Decision No. 27/2005/QD-BYT Regarding the Functions, Tasks, and Authorities of the Health Insurance Department

Pursuant to …;

Regarding the functions, tasks, and authorities of the Health Insurance Department

THE MINISTER OF HEALTH

Pursuant to Decree No. 86/2002/NĐ-CP dated November 5, 2002 of the Government stipulating the functions, tasks, powers, and organizational structure of ministries and ministerial-level agencies;

Pursuant to Decree No. 49/2003/NĐ-CP dated May 15, 2003 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

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

Pursuant to Decision No. 196/2005/QĐ-TTg dated August 8, 2005 of the Prime Minister on the establishment of the Health Insurance Department under the Ministry of Health;

At the proposal of the Director of the Organization and Cadres Department and the Director of the Health Insurance Department - Ministry of Health;

DECISION:

Article 1. Issuing with this Decision the "Regulations on the Functions, Tasks, and Authorities of the Health Insurance Department under the Ministry of Health".

Article 2. This Decision shall take effect fifteen days from the date of publication in the Official Gazette.

Abolishing Item 2 in the Regulation on the Functions and Tasks of the Treatment Department concerning health insurance issued pursuant to Decision No. 2964/2004/QĐ-BYT dated August 27, 2004 of the Minister of Health.

Article 3. The Heads of the Office, the Directors of the Organization and Cadres Department, the Health Insurance Department, the Inspectorate of the Ministry of Health, and the Heads of related units are responsible for implementing this Decision.

REGULATIONS

FUNCTIONS, TASKS, AND AUTHORITIES OF THE HEALTH INSURANCE DEPARTMENT
(Issued together with Decision No. 27/2005/QĐ-BYT dated September 13, 2005 of the Minister of Health)

1. Functions

The Health Insurance Department is a specialized management department under the Ministry of Health, having the function of advising the Minister of Health to manage state affairs in the field of health insurance throughout the country.

2. Tasks and Authorities

a) Drafting, amending, and supplementing draft laws, ordinances, and regulatory legal documents in the field of health insurance, submitting them to the Minister of Health for issuance within his/her authority or for the Minister to submit to competent authorities for issuance.

b) Drafting strategies, plans, long-term and short-term programs for the development of the health insurance industry towards universal health insurance, submitting them to the Minister of Health for approval within his/her authority or for the Minister to submit to the Government and the Prime Minister for approval and organizing their implementation after approval.

c) Taking the lead and coordinating with relevant units to draft and submit to the Minister of Health for issuance regulations on standards and technical expertise for healthcare facilities eligible to provide medical services to health insurance participants.

d) Taking the lead and coordinating with relevant units to draft, amend, and supplement lists of medicines, consumables, high-tech services, and large-cost items covered by the health insurance fund, and regulations and rules in the field of health insurance, submitting them to the Minister of Health for issuance.

đ) Participating in drafting hospital fee policies as the basis for payment of medical expenses from the health insurance fund. Studying and proposing measures to control health insurance medical expenses and measures to ensure and improve the quality of medical care for health insurance card holders.

e) Directing, guiding, and organizing the implementation of regulatory legal documents in the field of health insurance. Directing and guiding healthcare facilities to provide medical treatment, rehabilitation, and functional recovery services to patients with health insurance cards.

g) Taking the lead in organizing inspections; coordinating with the Inspectorate of the Ministry and relevant units to organize audits and handle violations of health insurance laws within their authority, resolving complaints and reports related to the field of health insurance.

h) Monitoring, evaluating, and summarizing activities in the field of health insurance.

i) Organizing scientific research and international cooperation in the field of health insurance.

k) Performing other tasks assigned by the Minister of Health.

3. Operation Mechanism and Staffing

a) Leadership of the Department:

The Director and Deputy Directors of the Department are appointed and relieved of duty by the Minister of Health. The Director is responsible to the Minister of Health for all activities of the Department. The Deputy Directors assist the Director and are responsible to the Director for the tasks assigned to them.

b) Specialists:

Specialists in the Department work under the specialist system and are responsible to the Department's leadership for the tasks assigned to them.

c) Staffing:

The staffing of the Department is determined by the Minister of Health and adjusted annually based on work needs and the proposal of the Director of the Health Insurance Department./.