Joint Circular No. 49-TTLB/CB on the system for collecting hospital fees

 JOINT CIRCULAR
On the Fee Collection System at Hospitals

The fee collection system at hospitals has been established for a long time, but to this day, there are still many difficulties and shortcomings in its implementation.

For cadres, workers, and employees, many agencies and construction sites have not yet completed payment of hospital fees, causing difficulties for hospitals in finalizing their income and expenditure statements. Most payments are made very slowly.

For the people, many patients who have the ability to pay are still introduced and classified as poor patients, and some patients even have money deposited at the hospital but are still exempted from hospital fees. Such public fund support is truly unreasonable.

This situation has significantly affected the budget and thus, the development of healthcare work.

Therefore, the Ministry of Health and the Ministry of Finance hereby re-establish the hospital fee collection system as follows:

I. FOR PATIENTS WHO ARE CADRES

1) The hospital will collect food expenses and nutritional supplements according to Circular No. 2796-PQC dated August 25, 1956 of the Ministry of Home Affairs, while drug costs will be collected based on actual expenditures from now on.

2) Agencies introducing cadres to stay at the hospital must follow the correct introduction form prescribed by the Ministry of Health for convenient fee settlement.

3) Once the cadre is admitted to the hospital, the agency must prepare fundsto pay monthly hospital fees as requested by the hospital (no longer waiting until the cadre is discharged to settle the account as before). The remaining amount will be settled when the cadre is discharged.

Thus, for the hospital, the agency must bear the responsibility for paying all hospital fees including: food expenses, nutritional supplements, and drug costs (the part of food expenses that the cadre must pay will be deducted from their salary).

4) For outstanding hospital fees up to now, the responsible agencies must immediately settle with the hospital. If there are any obstacles, they should promptly contact the hospital and the Ministry of Finance to resolve them.

II. FOR PATIENTS WHO ARE CITIZENS

1) It is divided into three cases as follows:

a) Patients with the ability to pay: will pay food expenses (including nutritional supplements if applicable) and drug costs based on actual expenditures.

b) Patients with limited ability to pay: will pay food expenses (and nutritional supplements if applicable); drug costs will be covered by public funds.

c) Patients without the ability to pay: both food and drug costs will be covered by public funds. In special cases, upon the treating physician's decision, supplementary allowances of 400 to 600 dong may be provided, which will also be covered by public funds.

2) Support for patients with limited ability to pay and those without the ability to pay will be borne by the provincial or municipal budget (social welfare funds).

For central hospitals, local authorities introducing patients will be responsible for settling hospital fees based on actual expenditures and as requested by the hospital.

3) The Provincial or Municipal People's Administrative Committee will plan annually social welfare funds for poor patients based on specific conditions in their locality (living conditions and health status of the people, budget capacity...).

Assessments of the ability to pay must be carefully considered and realistic (not solely based on social status...), ensuring that public fund support is reasonable, consistent with policy, and does not hinder medical treatment for the people.

4) Patient introductions must follow the correct format and procedures prescribed by the Ministry of Health.

III. - IMPLEMENTATION PROVISIONS

To allow sufficient preparation time, this circular will take effect from January 1, 1958.

A directive from the Ministry of Health will guide its implementation.

Previous regulations contrary to this circular are hereby abolished.

During implementation, hospitals will have additional tasks related to drug expense settlements; hospitals with many patients and unable to address these issues will report back to the Ministry for staffing solutions.