DECREE NO. 85/2012/NĐ-CP ON THE OPERATING MECHANISM, FINANCIAL MECHANISM FOR PUBLIC HEALTH INSTITUTIONS AND PRICES OF MEDICAL SERVICES AT PUBLIC MEDICAL ESTABLISHMENTS

DECREE

Von the operational mechanism and financial mechanism for public health care institutions and the service fees for medical examination and treatment at public medical facilities

public and the service fees for medical examination and treatment at public medical facilities;

medical examination and treatment public facilities;

_________________

Pursuant to the Law Ton organization and operation of the Government dated December 25, 2001;

Pursuant to the Law Becting people's health/acute infectious diseases of producers/processers ... 30th day of June 1989;June 2024;June 1989;

Pursuant to the Law Bealth insurance on June 14; 11 BASED ON THE CIVIL SERVANT LAW ON JANUARY 1,

Pursuant to the Law ảoal examination and treatment on June 23;June 2024;energy 11 ARTICLE 4. Finished traditional medicine is a form of traditional medicine that has undergone production processes, including packaging and labeling, using traditional or modern methods, belonging to one of the following forms: pills, liquids, tea, powder, extract, and other forms.

Pursuant to Decree No. 204/2004/NĐ-CP dated December 14, 2004 of the Government on salary systems for cadres, civil servants, and members of the armed forces; Decree No. 17/2013/NĐ-CP dated December 19, 2013 of the Government amending and supplementing Decree No. 204/2004/NĐ-CP dated December 14, 2004 on salary systems for cadres, civil servants, and members of the armed forces;gresolution No.and amended and supplemented by certain articles related to conditions for investment and business and administrative procedures in the field of information and communications on November 7, 20188/2008/QH12 dated June 3, 2008 of the National Assembly on accelerating the implementation of policies and laws on socialization to improve the quality of health care for the people; lLaw on Socialization to improve the quality of health care for the people; lquality of health care for the people;

iewing the proposal of the Minister of Health,thereof;

ốn ... tại: ..."b) In addition to the lists of public services issued according to the provisions of Clause 2, Article 4 of this Decree, specialized agencies under provincial People's Committees shall report to the provincial People's Committee for decision-making on amending, supplementing, or issuing the list of public services funded by the state budget within their jurisdiction and consistent with the local budget capacity within the approved budget by the Provincial People's Assembly, and send it to the Ministry of Finance and relevant ministries and sectors for supervision during implementation."the Government issued this Decree on the operational mechanism and financial mechanism for public health care institutions and the service fees for medical examination and treatment at public medical facilities."b) In addition to the lists of public services issued according to the provisions of Clause 2, Article 4 of this Decree, specialized agencies under provincial People's Committees shall report to the provincial People's Committee for decision-making on amending, supplementing, or issuing the list of public services funded by the state budget within their jurisdiction and consistent with the local budget capacity within the approved budget by the Provincial People's Assembly, and send it to the Ministry of Finance and relevant ministries and sectors for supervision during implementation."for acquisition, reacquisition, or renunciation of Vietnamese nationality.No.with public health institutions and the service fees for medical examination and treatment at public medical facilities;June 2024;medical examination and treatment public lublic,

PART I

GENERAL PROVISIONS

Article 1. ScopeANNEX I.A[31]ivate,nationalregulation

his Decree stipulates the operational mechanism and financial mechanism for public health care institutions and the service fees for medical examination and treatment at public medical facilities.oArticle 2. Definitions

1. "Public health care institution" means an organization established and managed by a competent state agency in accordance with the law, having legal personality, seal, bank account, and accounting system in accordance with the law on accounting to provide public services or serve state management in specialized fields of health such as preventive medicine; medical examination and treatment; rehabilitation; forensic medical, forensic psychiatric, and forensic medical examinations; traditional medicine; pharmaceutical, cosmetic, and medical equipment testing; food safety; population and family planning; reproductive health; health education and communication (hereinafter referred to as "public health care institution")ANNEX I.A[31] interpret terms

In this Decree, the following terms are understood as follows:

1. "Public health institution" is an organization established and managed by state agencies authorized under the law, having legal personality, seal, account, and accounting system according to the law on accounting to provide public services or serve state management in specialized fields of health such as:policies Healthpolicies prevention; medical examination and treatment; rehabilitation and functional recovery; forensic medical, forensic science, forensic psychiatry; traditional medicine; pharmaceutical testing, cosmetics, medical equipment; food safety; population - family planning; reproductive health; blood transfusion;ngransmission and educationắtransfer (of public health institutions)to The provincial Department of Health manages public health institutions at the local level..

2. "Superior management agency" means the agency with authority to manage public health care institutions: For public health care institutions under central management, it is Ministries, agencies equivalent to Ministries, and agencies under the Government; for public health care institutions under local management, it is the Department of Health. For coal-fired thermal power plants where the enterprise holds 100% of the registered capital and uses 100% of its own capital to invest in the project approved by the competent authority, E is determined as 100%;Provincial People's Committees manage public health institutions at the local level.

3. "Competent authority" means the Minister, Head of an agency equivalent to a Ministry, or an agency under the Government for public health care institutions under central management, and the Chairman of the People's Committee of the province for public health care institutions under local management. ||People's Committees of provinces manage public health institutions at the local level.

Article 3. Classification of Public Health Care Institutions

1. Public health care institutions shall be registered and classified into the following groups:

a) Group 1: Institutions that self-finance all recurrent expenditure and development investment expenditure from their own revenue;N ||| declaration of customs import procedures. Group 1: Institutions that self-finance all operating expenses and development investment funds;

b) Group 2: Institutions that self-finance all operating expenses;

c) Group 3: Institutions that self-finance part of their recurrent expenditure from their own revenue;N ||| declaration of customs import procedures. Group 3: Institutions that self-finance part of their operating expenses;

d) Group 4: Institutions with low or no revenue, where all recurrent expenditure according to their assigned functions and tasks is fully covered by the State budget.

2. The registration, classification, and adjustment of the classification of public health care institutions as prescribed in this Article shall be stable for a period of three years. In cases where there is significant change in revenue or expenditure leading to a fundamental change in the level of self-financing of recurrent expenditure, the classification may be adjusted before the end of the three-year period.N ||| declaration of customs import procedures. The Ministry of Health shall take the lead and coordinate with the Ministry of Finance and the Ministry of Home Affairs to guide the registration, classification, and adjustment of the classification of public health care institutions as prescribed in this Article.

3. Minister The Ministry of Health shall take the lead and coordinate with the Ministry of Finance and the Ministry of Home Affairs to guide the registration, classification, and adjustment of classification of public health institutions as stipulated in this Article.amendorganizational structure and operation

Chapter II

PROVISIONS ON THE OPERATIONAL MECHANISM

Article 4. Rules on organization and operation

1. Based on the assigned functions and tasks, the provisions of this Decree and the Rules on organization and operation issued by the Ministry of Health, health public service units shall establish their own Rules on organization and operation, to be reported to the superior management agency for approval.y regulations issued by the Ministry of Health, public health institutions shall develop internal regulations on organizational structure and operation, report to the superior supervisory agency for approval.FUNCTIONS, DUTIES, POWERS, ORGANIZATIONAL STRUCTURE, OPERATIONAL REGULATIONS, AND RELATIONSHIPS OF MANAGEMENT BOARDS; DUTIES, POWERS OF THE CHAIRPERSON, VICE CHAIRPERSON (IF ANY), SECRETARY, AND MEMBERS OF MANAGEMENT BOARDSBased on the internal regulations on organizational structure and operation, functions, tasks, and actual conditions, the institution shall develop a professional activity plan:policies For institutions in Group 3,

2. The Minister of Health shall specify the detailed contents of the model Rules on organization and operation according to the medical field.

Article 5. Building professional activity plans

1. Annually, based on the Rules on organization and operation, the assigned functions and tasks, and actual conditions, the unit shall build a professional activity plan:amendGroup 4: Institutions shall develop an activity plan including specific targets and tasks within their assigned functions and responsibilities based on their service capacity, budget allocated, and institutional self-financing income, and service activities (if any). The supervisory agency at the higher level shall approve the plan.

a) For units belonging to Group 1 and Group 2: The unit shall build an operational plan including professional targets and tasks within the assigned functions and tasks, and service targets and activities, to be reported to the superior management agency for registration, serving as a basis for monitoring, inspecting, and supervising implementation.

b) Institutions in Group 3,shallGroup 4: Institutions shall develop an activity plan including specific targets and tasks within their assigned functions and responsibilities based on their service capacity, budget allocated, and institutional self-financing income, and service activities (if any). The supervisory agency at the higher level shall approve the plan.June 2024;The supervisory agency at the higher level shall approve the plan.u The supervisory agency at the higher level shall approve the plan.asupervisory agency at the higher level. trThe superior management agency shall assign the operational plan for the budget and public service revenue portion, while service activities shall be independently built and registered for implementation by the unit.oInstitutions may independently develop and register to implement.amendInstitutions may contribute capital, raise funds, engage in joint ventures, and form partnerships according to the law to expand facilities, develop services and techniques; implement techniques outside the technical directory and assigned professional tasks; organize service activities to meet social needs but must be consistent with the specialized field, capabilities of the institution, and comply with the law. Capital contribution, fund raising, joint ventures, and partnerships must be accounted for separately or establish independent accounting units.

2. Public health service units may proactively decide measures to organize the implementation of the professional activity plan stipulated in Clause 1 of this Article in accordance with the laws and must ensure conditions regarding human resources, professional skills, infrastructure, and equipment as prescribed to provide services meeting standards and quality requirements.

3. Public health service units are subject to inspection and supervision by state agencies with competent authority over all aspects of the unit's operations.

4. The Ministry of Health shall develop and issue guidelines on professional matters and technical procedures; regulations on the division of technical specialties among healthcare facilities; main professional tasks for healthcare units in other fields according to specialty levels; basic contents and indicators in professional activity plans; and criteria for evaluating the completion of professional tasks.

Article 6. Regulations on joint ventures, collaborations, and servicescouncillORSUnits may contribute capital, raise funds, engage in joint ventures, and collaborate in accordance with the law to expand their base, develop services and techniques; implement techniques outside the technical catalog and assigned professional tasks; organize service activities to meet social needs but must align with the unit's professional field, capacity, and legal provisions. Capital contribution, fund raising, joint ventures, and collaborations must be accounted for separately or through the establishment of independent accounting entities.

1. The opinion of the institution under the locality.development Plan for recruitment of civil servantsdevelopmentThe Ministry of Health shall take the lead and coordinate with the Ministry of Home Affairs to guide the structure of civil servants by job titles and the corresponding number of civil servants working in various specialized fields of health based on guiding documents on the structure and number of civil servants issued by authorized agencies; based on functions, tasks, professional activity plans, work requirements, job positions, and salary funds of the institution, each year the institution shall develop a plan for recruiting civil servants, clearly stating the required quantity, quality, and structural composition of civil servants needed for its entire organizational structure.developmentFor institutions in Group 1 and Group 2: The plan for recruiting civil servants of the institutionêis decided by the head of the institution within their authority to ensure the implementation of the professional activity plan but must report to the superior supervisory agency for consolidation, monitoring, and supervision;õFor institutions in Group 3 and Group 4: The plan for recruiting civil servants of the institution

2. In cases where an independent accounting entity is established within the current premises of the unit: The unit must prepare a Proposal to report to the superior management agency for approval; the independent accounting entity must be a subordinate accounting unit of the unit, directly managed and operated by the unit, operating on the principle of self-financing all regular operating expenses and investment costs, and granted autonomy and responsibility for implementing professional tasks, organizational structure, staffing, and finance in accordance with current regulations.

Article 7. Organization of the administrative apparatus; plan for recruitment and management, use of civil servants and public officialsứOrganization of the administrative apparatus training Based on the Charter of organization and operation that has been approved, the unit is authorized to establish or reorganize departments, offices, and other subordinate organizations to implement the registered specialized activity plans or those assigned by the supervising authority;

1. Organization of the administrative apparatus

a) On the basis of the Charter of organization and operation that has been approved, the unit is authorized to establish or reorganize departments, offices, and other subordinate organizations to implement the registered specialized activity plans or those assigned by the supervising authority;c Units must establish a Management Board to decide important issues during the unit's operational process. The Management Board consists of nine members, including: one Chairman, one Deputy Chairman, and seven members. The Chairman of the Management Board is the head of the unit, and the Deputy Chairman is the Secretary of the Party Committee of the unit (in cases where the head of the unit concurrently holds the position of Secretary of the Party Committee, then the Deputy Secretary of the Party Committee participates);policiesMembers of the Board include: one representative from the superior supervising authority regarding professional medical management; one representative from the superior supervising authority regarding financial management; two are deputy heads of the unit (in cases where the unit only has one deputy head, the Director of the Planning and Synthesis Department participates); one is the Chairman of the Trade Union of the unit; two persons engaged in professional medical work are elected through secret ballot by all professional medical staff with a bachelor's degree or higher within the unit. The duties, responsibilities, and regulations on the operation of the Management Board are stipulated by the Minister of Health. The Minister, the Heads of Ministries equivalent to ministries, and agencies under the Government shall determine the establishment of the Management Board of units under central administration; the Chairman of the People's Council at the provincial level shall determine the establishment of the Management Board of units under local administration.of the Government stipulating functions, tasks, powers, and organizational structure of the Ministry of Home Affairst, trPlan for recruitment of public officials

b) The Ministry of Health leads and coordinates with the Ministry of Home Affairs to guide the structure of public officials according to job titles and the corresponding number of public officials working in various professional medical fields based on guiding documents on the structure and number of public officials issued by competent authorities; based on functions, tasks, specialized activity plans, work requirements, job positions, and the salary fund of the unit, each year the unit builds a plan for recruiting public officials, specifying the requirements for the number, quality, and structure of necessary public officials for the entire organizational system;shallm 1 For units belonging to Group 1 and Group 2: The plan for recruiting public officials of the unit is decided by the head of the unit within their authority to ensure the implementation of the specialized activity plan but must report to the superior supervising authority for consolidation, monitoring, and supervision; ||For units belonging to Group 3 and Group 4: The plan for recruiting public officials of the unit is approved by the agency or unit with the authority to appoint and dismiss the head of the unit;intention d) The head of the unit may enter into contracts for hiring and outsourcing for tasks that do not require regular staffing and other service activities; may enter into labor contracts and other forms of cooperation with experts and scientists both domestically and internationally in accordance with the provisions of the law to meet the professional needs of the unit;on Recruitment, management, and use of civil servants and public officials:shallThe head of the unit is responsible for reviewing, arranging, and using existing civil servants and public officials in accordance with their professional qualifications and actual conditions of the unit;policies For units belonging to Group 1 and Group 2: The head of the unit organizes the recruitment of public officials; decides on the recruitment of public officials through competitive examinations or selection and bears responsibility for their decisions;amendFor units belonging to Group 3 and Group 4: The agency or unit with the authority to appoint and dismiss the head of the unit delegates the implementation of recruitment to the head of the unit. The head of the unit is responsible for implementing recruitment in accordance with the law and bears responsibility for their decisions. In special cases, if the unit does not have the conditions to carry out recruitment, it must report to the agency or unit with the authority to appoint and dismiss the head of the unit to carry out recruitment;policies The head of the unit has the right to accept public officials from the rank of Chief Doctor and below;essentiald) Recruitment must be carried out in accordance with the current legal provisions on the recruitment of civil servants and public officials;ồThe unit must ensure the structure and number of qualified public officials as guided by the Ministry of Health and the Ministry of Home Affairs to meet the needs of health care for the people; BB 1.1The appointment, dismissal, commendation, and disciplinary action of civil servants and public officials are implemented in accordance with the current legal provisions; ||PROVISIONS ON THE FINANCIAL MECHANISMâFINANCIAL MECHANISM FOR CAPITAL INVESTMENT AND DEVELOPMENT EXPENSES lis approved by the agency or unit authorized to appoint and dismiss the head of the institution.

2. The head of the institution has the right to sign contracts for hiring and outsourcing for jobs that do not require regular staffing and other service activities; can sign labor contracts and other forms of cooperation with experts and scientists both domestically and internationally according to the law to meet the professional requirements of the institution.

a) Recruitment, management, and utilization of civil servants and civil servants:nationalThe head of the institution is responsible for reviewing, arranging, and utilizing existing civil servants and civil servants in accordance with their professional qualifications and actual conditions of the institution;on For institutions in Group 1 and Group 2: The head of the institution organizes the recruitment of civil servants; decides on the recruitment of civil servants through competitive examinations or direct appointments and bears responsibility for their decisions;policies;

b) Camendn cứ For institutions in Group 3 and Group 4: The agency or unit authorized to appoint and dismiss the head of the institution delegates the recruitment process to the head of the institution to carry out. The head of the institution is responsible for implementing the recruitment process according to the law and bears responsibility for their decisions. In special cases where the institution does not have the necessary conditions to conduct recruitment, they must report to the agency or unit authorized to appoint and dismiss the head of the institution to carry out the recruitment process;Plan for handling assets after the expiration of the joint venture and association periodThe head of the unit has the right to accept civil servants from the rank of chief physician and below;

c) Recruitment must be carried out in accordance with current laws on the recruitment of civil servants and civil servants; For coal-fired thermal power plants where the enterprise holds 100% of the registered capital and uses 100% of its own capital to invest in the project approved by the competent authority, E is determined as 100%;The institution must ensure the structure and minimum number of civil servants as guided by the Ministry of Health and the Ministry of Home Affairs to meet the needs of healthcare for the people. For coal-fired thermal power plants where the enterprise holds 100% of the registered capital and uses 100% of its own capital to invest in the project approved by the competent authority, E is determined as 100%;The appointment, dismissal, commendation, and disciplinary actions for civil servants and civil servants are implemented according to the current laws.

d) FINANCIAL MECHANISM REGULATIONS For coal-fired thermal power plants where the enterprise holds 100% of the registered capital and uses 100% of its own capital to invest in the project approved by the competent authority, E is determined as 100%;FINANCIAL MECHANISM FOR CAPITAL INVESTMENT DEVELOPMENT

The institution itself shall submit to the competent authority for approval.N ||| declaration of customs import procedures. Based on the approved development plan, the actual situation regarding infrastructure and equipment of the institution, current standards and norms, the institution shall prepare and submit to the competent authority for review and approval new construction, renovation, and upgrading projects according to the law.

3. To secure funding to implement investment projects according to the approved plan, if the competent authority approves the funding, the state budget will continue to allocate funds according to the plan to implement the project. Or when the competent authority encourages investment promotion,

a) promotes investment promotion.policies of the unit;

b) For units belonging to Group 1, Group 2: The head of the unit organizes the recruitment of civil servants; decides on the recruitment of civil servants through competitive examination or selection and bears responsibility for their decisions;

c) For units belonging to Group 3, Group 4: The agency or unit with the authority to appoint and dismiss the head of the unit assigns the head of the unit to carry out the recruitment process. The head of the unit has the responsibility to implement the recruitment process in accordance with the provisions of the law and bear responsibility for their decisions. In special cases, if the unit does not meet the conditions to conduct the recruitment process, it must report toothe agency or unit with the authority to appoint and dismiss the head of the unit to carry out the recruitment process;June 2024;oo the agency or unit with the authority to appoint and dismiss the head of the unit to carry out the recruitment process;

d) The head of the unit has the right to accept civil servants from the rank of chief physician and below;

d) Recruitment must be carried out in accordance with the current legal regulations on the recruitment of civil servants and civil servants;

e) The unit must ensure the necessary infrastructureof the Government stipulating functions, tasks, powers, and organizational structure of the Ministry of Home Affairsand the number of civil servants requiredANNEX I.A[31] to meet the minimum standards as guided by the Ministry of Health and the Ministry of Home Affairs to satisfy the health care needs of the people;

4. The appointment, dismissal, commendation, and disciplinary action of civil servants and civil servants shall be implemented in accordance with the current legal regulations;ANNEX I.A[31]THE FINANCIAL MECHANISM

Chapter III

FINANCIAL MECHANISM FOR INVESTMENT EXPENSES

Briefly describe technical improvements, production processes, raw materials, designs; new technology applications such as automation, digitalization, clean technology; management, marketing, distribution solutions; products winning awards or certifications related to innovation…):…ục 1

FOR INVESTMENT EXPENSES

Article 8. Construction of development plans and investment projects

1. Units shall base on:N ||| declaration of customs import procedures. The overall planning for the development of the healthcare system approved by the Prime Minister; The overall planning for the development of the healthcare system within the province or centrally governed city approved by the provincial People's Committee; The organizational regulations, functions, and tasks assigned to build their own development plan to be submitted for approval by the competent authority. ||Unit shall base on the approved development plan, the actual situation regarding infrastructure and equipment of the unit, current standards and regulations to establish and submit for review and approval by the competent authority new construction investment projects, renovation, and upgrading projects in accordance with the provisions of the law.N ||| declaration of customs import procedures. own unit to submit for approval by the competent authority;

2. Based on the approved development plan, the actual situation regarding the infrastructure and equipment of the unit, the current standards and regulations, the unit establishes and submits to the competent authority for review and approval new construction projects, renovation, and upgrading projects in accordance with the law;of the Government stipulating functions, tasks, powers, and organizational structure of the Ministry of Home Affairsaccording to the approved plan.

Article 9. Sources of capital for investment development

1. For units belonging to Group 1:

a) Investment credit from the Vietnam Development Bank as stipulated in Decree No. 75/2011/NĐ-CP dated August 30, 2011 of the Government on state investment credit and export credit. Loans from other financial institutions in accordance with the law;

b) Official Development Assistance (ODA) and non-governmental foreign aid (NGO) as decided by the competent authority (if any);

c) Capital raised from organizations and individuals in accordance with the law: Units may only raise funds for investment in projects that have been approved by the competent authority through a repayment method with an agreed maximum interest rate not exceeding 150% of the basic interest rate published by the State Bank of Vietnam at the time of borrowing;

d) The unit’s development fund for public services;

e) Other sources of capital as prescribed by law;

e) In cases where units are currently being allocated state budget capital to implement investment projects according to the approved plan by the competent authority, trIf the capital is allocated by the competent authority t,then the unit continues to receive state budget funding according to the plan to implement the project. Or whenrime Minister cthe competent authority approvesầencourages developmentpoliciesIncome from other activities as prescribed by law (if any);From 100 million VND to less than 300 million VNDIn cases involving new technologies and techniques, the State has the right to require units participating in implementation to support capital investment according to projects approved by competent authorities. Assets after the completion of the project shall be transferred by the State to the unit for management and use in accordance with Article 11 of this Decree.

2. For units belonging to Groups 2, 3, and 4:

a) The State ensures capital investment in infrastructure and equipment so that units have the necessary conditions to fulfill their specialized tasks according to their assigned functions and responsibilities; sources of investment capital include: Development investment capital from the state budget; government bonds; ODA and NGO assistance; lottery revenue and other lawful sources of capital at the local level.ANNEX I.A[31]The Ministry of Health shall specify standards for infrastructure; lists and quantities of medical equipment suitable for the scale and field of medical specialization;

The development fund for public services;nationalOther lawful sources of capital as prescribed by law;

b) In cases where units have utilized the sources of capital specified in Points a, b, and c of Clause 2 of this Article but still fail to meet the progress of projects and works: Units may borrow investment credit from the Vietnam Development Bank to supplement investment capital to accelerate the completion and utilization of projects and works; they may use the state budget allocated for investment development in subsequent years within the project implementation period as prescribed by law to repay principal loans, which can be incorporated into service prices to repay principal loans and interest on loans.

c) Other lawful sources of capital as prescribed by law;

d) In cases where the unit has utilized the sources of capital specified in Points a, b, and c of Clause 2 of this Article but still fails to meet the progress of the projects and works, the unit may borrow investment credit from the Vietnam Development Bank to supplement the investment capital in order toớbring the project and work into use; may use the state budget allocated for investment developmentdevelopmentassigned in subsequent years within the project implementation period as prescribed by law to repay the principal loan, to be incorporated into the service charge pricedevelopment repay interest onầN |||No.loans and ldebts.

The Ministry of Finance shall take the lead and coordinate with the Ministry of Planning and Investment and the Ministry of Health to provide detailed guidance on the types, criteria, and decision-making authorities for units to use the state budget for investment development to repay principal loans; and guide the incorporation of service prices to repay principal loans and interest on loans in these cases. lIn cases where units are permitted by authorized agencies to construct infrastructure projects within existing premises under the forms prescribed in Decree No. 10/2009/NĐ-CP dated November 27, 2009 of the Government and Decree No. 24/2011/NĐ-CP dated April 5, 2011 of the Government amending certain articles of Decree No. 108/2009/NĐ-CP dated November 27, 2009 on investment under the Build-Operate-Transfer (BOT) and Build-Transfer-Operate (BTO) models. For the Build-Transfer model, it shall be implemented in accordance with these decrees and guiding documents.

3. For BOT or BTO investment projects aimed at operating healthcare services, the investor and the unit shall agree on the repayment of capital to implement the project in accordance with the law in the contract.8/2009/ND-CP dated November 27, 2009 of the Government and Decree No. 24/2011/ND-CP issued on April 5, 2011 of the Government amending certain articles of Decree No. 108/2009/ND-CP dated November 27, 2009 on investment under the Build-Operate-Transfer (BOT) and Build-Transfer-Operate (BTO) models.       In accordance with For projects invested in under the BOT or BTO model to operate medical examination and treatment activities, the investor and the unit shall agree on the repayment of capital to implement the project in accordance with the provisions of the law in thenationalcontract.

regarding the "capacity, quality, and reputation" of public health institutions.ìThe head of the unit must develop a financial plan (capital mobilization°repay principal and interest on loans), an operational service plan; bear responsibility before the law for the effectiveness of borrowing, capital mobilizationnationaland service operations in accordance with the provisions of the law.

4. For hospitals: In cases where they are allowed by competent state agencies to pilot investment under the Public-Private Partnership (PPP) model, they shall follow the current regulations.

Article 10. Sources of investment development funds for healthcare facilities implementing socialization under public health institutionsNo.For independent accounting units that self-finance operational costs within their current premises, the sources of investment include:

1. Mobilizing funds from civil servants, officials, and employees within the unit through a fixed interest rate payment method with an agreed maximum interest rate not exceeding 150% of the basic interest rate published by the State Bank of Vietnam at the time of borrowing;u Investment credit funds from the Vietnam Development Bank;

a) In cases where units have utilized the sources of capital specified in Points a, b, and c of Clause 2 of this Article but still fail to meet the progress of projects and works: Units may borrow investment credit from the Vietnam Development Bank to supplement investment capital to accelerate the completion and utilization of projects and works; they may use the state budget allocated for investment development in subsequent years within the project implementation period as prescribed by law to repay principal loans, which can be incorporated into service prices to repay principal loans and interest on loans.

b) Joint venture and partnership capital from organizations and individuals, and other lawful sources of capital.ANNEX I.A[31]Units are allowed to mobilize funds, borrow funds, and utilize the "capacity, quality, and reputation" of the unit to participate in new healthcare facility construction outside the unit's premises through equity contribution and profit sharing according to the ratio of contributed capital with organizations and individuals as stipulated in Decree No. 69/2008/ND-CP dated May 30, 2008 of the Government on policies encouraging socialization in education, vocational training, healthcare, culture, sports, environment activities.° The Ministry of Health shall take the lead and coordinate with the Ministry of Finance and relevant ministries to guide the determination of the value of "capacity, quality, and reputation" of public health institutions.âUnit heads must develop financial plans (fund mobilization, loan repayment, and interest payment), service operation plans; bear legal responsibility for the effectiveness of borrowing, fund mobilization, and service operations in accordance with the provisions of the law. nArticle 11. On management and use of assets

c) Public health institutions are allocated assets in accordance with the Law on Management and Use of State Assets and guiding documents for implementation of the Law.

d) Assets constructed, purchased, or acquired with funds from the state budget (from retained revenue from fees and charges left for the unit to use according to prescribed regulations, development funds for institutional activities), from borrowed funds, mobilized funds, and income from various sources of revenue and service activities to repay borrowed and mobilized funds are considered state assets allocated to the unit for management and use.June 2024; Unit heads are responsible for managing, using, organizing, and ensuring funding for maintenance and repair of assets to enhance usage efficiency and service quality.

2. FINANCIAL MECHANISM FOR REGULAR AND NON-REGULAR OPERATING EXPENSESDeputy ministers of ministerial-level agencies,Article 12. Sources of regular operating expenses For coal-fired thermal power plants where the enterprise holds 100% of the registered capital and uses 100% of its own capital to invest in the project approved by the competent authority, E is determined as 100%;State budget for units belonging to Group 3 and Group 4 as stipulated in Article 13 of this Decree.periodRevenue from institutional services from providing medical services; including revenue from outpatient and inpatient services implemented in accordance with Articles 18 and 19 of this Decree.

Revenue from supplying goods and services under the procurement mechanism and assignment of tasks for provision of public service activities.ớRetained portion from revenue from fees and charges belonging to the state budget according to the law. cContributions from subordinate independent accounting units according to internal expenditure regulations; income shared by units mentioned in Clause 2 of Article 10 (if applicable) after fulfilling obligations to the state budget. đRevenue from other activities as prescribed by law (if applicable).councillORS Article 11. On Management and Use of Assets

3. Public health institutions are granted assets in accordance with the Law on Management and Use of State Assets and guiding documents implementing the Law.; Assets constructed, purchased with funds from the state budget (from revenue collected from fees and charges retained for the unit's use in accordance with regulations, the fund for developing public services), from borrowed capital, mobilized capital, and using income from various sources of revenue and service activities to repay borrowed capital and mobilized capital are considered state assets transferred to the unit for management and use.No.The head of the unit is responsible for managing, using, organizing, and ensuring funding for maintenance and repair of assets to enhance their usage efficiency and service quality.ệFINANCIAL MECHANISM FOR REGULAR AND NON-REGULAR OPERATING EXPENSESNo.Article 12. Sources of Regular Operating Expenses

The state budget for units belonging to Group 3 and Group 4 as stipulated in Article 13 of this Decree.

1. Revenue from public services from providing medical services; including revenue from medical examination and treatment services implemented in accordance with Articles 18 and 19 of this Decree..

2. Revenue from supplying goods and services under the procurement mechanism, assignment of tasks to provide public service.Plan for handling assets after the expiration of the joint venture and association period From the portion retained from fee and charge revenue belonging to the state budget as prescribed by law.ồContributions from independent accounting entities directly subordinate to the unit in accordance with internal expenditure regulations; income shared from entities mentioned in Clause 2 of Article 10 (if applicable) after fulfilling obligations to the state budget.Plan for handling assets after the expiration of the joint venture and association period Income from other activities as prescribed by law (if applicable).

3. Units performing preventive healthcare (including commune health stations).N ||| declaration of customs import procedures. The state budget ensures regular operations of the unit to fulfill assigned state tasks, including:

Briefly describe technical improvements, production processes, raw materials, designs; new technology applications such as automation, digitalization, clean technology; management, marketing, distribution solutions; products winning awards or certifications related to innovation…):…Chapter 2

Personnel costs: Determined based on the number of positions assigned by competent authorities and basic salary, allowances, contributions according to current policies for public institutions; adjusted when the state adjusts salary policies, allowances, or the number of positions. Operational costs to ensure regular activities of the unit according to the current state budget schedule such as payment for public services, office supplies, information, publicity,

communication, conference expenses, travel expenses, rental expenses, repair of property serving professional work and maintenance of infrastructure, professional service costs for regular monitoring of disease conditions, etc., and other reasonable expenses. This amount of funding is calculated and allocated to the unit based on the number of positions assigned by competent authorities or based on the population in the area managed by the unit, taking into account the disease model, natural conditions of the area, and average cost standards for each type of unit.

1. Disease prevention and control costs: This amount of funding is calculated and allocated to the unit to carry out disease prevention and control activities.

2. The Minister, Head of a ministry-level agency, or agency under the Government shall issue standards for allocating the state budget to subordinate units.

3. Provincial People's Councils decide or submit to competent authorities for decision on setting standards for allocating the state budget per capita or per position and specialized activities as a basis for annual budget allocation and assignment to units;uIn cases where units have fee and charge collection departments: Costs to ensure regular operations of the fee and charge collection department shall be implemented in accordance with current laws on fees and charges.

4. For specialized public health institutions such as food safety centers, family planning centers at district level, reproductive health care centers; health education and communication centers; units engaged in forensic medical examinations, forensic psychiatric examinations, medical examinations; units engaged in testing and international health quarantine;

5. Centers for preventing and controlling social diseases, other centers under the health system: The state budget guarantees all regular operating expenses for tasks assigned by theớstate through procurement mechanisms, assignment of tasks to provide public services.

6. Units performing preventive healthcare tasks (including commune health centers).

Article 13. The State budget ensures funding for regular operationsconcerning the classification and determination of state management authority in the field of crop productionFor units performing health examination and treatment tasks (excluding facilities performing leprosy and mental health examination and treatment tasks) belonging to Group 3 and Group 4:

1. In 2013: The State budget continues to ensure as in 2012 and funds for paying special allowances not included in the medical service price, and funds to implement new policies and regulations stipulated by the State according to the principle of ensuring a higher rate of increase in healthcare spending than the average rate of increase in the State budget as specified in Resolution No. 18/2008/QH12 dated June 3, 2008 of the National Assembly;

a) Period 2014-2015: The State budget ensures:

b) Maintenance and repair costs for fixed assets not included in the medical service price.

- Costs related to salaries, various allowances, and contributions as currently regulated (hereinafter referred to as the Basic Salary Fund): The budget ensures 100% of the Basic Salary Fund for district and county hospitals, 70% of the Basic Salary Fund for provincial hospitals in mountainous areas, the Central Highlands, and district hospitals in Hanoi and Ho Chi Minh City, and 50% of the Basic Salary Fund for central hospitals and hospitals under the direct management of the central government;

- Period 2016-2017: The State budget ensures 50% of the Basic Salary Fund for district and county hospitals; other hospitals have their Basic Salary Fund fully incorporated into maintenance and repair costs for fixed assets not included in the medical service price;onThe level of State support provided for in Point b and Point c of this Clause applies collectively to health examination and treatment facilities under ministries, sectors, and localities. Based on actual conditions, the Minister or Head of an equivalent agency decides the specific level of support for centrally-managed health examination and treatment facilities; the Chairman of the People's Committee at the provincial level decides or submits to the competent authority for decision on the specific level of support for locally-managed health examination and treatment facilities.o For units performing health examination and treatment tasks and caring for patients with leprosy and mental illness: The State budget ensures all operating expenses of the unit under the procurement mechanism, assignment of tasks to provide public services based on the number of beneficiaries and the expenditure levels for different types of beneficiaries served by the unit.

c) The Ministry of Health shall take the lead and coordinate with the Ministry of Finance to issue the cost standards for health examination and treatment and care for patients with leprosy and mental illness.to For units performing preventive healthcare tasks (including commune health stations).No. The State budget ensures the regular operation of the unit to fulfill assigned tasks, including:

d) Personnel costs: Determined based on the positions assigned by the competent authority and basic salary, various allowances, and contributions as stipulated by current policies for public service organizations; adjusted when the State adjusts salary policies, allowances, or the number of positions assigned to the unit.12. Leather shoesOperating and maintenance costs to ensure regular operations of the unit according to the current state budget classification such as payment for public services, medical supplies, information, publicity, communication, conference fees, travel expenses, rental costs, repair of property serving professional work, and maintenance of infrastructure, costs for professional activities to monitor disease situations regularly, etc., and other reasonable costs. These funds are calculated and allocated to the unit based on the number of positions assigned by the competent authority or based on the population in the area managed by the unit, taking into account the disease model, natural conditions of the area, and the average cost standard for each type of unit. ||Disease prevention and control costs: These funds are calculated and allocated to the unit to carry out disease prevention and control activities.shall The Minister, Head of an equivalent agency under the Government, or a governmental agency issues the allocation standards for the State budget for subordinate units.

2. The People's Committee at the provincial level decides or submits to the competent authority for decision on the allocation standards for the State budget per capita or per position and specialized activities as the basis for annual budget allocation and transfer to units.N ||| declaration of customs import procedures. In cases where units have fee collection departments: The costs for ensuring regular operations of the fee collection department are implemented according to the current regulations on fees and charges.of the Government stipulating functions, tasks, powers, and organizational structure of the Ministry of Home AffairsFor specialized healthcare public institutions such as food safety centers, family planning centers at the county level, reproductive health care centers, health education and communication centers; units performing forensic medical examinations, forensic psychiatric examinations, medical examinations; units performing laboratory testing and international health quarantine;

Centers for preventing and controlling social diseases, and other centers within the healthcare system: The State budget ensures all regular operational costs for tasks assigned by the State through the procurement mechanism, assignment of tasks to provide public services.

3. Units currently classified as partially self-financing for regular operations according to Decree No. 43/2006/NĐ-CP of the Government on the provisions regarding autonomy and responsibility for implementing tasks, organizational structure, staffing, and finance for public service organizations may be converted to operate under Group 1 or Group 2 upon decision by the competent authority. They will be considered and supported once with funding in the first year of implementation of the conversion, up to the maximum amount equal to the regular operational funding allocated for self-management of the unit in the immediately preceding year before the conversion.oThe state budget ensures the regular operation of the unit to implement the tasks assigned by the State, including: y Personnel expenses: Determined based on the positions assigned by the competent authority and the basic salary, various allowances, contributions according to the prevailing policies and regulations for public service institutions; adjusted when the State adjusts salary policies, allowances, or changes the number of positions assigned to the unit;

a) Operating costs and ensuring the regular operation of the unit according to the current state budget classification such as payment for public services, office supplies, information, propaganda,ANNEX I.A[31]communication, conference fees, travel expenses, rental fees, repair costs for assets serving professional work, maintenance and upkeep of infrastructure, professional activity costs for regular monitoring of disease situations, etc., and other reasonable expenses. This amount of funds is calculated and allocated to the unit based on the number of positions assigned by the competent authority or based on the population within the area under the unit's jurisdiction, taking into account the disease model, natural conditions of the area, and the average expenditure rate for each type of unit;

- Disease prevention and control expenses: This amount of funds is calculated and allocated to the unit to implement disease prevention and control activities;in number lconcerning the classification and determination of state management authority in the field of crop productionnationalThe Minister, the head of a ministry equivalent to a ministry, or a government agency shall issue the budget allocation standards for subordinate units;policies The provincial People's Committee decides or reports to the competent authority to decide on the budget allocation standards per capita or based on the number of positions and specialized activities, serving as the basis for annual budget allocation and assignment to units;nationalFor units that have fee and tax collection organizations: The operating costs of the organization responsible for collecting fees and taxes are implemented in accordance with the current regulations on fees and taxes;

- For specialized health service units such as food safety centers, family planning centers at the district level, reproductive health care centers; health education and communication centers; units responsible for forensic medical examinations, forensic psychiatric examinations, medical examinations; units responsible for testing and international health quarantine;amendCenters for preventing and controlling social diseases, other centers under the health system: The state budget guarantees all regular operational expenses for tasks assigned by the lState according to the procurement mechanism, assignment of public service provision tasks;ớThe competent authority may decide to convert to Group 1 or Group 2 implementation and will be supported once with the maximum amount equal to the regular budget allocated for self-management of the unit in the year immediately preceding the conversion year;

- Accumulate reserves for maintenance and repair of fixed assets, upgrading infrastructure, purchasing and equipping equipment for professional activities. The depreciation income from assets formed from borrowed capital or raised capital is used to repay the principal and interest of loans according to the internal financial rules of the unit, but must be consistent with the unit's financial capacity. Specifically, for vehicle standards, office space standards, telephone equipment at home, foreign travel expenses, foreign reception expenses: The unit cannot decide on higher expense levels than those stipulated

by the State;

The Chairperson of the People's Committee of communes, wards, and towns has the right to: ||Based on actual conditions and professional technical procedures to develop and promulgate economic and technical norms and cost standards that are appropriate according to the principle of issuing internal financial rules and bear responsibility for their decisions;councillORSTo improve housing and infrastructure to enhance service capacity and improve service quality;

b) d) Based on the nature of the work, the head of the unit has the right to decide on the cost allocation method for each department and subordinate unit to use funds efficiently;

4. Personnel costs are calculated according to the following principles: For services with labor rates included in the service price approved by the competent authority BB 1.1they are calculated according to the approved labor rate. For services not yet defined trung tâm phòng, chống bệnh xã hội, các trung tâm khác thuộc hệ thống y tế: Ngân sách nhà nước bảo đảm toàn bộ chi hoạt động thường xuyên đối với các nhiệm vụ do Nhà nước giao theo cơ chpolicies đặt hàng, giao nhiệm vụ cung cấp dịch vụ sự nghiệp công.

5. Units currently classified as partially self-financing for regular operations according to Decree No. 43/2006/NĐ-CP of the Government on the provisions regarding autonomy and responsibility for implementing tasks, organizational structure, staffing, and finance for public service organizations may be converted to operate under Group 1 or Group 2 upon decision by the competent authority. They will be considered and supported once with funding in the first year of implementation of the conversion, up to the maximum amount equal to the regular operational funding allocated for self-management of the unit in the immediately preceding year before the conversion.N ||| declaration of customs import procedures. which is currently classified as a unit partially self-financing its operational expenses.yaccording to Decree No. 43/2006/NĐ-CP of the Government on the regulations regarding autonomy and responsibility for the implementation of tasks, organizational structure, staffing, and finance for public service units, if authorized by the competent authority to switch to Group 1 or Group 2 operations, shall be supported with a one-time funding in the first year of the transition, up to the maximum level of the regular self-financed operating costs allocated to the unit in the immediately preceding year before the transition.rime Minister cm quyền quyết định chuyển đổi sang thực hiện theo nhóm 1 hoặc nhóm 2 thì được xem xDeclaration, re-declarationt, hỗ trợ một lần kinh phí vào năm đầu thực hiện chuyển đổi với mức tối đa bằng mức kANNEX I.A[31]nh phí chi thường xuyên giao tự chủ cho đơn vị năm trước liền kề năm chuyển đổi.

Article 14. Autonomy over revenue sources and collection levels

1. For medical examination and treatment services provided to patients, including those with health insurance cards: Implement according to the provisions of Article 19 of this Decree.

2. For fee and charge revenues: Collect accurately and fully according to the prescribed collection levels and target groups. For coal-fired thermal power plants where the enterprise holds 100% of the registered capital and uses 100% of its own capital to invest in the project approved by the competent authority, E is determined as 100%;o as stipulated by competent state authorities.

3. For goods and services ordered by authorized agencies: The collection level shall be based on prices set by competent state authorities; in cases where prices have not been specified by competent state authorities, the collection level shall be determined based on approved cost estimates by the same-level financial agency.

4. For service activities outside assigned functions and tasks, conducted under agreements with domestic and foreign organizations and individuals, joint ventures, and collaborations as stipulated in Article 6 of this Decree, and activities of units as stipulated in Article 10 of this Decree (excluding medical examination and treatment services implemented according to the provisions of Article 19 of this Decree):oThe entity shall determine the revenue sources and collection levels according to the principle of ensuring sufficient coverage of costs and generating surplus.ắp chi phí và có tích lũyThe entity must maintain accounting records to separately track and account for revenue, costs, and fulfill all fiscal obligations to the state budget as prescribed.N ||| declaration of customs import procedures. Article 15. Autonomy over the use of financial resources for regular operationsNo.Units may independently use financial resources for regular operations as stipulated in Article 12 of this Decree to fund their regular operations according to their functions and responsibilities; fees and charges collection expenses; service activity expenses (including expenses fulfilling state obligations, loan repayments, and interest payments) as follows:

Depreciation income from fixed assets shall be allocated to the Development Fund for maintenance and repair of fixed assets, upgrading infrastructure, purchasing equipment for professional activities. Depreciation income from assets formed from borrowed funds and raised capital shall be used to repay principal and interest according to loan agreements and fundraising agreements;This Resolution takes effect from the date it is adopted by the National Assembly.For management and professional activity expenses that have been prescribed by competent state authorities: Units may decide on higher or lower expense levels than those stipulated in their internal expenditure regulations, but they must align with the unit's financial capacity. Specifically, for vehicle usage standards, office space, home office phone equipment, and overseas travel expenses: Units cannot set higher expense levels than those prescribed by the state;

1. For management and professional activity expenses that have not been prescribed by competent state authorities: Units shall base their decisions on actual conditions and professional technical procedures to establish and issue economic and technical norms and expense levels suitable according to internal expenditure regulations and bear responsibility for their decisions;, Based on financial capacity and actual conditions, the head of the unit may decide to use part of the annual regular operation funding and part from the Development Fund for staff training, purchasing equipment, and repairing facilities to enhance service capacity and improve service quality;âd) Depending on the nature of work, the head of the unit has the authority to decide on cost allocation methods for each department and subordinate unit to use funds efficiently and economically.No.The borrowing and interest payment on borrowed funds shall be governed by the following provisions:

a) The depreciation revenue from fixed assets shall be recorded in the Development Fund for Public Services and used for maintenance, repair, upgrading of infrastructure, procurement of equipment for professional activities.development duy tu, bảo dưỡng tài sản cố định, đầu tư nâng cấp cơ sở hạ tầng, mua sắm trang thiết bị phục vụ hoạt động chuyên môn. Số thu khấu hao của các tài sản hình thành từ nguồn vốn vay, vốn huy động được sử dụng để chi trả gốc tiền vay, lãi vay theo các hnationalThe depreciation revenue from assets formed from borrowed capital and raised capital shall be used to repay the principal and interest on loans according to loan agreements and capital-raising agreements.

b) For management expenses and professional activity expenses that have been regulated by state agencies with authority, the unit may decide on higher or lower expense levels than those stipulated in the internal expenditure regulations of the unit, but must be consistent with the financial capacity of the unit. However, for vehicle standards, office space standards, home office equipment standards, foreign travel expenses, and foreign reception expenses, the unit cannot set higher expense levels than those prescribed by the state.on mức chi quy định trong quy chế chi tiêu nội bộ của đơn vị, nhưng phải phù hợp với khả năng tài chính của đơn vị. Riêng đối với tiêu chuẩn, định mức sử dụng xe ô tô, nhà làm việc, trang bị điện thoại công vụ tại nhà riêng, công tác phí nước ngoài, tiếp khách nước ngoài: Đơn vị không được quyết định mức chi cao hơn mức quy định cDeputy ministers of ministerial-level agencies,a nhà nước;

c) For management expenses and professional activity expenses not yet regulated by state agencies with authority, the unit shall base its decisions on actual conditions, technical procedures, and build and issue economic and technical norms and expense norms suitable to the internal expenditure regulations' issuance principles and bear responsibility for their decisions.ình thực tế, vào quy trình chuyên môn kỹ thuật để xây dựng và ban hành định mức kinh tế kỹ thuật và định mức chi cho phù hnationalp theo nguyên tắc ban hành theo quy chế chi tiêu nội bộ và phải chịu trách nhiệm về quyết định của mình;

d) Based on financial capacity and actual conditions, the head of the unit may decide to use part of the annual regular operating budget and part of the Development Fund for Public Services to train and improve the skills of staff, purchase equipment, and repair buildings and infrastructure to enhance service capacity and quality.ớn nhà cửa, cơ sở hạ tầng để tăng cường năng lực phục vụ và nâng cao chất lượng dịch vụ;

đ) Căn cứ tính chất công việc, thủ trưởng đơn vị được quyền quyết định phương thức khoán chi phí cho từng bộ phận, đơn vị trực thuộc nhằm sử dụng kinh phí tiết kDepending on the nature of the work, the head of the unit has the right to decide on cost allocation methods for each department or subordinate unit to use funds efficiently and economically.

2. The surplus of revenue exceeding expenditure (if any) shall be utilized as follows:

a) For units belonging to Group 1 and Group 2:

- At least 25% shall be allocated to establish the Development Fund for Public Services Activities;

- Establish the Additional Income Fund and the Stability Income Reserve Fund;

- Establish the Award Fund,inwelfare fund;

- Establish the Medical Examination and Treatment Support Fund for units performing medical examination and treatment tasks.

b) For units belonging to Group 3 and Group 4:

- At least 25% shall be allocated to establish the Development Fund for Public Services Activities. However, for units with a revenue surplus exceeding expenditure less than one time the salary fund based on rank and position stipulated by the State within the year, at least 15% shall be allocated;

- Allocate the Additional Income Fund to pay additional salaries and remuneration for experts and outstanding doctors. The total income of units in Group 3 in a year shall not exceed three times the salary fund based on rank and position stipulated by the State; for units in Group 4, it shall not exceed two times the salary fund based on rank and position stipulated by the State; lAllocate the Stability Income Reserve Fund to ensure the income of employees in cases where income decreases;

- Establish the Award Fund and Welfare Fund with a maximum total amount for both funds not exceeding three months' average salary, wages, and additional income implemented in the year;

- Establish the Medical Examination and Treatment Support Fund for units performing medical examination and treatment tasks.onThe allocation levels of the Funds shall be decided by the head of the unit according to the internal expenditure regulations of the unit and the provisions of this Article. After establishing the aforementioned Funds, any remaining surplus

- shall be supplemented into the Development Fund for Public Services Activities.ỗ The Medical Examination and Treatment Support Fund shall be used to support patients with high medical expenses who are unable to pay and to cover risks in medical examination and treatment activities.

c) Article 16. Provisions on Non-Recurring Budgets trAccording to their functions and tasks, units shall be funded from the state budget for non-recurring activities, including:ì Funding for scientific and technological tasks assigned.

d) Funding for disease prevention and control tasks (for units that are not preventive health care units).

Funding for implementing top-down guidance tasks, implementing hospital sanitation projects,

T权批准；由单位负责人签署的工资人员名单（每年初提交一次，并在有变动时提交）； implementing rotation schedules with fixed terms for practitioners as prescribed by the Law on Medical Examination and Treatment.

1. Funding for projects under National Target Programs.

2. Funding for training and cadre development tasks (if applicable).

3. Funding for non-recurring tasks assigned or commissioned by competent state agencies (surveys, planning, surveys, etc.). tiFunding for implementing personnel reduction policies according to state regulations (if applicable).policies Funding for purchasing equipment, work tools, and other fixed assets, and major repairs of fixed assets serving public service activities according to approved projects and budgets assigned to the unit for implementation but not linked to investment development projects using development capital.

4. Funding for implementing loan and aid projects according to approved projects, including counterpart funding.

5. Funding for other urgent tasks assigned by competent authorities.

6. Funds for implementing tasks assigned or commissioned by state agencies that are not routine (such as surveys, planning, inspections, etc.).

7. Funds for implementing personnel reduction policies as prescribed by the state (if applicable).

8. Funds for purchasing equipment, working tools, and other fixed assets, major repairs of fixed assets serving public services according to approved projects and budgets assigned for the unit to implement, but not linked to investment development projects using such funds.

9. Funds for implementing loan and aid projects according to approved projects by authorized bodies, including matching funds.

10. Funds for implementing other urgent tasks assigned by authorized bodies.

Article 17. Management and Use of Non-Recurring Funds

1. Non-recurring funds allocated and budgeted to units annually according to assigned tasks shall be managed, used, expended, and settled in accordance with the State Budget Law and other guiding documents for each source of funds received; they shall not be used to calculate revenue-expenditure differences or establish any Funds.

2. Units are responsible for managing, using, expending, and settling accounts in accordance with the provisions of the State Budget Law and guiding documents applicable to each source of funds received; they shall not be used to calculate revenue-expenditure differences or establish any Funds.amendREGULATIONS ON THE PRICES OF MEDICAL SERVICES

Chapter IV

Article 18. Prices of Medical Services

The price of medical services is the amount payable for each medical service examination and treatment, implemented according to the following schedule:

In 2013: The prices of medical service examinations and treatments shall be calculated based on the following direct costs:

1. Year 2013: Prices of medical service examinations and treatments shall be calculated based on the following direct costs: trCosts of medicines, chemicals, consumable materials, and replacement materials for providing the service (including storage and loss costs according to the prescribed standards by competent authorities);

a) Electricity, water, fuel, waste disposal, and environmental sanitation costs directly related to providing the service;

b) Maintenance and repair costs of equipment, purchase and replacement of tools and equipment directly used to provide the services;This Resolution takes effect from the date it is adopted by the National Assembly.Costs of allowances and surgical fees.

c) Period 2014-2017: The prices of medical service examinations and treatments shall be calculated based on the following costs:

d) Costs specified in Clause 1 of this Article;

2. Labor costs: For coal-fired thermal power plants where the enterprise holds 100% of the registered capital and uses 100% of its own capital to invest in the project approved by the competent authority, E is determined as 100%;For 2014-2015: Only 30% of the basic wage fund for provincial hospitals in mountainous areas, Central Highlands, and district hospitals in Hanoi and Ho Chi Minh City, and 50% of the basic wage fund for central hospitals and provincial hospitals in other centrally-administered cities and provinces;

a) For 2016-2017: 100% of the basic wage fund for provincial hospitals, central hospitals, and district hospitals in Hanoi and Ho Chi Minh City, and 50% of the basic wage fund for county hospitals in other areas;

b) Outsourced labor costs (if any). Special costs not exceeding 50% of the labor cost of the service to pay remuneration to encourage and attract skilled experts and doctors to work at the unit;

- Depreciation costs of fixed assets such as machinery and equipment directly used to provide the service according to the regime applicable to state-owned enterprises; interest costs under loan contracts and capital-raising contracts for investment in and procurement of equipment to provide the service (if any): Shall be calculated and allocated to the costs of services using these funds;

- Indirect costs and other lawful costs necessary to ensure normal operation of the hospital. lFrom 2018 onwards, the prices of medical service examinations and treatments shall include all costs to provide the service, including:

c) Direct costs:

d) Costs of medicines, chemicals, consumable materials, and replacement materials (including storage and loss costs according to the prescribed standards by competent authorities);y Costs of electricity, water, fuel, waste disposal, and environmental sanitation;

Wages, allowances, contributions according to regulations; outsourced labor costs; special costs not exceeding 50% of the labor cost of the service;

3. Maintenance, repair, and replacement costs of fixed assets, tools, and equipment directly used to provide technical services; For coal-fired thermal power plants where the enterprise holds 100% of the registered capital and uses 100% of its own capital to invest in the project approved by the competent authority, E is determined as 100%;Depreciation costs of fixed assets according to the regime applicable to state-owned enterprises; interest costs under loan contracts and capital-raising contracts for investment in and procurement of equipment to provide the service (if any): Shall be calculated and allocated to the costs of services using these funds.

a) Indirect costs:

- Costs of indirect departments and other lawful costs necessary to ensure normal operation of the hospital;Coat Training and scientific research costs to apply new techniques.

- Labor costs shall be calculated according to the following principle: For services with approved labor rates in the service rate approved by competent authorities, the labor costs shall be calculated according to the approved labor rates. For services without specified labor rates in the service rate, the labor costs shall be calculated based on labor consumption and the average wage level to provide the service.

- The prices of medical service examinations and treatments for units belonging to Group 1, Group 2, and public health institutions implementing socialization shall be fully calculated based on the cost factors specified in Clause 3 of this Article and have accumulations for development investment. The maximum accumulation rate shall not exceed 10% of the service cost and shall be supplemented into the Development Fund of the institution.

- Maintenance, repair, and replacement costs for fixed assets and tools directly used to provide technical services.

- Fixed asset depreciation costs according to the regime applied to state-owned enterprises; costs for paying interest on loans according to loan and capital-raising agreements for investment and equipment purchases to provide services (if applicable): These costs shall be calculated and allocated to the costs of services using these funds.nationalIndirect costs:

b) Costs of indirect departments and other lawful costs to operate and ensure normal hospital activities.

- Training and scientific research costs to apply new techniques.

- Wages costs shall be calculated based on the following principle: For services with wage rates included in the service price approved by authorized agencies, the wage rate already approved shall be used. For services without specified wage rates, wages costs shall be calculated based on labor consumption and average wage levels to perform the service.

4. Chi phí về tiền lương được tính theo nguyên tắc sau: Đối với những dịch vụ có đơn giá tiền lương trong đơn giá của dịch vụ được cơ quan có thẩm quyền phê duyệt thì được tính theo đơn giá tiền lương đã được phê duyệt. Đối với những dịch vụ chưa được quy định đN ||| declaration of customs import procedures. where the service unit price includes wages, the wage costs shall be calculated based on labor consumption and the average wage level to perform the servicein The cost factors for public health facilities subject to socialization shall be fully accounted for as specified in Clause 3 of this Article and shall accumulate for investment in development. The maximum accumulation rate shall not exceed 10% of the service costs and shall be added to the Development Fund for Public Services of the entity..

5. Service prices for outpatient and inpatient care for units in Groups 1 and 2, and socialized facilities of public health institutions shall include all factors of cost as stipulated in Clause 3 of this Article and accumulate to invest in development. The maximum accumulation rate shall not exceed 10% of the service costs and shall be added to the Development Fund for Public Services of the unit.o unit BB 1.1at central-level medical examination and treatment facilities; and by the ChairmanN ||| declaration of customs import procedures. of the provincial People's Committee when seeking treatment at local-level medical examination and treatment facilities.

Article 19. Authority to stipulate and decide on medical service prices

1. Medical examination and treatment service prices shall be calculated on a per-service or per-medical technology basis, or based on the case of illness.

2. The Ministry of Health shall take the lead and coordinate with the Ministry of Finance to stipulate the framework for medical examination and treatment service prices when payment is made on a per-service basis, and the framework for each type of disease or group of diseases when payment is made on a per-case basis, including:

a) The price framework according to the schedule prescribed in Article 18 of this Decree;

b) The price framework that fully includes all cost factors and accumulations as stipulated in Clause 5 of Article 18 of this Decree.

3. For medical service prices assigned or ordered by the State in accordance with Decision No. 39/2008/QĐ-TTg dated March 14, 2008 issued by the Government on tendering, ordering, and assigning tasks for providing public services funded by the state budget.

4. The prices of medical examination and treatment services shall be reviewed and adjusted under the following circumstances:nationalpursuant to the annual planning plan of the People's Committee (PC) on April 7, 2010, and the annual planning plan of the Provincial People's Committee (Clause 2, Article 32, Urban Planning Law).

a) When the competent state agency changes the economic and technical norms for medical examination and treatment services;

b) When the State changes its wage mechanism and policies;

c) When there are fluctuations in the prices of input factors.

5. The authority to stipulate specific service prices for state-run medical examination and treatment facilities shall be carried out in accordance with current regulations.

6. The level of adjustment for medical service prices and the timing of such adjustments shall be decided by the competent state agency responsible for regulating medical service prices based on the provisions of Articles 18 and 19 of this Decree and actual conditions.

Article 20. Provisions on the objects and methods of paying for medical examination and treatment costs

1. All individuals and organizations (including foreigners working, lresiding, studying, traveling, or transiting in Vietnam's territory) must pay for medical services at public medical examination and treatment facilities according to the service price levels and the quantity of services they have used, including:

a) Individuals with a Health Insurance Card: Their medical examination and treatment costs will be paid by the Health Insurance Fund to the medical examination and treatment facility according to the legal provisions on Health Insurance. The difference between the medical examination and treatment costs and the amount paid by the Health Insurance Fund shall be borne by the patient to the medical examination and treatment facility;

b) Individuals without a Health Insurance Card: They must pay for their medical examination and treatment costs to the medical examination and treatment facility, except for those specified in Clause 2 of this Article;

c) Foreign citizens from countries that have signed international treaties on medical examination and treatment with Vietnam shall have their medical examination and treatment costs applied according to the provisions of these international treaties. organize credit institutions, foreign bank branches are responsible for organizing the implementation of this Circular.The following subjects shall be reimbursed by the State for medical examination and treatment costs at public medical examination and treatment facilities:

2. Persons who are required to undergo medical treatment according to Article 66 of the Law on Medical Examination and Treatment;

a) Persons suffering from leprosy and certain other diseases as decided by the competent authority;

b) Patients in cases of natural disasters, major accidents, and emergencies as decided by the Minister or Head of a government agency when they are treated at central-level medical examination and treatment facilities; by the provincial People's Committee Chairman when they are treated at local medical examination and treatment facilities.

c) Payment based on service prices is payment based on the prices of individual medical services and technologies prescribed for public medical examination and treatment facilities and the cost of medicines, consumables, and replacement materials used by patients;Payment based on the case of illness is payment based on the cost of treating each specific type or group of diagnosed diseases. Encouragement is given to medical examination and treatment facilities to implement payment based on the case of illness. The Ministry of Health shall develop a roadmap so that by 2020, most types of diseases or groups of diseases will be reimbursed using this method. trconsumables, replacement materials used by patients; ||p tof the Government stipulating functions, tasks, powers, and organizational structure of the Ministry of Home AffairsEncouraging medical examination and treatment units to implement payment based on disease episodes. The Ministry of Health will develop a roadmap to ensure that by 2020, most types of diseases or disease groups are paid for under this method.onpursuant to Resolution No. 18/2008/QH12 dated June 3, 2008 of the National Assembly, ensuring that the growth rate of healthcare spending from the state budget exceeds the average growth rate of total state budget spending;

3. Payment method:

a) Payment based on service prices is payment based on the price of each medical service and technique prescribed for public hospitals and the cost of drugs, consumables, and spare parts used by patients.Coat creasing

b) Payment based on patient cases is payment based on the cost of treatment for specific diseases or disease groups diagnosed.ìEncouraging healthcare facilities to implement case-based payments. The Ministry of Health will develop a roadmap to ensure that by 2020, most diseases or disease groups will be paid for under this method.

at least 30% for

Article 21. Management and utilization of revenue from medical examination and treatment services

1. Revenue from medical examination and treatment services trwithin the price range framework issued by the Ministry of Finance and the Ministry of Health pursuant to this Decree shall be retained entirely by the service provider and not reflected in the state budget.

2. Units shall open accounts at the State Treasury to monitor and manage expenditures and settle accounts for revenue from medical examination and treatment services according to current regulations; they are permitted to open special accounts for medical services at commercial banks to collect payments on their behalf but must transfer funds to their accounts at the State Treasury within five working days for monitoring, managing expenditures, and settling accounts.

3. As for revenue from service activities of independent accounting units prescribed in Article 6 of this Decree:o The unit is permitted to open an account at a commercial bank for monitoring and management, but when using it, funds must be transferred to the unit's account at the State Treasury for managing expenditures and settling accounts.

4. Units must use invoices and receipts in accordance with Decree No. 51/2010/NĐ-CP dated May 14, 2010 of the Government on invoices for goods and services and current guiding documents.

Chapter V

OTHER PROVISIONS

Article 22. Payment of salaries, wages, and additional income

1. Units are responsible for ensuring basic salaries according to rank, grade, position, and the minimum wage stipulated by the State for workers.

2. Units base the Additional Income Fund to decide the level of payment for additional income in the internal expenditure regulation, following the principle that those who have high productivity, quality, efficiency, and significant contributions to completing the unit's specialized tasks should receive higher payments, with appropriate remuneration to encourage and attract experts and doctors to work at the unit, without limiting the maximum income of individual workers.ANNEX I.A[31] Article 23. Sources to ensure salary policy

Independence - freedom - happinessANNEX I.A[31]For units in Group 1 and Group 2: From the revenue of the unit as stipulated in Article 12 of this Decree. pay

1. For units in Group 3 and Group 4: From the revenue of the unit and state support. The State guarantees the budget to pay salaries, including additional salaries according to the salary reform roadmap for units in preventive health, food safety, population/family planning fields; other units, after utilizing revenue but still failing to ensure payment, will be considered and supplemented from the state budget to ensure payment of salaries, allowances, and contributions under current regulations for workers.

2. Article 24. Provisions regarding obligations to the state budgetANNEX I.A[31] Units are responsible for fulfilling obligations to the state budget in accordance with current regulations.Coat Independent accounting units under public health institutions meeting conditions, criteria, and scale as prescribed by the Government on policies encouraging socialization shall enjoy tax incentives similar to enterprises operating in the healthcare sector.

Article 25. Other provisionsớ1. Provincial People's Committees directly under the Central Government are responsible for submitting to the Provincial People's Council proposals to increase local budget spending on healthcare according to Resolution No. 18/2008/QH12 dated June 3, 2008 of the National Assembly, ensuring the rate of increase in healthcare budget spending exceeds the average rate of increase in the state budget;

1. Units shall base on:N ||| declaration of customs import procedures. At least 30% for preventive healthcare; allocate budgets so that healthcare facilities can implement rotation systems with fixed terms as prescribed by the Law on Medical Examination and Treatment.

2. Provincial People's Committees directly under the Central Government shall consider and propose to the Provincial People's Council to decide on mechanisms and policies to reward and create favorable conditions for housing and work to attract healthcare personnel, especially newly graduated doctors and pharmacists to work at public healthcare units under local management.

Heads of medical examination and treatment facilities are responsible for ensuring medicines, consumables, and replacement materials according to the list prescribed by the Ministry of Health for patient use, preventing patients from having to purchase them themselves.

Publicly disclose service prices for medical examination and treatment for the public to know and choose. Bear responsibility before the law for organizing collection, management, and utilization of unit revenue.Strictly prohibit healthcare facilities and healthcare civil servants from collecting additional fees from patients beyond the regulated prices by competent authorities, prescribing medical techniques not in accordance with technical guidelines and treatment guidelines. Violators will be dealt with according to the law.No. preventive healthcare; allocating the budget for medical establishmentsNo.The head of the medical examination and treatment facility is responsible for ensuring medicines, For coal-fired thermal power plants where the enterprise holds 100% of the registered capital and uses 100% of its own capital to invest in the project approved by the competent authority, E is determined as 100%;consumables, replacement materials according to the listNo.of violations will be handled in accordance with the provisions of the law. lĩnh vực y tế dự phòng; bố trí ngân sách để các cơ sở y tpolicies Ensuring that public health facilities implement the rotation system as prescribed by the Law on Medical Examination and Treatment.

|||The heads of healthcare facilities are responsible for ensuring the availability of medicines, consumables, and spare parts according to the list.

3. Thủ trưởng cơ sở khám bệnh, chữa bệnh có trách nhiệm bảo đảm thuốc, hCoat chất, vật tư tiêu hao, vật tư thay thế theo danh mục For coal-fired thermal power plants where the enterprise holds 100% of the registered capital and uses 100% of its own capital to invest in the project approved by the competent authority, E is determined as 100%;The Ministry of Health shall specify for use by patients, not allowing patients to have to purchase on their own, cpublicly declare the service fee levels for medical examination and treatment so that the public can be informed and make choices. Bear legal responsibility for organizing the collection, management, and utilization of revenue from the unit.

4. Strictly prohibit healthcare facilities, health civil servants, and health staff from collecting additional fees from patients beyond the prices set by competent authorities, and from prescribing medical techniques not in accordance with technical guidelines and treatment guidelines.ìIn case of violation, they will be dealt with according to the provisions of the law.nationalp vi phạm sẽ bị xử lý theo quy định của pháp luật.

Chapter VI

IMPLEMENTATION

Article 26. EffectivenessANNEX I.A[31] ADJUSTMENT

This Decree takes effect from December 1, 2012, and replaces Government Decree No. 95/CP dated August 27, 1994, on collecting part of medical service fees.

Previous regulations of the Government, the Prime Minister, ministries, ministerial-level agencies, and localities that conflict with the provisions of this Decree are abolished.ớArticle 27. Provisions

The Minister of Health shall take the lead and coordinate with the Minister of Finance and the Minister of Home Affairs to guide the implementation of this Decree.ANNEX I.A[31] ADJUSTMENT

1. The Minister of National Defense and the Minister of Public Security shall base their specific guidance on the implementation for public health institutions under their jurisdiction according to the provisions of this Decree.ANNEX I.A[31] 2. Civil servants, officials, and officers belonging to the armed forces working directly and regularly in the field of foreign affairs and international integration shall be recognized as being proficient in rare foreign languages if they meet the following conditions:

2. Ministers,

3. heads of ministerial-level agencies, heads of government agencies, Chairmen ||of provincial people's committees directly under the central government are responsible for enforcing this Decree; they shall direct, organize guidance, and regularly inspect and supervise public health institutions under their management in complying with the provisionsperiodof this Decree./.