Da Nang City delegation).

"Although before submitting the draft Law at this session, the Ministry of Health promptly issued Circular No. 22 regulating the direct payment of medicine and medical equipment costs for people with health insurance cards going to see a doctor or receive treatment, effective from January 1, 2025. However, this Circular does not resolve the above problems, nor can it completely resolve the current drug shortage. The conditions, records, and payment procedures stipulated in Circular 22 also have many problems and difficulties in implementation," the delegate stated.

Therefore, the delegate suggested that the drafting agency should study and add a provision on payment for health insurance patients who have to buy medicine and medical supplies from outside, when the medical examination and treatment facility does not have medicine and medical supplies in Article 31 to ensure the legitimate rights of people when going for medical examination and treatment under the health insurance regime.

General Secretary To Lam and President Luong Cuong listen to discussion opinions.

This draft Law also adds many regulations to facilitate patients when going for health examination and treatment under health insurance, especially transferring health examination and treatment facilities under health insurance, reducing administrative procedures and increasing access to services.

According to delegates, the draft Law needs to specify the roadmap for connecting and recognizing paraclinical results between medical examination and treatment facilities no later than January 1, 2026.

"This will help save the health insurance fund and the financial budget of families whose relatives need medical examination and treatment," the delegate emphasized.

Supplementing regulations requiring social insurance agencies to pay promptly

Giving comments at the parliament, delegate Dinh Van The (Gia Lai province delegation) proposed additional payments for patients in cases of shortage of medicine and medical supplies.

Accordingly, delegate Dinh Van The proposed to add to Article 31 provisions on cases of shortage of drugs and medical supplies due to objective reasons, force majeure and the inability to transfer patients to other medical examination and treatment facilities.

If the patient must purchase the medicine and medical supplies themselves as prescribed by the doctor, the medical examination and treatment facility is responsible for refunding the patient the amount of money spent on the medicine and medical supplies before the patient is discharged from the hospital; synthesizing the payment with the social insurance agency and being responsible for the payment request file.

Delegate Dinh Van The (Gia Lai province delegation).

Mr. The also pointed out that in recent times, despite signing medical examination and treatment contracts, the social insurance agency has not paid the medical examination and treatment costs covered by health insurance in a timely manner according to the contract.

This causes many difficulties for medical examination and treatment facilities, prolongs the process, and affects the operation of medical examination and treatment.

Therefore, to ensure an equal relationship between the two parties concluding and signing a medical examination and treatment contract, delegate Dinh Van The proposed to add a regulation that the social insurance agency must promptly and on time pay the medical examination and treatment costs covered by health insurance to the medical examination and treatment facility according to the signed contract.

In case the social insurance agency is late in payment, it must pay interest on the late payment amount according to the provisions of Clause 1, Article 468 of the 2015 Civil Code.

Improving the quality of medical examination and treatment is a key task.

Speaking and explaining some opinions raised by National Assembly deputies, Minister of Health Dao Hong Lan said that the goal of Resolution 20 is that by 2030, 95% of the population will be covered by health insurance.

In addition to increasing the number of people participating in health insurance, improving the quality of medical examination and treatment is one of the key tasks assigned to the health sector by the Party, National Assembly and Government.

Minister of Health Dao Hong Lan gave an explanatory speech.

In recent times, the health sector has applied information technology, reformed administration, put into use a patient satisfaction assessment system, implemented a green - clean - beautiful hospital model... demonstrating the great determination of the health sector to serve patients.

In the process of completing the draft Law, the drafting agency tries to harmonize all of the above objectives.

Regarding the subjects participating in health insurance, including students, active military personnel, ATK subjects (safe zones), border areas... on behalf of the drafting agency and the reviewing agency, the Minister said that he would like to receive, review and evaluate to synchronize with the legal system.

Regarding the conditions for transferring patients, according to Minister Dao Hong Lan, this is also a new content and implements the direction of the National Assembly Chairman and the Prime Minister, revised to ensure the most convenience for people, ensuring the stability and solidity of the health system, especially the grassroots health care system.

Regarding the issue of remote medical examination and treatment, this is the content of institutionalizing the regulations in the Law on Medical Examination and Treatment. The law stipulates the conditions for remote medical examination and treatment; technical expertise; payment capacity, resources for remote medical examination and treatment... which is a very good solution to support the development of grassroots medical facilities.

Regarding the regulations on interoperability of test results mentioned in the Law on Medical Examination and Treatment, Minister Dao Hong Lan said that to ensure the implementation of this content, there are also many synchronous solutions to have a new synchronous infrastructure to meet the interoperability requirements.

Source: https://www.baogiaothong.vn/de-nghi-thanh-toan-cho-benh-nhan-co-bao-hiem-y-te-phai-mua-thuoc-ben-ngoai-192241031172643727.htm