The case of "hanging" more than 2,485 billion VND in Ho Chi Minh City: What does Vietnam Social Security say?

Accordingly, Vietnam Social Security (VSS) said it had received an official dispatch from the Ministry of Health regarding the payment of costs exceeding the estimated cost of medical examination and treatment (KCB) under health insurance (HI) and not yet recovered the costs of technical services performed on medical equipment that have not completed the establishment of public ownership before March 4, 2023.

The Ministry of Health proposed but did not state the legal basis?

On this issue, Vietnam Social Security has 4 opinions.

Firstly, regarding the cost of health insurance services performed on medical equipment that has not completed the establishment of public ownership before March 4, 2023, the Ministry of Health has proposed that while waiting for the Government's opinion, Vietnam Social Security directs social security agencies at all levels not to recover.

However, the document of the Ministry of Health does not state the legal basis for the above proposal, in accordance with the provisions of Decree No. 29/2018/ND-CP dated March 5, 2018 of the Government in the order and procedures for establishing the entire people's ownership of assets and handling assets for which the entire people's ownership has been established.

Vụ treo hơn 2.485 tỷ đồng ở TPHCM: Bảo hiểm xã hội Việt Nam nói gì? - 1 — People go to the hospital for health insurance examination and treatment (Photo: Hoang Le).

Second, regarding the cost of exceeding the health insurance budget in 2023, Vietnam Social Security submitted a report on October 22, 2024 to the Social Security Management Board on the financial settlement in 2023 and was approved in Resolution No. 730/NQ-HDQL dated May 12, 2025.

However, the Resolution does not assign Vietnam Social Security to make advances for costs exceeding the 2023 budget estimate.

To resolve the cost of health insurance treatment exceeding the estimate assigned by the Prime Minister, the unpaid costs due to changes in legal regulations and difficulties in implementation, the Ministry of Finance has issued documents reporting to the Government leaders on the amount of health insurance treatment that has not been paid.

In which, there are costs exceeding the budget for 2023 and 2024.

On August 5, the Government Office issued Official Dispatch No. 7282/VPCP-KGVX on the implementation of Decree 188/2025/ND-CP.

Deputy Prime Minister Le Thanh Long directed the Ministry of Health to coordinate with the Ministry of Finance, the Ministry of Justice and relevant agencies to develop a project to completely handle outstanding health insurance medical examination and treatment expenses from 2025 and earlier.

In particular, it is necessary to clearly state the current situation and propose solutions to ensure feasibility, effectiveness, and compliance with regulations to overcome and thoroughly resolve the outstanding debt in settling medical examination and treatment costs of previous years, and report to the Government for consideration in the third quarter.

Need implementation instructions

Third, regarding the cost of exceeding the estimated health insurance expenditure in 2024, the Ministry of Health issued Official Dispatch No. 4922/BYT-BH, requesting the Ministry of Finance to urgently direct the Vietnam Social Security to guide the Social Security of provinces and cities to preside over and coordinate with the Department of Health and medical facilities to review and determine the above content.

However, according to Vietnam Social Security, this Official Dispatch does not clearly guide the content of reviewing and determining the costs exceeding the expected payment as requested by the Ministry of Finance, and is not clear enough for Vietnam Social Security to organize the implementation.

To ensure the effective, public, transparent and consistent use of the health insurance fund in determining the cost of health insurance treatment exceeding the estimated amount to be paid additionally, Vietnam Social Security believes that it is necessary and urgent to have a guiding document from the Ministry of Health for the provincial social insurance agencies, the Department of Health and health care facilities to implement, avoiding difficulties and problems.

Vietnam Social Security requests the Health Insurance Department to advise the Ministry of Health on the content of reviewing and determining the amount of health insurance medical examination and treatment expenditure exceeding the expected expenditure paid by the Health Insurance Fund and include it in the Project to report to the Government to determine the amount of excess expenditure in 2024, exceeding the estimate assigned by the Prime Minister.

Fourthly, regarding advance payment of health insurance medical examination and treatment costs, Vietnam Social Security said that it had sent an Official Dispatch dated June 23 to Social Security of provinces and centrally-run cities requesting full and correct implementation of regulations on advance payment and payment of health insurance medical examination and treatment costs.

From July 1, local Social Insurance will make a one-time advance payment of 90% of the health insurance medical examination and treatment costs according to the previous quarterly settlement report of the medical examination and treatment facility within 5 working days from the date of receiving the report of the medical examination and treatment facility according to the provisions of Article 32 of the Law on Health Insurance.

As Dan Tri reported, on August 1, 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.

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 estimated health insurance medical examination and treatment budget for 2023 and 2024, with a total amount of more than VND 2,485 billion. Of which, in 2023 it is more than VND 557.5 billion and in 2024 it is more than VND 1,928 billion.

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.

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 the 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.

On August 7, the Department of Health Insurance (Ministry of Health) sent an official dispatch to the Vietnam Social Security under the Ministry of Finance, stating urgent requests to handle the above issue.

Source: https://dantri.com.vn/suc-khoe/vu-treo-hon-2485-ty-dong-o-tphcm-bao-hiem-xa-hoi-viet-nam-noi-gi-20250814001501683.htm