On the afternoon of November 27, with the majority of delegates in favor, the National Assembly passed the Law amending and supplementing a number of articles of the Law on Health Insurance (HI).
At the meeting, Chairwoman of the National Assembly's Social Committee Nguyen Thuy Anh presented a report explaining, accepting and revising the draft law.
The law stipulates in the direction of expanding the scope of health insurance benefits with the form of remote medical examination and treatment, support for remote medical examination and treatment, family medical examination and treatment, and medical examination and treatment at home.
The National Assembly Standing Committee has directed the design of the draft Law on regulations on health insurance benefits on the basis of eliminating "administrative boundaries" in medical examination and treatment, maintaining stable health insurance benefits according to current law and expanding to some cases, such as rare diseases, serious diseases... to go directly to specialized medical examination and treatment facilities.
Compared with the current law, the law has 8 basic new groups of points.
Amend and update the subjects of participation, responsibility for paying health insurance, payment method, payment period, responsibility for making a list of health insurance payment, and card validity period to be more consistent and synchronized with the provisions of the Law on Social Insurance and other relevant laws.
Regulations on health examination and treatment under health insurance, including initial registration for health examination and treatment under health insurance, transferring patients between health examination and treatment facilities under health insurance according to the technical expertise level of the Law on Health Examination and Treatment 2023.
Regulate the level of health insurance benefits when implementing universal health insurance examination and treatment regardless of administrative boundaries, maintain the stability of the health insurance benefit rate according to current law and expand it to some cases.
In which, some cases of rare diseases, serious diseases... are taken directly to specialized medical examination and treatment facilities; some scope of benefits for people with health insurance cards is expanded, including treatment of strabismus and refractive errors of the eyes for people under 18 years old.
Regulations on transferring chronic disease cases to primary health care facilities for management in some cases to promote the role of primary health care facilities.
Adjust the ratio of expenditures for health examination and treatment under health insurance, reserve expenditures and organization of health insurance activities from health insurance contributions; clearly stipulate the deadline for notification of the results of appraisal of health examination and treatment costs to overcome problems related to prolonging payment and settlement time.
Supplementing the payment mechanism for drugs and medical equipment transferred between medical examination and treatment facilities and payment for paraclinical service costs transferred to other facilities in case of shortage of drugs and medical equipment.
Supplement specific regulations on late payment, evasion of health insurance payment and handling measures for these cases.
Regulations on the responsibility of the Ministry of Health in reviewing and regularly updating treatment regimens to ensure convenience in medical examination, treatment and health insurance payment.
Regulations on assessing the reasonableness of providing health examination and treatment services under health insurance; regulations on the application of information technology, digital transformation, data sharing in the field of health insurance, the connection and use of paraclinical results between health examination and treatment facilities in accordance with professional requirements and providing solutions to enhance the capacity of health examination and treatment under health insurance for grassroots health care.
Issue principles and criteria for developing a list of drugs, medical equipment, and medical services covered by health insurance to ensure standards, transparency, and publicity.
Supplementing regulations on issuing electronic health insurance cards, regulations on state audit to audit the annual report on settlement of health insurance organization and activities of social insurance agencies to synchronize with the Law on Social Insurance.
