Eliminate "administrative boundaries" in health insurance medical examination and treatment

In the latest Draft Law amending and supplementing a number of articles of the Law on Health Insurance, the level of health insurance benefits is designed on the basis of eliminating "administrative boundaries" in medical examination and treatment.

In the latest Draft Law amending and supplementing a number of articles of the Law on Health Insurance, the level of health insurance benefits is designed on the basis of eliminating "administrative boundaries" in medical examination and treatment.

The National Assembly Standing Committee gave opinions on accepting, explaining and revising the Draft Law amending and supplementing a number of articles of the Law on Health Insurance.

Continuing the 39th session, on the morning of November 15, the National Assembly Standing Committee gave opinions on accepting, explaining, and revising a number of major contents of the Draft Law amending and supplementing a number of articles of the Law on Health Insurance.

This is a draft law that has been discussed by the National Assembly and is expected to be passed on the afternoon of November 27.

Basically, the major contents of the draft law have reached consensus among the participating agencies in receiving and revising, said Chairwoman of the Social Committee Nguyen Thuy Anh when presenting the report.

Ms. Thuy Anh informed, receiving opinions of National Assembly deputies and to be consistent with the Law on Medical Examination and Treatment 2023, the draft law has supplemented and clarified new forms of medical examination and treatment that are covered by health insurance such as: remote medical examination and treatment; family medical examination and treatment; medical examination and treatment at home.

Regarding registration for initial medical examination and treatment, medical examination and treatment according to technical expertise level, the draft law is being designed in the direction of regulating the rights of health insurance card holders in registering for initial health insurance medical examination and treatment at initial and basic level medical examination and treatment facilities.

The draft law also outlines the principles for allocating health insurance cards to initial medical examination and treatment registration facilities and assigns the Minister of Health, the Minister of Public Security, and the Minister of National Defense, based on their authority, to issue detailed regulations and instructions on initial registration for health insurance examination and treatment.

The draft law stipulates that the transfer of patients between medical examination and treatment facilities is carried out according to professional requirements and the response capacity of the medical examination and treatment facility.

Notably, the Chairman of the Social Committee stated that the draft regulation on health insurance benefits is designed on the basis of eliminating "administrative boundaries" in medical examination and treatment according to the direction of the National Assembly Standing Committee, maintaining stable health insurance benefits according to current law and expanding to some cases, such as rare diseases, serious diseases... to go directly to specialized medical examination and treatment facilities.

Accepting the opinions of delegates, the subjects are officers, professional soldiers, officers, non-commissioned officers of the people's police, and people working in secretarial work who are receiving pensions, and will continue to enjoy the health insurance coverage of 95% of medical examination and treatment costs as per current regulations.

This is to ensure fairness with other retirees (not eligible for 100% payment such as those on active duty, Vietnamese heroic mothers, people with revolutionary contributions, children...).

During the discussion, many National Assembly delegates commented on the subjects participating in health insurance.

The Chairman of the Social Committee said that the draft law is expected to be accepted and revised in the direction of maintaining the subjects stipulated in the current law. At the same time, it will supplement the subjects stipulated in other laws, including the laws expected to be passed at this session such as the Law on Prevention of Human Trafficking (amended) and the Law on Cultural Heritage (amended).

Village health workers and village midwives are also added to the group of people participating in health insurance to encourage and motivate them and have appropriate policies for people taking care of their health in remote areas and to be fair to other groups in residential areas.

According to Ms. Thuy Anh, the draft law has not yet added the draft law on relatives of regular militiamen because the Law on Militia and Self-Defense Forces does not stipulate health insurance for this group.

Instead, the draft law assigns the Government to regulate other subjects participating in health insurance, after reporting to the National Assembly Standing Committee. After a period of stable implementation and full assessment, it will be studied and supplemented when comprehensively amending the law, according to Chairwoman Thuy Anh.

Moderating the discussion, Vice Chairwoman of the National Assembly Nguyen Thi Thanh requested a thorough review, especially of administrative procedures, to ensure flexibility in management and operation and meet practical requirements, including content related to payment of health insurance costs.

Ms. Thanh noted that the policy of universalizing health insurance examination and treatment is new, complex, and groundbreaking. The transition from 4 levels to 3 levels of medical examination and treatment affects the level of health insurance benefits and the initial registration for medical examination and treatment of people with health insurance cards.

The agencies are requested to assess and anticipate problems arising in practice to stipulate in the law issues of principle, create a flexible and feasible mechanism to operate new policies, and promptly handle arising problems... The Vice Chairman of the National Assembly stated.

In response to the opinions of National Assembly deputies, the Draft Law stipulates an increase in the allocation from health insurance revenue to spend on medical examination and treatment activities to 92%, a reduction in the amount for the reserve fund, and organization of health insurance fund activities to 8%, of which, a minimum of 4% of the health insurance premium is allocated to the reserve fund and a clear time limit for notifying the results of the appraisal of medical examination and treatment costs to overcome the problem of extending the payment and settlement time. At the same time, it stipulates the purchase of drugs, medical equipment and payment for drugs, medical equipment, and transfer of paraclinical services in cases where medical examination and treatment facilities lack drugs and medical equipment to treat patients and stipulates the mechanism for the health insurance fund to pay for these cases in the Draft.

Source: https://baodautu.vn/xoa-bo-dia-gioi-hanh-chinh-trong-kham-chua-benh-bao-hiem-y-te-d230116.html