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MoH clarifies health insurance

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Private hospitals that have signed health-insurance contracts with Việt Nam Social Insurance (VSI) will continue the contracts next year. However, private healthcare facilities must now have their classifications authorised by the Ministry of Health.

Private hospitals that have signed health-insurance contracts with Việt Nam Social Insurance (VSI) will continue the contracts next year. — Photo


Lê Văn Phúc, deputy director of VSI’s Department for Health Insurance Policy said that VSI did not order provincial social insurance agencies to end their existing healthcare contracts with private healthcare facilities.

The agency requested private healthcare facilities to add health ministry decisions on the levels of service and technical classifications of their facilities. He said this information would serve as a foundation to identify health-insurance payment levels according to the Health Insurance Law.

The levels of service provided will also determine the technical services provided, use of medicines and patient transfers to hospitals in other class.

However, the Ministry of Health has not issued any instructions about the levels of hospital classification for private healthcare facilities. This has caused difficulties for social insurance agencies and private hospitals in identifying health insurance prices. This means that hospitals of the same size but in different provinces are experiencing different health insurance payments.

Phúc said the Ministry of Health needed to issue the instructions or at least temporary criteria for classifications to solve the problem.

There are currently three levels of hospital classification for public hospitals based on groups of criteria set by the ministry.

The VSI has also ordered provincial social insurance agencies to work with local health departments to compile and publicise a list of healthcare facilities that linked healthcare with health insurance. The VSI will soon review contracts on healthcare facilities that have these facilities.

The VSI said it would not sign contracts with healthcare facilities that were reported by authorised State agencies to have misused and abused health insurance funds.

VSI asked local insurance agencies to strictly assess hospitals and healthcare facilities that register for next year.

Stricter punishment

People making fake social insurance-related documents to trick others and illegally enjoy social insurance policies by appropriating VNĐ10-100 million (US$440-4,400) will be fined VNĐ20-200 million ($880-8,800) or imprisoned from three months to two years.

It is one of the regulations in Penal Code No. 100/2015/QH13, which will come into effect from the beginning of next year. The regulations were announced by the VSI at a press meeting on Wednesday.

People will be fined VNĐ100-200 million, or sentenced to a prison term of 1-5 years if they have organised rings to appropriate VNĐ100-500 million from the social insurance fund or caused losses worth VNĐ200-500 million.

They will be sentenced to 5-10 years’ imprisonment if they have appropriated more than VNĐ500 million.

Owner of enterprises that refuse or use trickery to avoid paying social insurance and health insurance for workers will be fined VNĐ50-200 million or sentenced to prison for three months to one year depending of the level of violation.

If they repeat the violations more than twice or try to avoid paying social insurance by VNĐ1 billion they will be fined VNĐ200-500 million or sentenced to six months to three years’ imprisonment. 

They will be sentenced to a prison term of 2-7 years if they avoid paying social insurance by more than VNĐ1 billion ($44,000).

By the end of October this year, the total social insurance, health insurance and unemployment insurance debt was VNĐ16.6 trillion ($730.6 million), a decrease of VNĐ64 billion ($2.8 million) compared with the previous month, according to VSI.


Source: VNS

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