Joint Circular No. 16/2015/TTLT-BYT-BTC amends the provisions on organizing health insurance medical examinations and treatments on holidays and public holidays, and the responsibilities of healthcare facilities in notifying and disclosing costs to patients. This Circular takes effect from September 1, 2015.
适用范围
Healthcare facilities, social insurance organizations, and individuals holding health insurance cards
要点
- Healthcare facilities → must notify the social insurance organization before conducting medical examinations and treatments on holidays and public holidays.
- Individuals holding health insurance cards → shall be reimbursed by the health insurance fund within the scope of their health insurance benefits and entitlements.
- Healthcare facilities → must disclose the expenses that patients must pay outside the scope of their health insurance benefits, and must inform patients in advance.
- Patients → must bear the cost of expenses outside the scope of their health insurance benefits and entitlements (if any).
🌐 本文件的社会影响
- Positive impact: Patients will be reimbursed within the scope of their health insurance benefits, reducing financial burdens when seeking medical care on holidays and public holidays.
- Negative impact: Healthcare facilities have additional responsibilities to notify and disclose costs to patients, increasing management costs.
❓ 常见问题
What must healthcare facilities do when organizing medical examinations and treatments on holidays and public holidays?
Healthcare facilities must notify the social insurance organization to supplement the medical examination and treatment contract before implementing it.
How will individuals holding health insurance cards be reimbursed when seeking medical care on holidays and public holidays?
Individuals holding health insurance cards will be reimbursed by the health insurance fund within the scope of their health insurance benefits and entitlements.
What expenses must healthcare facilities disclose to patients?
Healthcare facilities must disclose the expenses that patients must pay outside the scope of their health insurance benefits.
What must patients do when seeking medical care on holidays and public holidays?
Patients must bear the cost of expenses outside the scope of their health insurance benefits and entitlements (if any).
When does this Circular take effect?
This Circular takes effect from September 1, 2015.
全文
JOINT CIRCULAR
Amend Clause 5 3. Amend Clause 3 Article 2 as follows:Article 13 TJoint Circular No. 41/2014/TTLT-BYT-BTC dated November 24, 2014
of B||| Re ceremony, B||| TMinistry of Finance guiding the implementation of health insurance
_____________________________
Based on the Health Insurance Law;
Pursuant to Decree No. 105/2014/NĐ-CP dated November 15, 2014 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;
This Circular prescribes procedures for receiving, providing health care for domestic violence victims and statistical reports on domestic violence victims at medical facilities.
Pursuant to Decree No. 215/2013/NĐ-CP dated December 23, 2013, promulgated by the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Finance;
The Minister of Health and the Minister of Finance issue this Joint Circular amending Clause 5, Article 13 of the Joint Circular No. 41/2014/TTLT-BYT-BTC dated November 24, 2014 of the Ministry of Health and the Ministry of Finance guiding the implementation of health insurance.
Article 1. Amends Clause 5 of Article 13 of Joint Circular No. 41/2014/TTLT-BYT-BTC dated November 24, 2014 of the Ministry of Health and the Ministry of Finance guiding the implementation of health insurance as follows:
"5. In cases where healthcare facilities organize health insurance examination and treatment on holidays or public holidays, they must notify the social insurance organization to supplement the examination and treatment contract before implementation. People with health insurance cards who come for examination and treatment will be reimbursed by the health insurance fund within the scope of their benefits and entitlements under the health insurance program. Healthcare facilities are responsible for ensuring human resources and professional conditions, and must publicly disclose any costs that patients must pay outside the scope of their benefits under the health insurance program, and must inform patients in advance. Patients must self-pay for any costs outside the scope of their benefits and entitlements under the health insurance program (if applicable)."
Article 2. Effective Date
This Circular takes effect from September 1, 2015.
Any difficulties encountered during implementation should be promptly reported to the Ministry of Health and the Ministry of Finance for study and resolution./.
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