Law amending Law on Health Insurance, Law No. 46/2014/QH13

ORDER

On the promulgation of law[1]

THE PRESIDENT OF THE SOCIALIST REPUBLIC
OF VIETNAM

Pursuant to Articles 88 and 91 of the Constitution of the Socialist Republic of Vietnam;

Pursuant to Article 91 of the Law on Organization of the National Assembly;

Pursuant to Article 57 of the Law on Promulgation of Legal Documents,

PROMULGATES

The Law Amending and Supplementing a Number of Articles of the Health Insurance Law,

Which was passed on June 13, 2014, by the XIII^th National Assembly of the Socialist Republic of Vietnam at its 7^th session.

President of the Socialist Republic of Vietnam
TRUONG TAN SANG

Law

Amending and Supplementing a Number of Articles of the Health Insurance Law[2]

Pursuant to the Constitution of the Socialist Republic of Vietnam;

The National Assembly promulgates the Law Amending and Supplementing a Number of Articles of Law No. 25/2008/QH12 on Health Insurance.

Article 1.

To amend and supplement a number of articles of the Health Insurance Law:

1. To amend and supplement Clause 1; and add Clauses 7 and 8 to, Article 2 as follows:

“1. Health insurance is a form of compulsory insurance applied to target groups prescribed in this Law for healthcare and non-profit purposes, the implementation of which is organized by the State.”

“7. Household participating in health insurance (below referred to as household) consists of all persons named in the household registration book or temporary residence book.

8. Health insurance-covered basic medical service package means essential healthcare services suitable to the health insurance fund’s payment capacity.”

2. To amend and supplement Clauses 2 and 3, Article 3 as follows:

“2. Levels of health insurance premiums shall be determined in percentage of the salary which serves as the basis for payment of compulsory social insurance as prescribed by the Social Insurance Law (below referred to as monthly salary), pension, allowance or basic salary.

3. Levels of health insurance benefits shall be based on the seriousness of sickness and category of the insured within the scope of benefits and health insurance payment duration.”

3. To amend and supplement Clause 3; and add Clause 10 to, Article 6 as follows:

“3. Promulgating professional and technical regulations, medical care process and treatment guidance and patient transferal to hospitals of different levels relating to health insurance-covered medical care;

“10. Promulgating the health insurance-covered basic medical service package.”

4. To add Articles 7a, 7b and 7c to Article 7 as follows:

“Article 7a. Responsibilities of the Ministry of Labor, War Invalids and Social Affairs

1. To direct, guide and organize the identification and management of persons under its management prescribed at Points d, e, g, h, i and k, Clause 3, and Clause 4, Article 12 of this Law.

2. To inspect and examine employers and employees in observing law regarding the responsibility to participate in health insurance prescribed in Clause 1, Article 12 of this Law and persons under its management prescribed at Points d, e, g, h, i and k, Clause 3, and Clause 4, Article 12 of this Law.

Article 7b. Responsibilities of the Ministry of Education and Training

1. To direct, guide and organize the identification and management of persons under its management prescribed at Point n, Clause 3, and Point b, Clause 4, Article 12 of this Law.

2. To inspect and examine persons under its management prescribed at Point n, Clause 3, and Point b, Clause 4, Article 12 of this Law, in observing law regarding the responsibility to participate in health insurance.

3. To assume the prime responsibility for, and coordinate with the Ministry of Health and related ministries and sectors in, guiding the establishment and consolidation of the school health system for primary healthcare for children, pupils and students.

Article 7c. Responsibilities of the Ministry of National Defense and the Ministry of Public Security

1. To direct, manage, guide and organize the identification, management and health insurance listing for persons under their management prescribed at Point a, Clause 1, Points a and n, Clause 3, and Point b, Clause 4, Article 12 of this Law.

2. To make lists of persons prescribed at Point l, Clause 3, Article 12 of this Law for request for grant of health insurance cards and provide these lists to health insurance institutions.

3. To inspect and examine persons under their management prescribed at Point a, Clause 1, Points a and n, Clause 3, and Point b, Clause 4, Article 12 of this Law in observing law regarding the responsibility to participate in health insurance.

4. To coordinate with the Ministry of Health and related ministries and sectors in guiding medical care establishments of the Ministry of National Defense and the Ministry of Public Security in signing health insurance-covered medical care contracts with health insurance institutions for medical examination and treatment for the insured.”

5. To amend and supplement Clause 2; and add Clause 3 to, Article 8 as follows:

“2. Apart from the responsibilities defined in Clause 1 of this Article, provincial-level People’s Committees shall direct the formation of the apparatus and resources to perform the state management of health insurance in their localities and manage and use funding sources under Clause 3, Article 35 of this Law.

3. Apart from the responsibilities defined in Clause 1 of this Article, People’s Committees of communes, wards and townships (below referred to as commune-level People’s Committees) shall make lists of the insured prescribed in Clauses 2, 3, 4 and 5, Article 12 of this Law in their localities by household, except those prescribed at Points a, l and n, Clause 3, and Point b, Clause 4, Article 12 of this Law. Commune-level People’s Committees shall make lists of children proposed for grant of health insurance cards concurrently with the grant of birth certificates.”

6. To amend and supplement Article 12 as follows:

Article 12. Target groups of health insurance

1. Persons whose health insurance premiums are paid by employees and employers, including:

a/ Laborers working under indefinite-term labor contracts or labor contracts of full three-month or longer term; salaried corporate managers; cadres, civil servants and employees (below collectively referred to as employees);

b/ Persons working on a part-time basis in communes, wards and townships as prescribed by law.

2. Persons whose health insurance premiums are paid by social insurance institutions, including:

a/ Persons on monthly pension or working capacity loss allowance;

b/ People on monthly social insurance allowance for labor accidents, occupational diseases or diseases on the list subject to long-term treatment; persons aged full 80 or older on monthly survivor allowance;

c/ Commune, ward or township cadres who have stopped working and are on monthly social insurance allowance;

d/ Persons on unemployment allowance.

3. Persons whose health insurance premiums are paid by the state budget, comprising:

a/ Officers, career army men, non-commissioned officers and soldiers on service; professional officers and non-commissioned officers and specialized and technical officers and non-commissioned officers who are working in the people’s public security force; people’s public security trainees, non-commissioned officers and policemen serving in the people’s public security force on a definite term; persons doing cipher work who are salaried as for army men; trainee cipher officers entitled to regimes and policies applicable to trainees of army and public security schools;

b/ Commune, ward or township cadres who have stopped working and are receiving monthly allowances from the state budget;

c/ Persons who have stopped receiving working capacity loss allowances and are receiving monthly allowances from the state budget;

d/ Persons with meritorious services to the revolution, war veterans;

dd/ Incumbent National Assembly deputies and People’s Council deputies at all levels;

e/ Under-six children;

g/ Persons entitled to monthly social insurance allowance;

h/ Members of poor households; ethnic minority people living in areas with difficult or exceptionally difficult socio-economic conditions; persons living in areas with exceptionally difficult socio-economic conditions; persons living in island communes and districts;

i/ Relatives of people with meritorious services to the revolution being natural parents, spouses or children of fallen heroes; persons raising fallen heroes;

k/ Relatives of people with meritorious services to the revolution other than those defined at Point i of this Clause;

l/ Relatives of the persons prescribed at Point a, Clause 3 of this Article;

m/ Persons who have donated parts of their bodies in accordance with law;

n/ Foreigners studying in Vietnam who are granted scholarships from the Vietnamese State’s budget.

4. Persons whose health insurance  premiums are paid with the state budget support, including:

a/ Members of households living just above the poverty line;

b/ Pupils and students.

5. Persons paying health insurance premiums by household, including household members other than those defined in Clauses 1, 2, 3 and 4 of this Article.

6. The Government shall define target groups other than those prescribed in Clauses 3, 4 and 5 of this Article; prescribe the grant of health insurance cards to persons managed by the Ministry of National Defense and the Ministry of Public Security and persons defined at Point l, Clause 3 of this Article; and the roadmap for health insurance implementation, the scope and levels of health insurance benefits, health insurance-covered medical care, management and use of funds for health insurance-covered medical care, health insurance assessment and health insurance payment and settlement for the persons defined at Point a, Clause 3 of this Article.”

7. To amend and supplement Article 13 as follows:

“Article 13. Health insurance premium rates and responsibility to pay health insurance premiums

1. Health insurance premium rates and responsibility to pay health insurance premiums are prescribed as follows:

a/ The monthly premium rate applicable to the persons defined at Point a, Clause 1, Article 12 of this Law equals up to 6% of the monthly salary, with the employer paying two -thirds of the amount and the employee, one-third. In the period when an employee takes maternity leave in accordance with the law on social insurance, the monthly premium rate equals up to 6% of the employee’s monthly salary before she takes maternity leave and shall be paid by the social insurance institution;

b/ The monthly premium rate applicable to the persons defined at Point b, Clause 1, Article 12 of this Law equals up to 6% of the basic salary, with the employer paying two-thirds of the amount, and the employee, one-third;

c/ The monthly premium rate applicable to the persons defined at Point a, Clause 2, Article 12 of this Law equals up to 6% of the pension or working capacity loss allowance and shall be paid by the social insurance institution;

d/ The monthly premium rate applicable to the persons defined at Points b and c, Clause 2, Article 12 of this Law equals up to 6% of the basic salary and shall be paid by the social insurance institution;

dd/ The monthly premium rate applicable to the persons defined at Point d, Clause 2, Article 12 of this Law equals up to 6% of the unemployment allowance and shall be paid by the social insurance institution;

e/ The monthly premium rate applicable to the persons defined at Point a, Clause 3, Article 12 of this Law equals up to 6% of the monthly salary, for salaried persons, and up to 6% of the basic salary, for persons on subsistence allowance, and shall be paid by the state budget;

g/ The monthly premium rate applicable to the persons defined at Points b, c, d, dd, e, g, h, i, k, l and m, Clause 3, Article 12 of this Law equals up to 6% of the basic salary and shall be paid by the state budget;

h/ The monthly premium rate applicable to the persons defined at Point n, Clause 3, Article 12 of this Law equals up to 6% of the basic salary and shall be paid by the scholarship-awarding agencies, organizations or units;

i/ The monthly premium rate applicable to the persons defined in Clause 4, Article 12 of this Law equals up to 6% of the basic salary and shall be paid by these persons with the state budget supporting part of this payment;

k/ The monthly premium rate applicable to the persons defined in Clause 5, Article 12 of this Law equals up to 6% of the basic salary and shall be paid by these persons by household.

2. In case a person concurrently belongs to different categories defined in Article 12 of this Law, he/she shall pay health insurance premiums like those in the first category which he/she belongs to in the order prescribed in Article 12 of this Law.

In case a person defined at Point a, Clause 1, Article 12 of this Law additionally has one or more than one indefinite-term labor contract or labor contract of full 3-month or longer term, he/she shall pay health insurance premiums according to the contract with the highest salary.

A person defined at Point b, Clause 1, Article 12 of this Law who belongs to different categories defined in Article 12 of this Law shall pay health insurance premiums in the following order: paid by the social insurance institution, by the state budget, by the insured and by the commune-level People’s Committee.

3. All household members prescribed in Clause 5, Article 12 of this Law shall pay health insurance premiums. The premium rate shall be reduced from the second member onward, specifically as follows:

a/ The rate applicable to the first person equals up to 6% of the basic salary;

b/ The rates applicable to the second, third and fourth persons equal respectively 70%, 60% and 50% of the rate paid by the first person;

c/ The rate applicable to the fifth person onward equals 40% of the rate paid by the first person.

4. The Government shall specify premium and support rates prescribed in this Article.”

8. To amend and supplement Clauses 4 and 5, Article 14 as follows:

“4. Other persons shall pay health insurance premiums based on the basic salary.

5. The maximum monthly salary used for calculation of health insurance premiums is 20 times the basic salary.”

9. To amend and supplement Article 15 as follows:

“Article 15. Methods of payment of health insurance premiums

1. Monthly, employers shall pay health insurance premiums for employees and concurrently make health insurance premium deductions from the latter’s salaries for payment to the health insurance fund.

2. For agricultural, forestry, fishery and salt-making enterprises which do not pay salaries on a monthly basis, every 3 or 6 months, employers shall pay health insurance premiums for employees and concurrently make health insurance premium deductions from the latter’s salaries for payment to the health insurance fund.

3. Monthly, social insurance institutions shall pay health insurance premiums to the health insurance fund according to Points c, d and dd, Clause 1, Article 13 of this Law.

4. Quarterly, scholarship-awarding agencies, organizations and units shall pay health insurance premiums to the health insurance fund according to Point h, Clause 1, Article 13 of this Law.

5. Quarterly, the state budget shall transfer to the health insurance fund the health insurance premiums paid and supported according to Points e, g and i, Clause 1, Article 13 of this Law.

6. Every 3, 6 or 12 months, representatives of households, organizations and individuals shall fully pay health insurance premiums to the health insurance fund.”

10. To amend and supplement Clauses 3 and 5, Article 16 as follows:

“3. The validity time of a health insurance card is prescribed as follows:

a/ For a person defined in Clause 1, 2 or 3, Article 12 of this Law who pays health insurance premiums for the first time, his/her health insurance card is valid on the date of payment of health insurance premiums;

b/ For a person who pays health insurance premiums continuously from the second time onward, his/her health insurance card is valid following the expiry date of the previous card;

c/ For a person defined in Clause 4 or 5, Article 12 of this Law who pays health insurance premiums on the effective date of this Law or fails to pay health insurance premiums continuously for 3 months or more in a fiscal year, his/her health insurance card is valid 30 days after the date of payment of health insurance premiums;

d/ For a under-6 child, his/her health insurance card is valid until he/she reaches full 72 months of age. For a child who reaches full 72 months of age before a school year starts, his/her health insurance card is valid till September 30 of that year.”

“5. Health insurance institutions shall issue the form of health insurance cards after obtaining agreement of the Ministry of Health.”

11. To amend and supplement Article 17 as follows:

“Article 17. Grant of health insurance cards

1. A dossier of request for grant of a health insurance card comprises:

a/ A written registration of health insurance participation by an organization or individual or a household, for those paying health insurance premiums for the first time;

b/ A list of the insured defined in Clause 1, Article 12 of this Law, made by the employer.

Lists of the insured defined in Clauses 2, 3, 4 and 5, Article 12 of this Law shall be made by household by commune-level People’s Committees, except for those defined at Points a, l and n, Clause 3, and Point b, Clause 4, Article 12 of this Law.

Lists of the insured managed by the Ministry of Education and Training and the Ministry of Labor, War Invalids and Social Affairs as prescribed at Point n, Clause 3, and Point b, Clause 4, Article 12 of this Law shall be made by education and training institutions and vocational training institutions.

Lists of the insured managed by the Ministry of National Defense and the Ministry of Public Security as prescribed at Point a, Clause 1, Points a and n, Clause 3, and Point b, Clause 4, Article 12 of this Law and lists of the insured prescribed at Point l, Clause 3, Article 12 of this Law shall be made by the Ministry of National Defense and the Ministry of Public Security.

2. Within 10 working days after receiving a complete dossier prescribed in Clause 1 of this Article, the health insurance institution shall send  health insurance card to the agency or organization managing the insured or to the insured.

3. The health insurance institution shall issue the form of the dossier prescribed in Clause 1 of this Article after obtaining the Ministry of Health’s agreement.”

12. To amend and supplement Clauses 3 and 4, Article 18 as follows:

“3. Within 7 working days after receiving a written request for re-grant of a card, the health insurance institution shall re-grant the card to the insured. Pending the re-grant of a card, the insured is still entitled to health insurance benefits.

4. A person who is re-granted a health insurance card shall pay a charge. The Minister of Health shall set charge rates for the re-grant of health insurance cards. A person who is re-granted a health insurance card is not required to pay a charge when the re-grant is due to the fault of the health insurance institution or the list-making agency.”

13. To add Point c to Clause 1, Article 20 as follows:

“c/ Health insurance cards are granted coincidentally.”

14. To annul Point b, Clause 1, Article 21; and amend and supplement Point c, Clause 1, and Clause 2, Article 21 as follows:

“b/ Transferal of patients from district hospitals to higher-level hospitals, for persons defined at Points a, d, e, g, h and i, Clause 3, Article 12 of this Law in case of emergency or for inpatients who need technical transferal.

2. The Minister of Health shall assume the prime responsibility for, and coordinate with related ministries and sectors in, promulgating lists and rates of, and payment conditions for, medicines, chemicals, medical supplies and technical medical services to be enjoyed by the insured.”

15. To amend and supplement Article 22 as follows:

“Article 22. Levels of health insurance benefits

1. An insured who uses medical care services under Articles 26, 27 and 28 of this Law has medical care costs covered by the health insurance fund within the scope of benefits at the following levels:

a/ 100% of the costs, for the persons defined at Points a, d, e, g, h and i, Clause 3, Article 12 of this Law. Medical care costs outside the scope of health insurance benefits of the persons defined at Point a, Clause 3, Article 12 of this Law shall be paid with the funds for health insurance-covered medical care for these persons. In case these funds are insufficient, such costs shall be paid by the state budget;

b/ 100% of the costs, for cases in which the cost of a check-up is below the level prescribed by the Government and for medical care provided at the commune level;

c/ 100% of the costs, when patients have paid health insurance premiums for 5 consecutive years or more and have the costs paid for medical care in the year higher than the basic salaries of 6 months, except cases of medical care at health insurance-covered hospitals of improper levels;

d/ 95% of the costs, for the persons defined at Point a, Clause 2, Point k, Clause 3, and Point a, Clause 4, Article 12 of this Law;

dd/ 80% of the costs, for other persons.

2. A person who belongs to different categories of the insured may enjoy health insurance benefits under the category with the highest benefits.

3. A health insurance card holder who receives medical care at a health insurance-covered hospital of an improper level may be paid by the health insurance fund at the levels of benefits prescribed in Clause 1 of this Article at the following rates, except for the case prescribed in Clause 5 of this Article:

a/ At central-level hospitals, 40% of the costs for inpatient treatment;

b/ At provincial-level hospitals, 60% of the costs for inpatient treatment from the effective date of this Law to December 31, 2020; and 100% of the costs for inpatient treatment from January 1, 2021 nationwide;

c/ At district-level hospitals, 70% of the costs for medical care from the effective date of this Law to December 31, 2015; and 100% of the costs for medical care from January 1, 2016.

4. From January 1, 2016, the insured that register primary medical care at commune-level health centers, polyclinics or district-level hospitals may receive health insurance-covered medical care at the levels of benefits prescribed in Clause 1 of this Article at commune-level health centers, polyclinics or district-level hospitals in the same province.

5. When receiving medical care at health insurance-covered hospitals of improper levels, the insured being ethnic minority people and members of poor households who are living in areas with difficult or exceptionally difficult socio-economic conditions; and the insured who are living in island communes or districts may be paid by the health insurance fund for medical care costs at district-level hospitals, and for inpatient treatment costs at provincial-level hospitals at the levels of benefits prescribed in Clause 1 of this Article.

6. From January 1, 2021, the health insurance fund shall pay inpatient treatment costs at the levels of benefits prescribed in Clause 1 of this Article for the insured who receive medical care at improper provincial-level medical care providers nationwide.

7. The Government shall specify levels of benefits for health insurance-covered medical care in adjacent areas, for medical care upon request, and other cases not prescribed in Clause 1 of this Article.”

16. To annul Clauses 10 and 12, Article 23; to amend and supplement Clauses 7 and 9, Article 23 as follows:

“7. Treatment of squint, short-sightedness and eye refractive defects, except for under-six children.”

“9. Medical care and function rehabilitation in case of disasters.”

17. To amend and supplement Article 24 as follows:

“Article 24. Health insurance-covered medical care providers

A health insurance-covered medical care provider is a health establishment prescribed by the Law on Medical Examination and Treatment which signs a medical care contract with the health insurance institution.”

18. To amend and supplement Point a, Clause 2, and Clause 4, Article 25 as follows:

“a/ Service beneficiaries and requirements on scope of service provision; expected number of cards and structure of the insured for health insurance-covered primary medical care providers.”

“4. The Ministry of Health shall assume the prime responsibility for, and coordinate with the Ministry of Finance in, providing a model contract on health insurance-covered medical care.”

19. To amend and supplement Point a, Clause 1, Article 30 as follows:

“a/ Rate-based payment, which means payment at the fixed premium rate within the scope of services for a card registered with a medical care service provider for a certain period;”

20. To amend and supplement Clause 2; and add Clause 5 to, Article 31 as follows:

“2. The health insurance institution shall pay medical care costs directly to health insurance card holders who use medical care services in the following cases:

a/ At a medical care provider which has no health insurance-covered medical care contract;

b/ The medical care is provided not in accordance with Article 28 of this Law;

c/ Other special cases prescribed by the Minister of Health.”

“5. The Minister of Health shall assume the prime responsibility for, and coordinate with the Minister of Finance in, setting uniform prices of health insurance-covered medical care services among hospitals of the same grade nationwide.”

21. To amend and supplement Article 32 as follows:

“Article 32. Advance, payment and settlement of costs of health insurance-covered medical care

1. The health insurance institution shall quarterly advance funds to health insurance-covered medical care providers as follows:

a/ Within 5 working days after receiving a health insurance-covered medical care provider’s settlement report of the preceding quarter, the health insurance institution shall advance once funds equal to 80% of the costs of health insurance-covered medical care according to this report;

b/ A medical care provider which signs a health insurance-covered medical care contract for the first time and has a health insurance-covered primary medical care registration certificate may receive an advance equal to 80% of the funds to be used at the medical care provider according to the health insurance institution’s notice at the beginning of a period. In case the medical care provider has no health insurance-covered primary medical care registration certificate, based on the book on medical care expenditures after one month of contract performance, the health insurance institution shall estimate and advance 80% of the medical care costs in the quarter;

c/ In case funds advanced to health insurance-covered medical care providers in a province exceed the funds permitted for use in a quarter, the provincial-level health insurance institution shall report such to Vietnam Social Security for addition of funds.

2. A health insurance-covered medical care provider and a health insurance institution shall make payment and settlement as follows:

a/ Within the first 15 days of each month, the health insurance-covered medical care provider shall send to the health insurance institution a summary request for payment of health insurance-covered medical care costs of the preceding month; within the first 15 days of each quarter, the health insurance-covered medical care provider shall send to the health insurance institution a report on settlement of health insurance-covered medical care costs of the preceding quarter;

b/ Within 30 days after receiving the medical care provider’s settlement report of the previous quarter, the health insurance institution shall notify the latter of the assessment result and the settled health insurance-covered medical care costs, which cover actual medical care costs within the scope and levels of health insurance benefits;

 c/ Within 10 days after notifying the settled health insurance-covered medical care costs, the health insurance institution shall complete payment to the medical care provider;

d/ The appraisal of annual settlement for the health insurance fund and payment of unused funds (if any) for provinces and centrally run cities must be conducted before October 1 of the subsequent year.

3. Within 40 days after receiving a complete dossier of request for payment from an insured who receives medical care according to Clause 2, Article 31 of this Law, the health insurance institution shall pay the medical care costs directly to that person.”

22. To amend and supplement Clause 1; to add Clause 3 to, Article 34 as follows:

“1. The health insurance fund shall be managed in a centralized, uniform, public and transparent manner with management decentralization within the system of health insurance institutions.

The Vietnam Social Insurance Management Council as prescribed in the Social Insurance Law shall manage the health insurance fund and advise on health insurance policies.”

“3. The Government shall annually report before the National Assembly on management and use of the health insurance fund.”

23. To amend and supplement Article 35 as follows:

“Article 35. Distribution and use of the health insurance fund

1. The health insurance fund shall be distributed and used as follows:

a/ 90% of health insurance premiums shall be used for medical care;

b/ 10% of health insurance premiums shall be used for setting up a provision fund and for costs of management of the health insurance fund, including at least 5% for the provision fund.

2. The temporarily idle money of the health insurance fund may be used for investment in the forms prescribed by the Social Insurance Law. The Vietnam Social Insurance Management Council shall decide on and take responsibility before the Government for the forms and structure of investment of the health insurance fund at the proposal of Vietnam Social Security.

3. In case a province’s or centrally run city’s collected health insurance premiums are higher than paid medical care costs in a year, after its settlement report is appraised by Vietnam Social Security, the unused funds shall be distributed according to the following roadmap:

a/ From the effective date of this Law through December 31, 2020, 80% of the funds shall be transferred to the provision fund and 20% to the locality for use in the following order of priority:

Supporting the fund for medical care for the poor; supporting payment of health insurance premiums for a number of target groups suitable to local socio-economic conditions; procuring medical equipment suitable to capacity and qualifications of health workers; procuring vehicles for patient transferal at the district level.

Vietnam Social Security shall transfer 20% of the unused funds to a locality within 1 month after it appraises the settlement report of that locality.

Within 12 months after Vietnam Social Security appraises a settlement report, the unused funds shall be transferred to the provision fund;

b/ From January 1, 2021, all unused funds shall be accounted into the provision fund for general balancing.

4. In case a province’s or centrally run city’s collected health insurance premiums are lower than paid medical care costs in a year, after appraising the settlement report, Vietnam Social Security shall supplement the whole different amount from the provision fund.

5. The Government shall detail Clause 1 of this Article.”

24. To amend and supplement Clause 2, Article 36 as follows:

“2. To pay health insurance premiums by household at health insurance agents nationwide; to select a health insurance-covered primary care provider under Clause 1, Article 26 of this Law.”

25. To amend and supplement Clauses 2 and 10, Article 41 as follows:

“2. To organize household-based payment of health insurance premiums at health insurance agents in a convenient manner for the persons defined in Clause 5, Article 12 of this Law. To guide health insurance participation registration dossiers, procedures and places and organize the implementation of health insurance regimes in a quick, simple and convenient manner for the insured. To scrutinize, summarize and certify lists of the insured to avoid coincident grant of health insurance cards to the persons defined in Article 12 of this Law, except for persons managed by the Ministry of National Defense and the Ministry of Public Security.”

“10. To archive health insurance files and data in accordance with law; to determine the time of health insurance payment to ensure benefits for the insured; to apply information technology to health insurance management and establish a national database on health insurance.”

26. To amend and supplement Clause 2 of; to add Clauses 7 and 8 to, Article 43 as follows:

“2. To provide patient files and records and documents on medical care and pay medical care costs of the insured at the request of health insurance institutions and competent state agencies. For dossiers of request for direct payment, within 5 working days after receiving a health insurance institution’s request, to provide patient files and records and documents on medical care of the insured.”

“7. To make statements of health insurance-covered medical care costs and take responsibility before law for the lawfulness and accuracy of these statements.

8. To provide statements of medical care costs for the insured upon request.”

27. To amend and supplement Clause 3, Article 45 as follows:

“3. To join the supervision of enforcement of the health insurance law, to urge employers to pay health insurance premiums for employees, to participate in the settlement of cases of shirking or delaying health insurance premium payment.”

28. To amend and supplement Article 49 as follows:

 “Article 49. Handling of violations

1. A person who violates this Law and other laws related to health insurance shall, depending on the nature and severity of his/her violations, be disciplined, administratively sanctioned or examined for penal liability, and, if causing damage, shall pay compensation in accordance with law.

2. An agency or organization that violates this Law and other laws related to health insurance shall be administratively sanctioned, and, if causing damage, shall pay compensation in accordance with law.

3. Agencies, organizations or employers that are liable to pay health insurance premiums but fail to pay or fully pay them as prescribed by law shall be handled as follows:

a/ They shall fully pay the unpaid amount and the interest, which equals 2 times the interbank interest rate, on the amount and period of late payment; if failing to do so, upon request of competent persons, banks or other credit institutions or the state treasury shall make deductions from deposit accounts of these agencies, organizations or employers to pay the unpaid amount, arrears and interests on these arrears into the account of the health insurance fund;

b/ They shall refund employees all costs within the scope and levels of health insurance benefits which have been paid by employees during the period they do not have health insurance cards.”

Article 2.

1. This Law takes effect on January 1, 2015.

2. The Government shall detail articles and clauses as assigned in the Law.

This Law was passed on June 13, 2014, by the XIII^th National Assembly of the Socialist Republic of Vietnam at its 7^th session.-

Chairman of the National Assembly
NGUYEN SINH HUNG