Thông tư 35/2021/TT-BYT sửa đổi Khoản 1 Điều 9 Thông tư 30/2020/TT-BYT hướng dẫn Nghị định 146/2018/NĐ-CP hướng dẫn Luật Bảo hiểm y tế do Bộ trưởng Bộ Y tế ban hành

CIRCULAR

AMENDMENTS TO CLAUSE 1 ARTICLE 9 OF CIRCULAR NO. 30/2020/TT-BYT DATED DECEMBER 31, 2020 OF THE MINISTER OF HEALTH ON ELABORATING TO DECREE NO. 146/2018/ND-CP DATED OCTOBER 17, 2018 OF THE GOVERNMENT ON ELABORATING TO LAW ON HEALTH INSURANCE

Pursuant to Law on Medical Insurance dated November 14, 2008 receiving amendments according to the Law on Medical Insurance dated June 13, 2014;

Pursuant to Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government on elaborating to Law on Health Insurance;

Pursuant to Decree No. 75/2017/ND-CP dated June 20, 2017 of Government on functions, tasks, powers, and organizational structure of the Ministry of Health of Vietnam;

At request of Director General of the Department of Health Insurance,

The Minister of Health of Vietnam promulgates Circular on amendments to Clause 1 Article 9 of Circular No. 30/2020/TT-BYT dated December 31, 2020 of the Minister of Health on elaborating to Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government on elaborating to Law on Health Insurance

Article 1. Amendments to Clause 1 Article 9 of Circular No. 30/2020/TT-BYT dated December 31, 2020 of the Minister of Health on elaborating to Decree No. 146/2018/ND-CP dated October 17, 2018 of the Government on elaborating to Law on Health Insurance:

“1. Transfer for provision of subclinical services shall be implemented in a manner conforming to technical requirements in medical examination and treatment, ensuring benefits of health insurance beneficiaries and applicable to the following services:

a) Subclinical services which are under list of medical technical services approved by competent authorities for medical examination and treatment establishments, currently being provided in medical examination and treatment establishments but cannot be implemented by the medical examination and treatment establishments when the services are designated for the patients;

b) Subclinical services which are not under list of medical technical services approved by competent authorities for medical examination and treatment establishments but are necessary for specialized activities according to regulations of Minister of Health on management, diagnosis and treatment in medical examination and treatment shall be paid by the HIF for cases of patients receiving inpatient treatment in district level hospitals or higher, except for cases specified in Point c of this Clause;

c) Subclinical services which are not under list of medical technical services approved by competent authorities for medical examination and treatment establishments but are necessary for specialized activities according to regulations of Minister of Health on management, diagnosis and treatment in medical examination and treatment for infectious diseases, including: Tuberculosis, Hepatitis B, Hepatitis C, HIV/AIDS, SARS-CoV-2, Dengue hemorrhagic fever shall be paid by the HIF for cases of patients receiving outpatient and inpatient treatment in district level hospitals or higher for testing technical services in the Appendix issued with this Circular;

Heads of medical examination and treatment establishments accepting health insurance shall rely on functions, tasks and scope of specialized operations approved by competent authorities to produce list of subclinical services that require transfer and send to social security agencies where contracts for provision of medical examination and treatment under health insurance are signed to enable both parties to add annexes thereto prior to implementation.

Article 2: Entry into force

This Circular comes into force as of February 15, 2022.

Article 3. Implementation

Director of Health Insurance Department, Chief of the Ministry Office, Ministerial Chief Inspector, Directors of Departments, General Directors of General Departments affiliated to Ministry of Health and relevant entities shall be responsible for the implementation of this Circular.

Difficulties that arise during implementation of this Circular should be reported to Ministry of Health of Vietnam (Health Insurance Department) for consideration./.

APPENDIX

LIST OF SUBCLINICAL SERVICES
(Issued together with Circular No. 35/2021/TT-BYT dated December 31, 2021 of the Minister of Health)

Note: Abbreviations in this Appendix:

- TT43: Circular No. 43/2013/TT-BYT dated December 11, 2013 of the Minister of Health providing for technical and professional levels in the network of health facilities.

- TT50: Circular No. 50/2014/TT-BYT dated December 26, 2014 of the Minister of Health on classification of surgeries, medical procedures and personnel norms applied to operations, medical procedures.

- TT21: Circular No. 21/2017/TT-BYT dated May 10, 2017 of the Minister of Health on amendments to list of medical techniques in health facilities issued together with Circular No. 43/2013/TT-BYT.