Chương X Nghị định 146/2018/NĐ-CP: Điều khoản thi hành

Chapter X

IMPLEMENTARY PROVISIONS

Article 39. Transitional provisions

1. Health insurance policyholders receiving medical services before the entry into force of this Decree and discharged from the entry into force of this Decree shall be entitled to the health insurance fund’s coverage for medical costs in the list of health insurance-covered costs with respective coverage rates and provisions laid down in Article 14 hereof.

2. Health insurance-covered medical service contracts signed before the effective date of this Decree shall be continuously implemented by end of December 31, 2018.

3. Tasks of payment, management and settlement of medical costs arising in the primary care domain at educational institutions, vocational training establishments, organizations and enterprises in 2018 which have been performed shall be continued till the end of December 31, 2018.

4. The settlement of costs of the health insurance fund in 2017 and 2018 shall be subject to provisions laid down in the Government’s Decree No. 105/2014/ND-CP dated November 15, 2014 elaborating and providing guidance on implementation of certain articles of the Law on Health Insurance and other directive documents.

5. If healthcare establishments have not yet implemented the regulations set forth in point c of clause 2 of Article 21 hereof, they shall be required to send all required electronic data on health insurance-covered medical service activities not later than end of December 31, 2019.

Article 40. Reference provision

In case where reference documents mentioned in this Decree are replaced or revised, the substitute or revised document shall prevail.

Article 41. Entry into force

1. This Decree shall be in effect on December 1, 2018.

2. The following documents shall be repealed from the entry into force of this Decree:

a) Government's Decree No. 105/2014/ND-CP dated November 15, 2014 elaborating and providing guidance on implementation of certain articles of the Law on Health Insurance; In particular, point b of clause 1 of Article 6 and Article 8 shall remain in effect till end of December 31, 2018;

b) Joint Circular No. 41/2014/TTLT-BYT-BTC dated November 24, 2014 of the Ministry of Health, the Ministry of Finance providing guidance on implementation of the health insurance program; In particular, provisions laid down in Article 11, clause 2 of Article 17 and Article 18 shall remain in effect till end of December 31, 2018;

c) Joint Circular No. 16/2015/TTLT-BYT-BTC dated July 2, 2015 of the Ministry of Health, the Ministry of Finance amending clause 5 of Article 13 of the Joint Circular No. 41/2014/TTLT-BYT-BTC dated November 24, 2014 providing guidance on implementation of the health insurance program;

d) Article 8 and clause 2 of Article 9 of the Decree No. 151/2016/ND-CP dated November 11, 2016 elaborating and providing guidance on implementation of certain articles on compensation regimes and policies under the Law on Professional Servicemen, National Defence Workers and Public Employees;

dd) Clause 6 of Article 11, point c of clause 1 and clause 2 of Article 12 of the Circular No. 40/2015/TT-BYT dated November 16, 2015 of the Ministry of Health prescribing registration of health insurance-covered primary care services and referral to levels of healthcare establishments.

Article 42. Implementation guidance responsibilities

1. The Ministry of Health shall assume the following responsibilities:

a) Provide guidance on implementation of articles or clauses enshrined in this Decree;

b) Preside over and cooperate with relevant ministries and bodies in implementation of policies and laws on health insurance;

c) Provide guidance on evaluation of requirements for signing health insurance-covered primary care contracts with healthcare establishments providing health insurance-covered medical services;

d) Issue code sets of the commonly used Classification Schedule for nationwide use, including medical technology services, modern and traditional medical drugs, medical supplies, equipment, blood and blood products, diseases viewed in the traditional medicine, diagnosis codes in the International Classification of Diseases (ICD), codes of healthcare establishments and other code sets meeting managerial requirements;

dd) Direct healthcare establishments to enhance application of information technologies to their provision of medical services; implied factor unalike; keep a timely, accurate and sufficient update of information about health insurance-covered medical services and transfer data to the system for receipt of health insurance-covered medical services of the Ministry of Health and the system of evaluation information of the Vietnam Social Security to serve the tasks of health insurance management, evaluation and payment of health insurance-covered medical costs;

e) Adopt regulations on specific tasks of application of information technologies to the provision of medical services;

g) Regulate the schedule of connection of data on results of tests, imaging diagnoses, medical therapy information of patients holding health insurance cards;

h) Preside over and cooperate with the Ministry of Finance and Vietnam Social Security in sending a report to the Government for its representation to the National Assembly on implementation of health insurance regimes and policies, including the review report on management and use of the health insurance fund prepared on an ad-hoc, regular or annual basis.

2. The Ministry of Finance shall assume the following responsibilities:

a) Balance the central budget and provide the central budget’s allocations for localities which are unable to balance its budget on their own in order to ensure availability of funds for implementation of health insurance policies under the provisions of laws on the state budget;

b) Report to the Government on the current state of management and use of the health insurance fund on an annual or unscheduled basis upon the request of the Government.

c) Prepare the review report on management and use of the health insurance fund on an annual basis and sent it to the Ministry of Health for its report synthesis as per point h of clause 1 of this Article;

3. The Ministry of National Defense and the Ministry of Public Security shall be responsible for providing guidance on implementation of the health insurance program with respect to policyholders under their management in accordance with clause 1 of Article 1, clause 13 and 15 of Article 3, clause 3 of Article 4 and Article 6 hereof.

4. The Ministry of Labor, War Invalids and Social Affairs shall assume the following responsibilities:

a) Research and establish criteria for determination of family households doing business in the agriculture, forestry, aquaculture and salt production industry which are earning average income to ensure that they are in line with socio-economic situations over periods of time, and submit them to the Prime Minister to seek his approval of promulgation thereof;

b) Provide guidance on preparing the list of policyholders referred to in clause 3, 5, point a of clause 9, 11, 12, 16 and 17 of Article 3, clause 1, 2 and 4 of Article 4 hereof.

5. The Vietnam Social Security shall assume the following responsibilities:

a) Give directions to all-level social insurance agencies for conclusion of contracts with healthcare establishments conforming to requirements prescribed herein;

b) Direct social insurance agencies in cities and provinces to preside over and cooperate with Departments of Health, Departments of Finance and healthcare establishments providing health insurance-covered medical services within localities under their jurisdiction and neighboring localities and relevant authorities in handling, within their competency, or requesting competent authorities to consider and take timely action on any difficulty that may arise;

c) Direct all-level social insurance agencies to provide forms and instructions for commune-level People’s Committees used for preparing lists and managing lists of family-based health insurance policyholders;

d) Perfect information technology systems in order to meet the needs of receipt, evaluation of and timely response to healthcare establishments related to health insurance-covered medical service data; ensure accuracy, safety, confidentiality of information and protection of interests of related parties;

dd) Prepare a regular, annual or ad-hoc review report upon the request of the state regulatory authority on implementation of health insurance regimes and policies; revenues, expenditures and management and use of the health insurance fund, and send it to the Ministry of Health and the Ministry of Finance for synthesis purposes as prescribed herein;

e) Regulate authority to sign health insurance-covered medical service contracts between social insurance agencies and healthcare establishments in order to ensure relevance to functions, duties, rights and organizational structures of the Vietnam Social Security;

g) Not later than January 1, 2020, social insurance agencies must issue electronic health insurance cards to health insurance policyholders.

6. People’s Committees of provinces and centrally-affiliated cities shall be responsible for submitting the budgetary plan to same-level People's Councils to ensure the adequate budget for payment of health insurance contributions for policyholders whose health insurance contributions are covered or supported by the state budget in accordance with existing regulations.

Article 43. Implementary responsibilities

Ministers, Heads of Ministry-level agencies, Heads of Governmental bodies, and Chairpersons of People’s Committees of centrally-affiliated cities and provinces, shall be responsible for implementing this Decree./.