Ho Chi Minh City Hospital's 2,500 billion VND health insurance 'suspended': Requesting the Ministry of Health to resolve the issue

Vietnam Social Security recently sent a document to the Department of Health Insurance under the Ministry of Health regarding the cost of exceeding the estimated health insurance examination and treatment expenditure for hospitals in 2023 and 2024.

The document stated that Vietnam Social Security has received an official dispatch from the Ministry of Health regarding the payment of costs exceeding the estimated cost of medical examination and treatment under health insurance and has not yet recovered the costs of technical services performed on medical equipment that has not completed the establishment of public ownership before March 4, 2023.

Regarding the cost exceeding the estimated expenditure and exceeding the estimated expenditure for health insurance examination and treatment in 2023, Vietnam Social Security has commented:

Vietnam Social Security has submitted a report to the Social Security Management Board on the 2023 financial settlement and it was approved in Resolution No. 730. However, the resolution does not assign Vietnam Social Security to make an advance payment for expenses exceeding the 2023 budget.

To address the cost of health insurance examination and treatment exceeding the budget, the Ministry of Finance has issued documents reporting to the Government leaders on the amount of health insurance examination and treatment costs that have not been paid, including the cost exceeding the budget for 2023 and 2024.

The Government Office also issued an official dispatch on the implementation of Decree 188. Deputy Prime Minister Le Thanh Long directed the Ministry of Health to coordinate with the Ministry of Finance, the Ministry of Justice and relevant agencies to develop a project to completely handle the backlog of health insurance medical examination and treatment expenses from 2025 and earlier.

It clearly states the current situation and proposes solutions to ensure feasibility, effectiveness, and compliance with regulations to overcome and thoroughly resolve the outstanding debt of medical examination and treatment costs of previous years, and reports to the Government for consideration in the third quarter of 2025.

Regarding the cost of exceeding the estimated expenditure and exceeding the estimated expenditure for health insurance examination and treatment in 2024, the Ministry of Health has issued an official dispatch on reviewing the amount of exceeding the estimated expenditure for health insurance examination and treatment in 2024.

In which, the Ministry of Finance is requested to urgently direct the Vietnam Social Security to guide the social security of provinces and centrally run cities to preside over and coordinate with the health department and medical examination and treatment facilities to review and determine the medical examination and treatment costs covered by health insurance that have been appraised by the social insurance agency every quarter in 2024 exceeding the expected amount of payment, and review the increased medical examination and treatment costs of medical examination and treatment facilities that have been warned.

However, the above document does not clearly guide the content of the review to determine the cost exceeding the expected payment as proposed by the Ministry of Finance, and is not clear for Vietnam Social Security to organize the implementation of detailed regulations and instructions for the implementation of a number of articles of the Law on Health Insurance.

Vietnam Social Security requests the Department of Health Insurance to advise the Ministry of Health on the content of reviewing and determining the amount of health insurance medical examination and treatment expenses exceeding the expected amount paid by the health insurance fund, and include it in the project report to the Government to determine the amount of health insurance medical examination and treatment expenses in 2024.

At the same time, the Department of Health Insurance under the Ministry of Health will promptly advise the Ministry of Health's leaders to submit to the Government a final settlement of unsettled health insurance medical examination and treatment costs from 2025 and earlier, as announced in Official Dispatch No. 7282 of the Government Office.