Thông tư 56/2017/TT-BYT về hướng dẫn Luật bảo hiểm xã hội và Luật an toàn vệ sinh lao động thuộc lĩnh vực y tế do Bộ trưởng Bộ Y tế ban hành

CIRCULAR

GUIDELINES FOR SOME ARTICLES ON HEALTH OF THE LAW ON SOCIAL INSURANCE AND THE LAW ON OCCUPATIONAL SAFETY AND HYGIENE

Pursuant to the Law on social insurance No. 58/2014/QH13 dated November 20, 2014;

Pursuant to the Law on occupational safety and hygiene No. 84/2015/QH13 dated June 25, 2015;

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

At the request of Director of the Legal Department, Director of Medical Examination & Treatment Administration, Director of Mother and Child Health Department,

The Minister of Health promulgates a Circular providing guidelines for some articles on health of the Law on social insurance and the Law on occupational safety and hygiene.

Chapter I

GENERAL PROVISIONS

Article 1. Scope

This Circular provides for:

1. Diseases, the authority to determine diseases eligible for lump-sum social insurance payout.

2. Medical assessment of work capacity reduction (whole person impairment) as the basis for workers and their relatives to receive social insurance payout.

3. Issuance of discharge notes, birth certificate, copies of medical records, confirmation of maternity leave, confirmation of poor postpartum health and confirmation of eligibility to receive social insurance benefits.

Article 2. Regulated entities

1. Workers participating in social insurance as specified in Clause 1 and Clause 4 Article 2 of the Law on social insurance and Article 43 of the Law on occupation safety and hygiene.

2. Workers specified in Clause 1 of this Article whose social insurance participation period is reserved or retired workers pending pension or monthly benefits; voluntary social insurance participants who have paid compulsory social insurance premiums for at least 20 years.

3. Relatives of workers who participated in social insurance applying for medical assessment of work capacity reduction to receive death benefits for the workers (hereinafter referred to as worker’s relative).

Article 3. Definitions

In this Circular, these terms are construed as follows:

1. “Sick leave” means a period of time over which a worker is not healthy enough to work and is required by a physician to take a sick leave.

2. “Valid copy” means a copy that is extracted from the original book or has been compared with the original by a competent authority.

3. “Medical record summary” means the summary of a medical record prescribed by regulations of law on medical examination and treatment.

Chapter II

DISEASES ELIGIBLE FOR LUMP-SUM SOCIAL INSURANCE PAYOUT AND DOCUMENTS OF MEDICAL ASSESSMENT FOR SOCIAL INSURANCE PAYOUT

Article 4. Diseases eligible for lump-sum social insurance payout

The diseases eligible for lump-sum social insurance payout include:

1. Cancer, polio, cirrhosis of the liver, leprosy, severe tuberculosis, HIV/AIDS and total loss of the worker’s functions, self-control or he/she is unable to move, dress, keep personal hygiene and complete other everyday tasks without other people watching, helping and taking care of him/her.

2. Diseases other than those specified in Clause 1 this Article that result in at least 81% of work capacity reduction or impairment level and total loss of the worker’s functions, self-control or he/she is unable to move, dress, keep personal hygiene and complete other everyday tasks without other people watching, helping and taking care of him/her.

Article 5. Documents of first medical assessment

1. Documents of first medical assessment due to an occupational accident:

a) Letter of introduction of the employer according to Annex 1 enclosed herewith in case the victim of occupational accidents is under the management of the employer at the time of medical assessment or the application for medical assessment according to Annex 2 enclosed herewith in case the victim is no longer under the management of the employer at the time of application for medical assessment;

b) Original copy or valid copy of the injury confirmation issued by the health facility (that provided treatment for the worker) in accordance with the template specified in Decision No. 4069/2001/QĐ-BYT dated September 28, 2001 of the Minister of Health;

c) Original copy or valid copy of the record of occupational accident investigation in accordance with Annex 7 enclosed together with Joint Circular No. 12/2012/TTLT-BLĐTBXH-BYT dated May 21, 2012 of the Ministry of Labor, War Invalids and Social Affairs and the Ministry of Health guiding the statement, investigation, statistics and reports on occupational accidents;

d) Discharge note as specified by the Minister of Health or the medical record summary. If the worker is not an outpatient or patient, papers of treatment for injury in conformity with the time of occurrence of the assessed occupational accident and injury.

In case the assessed person is one of the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene: the medical record summary must clearly state that the injury from occupational accident cannot become stable after treatment.

dd) One of the following documents with photo: ID; Citizen Identification; passport that remains valid. If there are no abovementioned documents, a written confirmation with a photo bearing a seal issued by the police authority of the Commune within the last 03 months from the time of application for medical assessment.

2. Documents of first medical assessment of occupational diseases:

a) Letter of introduction of the employer according to Annex 1 enclosed herewith in case the person being assessed of occupational diseases for the first time is under the management of the employer at the time of medical assessment or the application for medical assessment according to Annex 2 enclosed herewith in case the worker is retired or no longer does the jobs posing risk of occupational diseases is detected any occupational disease within the coverage period of the disease, including workers whose social insurance participation period is reserved, retired workers pending pension or monthly benefits and workers on pensions or monthly benefits;

b) Original copy or valid copy of the occupational disease record;

c) Medical record summary of treatment for occupational diseases of the worker relevant to occupational diseases (if any).

In case the assessed person is one of the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene: the medical record summary must clearly state that the occupational diseases cannot become stable after treatment.

d) One of the documents specified in Point dd Clause 1 this Article.

3. Documents of medical assessment as the basis for provision of pension for a worker:

a) Letter of introduction of the employer according to Annex 1 enclosed herewith in case the worker is paying compulsory social insurance or the application for medical assessment according to Annex 2 enclosed herewith in case of workers whose social insurance participation period is reserved and retired workers pending pension or monthly benefits;

b) Original copy or valid copy of at least one of the following medical documents: Medical record summary, disability confirmation, discharge note, prescriptions, copy of occupational disease record and assessment record of occupational diseases or occupational accidents in case the worker has been medically assessed occupational diseases or occupational accidents;

c) One of the documents specified in Point dd Clause 1 this Article.

4. Documents of medical assessment as the basis for provision of death benefits:

a) Application for medical assessment according to Annex 2 enclosed herewith;

b) Original copy or valid copy of at least one of the following medical documents: Medical record summary, disability confirmation, discharge note, prescriptions and assessment record of occupational diseases or occupational accidents in case the worker has been medically assessed occupational diseases or occupational accidents;

c) One of the documents specified in Point d Clause 1 this Article.

5. Documents of medical assessment for confirmation of inadequate postpartum health, inadequate health after receiving the child due to surrogacy or maternity leave;

a) Application for assessment according to Annex 2 enclosed herewith;

b) Original copy or valid copy of at least one of the following medical documents: Medical record summary (maternity record or other diseases), disability confirmation, discharge note, prescriptions, copy of occupational disease record and assessment record of occupational diseases or occupational accidents in case the worker has been medically assessed occupational diseases or occupational accidents;

c) One of the documents specified in Point dd Clause 1 this Article.

6. Documents of medical assessment for lump-sum social insurance payout:

a) Application for medical assessment according to Annex 2 enclosed herewith;

b) Original copy or valid copy of at least one of the following medical documents: Medical record summary, disability confirmation, discharge note, prescriptions, copy of occupational disease record and assessment record of occupational diseases or occupational accidents in case the worker has been medically assessed occupational diseases or occupational accidents;

c) One of the documents specified in Point dd Clause 1 this Article.

Article 6. Documents of re-assessment due to relapse

1. Documents of medical re-assessment due to relapse of injury from an occupational accident:

a) Application for medical assessment according to Annex 2 enclosed herewith;

b) Original copy or valid copy of medical record summary according to the template specified in Annex 4 enclosed herewith or discharge note according to the template specified in Annex 3 enclosed herewith which clearly specifies the injury relapse.

In case the assessed person is one of the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene: the medical record summary must clearly state that the injury from occupational accident cannot become stable after treatment.

c) Original copy or valid copy of the latest medical assessment record enclosing with the injury confirmations which bears the injuries assessed in the record.

In case the assessed person is one of the subjects specified in Clause 2 Article 12 hereof: original copy of the latest medical assessment record, in which the conclusion about the time limit for re-assessment must be specified.

d) One of the documents specified in Point dd Clause 1 Article 5 this Circular.

2. Documents of medical re-assessment due to relapse of occupational diseases:

a) Application for medical assessment according to Annex 2 enclosed herewith;

b) Original copy or valid copy of the occupational disease record;

c) Original copy or valid copy of medical record summary according to the template specified in Annex 4 enclosed herewith or discharge note according to the template specified in Annex 3 enclosed herewith which clearly specifies the injury relapse.

In case the assessed person is one of the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene: the medical record summary must clearly state that the occupational diseases cannot become stable after treatment.

d) Original copy or valid copy of the latest medical assessment record.

In case the assessed person is one of the subjects specified in Clause 2 Article 12 hereof: original copy of the latest medical assessment record, in which the conclusion about the time limit for re-assessment must be specified.

dd) One of the documents specified in Point dd Clause 1 Article 5 this Circular.

Article 7. Documents of general medical assessment

1. Letter of introduction of the employer according to Annex 1 enclosed herewith in case the person being generally assessed is under the management of the employer at the time of medical assessment or the application for medical assessment according to Annex 2 enclosed herewith in case the worker is retired or no longer does the jobs posing risk of occupational diseases is detected any occupational disease within the coverage period of the disease, including workers whose social insurance participation period is reserved, retired workers pending pension or monthly benefits and workers on pensions or monthly benefits.

2. Original copy or valid copy of the latest medical assessment record (if any).

3. Other documents as specified in Clause 1, Clause 2 Article 5 or Article 6 of this Circular in conformity with the subject and type of assessment.

4. One of the documents specified in Point dd Clause 1 Article 5 this Circular.

Article 8. Documents of reassessment by Central Medical Assessment Council if the case is beyond capacity

1. Letter of introduction prepared by the head of the governing organization of the Medical Assessment Council bearing the signature and seal as specified in Annex 1 enclosed herewith.

2. Documents of assessment as specified in Article 5, 6 or 7 this Circular in conformity with the subject and type of assessment.

3. Medical assessment record in case the provincial Medical Assessment Council has carried out the medical assessment of the subject or there are sealed and signed minutes of meeting of the Medical Assessment Council saying the case is beyond its capacity if no assessment has been carried out.

Article 9. Documents of reassessment by Central Medical Assessment Council at the request of organizations or individuals

1. Written request for reassessment by Central Medical Assessment Council of one of the following agencies:

a) The Medical Examination and Treatment Administration, the Ministry of Health;

b) The Ministry of Labor, Invalids and Social Affairs;

c) The Department of Health;

d) The Department of Labor, Invalids and Social Affairs;

dd) Social insurance authorities at provincial level or more;

e) Employers;

g) The provincial Medical Assessment Council in case the provincial Medical Assessment Council has carried out the medical assessment but the person disagrees with the conclusion given by the provincial Medical Assessment Council and requests the reassessment. The written request must bear the signature and seal of the head of the governing organization of the Medical Assessment Council assessing the person and must specify that the person disagrees with the conclusion given by the provincial Medical Assessment Council and requests the reassessment at the same time be enclosed with an application for reassessment by Central Medical Assessment Council prepared by such person in accordance with Annex 2 enclosed herewith.

2. Valid copy of the medical assessment record as specified in Article 5, 6 or 7 this Circular in conformity with each subject and type of assessment.

3. Original copy or valid copy of the medical assessment record of the provincial Medical Assessment Council.

Article 10. Documents of final medical reassessment

1. Written request for final reassessment by Central Medical Assessment Council of one of the following agencies:

a) The Ministry of Health;

b) The Ministry of Labor, Invalids and Social Affairs;

c) The Vietnam Social Security;

d) Employers;

dd) The Central Medical Assessment Council in case the Central Medical Assessment Council has carried out the medical assessment but the person disagrees with the conclusion given by the Central Medical Assessment Council and requests the reassessment.

The written request must bear the signature and seal of the head of the governing organization of the Central Medical Assessment Council assessing the person and must specify that the person disagrees with the conclusion given by the Council and at the same time be enclosed with an application for final reassessment by Central Medical Assessment Council prepared by such person.

2. Decision on establishment of the final Medical Assessment Council issued by the Minister of Health.

3. Medical assessment record as specified in Article 8 or 9 this Circular in conformity with each subject and type of medical assessment.

4. Medical assessment record of the Central Medical Assessment Council.

Article 11. Responsibility for preparing the documents of medical assessment

1. The worker shall prepare the documents of medical assessment and sent them to the Medical Assessment Council in the following cases:

a) The worker applies for assessment for lump-sum social insurance payout;

b) First assessment pending provision of pension for a worker whose social insurance participation period is reserved or a retired worker pending pension or monthly benefits;

c) Assessment of a retired worker or a worker suffering an occupational disease whose social insurance participation period is reserved;

d) Assessment for confirmation of inadequate postpartum health, inadequate health after receiving the child due to surrogacy or maternity leave;

dd) Assessment applied to the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene;

g) Assessment of relapse, including retired workers applying for assessment of relapse;

h) General assessment of a worker whose social insurance participation period is reserved or a retired worker.

If the worker specified in this Clause cannot prepare the documents by himself/herself due to health problems, the employer or relatives of the worker may prepare the documents of medical assessment on behalf of the worker. The application for medical assessment must be in accordance with Annex 2 enclosed herewith, in which the confirmation on the worker’s personal status issued by the People’s Committee or police authority at the Commune must be included.

2. The relative of the worker shall prepare the documents of medical assessment and sent them to the Medical Assessment Council in case of request for medical assessment for monthly benefits. The application for medical assessment must be in accordance with Annex 2 enclosed herewith, in which the confirmation on the worker’s personal status issued by the People’s Committee or police authority at the Commune must be included.

3. The employer shall prepare the documents of medical assessment and sent them to the Medical Assessment Council in the following cases:

a) Cases not specified in Clause 1, 2, 4 and 5 this Article;

b) Workers specified in Article 47 of the Law on occupational safety and hygiene.

4. Governing organization of the Provincial Medical Assessment Council shall prepare the documents of reassessment by Central Medical Assessment Council.

5. Governing organization of the Central Medical Assessment Council shall prepare the documents of final reassessment.

Article 12. Time limit for reassessment

1. Reassessment of an occupational accident or occupational disease shall be carried out at least after 02 years (24 months) from the day on which the Medical Assessment Council gives a conclusion on the rate of work capacity reduction because of the latest occupational accident or occupational disease, except for cases specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene.

2. In case of determination of continuously progressed injury from an occupational accident or occupational disease which leads to change in level of injury, the Medical Assessment Council may conclude the time limit for the next medical assessment shorter than the time limit prescribed in Clause 1 this Article.

3. An assessed person other than the subjects defined in Clauses 1 and 2 of this Article but have a new medical record summary or a new discharge note showing that they have other diseases or the assessed disease changes its level of illness compared to the status of the disease, disability concluded in the latest medical assessment record may be requested to be assessed in a period of 03 months from the issuance date of the new medical record summary or the new discharge note.

Article 13. Procedure and content of medical assessment

1. The processing of documents of medical assessment and procedure of medical assessment shall comply with Circular No. 52/2016/TT-BYT dated December 30, 2016 of the Minister of Health on tasks, rights, liaison and operation of Medical Assessment Council at all level (hereinafter referred to as Circular No. 52/2016/TT-BYT).

2. Content of medical assessment of an occupational accident:

a) Content of first medical assessment of an occupational accident according to the injuries recorded in the injury confirmation;

b) Content of medical assessment of relapse: carry out medical assessment of all injuries recorded in the injury confirmation and:

- Injury relapse recorded in the medical record summary in accordance with the injury confirmation;

- Injury which cannot become stable after treatment and is recorded in the medical record summary regarding the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene;

- Continuously progressed injury from an occupational accident which is recorded in the medical record summary as specified in Clause 2 Article 12 this Circular;

c) Content of general medical assessment of many occupational accidents under Point a and b this Clause and in accordance with each case.

3. Content of medical assessment of occupational diseases:

a) Content of first medical assessment of occupational diseases under the occupational disease record and injuries due to occupational diseases within the occupational disease coverage period in accordance with law provisions;

b) Content of medical assessment of occupational disease relapse: carry out medical assessment of all injuries recorded in the occupational disease record and:

- Injury relapse recorded in the medical record summary in accordance with the latest occupational disease and assessment record of occupational disease;

- Injury which cannot become stable after treatment and is recorded in the medical record summary regarding the subjects specified in Point c Clause 1 Article 47 of the Law on occupational safety and hygiene;

- Continuously progressed injury from an occupational accident which is recorded in the medical record summary as specified in Clause 2 Article 12 this Circular;

c) Content of general medical assessment of many occupational diseases under Point a and b this Clause and in accordance with each case.

4. Contents of medical assessments to receive retirement benefits, death benefits, parental leave and lump-sum social insurance payout based on the documents specified in Clause 3 or 4 Article 5 and Clause 2 Article 12 this Circular in accordance with each case.

In case of assessment record of occupational accident, occupational disease or war invalid, the diseases and injuries recorded in such assessment record shall not be re-assessed.

In case there is a medical assessment record of injuries and rates of injuries from occupational accident, occupational disease or war invalid which are different from the newly caught disease, the determined rates of injuries from occupational accident, occupational disease or war invalid shall be added to the rates of injuries from diseases to be assessed.

In case of assessment to receive lump-sum social insurance payout: The medical assessment record shall specify the contents as specified in Article 4 this Circular.

5. The content of general medical assessment shall be implemented as follows:

a) Content of general medical assessment as specified in Clause 2, 3 this Article and in accordance with each case;

b) When a person who is already suffering from an injury or occupational disease catches another injury or occupational disease which causes the same disability:

The rate of work capacity reduction shall be determined based on results of examination of all current injuries and occupational diseases in accordance with Joint Circular No. 28/2013/TTLT-BYT-BLDTBXH dated September 27, 2013 of the Ministry of Health and the Ministry of Labor, War Invalids and Social Affairs on ratings of impairments caused by injuries, illness, disability and occupational diseases (hereinafter referred to as Joint Circular No. 28/2013/TTLT-BYT-BLDTBXH).

c) When a person who is already suffering from an injury or occupational disease catches another injury or occupational disease which causes a different disability:

The rate of work capacity reduction caused by the new injury or occupational disease shall be aggregated with that of the previous occupational accident or occupational disease written in the previous medical assessment record in accordance with Joint Circular No. 28/2013/TTLT-BYT-BLDTBXH.

d) When a person has been carried out medical assessments due to occupational accidents or occupational diseases at least 2 times but the rate has not been aggregated:

- If the person has been carried out medical assessments due to occupational accidents or occupational diseases at least 2 times before the effective date of this Circular, the Medical Assessment Council shall aggregate the rate of injuries of such assessment records in accordance with Joint Circular No. 28/2013/TTLT-BYT-BLDTBXH and issue a new assessment record.

- Except for the abovementioned cases, the Medical Assessment Council shall carry out medical assessment to all injuries recorded in the latest assessment record and aggregate the injury rate with that of the remaining assessment record.

Article 14. Expiry date of a medical assessment record

A medical assessment record shall be unexpired until the issuance of the next medical assessment record with the same content and objective.

Chapter III

ISSUANCE OF DISCHARGE NOTES, BIRTH CERTIFICATE, SUMMARY OF MEDICAL RECORDS, CONFIRMATION OF MATERNITY LEAVE AND CONFIRMATION OF POOR POSTPARTUM HEALTH

Article 15. Issuance of discharge notes

1. Authority to issue discharge notes: Licensed health facilities providing inpatient treatment.

2. The discharge note template is provided in Annex 3 enclosed herewith.

3. If the patient stays at a commune-level Health station as specified in Point a Clause 4 Article 7 No. 41/2014/TTLT-BYT-BTC dated November 24, 2014 of the Ministry of Health and the Ministry of Finance guiding health insurance, the health station may issue a discharge note in accordance with the template specified in Annex 3 enclosed herewith when the patient is discharged from the health station.

Article 16. Issuance of birth certificates

1. Authority to issue birth certificates: Licensed health facilities providing midwifery service.

2. Procedures for issuance, reissuance and adjustment of birth certificates are specified in Circular No. 17/2012/TT-BYT and Circular No. 34/2015/TT-BYT.

3. The birth certificate template is provided in Annex 5 enclosed herewith.

The birth certificate of a child born from surrogacy shall be issued in accordance with Circular No. 34/2015/TT-BYT.

Article 17. Issuance of medical record summary

1. Authority to issue medical record summary: Licensed health facilities providing outpatient treatment.

2. The discharge note medical record summary template is provided in Annex 4 enclosed herewith.

3. If the patient stays at a commune-level Health station as specified in Point a Clause 4 Article 7 No. 41/2014/TTLT-BYT-BTC dated November 24, 2014 of the Ministry of Health and the Ministry of Finance guiding health insurance, the health station may issue a medical record summary in accordance with the template specified in Annex 4 enclosed herewith when the patient is discharged from the health station.

Article 18. Issuance of maternity leave confirmation

1. Authority to issue maternity leave confirmations:

a) Any licensed general hospital having an obstetrics department or maternity hospital may issue maternity leave confirmations due to obstetric diseases;

b) Any licensed general hospital or Medical Assessment Council may issue maternity leave confirmations due to sickness;

c) Practitioners at a health facility specified in Point a or b of this Clause may issue maternity leave confirmations due to obstetric diseases or sickness as authorized by the head of such facility.

2. The confirmation of maternity leave shall be based on the result of consultation held by departments relevant to the patient’s sickness.

3. The confirmation of maternity leave shall be carried out as follows:

a) The template specified in Annex 6 enclosed herewith shall be applied to pregnant workers who resigned and receive outpatient treatment;

b) The confirmation of eligibility to receive social insurance benefits in accordance with Annex 7 enclosed herewith shall be applied to pregnant workers paying compulsory social insurance who receive outpatient treatment;

c) The medical assessment record in accordance with the Annex enclosed in Circular No. 52/2016/TT-BYT in case the maternity leave is issued by the Medical Assessment Council;

d) The medical record summary according to the template specified in Annex 4 enclosed herewith or discharge note according to the template specified in Annex 4 enclosed herewith.

4. The medical assessment record must describe in detail the health status or name of the disease in case of assessment for maternity leave. In case of illness requiring long-term treatment, the disease code shall be inscribed; if the disease code is not available, the full name of the disease shall be written. The recording of the disease code and name shall comply with the provisions of Circular No. 46/2016/TT-BYT.

Term of maternity leave is based on the conclusions of the Medical Assessment Council: The decision on the number of days of leave must be based on the patient's medical condition, but must not exceed 30 days for an issuance of maternity leave confirmation.

The start date of leave must coincide with the day the patient visits the hospital.

Example: The date of doctor’s visit is July 13, 2018 and must go on a leave for 30 days. The “days absence from work” part must be written as 30 days from July 13, 2018, to August 11, 2018.

The medical assessment record for maternity leave is only valid in the granting of illness and maternity benefits.

5. Only one maternity leave confirmation shall be issued each doctor visit. In cases the patient needs to rest for more than 30 days or when the term of leave inscribed on the granted maternity leave confirmation is almost over, the patient must be conducted a follow-up examination so that the practitioner can consider and decide.

6. In case the maternity leave confirmation is lost within 05 working days from the issuance date:

a) The person granted the maternity leave confirmation shall prepare a written request for issuance of a copy of the maternity leave confirmation and send it to the authority issuing the lost maternity leave confirmation;

b) Within 02 working days from the receipt of the written request for issuance of the copy of the maternity leave confirmation, the authority issuing the lost maternity leave confirmation shall grant such person the copy of the maternity leave confirmation.

7. In case the maternity leave confirmation is lost as from the 6^th working day after the issuance date: the person must carry out the procedure for request of issuance of maternity leave confirmation again.

Article 19. Issuance of confirmation or poor postpartum health or poor health after receiving the child from surrogacy

1. The authority to issue confirmations or poor postpartum health or poor health after receiving the child from surrogacy: Provincial Medical Assessment Councils and above.

2. The medical assessment record shall be prepared in accordance with the Annex enclosed in Circular No. 52/2016/TT-BYT in which shall specifies that the mother is not healthy enough to provide care for her newborn child.

3. The conclusion specified in Clause 2 this Article is only used for grant of maternity benefits.

Chapter IV

ISSUANCE AND MANAGEMENT OF CONFIRMATION OF ELIGIBILITY TO RECEIVE SOCIAL INSURANCE BENEFITS

Article 20. Rules for issuance of confirmation of eligibility to receive social insurance benefits

1. The issuance of confirmation of eligibility to receive social insurance benefits shall comply with the following regulations:

a) Be issued by a licensed health facility. Practitioners at such health facility may sign the confirmation of eligibility to receive social insurance benefits as authorized by the head of such facility;

b) Be appropriate with the scope of operation of the health facility that issues the confirmation which is approved by a competent authority;

c) Be appropriate with the patient’s medical condition and professional instructions of the Minister of Health.

2. Only one confirmation of eligibility to receive social insurance benefits shall be issued each doctor visit. In cases the patient needs to rest for more than 30 days or when the term of leave inscribed on the granted confirmation of eligibility to receive social insurance benefits is almost over, the patient must be conducted a follow-up examination so that the practitioner can consider and decide.

If a worker is issued with more than one confirmations of eligibility to receive social insurance benefits by various departments of different health facilities, the one with the longest duration shall apply.

If a worker is treated at various departments of a health facility in a day, only one confirmations of eligibility to receive social insurance benefits shall be issued.

3.Practitioners at such health facility may sign the confirmation of eligibility to receive social insurance benefits as authorized by the head of such facility; if the health facility is not a juridical person, the practitioner must register his/her signature with the social insurance authority.

Article 21. Forms of issuance of confirmations of eligibility to receive social insurance benefits and guidance for the contents of confirmations of eligibility to receive social insurance benefits

1. The medical record summary according to the template specified in Annex 3 enclosed herewith shall be used for workers or children aged under 7 of workers receiving impatient treatment.

If the person transfers to another health facility during the treatment, a valid copy of the outward referral form shall be provided.

If the victim passed away at a health facility, such health facility is not required to issue a discharge note. The implementation of social insurance benefits during the treatment period of the victim at the health facility before his/her death shall be based on the date recorded in the death certificate prepared in accordance to form TP/HT/1999-C1 specified in Decision No. 1203-QĐ/1998/TP-HT.

2. The confirmation of eligibility to receive social insurance benefits according to the template specified in Annex 7 enclosed herewith shall be used for workers or children aged under 7 of workers receiving outpatient treatment.

If a patient needs to take a leave for outpatient treatment after discharged from the hospital, the social insurance authority shall provide social insurance benefits according to the leave duration (days) written on the discharge note.

3. The confirmation of eligibility to receive social insurance benefits template is provided in Annex 7 enclosed herewith.

4. The conclusion on the health condition specified in Clause 4 this Article is valid for 6 months from the date written on the confirmation of maternity leave and only used for grant of maternity benefits.

Chapter V

IMPLEMENTATION RESPONSIBILITIES

Article 22. Responsibilities of affiliates of the Ministry of Health

The Medical Examination & Treatment Administration shall take charge and cooperate with the Mother and Child Health Department, the Traditional Medicine Administration and Ministry Inspectorate in:

1. Organizing the implementation and reviews of implementation of this Circular nationwide.

2. Carrying out inspections, dealing with violations and handling issues arising during the implementation of this Circular in accordance with effective law provisions.

Article 23. Responsibilities of Vietnam Social Security

1. Provide instructions for social insurance authorities on implementation of this Circular.

2. Direct Social Securities at the provinces to provide instructions for health facilities on posting the list of facilities entitled to issue confirmation of eligibility to receive social insurance benefits on the websites of Vietnam Social Security and provincial social insurance authorities. Inspect the issuance of confirmation of eligibility to receive social insurance benefits by health facilities.

Article 24. Responsibilities of Provincial Departments of Health

1. Organize reviews of the implementation of this Circular within their provinces.

2. Carrying out inspections, dealing with violations and handling issues arising during the implementation of this Circular in accordance with effective law provisions.

Article 25. Responsibilities of Medical Assessment Councils

1. Update data about dossiers, documents, medical assessment record on the national medical examination and treatment database in order to connect to the data of social insurance authorities. Make electronic documents of medical examination and treatment covered by health insurance as specified in Decree No. 166/2016/NĐ-CP and take responsibilities for the legality and accuracy thereof.

2. Provide the following documents to the assessed person after the assessment is completed:

a) Assessment record;

b) Assessment bill and invoice;

c) List of assessment contents. In case the assessment contents are carried out by another health facility, the name of such health facility must be written in the “note” column.

Article 26. Responsibility of health facilities

1. Disseminate the content of this Circular among their practitioners and employees.

2. Provide documents for workers as the basis for receipt of social insurance benefits in accordance with this Circular; examine the content of documents specified in this Circular prepared by their practitioners and take legal responsibility for the accuracy and truthfulness thereof.

3. Update data about medical examination and treatment on the national medical examination and treatment database in order to connect to the data of social insurance authorities. Make electronic documents of medical examination and treatment covered by health insurance as specified in Decree No. 166/2016/NĐ-CP and take responsibilities for the legality and accuracy thereof.

4. Transferring health facilities shall provide copies of referral notes bearing their seals on request.

5. Health facilities issuing discharge notes, birth certificate, confirmation of maternity leave, confirmation of poor postpartum health and confirmation of eligibility to receive social insurance benefits shall:

a) Re-issue the discharge notes, birth certificate, confirmation of maternity leave, confirmation of poor postpartum health and confirmation of eligibility to receive social insurance benefits in the following cases:

- It is lost or broken;

- The person signing the confirmations is ultra-vires;

- The seals appended on the confirmations are invalid;

- Information recorded on the discharge notes, birth certificate, confirmation of maternity leave, confirmation of poor postpartum health or confirmation of eligibility to receive social insurance benefits is incorrect.

In case of re-issuance, a “re-issuance’ seal shall be appended on the discharge notes, birth certificate, confirmation of maternity leave, confirmation of poor postpartum health and confirmation of eligibility to receive social insurance benefits.

b) Supplement the contents of the discharge notes, birth certificate, confirmation of maternity leave, confirmation of poor postpartum health or confirmation of eligibility to receive social insurance benefits if the information recorded on the discharge notes, birth certificate, confirmation of maternity leave, confirmation of poor postpartum health or confirmation of eligibility to receive social insurance benefits is incorrect.

After the supplementation, such documents must bear the seal of the health facilities (the seal which is registered with the social insurance authority) where it is supplemented.

c) Register seal and signature samples which are used on the confirmation of eligibility to receive social insurance benefits as follows:

- Register seal samples in accordance with Annex 8 enclosed herewith if the health facility is a juridical person;

- Register seal and signature samples of the practitioners authorized to sign the confirmation of eligibility to receive social insurance benefits in accordance with Annex 8 enclosed herewith if the health facility is not juridical person.

In case the health facility changes the seal sample or the person authorized to sign the confirmation of eligibility to receive social insurance benefits on behalf of the organization head, the health facility must send a written notice to the provincial or district-level social insurance authority (as prescribed by the Vietnam Social Security) where its head office is located within 05 working days from the date of change.

The appliance of electronic signature shall comply with law provisions on electronic signature.

d) Authorize a person to sign on the confirmation of eligibility to receive social insurance benefits.

The authorization must be in writing and be sent to the provincial social insurance authority where the facility’s head office is located. The authorized person shall not re-authorize. The written authorization shall specify the following contents: Full name and position of the authorized person; scope of authorization (the authorized person may sign or seal on the documents on which case) and period of authorization.

Chapter VI

IMPLEMENTATION CLAUSE

Article 27. Effect

1. This Circular takes effect from March 01, 2018.

2. Circular No. 14/2016/TT-BYT dated May 12, 2016 of the Minister of Health providing guidelines for some Articles on health of the Law on social insurance shall be annulled from the effective date of this Circular.

Article 28. Grandfather clause

1. Discharge notes, birth certificates, confirmations of eligibility to receive social insurance benefits, injury confirmations and death certificates issued by the health facilities within their powers and professional regulations prescribed by the Ministry of Health from July 01, 2016 to before the effective date of this Circular but their forms, dates, seals or signatures are incorrect, they shall remain valid for granting social insurance benefits.

2. The templates of the confirmation of eligibility to receive social insurance benefits, discharge note and birth certificate issued before the promulgation date of this Circular are effective until December 31, 2018.

Article 29. Terms of reference

In case the legislative documents and regulations cited in this Circular are changed or replaced, the newer ones shall apply.

Difficulties that arise during the implementation of this Circular should be promptly reported to the Ministry of Health (via the Medical Examination & Treatment Administration) for consideration./.