Decision No. 105/2008/QĐ-BQP On the payment of medical examination and treatment costs for military personnel and defense civil servants when receiving medical examinations and treatments at civilian healthcare facilities

Pursuant to …;

On payment of medical examination and treatment costs for military personnel and defense civil servants when receiving medical examinations and treatments at civilian healthcare facilities

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MINISTER OF NATIONAL DEFENSE

Pursuant to the Law on Legislative Activities dated November 12, 1996, amended and supplemented on December 16, 2002;

Pursuant to the Law on Officers of the Vietnam People's Army dated December 21, 1999, amended and supplemented on June 3, 2008;

Pursuant to the Law on Military Service dated December 30, 1981, amended and supplemented on December 21, 1990, June 22, 1994, and June 14, 2005;

Pursuant to Decree No. 63/2005/NĐ-CP dated May 16, 2005 of the Government on the issuance of the Social Health Insurance Regulations;

Pursuant to Decree No. 30/2004/NĐ-CP dated January 16, 2004 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of National Defense;

At the proposal of the Director of the General Political Department,

DECISION:

Article 1. Scope and Applicability

1. This Decision regulates the payment of medical examination and treatment costs at civilian healthcare facilities for the following subjects:

a) Officers, professional soldiers, non-commissioned officers, and soldiers currently serving in the Vietnam People's Army (hereinafter referred to as military personnel);

b) Cadres, civil servants, employees, and defense workers (referred to as defense civil servants) and contractual laborers with quotas working in agencies, units, and enterprises under the General Staff.

2. The civilian healthcare facilities mentioned in this Decision include: civilian healthcare facilities, both public and private, that organize medical examinations and treatments under the social health insurance system.

3. Subjects specified in Points a and b of Clause 1 of this Article shall be reimbursed for medical examination and treatment costs at civilian healthcare facilities in the following cases:

a) Emergency treatment due to injury, accident, internal and surgical diseases, or childbirth, or rabies vaccination while on duty or on leave in areas without military healthcare facilities, if transferring along the referral chain would not ensure patient safety;

b) Emergency treatment due to injury, accident, internal and surgical diseases, or childbirth, or rabies vaccination in areas where the military base is located in remote and difficult-to-reach regions, far from military healthcare facilities or where such facilities lack specialized departments or sufficient capacity to treat, requiring referral to civilian healthcare facilities to ensure patient safety;

c) Female military personnel, female defense civil servants, and female contractual laborers with quotas working under the General Staff when undergoing gynecological and obstetric examinations and treatments, prenatal checkups, and childbirth, if the military healthcare facility lacks a gynecology and obstetrics department or if a nearby civilian healthcare facility has a gynecology and obstetrics department closer than a military hospital with such a department;

d) Specialized diseases requiring advanced diagnostic and treatment techniques, which have been reviewed and determined by the specialized boards of final-tier military hospitals (Central Military Hospital 108, Hospital 175) where military personnel, defense civil servants, and contractual laborers with quotas working under the General Staff are being treated, as beyond their professional capabilities, necessitating referral for medical examination and treatment at civilian healthcare facilities.

4. Cases not subject to implementation of this Decision:

Subjects specified in Points a and b of Clause 1 of this Article shall not be reimbursed for medical examination and treatment costs at civilian healthcare facilities in the following circumstances: suicide, intentional infliction of injury, drug addiction, or actions violating the law.

Article 2. The level of payment and sources of funds for paying medical examination and treatment costs at civilian health facilities.

1. The level of payment for medical examination and treatment costs for military personnel; defense civil servants and contractual laborers with quotas from the General Staff when undergoing medical examinations and treatments at civilian health facilities:

a) In cases specified in Clause 1, Article 1 of this Decision, the costs of medical examinations and treatments shall be reimbursed according to the provisions of Circular Joint No. 21/2005/TTLT-BYT-BTC dated July 27, 2005, issued by the Ministry of Health and the Ministry of Finance guiding the implementation of Decree No. 63/2005/NĐ-CP dated May 16, 2005 of the Government on the Medical Insurance Regulations. In cases requiring high-cost advanced medical techniques, the unit directly under the Ministry shall report in writing to the Military Health Department for consideration and submission to the Minister of National Defense for decision.

b) In cases where patients are transported by non-unit means, the level of payment for transportation costs shall be applied according to the provisions of Clause 4, Section I, Part II of Circular Joint No. 21/2005/TTLT-BYT-BTC.

2. Sources of funds for paying medical examination and treatment costs at civilian health facilities (including patient transportation costs not carried out by the unit):

a) For subjects specified in point a, Clause 1, Article 1 of this Decision: allocated from the annual regular defense budget for the military health sector;

b) For subjects specified in point b, Clause 1, Article 1 of this Decision: drawn from the revenue of medical insurance as stipulated by law;

c) For subjects specified in Clause 1, Article 1 of this Decision when requiring high-cost advanced medical techniques exceeding the medical insurance coverage, the defense budget will cover the costs.

Article 3. Documents and procedures for reimbursement of medical examination and treatment costs at civilian health facilities.

Military personnel, defense civil servants, and contractual laborers with quotas from the General Staff who undergo medical examinations and treatments at civilian health facilities as stipulated in Clauses 2 and 3, Article 1 of this Decision, shall have their medical examination and treatment costs reimbursed upon presenting the following documents:

1. Medical examination certificate, discharge certificate, or outpatient record issued by the civilian health facility. In cases of death, a death certificate from the hospital where the military personnel, defense civil servants, and contractual laborers with quotas from the General Staff underwent medical examinations and treatments and died must be provided.

2. Receipts for hospital fees, invoices for purchased medications as prescribed by the Ministry of Finance, contracts for patient transportation, or payment receipts for patient transportation in cases where transportation is not performed by the unit.

3. Certificate of sick leave requiring medical examinations and treatments at civilian health facilities issued by the military health unit according to regulations.

4. Application form for reimbursement of medical examination and treatment costs at civilian health facilities (Form No. 01 attached to this Decision) submitted by military personnel, defense civil servants, and contractual laborers with quotas from the General Staff.

5. In cases where individuals are on duty, on official business, on leave, or due to the limitations of the military health facility's capacity, they must also provide work certificates, leave certificates, or referral letters for medical examinations and treatments from the military health facility.

6. Approval form for reimbursement of medical examination and treatment costs at civilian health facilities (Form No. 02 attached to this Decision) issued by the competent authority.

Article 4. Responsibilities of agencies and units.

1. Units at Brigade level and equivalent or higher

a) Military personnel, defense civil servants, and contractual workers with quotas assigned by the General Staff who belong to a unit shall be directed by the unit head to coordinate with relevant agencies, introduce, assess, and settle medical examination and treatment costs at civilian healthcare facilities (including patient staffing costs not implemented by the unit - if applicable) in accordance with the provisions of this Decision.

b) Submit a letter requesting consideration and resolution for settling medical examination and treatment costs at civilian healthcare facilities for cases where the costs exceed the levels specified in Clause 1, Article 2 of this Decision.

2. Central units under the Ministry of National Defense

a) Report in writing to the Military Medical Department for consideration and recommendation on settling medical examination and treatment costs at civilian healthcare facilities for cases where the costs exceed the levels specified in Clause 1, Article 2 of this Decision.

b) Annually, compile the implementation situation and prepare the budget for medical examination and treatment costs at civilian healthcare facilities for the target groups, and submit it together with the military medical budget to the Military Medical Department, the Financial Department (from the budget), and the Social Insurance Department of the Ministry of National Defense (from the health insurance revenue); compile and report on the situation of medical examinations and treatments and settlement of medical examination and treatment costs at civilian healthcare facilities in accordance with regulations.

3. Military Medical Department - Logistics General Department

a) Take the lead and coordinate with functional agencies of the Ministry of National Defense to monitor, direct, and inspect the organization and implementation of medical examinations and treatments for military personnel, defense civil servants, and contractual workers with quotas assigned by the General Staff at civilian healthcare facilities.

b) Take the lead and coordinate with the Financial Department and the Social Insurance Department of the Ministry of National Defense to develop plans for allocating medical examination and treatment funds at civilian healthcare facilities for units.

c) Direct and guide military medical units to assess files and procedures for settling medical examination and treatment costs and report on the situation of medical examinations and treatments for military personnel, defense civil servants, and contractual workers with quotas assigned by the General Staff at civilian healthcare facilities in accordance with regulations.

4. Financial Department - Ministry of National Defense

a) Ensure sufficient and timely funding from the budget to settle medical examination and treatment costs at civilian healthcare facilities. Coordinate with the Military Medical Department to allocate and notify the budget (from the budget) for medical examinations and treatments at civilian healthcare facilities for units.

b) Take the lead and coordinate with the Military Medical Department and the Policy Department to examine and submit to the head of the Ministry of National Defense for resolution on settling (from the budget) for cases where the costs of medical examinations and treatments at civilian healthcare facilities exceed the levels specified by health insurance.

c) Direct and guide financial units to implement payment and annual settlement for the funds specified in point a, Clause 2, Article 2 of this Decision.

5. Policy Department - Political General Department

Take the lead and coordinate with functional agencies of the Ministry of National Defense to direct inspections and audits on the implementation of settling medical examination and treatment costs for military personnel, defense civil servants, and contractual workers with quotas assigned by the General Staff at civilian healthcare facilities.

6. Social Insurance Department of the Ministry of National Defense

Take the lead and coordinate with the Military Medical Department and the Financial Department to ensure funding for medical examinations and treatments for defense civil servants and contractual workers with quotas assigned by the General Staff when they undergo medical examinations and treatments at civilian healthcare facilities and annual settlement from health insurance revenue in accordance with the law.

Article 5. Implementation Provisions

1. The Military Medical Department is responsible for guiding the military medical system to provide medical examinations and treatments for contractual workers with quotas assigned by the General Staff as for defense civil servants within the same unit with the same salary level.

2. This Decision takes effect fifteen days after the date of signature. Previous regulations that conflict with this Decision are abolished.

3. When the Government issues new regulations on health insurance, the Ministry of National Defense will make adjustments to align with the organizational and operational characteristics of the military and the regulations on health insurance.

4. The Chief of the Political General Department, heads of agencies and units are responsible for implementing this decision.