On October 19, 2023, the Government issued Decree 75/2023/ND-CP, ushering in amendments and additions to various articles within the framework of Decree 146/2018/ND-CP, dated October 17, 2018. This decree delineates measures for implementing key provisions of the Law on Health Insurance. Effectively enforced from December 3, 2023, Decree 75 broadens the parameters for accessing and deriving benefits from health insurance policies. It extends the purview of State-supported health policyholders, amplifies support for premiums, and enhances benefits for medical examinations and treatments for targeted groups. Anticipating the nuances of enforcement instructions, the social security sector of Tien Giang province has collaborated with relevant entities to apply the decree, safeguarding the rights and interests of health insurance participants.
Mr. Vo Khanh Binh, Director of Tien Giang Social Security Agency, guides the implementation of Decree 75 in a meeting with Health Insurance Assessment Department leaders and officials.
Mr. Vo Khanh Binh, Director of Tien Giang Social Security Agency, said: “Decree 75 adds two groups of State-supported health insurance policyholders: (1) residential in communes in war safe zones where revolutionary forces resided during the wars have their personal information updated into in the national population database and residence database and are not subject to provisions in Clauses 1, 2 and 3 of Article 12 of the Health Insurance Law; and (2), and at least 70% of health insurance premium support for ethnic minorities living in communes of Region II, Region III, and extremely poor villages in ethnic minority and mountainous areas in the 2016-2020 period but these communes are no longer on the list of communes of Region II, Region III, and extremely poor villages in ethnic minority and mountainous areas in the 2021-2025 period according to Decision 861 of the Prime Minister.
Placing the people at the heart of service and promptly ensuring rights and interests for health insurance policyholders in the province, immediately after Decree 75 was issued, the Tien Giang Social Security Agency proactively coordinated with relevant bodies to advise the Tien Giang Provincial People’s Committee to issue Official Dispatch 7734 dated November 22, 2023 on implementation of Decree 75. Accordingly, the committee required provincial departments and relevant units to focus on implementing the following contents:
For the Department of Health, direct medical facilities to coordinate with social security agencies to comply with Decree 75 in receiving health-insured people and paying health insurance expenses during the transition period; amend and supplement re-examination appointment letters and medical referral letters for health-insured people; comply with laws on medical examination and treatment; review and promptly promulgate processes and professional guidance in medical examination and treatment for health-insured people, measures to prevent abuse and profiteering of health insurance funds; inspect and review insured medical examination and treatment costs by law; direct public and private medical facilities in Tien Giang province to urgently review and synthesize medical examination and treatment costs that exceeded total insurance payments in 2019, 2020 and 2022.
For the Department of Labor, Invalids and Social Affairs, direct its affiliates in districts, cities and towns to monitor, review and prepare the list of martyrs’ remarried spouses who receive regulatory monthly allowances and send it to social security agencies; notify people of changing benefit codes and increasing health insurance benefits: from 80% to 100% for people participating in the resistance wars; from 80% to 95% for people with meritorious services to the revolution and live with their family.
For the Department of Finance, promptly transfer State-financed funds to the Health Insurance Fund, support new beneficiaries according to Decree 75.
For the Provincial Security Agency, change benefit codes for people participating in the resistance wars, people with their recognized meritorious service to the revolution living with their family; promptly issue health insurance cards to people currently residing in communes in revolutionary war safe zones; grant health insurance cards to martyrs' remarried spouses at the request of the commune/ward people's committees; coordinate with the Department of Health to request medical facilities to accept people for medical treatment when presenting health insurance cards with photos or citizen identification cards; pay health insurance expenses for medical examination and treatment during the transition period.
For the Department of Information and Communications, direct information and communications on mass media regarding amended and supplemented contents of Decree 75.
For the Provincial Police, direct local police forces of districts, cities and towns to request police officers in communes in war safe zones to urgently support the local government to review people currently residing in these places with their personal information updated to the National Population Database and Residence Database.
For the Tien Giang Radio and Television Station and Ap Bac Newspaper, increase news, articles, and reports on amended and supplemented contents of Decree 75: Adding more beneficiaries, changing benefit codes, removing difficulties in payment of health insurance expenses.
For People's Committees of districts, cities, and towns, direct units to increase information and communication on new contents of Decree 75; direct the review and preparation of a list of health-insured people currently residing in 15 communes in revolutionary war safe zones, whose information has been updated into the National Population Database and the Residence Database.
“With its resolute and urgent actions, Tien Giang Social Security Agency quickly transferred benefit codes to 6,395 people participating in the resistance wars, 56 people with meritorious services to the revolution currently living with their family; issue 1,000 health insurance cards to martyrs' remarried spouses and over 120,000 health insurance cards to people in 15 communes in war safe zones. In addition, the agency advised the Provincial People's Committee to issue Official Dispatch 8476 dated December 22, 2023 on payment and settlement of insured medical examination and treatment costs in excess of the total payment amount according to Decree 75, thus enabling medical facilities to review medical costs that exceeded the total budget by VND44.7 billion transferred to medical facilities in 2019, 2020 and 2022. The medical cost that exceeded the total budget in 2019, 2020, and 2022 was over VND90 billion. Tien Giang Social Security Agency made a report to the Vietnam Social Security (VSS) and submit it to the Social Insurance Administration Council for consideration. Consequently, Decree 75 will remove “obstacles” in the payment mechanism for medical examination and treatment costs covered by health insurance, facilitate medical examination and treatment covered by health insurance, and ensure rights and interests for policyholders. This also shows Party’s and State's cares for people's healthcare," said Mr. Binh.
Source: Vietnam Business Forum
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