Decree No. 70/2015/NĐ-CP provides detailed regulations and guidance on the implementation of certain provisions of the Health Insurance Law for the People's Army, the People's Public Security, and personnel engaged in confidential work.

DECREE

Regulations detailing and guiding the implementation of certain provisions of

Law on Health Insurance for the People's Army and the People's Public Security Force

and individuals engaged in confidential work

Pursuant to the Law on Organization of the Government dated December 25, 2001;

Pursuant to Resolution No. 142/2024/QH15 dated June 29, 2024 of the seventh session of the 15th National Assembly;

At the proposal of the Minister of National Defense,

The Government promulgates this Decree to provide detailed regulations and guidance on implementing certain provisions of the Law on Health Insurance for the People's Army and the People's Public Security Force and persons engaged in confidential work.

PART I

SCOPE OF REGULATION, OBJECTS,

IMPLEMENTATION TIMELINE, CONTRIBUTION LEVELS, CONTRIBUTION OBLIGATIONS,

METHODS OF HEALTH INSURANCE CONTRIBUTIONS

Article 1. Scope of Regulation

1. This Decree provides detailed regulations and guidance on implementing certain provisions of the Law on Health Insurance dated November 14, 2008 and the Law Amending and Supplementing Certain Provisions of the Law on Health Insurance dated June 13, 2014 (hereinafter referred to collectively as the amended and supplemented Health Insurance Law) for subjects specified in Point a Clause 3 Article 12 of the amended and supplemented Health Insurance Law, including: Implementation timeline; contribution levels, contribution obligations, and methods of health insurance contributions; health insurance cards; scope of benefits and health insurance benefit levels; health insurance examination and treatment; management and utilization of funds allocated for health insurance examination and treatment; health insurance appraisal; health insurance settlement and finalization.

2. Implementing health insurance for the subjects stipulated in Article 2 of this Decree only replaces the method of implementation and financial guarantee for regular medical examinations and treatments from the state budget to the health insurance fund. Other state budget allocations for other military and public security health tasks will continue to be implemented according to the provisions of the Government's Decrees, including Decree No. 123/2003/NĐ-CP dated October 22, 2003 on material standards for active-duty military personnel; Decree No. 65/2009/NĐ-CP dated July 31, 2009 amending and supplementing certain provisions of Decree No. 123/2003/NĐ-CP dated October 22, 2003; Decree No. 13/2013/NĐ-CP dated January 25, 2013 on material standards for submarine forces; Decree No. 18/2013/NĐ-CP dated February 21, 2013 on material standards for officers, non-commissioned officers, and soldiers serving in the People's Public Security Force; Decree No. 32/2013/NĐ-CP dated April 16, 2013 detailing and guiding the implementation of certain provisions of the Confidential Work Law on policies for persons engaged in confidential work, and other relevant laws.

3. Medical assurance for combat readiness, disaster response, and wartime tasks for the military, public security, and confidential work units shall be carried out according to separate regulations of the Government.

Article 3. Subjects participating in health insurance

1. Military personnel participating in health insurance include:

a) Officers and professional military personnel on active duty;

b) Non-commissioned officers and soldiers on active duty.

2. Public security personnel participating in health insurance include:

a) Officers and non-commissioned officers in operational roles and officers and non-commissioned officers in technical roles currently working in the public security forces;

b) Non-commissioned officers and conscripts in the public security forces;

c) Public security academy students receiving living expenses from the state budget.

3. Personnel engaged in confidential work participating in health insurance include:

a) Personnel engaged in confidential work receiving salaries equivalent to those of military personnel currently working at the Government Confidential Service Bureau;

b) Confidential work academy students receiving living expenses from the state budget under the same regime and policies as military academy students;

c) Persons engaged in confidential work receiving salaries equivalent to those of military personnel working at confidential organizations under ministries, sectors, and localities.

Article 3. Implementation timeline for health insurance

1. From the date this Decree takes effect, health insurance shall be implemented for 100% of the subjects specified in Point c Clause 3 Article 2 of this Decree.

2. From the date this Decree takes effect until December 31, 2015, health insurance shall be implemented for 15%; from January 1, 2016, health insurance shall be implemented for at least 30% of the subjects specified in Article 2 of this Decree, excluding the subjects specified in Point c Clause 3 Article 2 of this Decree.

3. From January 1, 2018, health insurance shall be implemented for at least 60% of the subjects specified in Article 2 of this Decree, excluding the subjects specified in Point c Clause 3 Article 2 of this Decree.

4. From January 1, 2020, health insurance shall be implemented for 100% of the subjects specified in Article 2 of this Decree.

5. Based on the implementation timeline for health insurance stipulated in Clauses 2, 3, and 4 of this Article, the Minister of National Defense and the Minister of Public Security shall decide specifically which units under their jurisdiction shall participate in health insurance.

Article 4. Contribution levels for health insurance

1. The monthly contribution level for health insurance is stipulated as follows:

a) 4.5% of the monthly salary for subjects specified in Point a Clause 1; Point a Clause 2; Points a and c Clause 3 Article 2 of this Decree;

b) 4.5% of the base salary for subjects specified in Point b Clause 1; Points b and c Clause 2; Point b Clause 3 Article 2 of this Decree.

2. Based on actual circumstances, the Minister of National Defense shall take the lead, in coordination with the Ministers of Public Security, Health, Finance, and heads of relevant agencies to submit to the Government proposals to adjust health insurance contribution levels appropriately.

Article 5. Responsibilities for contributions and methods of health insurance contributions

1. The state budget ensures full funding for health insurance contributions for subjects specified in Article 2 of this Decree according to the current budget allocation.

2. Annually, based on the timeline stipulated in Article 3 of this Decree, ministries, central agencies, and local agencies build budgets for health insurance contributions for managed subjects specified in Article 2 of this Decree, consolidate them into their unit's state budget draft and submit to the same-level financial authority for settlement in accordance with the State Budget Law and implementing regulations.

3. At the beginning of each quarter, agencies and units managing subjects must contribute to health insurance through the Social Insurance Department of the Ministry of National Defense, the Social Insurance Department of the Ministry of Public Security, or the Social Insurance Department of the province or centrally-administered city (hereinafter referred to as the Social Insurance Department of the province).

Chapter II
HEALTH INSURANCE CARD

Article 6. Health Insurance Cards

1. The model and blank card for health insurance cards are implemented as follows:

a) The model of health insurance cards for subjects specified in Clauses 1 and 2, Points a and b Clause 3 Article 2 of this Decree is a separate model, prescribed by the Vietnam Social Security after consultation with the Ministry of National Defense, the Ministry of Public Security, and the Ministry of Health;

b) The blank cards for health insurance for subjects specified in Clause 1, Points a and b Clause 3 Article 2 of this Decree are issued and managed by the Social Insurance Department of the Ministry of National Defense; for subjects specified in Clause 2 Article 2 of this Decree, they are issued and managed by the Social Insurance Department of the Ministry of Public Security;

c) The model and blank cards for health insurance for subjects specified in Point c Clause 3 Article 2 of this Decree are issued and managed by the Vietnam Social Security.

2. Benefits under health insurance are calculated from the date of validity recorded on the health insurance card.

Article 7. Issuance of health insurance cards

1. Health insurance cards for subjects specified in Article 2 of this Decree managed by the Ministry of National Defense are issued by the Social Insurance Department of the Ministry of National Defense; those managed by the Ministry of Public Security are issued by the Social Insurance Department of the Ministry of Public Security; those managed by other ministries, sectors, or localities are issued by the Social Insurance Department of the province.

2. The issuance procedures for health insurance cards are carried out in accordance with Article 17 of the amended and supplemented Health Insurance Law.

Article 8. Reissuing and Exchanging Health Insurance Cards

1. Reissuing health insurance cards in case of loss is carried out in accordance with the provisions of Article 18 of the amended and supplemented Health Insurance Law.

2. The replacement of health insurance cards is carried out in accordance with Article 19 of the amended and supplemented Health Insurance Law.

Article 9. Revocation and Temporary Seizure of Health Insurance Cards

1. Health insurance cards for subjects specified in Article 2 of this Decree will be revoked in the following cases:

a) Resigning from service in the People's Army, People's Public Security, or confidential organizations;

b) Transferring to another non-military or non-police service;

c) Duplicate issuance of health insurance cards for the same subject;

d) Incorrect issuance of health insurance cards to non-military personnel, police, or confidential staff.

2. Agencies managing subjects specified in Article 2 of this Decree have the responsibility to revoke health insurance cards in the cases mentioned in Clause 1 of this Article and report to the Social Insurance Department that issued the card to reduce the health insurance contributions for that subject.

3. Health insurance cards for subjects specified in Article 2 of this Decree will be temporarily withheld if the card is used by someone else for medical treatment.

Those responsible for managing the card or who lend the health insurance card to others must bear disciplinary actions from the military, public security, or confidential services and must reimburse all medical expenses incurred (if any).

Chapter III
SCOPE AND LEVEL OF HEALTH INSURANCE BENEFITS

Article 10. Scope of Health Insurance Benefits

1. The scope of health insurance benefits for the subjects specified in Article 2 of this Decree shall be implemented according to the provisions of Article 21 of the Health Insurance Law which has been amended and supplemented.

2. In addition to the scope of health insurance benefits prescribed in Clause 1 of this Article and not falling within the cases prescribed in Article 23 of the Health Insurance Law which has been amended and supplemented, the subjects specified in Article 2 of this Decree shall also be reimbursed for other medical examination and treatment costs including: medicines, chemicals, medical supplies approved for circulation in Vietnam and medical technical services approved by competent authorities according to the prescription of professionals.

3. The medical examination and treatment costs prescribed in Clause 2 of this Article shall be reimbursed from the health insurance funding allocated for medical examination and treatment of the subjects specified in Article 2 of this Decree; in case this funding source is insufficient, it shall be guaranteed by the state budget.

Article 11. Level of Health Insurance Benefits

1. The subjects specified in Article 2 of this Decree when undergoing medical examinations and treatments shall have their costs covered by the health insurance fund within the scope of benefits prescribed in Article 10 of this Decree, with a reimbursement rate of 100% of medical examination and treatment costs without applying a limit on the payment ratio for certain medicines, chemicals, medical supplies, and medical technical services as stipulated by the Minister of Health for the following cases:

a) Medical examinations and treatments conducted in accordance with Articles 26, 27, and 28 of the Health Insurance Law which has been amended and supplemented and Article 15 of this Decree;

b) Medical examinations and treatments at district-level hospitals, or inpatient treatment costs at provincial-level hospitals, central-level hospitals for those working or residing permanently in areas with difficult socio-economic conditions, or extremely difficult socio-economic conditions, or residing in island communes, island districts when self-referring for medical examinations and treatments outside the designated level;

c) From January 1, 2016, if they register for initial medical examinations and treatments at commune health stations or multi-purpose clinics, or district-level hospitals and equivalent facilities when undergoing medical examinations and treatments at commune health stations or multi-purpose clinics, or district-level hospitals and equivalent facilities nationwide;

d) Inpatient treatment at provincial-level hospitals and equivalent facilities from January 1, 2021 nationwide.

2. For the subjects specified in Article 2 of this Decree under the management of the Central Government, or the Ministry of National Defense, the Ministry of Public Security, or provinces and centrally-administered cities, in addition to the rights regarding health insurance medical examinations and treatments, they shall also be implemented according to the regulations of the Central Government, or the Ministry of National Defense, the Ministry of Public Security, or provinces and centrally-administered cities.

3. The subjects specified in Article 2 of this Decree who self-refer for medical examinations and treatments outside the designated level shall have their costs covered by the health insurance fund within the scope of benefits prescribed in Clause 1 of Article 10 of this Decree, with the following levels of reimbursement:

a) 40% of inpatient treatment costs at central-level hospitals, except in the cases prescribed in Point b Clause 1 and Clause 2 of this Article;

b) 60% of inpatient treatment costs at provincial-level hospitals and equivalent facilities from the date this Decree takes effect until December 31, 2020, except in the cases prescribed in Point b Clause 1 and Clause 2 of this Article;

c) 70% of medical examination and treatment costs at district-level hospitals and equivalent facilities from the date this Decree takes effect until December 31, 2015, except in the cases prescribed in Point b Clause 1 and Clause 2 of this Article;

d) Outpatient medical examination and treatment costs and the remaining portion of inpatient treatment costs prescribed in Points a and b of this Clause; the remaining portion of medical examination and treatment costs prescribed in Point c of this Clause and medical examination and treatment costs prescribed in Clause 2 of Article 10 of this Decree (if applicable) shall be paid by the patient directly to the medical examination and treatment facility.

4. Cases of medical examinations and treatments on demand or using socialized medical technical services at medical examination and treatment facilities shall be reimbursed by the health insurance fund within the scope of benefits and at the levels prescribed in Clauses 1, 2, and 3 of this Article; the remaining costs shall be paid by the patient directly to the medical examination and treatment facility.

5. Transportation Costs

a) The health insurance medical examination and treatment fund shall cover transportation costs for the subjects specified in Article 2 of this Decree when they need emergency care or are being treated as inpatients and require transfer to another level of specialized technical care in the following situations: transferring from district-level hospitals and equivalent facilities upwards to higher levels; transferring horizontally between levels; transferring downwards from higher levels to district-level hospitals and equivalent facilities according to professional prescriptions or mission requirements;

b) The level of reimbursement for transportation costs shall be stipulated by the Ministers of National Defense, Public Security, Health, and Finance;

c) Documentation and procedures for reimbursement of transportation costs:

When using transportation provided by the medical examination and treatment facility, there must be an order or dispatch slip issued by the medical examination and treatment facility transferring the patient, confirmed by the receiving medical examination and treatment facility.

When not using transportation provided by the transferring medical examination and treatment facility, there must be a receipt for patient transportation expenses and it must be kept in the settlement file.

Article 12. Cases Not Entitled to Health Insurance Benefits

1. Cases not entitled to health insurance benefits shall be implemented in accordance with the provisions of Article 23 of the amended and supplemented Health Insurance Law.

2. Special cases due to national defense and security activities and tasks of military personnel, public security officers, and personnel engaged in confidential work shall be carried out in accordance with the guidelines of the Minister of National Defense, the Minister of Public Security, the Minister of Health, and the Minister of Finance.

Chapter IV

ORGANIZATION OF MEDICAL EXAMINATIONS AND TREATMENTS

AND METHODS OF PAYMENT FOR MEDICAL EXPENSES

UNDER HEALTH INSURANCE

Article 13. Registration for Medical Examinations and Treatments under Health Insurance

1. The subjects specified in Article 2 of this Decree shall register for initial medical examinations and treatments under health insurance in accordance with the provisions of Article 26 of the amended and supplemented Health Insurance Law at one of the convenient health insurance examination and treatment facilities near their workplace, place of residence, or if they register for initial medical examinations and treatments under the military health system or public security health system, such registration shall be carried out in accordance with the regulations of the Minister of National Defense and the Minister of Public Security.

For the subjects specified in Article 2 of this Decree who are under central management, they shall register for initial medical examinations and treatments at hospitals responsible for providing health care to centrally managed cadres; for those under provincial or municipal management, they shall register for initial medical examinations and treatments at the provincial or municipal Cadre Health Care Examination Clinics.

2. The procedures for registering for initial medical examinations and treatments for the subjects specified in Article 2 of this Decree shall be carried out as follows:

a) At the beginning of each fourth quarter annually, the Vietnam Social Security shall provide the Social Security of the Ministry of National Defense and the Social Security of the Ministry of Public Security with a list of initial health insurance examination and treatment facilities nationwide, including those under the Ministry of National Defense and the Ministry of Public Security. The social security agencies shall have the responsibility to notify these units to inform the subjects specified in Article 2 of this Decree.

b) The subjects specified in Article 2 of this Decree shall choose a suitable place to register for initial medical examinations and treatments and fill it in on the Health Insurance Card Application Form.

c) The unit assigned to compile the list for applying for health insurance cards shall include the information on the initial medical examination and treatment registration places of the subjects specified in Article 2 of this Decree and submit it to the Social Security of the Ministry of National Defense, the Social Security of the Ministry of Public Security, and the Social Security of the province.

d) The Social Security of the Ministry of National Defense, the Social Security of the Ministry of Public Security, and the Social Security of the province shall confirm the initial medical examination and treatment registration place on the health insurance card and transfer it to the unit to issue it to the subjects specified in Article 2 of this Decree.

3. In cases where the subjects specified in Article 2 of this Decree travel on business or take leave elsewhere, they may receive medical examinations and treatments at the nearest health insurance examination and treatment facility and enjoy health insurance benefits as if they were registered at their initial health insurance examination and treatment facility.

Article 14. Transfer Between Levels of Treatment

1. The transfer between health insurance examination and treatment facilities shall be carried out in accordance with the provisions of Article 27 of the amended and supplemented Health Insurance Law and the regulations of the Minister of Health, or according to the requirements of the task.

2. For the transfer of specialized levels within health insurance examination and treatment facilities under the Ministry of National Defense and the Ministry of Public Security, it shall be carried out in accordance with the regulations of the Minister of National Defense and the Minister of Public Security.

3. In cases requiring a transfer according to the requirements of the task, the managing agency or unit of the subjects specified in Article 2 of this Decree shall make a written request and ensure that the transferred-to examination and treatment facility has the professional capacity to meet the treatment needs of the patient.

4. Procedures for transferring between levels:

a) Routine transfers shall be carried out in accordance with the regulations of the Minister of Health.

b) Transfers according to the requirements of the task, in addition to the documents specified in Point a of this Clause, must also include a written request from the managing unit of the subject.

Article 15. Procedures for health examination and treatment under health insurance

1. The procedures for health examination and treatment under health insurance shall be implemented in accordance with the provisions of Article 28 of the Health Insurance Law which has been amended and supplemented.

2. In cases of traveling on business or taking leave, in addition to the provisions of Clause 1 of this Article, patients must present valid business travel certificates or leave certificates, at the latest before being discharged from the hospital.

3. In cases of performing urgent tasks or field exercises, in addition to the provisions of Clause 1 of this Article, patients must present introduction letters from their managing units, at the latest before being discharged from the hospital.

4. In cases where individuals participating in health insurance who are selected to join the Military, Police, or other organizations specified in Article 2 of this Decree, during the period without having received a health insurance card, must go for health examination and treatment, they must present personal identification documents with photographs and induction orders, or decisions of competent authorities.

5. In cases where individuals are waiting for issuance, replacement, or renewal of health insurance cards, they must present introduction letters from their units clearly stating the health insurance card code, or confirmation letters from social insurance agencies issuing health insurance cards.

Article 16. Contracts for health examination and treatment under health insurance

1. Contracts for health examination and treatment under health insurance shall be implemented in accordance with the provisions of Article 25 of the Health Insurance Law which has been amended and supplemented.

2. The Social Insurance Department of the Ministry of National Defense, the Social Insurance Department of the Ministry of Public Security, the Social Insurance Department of provinces, and the Health Insurance Appraisal Center and Multi-Tier Payment Center have the responsibility to sign contracts for health examination and treatment under health insurance with healthcare facilities meeting the conditions stipulated in the Medical Examination and Treatment Law of the Ministry of National Defense, Ministry of Public Security, Ministry of Health, relevant ministries, sectors, and localities within their jurisdiction to organize health examination and treatment for the subjects specified in Article 2 of this Decree.

3. Procedures and documents for signing contracts for health examination and treatment under health insurance

a) The heads of the Social Insurance Department of the Ministry of National Defense, the Social Insurance Department of the Ministry of Public Security, the Social Insurance Department of provinces, and the Health Insurance Appraisal Center and Multi-Tier Payment Center directly sign contracts with the directors of hospitals or heads of management units of healthcare facilities to organize health examination and treatment under health insurance at these healthcare facilities;

b) Documents for signing contracts for health examination and treatment under health insurance include: Healthcare facility operation permits; decisions on classification of healthcare facilities (if applicable), and requests from units participating in contract signing.

Article 17. Health Insurance Appraisal

1. Health insurance appraisal for the subjects specified in Article 2 of this Decree shall be carried out in accordance with the provisions of Article 29 of the Health Insurance Law which has been amended and supplemented.

2. The Social Insurance Department of the Ministry of National Defense and the Social Insurance Department of the Ministry of Public Security organize health insurance appraisals for the subjects specified in Article 2 of this Decree, except for those specified in Point c Clause 3, who receive health examination and treatment at healthcare facilities that have signed contracts for health examination and treatment under health insurance with the Social Insurance Department of the Ministry of National Defense and the Social Insurance Department of the Ministry of Public Security.

3. The Social Insurance Department of provinces carry out health insurance appraisals for the subjects specified in Article 2 of this Decree who receive health examination and treatment at healthcare facilities that have signed contracts for health examination and treatment under health insurance with the Social Insurance Department of provinces, report the results of the appraisals to the Vietnam Social Insurance, and simultaneously notify the results of the appraisals to the Social Insurance Department of the Ministry of National Defense and the Social Insurance Department of the Ministry of Public Security.

4. The Health Insurance Appraisal Center and Multi-Tier Payment Center conduct health insurance appraisals for the subjects specified in Article 2 of this Decree who receive health examination and treatment at healthcare facilities that have signed contracts for health examination and treatment under health insurance with the Health Insurance Appraisal Center and Multi-Tier Payment Center, and notify the results of the appraisals to the Social Insurance Department of the Ministry of National Defense and the Social Insurance Department of the Ministry of Public Security.

Article 18. Payment methods, advance payments, settlement of medical examination and treatment costs under health insurance

1. The payment method for medical examination and treatment costs under health insurance for the subjects specified in Article 2 of this Decree shall be implemented according to the provisions of Article 30 of the Health Insurance Law which has been amended and supplemented, and Article 5 of Decree No. 105/2014/NĐ-CP dated November 15, 2014 of the Government detailing and guiding the implementation of certain articles of the Health Insurance Law (hereinafter referred to as Decree No. 105/2014/NĐ-CP).

2. The payment of medical examination and treatment costs under health insurance shall be carried out according to the provisions of Article 31 of the Health Insurance Law which has been amended and supplemented, specifically as follows:

a) The Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security shall pay the medical examination and treatment costs under health insurance for the subjects who have health insurance cards issued by the Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security to examine diseases and receive treatment at medical facilities that have signed contracts for medical examination and treatment under health insurance with the Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security.

b) The Social Insurance of the province, the Health Insurance Appraisal Center and Multi-level Payment Center shall pay the medical examination and treatment costs under health insurance for the subjects specified in Point c Clause 3 Article 2 of this Decree and the subjects who have health insurance cards issued by the Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security to examine diseases and receive treatment at medical facilities that have signed contracts for medical examination and treatment under health insurance with the Social Insurance of the province, the Health Insurance Appraisal Center and Multi-level Payment Center, and implement multi-level payments with the Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security.

3. Advance payments, settlements of medical examination and treatment costs under health insurance between the Social Insurance agency and medical facilities providing medical examination and treatment under health insurance shall be implemented according to the provisions of Article 32 of the Health Insurance Law which has been amended and supplemented, and the following specific regulations:

a) The Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security shall carry out advance payments, settlements of medical examination and treatment costs under health insurance with medical facilities providing medical examination and treatment under health insurance that have signed contracts with the Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security.

b) The Social Insurance of the province, the Health Insurance Appraisal Center and Multi-level Payment Center shall carry out advance payments, settlements of medical examination and treatment costs under health insurance with medical facilities that have signed contracts for medical examination and treatment under health insurance with the Social Insurance of the province, the Health Insurance Appraisal Center and Multi-level Payment Center.

c) Quarterly, based on the data from the settlement of medical examination and treatment costs under health insurance of the previous year for the subjects specified in Article 2 of this Decree, the Vietnam Social Security shall unify with the Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security the amount of funds transferred for medical examination and treatment under health insurance so that the Vietnam Social Security can make advance payments and settle medical examination and treatment costs for the subjects specified in Article 2 of this Decree, except for the subjects specified in Point c Clause 3 when they examine diseases and receive treatment at medical facilities not signing contracts for medical examination and treatment under health insurance with the Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security.

4. Settlement of medical examination and treatment costs under health insurance for the Vietnam Social Security:

a) Quarterly, the Social Insurance of the province, the Health Insurance Appraisal Center and Multi-level Payment Center shall compile the medical examination and treatment costs of the subjects specified in Article 2 of this Decree examining diseases and receiving treatment at medical facilities that have signed contracts for medical examination and treatment under health insurance with the Social Insurance of the province, the Health Insurance Appraisal Center and Multi-level Payment Center, and report the settlement to the Vietnam Social Security.

b) Quarterly, the Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security shall settle with the Vietnam Social Security the medical examination and treatment costs under health insurance for the subjects specified in Article 2 of this Decree, except for the subjects specified in Point c Clause 3 when they examine diseases and receive treatment at medical facilities that have signed contracts for medical examination and treatment under health insurance with the Social Insurance of the Ministry of National Defense, the Social Insurance of the Ministry of Public Security; the medical examination and treatment costs under health insurance reported by the Social Insurance of the province, the Health Insurance Appraisal Center and Multi-level Payment Center for multi-level payments and the medical examination and treatment costs under health insurance settled directly.

Article 19. Direct payment for medical examination and treatment costs under health insurance

1. The cases of direct payment shall be implemented according to the provisions set out in Clause 2, Article 31 of the Health Insurance Law which has been amended and supplemented.

2. Documents for direct payment:

a) A request for direct payment of medical examination and treatment costs under health insurance by the patient;

b) The documents stipulated in Article 15 of this Decree;

c) Discharge certificate or prescription or medical record book;

d) Original valid receipts (medicine purchase invoices, hospital fee invoices, and related receipts).

3. Process and time limit for direct payment:

a) Military personnel, public security officers, and personnel engaged in confidential work submit the required documents as specified in Clause 2 of this Article to their managing unit for transfer to, or directly transfer to, the social insurance agency issuing the health insurance card;

b) Within forty working days from the date of receipt of all documents requesting direct payment, the social insurance agency issuing the health insurance card must complete the health insurance appraisal and make direct payment for medical examination and treatment costs for military personnel, public security officers, and personnel engaged in confidential work.

4. Amount of direct payment:

a) In case of medical examination and treatment at a facility with a health insurance medical examination and treatment contract: Payment within the scope of health insurance benefits and entitlements as prescribed in Articles 10 and 11 of this Decree;

b) In case of medical examination and treatment at a facility without a health insurance medical examination and treatment contract: Payment based on actual costs within the scope of health insurance benefits and entitlements but not exceeding the maximum amount prescribed by the Minister of Health and the Minister of Finance.

5. Responsibility for payment: The social insurance agency that issues the health insurance card to the subjects as stipulated in Article 2 of this Decree shall be responsible for making direct payments to those subjects.

Chapter V

MANAGEMENT AND USE OF HEALTH INSURANCE REVENUE

FOR MILITARY PERSONNEL, PUBLIC SECURITY OFFICERS,

AND PERSONNEL ENGAGED IN CONFIDENTIAL WORK

Article 20. Allocation and management of health insurance revenue

1. The total health insurance revenue of military personnel and personnel engaged in confidential work issued health insurance cards by the Social Insurance of the Ministry of National Defense; and public security officers issued health insurance cards by the Social Insurance of the Ministry of Public Security, shall be allocated and managed as follows:

a) Ninety percent of the health insurance contributions shall be allocated for medical examination and treatment (hereinafter referred to as the medical examination and treatment fund) and managed and used by the Social Insurance of the Ministry of National Defense and the Social Insurance of the Ministry of Public Security;

b) Ten percent of the health insurance contributions shall be transferred to the Vietnam Social Insurance for the reserve fund and administrative expenses of the health insurance fund.

2. The allocation, management, and use of the health insurance fund for personnel engaged in confidential work under ministries, sectors, and localities issued health insurance cards by the Social Insurance of the provincial or centrally-administered city shall be carried out in accordance with the provisions of Article 6 of Decree No. 105/2014/NĐ-CP; the ratio of funds allocated for purchasing medicine, bandages, chemicals, consumable medical supplies, and technical service fees for medical examination and treatment for these subjects shall be implemented in accordance with Point a, Clause 1, Article 21 of this Decree.

3. The Social Insurance of the Ministry of National Defense and the Social Insurance of the Ministry of Public Security may open deposit accounts for health insurance revenues and expenditures at the State Treasury, commercial banks with good credit ratings. All interest earned on the health insurance revenue account shall be transferred to the reserve fund and managed by the Vietnam Social Insurance.

Article 21. Use of the health insurance examination and treatment fund

1. The health insurance examination and treatment fund prescribed in Point a Clause 1 Article 20 of this Decree shall be used to settle health insurance costs within the scope and level of benefits stipulated in Articles 10 and 11 of this Decree for military personnel, public security officers, and civil servants with confidential work who have health insurance cards issued by the Social Insurance under the Ministry of National Defense and the Social Insurance under the Ministry of Public Security, including:

a) Allocating 10% of total health insurance revenue to transfer to military medical units and agency healthcare services for purchasing medicines, bandages, chemicals, consumable medical supplies, and technical service fees for examination and treatment at military medical units and agency healthcare services;

b) The remainder shall be used to settle health insurance examination and treatment costs and transportation expenses.

2. In cases where the examination and treatment fund of the Social Insurance under the Ministry of National Defense and the Social Insurance under the Ministry of Public Security exceeds the examination and treatment costs and transportation expenses in the year, including costs within the scope and level of benefits stipulated in Articles 10 and 11 of this Decree, after being reviewed and settled by the Vietnam Social Security, the unused portion of the budget shall be used as follows:

a) From the date this Decree takes effect until December 31, 2020, it shall be retained entirely by the Social Insurance under the Ministry of National Defense and the Social Insurance under the Ministry of Public Security for use and general regulation in medical facilities under the Ministry of National Defense and the Ministry of Public Security to support examination and treatment; purchase medical equipment suitable for the capabilities and qualifications of medical staff; purchase patient transport vehicles at grassroots units;

b) From January 1, 2021 onwards, 70% shall be retained by the Social Insurance under the Ministry of National Defense and the Social Insurance under the Ministry of Public Security for use and general regulation in medical facilities under the Ministry of National Defense and the Ministry of Public Security to support implementation of the contents as prescribed in Point a Clause 2 of this Article; 30% shall be transferred to the Vietnam Social Security for accounting into the Reserve Fund for general regulation.

3. In cases where the examination and treatment fund of the Social Insurance under the Ministry of National Defense and the Social Insurance under the Ministry of Public Security is less than the examination and treatment costs in the year, including costs within the scope and level of benefits stipulated in Articles 10 and 11 of this Decree, after being reviewed and settled by the Vietnam Social Security, it shall be implemented as follows:

a) The Vietnam Social Security shall be responsible for using the Reserve Fund to supplement the shortfall in the examination and treatment costs within the scope of health insurance payment benefits stipulated in Clause 1 Article 10 and Article 11 of this Decree;

b) In cases where the Reserve Fund of the Vietnam Social Security is insufficient to make up the shortfall, the Vietnam Social Security shall coordinate with the Social Insurance under the Ministry of National Defense or the Social Insurance under the Ministry of Public Security, compile and report to the Management Board of the Vietnam Social Security for a resolution plan;

c) For examination and treatment costs outside the scope of health insurance payment that are guaranteed by the state budget, the Vietnam Social Security shall compile and report to the Ministry of Finance to request the Prime Minister to provide additional funding.

4. The Ministers of National Defense, Public Security, Health, and Finance shall guide the implementation of Clauses 2 and 3 of this Article.

Article 22. Management expenses for health insurance of the Social Insurance of the Ministry of National Defense and the Social Insurance of the Ministry of Public Security

1. The management expenses for health insurance of the Social Insurance of the Ministry of National Defense and the Social Insurance of the Ministry of Public Security shall be guaranteed by the Vietnam Social Security.

2. The contents of the management expenses for health insurance shall be implemented in accordance with the provisions of Article 8 of Decree No. 105/2014/NĐ-CP.

Article 23. Preparation of budget estimates and settlement of revenue and expenditure of the health insurance fund

1. Annually, the Minister of National Defense and the Minister of Public Security shall instruct the Social Insurance of the Ministry of National Defense and the Social Insurance of the Ministry of Public Security to prepare budget estimates for revenue and expenditure of the health insurance fund, management costs of the health insurance fund for the objects specified in Article 2 of this Decree within their jurisdiction, and report to the Vietnam Social Security.

2. Annually, the Social Insurance of the Ministry of National Defense and the Social Insurance of the Ministry of Public Security shall report to the Minister of National Defense and the Minister of Public Security to issue decisions allocating budget estimates for revenue and expenditure of health insurance to units for implementation.

3. Annually, the Social Insurance of the Ministry of National Defense and the Social Insurance of the Ministry of Public Security shall settle revenue and expenditure of health insurance for the objects specified in Article 2 of this Decree within their jurisdiction for units, healthcare facilities providing health insurance services, and report the settlement of revenue and expenditure of health insurance to the Vietnam Social Security.

Chapter VI
IMPLEMENTING PROVISIONS

Article 24. Transitional Provisions

1. The objects specified in Article 2 of this Decree, during the period they have not yet joined health insurance according to the schedule prescribed in Article 3 of this Decree, shall still be entitled to regular medical examination and treatment and shall be covered by the state budget as currently provided.

2. The state budget shall ensure standards for medicines, bandages, chemicals, and medical supplies used at units; bed costs as stipulated in the Government's Decrees: Decree No. 123/2003/NĐ-CP dated October 22, 2003 on material standards for logistics for active-duty military personnel; Decree No. 65/2009/NĐ-CP dated July 31, 2009 amending and supplementing Decree No. 123/2003/NĐ-CP dated October 22, 2003 on material standards for logistics for active-duty military personnel; Decree No. 18/2013/NĐ-CP dated February 21, 2013 on material standards for logistics for officers, non-commissioned officers, and soldiers serving in the People's Public Security Forces; and Decree No. 32/2013/NĐ-CP dated April 16, 2013 detailing and guiding the implementation of certain articles of the Cryptographic Law regarding the system and policies for cryptographic staff. These standards will be adjusted accordingly to the schedule prescribed in Article 3 of this Decree and the practical implementation of health insurance for the objects specified in Article 2 of this Decree.

Article 25. Provisions on Application

The management and organization of health insurance for military personnel, public security personnel, and cryptographic staff performing special tasks shall be regulated by the Minister of National Defense and the Minister of Public Security.

Article 26. Effective date

This Decree takes effect from October 15, 2015.

Article 27. Responsibilities for Guidance on Implementation

1. The Minister of National Defense shall take the lead and coordinate with the Minister of Health and the Minister of Finance to guide the implementation of the provisions assigned in this Decree concerning the implementation of health insurance for military personnel and cryptographic staff.

2. The Minister of Public Security shall take the lead and coordinate with the Minister of Health, the Minister of Finance to guide the implementation of the provisions assigned in this Decree concerning the implementation of health insurance for public security personnel.

Article 28. Responsibility for Implementation

1. The Minister of Health shall be responsible for directing and guiding healthcare facilities to organize medical examinations and treatments under health insurance for the objects specified in Article 2 of this Decree.

2. The Ministers of National Defense and Public Security shall be responsible for consolidating and improving the organizational structure of health insurance, healthcare facilities within the Ministries of National Defense and Public Security to meet the requirements of implementing health insurance for the objects specified in Article 2 of this Decree; directing the connection and integration of the medical examination and treatment data systems of the Ministries of National Defense and Public Security with those of the Health Sector and the Social Security Sector, ensuring the specific requirements of national defense and security tasks.

3. The General Director of the Vietnam Social Security shall be responsible for coordinating with the Ministers of National Defense and Public Security to guide the implementation of health insurance for the objects specified in Article 2 of this Decree.

4. The Ministers, Heads of Ministries equivalent to Ministries, Heads of agencies under the Government, Chairpersons of Provincial People's Committees directly under the Central Government shall be responsible for enforcing this Decree.