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MINISTRY OF
HEALTH – MINISTRY OF FINANCE
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SOCIALIST REPUBLIC OF VIETNAM
Independence – Freedom - Happiness
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No.
37/2015/TTLT-BYT-BTC
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Hanoi,
October 29, 2015
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JOINT CIRCULAR
UNIFYING PRICES
FOR MEDICAL EXAMINATION AND TREATMENT SERVICES COVERED BY MEDICAL INSURANCE
AMONG HOSPITALS OF THE SAME LEVEL ACROSS THE COUNTRY
Pursuant to the Law on Medical examination
and treatment dated November 23, 2009;
Pursuant to the Law on Prices dated June 20,
2012;
Pursuant to the Law on amendments to a number
of the Law on Medical Insurance dated June 13, 2014;
Pursuant to the Government’s Decree No.
85/2012/ND-CP dated October 15, 2012 on operational and financial regimes
applicable to non-business medical providers and fees for medical examination
and treatment services by public medical examination and treatment facilities;
Pursuant to the Government’s Decree No.
16/2015/ND-CP dated February 14, 2015 providing for autonomy mechanism of
public service providers;
Pursuant to the Government's Decree No.
63/2012/ND-CP dated August 31, 2012 defining the functions, tasks, powers and
organizational structure of the Ministry of Health;
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The Minister of Health and the Minister of
Finance promulgate the joint circular unifying prices for medical examination
and treatment services covered by medical insurance among hospitals of the same
level across the country.
Article 1. Governing scope
1. This joint circular provides for prices for
medical examination and treatment services (herein ‘medical services’) covered
by medical insurance among hospitals of the same level across the country.
2. Price frame and authority to stipulate prices
for medical services not covered by medical insurance fund shall be instructed
in the Law on Prices, the Law on Medical examination and treatment and relevant
written instructions.
Article 2. Regulated entities
Medical facilities, units, organizations and
individuals that engage in medical examination and treatment, payment,
financial settlement of prices for medical services covered by medical
insurance.
Article 3. Prices for medical services
covered by medical insurance
1. Prices for medical services include:
a) Prices for medical examination as prescribed
in Annex I enclosed herewith;
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c) Prices for technical services as prescribed
in Annex III enclosed herewith;
2. Prices for medical services as prescribed in
Clause 1, this Article include:
a) Direct expenses:
- Expenses for medicine, intravenous fluids,
chemicals, consumable materials, substitute items;
Medicine, blood, intravenous fluids, chemicals,
consumable materials, substitute items that are not included in prices for
medical services as prescribed in Annex III enclosed herewith shall be paid for
on the basis of actual quantity used on patients, prices, scope and benefits as
prescribed.
- Expenses for electricity, water, fuel, waste
treatment and environmental hygiene;
- Expenses for maintenance and care of
equipment, purchase of instruments, tools for replacement;
b) Permanent allowances, allowances for
surgeries, maneuvers (hereinafter referred to as ‘peculiar allowances’) as
prescribed in the Prime Minister’s Decree No. 73/2011/QD-TTg dated December 28,
2011 providing for peculiar allowances for officials and civil servants,
employees in public medical facilities and allowances for epidemic fighting;
c) Salaries, allowances, contributions as
prescribed in respect of public service providers except for expenses as
prescribed in Clause 3, this Article
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a) Governmental Decree No. 64/2009/ND-CP dated
July 30, 2009 providing for policies on medical staff working in the areas
facing socio-economic difficulties;
b) Governmental Decree No. 116/2010/ND-CP dated
December 24, 2010 providing for policies on officials, civil servants and paid
armed force staff working in the areas facing socio-economic difficulties;
c) Governmental Decree No. 46/2009/QD-TTg dated
March 31, 2009 on peculiar allowances for officials, civil servants working in
Friendship Hospital, Unified Hospital, C Hospital, Central Health Protection
Divisions 1, 2, 2B, 3 and 5, Department A11 of 108 Hospital and Department A11
of Military Institute of Traditional Medicine (herein ‘Decision No.
46/2009/QD-TTg) and the Prime Minister’ Decision No. 20/2015/QD-TTg dated June
18, 2015 on amendments and supplements to a number of articles of Decision No.
46/2009/QD-TTg;
d) Point a, Clause 3, Article 6 of Governmental
Decree No. 204/2004/ND-CP dated December 14, 2004 on salaries
paid to cadres, civil servants, officials, and armed force personnel and
Governmental decree No. 76/2009/ND-CP dated September 15, 2009 on amendments
and supplements to a number of articles of Decree No. 204/2004/ND-CP;
4. Expenses as prescribed in Clause 2, this
Article shall be defined on the basis of limits prescribed by the Ministry of
Health.
5. Prices for medical services as prescribed in annexes
enclosed herewith shall be reviewed and adjusted by the Ministry of Health and
the Ministry of Finance as price components change.
Article 4. Application of prices for medical
services covered by medical insurance in some cases
1. For medical services
the prices for which are not stipulated hereof, apply the prices for medical
services ranked as equivalent in technique and implementation cost by the
Ministry of Health.
2. For surgeries, maneuvers not ranked by the
Ministry of Health and the prices for which are not stipulated hereof, apply
the prices for each surgery, maneuver in section “other surgeries, maneuvers”
of each specialty as prescribed in Annex III enclosed herewith.
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4. For institutes with patient beds, medical
centers of provincial level providing medical services; graded medical centers
of rural district level providing preventive healthcare and medical services,
apply the prices by hospitals of similar level;
5. For institutes with
patient beds, army medical infirmaries, ungraded medical treatment groups,
polyclinics, maternity wards, family clinics, traditional medicine treatment
clinics, medical centers of rural district level that are separated from
hospitals yet provide medical services, medical stations of communes, wards and
towns, medical clinics of agencies, units, organizations and schools, army
medical clinics, civil-military medical clinics, infirmaries, ungraded
hospitals and other medical facilities, apply the prices issued by hospitals of
IV level as prescribed in annexes enclosed herewith;
6. Private medical
clinics:
a) For medical treatment services, in-patient
services, medical insurance providers shall agree with private medical clinics
on application of the prices issued by any of graded hospitals as prescribed in
Annexes I and II enclosed herewith;
b) For medical services outside Point a, this
Clause, medical insurance providers shall agree with private medical clinics on
application of the prices as prescribed in Annexes III enclosed herewith;
Article 5. Implementation roadmap
1. The prices including direct expenses and
peculiar allowances shall take effect since March 01, 2016.
2. The prices including direct expenses,
peculiar allowances and pays shall take effect since July 01, 2016. Timing of
implementation by units, localities shall be reviewed and decided by the
Ministry of Health.
3. Medical facilities classified by competent
agencies as the units that cover their regular expenses and expenses for
investment may apply the prices including direct expenses, peculiar allowances
and pays since March 01, 2016.
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1. The Ministry of Health shall be responsible
for stipulating the lists of medical services equivalent in technique and
implementation cost as foundations for application of the prices as prescribed
in Clause 1, Article 4 hereof.
2. The Ministry of Health shall preside over and
cooperate with the Ministry of Finance, Vietnam Social Security in organizing
implementation and inspection and monitoring the implementation of this joint
circular.
3. The Ministry of Finance shall cooperate with
the Ministry of Health, Vietnam Social Security in organizing inspection and
monitoring the implementation of this joint circular.
4. Vietnam Social Security shall direct local
social security authorities, social security authorities of the Ministry of National
Defense, social security authorities of People’s Public Security of Vietnam in
carrying out payment of expenses for medical services covered by medical
insurance as prescribed hereof; cooperate with the Ministry of Health and the
Ministry of Finance in inspecting and monitoring the implementation of this
joint circular.
5. The state budget shall assure expenses under
benefit policies as prescribed in the documents specified in Clause 3, Article
3 hereof.
6. Public medical facilities' receipts earned
from medical services covered by medical insurance shall be used by the
facilities themselves as prescribed.
Article 7. Terms of reference
Any amendment or supplement that has been made
to documents referred to in this joint circular shall prevail over previous
amendments or supplements made thereto.
Article 8. Implementary provisions
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Article 9. Transitional provisions
For patients receiving medical services starting
before and ending after the effective date of this joint circular, apply prices
for medical services covered by medical insurance as prescribed by competent
authorities at the time preceding the effective date of the prices as
prescribed in Article 5 hereof until discharge from the hospital or end of
outpatient treatment.
Difficulties that arise during the
implementation of this Circular should be reported to the Ministry of Health
and the Ministry of Finance for consideration and handling./.
PP. MINISTER
OF FINANCE
DEPUTY MINISTER
Tran Van Hieu
PP MINISTER
OF HEALTH
DEPUTY MINISTER
Pham Le Tuan