National Assembly decides to abolish referral procedures for rare and serious diseases

The newly passed Law on Health Insurance stipulates that some cases of rare diseases, serious illnesses... can be taken directly to specialized medical examination and treatment facilities.

The National Assembly passed a law amending and supplementing a number of articles of the Law on Health Insurance - Photo: GIA HAN

On the afternoon of November 27, with 446/455 delegates present in favor, 6 delegates against, and 3 delegates not voting, the National Assembly passed the law amending and supplementing a number of articles of the Law on Health Insurance.

The new revised Law consists of 3 articles, Article 1 amends and supplements 42 articles of the current Law on Health Insurance (including 3 new clauses in 2 articles) and adds 2 new articles.

Article 2 abolishes 1 clause of the Law on Forces participating in protecting security and order at the grassroots level, Article 3 on the effective date.

Clearly stipulate the benefit level when providing medical examination and treatment under health insurance

Previously, Chairwoman of the National Assembly's Social Committee Nguyen Thuy Anh presented a report explaining, accepting and revising the draft law. Notably, compared to the current law, the new law has 8 groups of basic new points.

Specifically, amend and update the subjects of participation, responsibility for paying health insurance, payment methods, payment deadlines, responsibility for making a list of health insurance payment participants, and card validity period to be more consistent and synchronized with the provisions of the Law on Social Insurance and other relevant laws.

Regulations on medical examination and treatment under health insurance, including initial registration for medical examination and treatment under health insurance, transferring patients between medical examination and treatment facilities under health insurance according to the technical expertise level of the Law on Medical Examination and Treatment 2023.

Regulate the level of health insurance benefits when implementing universal health insurance examination and treatment regardless of administrative boundaries, maintain stable health insurance benefit rates according to current law and expand to some cases.

In which there are some cases of rare diseases, serious diseases... that are taken directly to specialized medical examination and treatment facilities.

Expanding some benefits for people with health insurance cards, including treatment of strabismus and refractive errors of the eyes for people under 18 years old.

Regulations on transferring chronic disease cases to primary health care facilities for management in some cases to promote the role of primary health care facilities.

Payment regulations in case of drug shortage

Adjust the ratio of expenditure for medical examination and treatment under health insurance, reserve expenditure and organization of health insurance activities from health insurance premiums.

Clearly stipulate the deadline for notifying the results of medical examination and treatment cost appraisal to overcome the problem of extending the payment and settlement time.

Supplementing the mechanism for payment of drugs and medical equipment transferred between medical examination and treatment facilities and payment of paraclinical service costs transferred to other facilities in case of shortage of drugs and medical equipment.

Supplement specific regulations on late payment and evasion of health insurance payment and measures to handle these cases.

Regulations on the responsibility of the Ministry of Health in reviewing and regularly updating treatment regimens to ensure convenience in medical examination, treatment and health insurance payment.

Regulations on assessing the reasonableness of providing medical examination and treatment services under health insurance.

Regulations on the application of information technology, digital transformation, data sharing in the field of health insurance, the connection and use of paraclinical results between medical examination and treatment facilities in accordance with professional requirements and providing solutions to enhance the capacity of medical examination and treatment under health insurance for grassroots health care.

Issue principles and criteria for developing a list of drugs, medical equipment, and medical services covered by health insurance to ensure standardization, transparency, and publicity.

Supplementing regulations on issuing electronic health insurance cards, regulations on the State Audit to audit annual reports on settlement of health insurance organization and activities of social insurance agencies to synchronize with the Law on Social Insurance.

Tuoitre.vn

Source: https://tuoitre.vn/quoc-hoi-chot-bo-thu-tuc-chuyen-tuyen-voi-benh-hiem-benh-hiem-ngheo-20241127142415245.htm