Will private hospitals have their medical examination and treatment contracts under health insurance terminated?

Nearly 200 private medical facilities nationwide will face losing patients because their contracts for medical examination and treatment for people with health insurance cards have been suspended, according to a new announcement just released by the Vietnam Social Security.

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Last November, the Vietnam Social Security (VSS) sent a dispatch to private hospitals and relevant agencies informing them that private medical facilities that have not been technically classified will not be allowed to provide medical examination and treatment using health insurance (HI) from January 1, 2018.

Ms. Nguyen Thi Quang Hien - Vice President of the Vietnam Private Hospital Association said that according to this document, private medical facilities must have a technical referral decision issued by specialized agencies. However, currently, medical facilities do not have a technical referral decision, which also means that from January 1, 2018, private medical facilities are not allowed to examine and treat patients under health insurance.

“I hope that the Ministry of Health and Social Insurance will resolve this issue soon because it is a matter of survival for private hospitals,” she said.

According to the understanding of private medical facilities, this means that these medical facilities will have their medical examination and treatment contracts with health insurance terminated. Nearly 200 private hospitals nationwide will be at risk of losing patients when this announcement is applied.

According to Lawyer Nguyen The Truyen - Thien Thanh Law Firm, Hanoi Bar Association, the contracts signed by the Social Insurance with public hospitals are fully allocated according to Circular 41 of the Ministry of Finance. However, the contracts signed by the Social Insurance with a number of private medical facilities have been greatly amended.

More specifically, Ms. Ngo Minh Chien, Tam Duc General Clinic Hospital, Binh Phuoc, said that in the insurance medical examination and treatment contract with private medical facilities, the Social Insurance arbitrarily added and removed the contract appendix clauses of Circular 41, causing disadvantages to private medical facilities, leading to the insurance agency arbitrarily stopping the medical examination and treatment contract with many private medical facilities. This is unfair.

People carry out procedures to get medical examination and treatment. Photo: Document

Ms. Truong Thi Mau - Head of Luong Dien General Clinic, Thanh Hoa, said that the current regulations have shortcomings. Private general clinics invest in facilities and quality of doctors, although better than normal medical stations, but are still not allowed to receive patients and treat emergency patients.

“In fact, the medical station is right next to the private clinic, but the facilities are not as good. Sometimes there is no oxygen and we have to borrow it from the private clinic, but the emergency treatment time is longer than at the private clinic,” Ms. Mau commented.

Mr. Pham Van Long - Deputy Director of Private Hospital 115, Nghe An also affirmed that the current Law on Health Insurance does not have any provisions allowing the Social Insurance agency to suspend contracts with private medical examination and treatment facilities.

“On the other hand, if you want to change, liquidate or terminate the contract, you must meet two conditions: there must be agreement from both parties and ensure that the medical examination and treatment of the health insurance participant is not interrupted as prescribed in Point e, Clause 2, Clause 3, Article 25 of the Law on Health Insurance and according to Clause 2, Article 8 of the health insurance medical examination and treatment contract form,” Mr. Long emphasized.

In response to these comments, Ms. Phan Thi Hai - Deputy Head of the Department of Medical Examination and Treatment Management, Department of Medical Examination and Treatment Management - Ministry of Health admitted that the policy towards private hospitals still has many inequalities, while private hospitals are equipped with modern equipment.

Regarding some recommendations on classification, medical facilities can send documents directly to the Ministry of Health and higher levels. Ms. Phan Thi Hai also said that this week, the leaders of the Ministry of Health will have a meeting to discuss solutions to help private hospitals have more favorable operating conditions.

Mr. Vu Xuan Bang - Representative of Vietnam Social Security also said that if private hospitals "still have any concerns or doubts, please notify the Private Hospital Association and we will have satisfactory and appropriate answers".

According to chinhphu.vn