Ensuring supply of medicine, medical examination and treatment costs covered by health insurance

On October 26, Vietnam Social Security said that recently, this agency has proactively implemented many solutions to facilitate participants and beneficiaries of health insurance policies such as: proposing and advising on the development of health insurance policies and laws; coordinating with relevant ministries and branches to strengthen direction, guidance, and effective implementation of synchronous health insurance policies from the central to local levels; promoting administrative procedure reform...

Bảo đảm cung ứng thuốc, kinh phí khám chữa bệnh BHYT - Ảnh 1. — About 60 - 70% of people participating in health insurance use health insurance cards for medical examination and treatment.

Vietnam Social Security has strengthened coordination with the health sector to focus on overcoming the shortage of drugs and medical supplies; handling problems, ensuring the settlement of health insurance examination and treatment costs in accordance with regulations.

To overcome the shortage of drugs and medical supplies, Vietnam Social Security has promptly advised and coordinated with the Ministry of Health to report to the Government to issue Resolution No. 144/NQ-CP on ensuring drugs, medical equipment and payment of health insurance examination and treatment costs; contributing opinions to Resolution No. 80/2023/QH15 of the National Assembly on continuing to implement a number of policies in the prevention and control of the Covid-19 epidemic and using drug circulation registration certificates and drug ingredients that have expired from January 1, 2023 to December 31, 2024... to ensure the supply of drugs and health insurance examination and treatment costs for patients.

On the other hand, Vietnam Social Security also issued many documents to thoroughly grasp and direct local Social Security agencies to uphold their sense of responsibility, closely coordinate with the health sector to promptly guide the resolution of difficulties and problems.

Notably, in April, Vietnam Social Security issued Official Letter No. 544/BHXH-CSYT requesting Social Security agencies of provinces and cities, based on the actual situation of the locality, to propose to the Provincial People's Committee to decide to expand the list of drugs for centralized bidding at the local level appropriately to reduce difficulties for medical examination and treatment facilities; at the same time, promptly give opinions to the Department of Health and medical examination and treatment facilities, to avoid the situation of slow bidding organization leading to a shortage of drugs to serve patients...

In many provinces, medical examination and treatment facilities have purchased additional drugs through other forms of bidding such as: designated bidding, direct purchasing, competitive bidding, additional 20% purchase, drug regulation, organizing additional bidding for items that failed to be bid, etc.; thus, the drug shortage has been basically overcome, ensuring the rights of health insurance patients.

In particular, Vietnam Social Security has established working groups led by the General Director and Deputy General Directors to work with 63 provincial and municipal Social Security agencies; including the content of removing obstacles in health insurance examination and treatment.

Implementing the direction of Vietnam Social Security, provincial Social Security has made quarterly settlements to transfer payment and advance funds for the following quarter, creating favorable conditions for medical examination and treatment facilities to operate.

In 2023, Vietnam Social Security has directed Social Security agencies of provinces and cities to pay the entire amount approved by the Prime Minister to medical examination and treatment facilities and settle the excess expenditures in 2018, 2019, 2020 in the financial settlement of 2022 with a total amount of 1,977 billion VND.

Many difficulties and problems in medical examination and treatment and payment of health insurance examination and treatment costs under the jurisdiction of Vietnam Social Security have been basically resolved, effectively serving the work of medical examination and treatment and ensuring good health insurance benefits for participants according to the law.

By the end of September, the whole country had more than 127 million people going for health examination and treatment under health insurance, an increase of 19.8% over the same period in 2022. The amount paid by the Health Insurance Fund was more than VND 88,300 billion, an increase of 15.9% over the same period in 2022.

According to statistics, in reality, about 60 - 70% of people participating in health insurance use health insurance cards for medical examination and treatment; the frequency of medical examination and treatment of people is from 2 - 2.1 times/year.

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