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GOVERNMENT OF VIETNAM
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THE SOCIALIST REPUBLIC OF VIETNAM
Independence - Freedom - Happiness
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No. 02/2025/ND-CP
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Hanoi, January 01, 2025
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DECREE
ON AMENDMENT TO SOME ARTICLES OF DECREE NO. 146/2018/ND-CP DATED
OCTOBER 17, 2018 OF THE GOVERMENT ELABORATING AND PROVING GUIDELINES ON
MEASURES TO IMPLEMENT LAW ON HEALTH INSURANCE, WHICH IS AMENDED BY DECREE NO.
75/2023/ND-CP DATED OCTOBER 19, 2023 OF THE GOVERNMENT
Pursuant to the Law on
Government Organization dated June 19, 2015; the Law on amendment to some
articles of the Law on Government Organization and the Law on Local Government
Organization dated November 22, 2019;
Pursuant to the Law on
Health dated November 14, 2008; the Law on amendment to some articles of the
Law on Health dated June 13, 2014 and the Law on amendment to some articles of
the Law on Health dated November 27, 2024;
At the request of the
Minister of Health;
The Government
promulgates the Decree on amendment to some articles of Decree No.
146/2018/ND-CP dated October 17, 2018 of the Government elaborating and proving
guidelines on measures to implement Law on Health Insurance, which is amended
by Decree No. 75/2023/ND-CP dated October 19, 2023 of the Government.
Article
1. Amendment to some articles of Decree No. 146/2018/ND-CP dated October 17,
2018 of the Government elaborating and proving guidelines on measures to
implement Law on Health Insurance, which is amended by Decree No. 75/2023/ND-CP
dated October 19, 2023 of the Government
1. Amendment to Article
14 of Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government
elaborating and proving guidelines on measures to implement Law on Health
Insurance, which is amended by clause 5 Article 1 of Decree No. 75/2023/ND-CP
dated October 19, 2023 of the Government:
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1. Participants specified
in clauses 3, 4, 5, 8, 9, 11, 17 and 20 of Article 3 of this Decree are
entitled to 100% of medical costs as specified in point a clause 1 of Article
22 of the Law on Health Insurance.
2. Participants entitled
to 100% of medical costs as specified in point a clause 1 Article 22 of the Law
on Health Insurance and not entitled to co-payment rates as specified in point
c clause 2 of Article 21 of the Law on Health Insurance include:
a) Persons participating
in Revolutionary activities before January 01, 1945;
b) Persons participating in
Revolutionary activities before January 01, 1945 to the August Revolution in
1945;
c) Vietnamese heroic
mothers;
d) War invalids,
beneficiaries of the same compensation policies as war invalids, class-B war
invalids and sick soldiers whose labor capacity is reduced by at least 81%;
dd) War invalids,
beneficiaries of compensation policies as war invalids, class-B war invalids
and sick soldiers whose injuries are cured or whose diseases relapse;
e) Partisans suffering
diseases due to exposure to toxic chemicals whose labor capacity is reduced by
at least 81%;
g) Children under 6 years
of age.
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4. 95% of medical costs
paid by the participants prescribed in clause 1 of Article 2, clauses 12, 18
and 19 of Article 3, and clause 1, 2 and 5 of Article 4 of this Decree.
5. The schedule for
implementation and application of rates of entitlement to health insurance
coverage when receiving outpatient care at secondary health facilities as
prescribed in points e and h, clause 4 of Article 22 of the Law on Health
Insurance:
a) From January 01, 2025,
when health insurance participants receiving outpatient care at secondary
health facilities, which are rated under 50 points or temporarily classified as
secondary level, they shall have 100% of the medical costs covered by the
health insurance fund;
b) From July 01, 2026,
when health insurance participants receiving outpatient care at secondary health
facilities, which are rated between 50 points and 69 points, they shall have
50% of the medical costs covered by the health insurance fund;
a) From July 01, 2026,
when health insurance participants receiving outpatient care at secondary
health facilities, which are classified as province-level, or central-level, or
equivalent to province-level, or equivalent to central-level health facilities
by competent authorities before January 01, 2025, they shall have 50% of the
medical costs covered by the health insurance fund;
d) From July 01, 2026,
when health insurance participants receiving outpatient care at tertiary health
facilities, which are classified as province-level, or equivalent to
province-level health facilities by competent authorities before January 01,
2025 in accordance with point h clause 4 of Article 22 of the Law on Health
Insurance, they shall have 50% of the medical costs covered by the health
insurance fund.
6. Participants specified
in point a clause 5 of this Article shall be considered to determine the
co-payment in a year in accordance with point d clause 1 of Article 22 of the
Law on Health Insurance.
7. Regarding health
insurance participants using medical service on demand:
a) Health insurance card
holders using medical service on demand are reimbursed by the health insurance
fund for the covered medical costs in accordance with Article 22 of the Law on
Health Insurance. The differences between on-demand medical costs and the
covered medical costs shall be paid by the patients;
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8. If the health
insurance participants are classified to another group of persons eligible for
health prescribed in Article 12 of the Law on Health Insurance by decisions of
competent authorities, which leads to changes in health insurance reimbursement
rate and changes of health insurance cards or information in health insurance
cards, the new health insurance reimbursement rate shall be applied from the
effective date of the new health insurance cards or information in health
insurance cards.".
2. Amendment to Article
15 of Decree No. 146/2018/ND-CP dated October 17, 2018, which is amended by
clause 6 Article 1 of Decree No. 75/2023/ND-CP dated October 19, 2023:
"Article
15. Procedures for health insurance-covered medical care prescribed in clause 1
Article 28 in Law on Health Insurance
1. When receiving medical
care, health insurance participants shall present information about the health
insurance card in one of following cases:
a) Health insurance card
or ID of health insurance card; if the card does not include a portrait, the
card holder shall present one personal document with a portrait, including ID
card, citizen ID card, identity certificate, passport, level-2 eID account on
VNeID application, or other identifications issued by competent authorities, or
certificates issued by commune-level police authorities, or others issued by
educational institutions in charge of management of students;
a) ID card or citizen ID
card or level-2 eID account on VNeID application with integrated information of
the health insurance card.
2. If the patient is under
6 years of age, it is required to present health insurance card or ID of health
insurance card; If the child does not have a health insurance card, it is
required to present the original or a copy or a vital record of the birth
certificate, the original or a copy of certificate, or ID card; If the child is
a newborn, their parent or relatives are required to sign in the medical
record, or a representative of the medical facility are required to sign such
document in case the child does not have any parent and relative.
3. When receiving medical
care, health insurance participant, who is waiting for re-issuance, replacement
of health insurance or information of health insurance card, shall present the
note of receipt of document and appointment for return of results of issuance,
re-issuance, or replacement of health insurance card, information of health
insurance card issued by social security authority, or by organizations,
individuals authorized by social security authority in accordance with Form No.
4 of the Appendix attached to this Decree and one identification in accordance
with point a, clause 1 of this Article.
4. Persons who have
donated body parts shall present information of health insurance card in
accordance with clauses 1 and 3 of this Article. If he/she does not have the
health insurance card, he/she shall present the discharge paper issued by the
medical facility where he/she has their body parts donated, and one of the
following identifications: ID card, citizen ID card, identity certificate,
passport, level-2 eID account on VNeID application, or other identifications
issued by competent authorities. If he/she has to undergo treatment immediately
after the donation, a representative of the medical facility where he/she has
their body parts donated shall sign in the medical record.
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6. Medical facilities,
social security authorities are not permitted to promulgate any regulation on
procedures for health insurance-covered medical care other than regulations in
this Article. The medical facilities are not permitted to make a copy of the
health insurance card, or other documents related to the medical care of the
patients for management purpose unless approved by the patient or the guardians
of the patient. It is not permitted to make the patients to make a copy by
themselves or charge the patients for this process.".
3. Amendment to point c,
clause 1, Article 16 of Decree No. 146/2018/ND-CP:
"c) The photocopy of
the decision on ranking or temporary ranking of professional classification of
the medical facility issued by competent authorities; with respect to cases
prescribed in points dd and h clause 4 Article 22 in Law on Health Insurance,
and point c clause 5 Article 14 of this Decree, it is required to include the
photocopy of the document on determination of healthcare levels issued on
January 01, 2025 by competent authorities. All prescribed documents must be
sealed by the medical facility".
4. Additional of point g
after point e clause 2 Article 21 of Decree No. 146/2018/ND-CP, which is
amended by point d clause 7 Article 1 of Decree No. 75/2023/ND-CP:
"g) Competent authorities
in ranking healthcare levels as prescribed in clause 3 Article 90 of Decree No.
96/2023/ND-CP dated December 30, 2023 of the Government on elaboration of Law
on Medical Examination and Treatment are responsible for disclosing the list of
medical facilities classified by level along with their corresponding scores on
the website of the authorities and on the system of management of medical care.
The medical facilities
shall disclose the results of the healthcare level ranking with the corresponding
scores on their websites and at the reception.".
5. Amendment to clause 1
Article 26 of Decree No. 146/2018/ND-CP:
"1. Health insurance
participants prescribed in clauses 3, 4, 7, 8, 9 and 11 of Article 3 of this
Decree who are undergoing inpatient treatment or have to be referred to another
health facility as prescribed in Article 27 of the Law on Health
Insurance.".
6. Additional of clauses
11, 12 and 13 after clause 10 Article 27 of Decree No. 146/2018/ND-CP:
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a) Private tertiary
health facilities are not permitted to collect the costs higher than the
highest health insurance-covered medical care cost of public tertiary health
facilities located within the province, or of secondary health facilities if
the province does not have public tertiary health facilities;
b) Private secondary
health facilities are not permitted to collect the costs higher than the
highest health insurance-covered medical care cost of public secondary health
facilities located within the province;
c) Private primary health
facilities are not permitted to collect the costs higher than the lowest health
insurance-covered medical care cost of public secondary health facilities
located within the province;
d) If private medical
facilities practice medical services, which are approved by competent
authorities, but the costs of such services have not been promulgated or
approved for public medical facilities within the province, they are permitted
to collect the costs lower than the highest health insurance-covered medical
care cost of public medical facilities at the same level located in contiguous
provinces, or of other provinces in the country if public medical facilities in
contiguous provinces do not have the costs for such services in accordance with
principles in points a, b, and c of this clause.
12. If public medical
facilities practice medical services, which are approved by competent
authorities, but the costs of such services have not been promulgated or
approved for medical facilities within the province, they are permitted to
collect the costs lower than the highest health insurance-covered medical care
cost of public medical facilities at the same level located within the province
or in contiguous provinces, or of other provinces in the country if public
medical facilities in contiguous provinces do not have the costs for such
services in accordance with principles in points a, b, c, and d, clause 11 of
this Article.
13. If public medical
facilities practice medical services, which are approved by competent
authorities (except services included in the daily hospitalization cost,
services that are part of another service cost), but the costs of such services
have not been promulgated or approved for nationwide public medical facilities
or the indicated services have been suspended due to the patient's health
condition, they are allowed to collect the medical care costs as follows:
a) Collect based on the
actual quantity of medicines, medical equipment covered by the health insurance
fund that are used for the patients and based on the purchase prices in
accordance with the law;
b) Collect based on the
salaries, wages, allowances, donations, and surgery allowances, medical
procedures allowances (if any) in accordance with the rates issued by the
Ministry of Health".
7. Replacement of certain
phrases:
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b) The phrase "shift
the level of medical practices" is replaced with the phrase "patient
referral among covered facilities" in points a and b, clause 2, Article 26
of Decree No. 146/2018/ND-CP;
c) The phrase "shift
the level of medical practices to the higher-level one" is replaced with
the phrase "patient referral among covered facilities according to the
professional requirements" in point b clause 2 Article 26 of Decree No.
146/2018/ND-CP;
d) The phrase
"giving directions to lower-level healthcare establishments" is
replaced with the phrase "giving professional instructions" in clause
7 Article 27 of Decree No. 146/2018/ND-CP;
dd) The phrase "of
the same class, level" is replaced with the phrase "at the same
healthcare level" in point b, clause 1, Article 21 of Decree No.
146/2018/ND-CP, which is amended by point a clause 7 Article 1 of Decree No.
75/2023/ND-CP; in point d clause 5 Article 42 of Decree No. 146/2018/ND-CP,
which is amended by point c clause 10 Article 1 of Decree No. 75/2023/ND-CP;
e) The phrase
"district- or equivalent-level" is replaced with the phrase "at
secondary health facilities, which are classified as district-level health
facilities by competent authorities before January 01, 2025, or rated under 50
points, or temporarily classified as secondary"; "province- or
equivalent-level" is replaced with the phrase "at secondary health
facilities, which are classified as province-level health facilities by
competent authorities before January 01, 2025, or rated from 50 points to under
70 points"; "central- or equivalent-level" is replaced with the
phrase "tertiary health facilities" in Article 30 of Decree No.
146/2018/ND-CP;
g) The phrase
"lower-level healthcare establishment" is replaced with the phrase
"medical facility" in Form No. 7 of the Health insurance-covered
medical care contracts attached to Decree No. 146/2018/ND-CP, which is amended
by clause 1 Article 2 of Decree No. 75/2023/ND-CP;
8. Amendment to some
phrases in Form No. 4 of the Receipt of document and appointment for return of
results of issuance, re-issuance, or replacement of health insurance card in
the Appendix attached to Decree No. 146/2018/ND-CP:
a) The phrase
"issuance, re-issuance, or replacement of health insurance card" is
replaced with the phrase "issuance, re-issuance, or replacement of health
insurance card and information in health insurance card";
b) The phrase
"re-issuance, merger, replacement, or adjustment of information in health
insurance card" is replaced with the phrase "issuance, re-issuance,
or replacement of information in health insurance card, or information related
to health insurance card";
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d) The phrase
"9-digit identification card" is replaced with the phrase "ID
card or citizen ID card".
Article
2. Annulment of Form No. 5 - Form for follow-up appointment and Form No. 6 -
Form for shifting the level of medical practices" in the Appendix attached
to Decree No. 146/2018/ND-CP, which is amended by clause 1 Article 2 of Decree
No. 75/2023/ND-CP.
Article
3. Effect
This Decree comes into
force from January 01, 2025.
Article
4. Transitional provisions
1. Health insurance
participants receiving medical care before the effective date of this Decree,
but finishing the treatment from the effective date of this Decree will be
reimbursed by the health insurance fund for the covered medical costs in
accordance with the Law on Health Insurance and clause 1 Article 1 of this
Decree.
2. Form for follow-up
appointment, Form for shifting the level of medical practices, Receipt of
document and appointment for return of results of issuance, re-issuance, or
replacement of health insurance card issued before January 01, 2025 may be used
until they become invalid.
Article
5. Implementation
Ministers, Heads of
ministerial authorities, Heads of governmental authorities, Chairpersons of
People's Committees of provinces and central-affiliated cities, related
organizations and persons are responsible to implement this Decree.
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ON THE BEHALF OF THE GOVERNMENT
PP. PRIME MINISTER
DEPUTY PRIME MINISTER
Le Thanh Long
Đã cập nhật Luật Đất đai 2024 mới nhất