Reduce procedures, reduce out-of-pocket expenses for people
On October 24, continuing the 8th Session, chaired by Politburo member and National Assembly Chairman Tran Thanh Man, the National Assembly listened to Minister of Health Dao Hong Lan present the Report on the Draft Law amending and supplementing a number of articles of the Law on Health Insurance.
Minister Dao Hong Lan said that the Draft Law amending and supplementing 40 articles, focusing on amending and supplementing regulations that need to be unified and synchronized with related laws, overcoming the shortcomings of current laws that are urgent, have full information and data, and reach consensus. In particular, there are regulations on transferring from 4 levels of medical examination and treatment to 3 levels of technical expertise to promptly take effect from January 1, 2025, in sync with the Law on Medical Examination and Treatment.
The Minister of Health also mentioned, such as amending the regulations on medical examination and treatment in the right and wrong line (cross-line) updated according to the technical expertise level of the Law on Medical Examination and Treatment in 2023. Eliminating the referral procedure for some rare diseases, serious diseases... to be directly promoted to a high level of expertise to reduce procedures, create convenience, reduce out-of-pocket expenses for people, and save costs for the fund. The draft also amends the regulations on initial registration for medical examination and treatment under health insurance and transferring patients between health examination and treatment facilities under health insurance to synchronize with the regulations on technical expertise level in the direction of creating more convenience for people and decentralizing and delegating authority to the Department of Health on initial registration for medical examination and treatment under health insurance and allocating health insurance cards.
This amendment also adds a payment mechanism for transferring drugs in cases where drugs have been purchased according to the most convenient regulations of the new Bidding Law but there is still a shortage of drugs, in order to overcome the shortage of drugs and ensure the rights of health insurance participants, so that patients do not have to buy by themselves and have their rights guaranteed.
Updating the payment mechanism for paraclinical service costs transferred to other qualified facilities is currently stipulated in the Government's decree. "Amending the regulation that the social insurance agency inspects the quality of medical examination and treatment to inspect the implementation of medical examination and treatment contracts to be consistent with the function, avoiding overlap with the State management agency on health. Adding a special form of payment for medical examination and treatment costs for the armed forces and people in border areas, especially difficult communes, and islands" said Minister of Health Dao Hong Lan.
Warning before applying criminal measures
Representative of the inspection agency, Chairman of the Social Committee Nguyen Thuy Anh assessed that the draft law has expanded the benefits of health insurance participants one step further when "providing universal medical examination and treatment".
However, the Social Committee recommends that the Government carefully assess the impact on the ability to balance the health insurance fund as well as the organization and operation of the medical examination and treatment system, including primary health care. Accordingly, the health insurance fund will pay for medical examination and treatment as prescribed in cases where patients can go to basic or specialized medical examination and treatment facilities in some cases of serious illness or critical illness. Or the health insurance fund will pay for medical examination and treatment at primary medical examination and treatment facilities and basic medical examination and treatment facilities that have been assigned to district levels by competent authorities before January 1, 2025 nationwide; medical examination and treatment at specialized medical examination and treatment facilities with a specific roadmap for increasing the level of benefits.
Regarding late payment and evasion of health insurance, the Social Committee believes that it is necessary to supplement regulations clarifying the concepts of "late payment of health insurance" and "evasion of health insurance" in Article 2 and specifying sanctions for late payment and evasion of health insurance. According to the Review Agency, it is necessary to have a thorough impact assessment and widely collect opinions from affected subjects; the application of the provisions of the Social Insurance Law needs to be carefully calculated and adjusted to suit the health insurance sector. In addition, the Social Committee suggests studying and supplementing forms of warning, urging, informing and reminding enterprises that are late in paying health insurance for employees before applying administrative and criminal measures.
