Law on Health Insurance No. 25/2008/QH12

LAW

Health Insurance

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Pursuant to the Constitution of the Socialist Republic of Vietnam in 1992 as amended and supplemented by Resolution No. 51/2001/QH10;

The National Assembly enacts the Health Insurance Law,

Chapter I GENERAL PROVISIONS

Article 1. Scope of Regulation and Applicability

1. This Law stipulates the health insurance regime and policies, including the subjects, contribution levels, responsibilities, and methods of health insurance contributions; health insurance cards; scope of health insurance benefits; organization of medical examination and treatment for health insurance participants; payment of medical examination and treatment costs under health insurance; health insurance fund; rights and responsibilities of parties related to health insurance.

2. This Law applies to organizations and individuals within the country and foreign organizations and individuals in Vietnam that are related to health insurance.

3. This Law does not apply to commercial health insurance.

In this Law, the following terms shall be understood as follows:

2. Universal health insurance means that all subjects specified in this Law participate in health insurance.

3. The health insurance fund is a financial fund formed from health insurance contributions and other legitimate sources, used to pay for medical examination and treatment costs for health insurance participants, management expenses of health insurance organizations, and other legitimate expenses related to health insurance.

4. Employers include state agencies, public service units, people's armed forces units, political organizations, political-social organizations, occupational-political-social organizations, social organizations, occupational-social organizations, enterprises, cooperatives, individual business households, and other organizations; foreign organizations and international organizations operating on Vietnamese territory have the responsibility to contribute to health insurance.

5. Primary health insurance medical facilities are the first medical facilities registered by health insurance participants and recorded on their health insurance cards.

Article 3. Principles of health insurance

1. Ensuring risk sharing among health insurance participants.

4. Medical examination and treatment costs under health insurance are shared between the health insurance fund and health insurance participants.

5. The health insurance fund is managed centrally, uniformly, transparently, ensuring revenue-expenditure balance, and protected by the State.

Article 4. State policy on health insurance

1. The State contributes or supports health insurance contributions for persons who have rendered meritorious service to the revolution and certain social groups.

3. The State creates conditions for organizations and individuals to participate in health insurance or contribute to health insurance for certain groups.

4. The State encourages investment in developing advanced technology and equipment in health insurance management.

Article 5. State Management Authority for Health Insurance

1. The Government shall uniformly manage state affairs concerning health insurance.

2. The Ministry of Health shall be responsible before the Government for implementing state management over health insurance.

3. Ministries and equivalent agencies within their respective duties and authorities shall coordinate with the Ministry of Health to implement state management over health insurance.

4. People's Committees at all levels shall implement state management over health insurance within their respective duties and authorities in their localities.

Article 6. Responsibilities of the Ministry of Health regarding Health Insurance

To take the lead and coordinate with ministries, equivalent agencies, and related organizations to perform the following tasks:

2. Develop strategies, planning, and comprehensive plans for the development of health insurance;

5. Promote and disseminate policies and laws on health insurance;

6. Direct and guide the implementation of health insurance systems;

7. Inspect, audit, handle violations, and resolve complaints and denunciations related to health insurance;

8. Monitor, evaluate, and conclude activities in the field of health insurance;

1. Coordinate with the Ministry of Health and related agencies and organizations to develop policies and laws on finance related to health insurance.

2. Audit and inspect the implementation of legal provisions on financial regimes for health insurance and the health insurance fund.

Article 8. Responsibilities of People's Committees at All Levels Regarding Health Insurance

1. Within their respective duties and authorities, People's Committees at all levels shall have the following responsibilities:

a) Direct the organization and implementation of policies and laws on health insurance;

b) Ensure funding for health insurance contributions for groups covered by state budget payments or support as stipulated by this Law;

c) Promote and disseminate policies and laws on health insurance;

d) Inspect, audit, handle violations, and resolve complaints and denunciations related to health insurance.

1. Health insurance organizations shall have the function of implementing health insurance systems, policies, and laws, managing and using the health insurance fund.

2. The Government shall specify in detail the organizational structure, functions, tasks, and powers of health insurance organizations.

The State Audit Office shall conduct periodic audits of the health insurance fund every three years and report the results to the National Assembly. In cases where the National Assembly, the Standing Committee of the National Assembly, or the Government requests, the State Audit Office shall conduct ad hoc audits of the health insurance fund.

Article 11. Prohibited Acts

2. Fraudulently falsifying health insurance files and cards.

3. Misusing health insurance contributions and health insurance funds for purposes other than intended.

4. Obstructing, creating difficulties, or causing damage to the legitimate rights and interests of health insurance participants and related parties.

5. Intentionally reporting false information or providing inaccurate data about health insurance.

6. Abusing positions, powers, expertise, and professional duties to violate laws on health insurance.

Chapter II OBJECTS, CONTRIBUTION LEVELS, RESPONSIBILITIES, AND METHODS OF HEALTH INSURANCE CONTRIBUTIONS

1. Workers under indefinite-term labor contracts or definite-term labor contracts of three months or more as prescribed by labor laws; workers who are business managers receiving salaries or wages as prescribed by salary and wage laws; cadres, civil servants, and public officials as prescribed by laws (hereinafter collectively referred to as workers).

2. Officers, non-commissioned officers in specialized roles, and officers, non-commissioned officers in technical roles working in the People's Public Security Forces.

3. Persons receiving monthly pension or disability benefits.

4. Persons currently receiving monthly social insurance benefits due to work-related accidents or occupational diseases.

5. Persons who have ceased to receive disability benefits and are now receiving monthly allowances from the state budget.

6. Village, town, and township cadres who have retired and are now receiving monthly social insurance benefits.

7. Village, ward, and town cadres who have retired and are now receiving monthly allowances from the state budget.

8. Persons currently receiving unemployment benefits.

9. Persons with meritorious service to the revolution.

10. Veterans as prescribed by laws on veterans.

11. Persons directly participating in the resistance war against America to save the country as prescribed by the Government.

12. Current members of the National Assembly and People's Councils at all levels.

13. Persons entitled to monthly social assistance allowances as prescribed by laws.

14. Persons belonging to poor households; ethnic minorities living in areas with difficult economic and social conditions, particularly extremely difficult conditions.

15. Relatives of persons with meritorious service to the revolution as prescribed by laws on preferential treatment for persons with meritorious service to the revolution.

16. Relatives of the following objects as prescribed by laws on officers of the People's Army, conscription, and public security forces and cipher services:

a) Officers and professional soldiers of the People's Army who are currently serving; non-commissioned officers and soldiers of the People's Army who are currently serving;

b) Officers, non-commissioned officers in specialized roles, and officers, non-commissioned officers in technical roles working in the People's Public Security Forces; non-commissioned officers and public security soldiers serving for a limited period;

c) Officers and professional soldiers working in cipher services at the State Cipher Office and persons working in cipher services receiving salaries according to the officer rank pay scale of the People's Army and the professional soldier pay scale of the People's Army but not being military personnel or public security personnel.

17. Children under six years old.

18. A person who has donated a human organ or tissue in accordance with the laws on donation, collection, transplantation of tissues and organs, and donation and collection of corpses.

19. Foreign students studying in Vietnam who are granted scholarships from the State budget of the Socialist Republic of Vietnam.

20. Persons belonging to near-poor households.

21. Students.

22. Members of households engaged in agriculture, forestry, fishery, and salt production.

23. Relatives of workers prescribed in Clause 1 of this Article whom the workers are responsible for supporting and living together in the same household.

24. Cooperative members and individual business households.

25. Other objects as prescribed by the Government.

1. The contribution levels and responsibilities for health insurance contributions are prescribed as follows:

a) The monthly contribution level of objects prescribed in Clauses 1 and 2 of Article 12 of this Law shall be a maximum of 6% of the worker's monthly salary or wage, of which the employer contributes 2/3 and the worker contributes 1/3. During the period when the worker is on maternity leave or caring for a child under four months old as prescribed by laws on social insurance, the worker and the employer do not need to contribute to health insurance but still count towards continuous health insurance participation to enjoy health insurance benefits;

b) The monthly contribution level of objects prescribed in Clause 3 of Article 12 of this Law shall be a maximum of 6% of the pension or disability allowance and shall be paid by the social insurance organization;

c) The monthly contribution level of objects prescribed in Clauses 4, 5, and 6 of Article 12 of this Law shall be a maximum of 6% of the minimum wage and shall be paid by the social insurance organization;

d) The monthly contribution level of objects prescribed in Clause 8 of Article 12 of this Law shall be a maximum of 6% of the unemployment benefit and shall be paid by the social insurance organization;

đ) The monthly contribution level of objects prescribed in Clauses 7, 9, 10, 11, 12, 13, 14, 15, 16, 17, and 18 of Article 12 of this Law shall be a maximum of 6% of the minimum wage and shall be paid by the state budget;

e) The monthly contribution level of objects prescribed in Clause 19 of Article 12 of this Law shall be a maximum of 6% of the minimum wage and shall be paid by the agency, organization, or unit providing scholarships;

g) The monthly contribution level of objects prescribed in Clauses 20, 21, and 22 of Article 12 of this Law shall be a maximum of 6% of the minimum wage and shall be paid by the object; The state budget will support part of the health insurance contribution for objects prescribed in Clauses 20 and 21 of Article 12 of this Law and objects prescribed in Clause 22 of Article 12 of this Law who have an average standard of living;

h) The monthly contribution level of objects prescribed in Clause 23 of Article 12 of this Law shall be a maximum of 6% of the minimum wage and shall be paid by the worker;

i) The monthly contribution level of objects prescribed in Clause 24 of Article 12 of this Law shall be a maximum of 6% of the minimum wage and shall be paid by the object;

k) The monthly contribution level of objects prescribed in Clause 25 of Article 12 of this Law shall be a maximum of 6% of the minimum wage.

2. In cases where a person simultaneously belongs to multiple different health insurance objects prescribed in Article 12 of this Law, they shall contribute to health insurance according to the first object they are determined to belong to in the order of objects prescribed in Article 12 of this Law.

If the object prescribed in Clause 1 of Article 12 of this Law has additional indefinite-term labor contracts or definite-term labor contracts of three months or more, they shall contribute to health insurance according to the labor contract with the highest salary or wage.

3. The Government shall prescribe specific contribution levels and support levels as prescribed in Clause 1 of this Article.

Article 14. Wages, salaries, and allowances as the basis for health insurance contributions

1. For employees subject to wage systems prescribed by the State, the basis for health insurance contributions shall be the monthly salary according to rank, grade, military rank, and allowances for position, seniority exceeding the ceiling, and occupational seniority (if applicable).

2. For employees receiving wages and salaries as stipulated by their employers, the basis for health insurance contributions shall be the monthly wages and salaries recorded in the labor contracts.

3. For those receiving pensions, disability allowances, and monthly unemployment benefits, the basis for health insurance contributions shall be the monthly pension, disability allowance, and unemployment benefit.

1. Monthly, employers contribute health insurance for employees and deduct the health insurance contribution from the employees' wages and salaries to pay into the health insurance fund at the same time.

7. The Government shall specify the methods of health insurance contributions for the subjects specified in Clauses 20, 21, 22, 23, 24, and 25, Article 12 of this Law.

Chapter III

HEALTH INSURANCE CARD

Article 16. Health Insurance Cards

a) For individuals participating in health insurance under Clause 3, Article 50 of this Law who have continuously paid health insurance contributions from the second payment onwards, or those participating in health insurance under Clause 2, Article 51 of this Law, the health insurance card becomes valid from the date of health insurance payment;

b) For individuals participating in health insurance under Clause 3, Article 50 of this Law making their first payment or non-continuous payments, the health insurance card becomes valid thirty days after the date of health insurance payment; specifically, for high-tech medical service benefits, the health insurance card becomes valid one hundred eighty days after the date of health insurance payment;

4. The health insurance card is invalid in the following cases:

a) The card has expired;

b) The card has been altered or erased;

c) The named individual no longer participates in health insurance.

1. Documents for issuing health insurance cards include:

a) Registration documents for health insurance participation from agencies or organizations responsible for paying health insurance premiums as stipulated in Clause 1, Article 13 of this Law;

b) List of individuals participating in health insurance provided by agencies or organizations responsible for paying health insurance premiums as stipulated in Clause 1, Article 13 of this Law, or representatives of voluntary participants;

c) Application forms of individuals or households participating in health insurance.

2. Documents for issuing health insurance cards for children under six years old include:

a) Copies of birth certificates or copies of birth registration certificates. In cases where children do not have copies of birth certificates or birth registration certificates, confirmation letters from the People's Committee of the commune, ward, or town where the parents or guardians reside must be provided;

b) Lists or requests for issuance of health insurance cards from the People's Committee of the commune, ward, or town where the child resides.

3. Within ten working days from the date of receiving complete documents as specified in Clauses 1 and 2 of this Article, health insurance organizations must issue health insurance cards to participants.

Article 18. Reissuance of Health Insurance Cards

1. Health insurance cards will be reissued in case of loss.

2. Individuals who lose their health insurance cards must submit a request for reissuance.

Article 19. Replacement of Health Insurance Cards

1. Health insurance cards will be replaced in the following cases:

a) Ripped, torn, or damaged;

b) Change of initial medical examination and treatment registration place;

c) Incorrect information recorded on the card.

2. Documents for replacing health insurance cards include:

a) Request for replacement submitted by the participant;

b) Health insurance card.

3. Within seven working days from the date of receiving complete documents as specified in Clause 2 of this Article, health insurance organizations must replace the card for participants. During the waiting period for replacement, cardholders still enjoy the benefits of health insurance participants.

4. Individuals who receive replaced health insurance cards due to damage must pay fees. The Minister of Finance shall specify the fee for replacing health insurance cards.

Article 20. Revocation and Temporary Seizure of Health Insurance Cards

1. Health insurance cards will be revoked in the following cases:

a) Fraud in issuing health insurance cards;

2. Health insurance cards will be temporarily seized when individuals use another person’s health insurance card for medical examination and treatment. Cardholders whose cards are temporarily seized are responsible for retrieving their cards and paying fines as prescribed by law.

Chapter IV

SCOPE OF HEALTH INSURANCE BENEFITS

1. Health insurance participants are entitled to reimbursement for the following expenses:

1. When participating in health insurance and going for medical examination and treatment as prescribed in Articles 26, 27, and 28 of this Law, the insured person shall be reimbursed by the health insurance fund for medical examination and treatment costs within the scope of benefits as follows:

a) 100% of medical examination and treatment costs for subjects specified in Clauses 2, 9, and 17 of Article 12 of this Law;

b) 100% of medical examination and treatment costs for cases where the cost for one-time medical examination and treatment is lower than the level set by the Government and conducted at commune-level facilities;

c) 95% of medical examination and treatment costs for subjects specified in Clauses 3, 13, and 14 of Article 12 of this Law;

d) 80% of medical examination and treatment costs for other subjects.

2. In cases where one person belongs to multiple categories of health insurance participants, they shall enjoy health insurance benefits according to the category with the highest benefits.

3. The Government shall stipulate the reimbursement levels for medical examination and treatment costs for cases exceeding technical specialty lines, voluntary medical examinations and treatments, high-cost advanced medical services, and other cases not covered under Clause 1 of this Article.

Article 23. Cases Not Entitled to Health Insurance Benefits

1. Costs in cases prescribed in Clause 1 of Article 21 have been paid from the state budget.

2. Convalescence and recuperation at convalescent care facilities.

4. Prenatal testing and diagnosis not aimed at treatment.

5. Use of assisted reproductive technology, family planning services, abortion, except in cases where termination of pregnancy is necessary due to fetal pathology or maternal illness.

6. Use of aesthetic services.

11. Medical examination and treatment for drug addiction, alcoholism, or addiction to other substances.

13. Medical and forensic psychiatric examinations.

14. Participation in clinical trials and scientific research.

Chapter V

MEDICAL EXAMINATION AND TREATMENT ORGANIZATIONS FOR HEALTH INSURANCE PARTICIPANTS

1. Health insurance medical examination and treatment facilities are healthcare institutions that have signed contracts for medical examination and treatment with health insurance organizations.

2. Health insurance medical examination and treatment facilities include:

a) Commune health stations and equivalent facilities, midwifery houses;

b) Polyclinics and specialized clinics;

c) General hospitals and specialized hospitals.

Article 25. Health Insurance Medical Examination and Treatment Contracts

1. A health insurance medical examination and treatment contract is a written agreement between a health insurance organization and a medical examination and treatment facility regarding the provision of services and the reimbursement of health insurance medical examination and treatment costs.

2. A health insurance medical examination and treatment contract includes the following main contents:

b) Payment methods for medical examination and treatment costs;

c) Rights and responsibilities of the parties;

d) Duration of the contract;

d) Liability for breach of contract;

1. Health insurance participants have the right to register for initial health insurance medical examination and treatment at commune-level or district-level medical facilities or equivalent ones, except in cases where they are registered at provincial-level or central-level medical facilities according to the regulations of the Minister of Health.

In cases where health insurance participants work on a mobile basis or temporarily reside in another locality, they are entitled to undergo initial medical examination and treatment at medical facilities suitable with their professional technical level and location of mobile work or temporary residence as prescribed by the Minister of Health.

2. Health insurance participants may change their initial medical examination and treatment registration facility at the beginning of each quarter.

3. The name of the initial health insurance medical examination and treatment facility shall be recorded on the health insurance card.

In cases where the medical expertise and technical capacity is exceeded, the health insurance medical facility has the responsibility to promptly refer the patient to another health insurance medical facility according to the regulations on referral for professional technical levels.

1. When attending medical examination and treatment, health insurance participants must present their health insurance card with photograph; in cases where the health insurance card does not yet have a photograph, they must present the health insurance card together with personal identification documents; for children under six years old, only the health insurance card needs to be presented.

2. In emergency cases, health insurance participants can receive medical examination and treatment at any medical facility and must present their health insurance card along with the documents specified in Clause 1 of this Article before being discharged from the hospital.

3. In cases of referral for treatment, health insurance participants must have a transfer record from the medical facility.

4. In cases of follow-up medical examination and treatment as required, health insurance participants must have a re-examination appointment letter from the medical facility.

Article 29. Health Insurance Audit

1. The contents of health insurance audit include:

a) Checking the procedures for health insurance medical examination and treatment;

b) Reviewing and evaluating the prescription of treatment, use of drugs, chemicals, medical supplies, medical equipment, and medical technical services for patients;

c) Verifying and determining the costs of health insurance medical examination and treatment.

2. The health insurance audit must ensure accuracy, transparency, and fairness.

3. Health insurance organizations conduct health insurance audits and bear legal responsibility for the results of the audit.

Chapter VI

PAYMENT OF HEALTH INSURANCE MEDICAL EXAMINATION AND TREATMENT COSTS

1. The payment of health insurance medical examination and treatment costs shall be carried out through the following methods:

b) Payment based on service prices is payment based on the costs of drugs, chemicals, medical supplies, medical equipment, and medical technical services used for patients;

c) Payment based on disease cases is payment according to the pre-determined costs of medical examination and treatment for each case based on diagnosis.

2. The Government shall specify the detailed application of the payment methods for health insurance medical examination and treatment costs stipulated in Clause 1 of this Article.

1. Health insurance organizations shall pay medical examination and treatment costs under health insurance to healthcare facilities according to medical examination and treatment contracts under health insurance.

a) At healthcare facilities without medical examination and treatment contracts under health insurance;

b) In cases of medical examination and treatment not in accordance with the provisions of Articles 26, 27, and 28 of this Law;

c) Outside the country;

d) Other special cases as prescribed by the Minister of Health.

3. The Ministry of Health shall take the lead and coordinate with the Ministry of Finance to prescribe procedures and payment levels for the cases stipulated in Clause 2 of this Article.

1. Health insurance organizations shall be responsible for quarterly advance payments to healthcare facilities under health insurance at least equal to 80% of the actual medical examination and treatment costs under health insurance of the previous quarter that have been finalized. For healthcare facilities signing medical examination and treatment contracts under health insurance for the first time, the initial advance payment level shall be at least 80% of the health insurance medical examination and treatment budget for one quarter as stipulated in the signed contract.

2. The settlement and finalization between healthcare facilities and health insurance organizations shall be carried out quarterly as follows:

a) Within the first month of each quarter, healthcare facilities under health insurance shall be responsible for submitting reports on the finalization of medical examination and treatment costs under health insurance of the previous quarter to health insurance organizations;

b) Within thirty days from the date of receipt of the finalization report from healthcare facilities under health insurance, health insurance organizations shall be responsible for reviewing and notifying the results of the finalization of costs. Within fifteen days from the date of notification of the finalization results, health insurance organizations must complete the payment process with healthcare facilities.

3. Within forty days from the date of receiving all documents requesting payment from insured persons for medical examination and treatment as prescribed in Points a and b of Clause 2 of Article 31 of this Law; within sixty days from the date of receiving all documents requesting payment from insured persons for medical examination and treatment as prescribed in Points c and d of Clause 2 of Article 31 of this Law, health insurance organizations must directly pay medical examination and treatment costs to these subjects.

CHAPTER VII

HEALTH INSURANCE FUND

Article 33. Sources of formation of the health insurance fund

1. Health insurance contributions as prescribed by this Law.

2. Profits from the investment activities of the health insurance fund.

3. Sponsorship and aid from domestic and foreign organizations and individuals.

4. Other lawful sources of income.

Article 34. Management of the health insurance fund

1. The Health Insurance Fund shall be used for the following purposes:

a) Paying for health insurance examination and treatment costs;

b) Administrative expenses for managing the health insurance organization according to the administrative expenditure standards of state agencies;

c) Investing to preserve and increase the Health Insurance Fund in accordance with the principles of safety and efficiency;

d) Establishing a reserve fund for health insurance examinations and treatments. The minimum reserve fund must equal the total examination and treatment costs of the two preceding quarters, and the maximum cannot exceed the total examination and treatment costs of the two preceding years.

2. In cases where provinces and centrally governed cities have higher health insurance revenue than their health insurance examination and treatment expenditures, they may use part of the surplus to serve health insurance examinations and treatments at the local level.

3. The Government shall specify this Article.

CHAPTER VIII

RIGHTS AND RESPONSIBILITIES OF PARTIES RELATED TO HEALTH INSURANCE

Article 36. Rights of Health Insurance Participants

1. Receiving a health insurance card upon payment of health insurance premiums.

3. Being entitled to health examinations and treatments.

4. Having the health insurance organization pay for health examination and treatment costs under the health insurance scheme.

5. Requesting the health insurance organization, health insurance examination and treatment facilities, and relevant authorities to explain and provide information on the health insurance scheme.

6. Complaining and reporting violations of health insurance laws.

Article 37. Obligations of Health Insurance Participants

1. Paying full health insurance premiums on time.

2. Using the health insurance card for its intended purpose and not lending it to others.

3. Adhering to the provisions of Article 28 of this Law when seeking health examinations and treatments.

4. Following the regulations and instructions of the health insurance organization and healthcare facilities when seeking health examinations and treatments.

5. Paying for health examination and treatment costs to healthcare facilities outside of the portion covered by the health insurance fund.

Article 38. Rights of Organizations and Individuals Paying Health Insurance Premiums

1. Requesting the health insurance organization and competent state agencies to explain and provide information on the health insurance scheme.

2. Complaining and reporting violations of health insurance laws.

Article 39. Responsibilities of Organizations and Individuals Paying Health Insurance Premiums

1. Preparing application files for health insurance cards.

2. Paying full health insurance premiums on time.

4. Providing complete and accurate information and documents related to the responsibility of employers and representatives of health insurance participants when requested by the health insurance organization, employees, or employee representatives.

5. Adhering to inspections and audits regarding the implementation of health insurance laws.

Article 40. Rights of Health Insurance Organizations

1. Requesting employers, representatives of health insurance participants, and health insurance participants to provide complete and accurate information and documents related to their responsibilities in implementing health insurance.

3. Requesting health insurance examination and treatment facilities to provide medical records and other documents related to examinations and treatments for health insurance appraisal purposes.

4. Refusing to pay health insurance examination and treatment costs that do not comply with the provisions of this Law or do not conform to the terms of the health insurance examination and treatment contract.

5. Requesting responsible parties to reimburse health insurance examination and treatment costs paid by the health insurance organization to health insurance participants.

6. Proposing to competent state agencies to amend and supplement health insurance policies and laws, and handle organizations and individuals violating health insurance laws.

Article 41. Responsibilities of Health Insurance Organizations

1. Propaganda and dissemination of policies and laws on health insurance.

3. Collect health insurance premiums and issue health insurance cards.

4. Manage and utilize the health insurance fund.

5. Sign health insurance medical examination and treatment contracts with medical establishments.

6. Pay costs for health insurance medical examinations and treatments.

7. Provide information about health insurance medical establishments and guide health insurance participants to choose primary medical establishments.

9. Protect the rights of health insurance participants; resolve complaints, grievances, and accusations regarding health insurance benefits within their authority.

11. Organize statistical work, reporting, and provide guidance on health insurance business; report periodically or urgently when required for managing and using the health insurance fund.

12. Organize training, enhance professional skills, conduct scientific research, and international cooperation on health insurance.

Article 42. Rights of Health Insurance Medical Establishments

1. Request health insurance organizations to provide complete and accurate information related to health insurance participants, medical examination and treatment expenses for health insurance participants at the medical establishment.

2. Be temporarily funded and paid for medical examination and treatment costs according to signed medical examination and treatment contracts by health insurance organizations.

3. Recommend to competent state agencies to handle violations of health insurance laws by organizations and individuals.

Article 43. Responsibilities of Health Insurance Medical Establishments

1. Organize medical examinations and treatments to ensure quality with simple procedures convenient for health insurance participants.

3. Ensure necessary conditions for health insurance organizations to perform appraisal work; cooperate with health insurance organizations in propaganda and explanation of health insurance benefits to health insurance participants.

4. Inspect, identify, and notify health insurance organizations of cases of violation in using health insurance cards; cooperate with health insurance organizations to recover or temporarily hold health insurance cards for cases stipulated in Article 20 of this Law.

5. Manage and use funds from the health insurance fund according to legal regulations.

Article 44. Rights of Labor Union Organizations and Employers' Organizations

1. Request health insurance organizations, medical establishments, and employers to provide complete and accurate information related to laborers' health insurance benefits.

2. Recommend to competent state agencies to handle violations of health insurance laws that affect the legitimate rights and interests of workers and employers.

Article 45. Responsibilities of organizations representing employees and organizations representing employers

1. Propaganda and dissemination of policies and laws on health insurance for employees and employers.

2. Participation in building and proposing amendments and supplements to policies and laws on health insurance.

Chapter IX

INSPECTION, COMPLAINTS, REPORTING, RESOLUTION OF DISPUTES AND HANDLING OF VIOLATIONS REGARDING HEALTH INSURANCE

Article 46. Health Insurance Inspection

The health inspection agency performs the specialized inspection function regarding health insurance.

Article 47. Complaints and Reports Regarding Health Insurance

Matters concerning complaints and their resolution against administrative decisions and administrative acts related to health insurance, as well as reports and their resolution regarding violations of laws on health insurance shall be carried out in accordance with the provisions of the law on complaints and reports.

Article 48. Disputes Regarding Health Insurance

1. Disputes regarding health insurance are disputes related to rights, obligations, and responsibilities under health insurance between the following entities:

a) Individuals participating in health insurance as stipulated in Article 12 of this Law and representatives of such individuals;

b) Organizations and individuals paying health insurance premiums as stipulated in Clause 1, Article 13 of this Law;

c) Health insurance organizations;

d) Medical facilities providing health insurance services.

2. Disputes regarding health insurance shall be resolved as follows:

a) The disputing parties have the responsibility to resolve disputes through self-mediation.

b) If amicable settlement fails, the disputing parties have the right to initiate litigation at the court in accordance with the provisions of the law.

1. Any person who violates the provisions of this Law and other relevant laws on health insurance shall be subject to disciplinary action, administrative penalties, or criminal prosecution, depending on the nature and severity of the violation; if damage is caused, compensation must be provided according to the law.

2. Agencies, organizations, and employers that have the responsibility to pay health insurance premiums but fail to pay or pay insufficiently as required by law must, in addition to paying the outstanding amount, also pay interest on the overdue amount at the basic interest rate published by the State Bank; if they fail to comply, upon request from the competent authority handling administrative violations, banks, credit institutions, and state treasuries shall be responsible for deducting the outstanding amount and interest from the accounts of those responsible for paying health insurance premiums and depositing them into the health insurance fund account.

CHAPTER X

IMPLEMENTING PROVISIONS

Article 50. Transitional Provisions

1. Health insurance cards and free medical examination and treatment cards for children under six years old issued before the effective date of this Law shall have the following validity:

a) According to the period indicated on the card in cases where the card indicates validity until December 31, 2009;

b) Until December 31, 2009 in cases where the card indicates validity after December 31, 2009.

2. The scope of benefits for individuals holding health insurance cards issued before the effective date of this Law shall be implemented according to the current regulations of the law on health insurance until December 31, 2009.

3. Subjects specified in Clauses 21, 22, 23, 24, and 25 of Article 12 of this Law, who have not yet complied with Points b, c, d, and đ of Clause 2, Article 51 of this Law, may voluntarily participate in health insurance in accordance with the Government's regulations.

Article 51. Effective Date

1. This Law takes effect from July 1, 2009.

2. The implementation roadmap for universal health insurance is as follows:

a) Subjects specified from Clause 1 to Clause 20 of Article 12 of this Law shall implement health insurance from the date this Law comes into effect;

b) Subjects specified in Clause 21 of Article 12 of this Law shall implement health insurance from January 1, 2010;

c) Subjects specified in Clause 22 of Article 12 of this Law shall implement health insurance from January 1, 2012;

d) Subjects specified in Clause 23 and Clause 24 of Article 12 of this Law shall implement health insurance from January 1, 2014;

đ) Subjects specified in Clause 25 of Article 12 of this Law shall implement health insurance in accordance with the Government's regulations no later than January 1, 2014.

Article 52. Detailed regulations and guidance on implementation

The Government shall provide detailed regulations and guidance on the implementation of the provisions assigned in this Law; provide necessary guidance on other contents of this Law to meet the requirements of state management.

This Law was passed by the National Assembly of the Socialist Republic of Vietnam, the fourth session of the twelfth term, on November 14, 2008./.