JOINT CIRCULAR No. 05/1999/TTLT/BLDTBXH-BYT-BTC Circular guiding the implementation of medical examination and treatment services exempted from partial hospital fees for extremely poor individuals as stipulated in Decree No. 95/CP dated August 27, 1994 of the Government.

CIRCULAR

JOINT CIRCULAR OF THE MINISTRIES OF LABOR - SOCIAL AFFAIRS - HEALTH - FINANCE NO. 05/1999/TTLT-BLDTBXH-BYT-BTC DATED JANUARY 29, 1999 GUIDING THE IMPLEMENTATION OF MEDICAL EXAMINATION AND TREATMENT WITH PARTIAL HOSPITAL FEES WAIVED FOR PERSONS IN EXTREME POVERTY AS PROVIDED IN DECREE 95/CP OF AUGUST 27, 1994 OF THE GOVERNMENT

Pursuant to Decree No. 95/CP dated August 27, 1994 of the Government on collecting part of hospital fees; Decree No. 33/CP dated May 23, 1995 of the Government amending Clause 1, Article 6 of Decree No. 95/CP.

Pursuant to Decree No. 58/1998/NĐ-CP dated August 13, 1998 of the Government on the Health Insurance Charter.

The Ministries of Labor - Social Affairs - Health - Finance guide the implementation of medical examination and treatment with partial hospital fees waived for persons specified in Point g, Clause 2, Article 3 of Decree No. 95/CP.

I. SUBJECTS ELIGIBLE FOR HEALTH INSURANCE CARDS FOR MEDICAL EXAMINATION AND TREATMENT WITH PARTIAL HOSPITAL FEES WAIVED
TREATMENT WITHOUT PAYING A PORTION OF THE FACILITY FEE

1- Persons in extreme poverty who are exempt from paying part of hospital fees as provided in Point g, Clause 2, Article 3 of Decree No. 95/CP dated August 27, 1994 of the Government are now detailed as follows: Persons in extreme poverty are those whose households are classified as starving and among the approximately 30% poorest people in the locality. The determination of starving and poor households is uniformly applied according to national standards published at different times. Currently, it is applied according to Circular No. 1751/LDTBXH dated May 20, 1997 of the Minister of Labor - Social Affairs.

2- Persons in extreme poverty as defined in Point 1 above shall be issued health insurance cards annually by the State.

II. SOURCES OF FUNDS FOR PURCHASING HEALTH INSURANCE CARDS AND PAYING FOR MEDICAL EXAMINATION AND TREATMENT FOR PERSONS IN EXTREME POVERTY WHO HAVE HEALTH INSURANCE CARDS

1- Sources of funds for purchasing health insurance cards:

1.1- Funds for purchasing health insurance cards for persons in extreme poverty are taken from the annual budget allocated for social security from local government budgets. To support the purchase of health insurance cards for persons in extreme poverty, contributions may be solicited from economic and social organizations, Red Cross, and charitable organizations depending on the economic and social conditions of each locality.

1.2- Health insurance cards for persons in extreme poverty are purchased at a value of 30,000 VND per card per person per year.

2- Health insurance medical examination and treatment benefits:

State healthcare facilities providing medical examination and treatment to persons in extreme poverty with health insurance cards will have their costs fully covered by the health insurance agency that issued the cards, in accordance with Circular No. 17/1998/TT-BYT dated December 19, 1998 of the Ministry of Health "guiding the implementation of medical examination and treatment, using the medical examination and treatment fund, and settling medical examination and treatment costs under health insurance." Persons in extreme poverty with health insurance cards will have all medical examination and treatment costs paid by health insurance.

III. IMPLEMENTATION

1. Procedure for issuing and purchasing health insurance cards:

1.1- Persons in extreme poverty as defined by national standards must be reviewed at village, hamlet, commune, or ward levels. Special attention should be given to elderly individuals without family support, orphaned children without caregivers, and severely disabled individuals whose families are in extreme poverty. The Chairman of the People's Committee at the district level establishes a list of individuals by village, hamlet, commune, or ward, which is approved by the People's Council and submitted to the Chairman of the People's Committee at the provincial level for review. The list is then submitted to the Department of Labor - Social Affairs of the province or centrally-administered city for consolidation.

1.2- Based on the annual budget allocation, the Department of Labor - Social Affairs of the province or centrally-administered city coordinates with relevant agencies to submit to the People's Committee of the province or centrally-administered city for approval of the number of persons in extreme poverty eligible for health insurance cards; organize the purchase of health insurance cards from the health insurance agency located in the locality and distribute them to the People's Committee at the district level according to the approved list.

1.3- The People's Committee at the district level issues health insurance cards to the People's Committee at the commune level according to the approved list.

1.4- The People's Committee at the commune level directly issues health insurance cards to eligible individuals.

2. Responsibilities of various levels and sectors and health organizations at central and local levels.

2.1- The Department of Labor - Social Affairs of the province or centrally-administered city is responsible for:

- Leading and coordinating with the Department of Finance - Price Control of the province or centrally-administered city to develop plans for funding the purchase of health insurance cards annually; guiding the implementation of procedures for issuing, purchasing, and distributing health insurance cards to persons in extreme poverty.

- Compiling and reporting final accounts to the Department of Finance - Price Control for review and consolidation into the final report of the province or centrally-administered city, to be sent to the Ministry of Finance in accordance with the Law on State Budget and related guiding documents.

- Reporting implementation status to the Ministry of Labor - Social Affairs periodically: quarterly, semi-annually, and annually.

- Coordinating with the Department of Health, the Department of Finance - Price Control, and the health insurance agency located in the province or centrally-administered city to advise the People's Committee of the province or centrally-administered city on organizing the implementation of this circular.

2.2- The Health Sector provides specific guidance on implementing medical examinations and treatments, using the medical examination and treatment fund, and payment methods for medical examination and treatment costs under health insurance for extremely poor individuals; organizing medical examinations and treatments for these subjects as stipulated in this circular in appropriate forms such as: medical examinations and treatments at healthcare facilities; organizing mobile medical examinations and treatments in communes, highlands, remote, and far-flung areas.

2.3- The Department of Finance - Price Control is responsible for implementing decisions of the People's Committee of the province or centrally-administered city to allocate funds for purchasing health insurance cards in accordance with the provisions of this circular.

2.4 Health Insurance Vietnam shall be responsible for directing health insurance agencies located at localities to coordinate with labor, war invalids, and social affairs agencies in issuing health insurance cards and guiding initial healthcare registration places, ensuring all benefits related to healthcare for individuals holding health insurance cards who fall under the extremely poor category as stipulated in this Circular. In case discrepancies arise between the cost of purchasing health insurance cards and actual healthcare expenses for those in the extremely poor category, health insurance agencies shall adjust within the general operations of health insurance and report to the joint ministries of Labor, War Invalids, and Social Affairs, Health, and Finance for consideration and adjustment of the health insurance card purchase price accordingly.

2.5 Encourage healthcare facilities to provide free medical services to individuals in the extremely poor category who do not have health insurance cards.

2.6 Localities shall mobilize all available resources and solicit contributions from economic and social organizations, Red Cross societies, charitable organizations, and domestic and foreign individuals to create funding sources for purchasing health insurance cards for individuals in the poor category.

IV - EFFECTIVE PROVISIONS

1 This Circular takes effect from February 1, 1999.

2 During implementation, if difficulties or obstacles arise, they should be reported to the joint ministries for consolidation and review, adjustment, and supplementation.