Vietnam amends health, social insurance guidelines

Authorities have revised regulations on medical examination and treatment.

Vietnam has amended several articles on its health and social insurance laws, including the elimination of referral procedures for rare and serious diseases and new regulations on medical examination and treatment.

New laws and amendments were passed in November 2024 and January 2025.

The Vietnam Social Security (VSS) held a conference on 9 January 2025 to discuss new decrees and circulars, as well as key tasks for the 2025 health insurance policy, according to a press release posted on the VSS website.

Amongst those discussed were the amendments and supplements to the subjects of participation and health insurance contributions; revisions to regulations on medical examination and treatment according to technical specialisation levels; and elimination of referral procedures for certain rare and serious diseases.

The conference also discussed the additional responsibilities for the Ministry of Health (MOH) in regulating the evaluation of the reasonableness of providing medical examination and treatment services; and additional responsibilities for the social security offices in checking health insurance-based medical examination and treatment contracts.

Participants also discussed new regulations, including those on the implementation roadmap and benefit rates for outpatient medical examination and treatment at grassroots-level medical facilities; regulations allowing private medical facilities to apply health insurance-based medical examination and treatment service prices of public medical facilities according to the level of technical specialization; and regulations on payment of medical examination and treatment service costs at state-owned medical facilities.

In particular, the payments are for service lists approved by competent agencies but have not had their prices approved by competent authorities.

During the conference, Deputy Director General Nguyen Duc Hoa urged VSS to ensure the rights of health insurance participants when accessing medical care.

He also reminded officials to strictly and correctly implement the provisions of the Law on Health Insurance and related government decrees.

He also reportedly called for innovating and enhancing the effectiveness and efficiency of medical claim review, ensuring adherence to the review process, strict control of health insurance-based medical care costs, and resolutely refusing payment for medical expenses that do not comply with regulations.