On September 17, leaders of Khanh Hoa Provincial Social Insurance (BHXH) informed that in the past time, the unit has implemented propaganda activities to disseminate Article 215 of the Penal Code on the crime of health insurance (BHYT) fraud to medical examination and treatment facilities in the area.
Accordingly, representatives of provincial social insurance have updated the regulations in the Law on Medical Examination and Treatment, the Law on Health Insurance and Decree No. 188/2025/ND-CP of the Government and focused on disseminating Article 215 of the Penal Code on health insurance fraud and related guiding regulations.
The disseminated content also mentioned Resolution No. 05.2019/NQ-HĐTP of the Council of Judges of the Supreme People's Court and Official Dispatch No. 5659/BCA-CSKT of the Ministry of Public Security on guiding recommendations for prosecution under Articles 214, 215 and 216 of the Penal Code.
In addition to updating legal regulations, in the program, relevant units also shared difficulties and obstacles in health insurance medical examination and treatment at establishments.
In which, pay attention to the process of medical examination and treatment, dossier preparation, cost finalization and management of the health insurance fund.
Medical examination and treatment facilities improve responsibility, properly implement professional regulations in designating technical services, medicines, medical supplies and compiling medical records; limit inappropriate designations, avoid incurring unnecessary costs for the health insurance fund.
Facilities are also required to strengthen self-inspection, promptly detect and overcome errors. Resolutely prevent acts of fraud, abuse, and profiteering from health insurance, including forging dossiers, prescriptions or intentionally designating services not in accordance with regulations.
Supervision and coordination between social insurance agencies, the health sector, the police and medical examination and treatment facilities are mentioned with situations from reality.
According to Khanh Hoa Provincial Social Insurance, in the first 6 months of 2026, total health insurance revenue reached more than 743.4 billion VND, equal to 48% of the year's estimate. While health insurance benefits were spent more than 657.3 billion VND, equal to 48.4% of the estimate.
Mr. Nguyen Manh Tu - Director of Khanh Hoa Provincial Social Insurance said that in the past time, functional agencies have not detected any cases of health insurance fraud in the area.
The dissemination of regulations will contribute to equipping more knowledge for relevant units in implementing health insurance policies, and at the same time prevent early and remote prevention.
