Tuesday, May 30 2017

VietNamNews

Health insurance abuses rampant

Update: April, 15/2017 - 09:00
Patients wait for health check ups at the Hòa Bình General Hospital. – VNA/VNS Photo Dương Ngọc
Viet Nam News

Gia Lộc

HCM CITY — A 47-year-old patient from HCM City’s District 8 visited several hospitals in the city for health examination and treatment a total of 162 times in the last quarter of last year.

In the first quarter of this year, he has visited hospitals 51 times.

Lưu Thị Thanh Huyền, deputy head of the city-based Social Insurance Agency, said the health insurance fund for medical check-ups and treatments covered VNĐ40.3 million (US$1,768) for his care in the two quarters.

He had the highest number of visits for examination and treatment, Huyền said, adding that he was one of three insured patients to misuse the insurance fund in the first quarter.

Huyền said that the three patients were required to commit that they will not abuse the service again.

Under the Health Insurance Law, violators are fined VNĐ500,000 to VNĐ40 million, and can even be imprisoned for misusing health insurance.

The number of the insured people in the city has reached 78 per cent, according to Huyền.

Misuse of the fund has been occurring in the city as well as provinces and other cities.

Nearly 100 insured patients in the country visited hospitals for health examination and treatment 50 times or more in last year’s fourth quarter, according to Việt Nam Social Insurance Agency.

At a National Assembly meeting on insurance held last month, Minister of Health Nguyễn Thị Kim Tiến said that health isurance misuse had occurred since health facilities had not controlled health insurance cardholders.

This was because since 2015, health insurance policies have had many changes, including regulations that allow patients to now visit more than one hospital for treatment. In the past, only one hospital was designated for treatment, and it was listed on their health insurance card.

They can now go to any district-level hospital or private hospital in the country and have the same benefits.

Huyền of the city’s Social Insurance Agency said that thanks to the new regulation, insured patients can visit many different hospitals in the city for health examination and treatment.

“In face of the situation, the agency has sent data and files relating to misuse of the health insurance fund to the city police for further investment,” she added.

It also instructed hospitals to frequently update and check patients’data on the health insurance medical information assessment system which was launched last year.

However, after the launch of the system, many hospitals did not check patients’ records regularly, Huyền said.

"If they check, they can discover if patients have visited other hospitals.

“We don’t pay the cost for health examination and treatment of insured patients at hospitals that have not updated or checked the patient data on the system,” she said.

At the National Assembly meeting on insured health, Deputy Prime Minister Vũ Đức Đam, said that of 12,000 health facilities in the country, only 60 per cent were connected the health insurance medical information assessment system.

Only 30 per cent have updated insured patients’ data every day, Đam said, adding that healthcare officials and staff must begin to take this activity seriously. — VNS

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