Ministry of Health proposes solutions to resolve slow health insurance payments

According to the Ministry of Health, the delay in paying health insurance medical examination and treatment costs exceeding the budget is putting great pressure on medical facilities, affecting medical examination and treatment activities and people's rights.

The situation of unpaid or late payment of health insurance medical examination and treatment expenses exceeding the budget is causing many difficulties for medical facilities, and at the same time affecting the legitimate rights of health insurance participants.

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According to the Ministry of Health , the delay in paying for medical examination and treatment costs exceeding the budget has caused many medical facilities to lack financial resources to maintain regular operations, especially in the context of medical examination and treatment service prices not being calculated correctly and fully.

Many units are facing arrears for drugs and medical supplies with suppliers, negatively affecting the quality of treatment as well as patients' access to medical services.

Regarding the costs of technical services performed on medical equipment that have not completed the procedures for establishing public ownership, on February 27, 2025, the Ministry of Health issued Official Dispatch No. 1042/BYT-BH to Vietnam Social Security, requesting not to recover health insurance medical examination and treatment costs for this group of services.

Currently, the Ministry of Health is synthesizing a report to the Government and recommending that the Vietnam Social Security direct localities to temporarily not revoke the certificate until there is an official decision from the Government or the Prime Minister .

Regarding the cost of health insurance examination and treatment exceeding the 2023 budget, on May 12, 2025, the Social Insurance Management Board issued Resolution No. 730/NQ-HDQL unanimously approving the principles of reporting the 2023 financial settlement of Vietnam Social Insurance.

On that basis, the Ministry of Health requested the Vietnam Social Security to urgently coordinate with the Ministry of Finance to submit to the Government for consideration and approval of the excess expenditure in 2023 to promptly pay medical facilities nationwide, including many units in Ho Chi Minh City that are under great financial pressure.

For 2024, on July 25, 2025, the Ministry of Health issued Official Dispatch No. 4922/BYT-BH requesting a review of the amount of excess expenditure, while emphasizing the implementation in accordance with the provisions of the Law on Health Insurance, Decree No. 146/2018/ND-CP and Decree No. 75/2023/ND-CP.

The Ministry of Health requested the Vietnam Social Security to direct social security agencies of provinces and centrally run cities to promptly implement payments in accordance with regulations to avoid disruptions in medical examination and treatment for people.

Regarding the advance payment of medical examination and treatment costs under health insurance, the Ministry of Health also requested the Vietnam Social Security to direct localities to implement the correct rate and number of advances as prescribed in Article 32 of the Law on Health Insurance, in order to ensure sufficient financial resources to serve medical examination and treatment for people with health insurance cards.

The Ministry of Health believes that if the delay in paying health insurance medical examination and treatment costs exceeds the budget, it will seriously affect the operations of medical facilities, create psychological instability for workers in the industry and especially cause disadvantages for patients.

Removing obstacles and speeding up payment progress is an urgent requirement to ensure that the health insurance system is truly a solid support for people in health care.

By the beginning of 2025, 95.52 million people nationwide were covered by health insurance, reaching a coverage rate of 94.2% of the population, an increase of 2% compared to 2023.

In 2024, 186.2 million health insurance-covered medical examinations and treatments were recorded, with the total amount requested for payment reaching 142,985 billion VND. The implementation of new regulations not only contributes to protecting the rights of citizens but also helps improve the efficiency of the healthcare system, creating the most favorable conditions for people during medical examinations and treatments.

Source: https://baodautu.vn/bo-y-te-de-xuat-giai-phap-thao-go-cham-thanh-toan-bao-hiem-y-te-d358455.html