Circular No. 36/2021/TT-BYT stipulates medical examination, treatment, and health insurance cost reimbursement related to tuberculosis examination and treatment.

CIRCULAR

Regulations on medical examination and treatment and payment of costs for medical examination and treatment under health insurance related to tuberculosis medical examination and treatment

treatment of health insurance related to tuberculosis diagnosis and treatment

Pursuant to the Health Insurance Law dated November 14, 2008, amended and supplemented by certain articles according to the Health Insurance Law dated June 13, 2014;

Pursuant to Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government detailing and guiding methods for implementing certain provisions of the Health Insurance Law;

Pursuant to the Government's Decree No. 75/2017/NĐ-CP dated June 20, 2017 stipulating the functions, tasks, powers, and organizational structure of the Ministry of Health;

At the request of the Director of the Health Insurance Department,

The Minister of Health issues this Circular regulating medical examination and treatment and payment of costs for medical examination and treatment under health insurance related to tuberculosis medical examination and treatment.

PART I

GENERAL PROVISIONS

Article 1. Scope of Regulation

This Circular stipulates on:

1. Medical examination and treatment and payment of costs for medical examination and treatment under health insurance related to tuberculosis medical examination and treatment.

2. Centralized procurement at the national level of anti-tuberculosis drugs using funds as stipulated in point a, Clause 1, Article 35 of the Health Insurance Law (hereinafter referred to as anti-tuberculosis drugs using the Health Insurance Fund).

Article 2. General Principles

1. Persons participating in health insurance suspected of having tuberculosis, suffering from tuberculosis, drug-resistant tuberculosis, latent tuberculosis, and persons using healthcare services related to tuberculosis medical examination and treatment:

a) Shall be reimbursed for costs of medical examination and treatment by the Health Insurance Fund in accordance with laws on health insurance and this Circular;

b) When using healthcare services related to diagnosis and treatment of tuberculosis, the Health Insurance Fund shall cover costs of medical examination and treatment in accordance with the Ministry of Health's Guidelines for Diagnosis, Treatment, and Prevention of Tuberculosis;

2. The centralized procurement at the national level of anti-tuberculosis drugs using the Health Insurance Fund shall be implemented in accordance with this Circular. For contents not specified in this Circular, they shall be carried out in accordance with the bidding procurement of medicines as stipulated in Circular No. 15/2019/TT-BYT dated July 11, 2019 of the Minister of Health on bidding for medicines at public healthcare facilities (hereinafter referred to as Circular No. 15/2019/TT-BYT).

Chapter II

MEDICAL EXAMINATION AND TREATMENT AND PAYMENT OF COSTS FOR MEDICAL EXAMINATION AND TREATMENT UNDER HEALTH INSURANCE RELATED TO TUBERCULOSIS MEDICAL EXAMINATION AND TREATMENT

1. Medical examination and treatment facilities at the commune level and equivalent (hereinafter referred to as the commune level) shall implement tuberculosis medical examination and treatment for persons participating in health insurance in accordance with Article 3 of Circular No. 40/2015/TT-BYT dated November 16, 2015 of the Minister of Health on registration for initial medical examination and treatment under health insurance and transfer for medical examination and treatment under health insurance (hereinafter referred to as Circular No. 40/2015/TT-BYT).

2. Medical examination and treatment facilities at the district level and equivalent (hereinafter referred to as the district level) shall implement tuberculosis medical examination and treatment for persons participating in health insurance, including:

a) Medical examination and treatment facilities at the district level as stipulated in Article 4 of Circular No. 40/2015/TT-BYT;

b) District hospitals, urban district hospitals, provincial city hospitals, and central city hospitals that have been granted permits to operate medical examination and treatment and meet the conditions to provide tuberculosis medical examination and treatment services in accordance with regulations;

c) Private hospitals ranked equivalent to Class III, equivalent to Class IV, or not yet ranked equivalent.

3. Medical examination and treatment facilities at the provincial level and equivalent (hereinafter referred to as the provincial level) shall implement tuberculosis medical examination and treatment for persons participating in health insurance, including:

a) Medical examination and treatment facilities at the provincial level and equivalent as stipulated in Article 5 of Circular No. 40/2015/TT-BYT;

b) Tuberculosis and Pulmonary Hospitals; Pulmonary Hospitals; Provincial and centrally-administered municipal hospitals with specialized pulmonary departments;

c) Private hospitals ranked equivalent to Class I, equivalent to Class II with specialized tuberculosis and pulmonary departments;

d) Other medical examination and treatment facilities assigned by competent state authorities to lead provincial-level tuberculosis prevention and control work.

4. Medical examination and treatment facilities at the central level and equivalent (hereinafter referred to as the central level) shall implement tuberculosis medical examination and treatment for persons participating in health insurance, including:

a) Facilities as stipulated in Article 6 of Circular No. 40/2015/TT-BYT;

b) Hospitals and institutes with beds directly under the Ministry of Health.

1. The transfer of medical examination and treatment routes for tuberculosis patients participating in health insurance shall be carried out in accordance with the provisions of Circular No. 40/2015/TT-BYT and one of the specific cases stipulated in Clauses 2, 3, 4, and 5 of this Article.

2. A person participating in health insurance suspected of having tuberculosis, suffering from tuberculosis, suffering from drug-resistant tuberculosis, or latent tuberculosis is considered to be within the correct medical examination and treatment route for health insurance when they fall under the cases specified in Article 6 of Circular No. 30/2020/TT-BYT dated December 31, 2020, issued by the Minister of Health detailing and guiding the implementation of certain provisions of Decree No. 146/2018/NĐ-CP dated October 17, 2018, of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law.

3. A person suspected of having tuberculosis, suffering from tuberculosis, or latent tuberculosis is considered to be within the correct medical examination and treatment route for health insurance in the following cases:

a) Complying with the provisions of Clauses 1 and 2 of this Article;

b) Registering for initial medical examination and treatment at the commune level and being transferred to the provincial level and vice versa.

4. A person suffering from drug-resistant tuberculosis is considered to be within the correct medical examination and treatment route for health insurance in the following cases:

a) Complying with the provisions of Clauses 1 and 2 of this Article;

b) Registering for initial medical examination and treatment at the commune level and being transferred to the provincial level and vice versa;

c) Registering for initial medical examination and treatment at the district level and being transferred to the central level and vice versa.

5. In the case where a person participating in health insurance does not know that they have tuberculosis but first visits a medical facility and is diagnosed with tuberculosis, subsequently, the patient is transferred according to the provisions of Clauses 1, 2, 3, and 4 of this Article.

Article 5. Payment of costs for medical examination and treatment under health insurance for persons suspected of having tuberculosis, suffering from tuberculosis, suffering from drug-resistant tuberculosis, latent tuberculosis, and users of healthcare services related to tuberculosis treatment

1. The payment of costs for medical examination and treatment under health insurance for persons suspected of having tuberculosis, suffering from tuberculosis, suffering from drug-resistant tuberculosis, latent tuberculosis, and users of healthcare services related to tuberculosis treatment shall be carried out in accordance with the laws on medical examination and treatment and health insurance. The health insurance fund will pay the costs of medical examination and treatment for the aforementioned patients when prescribed by:

a) A person holding a practice certificate for medical examination and treatment with a scope of professional activities specializing in tuberculosis or lung diseases;

b) A person holding a practice certificate for medical examination and treatment who does not fall under the case specified in point a of this clause must undergo training in tuberculosis treatment according to the Guidelines for Diagnosis, Treatment, and Prevention of Tuberculosis issued by the Ministry of Health;

c) A person responsible for prescribing medication in the cases specified in Article 6 of this Circular.

Article 6. Guidelines for dispensing anti-tuberculosis drugs using the Health Insurance Fund for insured persons undergoing inpatient treatment

In cases where patients are currently receiving outpatient treatment with anti-tuberculosis drugs but must be admitted for inpatient treatment for tuberculosis-related diseases or unrelated diseases, and during inpatient treatment, they run out of anti-tuberculosis drugs or such drugs are not available, they will be reimbursed by the Health Insurance Fund under certain circumstances as follows:

1. When the inpatient treatment department is within the same medical examination and treatment facility where the patient is currently receiving outpatient tuberculosis treatment:

a) The patient may continue to receive drugs at the outpatient tuberculosis treatment location or receive drugs at the inpatient treatment department if the doctor in the inpatient treatment department meets the conditions to prescribe anti-tuberculosis drugs as stipulated in points a and b of Clause 1, Article 5 of this Circular;

b) If the doctor in the inpatient treatment department does not meet the conditions to prescribe anti-tuberculosis drugs as stipulated in points a and b of Clause 1, Article 5 of this Circular, then a consultation must be held and agreement reached with the doctor at the outpatient tuberculosis treatment location to prescribe anti-tuberculosis drugs for the patient. Anti-tuberculosis drugs prescribed under points a and b of this clause must be recorded in the medical record, outpatient book, and dispensed together with inpatient treatment drugs.

2. When the medical examination and treatment facility where the patient is receiving inpatient treatment is different from the medical examination and treatment facility where the patient is currently receiving outpatient tuberculosis treatment:

a) If the medical examination and treatment facility where the patient is currently receiving inpatient treatment has anti-tuberculosis drugs, the patient can receive and use these drugs at this facility. The patient needs to present the outpatient book detailing the treatment regimen and the quantity of anti-tuberculosis drugs already provided as the basis for subsequent drug issuance. The doctor in the inpatient treatment department shall issue a prescription for anti-tuberculosis drugs if they meet the conditions to prescribe according to points a and b of Clause 1, Article 5 of this Circular.

If the doctor in the inpatient treatment department does not meet the conditions to prescribe anti-tuberculosis drugs as stipulated in points a and b of Clause 1, Article 5 of this Circular, they shall issue a prescription for anti-tuberculosis drugs strictly following the regimen the patient is currently using, which is recorded in the patient's outpatient book. Anti-tuberculosis drugs must be recorded in the medical record, outpatient book, and dispensed together with inpatient treatment drugs.

b) If the medical examination and treatment facility where the patient is currently receiving inpatient treatment does not have anti-tuberculosis drugs, the representative of the patient shall collect anti-tuberculosis drugs at the medical examination and treatment facility that provides such drugs to ensure continuous and timely tuberculosis treatment. When collecting the drugs, the representative of the patient must present valid identification (ID card or citizen identity card or passport) and a hospitalization confirmation form according to the model attached as an appendix to this Circular.

Chapter III

NATIONAL CONCENTRATED PROCUREMENT OF ANTI-TUBERCULOSIS DRUGS USING THE HEALTH INSURANCE FUND

Article 7. Responsibilities for developing plans and organizing contractor selection

1. The unit entrusted by the Minister of Health to organize national centralized procurement of anti-tuberculosis drugs using the Health Insurance Fund shall be responsible for developing plans and organizing the selection of contractors for anti-tuberculosis drugs funded by the Health Insurance Fund in accordance with Circular No. 15/2019/TT-BYT and this Circular.

2. The unit entrusted by the Minister of Health to serve as the lead entity responsible for directing tuberculosis and lung disease prevention and control work nationwide (hereinafter referred to as the National Lead Unit) shall be responsible for issuing guidelines on planning the demand for anti-tuberculosis drugs funded by the Health Insurance Fund to be sent to the provincial lead units entrusted by the Chairman of the Provincial People's Committee or the Director of the Provincial Department of Health to direct tuberculosis and lung disease prevention and control work in their respective provinces (hereinafter referred to as the Provincial Lead Units) to guide medical examination and treatment facilities in their areas to implement.

3. The Provincial Lead Unit shall be responsible for reviewing and consolidating the demand for anti-tuberculosis drugs funded by the Health Insurance Fund from all medical examination and treatment facilities in its province and reporting to the Provincial Department of Health for review before submitting the demand proposal to the National Lead Unit.

Article 8. Basis for establishing plans for tuberculosis drug requirements using health insurance fund resources at medical examination and treatment facilities

The establishment of plans for tuberculosis drug requirements using health insurance fund resources for payment at medical examination and treatment facilities shall be based on one or more of the following information:

1. The estimated number of people suspected of having tuberculosis, those with tuberculosis, drug-resistant tuberculosis, and latent tuberculosis who are under treatment as of December 31 of the preceding year relative to the planning year, and the projected number of people with tuberculosis in the planning year.

2. The estimated quantity of tuberculosis drugs remaining in stock according to each treatment regimen at medical examination and treatment facilities as of December 31 of the preceding year relative to the planning year. Tuberculosis drugs in stock at medical examination and treatment facilities at the end of the year are transferred to the next year for use and deducted from the procurement plan for the next year. The situation regarding the purchase, use, and stock of tuberculosis drugs from other sources in the preceding year relative to the planning year.

3. The tuberculosis treatment regimen according to the current guidelines for diagnosis, treatment, and prevention of tuberculosis.

4. The list of tuberculosis drugs prescribed in Appendix 1 issued together with Circular No. 30/2018/TT-BYT dated October 30, 2018, by the Minister of Health promulgating the list of chemical drugs, biological products, and markers within the scope of benefits for health insurance participants and the list of drugs included in the Drug List for Projects to Prevent and Control Certain Diseases Dangerous to the Community (tuberculosis) as stipulated in Section III Part C of Appendix II issued together with Circular No. 15/2020/TT-BYT dated August 10, 2020, by the Minister of Health concerning the issuance of the Drug Tender List, Centralized Drug Tender List, and Price Negotiation Drug List.

5. Guidelines for establishing plans for tuberculosis drug requirements using health insurance fund resources and directions for transitioning regimens from the National Lead Unit.

Article 9. Construction and consolidation of tuberculosis drug requirements using health insurance fund resources

1. Prior to the planning period, the National Lead Unit sends guidelines for establishing plans for tuberculosis drug requirements using health insurance fund resources to the Provincial Health Departments and the Provincial Lead Units.

2. Based on the guidelines for establishing plans for tuberculosis drug requirements using health insurance fund resources from the National Lead Unit, the Provincial Lead Units send guidelines for establishing plans for tuberculosis drug requirements using health insurance fund resources to medical examination and treatment facilities within their jurisdiction.

3. Medical examination and treatment facilities develop detailed requirements for the list, quantity, and supply schedule for each drug and group, and submit them to the Provincial Lead Unit. The Provincial Lead Unit is responsible for reviewing and consolidating the requirements of all medical examination and treatment facilities within its jurisdiction, reporting to the Provincial Health Department for review of the drug list, group, and quantity, and submitting the drug usage plan to the National Lead Unit along with the required documents as stipulated in Clause 1 of this Article.

4. The National Lead Unit is responsible for organizing the review and consolidation of tuberculosis drug requirements using health insurance fund resources nationwide.

Article 10. Implementation of the results of selecting contractors to supply anti-tuberculosis drugs using the Health Insurance Fund

1. Forecasting anti-tuberculosis drugs:

a) Based on signed contracts, drug usage plans, and treatment needs for the quarter, before the 15th day of the month immediately preceding the forecasted quarter or in case of emergency according to requirements, healthcare facilities shall prepare forecasts of the quantity of anti-tuberculosis drugs needed to be received, ensuring that it does not exceed 20% (twenty percent) of the quantity allocated in the framework agreement already signed, to send to the winning contractor, while also sending to the provincial focal unit for monitoring;

b) In cases where healthcare facilities require more drugs than 20% (twenty percent) of the quantity allocated in the framework agreement or signed contract, healthcare facilities shall follow the provisions set out in Article 11 of this Circular.

2. Supplying anti-tuberculosis drugs:

a) Within 10 (ten) days from receiving the forecast from healthcare facilities, the winning contractor is responsible for transporting anti-tuberculosis drugs to healthcare facilities based on the forecasted quantity or adjusted quantity (if any), based on the information and implementation content stipulated in Clause 1 of this Article;

b) In cases where the winning contractor fails to fully supply drugs or does not meet the deadline specified in the signed contract, healthcare facilities within the area shall report to the provincial focal unit for consolidation and reporting to the Department of Health and the national focal unit for resolution.

3. Reporting on the use of anti-tuberculosis drugs:

a) Before the 10th day of the first month of each quarter or in case of emergency, healthcare facilities shall prepare reports on the use of anti-tuberculosis drugs in the previous quarter, along with explanatory documents if there is a need to adjust excess or insufficient drugs, to send to the provincial focal unit;

b) Before the 15th day of the first month of each quarter or in case of emergency, the provincial focal unit shall report on the use of anti-tuberculosis drugs in the previous quarter, including information about adjustments between facilities within the province. In cases where there is a shortage or surplus of drugs requiring adjustment from the central level, the provincial focal unit must submit an explanatory document to the Department of Health and the national focal unit;

c) The winning contractor shall report the supply plan for anti-tuberculosis drugs to healthcare facilities based on the request of the national focal unit, ensuring sufficient quantity, quality, and progress as stipulated in the signed contract.

Article 11. Adjusting the process of implementing framework agreements for anti-tuberculosis drugs using the Health Insurance Fund

1. Adjusting drugs within the province:

a) The provincial focal unit shall adjust the additional quantity of drugs within the limit of not exceeding 20% (twenty percent) of the total quantity allocated in the framework agreement for all healthcare facilities within the area;

b) In cases where healthcare facilities require additional drugs exceeding 20% (twenty percent) of the quantity allocated in the framework agreement, the adjustment of drugs within the province shall be carried out as follows:

- Healthcare facilities within the area shall submit a written request for drug adjustment to the provincial focal unit, clearly stating the quantity of drugs needed to be adjusted (increased or decreased) and providing an explanation for the reasons;

- Within 10 (ten) working days from receiving the adjustment request from healthcare facilities, the provincial focal unit shall review the quantity of drugs already used, the remaining stock, and the remaining quantity in the framework agreement of healthcare facilities within the area to decide on the adjustment. The provincial focal unit shall issue an adjustment document sent to the healthcare facility receiving the adjusted drugs (including both the healthcare facility receiving the adjusted drugs and the healthcare facility adjusting drugs out), the winning contractor to implement the adjustment, and the provincial Social Insurance agency to coordinate the implementation;

- Within 10 (ten) working days from receiving the document from the provincial focal unit, the winning contractor shall carry out the drug adjustment according to the requirements of the provincial focal unit and shall be responsible for signing supplementary contract appendices with the healthcare facility receiving the adjusted drugs and the healthcare facility adjusting drugs out.

2. Adjusting drugs nationwide:

a) The national focal unit shall adjust the additional quantity of drugs within the limit of not exceeding 30% (thirty percent) of the total quantity approved in the tender selection plan;

b) In cases where the additional quantity of drugs exceeds 30% (thirty percent) of the total quantity approved in the tender selection plan, the entity assigned by the Ministry of Health to centrally procure anti-tuberculosis drugs using the Health Insurance Fund shall proceed with additional procurement procedures in accordance with laws on bidding and the provisions of this Circular;

c) The process of adjusting drugs nationwide:

- When exceeding the scope of drug adjustment prescribed in Clause 1 of this Article, the provincial focal unit shall submit a written request for drug adjustment to the national focal unit;

- Within 07 (seven) working days from receiving the request from the provincial focal unit, the national focal unit shall review the quantity of drugs already used, the remaining stock, and the remaining quantity in the framework agreement of healthcare facilities nationwide to decide on the adjustment. The national focal unit shall issue an adjustment document sent to the provincial focal unit, the winning contractor to implement the adjustment, and the provincial Social Insurance agency to coordinate the implementation;

- Within 10 (ten) working days from receiving the document from the national focal unit, the winning contractor shall be responsible for adjusting the drugs according to the requirements of the national focal unit.

3. For healthcare facilities requiring anti-tuberculosis drugs using the Health Insurance Fund but not included in the demand compilation when building the tender selection plan for drug procurement, the adjustment process shall be implemented as follows:

a) The medical examination and treatment facility sends a document requesting drug regulation to the provincial lead unit for consolidation and reporting to the national lead unit. Within ten (10) working days from the date of receipt of the document from the medical examination and treatment facility, the provincial lead unit must send the needs of the medical examination and treatment facility to the national lead unit;

b) Within ten (10) working days from the date of receipt of the document from the provincial lead unit, the national lead unit shall consolidate and review the usage requirements, quantity of drugs purchased, remaining quantity of drugs within the framework agreement of medical examination and treatment facilities nationwide to decide on the regulation;

c) Within seven (7) working days from the date of signing the supplementary appendix to the framework agreement, the successful bidder shall implement the signing of the supplementary supply contract for tuberculosis drugs for medical examination and treatment facilities with newly generated needs in accordance with the law on bidding;

d) The successful bidder is responsible for sending the contracts signed with each medical examination and treatment facility that have been supplemented, along with a list of medical examination and treatment facilities where the bidder has implemented the signing of supplementary supply contracts for tuberculosis drugs to the national lead unit, provincial lead unit, and Provincial Social Insurance. The list includes the following information: Medical examination and treatment facility code; name and address of the medical examination and treatment facility signing the contract; contract number, date of signing the supplementary contract; validity period of the contract; value of the supplementary contract implementation. Within seven (7) working days from the date of signing the contract, the successful bidder is responsible for supplying tuberculosis drugs to the supplemented medical examination and treatment facilities;

e) In cases where there is no regulation, the national lead unit shall send a document to the Department of Health and the provincial lead unit to inform the medical examination and treatment facilities. The document clearly states the reasons for not regulating;

Chapter IV

IMPLEMENTING PROVISIONS

Article 12. Effective Date

1. This Circular takes effect from February 15, 2022;

2. This Circular replaces Circular No. 04/2016/TT-BYT dated February 26, 2016, issued by the Minister of Health, concerning medical examination and treatment and payment of costs related to tuberculosis medical examination and treatment under health insurance;

Article 13. Reference Provisions

In cases where referenced documents in this Circular are replaced or amended, they shall be applied according to the replaced or amended documents.

1. The Minister, Heads of Ministries equivalent to ministries, Heads of government agencies, Chairmen of provincial People's Committees under the central government, and related agencies, units, and individuals are responsible for implementing this Circular.

1. Responsibilities of the national lead unit:

a) Review and consolidate the demand for tuberculosis drugs funded by the Health Insurance Fund;

b) Regulate tuberculosis drugs funded by the Health Insurance Fund throughout the country;

c) Periodically or randomly inspect the warehouse system of the successful bidder to ensure drug quality and readiness to meet the usage needs of medical examination and treatment facilities according to the signed contracts;

d) Direct and implement training, retraining, and training sessions for medical examination and treatment facilities under the tuberculosis prevention and control system to comply with the regulations set forth by the Minister of Health and this Circular;

2. Responsibilities of the Department of Health:

a) Select and assign responsibilities or submit to competent authorities for issuance of decisions assigning responsibilities to the provincial lead unit to perform tasks as stipulated in this Circular;

b) Review the plan for the demand for tuberculosis drugs funded by the Health Insurance Fund of medical examination and treatment facilities within its jurisdiction;

c) Direct the provincial lead unit to implement training, retraining, and training sessions for medical examination and treatment facilities under its management and within its jurisdiction to comply with the regulations set forth by the Minister of Health and this Circular;

3. Responsibilities of the provincial lead unit:

a) Based on the guidance of the national lead unit:

- Guide medical examination and treatment facilities within its jurisdiction to prepare plans for the demand for tuberculosis drugs funded by the Health Insurance Fund;

- Review and consolidate the demand for tuberculosis drugs funded by the Health Insurance Fund of all medical examination and treatment facilities within its jurisdiction;

- Submit to the Department of Health for review the plan for the demand for tuberculosis drugs funded by the Health Insurance Fund of medical examination and treatment facilities within its jurisdiction;

b) Regulate tuberculosis drugs funded by the Health Insurance Fund within the province in accordance with Clause 1, Article 11 of this Circular;

c) Organize training, retraining, and training sessions for staff of medical examination and treatment facilities within its jurisdiction to meet the needs of tuberculosis medical examination and treatment;

d) Implement periodic or random inspections of the implementation of regulations stipulated in this Circular and other relevant regulations regarding the management and use of tuberculosis drugs at medical examination and treatment facilities within its jurisdiction (including provincial, district, and commune levels);

4. Responsibilities of the Vietnam Social Security:

a) Guide the social security agencies of provinces and centrally administered cities to organize the implementation of regulations stipulated in this Circular;

b) Participate in the bidding and procurement process for tuberculosis drugs funded by the Health Insurance Fund in accordance with the law on bidding, Circular No. 15/2019/TT-BYT, Circular No. 15/2020/TT-BYT, and the provisions of this Circular;

c) Receive, manage, and promptly provide complete electronic data to medical examination and treatment facilities in accordance with current regulations;

d) Share information related to:

- Data on the use and settlement of costs for tuberculosis drugs funded by the Health Insurance Fund in the province to the provincial lead unit for management, monitoring, consolidation of needs, and regulation of drugs within its jurisdiction;

- Data on the use and settlement of costs for tuberculosis drugs funded by the Health Insurance Fund nationwide to the national lead unit for management, monitoring, consolidation of needs, and regulation of drugs assigned to it;

5. Responsibilities of medical examination and treatment facilities:

a) Study and organize the implementation of medical examination and treatment, prevention, and control of tuberculosis in accordance with laws on medical examination and treatment, health insurance, and the provisions of this Circular;

c) Prepare a plan for the demand for tuberculosis drugs funded by the Health Insurance Fund at the facility and send it to the provincial lead unit.

d) On a monthly or quarterly basis, compile and report the costs of anti-tuberculosis drugs funded by the Health Insurance Fund to the provincial lead unit.

đ) Comply with regulations on the extraction and transfer of electronic data for management and appraisal, as well as payment of costs for health insurance medical examinations and treatments.

6. Responsibilities of the successful bidder:

a) Ensure the timely and adequate supply of anti-tuberculosis drugs in accordance with the agreed framework and contracts signed with healthcare facilities.

b) Promptly adjust the supply of anti-tuberculosis drugs in compliance with the provisions set forth in this Circular.

c) On a quarterly basis, report the results of the previous quarter's supply of anti-tuberculosis drugs and the plan for the next quarter's supply to the national lead unit regarding the implementation of contracts with healthcare facilities.

During the course of implementation, if there are difficulties or obstacles, they should be reported to the Ministry of Health (Health Insurance Department) for consideration and resolution./.