Cases where health insurance examination and treatment contracts must be suspended

The Lao Dong Newspaper Legal Consulting Office replied:

Article 31 of Decree 188/2025/ND-CP stipulates the temporary suspension of health insurance examination and treatment contracts as follows:

1. The health insurance medical examination and treatment contract shall be temporarily suspended in whole or part in cases where the medical examination and treatment facility is completely or partially suspended according to the decision of the competent authority.

2. When deciding to suspend all or part of the operation of a medical examination and treatment facility, the competent authority is responsible for sending a notice to the social insurance agency where the contract is signed. The suspension of the medical examination and treatment contract is calculated from the time the decision to suspend all or part of the operation of the medical examination and treatment facility takes effect. When deciding to allow medical examination and treatment facilities to resume operations, the competent authority is responsible for sending a notice to the social insurance agency where the contract is signed.

3. In case the medical examination and treatment facility is suspended and the competent authority allows it to resume operations, the medical examination and treatment facility shall notify the social insurance agency in writing about continuing to perform the contract and supporting documents if there are changes compared to the dossier for signing the medical examination and treatment contract before suspending the contract.

4. When suspending the contract, the two parties must agree on a plan to ensure the rights of patients during the contract suspension period. When continuing to implement the contract, medical examination and treatment facilities are responsible for ensuring operating conditions in accordance with the signed health insurance medical examination and treatment contract.

Thus, in the above cases, the health insurance examination and treatment contract must be temporarily suspended.