Tasks and powers of Health Insurance Department - Ministry of Health in Vietnam

Tasks and powers of Health Insurance Department - Ministry of Health in Vietnam (Internet image)

1. Organizational structure of Department of Health Insurance - Ministry of Health of Vietnam

- Head of Department, Health Insurance Department:

The Director and the Deputy Directors are appointed and dismissed by the Minister of Health. The Director of the Department is responsible to the Minister of Health and to the law for all activities of the Department. The Deputy Directors assist the Director and take responsibility before the Director and the law for their assigned tasks.

- Payroll of the Health Insurance Department:

The payroll of the Department of Health Insurance is determined according to the provisions of the law on employment positions and is adjusted annually according to the needs of the position decided by the Minister and at the proposal of the Director of the Health Insurance Department.

- Operation Mechanism of the Health Insurance Department:

The Department of Health Insurance operates in a specialist mode. The civil servants in the Health Insurance Department are responsible to the Health Insurance Department Leaders for their assigned tasks.

(Article 3 of Decision 2135/QD-BYT in 2023)

2. Tasks and powers of Health Insurance Department - Ministry of Health in Vietnam

Tasks and powers of the Health Insurance Department - Ministry of Health in Vietnam , include:

- Presiding over the elaboration, amendment, and supplementation of legal documents, mechanisms, and policies in the field of health insurance, submitting them to competent authorities for promulgation, and organizing the implementation according to assigned tasks.

- Assuming the prime responsibility for formulating strategies and master plans for health insurance development and submitting them to the Minister of Health for approval according to his/her competence, or submitting them to the Prime Minister for approval and organizing the implementation according to assigned tasks

- Assuming the prime responsibility for formulating, amending, and supplementing the list and payment rates and conditions for drugs, chemicals, medical supplies, medical technical services, and other medical services within the scope of benefits for health insurance participants and submitting them to the Minister of Health for promulgation.

- Presiding over the development of a common code list for medical examination and treatment management covered by health insurance; standardizing and formatting output data for medical examination and treatment management; assessment and payment of medical examination and treatment expenses covered by health insurance; regulations on extracting and transferring electronic data in the management and payment of medical examination and treatment expenses covered by health insurance; submitting them to competent authorities for promulgation; and guiding, organizing, implementing, inspecting, and supervising the implementation. .

- Presiding over, developing, and submitting to competent authorities for promulgation solutions to ensure the balance of the health insurance fund:

+ Formulating and adjusting the payment rate, support level, and method of health insurance payment;

+ Developing, amending, and supplementing the scope of benefits and the level of health insurance enjoyment in accordance with the patient's ability to pay and the health insurance fund;

+ Advising and proposing solutions to support and encourage people to participate in health insurance;

+ Advising and proposing solutions to control costs of medical examination and treatment covered by health insurance, prevention of abuse and profiteering; solutions to ensure the interests of health insurance participants and medical facilities; the implementation of advance, settlement, and payment of medical examination and treatment expenses covered by health insurance; and mechanisms for handling health insurance funds in case of overspending or surplus.

- Formulating and submitting to competent authorities for promulgation methods of payment for medical examination and treatment expenses covered by health insurance and guiding and inspecting the application of methods of payment for medical examination and treatment expenses covered by health insurance.

- Directing and guiding the implementation and inspection of medical facilities, organizations, and individuals in the implementation of the law on health insurance.

- Assuming the prime responsibility for developing contents and coordinating training, retraining, and training activities to improve management capacity and organize the implementation of activities on health insurance.

- Presiding over the development of indicators, statistical forms, and reports on health insurance in the system of indicators, statistical forms and reports of the health sector. Synthesize, monitor, evaluate, review, and summarize health insurance activities.

- Organizing the implementation of legal work, administrative reform work, and the application of information technology in state management activities in the field of health insurance; carrying out scientific research activities; international cooperation; and assigning programs and projects on health insurance.

- Participating in and coordinating with relevant units:

+ Formulating a plan for the development of the medical examination and treatment system, national policies on drugs, and other policies related to the interests of health insurance participants;

+ Developing, amending, and supplementing professional and technical regulations, medical examination, and treatment procedures; guide the diagnosis, treatment, and transfer of medical examination and treatment establishments related to medical examination and treatment covered by health insurance;

+ Building, amending, and supplementing the health financing mechanism, the price of medical examination and treatment services; the basic medical service package paid for by the health insurance fund;

+ Developing, amending, and supplementing the process, content and method of medical insurance assessment;

+ Instructing medical facilities to organize medical examination, treatment, functional rehabilitation, periodical antenatal care, and childbirth for holders of health insurance cards; propose and apply solutions to improve the quality of medical examination and treatment for holders of health insurance cards;

+ Specialized inspection, settlement of complaints, and denunciations about the implementation of policies and laws on health insurance.

- Perform other tasks assigned by the Minister of Health.

(Article 2 of Decision 2135/QD-BYT in 2023)

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