Hanoi proposes using budget to pay for 7 medical services not covered by health insurance

Hanoi proposes using budget to pay for 7 medical services not covered by health insurance

Hanoi proposes 7 public health services using state budget when not yet covered by health insurance.

According to the proposal, 7 public health services not covered by health insurance will be funded by the Hanoi state budget. Of these, 3 are family medicine examination and treatment services and 4 are out-of-hospital emergency services.

Hanoi proposes 7 public health services using state budget when not yet covered by health insurance.

The Hanoi People's Committee has just submitted a document to the Hanoi People's Council requesting the issuance of a Resolution "Issuing the List of public career services using the state budget in the field of family medicine examination and treatment that have not been paid for by the Health Insurance Fund and out-of-hospital emergency care in Hanoi".

According to the Hanoi People's Committee, the outpatient emergency system is deployed at public facilities operating 24/7, ensuring emergency care and patient transportation for nearly 10 million people in Hanoi and neighboring provinces.

The goal of first aid is to intervene as soon as possible to maintain the patient's vital functions, which is the stage that determines the patient's life or death.

Over the past time, the above activities have been well maintained in terms of expertise as well as budget. However, the above activities need to be strengthened and developed further to comply with the Law on Medical Examination and Treatment in 2023. At that time, emergency and patient transport activities will be considered medical examination and treatment activities.

According to the proposal, the list of public career services using the state budget in the field of family medicine examination and treatment that have not been paid by the Health Insurance Fund of Hanoi City includes management and primary health care through creating, updating, and managing personal electronic health records of local residents; medical examination, consultation, disease prevention, and health promotion at home; emergency care and home care for patients.

List of public career services using the state budget in the field of outpatient emergency care in Hanoi City includes: Regular emergency care activities at locations where events and conferences are held (when requested); on-site emergency care and treatment without transporting patients; outpatient emergency care and patient transport; Emergency care at the scene without being able to pick up patients.

It is expected that the City People's Council will consider and approve it at the 18th session held on October 4.

Previously, talking about health insurance medical examination and treatment, according to Ms. Tran Thi Trang, Director of the Department of Health Insurance (Ministry of Health), the Ministry of Health is updating the list of health insurance drugs to reduce out-of-pocket expenses so that low-income people can access high-priced drugs with good treatment effects.

Accordingly, the updated list of health insurance drugs is quite large, with about 200 types. Therefore, it is necessary to carefully consider to choose drugs that meet the requirements of treatment effectiveness, as well as payment rates suitable to the payment capacity of the health insurance fund and the co-payment capacity of the people.

In addition, the Ministry of Health will also consider removing from the list of health insurance drugs those drugs that are ineffective in treatment or treatment costs, to reduce the burden on the health insurance fund.

The new point of updating the list of health insurance drugs this time is through medical technology assessment to recommend businesses to adjust drug prices appropriately, in order to increase the payment rate, helping low-income people access drugs with high prices and good treatment effects.

According to Ms. Trang, the Ministry of Health is drafting a Circular amending and supplementing a number of articles of Circular No. 35/2016/TT-BYT dated September 28, 2016 of the Ministry of Health promulgating the List and rates and payment conditions for medical technical services within the scope of benefits of health insurance participants.

In addition, there are four policies in the proposal to build a revised Law on Health Insurance that the Ministry of Health is carrying out to improve the quality of medical examination and treatment.

The first is to adjust the health insurance participants in line with relevant legal regulations. In addition, adjust the scope of health insurance benefits in accordance with the contribution level, balance the health insurance fund and health care requirements in each period.

In addition, adjust relevant health insurance regulations according to the level of technical expertise in medical examination and treatment and promote the role of grassroots health care in primary health care and medical examination and treatment under health insurance. At the same time, allocate and use health insurance funds effectively.

Accordingly, the Draft Law on Health Insurance Amendment proposes to adjust the maximum management cost from 5% as currently regulated to a maximum of 4% for health insurance fund management activities. The remaining 1% is added to the health insurance medical examination and treatment fund.

Ms. Tran Thi Trang said that the total budget added to the health insurance medical examination and treatment fund each year is about 1,100 billion VND and will be allocated and regulated from the beginning of the year for medical examination and treatment facilities.

Source: https://baodautu.vn/ha-noi-de-xuat-dung-ngan-sach-chi-tra-cho-7-dich-vu-y-te-chua-duoc-bao-hiem-y-te-thanh-toan-d226246.html