Circular No. 21/2025/TT-BQP on the classification of technical expertise levels; quality assessment and certification of medical facilities for diagnosis and treatment; registration and transfer of patients among medical facilities under the Ministry of National Defense.

CIRCULAR

Regulations on classification of technical specialties; quality assessment and recognitionứof medical examination and treatment facilities; registration and transfer of patients among medical examination and treatment facilities under the Ministry of National Defense subject, organization, unit under the People's Committee of the commune level Pursuant to the Health Insurance Law dated November 14, 2008, the Law Amending and Supplementing Certain Provisions of the Health Insurance Law dated June 13, 2014, and the Law Amending and Supplementing Certain Provisions of the Health Insurance Law dated November 27, 2024;

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Pursuant to the Law on Medical Examination and Treatment dated January 9, 2023;

Pursuant to Decree No. 16/2024/NĐ-CP dated February 16, 2024 of the Government on medical practitioners and medical examination and treatment facilities under the armed forces; Pursuant to Decree No. 01/2022/NĐ-CP dated November 30, 2022 of the Government on the functions, tasks, powers, and organizational structure of the Ministry of National Defense; and Decree No. 03/2025/NĐ-CP dated February 28, 2025 amending and supplementing certain provisions of Decree No. 01/2022/NĐ-CP; The proposal of the Director of the General Logistics Department - Technical Service; The Minister of National Defense promulgates this Circular on classification of technical specialties; quality assessment and recognition of medical examination and treatment facilities; registration and transfer of patients among medical examination and treatment facilities under the Ministry of National Defense. This Circular stipulates on classification, guidance, and support for technical specialties; technical catalogues; quality assessment of medical examination and treatment facilities; registration for health insurance medical examination and treatment and patient transfer among medical examination and treatment facilities under the Ministry of National Defense.on1. Medical examination and treatment facilities under the Ministry of National Defense.

2. Officers, professional soldiers, non-commissioned officers, and conscripts on active duty; military students, and civilian students receiving subsistence allowance who are Vietnamese citizens and foreigners.â3. Personnel working in confidential services receiving salaries equivalent to those of military personnel currently employed at the State Cryptographic Agency; civilian students receiving subsistence allowance from the state budget according to regulations and policies applicable to military students.â4. Reserve officer trainees undergoing training for three months or more without participating in social insurance or health insurance; defense workers and civil servants serving in the military when seeking medical examination and treatment.

5. Relatives of the subjects specified in Clauses 2, 3, and 4 of this Article, except relatives of foreign military students, civilian students receiving subsistence allowance, and reserve officer trainees undergoing training for three months or more.

Pursuant to the proposal of the Director of the Department of Ethnic Affairs and Religion Propaganda;on Article 3. Types and forms of organization of medical examination and treatment facilities at the primary level as stipulated in Point c Clause 1 Article 22 of the Health Insurance Law

Medical examination and treatment facilities at the primary level include:development1. Polyclinics including: Polyclinics of agencies and units at battalion level and above, and military-civilian polyclinics.

PART I

GENERAL PROVISIONS

Article 1. Scope of Regulation

2. Specialized clinics including: Specialized clinics, doctor clinics, traditional medicine clinics, consultation and preventive treatment clinics, occupational disease treatment clinics of agencies and units at battalion level and above.

Article 2. Applicability

3. Military health services of agencies and units including: Military health services of agencies and units; clinics with individuals responsible for professional practice within a multi-disciplinary scope; Medical teams of agencies and units.

CLASSIFICATION OF TECHNICAL SPECIALTIES; GUIDANCE AND SUPPORT FOR TECHNICAL SPECIALTIES FOR MEDICAL EXAMINATION AND TREATMENT FACILITIES UNDER THE MINISTRY OF NATIONAL DEFENSE

3. Persons engaged in cryptographic work receiving salaries equivalent to military personnel working at the Cryptographic Agency under the Government; students in cryptographic training receiving living expenses from the state budget according to the regime and policies similar to those for military students.

4. Students undergoing reserve officer training for three months or more who have not joined social insurance and health insurance; defense workers and civil servants serving in the military when seeking medical examination and treatment.

5. Relatives of the subjects specified in Clause 2, 3, and 4 of this Article, except relatives of military students, students in cryptographic training receiving living expenses who are foreigners, and students undergoing reserve officer training for three months or more.

Article 3. Types and forms of organization of healthcare facilities providing primary healthcare services as stipulated in Point c Clause 1 Article 22 of the Health Insurance Law.

Healthcare facilities providing primary healthcare services include:

1. Multi-specialty clinics including: multi-specialty clinics of agencies and units at the regiment level and above, military-civilian clinics.

2. Specialized clinics including: specialized clinics, doctor clinics, traditional medicine clinics, consultation and preventive treatment clinics, occupational disease treatment clinics of agencies and units at the regiment level and above.

3. Military medical units including: military medical units; clinics with individuals responsible for professional supervision within the scope of general medical practice; Medical teams of agencies and units.

Chapter II

TECHNICAL SPECIALTY RANKING; TECHNICAL SPECIALTY GUIDANCE AND SUPPORT FOR HEALTHCARE FACILITIES

UNDER THE MINISTRY OF NATIONAL DEFENSE

BELONGING TO THE MINISTRY OF NATIONAL DEFENSE

Article 4. Classification of Professional Technical Levels

1. The method for calculating points to classify professional technical levels for medical examination and treatment facilities shall be implemented in accordance with the provisions set out in Appendix V attached to Decree No. 96/2023/NĐ-CP dated December 30, 2023, of the Government detailing certain articles of the Law on Medical Examination and Treatment.

2. The dossier, procedures, and authority for classifying professional technical levels shall be implemented in accordance with the provisions of Clauses 3, 4, and 5 of Article 36 of Decree No. 16/2024/NĐ-CP dated February 16, 2024, of the Government regarding medical practitioners and medical examination and treatment facilities under the People's Armed Forces.

Article 5. Directive and Support in Professional Technical Matters

1. Principles

a) Medical examination and treatment facilities shall provide directive and support in professional technical matters to facilities at the same level and lower levels;

b) Ensure compatibility with functions and tasks; the organizational system of military medicine; the area of deployment and specialized medical examination and treatment.

2. Tasks

a) Military hospitals under the Ministry of National Defense and the Military Medical Academy shall provide directive and support in professional technical matters to hospitals under the General Logistics Department - Engineering, military regions, corps, services, and formations; provide directive and support in professional technical matters according to each specialized field of medical examination and treatment based on their capacity;

b) Hospitals under the General Logistics Department - Engineering shall provide directive and support in professional technical matters to medical examination and treatment facilities under the General Logistics Department - Engineering and other medical examination and treatment facilities within the hospital’s jurisdiction when assigned; provide directive and support in professional technical matters according to each specialized field of medical examination and treatment based on their capacity;

c) Military region, corps, service, and formation hospitals shall provide directive and support in professional technical matters to medical examination and treatment facilities within the same military region, corps, service, and formation; other medical examination and treatment facilities within the hospital’s jurisdiction when assigned; provide directive and support in professional technical matters according to each specialized field of medical examination and treatment based on their capacity;

d) Division-level infirmaries and equivalent facilities shall provide directive and support in professional technical matters to medical examination and treatment facilities within the same division; other medical examination and treatment facilities within the infirmary’s jurisdiction when assigned; provide directive and support in professional technical matters according to each specialized field of medical examination and treatment based on their capacity;

e) Regiment-level infirmaries and equivalent facilities shall provide directive and support in professional technical matters to medical examination and treatment facilities within the same regiment; other medical examination and treatment facilities within the infirmary’s jurisdiction when assigned; provide directive and support in professional technical matters according to each specialized field of medical examination and treatment based on their capacity.

3. The Military Medicine Department shall be responsible for directing and guiding the implementation of Clause 2 of this Article.

Article 6. Content and Forms of Directive and Support in Professional Technical Matters

1. Content

a) Implement legal regulations on medical examination and treatment, rules and regulations, professional standards, ethical conduct, patient safety, communication skills, and behavior of medical practitioners;

b) Professional technical matters in medical examination and treatment activities;

c) Ensuring military medical readiness and responding to various situations;

d) Establishing and maintaining professional work routines and systems; organizing medical examinations and treatments;

e) Regular health check-ups; health check-ups for recruitment, military training, and recruitment; health check-ups based on mission requirements;

f) Managing and evaluating the quality of medical examination and treatment facilities; applying science, technology, and digital transformation in medical examination and treatment.

2. Forms

a) Direct directive and support in professional technical matters at medical examination and treatment facilities;

b) Accepting, training, and teaching professional technical matters to military medical staff upon request from agencies and units;

c) Providing remote directive and support in professional technical matters.

Chapter III

TECHNICAL LIST IN MEDICAL EXAMINATION AND TREATMENT

Article 7. Establishing a technical procedure list for medical examination and treatment

1. Based on the technical procedure list issued by the Ministry of Health, medical examination and treatment facilities shall establish a technical procedure list suitable to their functions and tasks; organizational structure and staffing; level of specialized technical expertise; actual conditions regarding infrastructure, material resources, medical equipment, human resources, and professional qualifications. Medical examination and treatment facilities may implement higher-level technical procedures when they meet the required conditions.

2. For technical procedures not included in the list issued by the Ministry of Health

a) Medical examination and treatment facilities must comply with the conditions and regulations stipulated in Articles 96, 97, 98, 99, 100, 101, 102, 103, and 104 of Decree No. 96/2023/NĐ-CP;

b) The proposed technical procedure list for approval shall be reported to the Military Health Administration in accordance with Clause 2 of Article 8 of this Circular.

Article 8. Approving the technical procedure list for medical examination and treatment

1. The Director of the Military Health Administration approves and supplements the technical procedure list for medical examination and treatment

a) The technical procedure list for basic and deep specialized levels of medical examination and treatment shall be approved separately for each medical examination and treatment facility;

b) The technical procedure list for initial level medical examination and treatment performed by doctors shall be based on Appendix I attached to this Circular;

c) The technical procedure list for initial level medical examination and treatment not performed by doctors shall be based on Appendix II attached to this Circular.

2. Approving the technical procedure list for medical examination and treatment

a) Hospitals (excluding hospitals under the Provincial Military Command) shall prepare the proposed technical procedure list for approval or supplementary approval according to the model specified in Appendix III attached to this Circular, along with a description of the facility's capacity in terms of infrastructure, human resources, and medical equipment, through the Military Medical Science Council, and report to the Military Health Administration;

b) Basic-level medical examination and treatment facilities not covered by point a of Clause 2 of this Article shall prepare the proposed technical procedure list for approval or supplementary approval according to the model specified in Appendix III attached to this Circular, along with a description of the facility's capacity in terms of infrastructure, human resources, and medical equipment, and submit it to the immediate superior military health authority for review, through the Military Medical Science Council, and report to the Military Health Administration;

c) Initial-level medical examination and treatment facilities implementing technical procedures outside the lists specified in Appendices I and II attached to this Circular must submit the documents specified in point d of Clause 2 of this Article to the immediate superior military health authority for review, through the Military Medical Science Council, and report to the Military Health Administration;

d) Documents proposing the approval of the technical procedure list for medical examination and treatment shall be submitted to the Military Health Administration, including: the proposed technical procedure list for approval or supplementary approval accompanied by an electronic version, a description of the facility's capacity in terms of infrastructure, human resources, and medical equipment, minutes of the Military Medical Science Council meeting, and a request from the hospital or the direct subordinate military health authority under the Ministry of National Defense;

đ) The Military Health Administration shall review; the Director of the Military Health Administration shall approve the technical procedure list for medical examination and treatment.

Chapter IV

EVALUATION OF MEDICAL EXAMINATION AND TREATMENT FACILITIES QUALITY

Article 9. Self-assessment of basic quality standards for medical examination and treatment facilities

1. Annually, medical examination and treatment facilities at the basic level and specialized level shall be responsible for self-assessing the basic quality standards in accordance with the basic quality standards for hospitals issued by the Ministry of Health and submit the results to the Military Medical Bureau.

2. The self-assessment documentation includes: A self-scoring sheet based on criteria; minutes of the meeting of the Military Medical Science Council; a description of the facility's capacity in terms of infrastructure, human resources, medical equipment, and a hospital’s request letter (excluding hospitals under the Provincial Military Command and centrally-administered city commands) or a military medical unit’s request letter directly under the Ministry of National Defense for remaining hospitals and dispensaries.

3. The assessment results shall be publicly posted in accordance with point b, Clause 1, Article 37 of Decree No. 16/2024/NĐ-CP.

Article 10. Quality Assessment of Medical Examination and Treatment Facilities

1. Based on the self-assessment results of medical examination and treatment facilities, the Military Medical Bureau will randomly select facilities for basic quality assessment.

2. The Military Medical Bureau will conduct assessments and publicly post the results of enhanced quality standards in accordance with Clause 2 and Clause 3, Article 37 of Decree No. 16/2024/NĐ-CP.

Chapter V

REGISTRATION FOR MEDICAL EXAMINATION AND TREATMENT; TRANSFER OF PATIENTS BETWEEN MEDICAL EXAMINATION AND TREATMENT FACILITIES

BETWEEN MEDICAL EXAMINATION AND TREATMENT FACILITIES

Article 11. Registration for Medical Examination and Treatment under Health Insurance

1. Principles of registration for medical examination and treatment

a) In line with the system of medical examination and treatment facilities under the Ministry of National Defense;

b) Participants in health insurance as stipulated in Clause 2, Clause 3, and Clause 4, Article 2 of this Circular shall register for initial medical examination and treatment under health insurance at medical examination and treatment facilities under the Ministry of National Defense and other facilities as prescribed by the Minister of Health, depending on their category;

c) Initial registration for medical examination and treatment under health insurance at medical examination and treatment facilities must ensure convenience for units' locations and residents' places of residence; ensuring personnel management and hierarchical task assignment;

d) Military medical units are responsible for advising the unit leaders to guide the initial registration for medical examination and treatment under health insurance in compliance with the principles.

2. Initial Registration for Medical Examination and Treatment under Health Insurance

a) Participants in health insurance from all categories may choose one of the medical examination and treatment facilities specified in Clause 1, Article 2 of this Circular at the primary level for initial registration for medical examination and treatment under health insurance;

b) Lower-ranking officers, soldiers, and students receiving subsistence allowances may register for initial medical examination and treatment under health insurance at the medical examination and treatment facilities specified in Clause 1, Article 2 of this Circular when their unit's location and the medical examination and treatment facility are within the same district, county, town, or province, or adjacent areas, subject to approval (in writing) by the battalion-level commander or equivalent;

c) Officers up to the rank of lieutenant colonel or with equivalent salary levels may register for initial medical examination and treatment under health insurance at basic-level medical examination and treatment facilities; if registering at specialized-level facilities, they must obtain written approval from battalion-level commanders or equivalents, consistent with the unit's location or the participant's place of residence;

d) Officers above the rank of lieutenant colonel or with equivalent salary levels may register for initial medical examination and treatment under health insurance at both basic-level and specialized-level medical examination and treatment facilities consistent with the unit's location or the participant's place of residence;

e) Individuals under the management and health protection as per Instruction No. 52-HD/BTCTW dated December 2, 2005, of the Central Organization Department of the Communist Party of Vietnam regarding the adjustment and supplementation of examination and treatment subjects at certain central medical facilities may register for initial medical examination and treatment under health insurance at basic-level and specialized-level medical examination and treatment facilities consistent with the workplace or place of residence of the health insurance participant and other regulations of the Ministry of Health;

f) Retired military personnel when registering for initial medical examination and treatment under health insurance at the medical examination and treatment facilities specified in Clause 1, Article 2 of this Circular shall follow points c and d of Clause 2 of this Article, consistent with their military rank or equivalent salary level at retirement and their place of residence;

g) Active-duty officers, non-commissioned officers, soldiers, and foreign military students may register for initial medical examination and treatment under health insurance at the medical examination and treatment facilities specified in Clause 1, Article 2 of this Circular, and upon presenting their health insurance card and a referral letter from a battalion-level or higher unit, they can receive health insurance benefits equivalent to those at the initially registered medical examination and treatment facility;

h) Individuals specified in Clause 5, Article 2 of this Circular may register for initial medical examination and treatment under health insurance at the medical examination and treatment facilities specified in Clause 1, Article 2 of this Circular near their place of residence and consistent with the facilities' capacity.

3. Change of Initial Registration Location

a) Health insurance participants may change their initial registration location for medical examination and treatment under health insurance during the first 15 days of each quarter;

b) Social Insurance agencies shall implement changes to the initial registration location for medical examination and treatment under health insurance for health insurance participants on the paper health insurance card or in the health insurance card database.

Article 12. Transfer of Patients Between Health Insurance Medical Examination and Treatment Facilities

1. Transfer of patients between health insurance medical examination and treatment facilities shall be based on the patient's condition and the professional capacity of the medical examination and treatment facility; such transfers shall be decided by the medical examination and treatment facility according to professional requirements and relevant laws on medical examination and treatment.

2. Transfer patients between healthcare facilities at the same level of medical examination and treatment, from primary healthcare facilities to basic healthcare facilities, and from basic healthcare facilities to specialized healthcare facilities based on professional requirements and the patient's condition. In cases where the professional capacity is exceeded, healthcare facilities have the responsibility to promptly transfer patients to other suitable healthcare facilities according to the patient's condition and the professional scope of the receiving healthcare facility.

3. Transfer patients who have been stably treated from specialized healthcare facilities or basic healthcare facilities back to lower-level or equivalent healthcare facilities when such facilities are overloaded or for management, monitoring, or continued treatment of chronic diseases listed in the disease catalog prescribed by the Minister of Health, or according to the wishes of the patient or their lawful representative, or upon request for military personnel management.

4. Patients may be transferred beyond their level in the following cases (excluding emergency cases):

a) Exceeding the treatment capacity of the immediate level;

b) Patients diagnosed with rare, serious, or surgical diseases requiring high-level techniques as specified in the disease catalog prescribed by the Minister of Health;

c) Patients with chronic diseases or long-term treatments as specified in the disease catalog prescribed by the Minister of Health, whose referral certificates remain valid for one year from the date of issuance;

d) Other cases decided by commanders at division level and above, with the approval (in writing) of the receiving healthcare facility.

5. In emergency cases, insured individuals can access all healthcare facilities. After the initial emergency treatment phase, patients are admitted for inpatient treatment at the facility that initially received them for emergency care or are transferred to another facility for continued treatment based on professional requirements, or they may be referred back to their initial healthcare facility after stable treatment.

Article 13. Rescheduling Appointments and Transferring Healthcare Facilities

1. Rescheduling appointments: Patients may be rescheduled for one or more follow-up appointments by healthcare facilities covered under health insurance if it is necessary to monitor the progression of their illness, stage of disease, or to recheck the results of previous examinations and treatments based on professional requirements, and procedures as prescribed by the Minister of Health.

2. Transferring healthcare facilities

a) For transferring healthcare facilities covered under health insurance due to professional requirements for inpatients, the transferring healthcare facility must provide a referral record in accordance with the regulations of the Minister of Health;

b) Insured individuals falling under point c, Clause 4, Article 12 of this Circular shall proceed as follows: If the validity period of the referral certificate has expired but the patient is still undergoing treatment and requires continued treatment at the healthcare facility, the referral certificate remains valid until the end of the current treatment period;

c) If a patient is transferred to another healthcare facility and has additional conditions not listed on the referral certificate, the receiving healthcare facility will provide medical services for these conditions based on the patient's condition and its own professional capacity and scope of medical activities;

d) If a patient is transferred to another healthcare facility and requires multiple treatment sessions based on professional requirements, the patient may continue using the referral certificate until the end of treatment, and each subsequent treatment session must have a rescheduling appointment certificate issued by the receiving healthcare facility;

e) If a patient is transferred to another healthcare facility or visits a non-primary healthcare facility and is then transferred to another facility, only the referral certificate from the directly transferring healthcare facility is required.

Chapter VI

IMPLEMENTING PROVISIONS

Article 14. Effective Date

1. This Circular takes effect from May 29, 2025, and replaces Circular No. 46/2016/TT-BQP dated April 1, 2016, issued by the Minister of National Defense, concerning the professional technical levels of medical examination and treatment for individuals managed by the Ministry of National Defense.

2. In cases where the legal normative documents cited in this Circular are amended, supplemented, or replaced, the new documents shall apply.

Article 15. Responsibility for Implementation

The Director of the General Logistics Department - Technical Service, heads of agencies and units, and relevant individuals are responsible for implementing this Circular./.

DEPUTY MINISTER          

MINISTER          

(Signed)                  

Lieutenant General Vu Hai San