Thông tư liên tịch 24/2014/TTLT-BYT-BTC

JOINT-CIRCULAR

AMENDING AND SUPPLEMENTING A NUMBER OF ARTICLES OF THE MINISTRY OF HEALTH, THE MINISTRY OF FINANCE ‘S JOINT-CIRCULAR NO. 09/2009 / TTLT-BYT-BTC DATED AUGUST14, 2009 PROVIDING GUIDANCE ON THE IMPLEMENTATION OF MEDICAL INSURANCE

Pursuant to the Law on Health Insurance dated November 14, 2008;

Pursuant to the Government's Decree No. 62/2009/NĐ-CP dated July 27, 2009, specifying and guiding the implementation of a number of articles of the Law on Health insurance;

Pursuant to the Government's Decree No. 62/2003/NĐ-CP dated June 26, 2003, providing instructions on the implementation of specifying and the Law on State budget;

Pursuant to the Government's Decree No. 63/2012/NĐ-CP dated August 31, 2012 defining the functions, tasks, powers and organizational structure of the Ministry of Health;

Pursuant to the Government's Decree No. 215/2013/NĐ-CP dated December 23, 2013 defining the functions, tasks, entitlements and organizational structure of the Ministry of Finance;

The Minister of Health; the Minister of Finance promulgate the Joint-circular amending and supplementing a number of articles of the ministry of health, the ministry of finance ‘s Joint-Circular no. 09/2009 / TTLT-BYT-BTC dated August14, 2009 providing guidance on the implementation of medical insurance (hereinafter referred to as the Joint-Circular No. 09/2009 / TTLT-BYT-BTC).

Article 1. Amendment and supplementation of a number of articles of the Joint-Circular No. 09/2009 / TTLT-BYT-BTC

1. Amending and supplementing to Clauses 10, 11 and 13 of Article 1 as follows:

 “10. War veterans who participated in resistance wars on or before April 30, 1975, under Clause 6. Article 5 of the Government's Decree No. 150/2006 / ND-CP dated December 12, 2006 detailing and guiding a number of articles of the Ordinance on War Veterans; youth volunteers in the anti-French resistance war period under the Prime Minister's Decision No. 170/2008/QĐ-TTg dated December 18, 2008, on health insurance benefits and funeral allowances for youth volunteers in the anti-French resistance war period and the Prime Minister’s Decision No. 40/2011 / QD-TTg dated July 27, 2011 defining regulations for youth volunteers having completed their tasks in resistance.

11. People who personally participated in the anti-US resistance war for national salvation, national defense war, international missions in Cambodia, helping Laos after April 30, 1975 were demobilized, severed are under the Prime Minister's Decision, including:

a) Decision No 290/2005 / QD-TTg dated November 8, 2005 of the Prime Minister on the regulations and policies for some people personally participating in the anti-US resistance war for national salvation but have not yet enjoyed Party or State policies and the Prime Minister’s Decision No. 188/2007 / QD-TTg dated December 6, 2007 supplementing and amending Decision No 290/2005 / QD-TTg;

b) Decision No. 53/2010 / QD-TTg dated August 20, 2010 of the Prime Minister on the regime for officers and soldiers of the PEOPLE’S PUBLIC SECURITY FORCES participated in anti-US resistance who have less than 20 years of work in PEOPLE’S PUBLIC SECURITY FORCES demobilized and severed;

c) Decision No 142/2008 / QD-TTg dated October 27, 2008 of the Prime Minister on the implementation of the regime for soldiers participated in anti-US resistance who have less than 20 years of work in the army, demobilized and the Prime Minister's Decision No. 38/2010 / QD-TTg dated May 6, 2010 amending and supplementing the Decision No. 142/2008 / QD-TTg;

d) Decision No. 62/2011 / QD-TTg dated November 9, 2011 of the Prime Minister on the regime, the policy for participants in national defense war, international missions in Cambodia, helping Laos after April 30, 1975 demobilized, severed.

13. People on monthly social relief allowance under the Government's Decree No. 136/2013/NĐ-CP dated Octorber 21, 2013 defining support policies towards social relief beneficiaries, the Government's Decree No. 06/2011 / ND-CP dated January 14, 2011 providing instructions on the implementation of a number of articles of the Law on the elderly and the Government's Decree No. 28/2012 / ND-CP dated April 10, 2012 providing instructions on the implementation of a number of articles of the law on the disabled”

2. Amending to Point a, Clauses 2 and supplementing to clause 6 of Article 8 as follows:

“2…

a/ The health insurance fund shall pay return transportation expenses to patient-transporting health establishments at the level equal to 0.2 liter of petrol/km and based on the distance of transportation and petrol price at the time of transportation. If more than one patient is transported on the same vehicle, the level of payment will be only the same as in case of transportation of one patient: Medical facility receiving the patient shall sign to certify on the vehicle appointing sheet of the medical facility transfering the patient; in case of outside office hours, it must be signed by a standing doctor of medical examination department or emergency departments of the medical facility receiving patients. "

6. Payment of health insurance in some cases:

a) For the technical services done on-site by medical staff of the medical examination and treatment facility at higher level under online directing program and projects of support, improvement of professional capacity for lower levels:

- If the service is already in the list of techniques under regulations on decentralization of technical expertise approved by the competent authorities, the health insurance funds shall pay according to prices of the approved technical services;

- If the service is not included in the list of techniques approved by the competent authority under the decentralization of technical expertise and prices of health services, the health insurance fund shall temporarily pay according to the price of the health services of the faciltiies transferring technology approved by competent authorities. Medical examination and treatment facilities receiving the technical transfer shall notify the Provincial Social Insurance on technical services complied with the program, project, and request the competent authority for approval of the list of techniques and prices of health services as a basis for payment of health insurance.

For techincal services with heavy cost:

The level of health insurance payment for each patient shall be calculated under the salary of prescribed groups. Total costs to determine the health insurance payment for each patient shall include the cost of doing technical services at the prices of services approved by the competent authorities and the cost of medical supplies needed to do the services in the list of medical supplies covered by health insurance funds issued by the Ministry of Health but not included in the price of such technical services.

3. Amending and supplementing to clause 3 of Article 11 as follows:

3. Based on the local practical situation, provincial-level Health Departments shall determine commune, ward and township health stations, agencies' and schools' health sections in their localities that fully satisfy conditions on human resources, infrastructure and equipment for providing health insurance-covered medical, and prescribe the permitted scope of professional operations and lists of medicines and technical services to be provided by commune health stations.

For areas of border, islands and areas facing socio-economic difficulties, particular difficulties: based on the list of military medical facilities qualified for human resources, infrastructure, equipment for medical examniation and provided by the Military Medical Department - the Ministry of National Defense, the provincial Department of Health shall take charge and cooperate with the provincial Social Insurance to guide the signing of contract for medical services coverred by health insurance for military medical facilities to serve patients who have medical insurance cards in administrative division. "

4. Amending and supplementing to Clauses 3 and point b, clause 4 of Article 15 as follows:

“3. Monitoring and adjustment of the quota-based payment fund:

When there is a change in the quota-based fee, groups and card numbers under groups registered in medical examniation and treatment, provincial social insurance shall notify to the medical examniation and treatment the numbers of health insurance card under groups and the total quota-based payment fund used. If the cost of medical examniation, treatment increases due to changes in price medical examniation and treatment services, application of new medical services or changes in functions, duties of the medical examniation and treatment facilities, the two parties shall agree to determine the quota-based fee and adjusted the quota-based payment fund appropriately .

4...

b/ In case the quota-based payment fund sees a surplus, the medical facility may accounted for on the revenue of the public service providers. If the quota-based payment fund also includes costs for medical care at commune-level establishments, the unit assigned to sign medical care contracts with commune health stations shall deduct a part of the surplus for these commune health stations in proportion to the numbers of health insurance cards registered at these stations .The remaining surplus must not exceed 20% of the quota-based payment fund: the remainder shall be carried forward to the province 's medical care fund for management and use.

5. Amending to clause 1 of Article 24 as follows:

"1. Issuace of health insurance card and providing medical insurance for some people:

Vietnam social insurance shall provide guidance on procedures for for the issuance, reissuance and renewal of health insurance cards health insurance card shall be expired at least after one year. If employees are under labor contract for one year and are entitled to unemployment benefits, duration of use of health insurance cards shall be prescribed by Vietnam Social Insurance.

 For under-6 children, People's Committees of communes, wards and townships shall make and transfer a list of children born in the month in administrative division and transfer to social insurance for issuance of health insurance cards monthly.

c) For people who donate their organs as prescribed by legislation on donation, removal and transplantation of human’s tissues, organs and the dead body’s donation and receipt.

- The medical facility taking human’s organs shall clearly record the donated organ on the paper of discharge from the hospital issued for people who have donated their organs.

- The people who have donated their organs or their relatives shall bring the paper of discharge from the hospital to social insurance at district level for issuance of first-time medical insurance cards. The use durarion of social insurance cards shall be prescribed by Vietnam Social Insurance.

- Time of the health insurance card is valid and payment for health insurance shall be from the first of the consecutive months of the month written on the paper of discharge from the hospital.

- Based on people issued the first-time health insurance card, provincial social insurance shall manage the list of such people to ensure that the next time of issuanceof the card shall be continuous and timely.

d) In case officials and civil servants are in the time of impounding, detaintion or temporary suspension from work for consideration, discipline, they are still entitled to receive 50% of their current salary under rank and receive 50% of their salary if they are not disciplined or wrongfully concluded under the provisions of Article 24 of Decree No. 34/2011 / ND-CP dated May 17, 2011 and Article 23 of Decree No. 27/2012 / ND-CP dated April 6, 2012 of the Government, they must still pay health insurance under actual salary of 50% of their salary under rank.

If they are not disciplined or wrongfully concluded and receive their remaining salary, the social Insurance agency shall collect the health insurance premiums according to the amount of salary they receive in the time of impounding, detention or temporary suspension from work ".

Article 2. Effect

This Circular takes effect from September 1, 2014.

Any problems arising in the course of implement should be reported to the Ministry of Health and the Ministry of Finance for settlement. /.