Why is Ho Chi Minh City "suspended" 2,485 billion VND for health insurance examination and treatment?

(Dan Tri) - According to the Ho Chi Minh City Department of Health, the suspension of 2,485 billion VND in health insurance examination and treatment has caused some hospitals to fall into debt for medicine and not be able to pay the companies.

Hospital owes money for medicine due to huge expenses

Recently, the Ho Chi Minh City Department of Health sent an urgent document to the Ho Chi Minh City People's Committee, regarding the payment of excess funds for health insurance examination and treatment (HI) in 2023 and 2024.

According to the document, through reports from medical facilities, the Ho Chi Minh City Department of Health recorded that the Social Insurance agency has not paid the cost of exceeding the health insurance treatment budget for 2023 and 2024 with a total amount of more than 2,485 billion VND.

Of which, in 2023 it is more than 557.5 billion VND and in 2024 it is more than 1,928 billion VND.

The fact that health insurance medical expenses have not been paid for a long time in excess of the budget is causing difficulties for units in ensuring operating funds and balancing financial revenues and expenditures, when the price of health insurance services has not been calculated correctly and fully.

This has had a certain impact on the medical examination and treatment activities of medical units and the rights of patients. More worryingly, some units are currently in debt for medicine and are not able to pay the companies.

People register for medical examination under health insurance at a hospital in Ho Chi Minh City (Photo: Hoang Le).

Regarding instructions on payment of costs exceeding the estimated health insurance expenditure, according to the Ho Chi Minh City Department of Health, the Government has issued Decree No. 188/2025/ND-CP detailing and guiding the implementation of a number of articles of the Law on Health Insurance.

In case there are problems with the proposed payment of medical examination and treatment expenses according to regulations, the time to resolve the problem and make payment shall not exceed 12 months from the date the medical examination and treatment facility requests payment.

The Ho Chi Minh City Department of Health has sent the Ministry of Health and Vietnam Social Security documents on paying for costs exceeding the health insurance budget and not yet recovering technical service costs performed on medical equipment that has not completed the establishment of public ownership before March 4, 2023.

However, the Ho Chi Minh City Department of Health has not yet received a response from the Ministry of Health and Vietnam Social Security.

Therefore, the Department of Health requested the Ho Chi Minh City People's Committee to consider issuing a document requesting the Ministry of Health and Vietnam Social Security to guide Ho Chi Minh City Social Security to promptly pay the above amount, to create conditions for units to ensure operating funding sources when implementing financial autonomy still faces many difficulties.

The suspension of health insurance premiums exceeding the budget has more or less affected the operations of hospitals (Illustration: Hoang Le).

Why exceed the budget by thousands of billions of dong?

On August 5, Dan Tri reporter contacted the social insurance agency to find out details of the above incident.

A representative of Ho Chi Minh City Social Insurance said that Ho Chi Minh City is the final line of medical examination and treatment, a specialized treatment center, so many patients from the provinces come here.

After the Covid-19 pandemic, the number of people diagnosed with underlying diseases (such as cardiovascular disease, cancer, metabolic disorders) has also increased sharply. In addition, in 2024, the hospital fee structure will also increase. These factors contribute to the increase in health insurance treatment costs in Ho Chi Minh City.

In 2023, the cost of health insurance in Ho Chi Minh City exceeded the estimate by more than 743 billion VND. This amount was assessed by Ho Chi Minh City Social Insurance in coordination with the Ho Chi Minh City Department of Health and proposed to be paid by Vietnam Social Insurance.

To date, Vietnam Social Security has processed 186 billion VND according to its authority. The remaining 557 billion VND of overspending on health insurance for 2023 has been submitted by the Ministry of Finance and the Prime Minister has assigned the Ministry of Health to propose a solution.

The social insurance agency is waiting for instructions from the competent authority to pay for excess health insurance medical examination and treatment costs for hospitals (Illustration: Hoang Le).

With the cost of health insurance exceeding the estimate by more than 1,900 billion VND in 2024, Ho Chi Minh City Social Insurance is currently waiting for competent authorities to guide the appraisal to resolve this issue.

“For large amounts of money, payment requires decentralization according to regulations. Decree No. 188 issued in 2025 stipulates a settlement period of 12 months, so during this time, the maximum cost exceeding the budget of Ho Chi Minh City will be handled,” the above person informed.

Source: https://dantri.com.vn/suc-khoe/vi-sao-tphcm-bi-treo-2485-ty-dong-kham-chua-benh-bhyt-20250805151826345.htm