Law Amending and Supplementing Certain Articles of the Health Insurance Law No. 46/2014/QH13

LAW

AMENDMENTS AND SUPPLEMENTS TO CERTAIN PROVISIONS OF THE HEALTH INSURANCE LAW

On the basis of The Constitution of the Socialist Republic of Vietnam;

The National Assembly enacted the Law Amending and Supplementing Certain Articles of Health Insurance Law number 25/2008/QH12.

Article 1.

Amend and supplement some articles of the Health Insurance Law:

1. Amend and supplement Clause 1; add Clauses 7 and 8 of Article 2 as follows:

“1. Health Insurance is a mandatory form of insurance applied to the subjects as prescribed by this Law for health care purposes, not for profit, organized and implemented by the State.”

“7. Household participating in health insurance (hereinafter referred to collectively as household) includes all persons listed in the household registration book or temporary residence certificate.

8. Basic medical service package paid by the health insurance fund are essential medical services for health care, appropriate to the payment capacity of the health insurance fund.”

2. Amend and supplement Clause 2 and Clause 3 of Article 3 as follows:

“2. The health insurance contribution rate is determined as a percentage of the salary serving as the basis for compulsory social insurance contributions under the Social Insurance Law (hereinafter referred to collectively as monthly salary), pension, allowance, or basic salary.

3. The level of health insurance benefits is determined according to the degree of illness, group of subjects within the scope of rights and time of participation in health insurance.”

3. Amend and supplement Clause 3; add Clause 10 of Article 6 as follows:

“3. Issue regulations on specialized technical procedures, examination and treatment processes, and guidelines for treatment; transfer related to health insurance examination and treatment.”

“10. Issue the basic medical service package paid by the health insurance fund.”

4. Add Articles 7a, 7b, and 7c after Article 7 as follows:

"Article 7a. Responsibilities of the Ministry of Labor, Invalids and Social Affairs

1. Direct and guide the implementation of the identification and management of subjects managed by the Ministry of Labor, Invalids and Social Affairs as stipulated in Points d, e, g, h, i, and k of Clause 3 and Clause 4 of Article 12 of this Law.

2. Inspect and supervise the implementation of legal provisions regarding the responsibility to participate in health insurance of employers and employees as stipulated in Clause 1 of Article 12 of this Law and subjects managed by the Ministry of Labor, Invalids and Social Affairs as stipulated in Points d, e, g, h, i, and k of Clause 3 and Clause 4 of Article 12 of this Law.

Article 7b. Responsibilities of the Ministry of Education and Training

1. Direct and guide the implementation of the identification and management of subjects managed by the Ministry of Education and Training as stipulated in Point n of Clause 3 and Point b of Clause 4 of Article 12 of this Law.

2. Inspect and supervise the implementation of legal provisions regarding the responsibility to participate in health insurance of subjects managed by the Ministry of Education and Training as stipulated in Point n of Clause 3 and Point b of Clause 4 of Article 12 of this Law.

3. Take the lead and coordinate with the Ministry of Health and relevant ministries and sectors to guide the establishment and improvement of the school health system to provide initial health care for children, students, and trainees.

Article 7c. Responsibilities of the Ministry of National Defense and the Ministry of Public Security

1. Direct, manage, guide, and organize the implementation of the identification and management of lists for health insurance for subjects managed by the Ministry of National Defense and the Ministry of Public Security as stipulated in Point a of Clause 1, Point a and Point n of Clause 3, and Point b of Clause 4 of Article 12 of this Law.

2. Prepare and provide lists for issuing health insurance cards for subjects as stipulated in Clause 3, Point 1 of this Law to health insurance organizations.

3. Inspect and supervise the implementation of legal provisions regarding the responsibility to participate in health insurance of subjects managed by the Ministry of National Defense and the Ministry of Public Security as stipulated in Point a of Clause 1, Point a and Point n of Clause 3, and Point b of Clause 4 of Article 12 of this Law.

4. Coordinate with the Ministry of Health and relevant ministries and sectors to guide medical facilities of the Ministry of National Defense and the Ministry of Public Security to sign health insurance examination and treatment contracts with health insurance organizations to examine and treat subjects participating in health insurance.”

5. Amend and supplement Clause 2; add Clause 3 of Article 8 as follows:

“2. Provincial People's Committees and municipal people's committees directly under the central government, in addition to implementing responsibilities as prescribed in Clause 1 of this Article, have the responsibility to direct the construction of organizational structures and resources to implement state management of health insurance at the local level and manage and use funds as prescribed in Clause 3 of Article 35 of this Law.

3. Commune-level People's Committees (hereinafter referred to collectively as commune-level People's Committees), in addition to implementing responsibilities as prescribed in Clause 1 of this Article, have the responsibility to establish health insurance participation lists for the subjects as stipulated in Clauses 2, 3, 4, and 5 of Article 12 of this Law by household, except for subjects as stipulated in Points a, 1, and n of Clause 3 and Point b of Clause 4 of Article 12 of this Law; commune-level People's Committees must establish lists for issuing health insurance cards for children simultaneously with issuing birth certificates.”

6. Amending and supplementing Article 12 as follows:

"Article 12. Subjects participating in health insurance

1. Group whose contributions are made by employees and employers, including:

a) Workers employed under indefinite-term labor contracts, labor contracts with a term of three months or more; workers who are business managers receiving salaries; cadres, civil servants, and public officials (hereinafter collectively referred to as workers);

b) People engaged in part-time work at communes, wards, towns as prescribed by law.

2. Group for which the social insurance organization pays, including:

a) Persons receiving monthly pensions or disability benefits;

b) Persons currently receiving monthly social insurance benefits due to work-related accidents, occupational diseases, or diseases requiring long-term treatment; persons aged 80 or older currently receiving monthly survivor benefits;

c) Commune-level civil servants who have retired and are currently receiving monthly social insurance benefits;

d) Persons currently receiving unemployment benefits;

3. Group whose contributions are made by the state budget, including:

a) Officers, professional military personnel, non-commissioned officers, soldiers of the Vietnam People's Army on active duty; officers, non-commissioned officers in specialized positions, and officers, non-commissioned officers in technical and professional positions working in the People's Public Security Forces, students at public security academies, non-commissioned officers, and public security soldiers serving on a fixed-term basis in the public security forces; personnel engaged in confidential work receiving salaries equivalent to those of military personnel; students at confidential training institutions receiving benefits and policies according to the policies for students at military and public security schools;

b) Village, ward, town cadres who have retired and are currently receiving monthly benefits from the state budget;

c) Persons who have ceased receiving disability benefits and are currently receiving monthly benefits from the state budget;

d) Persons who have made contributions to the revolution, former combatants;

đ) Current members of the National Assembly and People's Councils at all levels;

e) Children under six years old;

g) Persons eligible for regular social assistance benefits;

h) Persons in poor households; ethnic minorities living in areas with difficult socio-economic conditions; persons living in areas with particularly difficult socio-economic conditions; persons living in island communes and islands.

i) Relatives of those who have rendered meritorious service to the revolution, including fathers, mothers, wives, husbands, children over six years old but under eighteen years old, or those aged eighteen or older if they continue their education or suffer from severe disabilities or extremely severe disabilities of martyrs; persons who have raised martyrs;

k) Relatives of persons who have made contributions to the revolution, except for the subjects specified in point i of this clause;

l) Relatives of the subjects specified in point a of Clause 3 of this Article;

m) Persons who have donated organs as prescribed by law;

n) Foreigners studying in Vietnam who are granted scholarships from the State budget of Vietnam.

4. Group supported by the state budget for contribution levels, including:

a) Members of near-poor households;

b) Students.

5. The group participating in health insurance under household registration includes members of the household, except for the subjects specified in Clauses 1, 2, 3, and 4 of this Article.

6. The Government shall specify other subjects outside those specified in Clauses 3, 4, and 5 of this Article; stipulate the issuance of health insurance cards for subjects managed by the Ministry of National Defense and the Ministry of Public Security and for subjects specified in point 1 of Clause 3 of this Article; stipulate the implementation roadmap for health insurance, scope of benefits, level of health insurance benefits, medical examination and treatment under health insurance, management and utilization of funds allocated for medical examination and treatment under health insurance, health insurance appraisal, payment, and settlement for the subjects specified in point a of Clause 3 of this Article.

7. Amend and supplement Article 13 as follows:

“Article 13. Contribution Levels and Responsibility for Health Insurance Contributions

1. Contribution levels and responsibility for health insurance contributions are stipulated as follows:

a) The monthly contribution level of the subject specified in point a of Clause 1 of Article 12 of this Law shall be a maximum of 6% of the monthly salary, of which the employer contributes 2/3 and the employee contributes 1/3. During the period when the employee is on maternity leave according to the laws on social insurance, the maximum monthly contribution level is 6% of the employee's monthly salary before going on maternity leave, and it is paid by the social insurance organization;

b) The monthly contribution level of the subject specified in point b of Clause 1 of Article 12 of this Law shall be a maximum of 6% of the base salary, of which the employer contributes 2/3 and the employee contributes 1/3;

c) The monthly contribution level of the subject specified in point a of Clause 2 of Article 12 of this Law shall be a maximum of 6% of the pension or disability allowance, and it is paid by the social insurance organization;

d) The monthly contribution level of the subjects specified in points b and c of Clause 2 of Article 12 of this Law shall be a maximum of 6% of the base salary, and it is paid by the social insurance organization;

đ) The monthly contribution level of the subject specified in point d of Clause 2 of Article 12 of this Law shall be a maximum of 6% of the unemployment benefit, and it is paid by the social insurance organization;

e) The monthly contribution level of the subject specified in point a of Clause 3 of Article 12 of this Law shall be a maximum of 6% of the monthly salary for those receiving salaries, and a maximum of 6% of the base salary for those receiving living expenses, and it is paid by the state budget;

g) The monthly contribution level of the subjects specified in points b, c, d, đ, e, g, h, i, k, l, and m of Clause 3 of Article 12 of this Law shall be a maximum of 6% of the base salary, and it is paid by the state budget;

h) The monthly contribution level of the subject specified in point n of Clause 3 of Article 12 of this Law shall be a maximum of 6% of the base salary, and it is paid by the agency, organization, or unit granting the scholarship;

i) The monthly contribution level of the subject specified in Clause 4 of Article 12 of this Law shall be a maximum of 6% of the base salary, which is self-paid by the subject and partially subsidized by the state budget;

k) The monthly contribution level of the subject specified in Clause 5 of Article 12 of this Law shall be a maximum of 6% of the base salary, and it is paid by the subject according to household registration.

2. In cases where a person simultaneously belongs to multiple different health insurance participation categories specified in Article 12 of this Law, they shall contribute to health insurance according to the first category that they are determined to belong to, in the order of the categories specified in Article 12 of this Law.

In cases where the subject specified in point a of Clause 1 of Article 12 of this Law has one or more indefinite-term employment contracts or fixed-term employment contracts with a duration of three months or longer, they shall contribute to health insurance according to the employment contract with the highest salary.

In cases where the subject specified in point b of Clause 1 of Article 12 of this Law simultaneously belongs to multiple different health insurance participation categories specified in Article 12 of this Law, they shall contribute to health insurance in the following order: paid by the social insurance organization, paid by the state budget, and paid by the subject and supported by the People's Committee at the commune level.

3. All members belonging to the household as specified in Clause 5 of Article 12 of this Law must participate in health insurance. The contribution level decreases gradually from the second member onwards, specifically as follows:

a) The first person contributes a maximum of 6% of the base salary;

b) The second, third, and fourth persons contribute successively at 70%, 60%, and 50% of the first person's contribution rate;

c) From the fifth person onwards, they contribute at 40% of the first person's contribution rate.

4. The Government shall specify in detail the contribution levels and support levels stipulated in this Article.

8. Amend and supplement Clause 4 and Clause 5 of Article 14 as follows:

“4. For other subjects, the basis for health insurance contributions is the base salary.

5. The maximum monthly salary for calculating the amount of health insurance contributions is 20 times the base salary.”

9. Amend and supplement Article 15 as follows:

“Article 15. Methods of Health Insurance Contributions

1. Monthly, the employer pays health insurance contributions for employees and deducts the health insurance contribution from the employee's salary to pay into the health insurance fund at the same time.

2. For businesses in agriculture, forestry, fisheries, and salt production that do not pay salaries monthly, the employer pays health insurance contributions for employees and deducts the health insurance contribution from the employee's salary to pay into the health insurance fund every three or six months.

3. Monthly, the social insurance organization pays health insurance contributions as specified in points c, d, and đ of Clause 1 of Article 13 of this Law into the health insurance fund.

4. Quarterly, the agency, organization, or unit granting scholarships pays health insurance contributions as specified in point h of Clause 1 of Article 13 of this Law into the health insurance fund.

5. Quarterly, the state budget transfers the amount of contributions and support for health insurance contributions as specified in points e, g, and i of Clause 1 of Article 13 of this Law into the health insurance fund.

6. Periodically every three, six, or twelve months, the representative of the household, organization, or individual pays the full amount due into the health insurance fund.”

10. Amend and supplement Clause 3 and Clause 5 of Article 16 as follows:

“3. The effective date of the health insurance card is stipulated as follows:

a) Subjects specified in Clauses 1, 2, and 3 of Article 12 of this Law participating in health insurance for the first time shall have their health insurance cards become valid from the date of payment for health insurance.

b) Subjects participating in health insurance continuously from the second time onwards shall have their health insurance cards remain valid until the expiration date of the previous card.

c) Subjects specified in Clause 4 and Clause 5 of Article 12 of this Law participating in health insurance from the date this Law takes effect or participating intermittently for three months or more within a fiscal year shall have their health insurance cards become valid thirty days from the date of payment for health insurance.

d) In the case of children under six years old, the health insurance card shall be valid until the child reaches seventy-two months of age. If the child reaches seventy-two months but has not yet reached the school entry period, the health insurance card shall be valid until September 30 of that year.

"5. Health insurance organizations shall issue health insurance card templates after obtaining the unified opinion of the Ministry of Health."

11. Amend and supplement Article 17 as follows:

"Article 17. Issuance of Health Insurance Cards"

1. The application dossier for issuing health insurance cards includes:

a) The health insurance participation declaration form of organizations, individuals, and households for subjects participating in health insurance for the first time;

b) The list of health insurance participants specified in Clause 1 of Article 12 of this Law prepared by the employer.

The list of health insurance participants of the subjects specified in Clauses 2, 3, 4, and 5 of Article 12 of this Law shall be prepared by the People's Committee of communes according to household units, except for the subjects specified in Points a, 1, and n of Clause 3 and Point b of Clause 4 of Article 12 of this Law.

The list of health insurance participants of the subjects managed by the Ministry of Education and Training and the Ministry of Labor, Invalids, and Social Affairs as specified in Point n of Clause 3 and Point b of Clause 4 of Article 12 of this Law shall be prepared by educational and training institutions and vocational training centers.

The list of health insurance participants of the subjects managed by the Ministry of National Defense and the Ministry of Public Security as specified in Point a of Clause 1, Point a and Point n of Clause 3, and Point b of Clause 4 of Article 12 of this Law, and the list of subjects specified in Point 1 of Clause 3 of Article 12 of this Law shall be prepared by the Ministry of National Defense and the Ministry of Public Security.

2. Within ten working days from the date of receiving the complete dossier as stipulated in Clause 1 of this Article, the health insurance organization must transfer the health insurance cards to the management agencies or to the health insurance participants.

3. The health insurance organization shall issue the application dossier template as stipulated in Clause 1 of this Article after obtaining the unified opinion of the Ministry of Health.

12. Amend and supplement Clause 3 and Clause 4 of Article 18 as follows:

"3. Within seven working days from the date of receipt of the request for issuance of a new card, the health insurance organization must issue a new card to the health insurance participant. During the waiting period for the issuance of a new card, the health insurance participant still enjoys health insurance benefits.

4. The person receiving a new health insurance card must pay the fee. The Minister of Finance shall specify the fee for issuing a new health insurance card. In cases where the error is due to the health insurance organization or the agency preparing the list, the person receiving a new health insurance card does not need to pay the fee."

13. Supplement Point c of Clause 1 of Article 20 as follows:

"c) Issuing duplicate health insurance cards."

14. Repeal Point b of Clause 1 of Article 21; amend and supplement Point c of Clause 1 and Clause 2 of Article 21 as follows:

"b) Transporting patients from district-level hospitals to higher-level hospitals for the subjects specified in Points a, d, e, g, h, and i of Clause 3 of Article 12 of this Law in emergency situations or when they are undergoing inpatient treatment and require transfer for specialized medical services.

2. The Minister of Health shall take the lead and coordinate with relevant ministries and sectors to promulgate the list and reimbursement rates and conditions for medicines, chemicals, medical supplies, and medical technical services within the scope of health insurance benefits for health insurance participants."

15. Amend and supplement Article 22 as follows:

"Article 22. Health Insurance Benefits Level

1. When health insurance participants go for medical examination and treatment as prescribed in Articles 26, 27, and 28 of this Law, they shall be reimbursed by the health insurance fund for medical examination and treatment costs within the scope of benefits at the following levels:

a) 100% of medical examination and treatment costs for the subjects specified in Points a, d, e, g, h, and i of Clause 3 of Article 12 of this Law. Costs for medical examinations and treatments outside the scope of health insurance benefits for the subjects specified in Point a of Clause 3 of Article 12 of this Law shall be paid from the health insurance budget allocated for medical examinations and treatments of this group; if the budget is insufficient, it shall be guaranteed by the state budget;

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

c) 100% of medical examination and treatment costs when the patient has participated in health insurance continuously for five years or more and the total amount of co-payment for medical examination and treatment costs in a year exceeds six times the minimum wage; except in cases where the patient seeks medical examination and treatment outside the designated facility;

d) 95% of medical examination and treatment costs for the subjects specified in Point a of Clause 2, Point k of Clause 3, and Point a of Clause 4 of Article 12 of this Law;

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

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

3. In cases where a person with a health insurance card seeks medical examination and treatment outside the designated facility, the health insurance fund shall reimburse according to the benefit level stipulated in Clause 1 of this Article at the following rates, except in cases stipulated in Clause 5 of this Article:

a) At central hospitals, 40% of inpatient treatment costs;

b) At provincial hospitals, 60% of inpatient treatment costs from the date this Law takes effect until December 31, 2020; 100% of inpatient treatment costs from January 1, 2021 throughout the country;

c) At district hospitals, 70% of medical examination and treatment costs from the date this Law takes effect until December 31, 2015; 100% of medical examination and treatment costs from January 1, 2016.

4. As of January 1, 2016, individuals participating in health insurance who register for initial medical examination and treatment at village-level health stations or multi-purpose clinics or district-level hospitals have the right to seek medical examination and treatment under health insurance at village-level health stations or multi-purpose clinics or district-level hospitals within the same province according to the benefits specified in Clause 1 of this Article.

5. Ethnic minority individuals and members of poor households participating in health insurance residing in areas with difficult socio-economic conditions or extremely difficult socio-economic conditions; individuals participating in health insurance residing in island communes or island districts when self-seeking medical examination and treatment outside their designated level shall have their costs covered by the health insurance fund for hospitalization at provincial-level hospitals, central hospitals, and outpatient services at district-level hospitals according to the benefits specified in Clause 1 of this Article.

6. As of January 1, 2021, the health insurance fund will cover the cost of inpatient treatment according to the benefits specified in Clause 1 of this Article for individuals participating in health insurance who self-seek medical examination and treatment outside their designated level at provincial-level hospitals nationwide.

7. The Government shall specify the benefit levels for medical examination and treatment under health insurance in border areas; cases of medical examination and treatment on demand, and other cases not covered by Clause 1 of this Article.

16. Repeal Clause 10 and Clause 12 of Article 23; amend and supplement Clause 7 and Clause 9 of Article 23 as follows:

“7. Treatment of strabismus, myopia, and refractive errors of the eye, except for children under six years old.”

“9. Medical examination and treatment, and rehabilitation in disaster situations.”

17. Amend and supplement Article 24 as follows:

“Article 24. Health Insurance Medical Examination and Treatment Facilities

Health insurance medical examination and treatment facilities are healthcare establishments as defined by the Law on Medical Examination and Treatment that have signed contracts for medical examination and treatment with health insurance organizations.”

18. Amend and supplement Point a Clause 2 and Clause 4 of Article 25 as follows:

“a) Service targets and requirements for service provision scope; estimated number of cards and group structure of participants in health insurance for primary health insurance medical examination and treatment facilities.”

“4. The Ministry of Health shall take the lead and coordinate with the Ministry of Finance to establish a model contract for health insurance medical examination and treatment.”

19. Amend and supplement Point a Clause 1 of Article 30 as follows:

“a) Payment based on predetermined rates is payment according to the fee determined in advance for the scope of services provided to one cardholder registered at a healthcare service provider within a specific period of time;”

20. Amend and supplement Clause 2; add Clause 5 of Article 31 as follows:

“2. Health insurance organizations shall directly pay the costs of medical examination and treatment under health insurance to individuals holding health insurance cards in the following cases:

a) At medical facilities without a health insurance medical examination and treatment contract;

b) Receiving medical examination and treatment not in accordance with the provisions of Article 28 of this Law;

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

“5. The Minister of Health shall take the lead and coordinate with the Minister of Finance to unify the prices of health insurance medical examination and treatment services among hospitals of the same grade nationwide.”

21. Amend and supplement Article 32 as follows:

“Article 32. Advance Payment, Settlement, and Finalization of Costs for Health Insurance Medical Examination and Treatment

1. The advance payment of funds from health insurance organizations to health insurance medical examination and treatment facilities shall be carried out quarterly as follows:

a) Within five working days from the date of receiving the previous quarter's finalization report from the medical examination and treatment facility, the health insurance organization shall make a one-time advance payment equal to 80% of the health insurance medical examination and treatment costs reported in the previous quarter's finalization report;

b) For health insurance medical examination and treatment facilities signing their first contract for health insurance medical examination and treatment with initial registration, they shall receive an advance payment of 80% of the funding available at the facility according to the initial notification from the health insurance organization; if there is no initial registration, the health insurance organization shall estimate and advance 80% of the health insurance medical examination and treatment costs in the quarter based on the actual expenses incurred in the first month of implementing the contract;

c) In cases where the advance payment for health insurance medical examination and treatment facilities in a province exceeds the amount of funding available for use in the quarter, the health insurance organization of the province or centrally-administered city shall report to the Vietnam Social Security for additional funding;

2. The settlement and finalization between medical examination and treatment facilities and health insurance organizations shall be carried out as follows:

a) Within the first 15 days of each month, health insurance medical examination and treatment facilities shall submit a consolidated request for payment of the previous month's health insurance medical examination and treatment costs to the health insurance organization; within the first 15 days of each quarter, health insurance medical examination and treatment facilities shall submit a finalization report of the previous quarter's health insurance medical examination and treatment costs to the health insurance organization;

b) Within 30 days from the date of receiving the previous quarter's finalization report from the medical examination and treatment facility, the health insurance organization shall notify the results of the review and the finalization amount of health insurance medical examination and treatment costs including actual costs within the scope of benefits and the health insurance coverage level to the medical examination and treatment facility;

c) Within 10 days from the date of notifying the finalization amount of health insurance medical examination and treatment costs, the health insurance organization must complete the payment to the medical examination and treatment facility;

d) The annual finalization audit of the health insurance fund and the settlement of unused funds (if any) for provinces and centrally-administered cities must be completed before October 1 of the following year.

3. Within 40 days from the date of receiving all necessary documents for direct payment of medical examination and treatment costs from health insurance participants as stipulated in Clause 2 of Article 31 of this Law, the health insurance organization must make the direct payment to these individuals.”

22. Amend and supplement Clause 1; add Clause 3 of Article 34 as follows:

"1. The health insurance fund shall be centrally managed, uniformly, transparently, and with hierarchical management within the health insurance organization system.

"2. The Social Insurance Management Council, in accordance with the provisions of the Social Insurance Law, shall be responsible for managing the health insurance fund and advising on health insurance policies."

"3. Annually, the Government shall report to the National Assembly on the management and utilization of the health insurance fund."

23. Amend and supplement Article 35 as follows:

"Article 35. Allocation and use of the health insurance fund"

1. The health insurance fund shall be allocated and utilized as follows:

"a) Ninety percent of the health insurance contributions shall be allocated for medical examination and treatment;"

"b) Ten percent of the health insurance contributions shall be allocated for the reserve fund and administrative costs of the health insurance fund, of which at least five percent of the health insurance contributions shall be allocated for the reserve fund."

"2. The temporarily idle funds of the health insurance fund shall be used for investment in forms prescribed by the Social Insurance Law. The Social Insurance Management Council shall decide and be responsible to the Government for the form and structure of the health insurance fund's investment based on the proposal of the Vietnam Social Security."

"3. In cases where the province or centrally-administered city has a higher amount of health insurance revenue allocated for medical examination and treatment than the expenditure on medical examination and treatment in the year, after being audited and settled by the Vietnam Social Security, the unused portion of the budget shall be allocated according to the following schedule:"

"a) From the date this Law takes effect until December 31, 2020, eighty percent shall be transferred to the reserve fund, twenty percent shall be transferred back to the locality for use in the following priority order:"

"Supporting the health examination and treatment fund for the poor; supporting the health insurance contribution level for certain groups of people suitable to the economic and social conditions of the locality; purchasing medical equipment appropriate to the capacity and qualifications of healthcare staff; purchasing transportation means for patients at the district level."

"Within one month from the date of the Vietnam Social Security's audit and settlement, the Vietnam Social Security must transfer twenty percent of the unused budget back to the locality."

"Within twelve months from the date of the Vietnam Social Security's audit and settlement, the unused budget shall be transferred to the reserve fund;"

"b) From January 1, 2021, the entire unused budget shall be fully recorded into the reserve fund for overall regulation."

"4. In cases where the province or centrally-administered city has a lower amount of health insurance revenue allocated for medical examination and treatment than the expenditure on medical examination and treatment in the year, after being audited and settled, the Vietnam Social Security shall be responsible for supplementing the entire difference from the reserve fund."

"5. The Government shall provide detailed regulations for paragraph 1 of this Article."

"24. Amend and supplement paragraph 2 of Article 36 as follows:"

"“2. Be able to contribute to health insurance as a household at health insurance agencies nationwide; choose primary health examination and treatment facilities in accordance with the provisions of paragraph 1 of Article 26 of this Law.”"

"25. Amend and supplement paragraph 2 and paragraph 10 of Article 41 as follows:"

"“2. Organize for the subjects specified in paragraph 5 of Article 12 of this Law to conveniently contribute to health insurance as a household at health insurance agencies. Guide the application procedures, registration places for health insurance participation, and organize the implementation of health insurance benefits to ensure speed, simplicity, and convenience for health insurance participants. Review, consolidate, and confirm the list of health insurance participants to avoid duplicate issuance of health insurance cards for the subjects specified in Article 12 of this Law, except for those managed by the Ministry of Defense and the Ministry of Public Security.”"

"“10. Store health insurance records in accordance with the law; determine the period of health insurance participation to ensure the rights of health insurance participants; apply information technology in health insurance management, and build a national database on health insurance.”"

"26. Amend and supplement paragraph 2; add paragraph 7 and paragraph 8 of Article 43 as follows:"

"“2. Provide medical records, related documents for health examination and treatment, and payment of health examination and treatment costs of health insurance participants upon request of the health insurance organization and competent state authorities; for direct payment requests, within five working days from the date of receiving the request from the health insurance organization, the health examination and treatment facility shall be responsible for providing the medical records and related documents for health examination and treatment of health insurance participants.”"

"“7. Prepare a list of health examination and treatment costs under health insurance and bear legal responsibility for the legality and accuracy of this list."

"8. Provide the list of health examination and treatment costs to health insurance participants upon request."

"27. Amend and supplement paragraph 3 of Article 45 as follows:"

"“3. Participate in supervising the enforcement of laws on health insurance, urging employers to pay health insurance contributions for employees, and participate in resolving cases of non-payment or delayed payment of health insurance contributions.”"

"28. Amend and supplement Article 49 as follows:"

"Article 49. Handling Violations"

"1. A 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, and if damage is caused, they must compensate according to the law."

"2. An agency or organization that violates the provisions of this Law and other relevant laws on health insurance shall be subject to administrative penalties, and if damage is caused, they must compensate according to the law."

"3. Agencies, organizations, and employers who have the responsibility to pay health insurance contributions but fail to pay or pay insufficiently according to the law shall be handled as follows:"

"a) They must pay the full amount of unpaid contributions and pay interest equal to twice the inter-bank lending rate on the unpaid amount and the period of delay; if not implemented, upon the request of the authorized authority, banks, other financial institutions, and state treasuries shall be responsible for deducting the unpaid and overdue amounts and interest from the accounts of the agencies, organizations, and employers responsible for paying health insurance contributions and depositing them into the health insurance fund account;"

b) Shall reimburse the entire cost to the employee within the scope of health insurance benefits that the employee has paid during the period without a health insurance card.

Article 2.

1. This Law takes effect from January 1, 2015.

2. The Government shall provide detailed regulations for the Articles and Clauses assigned in the Law.

This Law was passed by the National Assembly of the Socialist Republic of Vietnam, the seventh session of the XIIIth term, on June 13, 2014.