THE LAW
Amending and supplementing a number of articles of the Health Insurance Law
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Pursuant to the Constitution of the Socialist Republic of Vietnam;
The National Assembly promulgates the Law Amending and Supplementing a Number of Articles of the Health Insurance Law No. 25/2008/QH12.
Article 1.
Amending and supplementing a number of articles of the Health Insurance Law:
1. Amend and supplement clause 1; Add Clause 7 and Clause 8, Article 2 as follows:
"first. Health insurance is a form of compulsory insurance applied to subjects prescribed by this Law for health care, not for profit purposes, organized and implemented by the State.
“7 . Households participating in health insurance (hereinafter referred to as households) include all people named in the household registration book or temporary residence book.
8. The basic medical service package paid for by the health insurance fund is essential medical services for health care, consistent with the payment ability of the health insurance fund.”
2. Amend and supplement clause 2 and clause 3 of Article 3 as follows:
"2. The health insurance premium is determined according to the percentage of salary as the basis for compulsory social insurance payment according to the provisions of the Law on Social Insurance (hereinafter referred to as monthly salary), pension , stipend or base salary.
3. Health insurance coverage depends on the level of illness, target groups within the scope of benefits, and duration of health insurance participation.”
3. Amend and supplement clause 3; Clause 10, Article 6 is added as follows:
“3. Promulgating professional and technical regulations, medical examination and treatment procedures and treatment instructions; Referrals related to medical examination and treatment covered by health insurance;”
"ten. Promulgate a basic medical service package paid for by the health insurance fund.”
4. Add Articles 7a, 7b and 7c after Article 7 as follows:
“ Article 7a. Responsibility of the Ministry of Labor, War Invalids and Social Affairs
1. Direct and guide the organization and implementation of identification and management of subjects managed by the Ministry of Labor, War Invalids and Social Affairs specified in Points d, e, g, h, i and k, Clause 3 and Clause 4, Article 12 of this Law.
2. Inspect and examine the implementation of legal provisions on the responsibility to participate in health insurance of employers and employees specified in Clause 1, Article 12 of this Law and subjects assigned by the Ministry of Labor Mobilization - War Invalids and Social Affairs management specified in Points d, e, g, h, i and k, Clause 3 and Clause 4, Article 12 of this Law.
Article 7b. Responsibility of the Ministry of Education and Training
1. Direct and guide the organization of identification and management of subjects managed by the Ministry of Education and Training specified in Point n, Clause 3 and Point b, Clause 4, Article 12 of this Law.
2. Inspect and examine the implementation of legal provisions on the responsibility to participate in health insurance of subjects managed by the Ministry of Education and Training as prescribed in Point n, Clause 3 and Point b, Clause 4, Article 12 of this Law.
3. Preside and coordinate with the Ministry of Health and relevant ministries and branches to guide the establishment and consolidation of the school health system to provide primary health care for children, pupils and students.
Article 7c. Responsibilities of the Ministry of National Defense and the Ministry of Public Security
1. Direct, manage, guide, and organize the identification, management, and creation of health insurance lists for subjects managed by the Ministry of National Defense and the Ministry of Public Security as prescribed in Point a, Clause 1 , Points a and n, Clause 3, Point b, Clause 4, Article 12 of this Law.
2. Make a list and provide a list of requests for health insurance cards for the subjects specified in Point l, Clause 3, Article 12 of this Law to the health insurance organization.
3. Inspect and examine the implementation of legal provisions on the responsibility to participate in health insurance of subjects managed by the Ministry of National Defense and the Ministry of Public Security as prescribed in Point a, Clause 1, Points a and Points n Clause 3, Point b Clause 4 Article 12 of this Law.
4. Coordinate with the Ministry of Health and relevant ministries and branches to guide medical examination and treatment facilities of the Ministry of National Defense and the Ministry of Public Security to sign health insurance medical examination and treatment contracts with insurance organizations. Health insurance for medical examination and treatment for health insurance participants.”
5. Amend and supplement clause 2; Clause 3 Article 8 is added as follows:
"2. The People's Committees of provinces and centrally run cities, in addition to performing the responsibilities specified in Clause 1 of this Article, are responsible for directing the building of apparatus and resources to carry out state management of health insurance. local economy and manage and use funding sources according to the provisions of Clause 3, Article 35 of this Law.
3. People's Committees of communes, wards and towns (hereinafter collectively referred to as commune-level People's Committees), in addition to performing the responsibilities specified in Clause 1 of this Article, are responsible for making a list of insurance participants. medical care in the area for the subjects specified in Clauses 2, 3, 4 and 5, Article 12 of this Law per household, except for the subjects specified in Points a, l and n, Clause 3 and Point b, Clause 4 Article 12 of this Law; The Commune People's Committee must prepare a list of requests for issuance of health insurance cards to children at the same time as issuance of birth certificates."
6. Amend and supplement Article 12 as follows:
“ Article 12. Subjects participating in health insurance
1. Groups owned by employees and employers include:
a) Employees working under an indefinite-term labor contract or a labor contract with a term of 3 months or more; The employee is a business manager and receives a salary; officials, civil servants, and public employees (hereinafter collectively referred to as employees);
b) Persons working part-time in communes, wards and towns according to the provisions of law.
2. Groups paid by social insurance organizations include:
a) People receiving monthly pension or disability allowance;
b) People who are receiving monthly social insurance benefits due to a work accident, occupational disease or a disease on the list of diseases requiring long-term treatment; people aged 80 or older who are receiving monthly death benefits;
c) Commune, ward, and town officials who have retired and are receiving monthly social insurance benefits;
d) People receiving unemployment benefits.
3. Groups paid for by the state budget include:
a) Officers, professional soldiers, non-commissioned officers, active military soldiers; Professional officers, non-commissioned officers and professional and technical officers and non-commissioned officers working in the People's Public Security force, People's Police cadets, non-commissioned officers and soldiers serving for a limited period of time. Police; People who do cipher work are paid the same as soldiers; Cipher students are entitled to benefits and policies according to the regimes and policies for students at military and police schools;
b) Commune, ward, and town officials who have quit their jobs and are receiving monthly benefits from the state budget;
c) People who have stopped receiving disability benefits and are currently receiving monthly benefits from the state budget;
d) People with meritorious services to the revolution, veterans;
d) Current National Assembly deputies and People's Council deputies at all levels;
e) Children under 6 years old;
g) People eligible for monthly social protection benefits;
h) People from poor households; Ethnic minorities living in areas with difficult socio-economic conditions; people living in areas with particularly difficult socio-economic conditions; people living in island communes and island districts;
i) Relatives of people who have contributed to the revolution are the father, mother, spouse, or children of martyrs; people who have contributed to nurturing martyrs;
k) Relatives of people with meritorious services to the revolution, except for the subjects specified in Point i of this Clause;
l) Relatives of the subjects specified in Point a, Clause 3 of this Article;
m) People who have donated human organs according to the provisions of law;
n) Foreigners studying in Vietnam are granted scholarships from the Vietnamese State budget.
4. Groups supported by the state budget include:
a) People from near-poor households;
b) Pupils and students.
5. The group participating in household health insurance includes people belonging to the household, except for the subjects specified in Clauses 1, 2, 3 and 4 of this Article.
6. The Government regulates subjects other than those specified in Clauses 3, 4 and 5 of this Article; regulate the issuance of health insurance cards for subjects managed by the Ministry of National Defense and the Ministry of Public Security and subjects specified in Point l, Clause 3 of this Article; regulates the roadmap for implementing health insurance, scope of benefits, health insurance benefits, medical examination and treatment covered by health insurance, management and use of funds for medical examination and treatment covered by insurance health care, health insurance assessment, health insurance payment and finalization for the subjects specified in Point a, Clause 3 of this Article.”
7. Amend and supplement Article 13 as follows:
“ Article 13. Health insurance premiums and responsibilities
1. Health insurance premiums and responsibilities are regulated as follows:
a) The maximum monthly payment of the subjects specified in Point a, Clause 1, Article 12 of this Law is equal to 6% of the monthly salary, of which the employer pays 2/3 and the employee pays 1/3. During the time the employee takes leave to enjoy maternity benefits according to the provisions of the law on social insurance, the maximum monthly payment is equal to 6% of the employee's monthly salary before maternity leave and is paid by the organization. paid social insurance;
b) The maximum monthly payment rate of the subjects specified in Point b, Clause 1, Article 12 of this Law is equal to 6% of the base salary, of which the employer pays 2/3 and the employee pays 1/3. ;
c) The maximum monthly payment of the subjects specified in Point a, Clause 2, Article 12 of this Law is equal to 6% of pension and disability allowance and is paid by the social insurance organization;
d) The monthly payment rate of the subjects specified in Points b and c, Clause 2, Article 12 of this Law is at most 6% of the base salary and is paid by the social insurance organization;
d) The maximum monthly payment rate of the subjects specified in Point d, Clause 2, Article 12 of this Law is equal to 6% of unemployment benefits and is paid by the social insurance organization;
e) The maximum monthly payment rate of the subjects specified in Point a, Clause 3, Article 12 of this Law is equal to 6% of the monthly salary for salary earners, maximum is equal to 6% of the base salary for people enjoying living expenses. fees and paid by the state budget;
g) The monthly payment rate of the subjects specified in Points b, c, d, dd, e, g, h, i, k, l and m, Clause 3, Article 12 of this Law is at most 6% of the base salary. Department and paid by the state budget;
h) The maximum monthly payment of the subjects specified in Point n, Clause 3, Article 12 of this Law is equal to 6% of the base salary and is paid by the agency, organization, or unit granting the scholarship;
i) The monthly payment rate of the subjects specified in Clause 4, Article 12 of this Law is at most 6% of the base salary paid by the subjects themselves and is partially supported by the state budget;
k) The maximum monthly payment rate of the subjects specified in Clause 5, Article 12 of this Law is equal to 6% of the base salary and is paid by the subjects per household.
2. In case a person simultaneously belongs to many different health insurance subjects as prescribed in Article 12 of this Law, the health insurance premium must be paid according to the first subject that that person is identified in the order of the conditions. subjects specified in Article 12 of this Law.
In case the subjects specified in Point a, Clause 1, Article 12 of this Law have one or more labor contracts of indefinite term or labor contracts with a term of 3 months or more, they must pay health insurance. according to the labor contract with the highest salary.
In case the subjects specified in Point b, Clause 1, Article 12 of this Law simultaneously belong to many different health insurance participants specified in Article 12 of this Law, then pay health insurance in the following order: paid by social insurance organizations, paid by the state budget, paid by subjects and commune-level People's Committees.
3. All members of the household as prescribed in Clause 5, Article 12 of this Law must participate in health insurance. The contribution level is gradually reduced from the second member onwards, specifically as follows:
a) The first person contributes a maximum of 6% of the base salary;
b) The second, third, and fourth person pay 70%, 60%, and 50% of the first person's payment, respectively;
c) From the fifth person onwards, the payment is equal to 40% of the first person's payment.
4. The Government specifically regulates the contribution and support levels specified in this Article.
8. Amend and supplement Clauses 4 and 5, Article 14 as follows:
“4. For other subjects, the basis for paying health insurance is the base salary.
5. The maximum monthly salary to calculate health insurance premiums is 20 times the base salary.”
9. Amend and supplement Article 15 as follows:
“ Article 15. Method of paying health insurance
1. Every month, the employer pays health insurance for the employee and deducts the health insurance premium from the employee's salary to pay at the same time to the health insurance fund.
2. For businesses in the fields of agriculture, forestry, fishery, and salt production that do not pay salaries monthly, every 3 months or every 6 months, the employer pays health insurance for employees. mobilize and deduct health insurance premiums from the employee's salary to pay at the same time to the health insurance fund.
3. Every month, the social insurance organization pays health insurance according to the provisions of Points c, d and dd, Clause 1, Article 13 of this Law into the health insurance fund.
4. Every quarter, agencies, organizations, and units granting scholarships pay health insurance according to the provisions of Point h, Clause 1, Article 13 of this Law to the health insurance fund.
5. Every quarter, the state budget transfers the amount of health insurance contributions and support as prescribed in Points e, g and i, Clause 1, Article 13 of this Law to the health insurance fund.
6. Every 3 months, 6 months or 12 months, representatives of households, organizations and individuals pay the full amount of responsibility to the health insurance fund.”
10. Amend and supplement Clause 3 and Clause 5, Article 16 as follows:
“3. The time when the health insurance card is valid for use is specified as follows:
a) Subjects specified in Clauses 1, 2 and 3, Article 12 of this Law participating in health insurance for the first time, the health insurance card is valid from the date of payment of health insurance;
b) For those who participate in health insurance continuously from the second time onwards, the health insurance card will be valid for use continuously with the expiration date of the previous card;
c) Subjects specified in Clause 4 and Clause 5, Article 12 of this Law who participate in health insurance from the effective date of this Law or participate intermittently for 3 months or more in the fiscal year will have the insurance card. Health insurance is valid for use after 30 days from the date of payment of health insurance;
d) For children under 6 years old, the health insurance card is valid until the child turns 72 months old. In case a child is 72 months old but has not yet entered school, the health insurance card is valid until September 30 of that year.
“5. The health insurance organization issues the health insurance card form after obtaining the consensus of the Ministry of Health.”
11. Amend and supplement Article 17 as follows:
“ Article 17. Issuance of health insurance cards
1. Documents for issuance of health insurance card, including:
a) Health insurance participation declaration of organizations, individuals, and households for first-time health insurance participants;
b) List of health insurance participants of subjects specified in Clause 1, Article 12 of this Law prepared by the employer.
The list of health insurance participants of subjects specified in Clauses 2, 3, 4 and 5, Article 12 of this Law is prepared by the commune-level People's Committee according to households, except for subjects specified in the following provisions: Points a, l and n, Clause 3 and Point b, Clause 4, Article 12 of this Law.
The list of health insurance participants managed by the Ministry of Education and Training and the Ministry of Labor, War Invalids and Social Affairs according to the provisions of Point n, Clause 3 and Point b, Clause 4, Article 12 of this Law established by educational and training establishments and vocational establishments.
List of health insurance participants of subjects managed by the Ministry of National Defense and the Ministry of Public Security specified in Point a Clause 1, Points a and n Clause 3, Point b Clause 4 Article 12 of this Law and the list of health insurance participants. The policies of the subjects specified in Point l, Clause 3, Article 12 of this Law are prepared by the Ministry of National Defense and the Ministry of Public Security.
2. Within 10 working days from the date of receipt of complete documents specified in Clause 1 of this Article, the health insurance organization must transfer the health insurance card to the agency or organization managing the subject or to the health insurance participants.
3. The health insurance organization shall issue the application form specified in Clause 1 of this Article after obtaining the consensus of the Ministry of Health.”
12. Amend and supplement Clauses 3 and 4, Article 18 as follows:
“3. Within 7 working days from the date of receiving the application to re-issue the card, the health insurance organization must re-issue the card to the health insurance participant. While waiting for the card to be reissued, health insurance participants will still enjoy health insurance benefits.
4. The person whose health insurance card is reissued must pay the fee. The Minister of Finance regulates the fee for reissuing health insurance cards. In case the error is caused by the health insurance organization or the agency that compiles the list, the person who is re-issued the health insurance card does not have to pay the fee.
13. Add Point c, Clause 1, Article 20 as follows:
“c) Issuing duplicate health insurance cards.”
14. Abolish point b, clause 1, Article 21; Amend and supplement point c, clause 1 and clause 2, Article 21 as follows:
“b) Transporting patients from district level to higher level for subjects specified in Points a, d, e, g, h and i, Clause 3, Article 12 of this Law in case of emergency or while undergoing treatment. Residents must be transferred to technical and professional levels.
2. The Minister of Health presides over and coordinates with relevant ministries and branches to promulgate a list, rates, and payment conditions for drugs, chemicals, medical supplies, and medical technical services under scope of benefits of health insurance participants.”
15. Amend and supplement Article 22 as follows:
“ Article 22. Health insurance benefits
1. Health insurance participants who go for medical examination and treatment according to the provisions of Articles 26, 27 and 28 of this Law will have the health insurance fund pay the medical examination and treatment costs within the allowed scope. enjoy benefits as follows:
a) 100% of medical examination and treatment costs for subjects specified in Points a, d, e, g, h and i, Clause 3, Article 12 of this Law. Medical examination and treatment costs outside the scope of health insurance coverage of subjects specified in Point a, Clause 3, Article 12 of this Law are paid from the health insurance funding source for medical examination and treatment of the subjects. this target group; In case this funding source is not enough, it will be guaranteed by the state budget;
b) 100% of medical examination and treatment costs in cases where the cost for one medical examination and treatment is lower than the level prescribed by the Government and medical examination and treatment at the commune level;
c) 100% of medical examination and treatment costs when the patient has participated in health insurance for 5 consecutive years or more and has the amount of money to pay for medical examination and treatment costs in the year greater than 6 months' salary. facility, except for cases where one goes for medical examination or treatment at the wrong level;
d) 95% of medical examination and treatment costs for subjects specified in Point a Clause 2, Point k Clause 3 and Point a Clause 4 Article 12 of this Law;
d) 80% of medical examination and treatment costs for other subjects.
2. In case a person belongs to many subjects participating in health insurance, he/she will receive health insurance benefits according to the subject with the highest benefit.
3. In case a person with a health insurance card goes for medical examination or treatment at the wrong route, the health insurance fund will pay the benefit specified in Clause 1 of this Article at the following rate, except for the cases specified. in Clause 5 of this Article:
a) At central hospitals, it is 40% of inpatient treatment costs;
b) At provincial hospitals, it is 60% of inpatient treatment costs from the effective date of this Law to December 31, 2020; 100% of inpatient treatment costs from January 1, 2021 nationwide;
c) At district hospitals, it is 70% of medical examination and treatment costs from the effective date of this Law to December 31, 2015; 100% of medical examination and treatment costs from January 1, 2016.
4. From January 1, 2016, health insurance participants who register for initial medical examination and treatment at a commune-level medical station or general clinic or district hospital are entitled to insured medical examination and treatment. Health insurance at a commune health station or polyclinic or district hospital in the same province has the benefit level as prescribed in Clause 1 of this Article.5. Ethnic minorities and people from poor households participating in health insurance are living in areas with difficult socio-economic conditions, areas with extremely difficult socio-economic conditions; Health insurance participants living in island communes and island districts, when they go for medical examination and treatment at the wrong level, will have their medical examination and treatment costs paid by the health insurance fund at district and hospital hospitals. Inpatient treatment for provincial and central hospitals and benefits as prescribed in Clause 1 of this Article.6. From January 1, 2021, the health insurance fund will pay inpatient treatment costs according to the benefit level specified in Clause 1 of this Article for health insurance participants when they go for medical examination and treatment on their own. at the right level at provincial medical examination and treatment facilities nationwide.
7. The Government specifically regulates the benefit levels for medical examination and treatment covered by health insurance in bordering areas; Cases of medical examination and treatment upon request and other cases not specified in Clause 1 of this Article.”
16. Abolish Clause 10 and Clause 12, Article 23; Amend and supplement Clause 7 and Clause 9, Article 23 as follows:
“7. Treatment of strabismus, nearsightedness and refractive errors of the eyes, except for children under 6 years old.”
“9. Medical examination, treatment, and rehabilitation in case of disaster.”
17. Amend and supplement Article 24 as follows:
“ Article 24. Medical examination and treatment facilities covered by health insurance
Medical examination and treatment facility covered by health insurance is a medical facility according to the provisions of the Law on Medical Examination and Treatment that has signed a medical examination and treatment contract with a health insurance organization.”
18. Amend and supplement point a, clause 2 and clause 4, Article 25 as follows:
“a) Subjects served and requirements for scope of service provision; Estimated number of cards and structure of health insurance participants for medical examination and treatment facilities covered by primary health insurance.”
“4. The Ministry of Health shall preside over and coordinate with the Ministry of Finance to stipulate the form of health insurance medical examination and treatment contract."
19. Amend and supplement point a, clause 1, Article 30 as follows:
“a) Capitation payment is payment at a predetermined fee according to the scope of service for a card registered at a medical service provider for a certain period of time;”
20. Amend and supplement clause 2; Clause 5, Article 31 is added as follows:
"2. Health insurance organizations pay health insurance medical examination and treatment costs directly for health insurance card holders who go for medical examination and treatment in the following cases:
a) At a medical examination and treatment facility without a medical examination and treatment contract with health insurance;
b) Medical examination and treatment not in accordance with the provisions of Article 28 of this Law;
c) Other special cases prescribed by the Minister of Health.”
“5. The Minister of Health shall preside over and coordinate with the Minister of Finance to uniformly regulate the prices of medical examination and treatment services covered by health insurance among hospitals of the same class nationwide."
21. Amend and supplement Article 32 as follows:
“ Article 32. Advance, payment, settlement of medical examination and treatment costs covered by health insurance
1. The advance payment of funds by health insurance organizations to medical examination and treatment facilities covered by health insurance is carried out quarterly as follows:
a) Within 5 working days from the date of receipt of the previous quarter's final settlement report from the medical examination and treatment facility, the health insurance organization shall make a one-time advance payment equal to 80% of the medical examination and treatment costs. Health insurance according to the previous quarterly settlement report of the medical examination and treatment facility;
b) For medical examination and treatment facilities that sign a medical examination and treatment contract with health insurance for the first time and register for initial medical examination and treatment under health insurance, they will receive an advance of 80% of the funds used. used at medical examination and treatment facilities according to the beginning notice of the health insurance organization; In case there is no initial medical examination and treatment registration under health insurance, based on the amount of medical examination and treatment expenses after one month of contract implementation, the health insurance organization estimates and advances 80% of the cost. Medical examination and treatment covered by health insurance during the quarter;
c) In case the advance funding for medical examination and treatment facilities covered by health insurance in the province exceeds the amount of funding used in the quarter, the health insurance organization of the province or centrally run city Report to Vietnam Social Insurance to supplement funding.
2. Payment and settlement between medical examination and treatment facilities and health insurance organizations are carried out as follows:
a) Within the first 15 days of each month, the health insurance medical examination and treatment facility is responsible for sending a summary of the request for payment of health insurance medical examination and treatment costs of the previous month to the organization. Health Insurance; Within the first 15 days of each quarter, health insurance-covered medical examination and treatment facilities are responsible for sending a final report on health insurance medical examination and treatment costs of the previous quarter to the health insurance organization;
b) Within 30 days from the date of receipt of the previous quarter's final settlement report from the medical examination and treatment facility, the health insurance organization is responsible for notifying the assessment results and the final settlement number of examination costs. Health insurance covers actual medical examination and treatment costs within the scope of health insurance benefits and benefits for the medical examination and treatment facility;
c) Within 10 days from the date of notification of the final settlement of medical examination and treatment costs covered by health insurance, the health insurance organization must complete the payment with the medical examination and treatment facility;
d) The appraisal of the annual settlement of the health insurance fund and payment of unused funds (if any) for provinces and centrally run cities must be done before October 1 of the year. after.
3. Within 40 days from the date of receipt of complete dossier requesting payment from the health insurance participant for medical examination and treatment according to the provisions of Clause 2, Article 31 of this Law, the health insurance organization Must pay medical examination and treatment costs directly for these subjects."
22. Amending and supplementing clause 1; Clause 3, Article 34 is added as follows:
"first. The health insurance fund is managed centrally, uniformly, publicly, transparently and has decentralized management within the health insurance organization system.
The Vietnam Social Insurance Management Council according to the provisions of the Social Insurance Law is responsible for managing the health insurance fund and consulting on health insurance policies.”
“3. Every year, the Government reports to the National Assembly on the management and use of the health insurance fund.”
23. Amend and supplement Article 35 as follows:
“ Article 35. Allocation and use of health insurance fund
1. The health insurance fund is allocated and used as follows:
a) 90% of the health insurance premium is for medical examination and treatment;
b) 10% of the health insurance premium is reserved for the reserve fund and health insurance fund management costs, of which at least 5% of the health insurance premium is reserved for the reserve fund.
2. Temporarily idle money of the health insurance fund is used for investment according to the forms prescribed by the Social Insurance Law. The Vietnam Social Insurance Management Council decides and is responsible to the Government for the form and investment structure of the health insurance fund based on the request of Vietnam Social Insurance.
3. In case a province or centrally run city has health insurance revenue for medical examination and treatment greater than the amount of medical examination and treatment expenditure in the year, after being appraised and decided by Vietnam Social Insurance The unused budget will be allocated according to the following schedule:
a) From the effective date of this Law until December 31, 2020, 80% will be transferred to the reserve fund, 20% will be transferred to localities for use in the following order of priority:
Support medical examination and treatment funds for the poor; Support health insurance premiums for some target groups in accordance with local socio-economic conditions; Purchase medical equipment appropriate to the capacity and qualifications of medical staff; Purchase vehicles to transport patients at the district level.
Within 1 month from the date Vietnam Social Insurance appraises the settlement, Vietnam Social Insurance must transfer 20% of the unused funds to the locality.
Within 12 months from the date Vietnam Social Insurance appraises the settlement, the unused funds will be transferred to the reserve fund;
b) From January 1, 2021, the unused budget will be fully accounted for in the reserve fund for general regulation.
4. In cases where a province or centrally run city has health insurance revenues for medical examination and treatment that are smaller than the amount of medical examination and treatment expenses during the year, after evaluating the settlement, Vietnam Social Insurance Nam is responsible for supplementing this entire cost difference from the reserve fund.
5. The Government shall detail Clause 1 of this Article.”
24. Amend and supplement Clause 2, Article 36 as follows:
"2. Receive health insurance by household at health insurance agents nationwide; have the right to choose a medical examination and treatment facility covered by initial health insurance according to the provisions of Clause 1, Article 26 of this Law.”
25. Amend and supplement Clause 2 and Clause 10, Article 41 as follows:
"2. Organize for the subjects specified in Clause 5, Article 12 of this Law to conveniently pay health insurance according to their households at health insurance agents. Guide documents, procedures, where to register for health insurance and organize the implementation of health insurance regimes, ensuring quick, simple and convenient for health insurance participants. Review, synthesize, and confirm the list of health insurance participants to avoid issuing duplicate health insurance cards to subjects specified in Article 12 of this Law, except subjects approved by the Ministry of National Defense and the Ministry of Public Security. manage."
"ten. Store records and data on health insurance according to the provisions of law; Determine the time to participate in health insurance to ensure benefits for health insurance participants; Apply information technology in health insurance management, build a national database on health insurance.”
26. Amend and supplement clause 2; Add Clause 7 and Clause 8, Article 43 as follows:
"2. Provide medical records, documents related to medical examination and treatment and payment of medical examination and treatment costs for health insurance participants at the request of health insurance organizations and state agencies competent; For dossiers requesting direct payment, within 5 working days from the date of receiving the request from the health insurance organization, the health insurance medical examination and treatment facility is responsible for providing Medical records and documents related to medical examination and treatment of health insurance participants.”
“7. Prepare a list of medical examination and treatment costs covered by health insurance and be responsible before the law for the legality and accuracy of this list.
8. Provide a list of medical examination and treatment costs to health insurance participants upon request.”
27. Amend and supplement Clause 3, Article 45 as follows:
“3. Participate in monitoring the implementation of health insurance laws, urge employers to pay health insurance for employees and participate in resolving cases of evasion and debt of health insurance payment.
28. Amend and supplement Article 49 as follows:
“ Article 49. Handling of violations
1. People who violate the provisions of this Law and other provisions of law related to health insurance will, depending on the nature and severity of the violation, be disciplined or fined for violations. or be prosecuted for criminal liability; if causing damage, compensation must be made according to the provisions of law.
2. Agencies and organizations that violate the provisions of this Law and other provisions of law related to health insurance shall be administratively sanctioned. If causing damage, they must compensate according to the law. provisions of law.
3. Agencies, organizations, and employers who are responsible for paying health insurance but do not pay or pay insufficiently as prescribed by law will be handled as follows:
a) Must pay the outstanding amount and pay an interest equal to twice the interbank interest rate calculated on the amount and time of late payment; If not done, at the request of the competent person, banks, other credit institutions, and the state treasury shall be responsible for deducting money from the deposit accounts of relevant agencies, organizations, and employers. Responsibility for paying health insurance to pay unpaid and late payments and interest on this amount to the health insurance fund account;
b) Must reimburse all expenses to the employee within the scope of health insurance benefits and benefits that the employee has paid while not having a health insurance card.”
Article 2.
1. This Law takes effect from January 1, 2015.
2. The Government regulates in detail the assigned articles and clauses in the Law. This Law was passed by the 13th National Assembly of the Socialist Republic of Vietnam, 7th session, on June 13, 2014./ .
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PRESIDENT OF CONGRESS |
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(Signed)
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Nguyen Sinh Hung
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