Circular No. 99/2024/TT-BCA on registration for initial health insurance medical examination and treatment and transfer of patients among medical facilities under the Ministry of Public Security

CIRCULAR

Regulations on registration for initial health check-ups and medical treatment under health insurance and transfer of patients among healthcare facilities under the Ministry of Public Security

transfer patients among medical examination and treatment facilities under the Ministry of Public Security

Pursuant to the Law on Health Examination and Treatment No. 15/2023/QH15 dated January 9, 2023;

Pursuant to the Health Insurance Law No. 25/2008/QH12 dated November 14, 2008; the Law Amending and Supplementing Certain Provisions of the Health Insurance Law No. 46/2014/QH13 dated June 13, 2014 and the Law Amending and Supplementing Certain Provisions of the Health Insurance Law No. 51/2024/QH15 dated November 27, 2024;

Pursuant to the Law on People's Public Security No. 37/2018/QH14 dated November 20, 2018; the Law Amending and Supplementing Certain Provisions of the Law on People's Public Security No. 21/2023/QH15 dated June 22, 2023;

Pursuant to Decree No. 96/2023/NĐ-CP dated December 30, 2023 of the Government detailing certain provisions of the Law on Medical Examination and Treatment;

Pursuant to Decree No. 16/2024/NĐ-CP dated February 16, 2024 of the Government on persons practicing health examination and treatment and healthcare facilities under the people's armed forces;

Pursuant to Decree No. 01/2018/NĐ-CP dated August 6, 2018 of the Government stipulating the functions, tasks, powers, and organizational structure of the Ministry of Public Security;

Upon the proposal of the Director of the Health Bureau;

The Minister of Public Security promulgates this Circular regulating registration for initial health check-ups and medical treatment under health insurance and patient transfer among healthcare facilities under the Ministry of Public Security.

Article 1. Scope of Regulation

This Circular regulates the registration for initial health check-ups and medical treatment under health insurance at primary, basic, and specialized healthcare facilities and participants in health insurance under the management authority; and the transfer of patients among healthcare facilities under health insurance within the management authority of the Ministry of Public Security.

Article 2. Applicability

Article 1. Healthcare facilities under the Ministry of Public Security as stipulated in Clause 2, Article 4 of Decree No. 16/2024/NĐ-CP dated February 16, 2024 of the Government on persons practicing health examination and treatment and healthcare facilities under the people's armed forces shall participate in health examination and treatment under health insurance.

Article 2. Officers, non-commissioned officers in business affairs; officers, non-commissioned officers in technical professions currently working in the People's Public Security force (excluding officers, non-commissioned officers sent abroad for work, study, and provided with medical expenses); non-commissioned officers, conscripts in the People's Public Security force; students receiving living allowances studying at schools both inside and outside the People's Public Security force in Vietnam; students receiving living allowances who are foreign nationals.

Article 3. Workers employed under labor contracts in the People's Public Security force; public security workers; citizens temporarily recruited before being officially selected into the People's Public Security force; personnel working in the People's Public Security force upon retirement; relatives of the subjects specified in Clause 2 of Article 2 of this Circular, including relatives of officers, non-commissioned officers sent abroad for work, study, and provided with medical expenses (excluding relatives of foreign students studying at public security schools funded from the state budget); relatives of public security workers; students at Cultural Schools managed by the Ministry of Public Security; civilian students studying at public security schools.

Article 4. Registration for Initial Health Check-ups and Medical Treatment Under Health Insurance

Clause 1. Subjects specified in Clause 2 of Article 2 of this Circular and retired officers, non-commissioned officers of the People's Public Security force may register for initial health check-ups and medical treatment under health insurance at primary, basic, and specialized healthcare facilities under the management authority of the Ministry of Public Security, consistent with the provincial administrative area where they work, study, or reside.

Clause 2. Workers employed under labor contracts in the People's Public Security force, public security workers, students at Cultural Schools managed by the Ministry of Public Security; civilian students; relatives of public security personnel, relatives of public security workers; personnel working in the People's Public Security force upon retirement (excluding the subjects specified in Clause 1 of this Article) may register for initial health check-ups and medical treatment under health insurance at primary and basic healthcare facilities under the management authority of the Ministry of Public Security, consistent with their place of work, study, or residence.

Clause 3. Students and trainees specified in Clauses 2 and 3 of Article 2 of this Circular in the health sector who have been studying and training for at least 90 days; workers currently working at healthcare facilities under health insurance may register for initial health check-ups and medical treatment under health insurance at the healthcare facility where they are working, studying, or training.

Clause 4. Subjects specified in Clause 2 of Article 2 of this Circular who register for initial health check-ups and medical treatment under health insurance at healthcare facilities under the Ministry of Public Security may receive health check-ups and medical treatment under health insurance at all healthcare facilities under the Ministry of Public Security within the provincial administrative area where they are working, studying, or on leave but must present their health insurance card or integrated health insurance information on the National Identity Application VNeID and relevant proof issued by the competent authority before the end of the health check-up and treatment period to be considered appropriate to their professional technical level.

Clause 5. The change of registration for initial health check-ups and medical treatment under health insurance shall be carried out as follows:

Participants in health insurance may change their registration for initial health check-ups and medical treatment within the first 15 days of each quarter to suit their place of residence, work, or study; in cases where participants in health insurance are transferred to a new work region, they may immediately change their registration for initial health check-ups and medical treatment.

Article 4. Transfer of patients between healthcare facilities providing health insurance medical services

1. The transfer of patients between healthcare facilities providing health insurance medical services shall be carried out in accordance with the provisions of the law on medical examination and treatment.

2. The cases of transferring patients between healthcare facilities providing health insurance medical services according to the prescribed procedure include:

a) Transferring patients between healthcare facilities providing health insurance medical services within the same level of medical examination and treatment, from primary healthcare facilities to basic healthcare facilities, from basic healthcare facilities to specialized healthcare facilities based on professional requirements, patient's condition, or exceeding the capacity of the healthcare facility outside the cases specified in point d of this clause and the regulations of the Ministry of Health for cases of confirming diagnosis, treating certain rare diseases, serious illnesses, requiring surgery or using advanced techniques as stipulated in point a of Clause 4, Article 22 of the Health Insurance Law;

b) Transferring patients from primary healthcare facilities to specialized healthcare facilities when the capacity of basic healthcare facilities is exceeded;

c) Transferring patients who have been stably treated from specialized healthcare facilities back to basic healthcare facilities or primary healthcare facilities, transferring patients from basic healthcare facilities back to primary healthcare facilities for continued treatment and monitoring;

d) Transferring patients from specialized healthcare facilities or basic healthcare facilities back to initial healthcare facilities providing health insurance for chronic disease treatment, management, and monitoring as prescribed by the Ministry of Health;

đ) For patients with chronic diseases or long-term treatment as specified in the list of diseases by the Ministry of Health, the referral form for healthcare facilities remains valid for 01 year from the date indicated on the referral form and shall be implemented in accordance with the regulations of the Ministry of Health;

e) In cases where individuals with health insurance cards self-examine and treat without following Articles 26 and 27 of the Health Insurance Law and fall under the cases specified in points e, g, h (excluding cases entitled to 100% coverage at points e and h) of Clause 4, Article 22 of the Health Insurance Law, they may then be referred to another healthcare facility for further treatment based on professional requirements;

g) In emergency cases, after the initial emergency treatment phase, patients may be transferred for inpatient treatment at the healthcare facility that initially received them for emergency care or referred to another healthcare facility for continued treatment based on professional requirements, or transferred back to their initial registered healthcare facility after stable treatment;

3. In cases of transferring healthcare facilities based on mission requirements for the subjects specified in Clause 2 of this Circular, there must be a request for transfer document stamped by the direct managing unit of such personnel;

4. Patients diagnosed with certain rare diseases, serious illnesses, or requiring surgery or advanced techniques shall be treated at specialized or basic healthcare facilities in accordance with the regulations of the Ministry of Health;

5. Rescheduling for follow-up examinations

Patients receiving health insurance medical services shall be rescheduled for follow-up examinations by healthcare facilities when it is necessary to continue monitoring the condition of the disease or rechecking the results of the previous examination and treatment period based on professional requirements, in accordance with the regulations of the Ministry of Health;

6. The procedures for transferring healthcare facilities shall be carried out in accordance with the regulations of the Ministry of Health.

Article 5. Responsibilities of the Public Security Units and Localities

1. Health Department

a) Coordinate with relevant units to publish the list of primary, basic, and specialized health care facilities for health insurance on their websites and information systems related to medical examination and treatment activities under the Ministry of Public Security, along with the number of points.

b) Guide the transfer of patients among health care facilities for health insurance under the management authority of the Ministry of Public Security.

2. The Cadre and Civil Servant Organization Department

a) Coordinate with relevant units to direct, guide, organize the implementation, and inspect the compliance with the provisions of this Circular.

b) Provide information on the number of health insurance cards registered for medical examination and treatment to the Health Service Bureau and health care facilities for health insurance under the management authority of the Ministry of Public Security before October 31 each year.

c) Share health insurance card information of the subjects specified in Clause 2, Article 2 of this Circular with health care facilities for health insurance when conditions are met.

3. Health Care Facilities for Health Insurance within the People's Public Security Force

a) Fully and promptly implement all provisions of this Circular.

b) Ensure sufficient conditions for health insurance medical examination and treatment according to health insurance medical examination and treatment contracts, the provisions of this Circular, and laws on medical examination and treatment and health insurance.

c) Publicize the results of technical specialty ranking scores on the facility's website and at patient reception areas.

d) Advise and guide health insurance participants about diseases that can be treated at basic and specialized health care facilities without the need to follow procedures for transferring to facilities listed in the directory when patients self-refer for medical examination and treatment to ensure their rights.

đ) Train, instruct, and ensure healthcare practitioners and staff understand how to record disease codes and names in accordance with regulations.

Article 6. Effectiveness

1. This Circular takes effect from January 1, 2025.

2. In case the referenced legal documents in this Circular are amended, supplemented, or replaced, the referenced content shall be implemented according to the newly issued documents.

Article 7. Responsibility for Implementation

1. The Health Service Bureau is responsible for guiding, urging, and inspecting the implementation of this Circular.

2. Heads of units under the Ministry, Provincial Public Security Directors, and related organizations and individuals are responsible for implementing this Circular.

3. During the implementation of this Circular, if there are difficulties or obstacles, Public Security units and localities should report to the Ministry (through the Health Service Bureau) for timely guidance./.