The Ministry of Health has just issued Circular 37 amending and supplementing new regulations to remove difficulties for hospitals and facilitate patients. The new Circular takes effect from January 1, 2025.
Increase patient access to treatment drugs (illustrative photo).
According to Ms. Vu Nu Anh, Deputy Director of the Health Insurance Department (Ministry of Health ), in recent years, medicine has always been an important component and always accounts for a large proportion of the total cost of medical examination and treatment under health insurance.
Currently, the promulgation of the List and regulations on health insurance payment for drugs is being implemented according to Circular No. 20/2022/TT-BYT dated December 31, 2022 of the Minister of Health promulgating the list and rates, payment conditions for pharmaceutical drugs, biological products, radioactive drugs and markers within the scope of benefits of health insurance participants.
Ms. Nu Anh said that after nearly 2 years of implementation, Circular No. 20 has revealed a number of problems, requiring amendments, supplements, and adjustments to suit the actual situation.
The Ministry of Health has just issued Circular 37 to overcome the above shortcomings and from January 1, 2025, medical examination and treatment facilities nationwide will follow this new circular.
Accordingly, previously, drugs were used and paid for by health insurance at medical examination and treatment facilities according to hospital class including: Special class, class I, class II, class III and class IV hospitals; technical professional levels including: Central, provincial, district and communal levels.
According to the new circular, the drug list is not divided by hospital class. Accordingly, medical examination and treatment facilities are allowed to 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.
This encourages medical examination and treatment facilities to develop their expertise and techniques; attracts human resources and encourages the development of medical staff's capacity, especially creating conditions for the development of grassroots health care by ensuring fairness in access and payment of health insurance for drugs.
Not dividing the drug list by hospital class also helps limit 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.
The new circular also adds new regulations on drug payment instructions such as payment regulations for drugs at commune health stations, contributing to increasing access to drugs for patients with chronic diseases when being managed and treated at health stations, while creating a financial mechanism to encourage the development and improvement of professional capacity of staff at commune health stations.
Or regulations on payment for drugs to treat chronic diseases when the patient is being treated as an inpatient for another disease, to ensure that health insurance participants have continuous access and ensure health insurance payment benefits for drugs.
There are also regulations on payment for drugs in special cases, contributing to flexibility in special situations such as natural disasters, wars, and catastrophes.
According to the leader of the Health Insurance Department, these new regulations will help supplement cases covered by the Health Insurance Fund to increase access to drugs, provide flexibility in payment instructions for patients, and create conditions for medical examination and treatment facilities to pay for drug costs that were not previously paid due to lack of specific instructions.
Thereby, contributing to ensuring the rights of health insurance participants, while creating a financial mechanism to promote the development of medical examination and treatment facilities.
Source: https://www.baogiaothong.vn/tu-2025-bo-quy-dinh-phan-chia-danh-muc-thuoc-theo-hang-benh-vien-192241119160002018.htm
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