Hospitals have their health insurance settlement of nearly 2,500 billion VND suspended: request for advance payment

Propose that Vietnam Social Security direct the advance payment of health insurance medical examination and treatment costs according to the prescribed rate and number of advances to ensure funding for health insurance medical examination and treatment activities for the people.

Ensuring the rights of patients covered by health insurance.

Regarding the issue of hospitals in Ho Chi Minh City not yet receiving settlements for nearly 2,500 billion VND in health insurance payments over the past two years, on August 13th, the Health Insurance Department of the Ministry of Health announced that the Ministry had sent a letter to the Vietnam Social Security, requesting that it direct the social security agencies in provinces and cities to advance health insurance medical examination and treatment costs according to the prescribed rates and number of advances as stipulated in Article 32 of the Health Insurance Law, in order to ensure funding for health insurance medical examination and treatment activities.

We request that the social insurance agency advance the remaining unsettled expenses to ensure funding for medical examinations and treatment under health insurance.

PHOTO: TUAN MINH

Previously, the Ministry of Health received a document from the Ho Chi Minh City Department of Health regarding the overpayment of medical examination and treatment costs under health insurance and the failure to recover costs for technical services performed on medical equipment that had not yet been officially registered as public property before March 4, 2023.

According to the report, in 2023, health insurance medical facilities in the city had health insurance medical examination and treatment costs exceeding the budget by 557.5 billion VND, which was audited and assessed by the Ho Chi Minh City Social Insurance and submitted to the Vietnam Social Insurance.

In 2024, the cost of medical examinations and treatment covered by health insurance continued to rise, exceeding the projected expenditure by approximately 1,950 billion VND.

At the same time, Ho Chi Minh City Social Insurance is recovering the costs of medical examinations and treatments covered by health insurance for medical equipment that had not yet been officially registered as public property before March 4, 2023.

The failure to pay and the excessively long payment delays for medical examination and treatment costs covered by health insurance, exceeding the hospitals' budget estimates, create difficulties for these units in securing operating funds and balancing their finances. This is especially problematic when the service fees for medical examination and treatment are not calculated correctly and fully, and when there are outstanding payments to drug suppliers. This significantly impacts the medical examination and treatment activities of healthcare facilities and the rights of health insurance participants.

Regarding solutions to the aforementioned issues, the Ministry of Health stated that, concerning the costs of medical examination and treatment covered by health insurance for medical services performed on medical equipment that has not yet been officially registered as state-owned, from February 2025, the Ministry of Health has sent a letter to the Vietnam Social Security requesting that the costs of medical examination and treatment covered by health insurance for technical services performed on medical equipment that has not yet been officially registered as state-owned not be recovered.

The Ministry of Health is compiling and reporting this matter to the Government .

The Ministry of Health has requested the Vietnam Social Security to instruct the social security agencies in provinces and cities not to recover this amount until a decision is made by the Government or the Prime Minister.

Regarding the cost of medical examinations and treatments covered by health insurance exceeding the budget for 2023, From May 2025, the Vietnam Social Insurance Management Council issued a resolution unanimously approving in principle the 2023 financial settlement report of Vietnam Social Insurance. Therefore, the Ministry of Health requests Vietnam Social Insurance to urgently report to the Ministry of Finance and submit to the Government for consideration and approval the medical examination and treatment costs covered by health insurance exceeding the 2023 budget to pay medical facilities, including those in Ho Chi Minh City.

Regarding the cost of medical examination and treatment covered by health insurance in 2024, on July 25th, the Ministry of Health issued a document reviewing the amount exceeding the projected expenditure, requesting the Vietnam Social Security to direct the social security agencies in provinces and cities to promptly implement the regulations of the Health Insurance Law and the Government's decrees detailing and guiding the implementation of some articles of the Health Insurance Law.

Source: https://thanhnien.vn/cac-benh-vien-bi-treo-quyet-toan-gan-2500-ti-dong-bao-hiem-y-te-de-nghi-tam-ung-tien-185250813143202471.htm