Since July 2017, the Provincial Social Insurance has evaluated the results of fund usage monthly.

(Baonghean) - Starting from July 2017, every month the Department of Health will preside over and coordinate with the Provincial Social Insurance to evaluate the results of the health insurance examination and treatment work in the area, the use of the Health Insurance Fund; promptly report to the Provincial People's Committee for consideration and direction of handling if necessary.

That was the conclusion of comrade Nguyen Xuan Duong at the working session with the Provincial Social Insurance, Department of Health and other sectors on the issue of exceeding funds in implementing health insurance examination and treatment.

The Department of Health and the Provincial Social Insurance, according to their assigned functions and tasks, shall further strengthen the direction and control of the implementation of health insurance examination and treatment; Continue to promote inspection, examination and strict handling (regarding responsibilities, positions, including economic compensation, prosecution according to the provisions of law...) of individuals who violate the law on abuse and exploitation of the health insurance fund.

Provincial Social Insurance officers advise employees on social insurance, health insurance, and unemployment insurance policies. Photo courtesy

Enhance the responsibility of leaders at hospitals and medical examination and treatment units; Hospital directors and heads of medical examination and treatment units strengthen management and thoroughly educate medical staff to properly implement the regulations of the Ministry of Health in examination and treatment; Use health insurance funds economically, effectively and for the right purposes; Timely correct errors and limitations in medical examination and treatment in general, and health insurance examination and treatment in particular.

The Provincial Social Insurance shall preside over and coordinate with the Department of Health and relevant sectors and units to strengthen the development of health insurance participants; Expand health insurance coverage according to the direction of the Prime Minister in Decision No. 1176/QD-TTg dated June 28, 2016 on adjusting the assignment of health insurance implementation targets for the period 2016 - 2020; Continue to implement Directive No. 02/CT-UBND dated January 21, 2017 of the Provincial People's Committee on strengthening the collection of state budget, social insurance and health insurance in 2017 in the province; Take measures to promptly handle the situation of arrears and evasion of health insurance payment in a number of units and organizations; Review and make a list of subjects that are paid by the State budget and supported with health insurance payment levels to promptly issue health insurance cards; Strengthen propaganda work on health insurance policies(on the proper use of the Health Insurance Fund, on the implementation of the goal of universal health insurance,...).

The Department of Health and Social Insurance of the province regularly update, exchange and share the advantages, difficulties and obstacles in implementing health insurance examination and treatment and promptly report to the Provincial People's Committee, the Ministry of Health and Vietnam Social Insurance in necessary cases; Develop and complete the coordination regulations between the two units to direct the implementation of health insurance examination and treatment more effectively; Strengthen the inspection, examination and appraisal of the implementation of health insurance examination and treatment at the facility.

The Department of Health shall preside over and coordinate with the Provincial Social Insurance to review and evaluate the actual bed arrangement of medical examination and treatment facilities in a way that is consistent with reality, ensuring service quality and patient rights; Direct medical examination and treatment facilities to have solutions to overcome existing problems, cut unreasonable costs to minimize health insurance overspending, absolutely not allowing congestion in medical examination and treatment work, ensuring that all activities of medical examination and treatment facilities must take place normally.

Youth Union members of Nghe An Social Insurance give gifts to war invalids and policy beneficiaries. Photo: Document

In case of continued imbalance in the Health Insurance Fund, the Provincial Social Insurance shall coordinate with the Department of Health to proactively report to the Provincial People's Committee on the situation and propose a solution for the Provincial People's Committee to report to the Prime Minister, the Ministry of Health, and the Vietnam Social Insurance for consideration and resolution.

The Provincial Social Insurance shall review all Health Insurance Contracts with medical facilities to manage them in accordance with regulations and promptly make adjustments when necessary.

The Department of Health shall strengthen the direction and guidance of hospitals and medical examination and treatment units in the management and use of medical equipment according to regulations, focusing on the management and use of medical equipment in the form of socialization; Strongly educate collectives and individuals in the whole sector about the spirit of practicing thrift in medical examination and treatment, including health insurance examination and treatment; Strictly implement the direction of the Ministry of Health in Official Dispatch No. 2955/BYT - BH dated June 1, 2017 on inspection and examination to prevent fraud and profiteering of health insurance funds, resolutely handle the abuse and profiteering of health insurance funds; Regularly direct, urge, guide and inspect the strict compliance with regulations and professional instructions of the Ministry of Health for hospitals and medical examination and treatment units in the province; Direct hospitals and medical examination and treatment units to promptly develop technical procedures and treatment regimens according to the instructions of professional agencies.

Directors and Heads of medical examination and treatment units in the province: Promote the application of information technology in the management of medical examination and treatment at the unit; Direct the effective implementation of the connection of electronic data on medical examination and treatment with health insurance according to regulations, look up data on medical examination and treatment schedules to control the medical examination and treatment situation of patients; Proactively inspect and implement measures to effectively manage medical examination and treatment and payment of medical examination and treatment costs, especially in medical examination and treatment with health insurance, and prevent abuse and profiteering of the health insurance fund. Directors of medical examination and treatment facilities must take full responsibility if abuse and profiteering of the health insurance fund occurs at the unit under their management.

Starting from July 2017, every month the Department of Health will preside over and coordinate with the Provincial Social Insurance to evaluate the results of the health insurance examination and treatment work in the area, the use of the Health Insurance Fund; promptly report to the Provincial People's Committee for consideration and direction of handling in necessary cases./.

Provincial Social Insurance