On the morning of October 24, Minister of Health Dao Hong Lan submitted to the National Assembly a draft law amending and supplementing a number of articles of the Law on Health Insurance (HI).

The draft Law amends and supplements 40 articles on subjects participating in health insurance, responsibility for payment, benefits, scope of benefits, organization of health insurance examination and treatment, fund management and some technical regulations...

Regarding specific content, the Minister of Health said that the draft Law amends and supplements the subjects participating in and the responsibility for paying health insurance to overcome shortcomings and be consistent with the Law on Social Insurance; updates the subjects that have been stably implemented in laws and decrees; and adds a number of subjects that need State support to increase universal health insurance coverage.

202410240818496546_z5961459972790_63e38c769a6ddb80460ebe7634235db6.jpg
Minister of Health Dao Hong Lan presented the draft Law amending and supplementing a number of articles of the Law on Health Insurance this morning. Photo: National Assembly

In particular, the draft Law amending regulations on medical examination and treatment in the right and wrong line (cross-line) is updated according to the technical expertise level of the 2023 Law on Medical Examination and Treatment; removing the referral procedure for some rare diseases, serious diseases, etc., which are transferred directly to a higher level of expertise to reduce procedures, create convenience, reduce out-of-pocket expenses for people, and save costs for the fund.

Specifically, in emergency cases at all medical examination and treatment facilities nationwide: 100% payment of inpatient and outpatient health insurance examination and treatment costs according to the percentage of the benefit level .

Patients are allowed to go to medical examination and treatment facilities at the basic or advanced technical level in case of diagnosis and treatment of certain rare diseases, serious diseases, diseases requiring surgery or using advanced techniques according to the list of diseases and techniques prescribed by the Minister of Health: 100% payment of inpatient and outpatient health insurance examination and treatment costs according to the percentage of the benefit level .

In case of medical examination and treatment at primary medical examination and treatment facilities and basic medical examination and treatment facilities that have been assigned by competent authorities to district level before January 1, 2025: 100% payment of inpatient and outpatient health insurance examination and treatment costs according to the percentage of the benefit level .

202410240818496703_z5961460553205_c19c56fa1e0d5ef39ccad6475758fe50.jpg
Chairwoman of the Social Committee Nguyen Thuy Anh presented the report on the investigation. Photo: National Assembly

Reviewing this content, Chairwoman of the Social Committee Nguyen Thuy Anh said that the amendment of the regulations on "transfer of medical examination and treatment" in the direction of expanding one step further, better ensures the rights of health insurance participants.

Accordingly, the health insurance fund will pay as when going to medical examination and treatment according to regulations in case the patient goes to a basic or specialized medical examination and treatment facility in case of serious or dangerous illness; medical examination and treatment at primary medical examination and treatment facilities and some basic medical examination and treatment facilities nationwide and medical examination and treatment at specialized medical examination and treatment facilities with appropriate roadmap.

However, the Chairman of the Social Committee noted that it is necessary to further assess the impact on the ability to balance the health insurance fund as well as the organization and operation of the medical examination and treatment system, including grassroots health care, to propose measures to ensure appropriate implementation.

Minister Dao Hong Lan said that the draft regulation expands the rate of health insurance benefits for health insurance participants when they go to basic and specialized medical examination and treatment facilities that were divided into provincial levels before January 1, 2025, from 0% to 50% of the cost of outpatient medical examination and treatment, implemented from July 1, 2026 to have time to prepare conditions to strengthen capacity at lower levels and prevent overload at upper levels.

However, through impact assessment, increasing the payment rate is at risk of creating difficulties and challenges affecting the grassroots health system, causing overload at higher levels, affecting the quality of medical examination and treatment services, and increasing costs from the health insurance fund, which is estimated to be incomplete at more than VND 1,131 billion per year.

Patients who have to buy their own medicine will be paid directly by health insurance.

Patients who have to buy their own medicine will be paid directly by health insurance.

From January 1, 2025, patients will be paid directly by the Health Insurance Fund if hospitals lack drugs and supplies. However, this regulation is not applied universally.
Minister of Health responds to proposal to consider reducing or supporting health insurance premiums

Minister of Health responds to proposal to consider reducing or supporting health insurance premiums

The Minister of Health responded to the petition of voters in many localities regarding the consideration of reducing or supporting health insurance premiums when the basic salary increases, causing difficulties for people.