Vietnam Social Security proposes inspection of private medical facilities

After a series of multidisciplinary clinics in Dong Nai province were raided by authorities, Vietnam Social Security has just sent a dispatch to the Ministry of Health regarding violations in issuing certificates of leave for social insurance benefits.

BHXH Việt Nam đề nghị xử lý nghiêm các hành vi trục lợi quỹ BHXH, BHYT - Ảnh 1. — Police force searched Tan Long General Clinic

According to the report of Dong Nai province Social Insurance, the issuance of certificates of leave to enjoy social insurance benefits for 6 general clinics in Dong Nai province is not in accordance with regulations: patients who do not go to the clinic are still issued certificates of leave to enjoy social insurance benefits; doctors who do not go to work at the clinic still sign and issue certificates of leave to enjoy social insurance benefits; even when not sick, they still prescribe tests, diagnostic imaging, medicine... to take advantage of social insurance and health insurance funds.

Vietnam Social Security has issued many documents directing social security agencies of provinces and cities to regularly review, inspect, and closely coordinate with relevant agencies.

In particular, the issuance of social insurance leave certificates for 6 general clinics in Dong Nai province from May 2022, Dong Nai Social Insurance proactively coordinated with relevant agencies to detect and transfer to Dong Nai Provincial Police.

To ensure compliance with the implementation of legal policies as prescribed, in this document, Vietnam Social Security requests the Ministry of Health to direct medical examination and treatment facilities under the Ministry of Health and health departments to rectify medical examination and treatment facilities in the area to strictly implement the Law on Medical Examination and Treatment, the Law on Health Insurance, the medical examination and treatment procedures of the Ministry of Health and strictly prohibit acts of profiteering from the Social Security and Health Insurance funds.

Vietnam Social Security also requested the Ministry of Health to direct health departments to strengthen inspection and examination of the implementation of health insurance coverage at health facilities in the area, especially private health facilities.

For medical facilities identified as having committed acts of profiteering from the Social Insurance and Health Insurance Fund, the Departments of Health shall coordinate with the Social Insurance of provinces and cities to impose administrative sanctions for violations in the health sector according to the provisions of Decree No. 117/2020/ND-CP dated September 28, 2020 of the Government; Article 23 of Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government...

Regarding the incident in Dong Nai, on June 3, the Dong Nai Department of Health sent an urgent document to the provincial Social Insurance Department agreeing to temporarily suspend the health insurance treatment contract for 4 private clinics in Bien Hoa City, including: Tan Long General Clinic, Long Binh Tan (Long Binh Tan Ward); Tam Duc (Tan Hiep Ward) and My Duc International General Clinic (Long Binh Ward) due to their involvement in the case of issuing fake leave certificates to profit from the social insurance and health insurance funds.

The implementation period is from June 3 until the Social Insurance and the Department of Health of Dong Nai province have new documents and notices based on the conclusion of the competent authority on the behavior of profiteering from the Social Insurance and Health Insurance funds of the above clinics.

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