The Ministry of Health said that, based on Clause 5, Article 15 of Decree 146/2018/ND-CP detailing and guiding measures to implement a number of articles of the Law on Health Insurance, it is stipulated as follows:
In case of referral for medical examination and treatment, the health insurance participant must present the referral record of the medical examination and treatment facility and the referral paper according to Form No. 6 of the Appendix issued with this Decree. In case the referral paper is valid until December 31 but the treatment period has not ended, the referral paper can be used until the end of the treatment period.
In case of re-examination upon treatment request, health insurance participants must have a re-examination appointment paper from the medical examination and treatment facility according to Form No. 5 of the Appendix issued with this Decree.
Thus, according to the above regulations, it can be seen that the current duration of health insurance referral papers does not have a fixed duration, but will be determined based on the patient's health and treatment situation, and will be clearly stated on the referral paper.
Also according to information from the Ministry of Health, current referral conditions stipulate that medical examination and treatment facilities transfer patients from lower levels to higher levels when meeting the following conditions:
- The disease is not suitable for the diagnostic and treatment capacity and technical list of the medical examination and treatment facility approved by the competent State health agency or the disease is suitable for the diagnostic and treatment capacity and technical list of the medical examination and treatment facility approved by the competent State health agency but due to objective conditions, the medical examination and treatment facility is not qualified to diagnose and treat;
- Based on the technical list approved by the competent State health agency, if the adjacent upper-level medical examination and treatment facility does not have suitable technical services, the lower-level medical examination and treatment facility will be transferred to a higher level;
- Before transferring to another facility, the patient must be consulted and have a referral indication (except for clinics and level 4 medical examination and treatment facilities).
Medical examination and treatment facilities transfer patients from higher levels to lower levels appropriately when the patient has been diagnosed, treated through the emergency phase, and determined that the disease has improved and can continue treatment at the lower level.
Conditions for transferring patients between medical examination and treatment facilities at the same level:
- The disease is not in accordance with the technical list of the medical examination and treatment facility approved by the competent State health agency or the disease is in accordance with the technical list of the medical examination and treatment facility approved by the competent State health agency but due to objective conditions the medical examination and treatment facility is not qualified to diagnose and treat;
- The disease is consistent with the technical list of the medical examination and treatment facility of the same level to which the patient is expected to be transferred, approved by the competent State health agency.
