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| Ensuring the rights of health insurance participants when examining at medical facilities. (Illustration photo) |
structured, the principles of building and updating the list are built to promote the implementation of the policy of rational, safe and effective use of drugs and the development of traditional medicine. Meeting the needs of treatment with traditional medicine, in accordance with the disease model of Vietnam. Encouraging the use of herbal medicines and traditional medicines produced from domestically grown raw materials; combining traditional medicine with modern medicine.
Ensure the rights of health insurance participants, contributing to gradually reducing the direct payment rate of health insurance participants. Ensure the payment capacity of the health insurance fund in each stage. Selectively inherit the drug lists issued by the Minister of Health. Refer to the list of essential drugs of Vietnam and at the same time create conditions for the development of grassroots health care.
Regarding payment principles, the circular provisions that the health insurance fund shall pay for the costs of herbal medicines, medicines containing pharmaceutical ingredients combined with medicinal herbs, traditional medicines, medicinal herbs, and decoctions used at medical examination and treatment facilities and medicines processed and prepared by medical examination and treatment facilities themselves based on the actual quantity used for patients, the purchase price of the facility according to the provisions of the law on bidding, the cost of loss during the process of preservation, transportation, dispensing, preparation, weighing, division, and using drugs according to the regulations of the Minister of Health and other costs (if any) within the scope of benefits and levels of enjoyment according to the provisions of the law on health insurance.
For management costs and depreciation costs of machinery for medicinal materials and drugs self-processed and prepared by medical examination and treatment facilities as prescribed in this Circular, the health insurance fund shall pay according to the roadmap for adjusting the components of the price of medical examination and treatment services covered by health insurance and shall be applied at the same time as the price of medical examination and treatment services covered by health insurance as prescribed.
The health insurance fund pays for herbal medicines, traditional medicines, medicines that combine active ingredients with medicinal herbs listed in the list of traditional medicines within the scope of benefits for health insurance participants or according to the name of the drug ingredients in case the drug ingredients have different names.
In addition, the circular also specifically regulates payment for traditional medicines; payment for herbal medicines; payment for prepared medicines self-processed and prepared by medical examination and treatment facilities; and medicines paid for in special cases.
The Circular also clearly stipulates that the health insurance fund will not pay for drugs or batches of drugs that have been suspended from circulation or recalled by authorized authorities; Drug that has been included in the price of medical examination and treatment services or the total price collected per case according to current regulations; Part of the drug cost is covered by the state budget or other funding sources.
This Circular will take effect from September 1, 2025.
According to People's Electronic
Source: https://baotuyenquang.com.vn/xa-hoi/y-te/202507/thanh-toan-bao-hiem-y-te-doi-voi-thuoc-y-hoc-co-truyen-duoc-lieu-2c778a0/
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