Joint Circular No. 85/2016/TTLT-BQP-BYT-BTC guiding the implementation of health insurance for military personnel and those working in confidential services

JOINT CIRCULAR

guiding the implementation of health insurance for military personnel

and individuals engaged in confidential work

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Pursuant to the Health Insurance Law dated November 14, 2008 and the Law Amending and Supplementing Certain Provisions of the Health Insurance Law dated June 13, 2014;

Pursuant to Decree No. 70/2015/NĐ-CP dated September 1, 2015 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law concerning the People's Army, the People's Public Security Force, and individuals engaged in confidential work;

Pursuant to Decree No. 35/2013/NĐ-CP dated April 22, 2013, of the Government, stipulating the functions, tasks, powers, and organizational structure of the Ministry of National Defense;

This Circular prescribes procedures for receiving, providing health care for domestic violence victims and statistical reports on domestic violence victims at medical facilities.

Pursuant to Decree No. 215/2013/NĐ-CP dated December 23, 2013 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Finance,

The Minister of National Defense, the Minister of Health, and the Minister of Finance issue this Joint Circular guiding the implementation of health insurance for military personnel and individuals engaged in confidential work.

PART I

GENERAL PROVISIONS

Article 1. Scope of Regulation

Article 1. This Circular guides the implementation of health insurance for the subjects specified in Clauses 1 and 3 of Article 2 of Decree No. 70/2015/NĐ-CP dated September 1, 2015 of the Government detailing and guiding the implementation of certain provisions of the Health Insurance Law concerning the People's Army, the People's Public Security Force, and individuals engaged in confidential work (hereinafter referred to as Decree No. 70/2015/NĐ-CP).

Article 2. For the subject specified in Clause 3 of Article 2 of this Circular

a) Prepare the budget for health insurance contributions according to Clauses 2 and 3 of Article 5 of Decree No. 70/2015/NĐ-CP;

b) Issue, reissue, replace, and recover health insurance cards; allocate, manage, and utilize the health insurance fund according to Articles 7, 8, 9, and Clause 2 of Article 20 of Decree No. 70/2015/NĐ-CP and this Circular.

Article 3. Subjects participating in health insurance

The subjects participating in health insurance specified in Clauses 1 and 3 of Article 2 of Decree No. 70/2015/NĐ-CP applicable in this Circular include:

1. Officers, non-commissioned officers, and conscripts currently serving.

2. Individuals engaged in confidential work receiving salaries equivalent to those of military personnel working at the Confidential Work Department under the Government;

3. Individuals engaged in confidential work receiving salaries equivalent to those of military personnel working at ministries, sectors, and localities that employ confidential workers;

4. Confidential students receiving living expenses from the state budget according to policies similar to those for military students.

Article 3. Preparation of Budget Estimates, Contribution Methods, Responsibility for Contributions, and Settlement of Health Insurance Contribution Funds

1. Based on the timeline specified in Article 3 of Decree No. 70/2015/NĐ-CP dated September 1, 2015 of the Government, the Ministry of National Defense, central agencies, and localities employing individuals engaged in confidential work shall prepare budget estimates for health insurance contributions for the subjects under their management and submit them to the financial authorities at the same level for consolidation and submission to the competent authority in accordance with the State Budget Law and related guiding documents.

2. The Ministry of National Defense is responsible for calculating deductions for drug, bandage, chemical, medical supply costs, and bed charges guaranteed for the Military Medical Service according to Decree No. 123/2003/NĐ-CP dated October 22, 2003, and Decree No. 65/2009/NĐ-CP dated July 31, 2009 amending and supplementing Decree No. 123/2003/NĐ-CP stipulating material standards for logistical support for military personnel corresponding to the number of insured military personnel according to the timeline specified in Article 3 of Decree No. 70/2015/NĐ-CP.

3. Management, utilization, and settlement of health insurance contribution funds provided by the state budget shall be carried out in accordance with the State Budget Law, the Health Insurance Law, and related guiding documents.

4. Subjects specified in Article 2 of this Circular who are entitled to salary during maternity leave or adoption leave or are receiving sickness benefits due to long-term illness listed in the Directory of Diseases Requiring Long-Term Treatment issued by the Ministry of Health according to social insurance laws shall have their health insurance premiums paid by the social insurance fund based on their monthly salary and allowances before taking maternity leave or sick leave.

5. Subjects specified in Article 2 of this Circular who are sent abroad for study or work shall not pay health insurance premiums; the time spent abroad shall be counted as participation in health insurance until the date of the decision to return issued by the sending agency or organization.

6. Annually, the Social Insurance Department of the Ministry of National Defense shall report the settlement of health insurance premiums collected from the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular to the Vietnam Social Security.

Chapter II

HEALTH INSURANCE CARD

Article 4. Procedures and formalities for issuing health insurance cards to subjects specified in Clauses 1, 2, and Clause 4, Article 2 This circular

1. Health insurance cards shall be issued in cases where they have not been issued or when changing the subject participating in health insurance from another group or when the health insurance card has expired, in accordance with the provisions of Article 7 of Decree No. 70/2015/NĐ-CP.

2. The dossier for issuing health insurance cards includes:

a) A form for providing and changing information on individuals participating in social insurance and health insurance for the first time participating in health insurance;

b) A list of subjects specified in Clauses 1, 2, and Clause 4, Article 2 of this Circular (accompanied by electronic data of the list of health insurance participants), established by units at division level and equivalent;

c) Forms for providing and changing information on individuals participating in social insurance and health insurance, lists of health insurance participants, and other forms in the dossier for issuing health insurance cards, issued by the Vietnam Social Security after coordinating with the Social Security Department of the Ministry of National Defense to ensure compliance with the management of subjects by the Ministry of National Defense.

3. Procedures and formalities for issuing health insurance cards include:

a) In the fourth quarter of each year, subjects specified in Clauses 1, 2, and Clause 4, Article 2 of this Circular who participate in health insurance for the first time must fill out the form for providing and changing information on individuals participating in social insurance and health insurance as stipulated in Point a, Clause 2 of this Article and submit it to the directly managing unit;

b) Within five working days from the date of receiving a valid form, the directly managing unit of subjects specified in Clauses 1, 2, and Clause 4, Article 2 of this Circular must check the legality and accuracy, compile, and establish a list of health insurance participants in their own unit and issue a written request to the personnel department of the unit at battalion level and equivalent. If the form is invalid, the directly managing unit must guide the subject to complete the form in accordance with regulations;

c) Within five working days from the date of receiving the written request from the directly managing unit accompanied by the list of health insurance participants and the valid form of subjects specified in Clauses 1, 2, and Clause 4, Article 2 of this Circular, the unit at battalion level and equivalent must issue a written request to the personnel department of the unit at division level and equivalent;

d) Within five working days from the date of receiving the written request from the unit at battalion level and equivalent accompanied by the list of health insurance participants and the valid form of subjects specified in Clauses 1, 2, and Clause 4, Article 2 of this Circular, the unit at division level and equivalent must compile the list, report to the personnel department of the unit under the direct control of the Ministry of National Defense for management and storage of the health insurance participation form, and simultaneously send a written request for issuance of health insurance cards along with the list and electronic data file to the Social Security Department of the Ministry of National Defense;

đ) Within ten working days from the date of receiving the dossier as stipulated in Clause 2 of this Article, the Social Security Department of the Ministry of National Defense must issue health insurance cards and transfer them back to the unit for the health insurance participant; if the card is not issued, the Social Security Department of the Ministry of National Defense must issue a written notice to the unit explaining the reasons;

e) The dossier for issuing health insurance cards must be sent directly or through military postal service to the Social Security Department of the Ministry of National Defense.

4. Issuance of health insurance cards for certain cases:

a) Subjects transferred or reassigned from units that have not yet implemented health insurance according to the schedule specified in Article 3 of Decree No. 70/2015/NĐ-CP to units that are implementing health insurance: Upon receipt, the unit must guide individuals to declare, compile a list for issuing health insurance cards, and report to the unit at division level and equivalent to the Social Security Department of the Ministry of National Defense. The list for issuing health insurance cards must clearly state the effective date of the decision on the transfer or reassignment of the subject. The health insurance card will be valid from the effective date of the decision on the transfer or reassignment of the subject;

b) Cases of switching from a subject participating in health insurance in another group to a subject specified in Article 2 of this Circular: Upon receipt, the unit must guide individuals to declare, compile a list for issuing health insurance cards, and report to the unit at division level and equivalent for compilation and transfer to the Social Security Department of the Ministry of National Defense along with the old social insurance card (if available) for recovery. The new health insurance card will be valid from the effective date of the recruitment or transfer decision by the competent authority;

c) Other special cases shall be guided by the Director of the Social Security Department of the Ministry of National Defense.

5. The Director of the Social Security Department of the Ministry of National Defense shall specify the validity period of the card issued by the Social Security Department of the Ministry of National Defense, but not exceeding twenty-four months.

6. Military medical units manage health insurance cards of subjects.

Article 5. Reissue and replace health insurance cards for subjects specified in Clauses 1, 2, and Clause 4, Article 2 of this Circular.

1. Reissue health insurance card in case of loss.

2. Replace health insurance card in accordance with Clause 1, Article 19 of the amended and supplemented Health Insurance Law and the following provisions:

a) Change from non-commissioned officer, soldier to officer, professional military personnel; from student of technical school to technical staff or to officer, professional military personnel;

b) Insured persons who are transferred to work in areas with difficult economic and social conditions, extremely difficult conditions, or island communes, island districts, and vice versa.

3. Documents for reissuing and replacing health insurance cards

a) In case of reissuing card: Application for reissuance of health insurance card by the insured person;

b) In case of replacing card: Application for replacement of health insurance card by the insured person and the health insurance card;

c) Request document and list of reissued and replaced health insurance cards established and sent by division-level units and equivalent units to the Social Insurance Department under the Ministry of National Defense.

4. Procedures for reissuing and replacing health insurance cards shall be carried out in accordance with Clause 3, Article 4 of this Circular. Within seven working days from the date of receipt of complete documents as stipulated in Clause 3 of this Article, the Social Insurance Department under the Ministry of National Defense must reissue or replace the health insurance card; if not reissued or replaced, the Social Insurance Department under the Ministry of National Defense must reply in writing and specify the reasons. During the waiting period for reissuing or replacing the health insurance card, the insured person when seeking medical examination and treatment shall comply with the provisions of Clause 5, Article 15 of Decree No. 70/2015/ND-CP and enjoy full benefits of health insurance.

5. Fees for reissuing and replacing health insurance cards

a) Subjects requesting reissuance or replacement of health insurance cards must pay fees in cases where the card is lost or damaged by the individual. The fee for reissuance and replacement shall be implemented according to the regulations of the Ministry of Finance;

b) Individuals or units pay the fee for reissuance and replacement of health insurance cards to the financial unit managing directly. Monthly, the financial unit summarizes and reports the amount of fees collected for reissuance and replacement of health insurance cards to the higher financial authority up to the financial department of the unit directly subordinate to the Ministry of National Defense;

c) Annually, at the time of settlement of income and expenditure of health insurance, the Social Insurance Department under the Ministry of National Defense will settle the fee for reissuance and replacement with the financial department of the unit directly subordinate to the Ministry of National Defense.

Chapter III

SCOPE OF HEALTH INSURANCE BENEFITS AND EXPENSES FOR MEDICAL EXAMINATION AND TREATMENT

 IN SOME CASES AND TRANSPORTATION COSTS

AND TRANSPORTATION COSTS

Article 6. Scope of health insurance benefits for subjects specified in Article 2 of this Circular

1. Medical examination, treatment, rehabilitation, regular prenatal check-ups, and childbirth.

2. Transportation costs as prescribed in Clause 5, Article 11 of Decree No. 70/2015/ND-CP.

3. Not applicable to the provisions on the limit of reimbursement ratio for some medicines, chemicals, medical supplies, and medical techniques as prescribed by the Minister of Health for the expenses specified in Clause 1 of this Article.

4. Expenses for medical examination and treatment outside the scope of health insurance coverage include: Medicines, chemicals, medical supplies permitted for circulation in Vietnam and medical techniques approved by competent authorities.

Article 7. Payment for medical examination and treatment costs as prescribed in Clause 2, Article 10 of Decree No. 70/2015/NĐ-CP

1. The health insurance medical examination and treatment fund for the group of subjects as stipulated in Article 2 of this Circular shall pay for medical examination and treatment costs outside the scope of health insurance benefits for these subjects when:

a) Medical examinations and treatments comply with the provisions of Articles 26, 27, and 28 of the Health Insurance Law which has been amended and supplemented, or in emergency cases;

b) Medicines and chemicals must be licensed for circulation in Vietnam, medical supplies must be included in the list of approved usage, and medical techniques must be approved by the competent authority;

c) Service technique prices must be approved by the competent authority; medicine, chemical, and medical supply prices according to tender results shall be implemented in accordance with the laws on procurement of medicines, chemicals, and medical supplies;

d) Using medicines, chemicals, medical supplies, and medical service techniques outside the health insurance payment list must be approved by a consultation or signed off by the head of the medical examination and treatment facility (or their authorized representative) and recorded in the patient's medical record.

2. In cases where the medical examination and treatment fund for the group of subjects as stipulated in Article 2 of this Circular is insufficient, the state budget will continue to ensure these expenditure items.

3. Medical examination and treatment facilities shall settle accounts for the expenditure items under Clauses 1 and 2 of this Article (if applicable) with the Social Insurance Department of the province, the Social Insurance Department of the Ministry of National Defense. The Vietnam Social Security will compile the expenditure items under Clause 2 of this Article and report to the Ministry of Finance to supplement funds from the state budget.

Article 8. Allocation and payment of funds for medical examination and treatment at military units' healthcare and agency healthcare

1. Allocation and payment of funds for medical examination and treatment at military units' healthcare and agency healthcare under the management of the Ministry of National Defense

a) Quarterly, based on the number of health insurance cards issued and the corresponding health insurance revenue of the subjects as stipulated in Clauses 1, 2, and 4 of Article 2 of this Circular, the Social Insurance Department of the Ministry of National Defense will notify and transfer funds to the financial department of subordinate units directly under the Ministry of National Defense equal to 10% of the total health insurance revenue of the subjects to allocate funds to battalion-level units and equivalent units for the medical examination and treatment of these subjects at military units' healthcare and agency healthcare. Military units' healthcare and agency healthcare of battalion-level units and equivalent units will take the lead in coordinating with the same-level financial departments to develop plans for using funds, report to the unit leaders for approval;

b) Ensuring and using funds for medical examination and treatment at military units' healthcare and agency healthcare as follows:

The contents of expenses for medical examination and treatment at military units' healthcare and agency healthcare include: medicines, bandages, chemicals, consumable medical supplies within the health insurance payment list; costs of medical service techniques and rehabilitation services in health insurance medical examination and treatment, which have been approved by the competent authority for the list and payment prices;

The Chief of Military Medicine of battalion-level units and equivalent units will build and submit to the higher-level Chief of Military Medicine for approval the list of medicines used at the military units' healthcare and agency healthcare, and organize the supply of medicines, bandages, chemicals, and consumable medical supplies within the scope of expertise through bidding or competitive bidding to purchase directly for military units' healthcare and agency healthcare under their management. In cases where battalion-level units and equivalent units cannot ensure the supply of medicines, bandages, chemicals, and consumable medical supplies, the military units' healthcare and agency healthcare of division-level units and equivalent units or those directly under the Ministry of National Defense will implement this content;

Quarterly, military units' healthcare and agency healthcare will aggregate and prepare reports on health insurance fund expenses according to the prescribed format of the Vietnam Social Security;

c) Payment and settlement methods:

Quarterly, military units' healthcare and agency healthcare will base on daily records of medical examinations, drug distribution, and treatment, statistics of professional activities using drugs and procedures at the unit to aggregate and prepare reports on health insurance fund expenses according to the prescribed format and transfer them to battalion-level units and equivalent units;

Quarterly, the unit's financial department will take the lead in coordinating with the same-level military medicine department to review, audit, and confirm the settlement of medical examination and treatment expenses as stipulated in Point b of this Clause; aggregate and prepare reports for settlement with the higher-level financial department up to the financial department directly under the Ministry for settlement with the Social Insurance Department of the Ministry of National Defense;

Funds used for medical examination and treatment at military units' healthcare and agency healthcare in the period that are not fully spent can be carried over to the next period for continued use. In cases where expenditures exceed the allocated budget, the excess amount will not be settled with the Social Insurance Fund;

Annually, if the allocated funds are not fully utilized, the unit must report to the unit leader and report upwards to the higher level, reporting to the Social Insurance Department of the Ministry of National Defense; these funds will be transferred for use in the following year. In cases where expenditures exceed the allocated budget, the subordinate units of the Ministry of National Defense must prepare a report explaining the situation and send it to the General Department of Military Medicine for consolidation and reporting to the Ministry of National Defense for consideration of supplementary funding from the state budget. In cases of excessive spending due to unusual illness, injury, accident, or epidemic among the subjects stipulated in Article 2 of this Circular, the unit must immediately prepare a report to promptly supplement from the state budget, without allowing shortages of medicines;

d) Healthcare practitioners at military units' healthcare and agency healthcare must hold a practice certificate as prescribed by law; in cases where treatment exceeds the professional capacity, patients should be referred to the initial healthcare facility registered on the health insurance card (except in emergency cases where patients can be transferred to the nearest convenient healthcare facility);

2. Allocation and payment of funds for medical examination and treatment at agency healthcare for the subjects as stipulated in Clause 3 of Article 2 of this Circular

a) Quarterly, based on the number of health insurance cards issued and the corresponding health insurance revenue of the subjects specified in Clause 3, Article 2 of this Circular, the Social Insurance Department that issues the health insurance cards shall notify and transfer funds to the financial agencies of ministries, sectors, and localities equal to 10% of the total health insurance revenue of the subjects for allocation of funds to healthcare units directly managing the health of the subjects for their medical examination and treatment expenses. The healthcare units directly managing the health of the subjects shall take the lead and coordinate with the same-level financial agencies to prepare plans for fund usage and report to the heads of the units for approval.

b) The expenditures for medical examination and treatment at healthcare units include: medicines, bandages, chemicals, consumable medical supplies listed in the health insurance reimbursement directory; technical service fees and rehabilitation costs in health insurance-covered medical examinations and treatments approved by authorized bodies with regard to the reimbursement directories and prices.

c) Payment and settlement methods:

Quarterly, healthcare units directly managing the health of the subjects shall base on daily records of medical examinations, prescription issuance, and treatment, compile statistics on professional activities involving drug use and procedures performed at the unit, and prepare and submit reports on health insurance fund expenditures according to prescribed formats to the same-level financial agencies.

Quarterly, the financial agency of the unit shall take the lead and coordinate with the same-level healthcare agency to review, audit, and confirm settlement of medical examination and treatment expenses as stipulated in Point b of this Clause; aggregate and prepare settlement reports to be submitted to higher-level financial agencies for settlement with the Social Insurance Department of the province.

Unspent health insurance funds for medical examination and treatment at healthcare units during the period may be carried over to the next period for continued use. In cases where expenditures exceed the allocated budget, the excess amount will not be settled with the Social Insurance Agency from the health insurance fund.

Annually, if the allocated funds are not fully utilized, the unit must report to its head and then report upwards to higher authorities and to the Social Insurance Department of the province; these unspent funds will be transferred for use in the following year.

Article 9. Payment of transportation costs as stipulated in Clause 5, Article 11 of Decree No. 70/2015/NĐ-CP

1. Conditions for payment and procedures for settling transportation costs shall be implemented in accordance with Points a and c of Clause 5, Article 11 of Decree No. 70/2015/NĐ-CP.

2. The level of payment for transportation costs within the health insurance fund scope

a) In cases where transportation means are provided by healthcare facilities, the health insurance fund shall reimburse transportation costs for both the outbound and return journeys for the healthcare facility at a rate of 0.2 liters of gasoline per kilometer based on the actual distance between two healthcare facilities and the gasoline price at the time of use. If more than one person is transported together, the reimbursement rate will still be calculated as if only one person were being transported.

b) In cases where transportation means are not provided by healthcare facilities, the health insurance fund shall reimburse one-way transportation costs (outbound journey) for patients at a rate of 0.2 liters of gasoline per kilometer based on the actual distance between two healthcare facilities and the gasoline price at the time of patient transportation.

c) Transportation costs as stipulated in Points a and b of this Clause shall not be reimbursed for accompanying persons escorting patients transferring to another facility (if applicable).

d) The level of reimbursement for transportation costs as stipulated in Points a and b of this Clause applies to road and rail transport. For waterway transport, nautical miles shall be converted to kilometers; air transport shall not be treated the same as road transport.

đ) Quarterly, the Social Insurance Agency shall settle transportation costs for healthcare facilities simultaneously with the settlement of health insurance-covered medical examination and treatment costs.

3. Transportation costs outside the scope stipulated in Clause 2 of this Article

a) Transportation costs outside the scope stipulated in Clause 2 of this Article shall be covered by the state budget, including: transportation costs from the place of work, study, or residence to the initial healthcare registration location; from the final healthcare location back to the place of work, study, or residence; costs for accompanying persons; and any costs exceeding the stipulated reimbursement levels as specified in Point d.

b) Settlement documents shall include: an individual's application for reimbursement of transportation costs outside the health insurance coverage, confirmed by the unit, a copy of the discharge certificate, and original receipts and invoices for transportation costs.

c) Settlement procedure:

Individuals shall prepare the documents as specified in Point b of this Clause and submit them to the financial agency of the directly managing unit for submission to higher-level financial agencies.

Within ten working days, the financial agency of the regiment-level unit and equivalent, or if there is no such agency, the financial agency of the division-level unit and equivalent, must examine and settle transportation costs outside the health insurance coverage for the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular and settle annually according to current regulations; financial agencies under ministries, sectors, and provinces using confidential communications must examine and settle transportation costs outside the health insurance coverage for the subjects specified in Clause 3 of Article 2 of this Circular and settle annually according to current regulations.

4. Annually, the Financial Department of the Ministry of Defense shall take the lead and coordinate with the Medical Service Department of the Ministry of Defense and financial agencies under ministries, sectors, and provinces to prepare budgets for the cases stipulated in Clause 3 of this Article concurrently with the preparation of the medical and health sector budget, and report to the Ministry of Finance to ensure and implement annual settlements in accordance with the State Budget Law and related implementing regulations.

Article 10. Payment for hospital meals and infirmary meals for the subjects specified in Article 2 of this Circular

1. The subjects specified in Article 2 of this Circular when admitted for inpatient treatment at military medical facilities or medical facilities of ministries, sectors, and localities that organize nutritional care according to the regulations of the Ministry of Health shall be entitled to hospital meal and infirmary meal allowances at the levels prescribed in Decree No. 123/2003/ND-CP dated October 22, 2003 on material standards for logistics for active-duty military personnel and Decree No. 65/2009/ND-CP dated July 31, 2009 amending and supplementing Decree No. 123/2003/ND-CP dated October 22, 2003; Decree No. 13/2013/ND-CP dated January 25, 2013 on material standards for logistics for campaign submarine forces and Decree No. 32/2013/ND-CP dated April 16, 2013 detailing and guiding the implementation of certain provisions of the Law on Cryptographic Affairs regarding policies for cryptographic staff and expenses guaranteed by the state defense budget for subjects managed by the Ministry of National Defense and the Government Cryptographic Service; the budgets of ministries, sectors, and localities guaranteeing such expenses for subjects managed by these ministries, sectors, and localities.

2. Military medical facilities have the responsibility to ensure the standard and hospital meal and infirmary meal allowance directly for patients and settle monthly with the financial authorities at the same level. Patients must pay the basic meal fee to the medical facility. The hospital meal and infirmary meal allowance must be ensured according to the standard and quantity, not provided in cash to patients.

3. In cases where inpatient treatment is conducted at medical facilities outside the military, the difference in hospital meal costs is guaranteed based on the actual number of days of treatment. Financial authorities and units managing the subjects specified in Article 2 of this Circular are responsible for paying the subjects and settling monthly with higher-level financial authorities. Settlement documentation includes a photocopied discharge certificate confirmed by the head of the direct management unit of the subject and a confirmation of the provision of hospital meals from the medical facility treating the subject.

Chapter IV

ORGANIZATION OF MEDICAL EXAMINATION AND TREATMENT, MANAGEMENT, USE, AND PAYMENT FOR MEDICAL EXPENSES UNDER HEALTH INSURANCE

Article 11. Registration for initial medical examination and treatment and referral for health insurance medical examination and treatment

Registration for initial health insurance medical examination and treatment and referral for health insurance medical examination and treatment in medical facilities for the subjects specified in Article 2 of this Circular shall be carried out in accordance with the provisions of Circular No. 46/2016/TT-BQP dated April 1, 2016 of the Minister of National Defense on technical lines for medical examination and treatment; registration and referral for medical examination and treatment for subjects under the management of the Ministry of National Defense and Circular No. 40/2015/TT-BYT dated November 16, 2015 of the Minister of Health on registration for initial health insurance medical examination and treatment and referral for health insurance medical examination and treatment.

Article 12. Method of payment

1. The method of payment for health insurance medical examination and treatment expenses for the subjects specified in Article 2 of this Circular at health insurance medical facilities shall be implemented in accordance with the provisions of Clause 1 and 2 of Article 18 of Decree No. 70/2015/ND-CP and Articles 10, 11, and 12 of the Joint Circular No. 41/2014/TTLT-BYT-BTC dated November 24, 2014 of the Ministry of Health and the Ministry of Finance guiding the implementation of health insurance (hereinafter referred to as Joint Circular No. 41/2014/TTLT-BYT-BTC).

2. Medical facilities providing health insurance medical examination and treatment implementing the payment method based on fixed rates as stipulated in Article 10 of Joint Circular No. 41/2014/TTLT-BYT-BTC shall exclude from the total medical examination and treatment costs used as the basis for determining the fixed rate fee of these health insurance medical facilities any costs outside the scope of payment by the health insurance fund (if any) for the group of subjects specified in Article 2 of this Circular.

3. Medical facilities providing health insurance medical examination and treatment applying Clause 6 of Article 11 of Joint Circular No. 41/2014/TTLT-BYT-BTC shall include the medical examination and treatment costs (excluding costs outside the scope of payment by the health insurance fund) for the group of subjects specified in Article 2 of this Circular in the total payment amount for health insurance medical examination and treatment for other insured individuals at those medical facilities.

Article 13. Direct payment of medical examination and treatment costs under health insurance

1. Direct payment of medical examination and treatment costs under health insurance shall be implemented in accordance with Article 19 of Decree No. 70/2015/NĐ-CP.

2. The level of direct payment as stipulated in Point b Clause 4 Article 19 of Decree No. 70/2015/NĐ-CP shall be implemented in accordance with Point b Clause 3 Article 16 of Circular Joint Circular No. 41/2014/TTLT-BYT-BTC.

3. Direct payment in emergency cases

a) The subjects specified in Article 2 of this Circular shall be fully reimbursed for all medical examination and treatment costs during the emergency phase. The portion covered by the health insurance fund shall be carried out according to Clauses 1 and 2 of this Article, while the difference between the actual cost and the prescribed payment level in Clause 2 of this Article shall be guaranteed by the state budget;

b) Payment of the difference between the actual cost and the prescribed payment level in Clause 2 of this Article shall be conducted as follows:

The payment dossier includes: Photocopies of the documents specified in Clause 2 of Article 19 of Decree No. 70/2015/NĐ-CP, certified by the relevant unit, the Direct Payment Medical Examination and Treatment Cost Reimbursement Form C78-HD issued pursuant to Circular No. 178/2012/TT-BTC dated October 27, 2012 of the Ministry of Finance guiding accounting for the Vietnam Social Security, provided by the social security agency responsible for direct payment, and a letter requesting payment from the directly managing unit;

The procedure for payment: Individuals shall prepare the dossier in accordance with Point b of this Clause, submit it to the directly managing unit for forwarding to the Military Hospital Administration Department of the Ministry of National Defense for the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular; forward to ministries, sectors, and localities using cryptographic systems for the subjects specified in Clause 3 of Article 2 of this Circular.

Within forty working days from the date of receipt of a complete and valid payment request dossier, the Military Hospital Administration Department of the Ministry of National Defense or ministries, sectors, and localities using cryptographic systems must complete the verification and payment of the difference to the patient. In case of non-resolution, a written response with detailed reasons must be provided.

Article 14. Appraisal of medical examination and treatment costs under health insurance at medical facilities providing health insurance services

1. Basis for appraising medical examination and treatment costs under health insurance at medical facilities providing health insurance services:

a) The list and prices of medical technical services performed at the medical facility, approved by the competent authority;

b) The list of medicines, chemicals, and medical supplies used at the medical facility, established by the medical facility in accordance with the regulations of the competent authority; the prices of medicines, chemicals, and medical supplies shall be implemented according to the decision approving the annual tender results of the competent authority.

2. In cases where medicines, medical supplies, and medical technical services outside the reimbursement list are used, the subjects specified in Article 2 of this Circular shall only be reimbursed by the health insurance fund when the medical facility complies with Clause 1 of Article 7 of this Circular.

3. Based on shared information data from the multi-line appraisal database of the Vietnam Social Security, the Social Security of the Ministry of National Defense shall cooperate with the Social Security of the province to conduct appraisals for cases with unusual costs or large expenses at medical facilities nationwide.

4. The social security agency shall implement health insurance appraisals in accordance with Article 29 of the amended and supplemented Health Insurance Law and the guidance documents of the Ministry of Health and the Vietnam Social Security.

Article 15. Aggregation and analysis of medical examination and treatment costs for the subjects specified in Article 2 of this Circular

1. The aggregation of medical examination and treatment costs for the subjects specified in Article 2 of this Circular shall be analyzed independently from other health insurance participants according to the following principles:

a) Based on the number of health insurance cards registered for initial medical examinations and treatments and the contribution level of this group to calculate a separate fund for medical examinations and treatments;

b) Analyze separately the costs within the scope of payment covered by the health insurance fund and the costs outside the scope of payment covered by the health insurance fund to balance the fund;

c) Quarterly, aggregate and settle the costs of medical examinations and treatments together with the settlement period of other subjects;

d) The total cost data within the scope of payment covered by the health insurance fund and outside the scope of payment covered by the health insurance fund shall be included in the separate medical examination and treatment fund for this group of subjects.

2. Model for aggregating medical examination and treatment costs

a) Use the model as prescribed for other health insurance participants but prepare detailed statements suitable for the benefits of the subjects specified in Article 2 of this Circular and prepare separate summary statements to account for the health insurance fund portion of the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular with the Social Insurance of the Ministry of National Defense and of the subjects specified in Clause 3 of Article 2 of this Circular with the Social Insurance of the province;

b) The Vietnam Social Security applies information technology to provide specific guidance on using models suitable for the actual costs of medical examinations and treatments of this group of subjects.

Article 16. Advance payment, settlement, and final settlement of medical examination and treatment costs under health insurance and final settlement of income and expenditure of the health insurance fund with the Vietnam Social Security

1. The Social Insurance of the Ministry of National Defense transfers funds for medical examinations and treatments to the Vietnam Social Security to settle the medical examination and treatment costs under health insurance for the subjects specified in Clauses 1, 2, and Clause 4 of Article 2 of this Circular when they seek medical examinations and treatments at healthcare facilities not contracted with the Social Insurance of the Ministry of National Defense for health insurance medical examinations and treatments, in accordance with Point c Clause 3 Article 18 Decree 70/2015/ND-CP, specifically as follows:

a) Based on the schedule stipulated in Article 3 of Decree 70/2015/ND-CP and the actual implementation of health insurance for the subjects specified in Clauses 1, 2, and Clause 4 of Article 2 of this Circular, in the first quarter of the implementation period of health insurance, the Social Insurance of the Ministry of National Defense transfers 35% of the remaining fund for medical examinations and treatments of the group based on the number of registration cards for initial medical examinations and treatments to the Vietnam Social Security after completing the content stipulated in Point a Clause 1 Article 21 Decree No. 70/2015/ND-CP;

b) In subsequent periods, upon receiving notification of multi-level medical examination and treatment costs from the previous quarter from the Vietnam Social Security, the Social Insurance of the Ministry of National Defense transfers the full amount of multi-level medical examination and treatment costs from the previous quarter and transfers the next quarter's funds equal to 80% of the multi-level medical examination and treatment costs from the previous quarter;

c) The Vietnam Social Security is responsible for providing advance payments and settling the costs of medical examinations and treatments for the subjects at healthcare facilities contracted with the Social Insurance of the province for medical examinations and treatments.

2. After completing the annual settlement figures, the Vietnam Social Security and the Social Insurance of the Ministry of National Defense will calculate the expenditures and the amounts already advanced to transfer the full health insurance medical examination and treatment funds for the year.

3. Annually, the Social Insurance of the Ministry of National Defense prepares a financial plan for health insurance revenue and expenditure (including costs within and outside the scope of health insurance) for the subjects specified in Clauses 1, 2, and Clause 4 of Article 2 of this Circular, to be approved by the Minister of National Defense and reported to the Vietnam Social Security.

Within fifteen days from the date of receipt of the Decision on the budget allocation issued by the Prime Minister, the Social Insurance of the Ministry of National Defense completes the budget allocation for health insurance revenue and expenditure for implementing units and sends a notification to the Vietnam Social Security.

4. The Vietnam Social Security and the Social Insurance of the province organize the implementation for the subjects specified in Clause 3 of Article 2 of this Circular.

Article 17. The use of the health examination and treatment fund in accordance with the provisions of Clause 2 and Clause 3 of Article 21 of Decree No. 70/2015/NĐ-CP.

1. In cases where the expenditure on health examinations and treatments from the health examination and treatment fund is less than the revenue:

After being reviewed and settled by the Vietnam Social Security, based on the remaining health insurance funds for health examinations and treatments that have not been used up in the year, the Vietnam Social Security under the Ministry of National Defense shall take the lead and coordinate with the Military Health Service General Department and the Finance General Department of the Ministry of National Defense to develop a plan for use, submit it for approval by the Minister of National Defense to implement expenditures for the following purposes:

a) Supporting health examinations and treatments for subjects as stipulated in Clauses 1, 2, and Clause 4 of Article 2 of this Circular;

b) Purchasing medical equipment suitable for the capacity and qualifications of healthcare staff and the category of health examination and treatment facilities of the Ministry of National Defense;

c) Purchasing patient transportation means for military health facilities and unit healthcare facilities.

2. In cases where the expenditure on health examinations and treatments from the health examination and treatment fund exceeds the revenue:

After being reviewed and settled by the Vietnam Social Security for the expenses within the prescribed limits, the Vietnam Social Security under the Ministry of National Defense shall compile and analyze the sources of excess expenses from the health examination and treatment fund as follows:

a) In cases where the expenses within the scope of health insurance coverage exceed the health examination and treatment fund, the Vietnam Social Security will cover the entire amount exceeding the fund for these expenses; the expenses outside the scope of health insurance coverage will be compiled and reported to the Ministry of Finance by the Vietnam Social Security;

a) In cases where the expenses within the scope of health insurance coverage do not exceed the fund but the total expenses exceed the health examination and treatment fund, the Vietnam Social Security will compile and report to the Ministry of Finance to request additional funding;

c) After receiving approval for additional funding for the excess expenses, the Vietnam Social Security under the Ministry of National Defense shall transfer the additional funds to the health examination and treatment facilities according to regulations.

3. The Vietnam Social Security and the provincial social security organizations shall organize the implementation of this Article for the subjects as stipulated in Clause 3 of Article 2 of this Circular.

Chapter V

HEALTH INSURANCE EXAMINATION AND TREATMENT CONTRACT BETWEEN MILITARY HEALTH FACILITIES AND SOCIAL INSURANCE ORGANIZATIONS

Article 18. Military health facilities participating in health insurance examination and treatment

1. Conditions for participation in health insurance examination and treatment:

a) Military health facilities must have a license to operate in accordance with the laws on health examination and treatment;

b) Healthcare practitioners must have a practice certificate in accordance with the laws on health examination and treatment;

c) When participating in health insurance examination and treatment for individuals who do not belong to the management units of their own organization, they must obtain written consent from the head of the directly subordinate unit of the Ministry of National Defense based on the regulations of the Ministry of National Defense.

2. The Military Health Service General Department under the Ministry of National Defense shall take the lead and coordinate with relevant agencies to organize the review and propose to the Ministry of National Defense to recognize military health facilities meeting the conditions for participation in health insurance examination and treatment, and notify the Vietnam Social Security under the Ministry of National Defense and the Provincial Health Departments of centrally governed cities.

Article 19. Health insurance examination and treatment contract

1. General principles:

a) A health insurance examination and treatment facility is a medical facility as defined by the Law on Health Examination and Treatment that has signed a health insurance examination and treatment contract with a social insurance organization;

b) Responsibilities of the social insurance agency in signing health insurance examination and treatment contracts: The Vietnam Social Security under the Ministry of National Defense is responsible for signing health insurance examination and treatment contracts with military health facilities; the provincial social security organizations are responsible for signing health insurance examination and treatment contracts with military health facilities and other medical facilities to implement the payment of health insurance examination and treatment costs for the subjects specified in Article 2 of this Circular and other insured persons;

c) Responsibilities of military health facilities in signing health insurance examination and treatment contracts: Military hospitals shall sign health insurance examination and treatment contracts directly with the social insurance agency by the hospital director; other military health facilities shall sign health insurance examination and treatment contracts with the social insurance agency by the head of the division-level unit or equivalent unit in charge of such military health facilities;

d) The health insurance examination and treatment contract shall be established according to the model prescribed by the Ministry of Health and the Ministry of Finance at Appendix No. 03 issued together with Joint Circular No. 41/2014/TTLT-BYT-BTC. Depending on the conditions of the military health facility, the Vietnam Social Security under the Ministry of National Defense, the provincial social security organizations, and the military health facility may agree to supplement the contents of the contract without contravening the laws on health insurance;

đ) The validity period of the contract runs from January 1 to December 31 of the fiscal year; for the first contract signed, the validity period is calculated from the date of signing until December 31 of the year. Special cases are regulated by the Director of the Vietnam Social Security under the Ministry of National Defense;

e) The expenses for health examinations and treatments for insured persons who seek health examinations and treatments before January 1 but are discharged after January 1 shall be handled as follows:

If the medical facility continues to sign a health examination and treatment contract, the expenses shall be included in the health examination and treatment costs of the following year.

If the medical facility does not continue to sign a health examination and treatment contract, the expenses shall be included in the health examination and treatment costs of the previous year.

2. Documents for signing a health insurance examination and treatment contract:

a) A letter requesting to sign a contract from the hospital or the managing unit of the military health facility sent to the Vietnam Social Security under the Ministry of National Defense or the provincial social security organization;

b) Operating permit of the military health facility;

c) Decision on the classification of health examination and treatment facilities by the competent authority;

d) For facilities signing annual contracts: Supplement functions, tasks, scope of expertise, hospital grade approved by the competent authority (if applicable).

3. Procedures for signing a health insurance examination and treatment contract:

a) For military health facilities signing a contract for the first time:

Military medical facilities shall submit one set of documents as prescribed in Clause 2 of this Article to the Social Insurance Department under the Ministry of National Defense or the social insurance agency according to the classification level. Within thirty days from the date of receipt of complete valid documents (as indicated on the receipt stamp), the social insurance agency must complete the review of the documents and sign the contract; in case of disagreement with signing the health examination and treatment insurance contract, they must provide a written response stating the reasons.

b) For military medical facilities that sign annual health examination and treatment insurance contracts: such facilities and the social insurance agency shall complete the signing of the next year's health insurance contract before December 31 of the previous year.

Chapter VI

RESPONSIBILITIES OF ORGANIZATIONS, UNITS, AND INDIVIDUALS IN IMPLEMENTING HEALTH INSURANCE

Article 20. Responsibilities of the Vietnam Social Security

1. Directing and guiding the Social Insurance Department under the Ministry of National Defense to implement health insurance policies for the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular in accordance with organizational staffing and defense and cryptographic activities characteristics.

2. Directing the provincial social insurance agencies to organize the implementation of health insurance for the subjects specified in Clause 3 of Article 2 of this Circular.

3. Directing the provincial social insurance agencies to sign health examination and treatment insurance contracts with healthcare facilities both within and outside the military on the territory to organize health examinations and treatments and ensure the rights of the subjects specified in Article 2 of this Circular; temporarily advance funds, conduct audits, guide the compilation of comprehensive cost reports, analyze costs from appropriate sources, settle, and finalize health examination and treatment insurance costs and direct payment audits (if applicable).

4. Directing the provincial social insurance agencies to take the lead and coordinate with the Health Departments to create favorable conditions for subjects holding health insurance cards issued by the Social Insurance Department under the Ministry of National Defense to register for initial health examinations and treatments at healthcare facilities within their management area.

5. Prioritize ensuring necessary conditions regarding equipment and support information technology training for the Social Insurance Department under the Ministry of National Defense and the provincial social insurance agencies to manage the subjects specified in Article 2 of this Circular participating in health insurance; manage income and expenditure of health insurance; audit, settle, and finalize health examination and treatment insurance costs and account separately the health insurance fund of the subjects specified in Article 2 of this Circular.

6. Issue, guide the use, and settle management costs of health insurance for the subjects specified in Article 2 of this Circular for the Social Insurance Department under the Ministry of National Defense in accordance with Article 22 of Decree No. 70/2015/NĐ-CP.

Temporarily advance funds and settle health examination and treatment insurance costs with the provincial social insurance agencies to implement health examination and treatment insurance for the subjects specified in Article 2 of this Circular.

Article 21. Responsibilities of Provincial Health Departments

1. Take the lead and coordinate with the provincial social insurance agencies to disseminate, direct, and guide healthcare facilities under their management to implement health examinations and treatments and transfer patients for further treatment for the subjects specified in Article 2 of this Circular.

2. Coordinate with the provincial social insurance agencies to guide the signing of health examination and treatment insurance contracts with healthcare facilities meeting the conditions for health examination and treatment insurance on the territory.

Article 22. Responsibilities of the Military Health Service Department under the Ministry of National Defence

1. Take the lead and coordinate to research, advise and propose health insurance policies, programs, plans, and methods of organization and implementation for the subjects specified in Article 2 of this Circular, in accordance with the development of health insurance laws and the requirements for building the military in new circumstances.

2. Coordinate to propose measures to strengthen and improve military medical facilities to meet the conditions for examination and treatment for the subjects specified in Article 2 of this Circular and other health insurance participants.

3. Propose the classification and specialization levels for military medical facilities within the Ministry of National Defence for approval by the Minister of National Defence.

4. Approve the list of technical services provided at military medical facilities under the Ministry of National Defence within its authority. Lead and coordinate with relevant agencies to propose the Ministry of National Defence issue permits for operation of examination and treatment facilities, and certificates of practice for examination and treatment practitioners managed by the Ministry of National Defence, in accordance with the law.

5. Lead and coordinate with relevant agencies to organize evaluations and propose the Ministry of National Defence recognize military medical facilities meeting the conditions to participate in examination and treatment under health insurance, notify the Social Insurance Department under the Ministry of National Defence and Provincial Departments of Health under central cities; direct and guide military medical facilities to sign and implement contracts for examination and treatment under health insurance.

6. Lead and coordinate with the Social Insurance Department under the Ministry of National Defence and relevant agencies to guide the division of treatment lines for the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular who register for initial examination and treatment at military medical facilities, healthcare sector, and healthcare departments of ministries and agencies providing examination and treatment under health insurance, in accordance with the characteristics of the military and the capacity of examination and treatment facilities.

7. Lead and coordinate with relevant agencies to inspect and supervise the implementation of health insurance policies and regulations at agencies, units, and examination and treatment facilities under the Ministry of National Defence.

8. Coordinate to promote health insurance policies and regulations within the Ministry of National Defence.

Article 23. Responsibilities of the Finance Department under the Ministry of National Defence

1. Coordinate with the Military Health Service Department under the Ministry of National Defence to research, advise and propose health insurance policies, programs, plans, and methods of organization and implementation for the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular.

2. Guide units to develop budget plans for health insurance contributions for the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular, to be submitted to the Finance Department for approval by the Minister of National Defence.

3. Transfer full and timely funds for health insurance contributions for the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular from state budget sources to subordinate units under the Ministry of National Defence; carry out settlement procedures with the Ministry of Finance according to current regulations.

4. Allocate national defence budgets to ensure funding for items not covered by the health insurance fund designated for examination and treatment under this Circular, and guide subordinate units under the Ministry of National Defence to consolidate, settle, and finalize accounts.

5. Coordinate with the Social Insurance Department under the Ministry of National Defence to guide military medical facilities providing examination and treatment under health insurance, and agencies and units managing the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular on valid procedures and documents for payment and settlement of examination and treatment costs under health insurance from the health insurance fund and state budget as stipulated in this Circular; exchange information between the two agencies after concluding the settlement of income and expenditure of health insurance for the specified subjects to manage and use the state budget and health insurance fund strictly in accordance with the law.

6. Inspect and supervise the management and use of state budget funds for health insurance contributions for the subjects specified in Clauses 1, 2, and 4 of Article 2 of this Circular and health insurance examination and treatment funds at agencies, units, and examination and treatment facilities under the Ministry of National Defence.

7. Coordinate to promote health insurance policies and regulations within the Ministry of National Defence.

Article 24. Responsibilities of the Social Insurance under the Ministry of National Defense

1. Take the lead in guiding, implementing, and managing the organization to carry out the health insurance system and policies within the Ministry of National Defense; summarize and evaluate the management and implementation of health insurance work within the Ministry of National Defense.

2. Take the lead in managing and settling the collection of health insurance funds for the subjects specified in Clauses 1, 2, and Clause 4 of Article 2 of this Circular from units under the Ministry of National Defense.

3. Take the lead in managing and using the health insurance funds allocated for medical examination and treatment as stipulated in Article 21 of Decree No. 70/2015/ND-CP; develop plans for using the portion of funds specified in Clause 2 of Article 21 of Decree No. 70/2015/ND-CP; allocate and guide the use of health insurance management funds as stipulated in Article 22 of Decree No. 70/2015/ND-CP; directly settle the costs of medical examination and treatment for the subjects specified in Clauses 1, 2, and Clause 4 of Article 2 of this Circular according to the provisions of Article 19 of Decree No. 70/2015/ND-CP.

4. Coordinate with the Military Medical Service under the Ministry of National Defense and the Financial Service under the Ministry of National Defense to study, advise, and propose systems, policies, programs, plans, and methods for organizing the implementation of health insurance for the subjects specified in Clauses 1, 2, and Clause 4 of Article 2 of this Circular.

5. Sign contracts for medical examination and treatment under health insurance with military medical facilities to organize medical examination and treatment for the subjects specified in Clauses 1, 2, and Clause 4 of Article 2 of this Circular and other subjects participating in health insurance issued cards by the Social Insurance under the Ministry of National Defense; temporarily advance funds, inspect, settle, and finalize the costs of medical examination and treatment under health insurance for military medical facilities providing such services according to Point a, Clause 3, Article 18 of Decree No. 70/2015/ND-CP; temporarily advance funds for medical examination and treatment under health insurance with the Vietnam Social Security according to Point c, Clause 3, Article 18 of Decree No. 70/2015/ND-CP. Settle and finalize the costs of medical examination and treatment for the subjects specified in Clauses 1, 2, and Clause 4 of Article 2 of this Circular who seek medical examination and treatment at medical facilities with the Vietnam Social Security.

6. Take the lead and coordinate with the Military Medical Service under the Ministry of National Defense to guide the registration of initial medical examination and treatment for the subjects specified in Clauses 1, 2, and Clause 4 of Article 2 of this Circular at military medical facilities and external medical facilities outside the Ministry of National Defense that provide medical examination and treatment under health insurance, in accordance with the characteristics of the Military, the conditions of the unit, and the capacity of the medical facilities.

7. Periodically or unexpectedly implement inspections on the use of medical examination and treatment funds at military medical facility units and agency healthcare facilities.

8. Take the lead and coordinate with relevant agencies to audit the collection of health insurance from the subjects specified in Clauses 1, 2, and Clause 4 of Article 2 of this Circular according to the laws.

9. Provide information about medical facilities providing medical examination and treatment under health insurance and guide health insurance participants to choose appropriate initial medical examination and treatment facilities.

10. Coordinate in auditing and inspecting the implementation of health insurance by agencies, units, and medical examination and treatment facilities; resolve difficulties in the organization of implementation.

11. Take the lead and coordinate in disseminating, popularizing, and guiding the implementation of health insurance policies and laws within the Ministry of National Defense.

12. Annually take the lead and coordinate in organizing training in health insurance business for personnel working in health insurance in agencies and units under the Ministry of National Defense.

Article 25. Responsibilities of medical facilities providing health insurance services

1. Organize convenient medical examinations and treatments for subjects as stipulated in Article 2 of this Circular.

2. Ensure full health insurance benefits for subjects as stipulated in Article 2 of this Circular; transfer patients to higher-level hospitals in accordance with regulations.

3. Purchase medicines, chemicals, and medical supplies strictly in compliance with legal provisions.

4. Provide medical records and related documents on medical examinations and treatments, and health insurance payment costs of subjects as stipulated in Article 2 of this Circular upon request from social insurance agencies and competent state authorities.

5. Aggregate and analyze costs, payments, and settlements of medical examination and treatment expenses of subjects as stipulated in Article 2 of this Circular in accordance with general regulations and this Circular; manage, clearly separate, and strictly control the health insurance fund for subjects as stipulated in Article 2 of this Circular from other health insurance funds and state budget in compliance with regulations.

Article 26. Responsibilities of units under the Ministry of National Defense, Ministries, sectors, and localities managing subjects as stipulated in Article 2 of this Circular

1. Promote and disseminate policies and laws on health insurance for managed subjects.

2. Annually, units at battalion level and above guide subjects as stipulated in Article 2 of this Circular to fill out information declaration forms accurately according to the provided guidelines, bear legal responsibility for the list of social insurance and health insurance card applications submitted by the unit, and retain the declaration forms of subjects within the unit.

3. Implement regulations on health insurance systems and policies for subjects as stipulated in Article 2 of this Circular; manage subjects and collect health insurance premiums; issue health insurance cards; manage allocated health insurance funds strictly for their intended purposes; timely prepare budgets, make payments, and report settlements in compliance with regulations.

4. Closely and regularly coordinate with the Military Health Department of the Ministry of National Defense, Social Insurance of the Ministry of National Defense, Provincial Health Departments, and Social Insurance of centrally governed cities to ensure optimal healthcare for subjects as stipulated in Article 2 of this Circular.

5. Propose to the Minister of National Defense and competent state authorities to handle violations of health insurance laws that affect the rights and legitimate interests of subjects as stipulated in Article 2 of this Circular.

6. Heads of units directly under the Ministry of National Defense are responsible for implementing Clause 1, Point c of Article 18 of this Circular to ensure security and safety without affecting unit tasks.

Article 27. Responsibilities of subjects as stipulated in Article 2 of this Circular

1. Be familiar with health insurance policy regulations for subjects as stipulated in Article 2 of this Circular.

2. Fully comply with regulations on information declaration and bear legal responsibility for the accuracy of information for health insurance card issuance; strictly follow regulations on health insurance card management at the unit and during medical examinations and treatments.

3. Safeguard the health insurance card, refrain from erasing, altering, lending it to others, and use it for its intended purpose.

4. Adhere to regulations and guidance from social insurance agencies and medical facilities when seeking medical examinations and treatments; follow prescribed procedures and formalities.

5. Report promptly to competent authorities on the implementation of health insurance systems and policies by health insurance medical facilities and social insurance agencies.

Chapter VII

IMPLEMENTING PROVISIONS

Article 28. Transitional Provisions

1. For units under the Ministry of National Defense transitioning to health insurance-based medical examination and treatment according to the schedule specified in Article 3 of Decree No. 70/2015/NĐ-CP, organize inventory of unused medicines, chemicals, and medical supplies, report upwards to the Military Health Department and Social Insurance of the Ministry of National Defense for resolution.

2. In cases where subjects as stipulated in Article 2 of this Circular are admitted for inpatient treatment before January 1, 2016 but discharged after January 1, 2016, they will only be reimbursed according to health insurance benefits and levels specified in this Circular from January 1, 2016 until discharge.

3. For health insurance medical examination and treatment contracts signed prior to the effective date of this Circular, social insurance agencies and medical facilities shall negotiate amendments and supplements to align with this Circular's provisions.

Article 29. References

References in this Circular, when amended, supplemented, or replaced by another document, the referenced contents will also be adjusted accordingly based on the amending, supplementing, or replacing documents.

Article 30. Effective Date

1. This Circular takes effect from August 6, 2016. The systems and policies stipulated in this Circular will be implemented from January 1, 2016.

2. The following documents cease to be effective from the date this Circular takes effect and correspondingly with the timeline for participating in health insurance as stipulated in Article 3 of Decree No. 70/2015/NĐ-CP:

a) Decision No. 105/2008/QĐ-BQP dated July 11, 2008 of the Minister of National Defense on the reimbursement of medical examination and treatment costs for military personnel and civil servants of the defense industry when receiving medical care at civilian medical facilities;

b) Articles 6 and 7 of Joint Circular No. 08/2014/TTLT-BQP-BTC-BYT dated February 14, 2014 of the Ministry of National Defense, Ministry of Finance, and Ministry of Health guiding the implementation of certain material standards and medical care systems for cryptographers; Article 9 of Circular No. 116/2015/TT-BQP dated October 1, 2015 of the Minister of National Defense on material standards for cryptographer trainees.

During implementation, if there are any difficulties, relevant agencies, units, and health insurance medical facilities should promptly reflect them to the Ministry of National Defense, Ministry of Health, and Ministry of Finance for research and resolution./.