According to the latest regulations of the Ministry of Health, medical examination and treatment facilities are allowed to use all health insurance drugs in the list, in accordance with the scope of professional activities, diagnosis and treatment instructions, regardless of hospital class or technical expertise level.
Eliminate hospital classification for using health insurance drugs
The Ministry of Health has just issued Circular No. 37/2024/TT-BYT dated November 16, 2024, providing new regulations on principles, criteria for developing, updating, recording information, structure of the list and payment instructions for drugs within the scope of benefits of health insurance participants (hereinafter referred to as Circular 37). This Circular takes effect from January 1, 2025.
Commune and ward health stations are allowed to prescribe and dispense medicine like higher-level health stations, in accordance with their professional capacity.
Circular 37 has some important new points, which is to remove the columns classifying hospitals using drugs. Previously, drugs were used and paid for by health insurance at medical examination and treatment facilities according to hospital class, including: special class, class 1, class 2, class 3 and class 4 hospitals; technical professional levels include: central, provincial, district and communal levels.
Not dividing the drug list according to hospital class has advantages: medical examination and treatment facilities can use all drugs in the list, in accordance with the scope of professional activities, diagnosis and treatment instructions, regardless of hospital class or technical expertise level.
Encourage medical examination and treatment facilities to develop expertise and techniques; attract human resources and encourage capacity development of medical staff, especially creating conditions for development of grassroots health care by ensuring fairness in access and health insurance payment for drugs.
Contribute to limiting the number of patients choosing to go to medical examination and treatment facilities with high technical expertise, reducing the overload situation at some medical examination and treatment facilities with high technical expertise.
Commune health station manages chronic diseases
One of the notable new points is the regulation that the Health Insurance Fund pays for medicine for cases where health insurance participants are managed for chronic diseases at commune health stations.
Accordingly, the medical station examines, prescribes and dispenses medicine within the scope of professional activities and technical services approved by competent authorities; medicine is dispensed by the medical station according to the prescription of a medical examination and treatment facility with higher technical expertise.
In case the commune health station has medical practitioners who are mobilized, rotated to examine, treat, provide professional support, and provide technical guidance from a higher level of technical expertise according to the assignment or plan of the competent authority or according to the contract; in case of technical transfer according to the contract, in case of remote medical examination and treatment or support for remote medical examination and treatment according to the provisions of law on medical examination and treatment:
According to Circular 37, the Health Insurance Fund pays for drugs in accordance with the capacity and scope of expertise of practitioners assigned to rotate, direct, provide professional support, transfer techniques, provide remote medical examination and treatment or support remote medical examination and treatment and provide guidance on diagnosis and treatment from the Ministry of Health.
Source: https://thanhnien.vn/quy-dinh-moi-ve-bao-hiem-y-te-y-te-xa-duoc-ke-don-thuoc-tuyen-tu-185241119144948694.htm
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