Decree No. 75/2023/ND-CP amending and supplementing some articles of Decree No. 146/2018/NĐ-CP dated October 17, 2018 of the Government detailing and guiding methods to implement certain provisions of the Health Insurance Law.

DECREE

AMENDING AND SUPPLEMENTING CERTAIN ARTICLES OF THE GOVERNMENTAL DECREE NO. 146/2018/NĐ-CP OF OCTOBER 17, 2018 PROVIDING DETAILS AND GUIDELINES FOR IMPLEMENTATION OF CERTAIN PROVISIONS OF THE HEALTH INSURANCE LAW

Pursuant to the Law on Organization of the Government dated June 19, 2015; the Law Amending and Supplementing Certain Provisions of the Law on Organization of the Government and the Law on Organization of Local Administration dated November 22, 2019;

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 Health,

The Government promulgates this Decree amending and supplementing certain articles of the Governmental Decree No. 146/2018/NĐ-CP of October 17 October 2018 providing details and guidelines for implementation of certain provisions of the Health Insurance Law.

Article 1. Amending and supplementing certain articles of the Governmental Decree No. 146/2018/NĐ-CP of October 17, 2018 providing details and guidelines for implementation of certain provisions of the Health Insurance Law

1. Amending and supplementing some clauses of Article 3 as follows:

a) Amending and supplementing Clause 8 as follows:

“8. Persons entitled to monthly social assistance benefits under the laws on elderly persons, persons with disabilities, and social assistance.”

b) Amending and supplementing Point a of Clause 9 as follows:

“a) Households classified as poor households according to the multidimensional poverty standard for the period 2022-2025 stipulated in the Governmental Decree No. 07/2021/NĐ-CP dated January 27, 2021, providing multidimensional poverty standards for the period 2021-2025 (hereinafter referred to as the Governmental Decree No. 07/2021/NĐ-CP) and other documents issued by competent authorities amending, supplementing, or replacing the poverty standard applicable for each period;”

c) Supplementing Clause 20 following Clauses 18 and 19 which were supplemented by Clause 1 of Article 183 of the Governmental Decree No. 131/2021/NĐ-CP dated December 30, 2021, providing detailed measures for implementing the Preferential Treatment Ordinance for Persons Contributing to the Revolution as follows:

“20. Citizens residing in safe zones and revolutionary safe areas during the anti-French and anti-American resistance wars, who have been updated in the National Population Database and the Residency Database, and who do not fall within the categories specified in Clauses 1, 2, and 3 of Article 12 of the Health Insurance Law.”

2. Amending and supplementing certain clauses of Article 4 as follows:

a) Amend and supplement Clause 1 as follows:

“1. Persons belonging to near-poor households according to the near-poor household standard for the period 2022-2025 stipulated in the Governmental Decree No. 07/2021/NĐ-CP and other documents issued by competent authorities amending, supplementing, or replacing the near-poor household standard applicable for each period.”

b) Amend and supplement Clause 4 as follows:

“4. Persons belonging to households engaged in agriculture, forestry, fisheries, and salt production with a medium living standard according to the medium living standard household standard for the period 2022-2025 stipulated in the Governmental Decree No. 07/2021/NĐ-CP and other documents issued by competent authorities amending, supplementing, or replacing the medium living standard household standard applicable for each period.”

c) Supplement Clause 5 after Clause 4 as follows:

“5. Ethnic minority citizens currently residing in areas of Zone II, Zone III, and extremely difficult communes in ethnic minority and mountainous regions during the period 2016-2020, where these communes are no longer listed in the Zone II, Zone III, and extremely difficult commune lists in ethnic minority and mountainous regions for the period 2021-2025 as decided by the Prime Minister.”

3. Amending and supplementing certain clauses of Article 8 as follows:

a) Amending and supplementing Points a and b of Clause 1 as follows:

“a) Providing 100% support for health insurance contributions for persons belonging to near-poor households residing in poor districts as decided by the Prime Minister and other competent authorities;

b) Providing at least 70% support for health insurance contributions for the subjects specified in Clauses 1, 2, and 5 of Article 4 of this Decree;”

b) Amend and supplement Clause 3 as follows:

“3. Provincial People's Committees shall base their decisions on the local budget capacity and other legitimate sources of funding to submit to the Provincial People's Councils for approval:

a) The level of support for health insurance contributions for subjects higher than the minimum support levels specified in Points b and c of Clause 1 of Article 8 of this Decree;

b) The level of support for health insurance contributions for subjects not eligible for the support levels specified in Clause 1 of Article 8 of this Decree;

c) Subjects eligible for support and the level of support and co-payment for medical examination and treatment costs under health insurance for insured individuals when seeking medical examination and treatment.”

4. Amend and supplement some clauses of Article 9 as follows:

a) Amend and supplement Clause 2 as follows:

“2. For the subjects specified in Clauses 3, 5, 8, 11, 12, 18, 19, and 20 of Article 3 of this Decree, quarterly, the labor, invalids, and social affairs agency shall transfer funds from the implementation of preferential policies for persons contributing to the revolution and the implementation of social assistance policies into the health insurance fund. By December 15 each year, the labor, invalids, and social affairs agency must complete the settlement and transfer of funds into the health insurance fund for that year.”

b) Amend and supplement Clause 3 as follows:

“3. For the subjects specified in Clauses 1, 4, 6, 7, 9, 10, 13, 14, and 17 of Article 3 and Clauses 1, 2, and 5 of Article 4 of this Decree:

a) Quarterly, the social insurance agency shall compile the number of health insurance cards issued and the amount of contributions and supported contributions according to Model 1 of the Appendix attached to this Decree, and send it to the finance agency to transfer funds into the health insurance fund as stipulated in Clause 9 of this Decree;

b) The time for calculating the amount due for subjects whose lists are compiled annually shall be calculated from January 1; for subjects added during the year, the calculation shall start from the date determined in the decision approving the list by the competent authority;

c) In cases where insured individuals die, go missing, or no longer reside in Vietnam, the amount of health insurance contributions shall be calculated from the contribution date to the cessation date according to the reduction list established by the competent authority.”

5. Amending and supplementing Points a and e of Clause 1 of Article 14 as follows:

Amend and supplement point a as follows:

“a) 100% of medical examination and treatment costs for the subjects specified in Clauses 3, 4, 5, 8, 9, 11, 17, and 20 of Article 3 of this Decree;”

b) Amend and supplement Point e as follows:

“e) 95% of medical examination and treatment costs for the subjects specified in Clause 1 of Article 2, Clauses 12, 18, and 19 of Article 3, and Clauses 1, 2, and 5 of Article 4 of this Decree;”

6. Amending and supplementing Clause 1 of Article 15 as follows:

"1. Health insurance participants when seeking medical examination and treatment must present their health insurance card with photo or national identity card; in cases where presenting a health insurance card without photo, they must additionally present one of the following identification documents with photo issued by authorized agencies or organizations, or a confirmation letter from the local police station or other documents with confirmation from educational institutions managing students and trainees; other lawful personal identification documents or electronic identity level 2 documents as prescribed in Decree No. 59/2022/NĐ-CP dated September 5, 2022 of the Government on digital identity and authentication."

"2. Persons exempted from certain conditions for acquiring Vietnamese citizenship as stipulated in Clauses 2 and 3 of Article 19 of this Law shall be exempted from corresponding documents related to the exempted conditions."

a) Amend and supplement Clause 1 as follows:

"1. Rights of medical examination and treatment facilities:"

"a) Implement the rights as stipulated in Article 42 of the Health Insurance Law and the regulations on medical examination and treatment;"

"b) Be provided timely information when the health insurance claim adjudication system detects an increase in medical examination and treatment costs under health insurance exceeding the average cost at the same level, same category, and same specialty facility to promptly review, inspect, verify, and implement appropriate adjustment measures;"

"a) Deposits of microfinance organizations at credit institutions, branches of foreign banks, except deposits at credit institutions under special control according to Clause 9, Article 174 of the Law on Credit Institutions;"

"a) Fulfill the responsibilities as stipulated in Article 43 of the Health Insurance Law and other responsibilities as prescribed by laws on medical examination and treatment;"

c) Amend and supplement Point b Clause 2 as follows:

"b) Comply with the regulations on medical examination and treatment, professional guidelines of the Ministry of Health, and relevant laws on procurement and bidding to ensure the supply of quality, effective, and economical medicines, chemicals, medical supplies, and medical technical services;"

"d) Supplement Points d and e in Clause 2 as follows:"

"d) Establish an information technology infrastructure system, upgrade, and complete hospital management software systems to comply with legal provisions on input data standards, output data standards, electronic data extraction and transfer, digital transformation, and electronic transactions in the healthcare sector;"

"e) Review and promulgate promptly the procedures and professional guidelines for medical examination and treatment under health insurance, measures to prevent abuse and fraud of the health insurance fund within their authority; organize inspections and reviews of the implementation of health insurance medical examination and treatment cost settlements in accordance with legal provisions; proactively identify, review, inspect, and verify high-cost medical examination and treatment expenses at the facility based on recommendations and warnings from the social insurance agency and make appropriate adjustments;"^”.

"8. Amend and supplement Clause 3 of Article 24 as follows:"

"3. Principles of payment:"

"a) The service fees for medical examination, bed day service fees, and technical service fees, laboratory tests used for patients within the scope and benefit levels of health insurance participants shall be paid according to the actual quantity used and the current regulated prices;"

"b) Medicines, chemicals, and medical supplies costs not included in the price of medical examination and treatment services under health insurance or used in technical services without established health insurance examination and treatment prices, if used for patients within the scope and benefit levels of health insurance participants, shall be paid according to the actual quantity used and the purchase price as prescribed by laws on bidding;"

"c) Blood and blood products costs shall be paid according to the guidelines of the Minister of Health;"

"9. Amend and supplement Article 36 as follows:"

"Article 36. Financial Planning and Settlement"

"1. Each year, the Vietnam Social Security establishes a financial plan for health insurance fund revenue and expenditure, health insurance fund management costs, and investment from temporarily idle health insurance fund money. The Ministry of Finance takes the lead and coordinates with the Ministry of Health to examine, consolidate, and submit the financial plan to the Prime Minister for approval;"

"2. Establishing and allocating the budget for health insurance medical examination and treatment costs and announcing the estimated health insurance medical examination and treatment costs:"

"a) The Vietnam Social Security establishes the budget for health insurance medical examination and treatment costs for the next year (including the budget of the Military Social Security and the Public Security Social Security) and sends it to the Ministry of Finance before August 30 each year. The Ministry of Finance leads and coordinates with the Ministry of Health to consolidate and submit the health insurance medical examination and treatment budget to the Prime Minister for approval from the health insurance fund revenue and reserve fund for the Vietnam Social Security;"

"b) Based on the approved budget, the Vietnam Social Security allocates the health insurance medical examination and treatment budget to the Military Social Security, the Public Security Social Security, and the provincial and municipal social security offices within 90% of the national health insurance revenue budget;"

"c) Based on the request of medical examination and treatment facilities, the provincial and municipal social security offices announce the estimated health insurance medical examination and treatment costs to the medical examination and treatment facilities (this does not serve as the basis for provisional payment, settlement, or final settlement of health insurance medical examination and treatment costs by the medical examination and treatment facilities in cases of exceeding the estimated costs). If the medical examination and treatment facilities have an increase or decrease in the estimated costs for the year compared to the announced amount, the facilities must send a written notice to the provincial and municipal social security offices before October 15 each year for consolidation and adjustment within the allocated budget;"

"d) In cases where the total estimated health insurance medical examination and treatment costs of the medical examination and treatment facilities, the estimated health insurance medical examination and treatment costs of the Military Social Security and the Public Security Social Security for the year exceed or fall short of the allocated budget by the Vietnam Social Security, the provincial and municipal social security offices, the Military Social Security, and the Public Security Social Security must consolidate and send the report to the Vietnam Social Security before October 30 each year for consideration and adjustment between provinces and municipalities and the Military Social Security and the Public Security Social Security."

The Vietnam Social Security shall aggregate and review the adjustment of the budget for medical examination and treatment expenses under health insurance between social security agencies of provinces and centrally-administered cities, the Ministry of National Defense Social Security, and the People's Public Security Social Security within the allocated budget by the Prime Minister before November 15 each year to serve as the basis for adjusting the estimated expenditure on medical examination and treatment under health insurance at medical facilities.

3. Supplement funds for medical examination and treatment under health insurance for medical facilities in cases where the actual expenditure on medical examination and treatment under health insurance in a year exceeds the estimated expenditure (including the initial notification at the beginning of the year and adjustments made during the year) and surpasses the allocated budget for medical examination and treatment under health insurance assigned by the Vietnam Social Security as follows:

a) The provincial social security agency shall take the lead and coordinate with the Department of Health and medical facilities to review and determine the additional costs for medical examination and treatment under health insurance that exceed the estimated expenditure and supplement funds for medical facilities.

b) In cases where the allocated budget by the Vietnam Social Security is insufficient to supplement funds for medical facilities, the provincial social security agency, the Ministry of National Defense Social Security, and the People's Public Security Social Security shall aggregate and submit to the Vietnam Social Security for consideration and supplementation of funds for medical examination and treatment under health insurance.

4. In cases where the total actual expenditure on medical examination and treatment under health insurance in a year exceeds the allocated budget by the Prime Minister, the Vietnam Social Security shall supplement funds for medical examination and treatment under health insurance to settle accounts with medical facilities from the reserve fund and compile reports to submit to the Social Security Council, the Ministry of Finance, the Ministry of Health, and the Prime Minister.

In cases where the health insurance reserve fund is insufficient to supplement funds for medical examination and treatment for provinces and centrally-administered cities, the Ministry of National Defense Social Security, and the People's Public Security Social Security, relevant agencies shall implement according to the provisions of Clause 3, Article 35 of this Decree.

5. Advance payments, settlements, and final settlements of medical examination and treatment expenses under health insurance for medical facilities shall be carried out quarterly in accordance with the provisions of Clauses 1 and 2, Article 32 of the Health Insurance Law.

6. Annually, before October 1, the Vietnam Social Security shall be responsible for compiling and preparing the final settlement report of the health insurance fund of the previous year in accordance with Article 32 of the Health Insurance Law."

10. Amend and supplement some clauses of Article 42 as follows:

a) Amend Point g Clause 1 as follows:

"g) Provide regulations and guidance on the implementation of data linkage regarding test results, imaging diagnostics, functional examinations, and patient medical examination and treatment information under health insurance."

b) Add Point i after Point h Clause 1 as follows:

"i) Direct medical facilities and centralized procurement units to strictly comply with relevant regulations on procurement and bidding to ensure timely supply of medicines, chemicals, and medical supplies within the scope of benefits for health insurance participants, enhance thrift and prevent waste. Direct medical facilities to adhere to laws and regulations on medical examination and treatment, professional guidelines issued by the Ministry of Health, and related laws concerning the provision of medical technology services to ensure quality, effectiveness, and thrift. Review and update the lists, conditions, scopes, and reimbursement rates for medicines, medical supplies, medical technology services, and goods within the scope of health insurance fund reimbursement to ensure effective management and utilization of the fund."

c) Amend and supplement Point d Clause 5 of Article 42 as follows:

"d) Improve the information technology system to meet the requirements for receiving, appraising, and promptly providing feedback to medical facilities on health insurance medical examination and treatment data; ensure accuracy, safety, and confidentiality of information and rights of all parties involved; proactively review, detect, and promptly provide warning information to health insurance medical facilities about medical examination and treatment costs under health insurance that are higher than the average cost of medical facilities of the same level, same tier, and same specialty."

Article 2. Amend and abolish certain provisions of Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government detailing and guiding methods for implementing some articles of the Health Insurance Law.

1. Amend and supplement Model Nos. 5, 6, and 7 attached to Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government detailing and guiding methods for implementing some articles of the Health Insurance Law with Model Nos. 5, 6, and 7 attached to this Decree.

2. Abolish Clause 16, Article 3 of Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government detailing and guiding methods for implementing some articles of the Health Insurance Law.

3. Abolish Clauses 4, 5, and 6 of Article 24 of Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government detailing and guiding methods for implementing some articles of the Health Insurance Law.

Article 3. Effectiveness

1. This Decree takes effect from December 3, 2023.

2. The provisions at Clause 1, Points a and b of Clause 2, Clauses 3, 4, 5, and 6 of Article 1 of this Decree shall be applied from October 19, 2023.

3. The State budget shall support the subjects specified in Point c of Clause 2, Article 1 of this Decree during a period of 36 months starting from November 1, 2023.

4. The provisions at Clause 8, Article 1 and Clause 3, Article 2 of this Decree shall be applied from January 1, 2019. Settlement and finalization of health insurance examination and treatment costs from January 1, 2019 shall be carried out according to the provisions of Articles 30 and 31 and Clause 2, Article 32 of the Health Insurance Law and the provisions at Clause 8, Article 1 of this Decree.

Article 4. Transitional Provisions

Participants in health insurance who enter healthcare facilities for treatment before this Decree takes effect but are discharged on or after the date this Decree takes effect shall be reimbursed by the health insurance fund within the scope and level of benefits stipulated in the Health Insurance Law, as provided for in Points b, c, d, đ, g, and h of Clause 1, Clauses 2, 3, 4, and 5 of Article 14 of Decree No. 146/2018/ND-CP and the provisions at Clause 5, Article 1 of this Decree.

Article 5. Responsibilities for Implementation

Ministers, Heads of ministerial-level agencies, Heads of government-affiliated agencies, Chairpersons of provincial/municipal People's Committees directly under the central government, and related organizations and individuals are responsible for implementing this Decree./.

ANNEX

(Attached to Decree No. 75/2023/ND-CP dated October 19, 2023 of the Government)

Model No. 5

RESCHEDULED APPOINTMENT FORM

Patient's name: … Male □ Female □

Date of birth: … month … year …

Place of residence: …

Health insurance card number: …

Expiry date of health insurance card: … month … Year …

Expired: □             Unable to determine expiry date: □

Date of examination: … day … month 202...

Admitted to hospital: … day … month 202...;

Reason for admission:

Emergency □        Correct level □    Incorrect level □

Discharged: … day … month 202….;

Diagnosis: …

Associated diseases: …

Rescheduled appointment for … hour … day … month … year 202... or any time before the rescheduled appointment if there are unusual signs (symptoms). If the patient misses the rescheduled appointment, they must contact medical staff within 10 days of the rescheduled appointment to register for a suitable appointment or visit the facility themselves.

This rescheduled appointment form is only valid once from the date it was issued./.

Model No. 6

REFERRAL LETTER FOR HEALTH INSURANCE EXAMINATION AND TREATMENT

Respectfully submitted to: ...

Healthcare facility: …Respectfully introduces:

- Name of patient: … Male/Female: … Year of birth: …

- Address: ...

- Ethnicity: … Nationality: …

- Occupation: … Workplace: …

- Health insurance card number: …

- Expiry date of health insurance card: … month … Year …

Expired: □             Unable to determine expiry date: □

- Has been examined and treated:

+ At: … (Level …) from … day … month 202… to … day … month … year 202…

+ At: … (Level …) from … day … month … year 202… to … day … month … year 202...

SUMMARY OF MEDICAL RECORD

- Clinical symptoms: …

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

- Laboratory and clinical test results: …

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

- Diagnosis: …

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

- Methods, procedures, techniques, and medications used in treatment: …

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

- Patient's condition at the time of transfer: …

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

- Reason for transfer: Circle the appropriate reason for transfer. If selecting option 1, mark (X) in the corresponding box.

(1) Meets conditions for transfer:

a) Compliant with transfer regulations^(*): □

b) Beyond the capacity of the healthcare facility. □

(2) At the request of the patient or their legal representative.

- Treatment plan: …

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

- Time of transfer: … hour … minute, … day … month … year 202…

- Mode of transportation: …

- Name, position, and professional qualifications of escort (if any): …

…………………………………………………………………………………………………………

(*). Patients undergoing health insurance examination and treatment at the correct level of specialization may be transferred to a higher level, a lower level, or between healthcare facilities at the same level in accordance with the law.

Model No. 7

SOCIALIST REPUBLIC OF VIET NAM
Independence - Freedom - Happiness
--------------------

HEALTH INSURANCE EXAMINATION AND TREATMENT CONTRACT Year 202...

(Number: …/HDKCB-BHYT)⁽¹⁾

Based on the Civil Code dated … day … month … year …;

Based on the Health Insurance Law dated … day … month … year …;

Based on the Medical Examination and Treatment Law dated … day … month … year …;

Based on Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government detailing and guiding methods for implementing some articles of the Health Insurance Law; Decree No. 75/2023/ND-CP dated October 19, 2023 of the Government amending and supplementing certain articles of Decree No. 146/2018/ND-CP;

Based on Decision No. … dated … day … month … year … of … regarding the functions and tasks of healthcare facilities …⁽²⁾

Based on Decision No. … dated … day … month … year … of … regarding the functions and tasks of the Provincial/Municipal Social Insurance Office ⁽³⁾ ……………….

Today, … day … month … year 202… at …, we include:

Party A Social Insurance (province/district) …

Address:…

Email address: …

Telephone:...Fax:...

Account number:...At State Treasury or Bank...

Representative: Mr./Ms. ...

Position: Director or Deputy Director (Power of Attorney No.:... date...month...year 202...)⁽⁴⁾

Party B: (Name of medical examination and treatment facility or agency signing the medical examination and treatment contract):   send a text message Account number:...At State Treasury or Bank...

Address:…

Email address: …

Telephone:...Fax:...

bank... send a text message Position: Director or Deputy Director (Power of Attorney No.:...date...month...year 202...)

Representative: Mr./Ms. ...

After reaching an agreement, both parties agree to sign this medical examination and treatment health insurance contract according to the following terms and conditions:⁽⁵⁾

Article 1. Organization of Medical Examination and Treatment

1. Service Object:

Persons participating in health insurance who come for medical examination and treatment at Party B's medical examination and treatment facility.

2. Scope of Service Provision:

Party B ensures medical examination and treatment in accordance with health insurance regulations; conducts bidding procurement of medicines, chemicals, and medical supplies in compliance with regulations to meet the provision of medical technical services within the scope of expertise of the medical examination and treatment facility and other medical technical services stipulated by laws on medical examination and treatment and the coverage of persons participating in health insurance.

Article 2. Payment Method

Both parties agree on payment methods and specify them clearly regarding the objects and scope (specify the payment method): ...

Article 3. Advance Payment, Settlement, Final Settlement

………………………………………………………………………………………………………..

………………………………………………………………………………………………………..

Both parties shall implement advance payment, settlement, and final settlement of medical examination and treatment costs in accordance with Article 32 of the Health Insurance Law, Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law; Decree No. 75/2023/ND-CP dated October 19, 2023 of the Government amending and supplementing certain articles of Decree No. 146/2018/ND-CP and related legal documents.

Article 4. Rights and Obligations of Party A

1. Rights of Party A:

a) To comply with the provisions of Article 40 of the Health Insurance Law.

b) To request Party B to ensure the implementation of the contents stipulated in Clause 2, Article 1 of this Contract.

c) To request Party B to provide documents to serve the appraisal work, including: medical records, joint venture and cooperation project plans for implementing medical technical services, employment contracts between the medical examination and treatment facility and healthcare practitioners (if any); Decision of the competent authority on the implementation of the project plan or technology transfer and medical support contracts for lower-level facilities; list of medical technical services; list and prices of medicines, chemicals, and medical supplies within the coverage of persons participating in health insurance used at the medical examination and treatment facility.

d) To refuse to pay medical examination and treatment costs under health insurance that do not comply with regulations or do not match the content of this contract.

2. Obligations of Party A:

a) To comply with the provisions of Clause 5, Article 41 of the Health Insurance Law and Articles 19, 20, and 21 of Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government and related amendments, supplements, or replacements.

b) To make advance payments to Party B in accordance with Clause 1, Article 32 of the Health Insurance Law; in cases where both parties have not reached an agreement on the appraisal results, Party A still makes advance payments to Party B in accordance with Article 32 of the Health Insurance Law.

c) Not to request Party B to recheck information on health insurance cards for patients participating in health insurance whose medical examination and treatment costs have been settled through the fiscal year.

d) Not to deduct or recover costs that Party B has already used for patients and which have been completed by the medical examination and treatment facility for settlement procedures when there is incorrect information on the health insurance card.

đ) To comply with legal regulations on medical examination and treatment in conducting appraisal work; to be responsible before the law for the results of appraisal and settlement of medical examination and treatment costs under health insurance.

d) Comply with the provisions of laws on medical examination and treatment in conducting appraisal work; be liable under the law for the results of the appraisal and the settlement of costs for medical examination and treatment under health insurance.

Article 5. Rights and responsibilities of Party B

1. Rights of Party B:

Implement as prescribed in Article 42 of the Health Insurance Law;

2. Responsibilities of Party B:

a) Implement as prescribed in Article 43 of the Health Insurance Law.

b) Designate the use of medicines, chemicals, medical supplies, and healthcare services reasonably, safely, and effectively; avoid waste and abuse;

c) Provide Party A with documents necessary for the appraisal process, including: medical records; joint venture and cooperation plans to implement medical technology services, employment contracts between healthcare facilities and practitioners (if any); Decisions of competent authorities regarding implementation of joint ventures or technology transfer agreements, and medical support for lower-level facilities; lists of medical technologies; lists and prices of medicines, chemicals, and medical supplies within the scope of health insurance coverage used at healthcare facilities;

d) In case there are changes to the list of medical technologies, the list and prices of medicines, chemicals, and medical supplies approved by competent authorities, and personnel involved in the performance of the contract must notify Party A in writing and update on the Information System's Appraisal Insurance Portal;

đ) Bear legal responsibility for violations committed by Party B in implementing policies and laws on health insurance;

Article 6. Duration of the Contract

From the date....of...year 202...to December 31, 202...

Article 7. Mechanism for Handling Disputes in the Contract

1. If any issues arise related to the execution of the contract, both parties will discuss and resolve them based on compliance with the law, the legitimate rights and interests of the parties, and insured patients, and the spirit of cooperation, mutual agreement, and mediation.

2. In case of disagreement, the parties shall refer the dispute to the state management agency responsible for health insurance according to Clause 4, Article 5, and Clause 2, Article 8 of the Health Insurance Law.

3. If the dispute cannot be resolved, either party may initiate legal proceedings according to Article 48 of the Health Insurance Law. The court's decision is final for both parties to execute.

4. During the dispute period, both parties must ensure that the examination and treatment of insured patients are not interrupted.

5. In case of contract modification or termination, it shall be carried out according to the provisions of Point e, Clause 2, Article 25 of the Health Insurance Law, Article 22 or Article 23 of Decree No. 146/2018/NĐ-CP dated October 17, 2018 of the Government.

Article 8. General Commitments

1. Both parties commit to fulfilling all agreed terms in the contract and relevant legal provisions.

2. Notifications and agreements shall be made in writing and sent via postal service or email to the addresses stated in this Contract.

3. Both parties agree to comply with regulations and cooperate in applying information technology to facilitate the appraisal and settlement of costs for health insurance examination and treatment.

4. Parties shall not provide or disseminate information that affects the reputation and interests of the parties or impacts health insurance policies and laws.

5. When conducting inspections, Party A must inform Party B in advance about the time and content of the inspection and obtain Party B's consent.

6. Any other agreements (if any) must be recorded as Appendices to this Contract but shall not contravene legal provisions.

This Contract is established in four (4) identical copies, each party retains two (2) copies./.

Note:

(1): the contract number is assigned sequentially throughout the year, starting from number 01 on January 1st and ending on December 31st of the contract's final year.

(2): recorded according to the Decision establishing the unit or the Decision approving the unit's professional scope.

(3): recorded according to the Decision establishing the unit.

(4), (5): recorded when both parties appoint representatives to sign the Contract on behalf of the Director.

* Depending on the conditions of the healthcare facility and the Social Insurance Agency, both parties may supplement the content of the contract but shall not contravene legal provisions on healthcare and health insurance.