JOINT CIRCULAR No. 24/2014/TTLT-BYT-BTC Amending and supplementing certain provisions of Joint Circular No. 09/2009/TTLT-BYT-BTC dated August 14, 2009 of the Ministry of Health and the Ministry of Finance guiding the implementation of health insurance

JOINT CIRCULAR

Amending and supplementing certain articles of Joint Circular No. 09/2009/TTLT-BYT-BTC dated August 14, 2009 of the Ministry of Health and the Ministry of Finance guiding the implementation of health insurance

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Pursuant to the Health Insurance Law dated November 14, 2008;

Pursuant to Decree No. 62/2009/NĐ-CP dated July 27, 2009 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law;

Pursuant to Decree No. 60/2003/NĐ-CP dated June 6, 2003, promulgated by the Government detailing and guiding the implementation of the Law on State Budget;

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 and supplementing certain articles of Joint Circular No. 09/2009/TTLT-BYT-BTC dated August 14, 2009 of the Ministry of Health and the Ministry of Finance guiding the implementation of health insurance (hereinafter referred to as Joint Circular No. 09/2009/TTLT-BYT-BTC).

Article 1. Amending and supplementing certain articles of Joint Circular No. 09/2009/TTLT-BYT-BTC

1. Amending and supplementing Clauses 10, 11, and Clause 13 of Article 1 as follows:

"10. Veterans who participated in the resistance war from April 30, 1975, forward according to Clause 6, Article 5 of Decree No. 150/2006/NĐ-CP dated December 12, 2006 of the Government detailing and guiding the implementation of certain provisions of the Ordinance on Veterans; young volunteers according to Decision No. 170/2008/QĐ-TTg dated December 18, 2008 of the Prime Minister regarding the health insurance and funeral allowance regime for young volunteers during the anti-French resistance war and Decision No. 40/2011/QĐ-TTg dated July 27, 2011 of the Prime Minister regarding the regime for young volunteers who have completed their tasks in the resistance war.

11. Individuals directly participating in the resistance war against America to save the country and in the war to protect the homeland and international missions in Cambodia and assisting Laos after April 30, 1975, who have been demobilized, discharged, or retired are the subjects defined in the following Decisions of the Prime Minister, including:

a) Decision No. 290/2005/QĐ-TTg dated November 8, 2005 of the Prime Minister on the regime and policies for some individuals directly participating in the resistance war against America but not yet enjoying the policies of the Party and State and Decision No. 188/2007/QĐ-TTg dated December 6, 2007 of the Prime Minister on supplementing and amending Decision No. 290/2005/QĐ-TTg;

b) Decision No. 53/2010/QĐ-TTg dated August 20, 2010 of the Prime Minister on the regime for police officers who participated in the resistance war against America with less than 20 years of service in the People's Public Security and have retired, been discharged, or left their jobs;

c) Decision No. 142/2008/QĐ-TTg dated October 27, 2008 of the Prime Minister on implementing the regime for military personnel who participated in the resistance war against America with less than 20 years of service in the military and have been demobilized, discharged, or left their jobs and Decision No. 38/2010/QĐ-TTg dated May 6, 2010 of the Prime Minister on amending and supplementing Decision No. 142/2008/QĐ-TTg;

d) Decision No. 62/2011/QĐ-TTg dated November 9, 2011 of the Prime Minister on the regime and policies for individuals participating in the war to protect the homeland and international missions in Cambodia and assisting Laos after April 30, 1975, who have been demobilized, discharged, or left their jobs."

13. Individuals entitled to monthly social assistance benefits as prescribed in Decree No. 136/2013/NĐ-CP dated October 21, 2013 of the Government on social assistance policies for social welfare beneficiaries, Decree No. 06/2011/NĐ-CP dated January 14, 2011 of the Government detailing and guiding the implementation of certain provisions of the Law on Elderly Persons, and Decree No. 28/2012/NĐ-CP dated April 10, 2012 of the Government detailing and guiding the implementation of certain provisions of the Law on Persons with Disabilities.”

2. Amending Point a Clause 2 and supplementing Clause 6 of Article 8 as follows:

"2…

a) The health insurance fund shall pay transportation costs, both ways, for transferring patients to healthcare facilities at a rate of 0.2 liters of gasoline per kilometer based on administrative boundaries and the gasoline price at the time of use. If more than one patient is transported together on the same vehicle, the payment rate will be calculated as if only one patient were being transported. The receiving healthcare facility must sign confirmation on the dispatch form of the transferring healthcare facility; in cases outside regular working hours, the signature of the on-duty doctor from the Outpatient Department or Emergency Department of the receiving healthcare facility is required."

6. Health insurance payments in certain cases:

a) For technical services performed by medical staff of higher-level healthcare facilities at the site under the program of direct guidance, support projects, and capacity enhancement for lower-level facilities:

- In cases where the service is included in the technical service catalog approved by the competent authority according to the division of technical specialties, the health insurance fund shall pay according to the approved price of the technical service;

- In cases where the service is not included in the technical service catalog approved by the competent authority according to the division of technical specialties and the price of medical services, the health insurance fund shall temporarily pay according to the approved price of the medical service of the transferring facility. The receiving healthcare facility has the responsibility to notify the Social Insurance Provincial Office about the technical services carried out under the program and project, and simultaneously submit to the competent authority for approval of the technical service catalog and the price of medical services as the basis for health insurance payments.

b) For high-cost technical services:

The health insurance payment level for each patient is calculated according to the benefit level of the group of subjects as stipulated. The total cost to determine the health insurance payment level for each patient includes the cost of performing the technical service at the approved price of the service and the cost of necessary medical supplies within the health insurance fund's payment scope issued by the Ministry of Health but not included in the price of the technical service.

3. Amending and supplementing Clause 3 of Article 11 as follows:

"3. The Department of Health shall, based on the specific situation of the locality, define village health stations, workplace health units, and school health units located within the area that meet the conditions in terms of human resources, infrastructure, and equipment for health insurance medical examination and treatment, and at the same time define the scope of expertise, drug list, and technical service catalog that can be implemented at these health stations."

For border areas, islands, regions with difficult economic and social conditions, and particularly difficult regions: based on the list of military health facilities that meet the conditions regarding human resources, infrastructure, and medical examination and treatment equipment provided by the Military Health Administration under the Ministry of National Defense, the Department of Health shall take the lead and coordinate with the Social Insurance Provincial Branch to guide the signing of health insurance medical examination and treatment contracts with military health facilities to serve patients holding health insurance cards within the area.

4. Amend Clause 3 and Point b of Clause 4 of Article 15 as follows:

"3. Monitor and adjust the fixed-rate fund:

When there are changes in the fee rate, group of subjects, and number of health insurance cards registered at the medical examination and treatment facility, the Social Insurance Provincial Branch shall notify the medical examination and treatment facility of the number of health insurance cards according to each group of subjects and the total fixed-rate fund available for use. In cases where additional medical examination and treatment costs arise due to changes in service fees, application of new medical services, or changes in the functions and tasks of the medical examination and treatment facility, both parties shall agree to determine the new fee rate and adjust the fixed-rate fund accordingly.

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b) If the fixed-rate fund has surplus funds, the healthcare facility may record these as part of the unit's income. If the fixed-rate fund includes costs for medical examinations and treatments at commune health stations, the entity responsible for signing medical examination and treatment contracts at these stations must allocate a portion of the surplus to each commune health station according to the number of cards registered at each station. The maximum surplus retained cannot exceed 20% of the fixed-rate fund; the remaining amount shall be transferred to the provincial common medical examination and treatment fund for management and use.

5. Amend Clause 1 of Article 24 as follows:

"1. Issuing health insurance cards and implementing health insurance for certain groups:

a) The Vietnam Social Security is responsible for guiding the procedures and formalities for issuing new, replacement, and exchange health insurance cards. Health insurance cards have a minimum validity period of one year. In cases where employees sign labor contracts for less than one year and those receiving unemployment benefits, the validity period of the health insurance card shall be determined by the Vietnam Social Security.

b) For children under six years old, the People's Committee of communes, wards, and towns shall be responsible for compiling a list of children born in the month on their territory and transferring it to the Social Security for issuance of health insurance cards.

c) For individuals who have donated body parts in accordance with the laws on donation, collection, and transplantation of human tissues and organs and donation and collection of corpses:

- The medical facility where the body part was collected shall be responsible for clearly recording the donated body part on the discharge certificate issued to the donor.

- The donor or their relatives shall bring the discharge certificate to the Social Insurance District Office where they reside to obtain their first health insurance card. The validity period of the card shall be determined by the Vietnam Social Security.

- The effective date of the health insurance card and the start of health insurance contributions shall be from the first day of the month immediately following the month recorded on the discharge certificate.

- Based on the initial recipients of health insurance cards, the Social Security Provincial Office shall be responsible for managing the list of recipients to ensure continuous and timely issuance of subsequent cards.

d) For civil servants and public officials during the period of temporary detention, arrest, or suspension of duties pending disciplinary action, who still receive 50% of their current salary according to their rank and grade and are entitled to recover the remaining 50% of their current salary if not disciplined or found innocent according to Article 24 of Decree No. 34/2011/ND-CP dated May 17, 2011, and Article 23 of Decree No. 27/2012/ND-CP dated April 6, 2012 of the Government, they must continue to pay health insurance contributions at 50% of their actual salary. If they are not disciplined or found innocent and thus recover the remaining salary, the Social Insurance agency shall collect the corresponding health insurance contributions for the period of temporary detention, arrest, or suspension of duties.

Article 2. Effective Date

This Circular takes effect from September 1, 2014. During implementation, if any difficulties arise, please promptly report them to the Ministry of Health and the Ministry of Finance for research and resolution.