Hospitals implement new Health Insurance Law
According to the reporter, on January 3, many patients came to the Ho Chi Minh City Oncology Hospital for medical examination and treatment with health insurance, including patients in the list of 62 rare and serious diseases that do not require referral papers. The hospital also increased its staff to explain the health insurance benefits of patients according to the new guidelines of Circular 01/2025/TT-BYT.
According to statistics from the Ho Chi Minh City Oncology Hospital, on January 2, the hospital received more than 800 visits for health insurance examination and treatment. Of these, nearly 50 cases of self-examination and treatment for diseases in the list of 62 rare and serious diseases were still entitled to health insurance benefits.
Speaking with Lao Dong Newspaper, Dr. Diep Bao Tuan - Director of Ho Chi Minh City Oncology Hospital said that in fact, the groups of diseases issued in the list of rare and dangerous diseases that do not require a referral letter have been carefully studied by the Ministry of Health as well as received comments and additions from all medical facilities nationwide.
"There are many changes compared to before. However, these changes are all in a positive direction, helping to create favorable conditions for patients to go for health insurance examination and treatment, reduce travel costs and shorten waiting time" - Director of Ho Chi Minh City Oncology Hospital commented.
Ho Chi Minh City Oncology Hospital, including facility 1 in Binh Thanh District and facility 2 in Thu Duc City, are both classified as specialized. Right on the New Year holiday, January 1, after receiving Circular 01/2025/TT-BYT of the Ministry of Health detailing and guiding the implementation of a number of articles of the Law on Health Insurance, the hospital has planned to arrange personnel to guide patients to come for health insurance examination and treatment in accordance with the issued regulations.
Unlike before, some diseases such as pancreatic cancer, malignant tumors of the lymphatic system, hematopoietic system and related tissues... had to request a hospital transfer certificate every calendar year. Now, patients with these diseases can continue treatment at the Oncology Hospital without requesting a hospital transfer certificate.
In addition, cancer cases at the Pediatric Oncology Department can also stay and continue treatment without having to return to their hometown to apply for a hospital transfer as in previous years.
Forecast of high number of medical examinations and treatments
Dr. Diep Bao Tuan assessed that with the issued regulations, medical examination and treatment for rare and serious diseases can be carried out continuously without the patient having to request a hospital transfer certificate every year.
In addition, updating transfer information on the hospital software system only needs to be done once instead of updating annually when the patient requests a new transfer form. Therefore, it helps reduce administrative work for hospital staff.
However, in the coming time, the number of patients coming to the Ho Chi Minh City Oncology Hospital for examination and treatment may increase because in many cases, patients can come directly to the hospital for health insurance examination and treatment without needing to request a referral from the local hospital.
At the same time, the work of organizing services and identifying the right patients in the list of 62 rare and serious diseases may take more time than before. The software system at the hospital also needs to be upgraded to support the work of receiving patients according to regulations.
Therefore, the hospital prepares staff in clinical departments to be ready to support areas where there may be a sudden increase in the number of patients coming for medical examination and treatment. At the same time, research and additional software system updates have also been deployed to quickly update the rules and support medical staff to comply with regulations.
According to the Ministry of Health, by 2024, the health insurance coverage rate is estimated to reach about 94% of the population, the number of medical examinations and treatments covered by health insurance will be about 180 million with an estimated expenditure of about 142,000 billion VND.
The Ho Chi Minh City Department of Health requests all medical examination and treatment facilities to urgently study and implement the Law amending and supplementing a number of articles of the Law on Health Insurance and Circular 01/2025/TT-BYT. The Ho Chi Minh City Department of Health will coordinate with the Ho Chi Minh City Social Insurance to develop a plan to organize and implement.
