part1. legaldocuments orderno. 2312m81l-cl'n of november 28,2(mnri (lie promulgationofla ·...

Part 1 . LEGAL DOCUMENTS

11111 ;; S'FA'Hs'_ PRES1D1?N1'

Order No. 2312M81L-C"l'N of November28, 2(M nri (lie promulgation of law

1'H1 : PRI::SIf)FN'1' C)N"1'HE SOCIALIST'=RF1ItJ13LIC OF VI1;TN.AM

Pursuit to Articles 103 amt 106 of the 1992Constitutirm of tlic Sor irilisi Relxrhlic of Wemam,which lvra. alnemlcrl rmcl .st1111r1c'lrrrntr." rt wulerResolrrlioik .No- 511201711()1110 of- Dec rinher 25,2001,11f'theX'r' NalionulAsm,mb1k the 7f, sessi(111 ;

Pursm4w to Article 91 of the Law onOrganization of flit" Nolioital Axsernhlv;

Purcurorl to Arlirle 701 of the Laic on the1'r -olrrrrl,~~rrtiall of 1.rgal 0ocamen1s,

f'IZOMt!I_GNFFS :

the Law on Health Insurance,

which was passed on NovernIxer 14, 2(X)8. bythe X11`" National Assembly of the SocialistRepublic of Vietnam at its 411' session.

Prrsirlenl ofthe Socialist Kclmhlit of 1"'icti1r1111

N(;IJYEN MI NII TRI1 h

Law on Health Insurance

(No. 251200,V01112)

Parrsroint to tire

1992 Consiitrr1ion ofI theSocialist Rrl,ulAt - rrf 1ienram, u hip h ilya .s ulne1xkrl

OFFICIAL GAZETTE

QH101:

_Iss ue nos 09-10IMarch 2009(Cong Bao nos 147-J481hlarch 14, 2009)4

awl sulrldemenletl utirh ,r Rc.whainn No . ? 912001/

Die 1Vaiional Assembl1' I71(lmul,~alcs the Lrav1117 11collh 11murance.

Cazryller 1

GENERALPR{)VISIONS

Article 1. Governing scol7L and SL1hjCC tS Ofapplication

I . This Law provides the health insurancerc;ime and policies . inCILlLli11" participants .premium rates, responsibilities and methods of'payment of health insurance pi -cinlunis, healiliinsurance carols ; eligible health insurancehenelicMiles ; rtieclicaI care for the Insured ; payineiitof cask ol' medical care covered by healthinsurance ; health insurancc fund : and rights andresponsibilities of parties involved in healthinsurance.

2. This Law applies to domestic and foreignorganizations and individuals in Vietn;irn that areinvolved in health insurance .

~ . This Law does not apply to ccnrlinorcialhealth insurance.

Article 2. Interpretation of testis

In this Law, the terms below are construccl asfol lows-

I . 11ralth insurrince is a lorni of insuranceapplied in the health care sector for noel-profitpurposes . organized by the State and joined byresponsible persons under this Law.

2. A11-heoplu health insurance means healthiiistlrance joined by all persoris prescribed iii thisf 'aw.

3. 11calth insurance fulrrl means a linanLlalfacility set lip from Health insurance pronminpayments and otlicr lawful collections . which i5

used to cover costs of medical care for the insured.

0 VIETNAM LAW & LEGAL FORUM

_Issue nos t}9-10IMarch 2009[Cdrrg Bjo nos 141-1481March 14. 2009]

itiaiia ,_, erial costs of health insurance institutionsand other lawful costs related to health insurance .

4. 1)rrhloYer v IiicItide state at,Gncies . public noi1-bitsiness units, pe.ople's armed forces units . politicalomaniistions . scx:io-political organizations, sex in-political-professional organizations . socialorganizations . socio-professional organizations .enterprises, cooperatives . individual businesshouseholds and other organizations ; forci-norganizations, and international organizationsop-rating in tlic Vietnamese territory . which areresponsible for making health insurancecorttr~'~utinns .

? . 11ralrh irr .sur-(irr( - r,-cover -c!rl l)rirriat_v careI)rmvder means the first medical examination andtreatincrit establishment registered by 'an insuredrind indicated in the health insurance card .

*

G . Health in.mrance assessmew meansprofessional activities conducted by a healthIIsru -aizce institution to evaluate the reasonablenesstf medical care services provided to an insured .serving as a basis for the payrrtent ofcosts of healthinsurance-covered medical care .

Article 3 . Health insurance principles

1 . Ensuriit

the sharing of- risks among theinsured .

2 . Health insurance premiums shall hedetermined in percentage of wage . remuneration,pension . allowance or mmirnum salary in theadministrative sector (below referred to as therninirnum salary) .

3 . Health insurance benefits shall he based on(tie seriousness of sickness and category ofbeneficiaries within the scope of the insured'sbi ;rtcfits.

4. Costs of health insurance-covered medicalcare shall be jointly paid by the health insurancefund mid the insured .

5 . The health insurance f -rind shall be managedin a centralized . unified, public and transparent

OFFICIAL GAZETTE

manner. ensuring the balance Ix°tweerr revenue andexpenditure, and be protected by the State .

Article =4. State policies on health insurance

l . The State pays . or assists pay incrrt of, healthinsurance prerjjinms foi - pxohle with meritoriousservices to the revolution and a nuinlxr of socialbeneficiary groups .

2 . The State adopts preferential pokies for thehealth irrsur- artce feud's investments iW order topreSe iti'e and increase the fund . The func~reVeil tiesand profits fi-om its investments are tax-'free .

3 . The State creaks favorable conditions for

organizations and individuals to Jnfn healthinsurance or preys health insurance prcibiunis forseveral heneficiary groups .

4 . The State encourages invostment intecfmological develohtitent and advancod technicaIfacilities far health insurance managctyrnt .

Articles . State management age it cit'irt chargeof health insurance

1 . '11te Government lxrforins the Lm 11-1ed Statemanagement of health insurance .

2 . The Ministry oft lea Idt shall take responsibilitybefore the Government for lxrforinu ige the statemanagement of health insurance .

3 . Ministries and trtinisterial-Icve°'agenciesshall, within the arttbit of their tasks and powers .coordinate with the Ministry of Wealth inperforming the state managervient-1pf healthinsurance .

_

4.1'eoplc's ('omrniItees at all levels gall, withinthe ambit of their tasks and powers . pcc5rform thestate management of-health insurance in localities .

Article 6. The Ministry of Health'sresponsibilities for health insurance

To assume the prime responsihilily for. andcoordinate with other ministries . ministerial-levelagencies and relevant aeoFICIC,; and organizationsin . performing the following, casks :

® VIETNAM LAW & LEGAL FORUM

1 . Formulating health insurance policies andlaw, organizing the health care system . professionaland technical lines and financial sources for theprotection, care and improvement of people'shealth, based on all-people; health insurance ;

'_' . Formulating strategies, planning and masterplans oil development. of health insurance,

3 . Prot

Iaatin L, lists of drugs . medical SLIPPIICS

and technMI services :vhich the insured is entitledto, and rxessional and technical regulations onhealth il15MUICC-covered medical care :

f . WGoverntrlhealth instance fund ;

ing out and submitting to thesolutions to ensure the balance of the

5 . Povlarizing and disseminating healthinsuranct-policies and law :

6. Direnc ing and ~~uiding the implementationof the head insurance regime ;

7 . Innecting . examining and handlingviolatior in, and settling complaints anddenunciatMs about, health insurance,

S . MOwrtoring . assessing arid reviewingactivities r the health insuralH.:e domain :

9 . O[Gnizirlg scientific research andintematioml cooperation oil health insurance .

ArtictC7 . The Finance Ministry's responsi-bilities di'I~health insurance

1 . To 21ordinate with the Ministry of Health,concern agencies and organizations inlormulat , health insurance-related financialpolicies and regulations .

?. 'Io inspect and examine the implementationof legal provisions on financial mechanismsapplicable to health insurance and the healthinsurance fund .

Article 8. Responsibilities of People'sCormxltttces at all levels for health illsllr;flice

1 . Within the ambit of their- tasks and powers .

OFFICIAL GAZETTE Issue nos 09-10/March 2009~Cong Bao rlos 147-1481March 14, 2909) ,

People's Committees at all levels shall :

al Direct and orLanize the implementation ofpolicies and law on health insurance :

hl Ensure funding to pay health insurancepremiums for persons el igihIc for premium paymentor support from the state hudgct under this Law:

cl Popularize and disseminate health insurancepolicies and law ;

dl Inspect, examine and handle violations of.and settle complaints and denunciations about,health insurance .

2 . Apart from the responsibilities defined III

Clause l of this Article . Peoples Committees ofprovinces and centrally run cities shall also manageand use funding sources under C:I lllse 2 . Article35 of this law.

Article 9 . Health insurance institutions

1 . Health insurance institutions function toimplement health insurance regimes . policies andlaw, arid manage and use the health insurance fund . 4

2 . 'fhe Government shall specify theo}manIzallon . functions, tasks and powers of healthinsurance institutions .

Article 10 . Audit of the health insurance fund

Once every three years . the State Audit shallaudit the health insurance fund and relxnt the resultsto the National Assembly.

If requested by the National Assembly, theNational Assembly Standing Cotnrnittee of theGovernment, the State Audit shall conductextraordinary audit of the health insurance fund .

Article 11 . Prohibited acts

1 . Failing to pay or fully pay health insurancepremiums under this I_aw.

2 . Committing fraud related to or forging healthinsurance files or cards .

3 . Lising collected health insurance premiumsor the health insurance fund for irnproper purl mses .

© VIETNAM LAW & LEGAL FORUM

Issue nos os-1 o/March 200940 [Cong Bdonos 147-14SIMarch 14, 2049]

4 . Ohstr(rcting, troubling, or causing harms tothe insured and parties involved in health insurancein the exercise caf their' law ftrl rights ~tt1tl eil- joymentof tlicir bctlchts .

5 . Deliberately making false reports carproviding false information and data on healthinsurance-

0. Abusing one's position, power car professionalopcratlons to act in contravention of the healthinsurance law.

C'Jirr1)tcr 11

THE INSL" RED, RATES, IJA131L11'1ES ANDME.THC)DS ()F PAYMENT C7F HFAI A'f I

INS L.!RANCE PREMILIMS

Article 12 . Ttle Insured

I - L.aborcrs working tinder indefltutc-terin laborcontracts or labor contracts of full three-month orlon-er term according to the labor law ; business11

Vnanagers who enjoy salaries of remunerationsmaunder the salary and remititeration law . cadres, civiI

sell ants and employees prescribed by law (l.elowcolic,ctively referred to as employees) .

2 . Prolcssional officers and non-commissionedofficers and of - ficers and non-commissionedol - fivers specialized in technical areas who areserving in the people's security force .

3 . Persons can pension or monthly workingcapacity loss allowance .

4 . People on monthly social insuranceallowance for labor accident or occupationaldisease .

5 . People who have stopped enjoying workingcapacity loss allowances and are en- j{crying monthlyallowances from the :irate bude-et .

Ca . Commune, ward or township cadres whohave stopped working and are enjoying monthlysocial insurance allowances .

7 . Commune, ward or township cadres who

OFFICIAL GAZETTE

have stolapcd working and are enjoying monthlyallowances from the state lmd"cl .

11

8 . People oil unemployment allowance .

9 . People with meritorious services to therevolution-

ICI . War veterans as defined by the war veteranlaw.

11 . People who personally IrirticIpakcl in theant1AJS resistance war for national saIV, lOit underthe (iovenlineiit's regul ,.tlDnS-

12 . IFICtrnlbcm National Assembly (LPlities andPeoples ( .' ouncll deputies at all level

13 . People oil monthly social weifare' allowanceas prescribed by law .

14 . Poor household meniN" rs : ctImic minoritypeople living in areas willi difficult or ex&ptionaIlydifficult socio-economic conditions-

15 . Relatives of people with moritoriousservices to the revolution its prescrihed ,~y the lawoil preferential treatment toward peMle withmeritorious services to the revolution . . . .:

16 . Relatives of the following ~kople asprescribed in the laws on People's Ann,' -officers,in[ Ii tary service, peoples public security� cipherofficers :

al On-service o17 icers, career army aawn of thePeople's Army, non-commissioned offccrs andsoldiers who are servitiL ill tile Pcoplc~~rmy :

hl Professional officers and non-coiZtissionedofficers and specialized technical of ficc

andnoncommissioned officers who are wor'

,- in thelxmple's security force : non-commissiolicd officersand soldiers who are serving in the people's securityforce for a given period -,

cl Career officers and army Men doing cil)llerwork in the C;overnment [.'ipher C_'otrimittee andthose doing cipher work and salaried according tothe stale payroll of PeopIc's Army ofllcers or thestate payroll of Peopie'sArmy career men wlio are

C VIETNAM LAW & LEGAL FORUM

10

neither army men nor policemen .

11 . Children aged under G years-

18 . People who have donated pans of theirbodies under the law on donation, taking aridtransplantation of tissues and human organs anddonation and taking of cadavers .

l9 . l=oreiLners studying in Vietnam who aregranted se°3Tolarships front the G'ietnamese State'sbudget .

24 .business

2(} . M

¬iber's of' households living just abovethe pover%lme .

21 . PL9s and students .

22 . N

lbcrs of agricultural, forestry, fisheryand saltwtrarlcing households .

01123.Relatives ofemployees defined in Clause 1

of this ACcle whom the employees have to rearand wbowhvc together with them in the same11. 11 111lies-

bers of cooperatives or individualrsehoids .

25 . her persons according to the(iovemzrj,,stt's regulations .

Artic!W13 . I fealth insurance premium rates andrcsponsiL#kties to pay health insurance premiums

1 . H o~A th insurance premium rates andresponsiSiditics to pay health insurance premiumsare prescr

ed as follows :al TI-Wzzenthly premium rate applicable to

persons damned in Clauses I and 2, Article 12 ofthis Law*"" equal up to 6% of the employee'smonthly salary or remuneration, with the employerpaying two thirds of the amount and the ernployceone-third . In the period when the employee takesmaterznty leave or rears an adopted chili! of under4 months according to the social insurance law,the employee and errtployer are not required to payhealth insurance premium and this period is stillcounted in their consecutive health insuranceparticipation time for entitlement to licalth

OFFICIAL GAZETTE Issue nos 09-10/March 2009(Cong Sao nos 147-1481March 14. 2009)4

Insurance benefits :

bl The monthly premium rate applicable topersons defined in Clause 3, ;Article 12 ofthis Lawis equal up to 6 1h of their pension car workingcapacity loss allowance . and such lNeIIIiuzns shallbe paid by the social insurance institution :

cl The monthly premium rate applicable topersons defined in Clauses 4 . 5 and 6, Article 12 ofthis Law is equal up to 6 1I of the minimum salaryand such premiums shall be paid by the socialinsurance institution ;

dl The monthly premium rate applicable topersons defined in Clause 8 . Article 12 of this I .awis equal up to 01,'o of their unemployment allowanceand such premiums shall be paid by the socialinsurance institution :

cl The monthly premium rate applicable topersons defined lit Clauses 7 . {9 . 10, 11, 12, 1 _7, 14 .15 . 16 . 17 and 18 . Article 12 of this Law is equalup to 0`Iv of the minimum salary arid suchpremitlnns shall be paid by the state budget-,

The 'monthly premium rate applicable to,persons defined ill Clause 19 . Article 12 of tliisLaw is equal u1) to 6% of the minimum salary andsuch premiums shall be paid by the scholarship-awarding agencies, organizations or units;;

gl The monthly premium rate applicable topersons defined in Clauses 20, 21 and 22 . Article12 of this Law is equal up to 6% of the minimumsalary and such premiums shall be paid by thesepersons ;

The state budget shall pay part of healthinsura11cc premiums forpersons defined in Clauses20 and 21 . Article 12 of this Law and those definedin Clause 22, Article 12 of this Law who haveayerrge living standards ;

hl The monthly premium rate applicable topersons defined in Clause 23 . Article 12 of' rhisLaw is up to 611 of the minimum salary and paidby the employees :

il The monthly premium rate applicable topersons defined itr Clause 24, Article 12 o1 this


_Issue. nos 09-10IMarch 2009m$ (Corm Bao nos 147-1481March 14, 2009)

[ .aw is cquaI up to G'ic! of the minimum salary andSLICII premiums shall be paid by these persons :

j/ The monthly premium rate applicahle topersons defined in Clause 25, Article 12 of thisLaw is equal up to G% of the rninimurn salary .

? . [n case an Insured concur -entIv belongs todifferent cate-ories specified in Article 12 of this

Law . I1elshe shall pay health insurance preMILrmslike those in the fiustcateaory which he/she IvIoilgsto in the order of priority defined in Article 12 ofthis Law .

[n case a person defined in Clause 1, Article 12ol - thl .~ Law has additionally one or severalinde,1irritc-lcrm labor contracts or labor contracts0f 1-month ar longer term, he/she shall pay healthinsurance. llrerniunt according t0 the contract withthe highest salary or rcnutneration level .

'.The. Government shall specify premium andsuppoit rates referred to in Clause 1 of this Artiele .

Article 14 . Salaries . remuneration . allowancesserving as .t basis for health insurance prernilullpaynlcirt

I . Employees salaried under state rqulationsshall /nay health insurance premiums haled nil theirmontflly salaries paid according to their ranks orgrades, and position, extra-seniority or tradeScillonly allowances (if any) .

? . Employees salaried or rerlluneratedaccording to their employers' regulations shallpay social insurance premiums based on theirmonth1v Salarics or remuneratlons indicated inthen' labor contraC ts .

3 . l7 Lr- sllrl5 on monthly pension, workingcapacity loss allowance orjoh-lass allowance shall]),IV heal1f1 irtiurance prcnniur11s based on tllcil-mat1t11ly pensions, workim~ capacity lossallo41'ances or jab-loss allowances .

4 . Other lea:sons shall pay health insurancepremitrnts based 0n the minimum salary .

5 . 1'11c Irlaxinlum n mtmeratian or salary level

OFFICIAL GAZETTE

used for the calculation of health insurancepremiums is 2[l limes the minimum salary.

Article 15. Methods of paymcni of healthinsurance prem117r11S

1 . Monthly, cnlployel s "/tall pity healthinsurance premiums for employees and makedeductions from the latter's salaries andrerllt .1Iler ;tllan for payment of lie Atl-~,iusuranceprernILlrrts 11110 the health insurance fuwL

2 . For agricultural, forestry . lish"Zand salL-making enterprises which do not pay saktries on aIItonlhly has is, employers shall, once

Z~ry threeor six months. pay health insurance pr

fiitrns faremployees and make health insurattc

remiumsfront the 1~LLlers S~L1arIC:S al - rcrnLtncrtli~ ~ti

nrpayinginto the health insurance fund .

3 . Monthly. social insurance institutions shallpay health insuraltce prernILiais II- I-v :s~_ws definedin Clauses 3, 4, 5, G and S . Article 12 okliis Law,into the health insurance fund .

4 . Annually. agencies and organizationsmanaging persons defined in Clauses mil, 1(l . 11 .12, 13 . 14, 17 and l S . Article 12 of - thii _aw shallpay health insurance prentmrlls far the personsinto the health insurance fund_

5 . Annually, agencies and org .izationsmanaging people with meritorious set'Mes to [lierevolution and peersons defined at. I'oin6 i, b and c .0ausc 16, Article 12 of this Law shalray healthinsurance premiums for their rclativ linto theheaft.h insurance fund .

ti . Monthly. scltalarship-awarditfg" . a ,,Ycncics,oreallIZatiorts and units shall pay health insurancepremiums fifr persons dclilrcd in CIAISC. 19 . Article12 of this Law, into the health II1SLIr1InCC fund .

7_ `hlie Covennm nt. shall specify methods ofpayment of health insurance pivimunis for personsdefined it) Clauscs ?C1. 21 . ?? . 2 3, 24 and ?5 . Article12 of this Law.


12

Chaplcr III

IIFAI'Hi INSIJIZANCH CAIZUS

Article 16 . Health insurance cards

l . A health insurance card is granted to allinsured as a basis for enjoying health insurancebenefits uM3er this Law.

2 . Eve!-Vone may i)c granted only one healthi nsurarrce~~mrd .

3 . The lirne when a health insurance cardbecomes y;~id is prescribed as follows :

a/ Ford insured defined in Clause _3 . Article50oftliisUw who pays health insurance premiumscontinuouafy from IIic second time on or an insureddefined i .r?, ;'lause 4 . Article 51 ofthis I,aw, his/herhealth iris ifance card will become valid on the dateof pa.ynickof health insurance premiums .

b/ For.: ,n insured defined in Clause 3, Article50 ol - this /maw who pays health insurance premiumsfor the firsk time or fails to pay health insurancepreinium otitiriuously . his/her health insurancecard will *come valid 30 days after the date ofpayment ofheaIIli insurance premiums ; particularlyfor entitlement to hi-tech services, his/her healthinsurance card will become valid 180 days afterthe date ofpayment of health insurance pretiiiuriis ;

c/ Wi~i ..TePrd to a child under () years, his/herlicalth ins`tifancc card is valid until he/she reachesfull 72 ratitTtlis of"ge: .

4 . A health insurance card is invalid in thefol!owitf- .Cases :

a/ Its validity duration expires ;b/ It has been modified or erased ;c/ The card holder no longer Joins health

insurance: .

5 . Health insurance institutions shall providethe model of health insurance card, manage : healthinsurance: cards miiformly nationwide, and issue

OFFICIAL GAZETTE Issue nos 09-10/March 2009(Clog Sao nos 947-1481March 14, 2049) 4

health insurance cards attaclied with photos of theinsured by January l . 2014 at the latest .

Article 17 . Grant of health insurance cards

1 . Adossier of request for the grant of a healthinsurance card compfSCS :

a/ A written registration of health -IIISLrranceparticipation by an agency or organizationresponsible for paying health insurance premiumsdefined in Clause t . Article

13 of this Law-,b/ A list of the insured, made by the ,I( , ency or

organization responsible for paying IZcalthinsurance premiums defined in Clause 1 . Article13 of this Law or by the representative of thevoluntary insured ;

c/ A written declaration of the individual orhousehold participating in health insurance .

2 . A dossier of request fe)I - the grant of a healIhinsurance card to in under-6 child comprises :

a/ A copy of tire birth proof paper or birthcertificate . In case the child Iias no such a palter or4certificate . a written certification I)y tire People sCommittee of - the commune, ward or townshipwhere the child's father, mother or guardian residesis required ;

b/A list or written request for the; grant ofhealthinsurance cards by tire People's Committee of thecommune . ward or township where the childresides .

3_ Within 1(1 working clays after receiving acomplete dossier prescribed in Clauses 1 and 2 ofthis Article, tire health InSLIranCe institution shallgrant a health insurance card to the insured_

Article 18 . Ire-grant of health insurance cards

l . Health insurance cards may be re-r- anted toreplace the lost ones .

? . A person who loses his/her health insurancecard shall tile a written request for the re-grant ofthe carol .


Issue nos 09-101March 2009(Cong Sao nos 147-1481March 14, 2009)

3 . Within 7 working days after receiving awritten reyuesl for the re-grant of a card, thellcalth insurance institution shall re-grant the cardto the insured . Pending the re-grant of a card,the card holder is still entitled to health Insurancebenefits .

4 . A person who is re-granted a health insurancecard shall pay a charge . The Minister of Healthshall set charge rates for the re-grant of - healthinsurance cards .

Article 19 . Exchange of health insurance cards

1_ A health insurance card may be exchangedin the following cases:

al It is torn, rumpled or damaged;bl The registered primary care provider is

cha1l~~~x1 ;cl The information printed in the card is

incorrect :

2. A dossier of request for the exchange of ahealth insurance card comprises :

ill The insured's written request for cardexchange ;

b/ 'File health insurance card .

3 . Within 7 working days after receiving acomplete dossier prescribed in (1ause 2 of thisArticle . the health insurance institution shallexchange the card for the insured . Pending the cardexchange, the card holder is still entitled to healthinsurance benefits .

4 . A person who has a torn, rumpled or damagedhealth i nsurance card exchanged shall pay a cllarge .Tile Minister of Finance shall set charge rates I -orthe exchange of llcalth insurance cards .

Article 20. Revocation. seizure of healthinsurance cards

1 . A llcalth insurance card may be revoked inthe follow1112 cllses :

a/Tllcre is fraud in its grant :

OFFICIAL GAZETTE 13

bl The card holder no finger joins healthinsurance .

2 . A health insurance card shall be seized wherea person seeks medical care services with another'scard . A person whose health I nsurance curd is seizedshall show up in order to receive hack the card andpay a fine in accordance with law.

Caxapttr 1V

Wt )PE OF HEA11T 11NSL?R .A W-EBENEFITS

6 +a

Article 21 . Scope of health insurancebenefits

I . The insured has the following cones coveredby the llcalth insurance fund :

X.

,al [. ,'osIS ofmedical exalnlnatloll aIlatreatment,function rehabilitation, relvrular pregnirrky check-ups and birth giving ;

bl C''osts of medical cxarnillation fand early diagnosis ol'some diseases :

c/ C .' osts of transferal from district h"spitals tohigher-level hospitals, for persons ~,efined inClauses 9, 13 . 14 . 17 and 20, Articlo-42 of thisLaw in case of emergency or for inp:zticllts whoneed technical transferal .

jc:reenillg

2 . The Minister of I [ealth shall spe(!), Point b,Clause 1 of this Article, and assum"le primeresponsibility for, and coordinate wi relevantagencies in, promulgating lists of' ,Medicines,chemicals, medical supplies and egtliprtmnt as wellas technical services which the insurecis entitledto .

Article 22. Levels of health insurance benefits

1 . A11 insured Who uses medical carp: servicesdefined in Articles 26, 27 and 28 of this Law hasmedical care costs covered by the health insurancefund at the following levels : ,

,ll 1(}(}i~? of- the costs, for persons defined in['lauses 2. 9 and 17 . Article 12 of this Lave :


14

b/ 1[l[1°h of - the costs . for cases in which thecost of a check:-tip is below the level prescribed bythe Government and conducted at a communehospital :

c/ 95°7 of the costs, for persons defined inClauses 3 . 1,3 and 14, Article 12 of this I_aw ;

ci/ 8[f`'~ : of the costs, for other persons .

2 . if tl

insured helomgs to different categories .he/she is

igible for the highest benefit for aninsured o

category.

3 . Th Clovcrntnent shall specify levels ofmedical

costs paid for the cases of transferalto higher

wcl hospitals, rlledical examination andtreatmenCHt upcrn request, and use of hi-tech aridexperisiG'rervices and other cases not specified inClause 1's4 this Article .

Arti* 23. (.'ases not eligible I- or healthinsurance Senefits

I . C'a

specified in Clause 1 of Article 21 in

2 . Co~wdescence at sanatoria or convalescencecti(abltshWnts .

which co

have beer) paid by the state budget .

3 . M4cal check-up .

4 . PreFfmaI tests and diagnosis Ior non-treatmentpurposes :

5 . Use4ohstctric supportivetechnigties . familyplanninb rvices or abortion services . except forcases of .

..r . {mtir}nation of pregnancy due to fetal

or tnatcr diseases .

6 . Useof aestlictic services .

7 . 'lfeatment ol - squint, short-sightedness andretractive defects .

$ . 11so of prostheses including artificial limbs .eyes, teeth . glasses . /)Caring aids or movement aidsin medical examination, treatment and functionrehabilitation .

9 . Medical examination . treatment and function

OFFICIAL GAZETTE Issue nos 09-10IMarch 2009(Cong Bao nos 147-1481March 14, 2009)

rehabilitation in cast of occupational diseases, laboraccidents or disasters .

1{l . Medical examination and treatment in caseof suicide or self-inflicted injuries .

11 . Medical examination and treatment foraddiction to drugs . alcohol or other habit-lor tningsuhstatrccs .

12 . Medical examination and treatment ofphysical or mental injuries caused by the injured'slaw-breaking acts .

13 . Medical assessment . forcristc examination,forensic mental examination .

14. Participation in clinical trials or scientificresearch .

( .'lrrrjNr." r- V

ORGANIZATION Of; M1~171C'AI, CARE F{)R'ITIE INSI?REI7

Article 24. Health insurance-covered rnedical4care providers

l . A health insurance-covered medical careprovider is a health establishment which shins amedical care contract with a health insuranceinstitution .

? . Health insurance-covered medical careproviders include :

a/ Commune health stations and the equivalent .Maternity houses ;

b/ General and special-Ged clinics ;c/ General and specialised hospitals .

Article 25 . Contracts on health insurancc-covered medical care

1 . A hcalth insurance-covered medical carecontract is a written agreement between a healthinsurance institution and a medical establishmenton (lie provision of' health insurance-coveredmedical care services and payment for these


_Issue nos 09-f 0I Ma_rch 2009(Cong Bao nos 147-1481March 14. 2009)

services .

? . .A health insurance-covered medical carecontract has the following piincipal details :

a/ Service beneficiaries and qualityrequirements ;

b/ Method of payment of medical care costs :c/ Rights and duties of tile contractual parties ;d/ 'term of the contract ;e/ Liabilities for breach of tile contract ;11('onditions for modification, liquidation and

termination of tile contract .

3 . Any agreement on conditions forrnodilication . liquidation and ter'rnination of acontract defined at Point e . Clause 2 of this Articlemust riot intermpt medical care for the concernedi nsur'ed .

4 . The Ministry of I fealth shall provide it mex}elcontract on health insurance-covered medical care .

Article 26 . Registration for health insurance-overcd medical care services

1 .I'lle insured may register for health inslrrance-covered primary care services at rrtedicalestablishments of- corntraune and district orequivalent levels, except I -or cases in which theyare entitled to register at provincial or centralmedical establishments under regulations of theMinister of Health .

If an insured works on .t mobile basis or movesin adifferent locality, he/she may seek primary careservices at a medical establishment ofcorresponding technical line in the locality wherehe/Aae works or resides under regulations of theMinister of Health .

2 . The insured may change tile registeredprimary care provider at [lie beginning of everygllartcr.

3 . The name of the primary care provider shallbe specified in a health insurance card .

OFFICIAL GAZETTE

Article 27 . Ticatrrlent-line transfer

For a case falling beyond the professional andtechnical capacity of a health insurance-coveredmedical care provider. such provider may transfertile patient to another provider according toregulations on technical transfer.

Article 28 . l'rocodures for health insurance-covered medical care

I . An insured seeking medical ca.1'eservlcesshall present his/her health insurance _attachedwith his/her photo : a card without photo must bLproduced together with a written proof

Nrsonalidentity of the card holder; for childr

under 6years . only health insurance cards r :d to beproduced .

""`

2. In case of emergency, an insured may seekmedical care services at airy taaedical est,~,alishmentand shall produce his/her health 'its -L ice cardtogether with papers defined in [."iaus~[ of thisArticle before he/she is dischaqed froth hospital .

3.1n case oftreatment.-line transferal,,art insuredshall obtain a transferal dossier from thettmcernedmedical establishment .

4 . In case of rc-examination to mee4ftreatmentrequirements, an insured shall obtairf-Ilhate ofappointment from the concernec riedicalestablishment .

Article 29 . 1Ica]th insurance assess'jentf . I }ealth insurance assessment cova/ Scrutinizing medical care proced

s;b/ Checking and evaluating th.rder of

treatment, prescription, and t11e use of medicines,chemicals. medical supplies and technical Servicesfor patients :

c/ Inspecting and determining costs of healthinsurance-covered medical carp .

2 . Health insurance a5SeSSralent must ensureaccuracy . publicity and transparl',ncv.


16

~ . llcalth insurance institutions shall conducthealth insurance aSSCstiment and take responsibilitybefore law for assessment results .

0rctj)ter VI

PAYM [-N'l C)F COSTS OF HEALTHIN SURANCE-CC7VFR F1) ME[)ICA1, CARE

ArticW311. McthWs of - payment of costs ofinsured uNtMical care

l . CIO= of' health insurance-covered medicalcart: shall

pald by one oftile following methods :

al km-based payment . which meanspaymentcording to medical care cost normsand the TYfemiurn rate fixed on each healthinsurartcCcard as registered with a healthinsurancr ovcred medical care provider duringa certain~~riod :

hl Sl

ice charge-based payment, whichmeans pjyment on the basis of costs of'rrtcdicin

chemicals, medical supplies andCCIUIPITIC

rSIS well as lec[lit IcaI services providedI -or patio

cl I)i ase-based payment, which meanspayment-(cording to medical care costs pre-dctermint~t for each case based on diagnosis .

2 . Thq

ovomment shall specify the applicationof methca

of'paymentof - lica[th insurance-coveredmedical e;rre costs defined in Clause 1 of thisArticle.

Artiinsurance--covered medical care

31 . Payment of costs of' health

1 . Health insurance institutions shall pay costsof health insurance-covered medical care tomedical cart: providers according to healthinsurance-covered medical care . contracts

? . llcalth insurance institutions shall paymedical care costs directly to health insurancecard holders who use medical care services in

OFFICIAL GAZETTE

the following cases :

_Issue nos_09-_10/Marc h 2009(Cong Sao nos 147-1481March 14. 2009) 40

al At a health insurance-covered medical careprovider which has no health insurance-coveredmedical care contract ;

b/ 'rite medical care is provided not inaccordance with Articles ?6 . 27 and 28 ofthisLaw:

c/ In foreign coumries ;dl Other special cases as specified by the

Minister of Health .

3 . The M.inistry of Health shall assume theprime responsibility for, art d coordinate with theMinistry of Finance lit, specifying paymentprocedures and levels for cases defitied in Clause2 of - this Article .

=1 . llcalth insurance institutions shall paymedical cart,' Costs on the basis of hospital cIiargcsaccording to the Government's regulations .

Article 32 . Advancement . payment,set.tlerlIent o1' Costs of health insurance-coveredmedical care

1 . Health insurance institutions shall quarterlypay in advance to health insurance-coveredmedical care providers at least 8Ch/ : of the costsof health insurance-covered medical care of thepreceding quarter which have been settled . Withregard to a health insurance-covered medical careprovider which signs a health insurance-coveredmedical care contract for the first time, the firstadvance will at least equal St}% of the medicalcare cost of one quarter under the signed contract .

2 . An health insurance-covered medical careprovider and a health insurance institution shallmake payment and settlement on a quarterly basisas follows :

al In the first month ofevery quarter, thehealth insurance-covered medical care providershall send a report on settlcirtcnt ol'costs of healthinsurance-covered medical care in the previous


Issue nos 09-101March 2009

(Cong Sao nos 147-14&March 14, 2009)

quarter to the health insurance institution ;

hl Within 30 days after receiving thesettlenterit report from the health insurance-covered medical care provider, the healthinsurance institution shall consider and notify thelatter oI- the results of sealemcitt . Within 15 daysafter notifying the settlement results, the healthinsurance institution shall complete theseatlement with the health insurance-coveredmedical care provider.

3 . Within 4[l days -after receiving a completedosslc r of request for payment of medical carecosts from an insured under Points a and b,Cause 2 . Article 31 of this Law or 00 days, forcases defined at Points c and d . Clause 2, Article31 of this Law, the health insuralIec institutionshall pay the medical care costs to that insured .

Chapter V11

HEALTH INSURANCE FUND

Article 33. Sources for setting rip the healthinsurance fund

1 _ Health insurance premiums prescribed inthis Law.

? . Profits from investments by the fund .

3 . Financial aid from domestic and foreignorganizations .

4 . Other lawful revenues .

Article 34. Management of the healthinsurance fund

1 . The health insurance fund shall be managedin a centralized, uniform, public and transparentmanner with management decentralizatioirwithin the system of - health insurance institutions .

? . The Government shall specify themanagement {if the health insurance I -urld, decideon financial sources to ensure health insurance-covered medical care in case the health insurance

OFFICIAL GAZETTE

fund faces a revenlae-expenditure imbalance .

Article 35. 1:Jse of the Health insurance Rind

1 . The health insurance fund is used for thefollowing purposes :

al Payment of health insurance-coveredmedical care costs ;

bl Payment of costs of organizationalmanagement of health insurance i itudons,according to the administrative spcnTi-fig normsapplicable to state agencies : -,. .

cl Investment for preservation and growthpurposes on the principle of safety andrfficiency ;

dl Setting up o1' a provision fundlor healthinsurance-covered medical care . The:~rovisionmust be at least equal to the total costs of Ilealdiinsurance-covered medical care of' the twoconsecutive previous quarters and notyV.,,\ ceed thetotal health insurance-covered incdic~d p=are costs

of the two last consecutive years .

..

2 . In case a province or centrallFii"un cityshealth insurance premium payments, are biggerthan the health insurance-covered medical carecosts, the locality rnay use part of - balancefor the provision of tncdical care services .

3 . The Government shall detail t1

Article .

C7hapter V111

RIGIITS AND RESPONS IRIi .1

VS OFPARTIES INVOLVED 1N I IEX:hH

INStJRANC'E

_ ~

Article 36 . Rights of' the insured .:~1",

17

1 . To be granted health insurance cards ifpaying health insurance premiums .

2 . To select a primary care provider underClause 1 . Article 26 of this Law.

3 . To be entitled to inedical care_

4 . To get inedical care costs paid by health


18

insurance institutions .

S . To request health insurance institutions . healthinsurance-covered medical care providers andrelevant agencWs to explain and provideinformation on health insurance .

ti . Zb complain about. or denounce violationsof the health insurance law .

Article

7. Responsibilities of the insured

1 . To pm health insurance premiums fully andon t i roe .

2 . To mt~ health insurance cards for properpurposes :

- to lend their cards to ethers .

3 . li-aWe by then provisions of Article 28 ofthis Law. glen using medical care services .

4 . 1,0 c*reply with regulations and guidance ofhealth i4turance institutions and medicalestablish"lts where using tnedical care services .

5 . Tommy medical care costs to medicalestabllshri~Tts . in addition to the costs covered bythe health tsurance fund .

Artier 38. Rights of organizations andindividuaWpaying health insurance premiums.

00-

1 . To Suest health insurance institutions andcompetert"tate -agencies to explain and provideinformatiZa,on health insurance regimes .

2 . To

-rplain about and denounce violations

of the hea" insurance law .

Artifi.1=9. Responsibilities of organizationsand individuals paying health insurance premiums

1 . 'l[) make dossiers of request for the grant ofhealth insurance cards .

2 . To pay health insurance premiums fully andoil sclicclule .

3 . To hand he-altll irlsur-ulce cards to the insured .

4 . To provide f'uli and accurate information and

OFFICIAL GAZETTE _Issue nos 09-10(MarchD09(Cong Bao nos 947-9481March 94, 2009) 0

dcxtnnents related to the health insurance duties ofemployers and their representatives to the insuredupon request of health insurance institutions,employees or their representatives .

5 . To be subject to examination arid inspectionof the observance of the health insurance law .

Article 40 . Rights o1 health insuranceinstitutions

1 . 'l'o request employers . representatives of theinsured and the insured to provide full alld accurateinformation and documents related to their healthinsurance duties .

2.'fo inspect and evaluate the provision elfhealthinsurance-covered medical care services : to revokeor seize health insurance cards, for cases definedin Article 20 of this Law:

3 . To request health insurance-covered medicalcare providers to provide patient files and recordsarid medical care docutrlents for health insuranceassessment .

4 . To refuse payment of costs of healthinsurance-covered medical care which violate thisLaw or the health insurance-covered medical carecontracts .

5 . 7'o request. persons who are liable to paydamages to the insured to refund medical care costswhich have been paid by health Insuranceinstitutions .

6 . To propose competent state agencies to rcvis .~health insurance policies or lave and handleorgan izatiexls and individuals that violate the healthinsurance lavv .

Article 41. Responsibilities [lf- licalth insuranceinstitutions

I . To popularize and disseminate healthinsurance ixficies and law .

2.'lb provide dossier aild procedural guidance .to organize the irnhlelncntation of - health insurance


Issue nos 09-t0IMarch 2009(Cong Bjo nos 147-1481March 14, 2009)

regimes in a quick . simple : and convenient mannertin- t .lw insured .

3 . To collect health insurance prcrululns andgrant llcalth insurance cards .

4 . '176 manage and use talc health insurancc fund .

5 . To sign health insurance-covered medicalcare contracts with medical establishments .

G . To pay health insurance-covered medical carecosts .

7 . To provide information on health insurance-covered medical care providers and guide theinsured in selecting primary care providers .

S .'1'o check the quality of medical care services ;to conduct health insurance assessment .

9 . 1cl protect interests of the insured ; to settleaccording to t116rcompctence petitioits, complaintsand denunciations on health insurance regimes .

Itl . To archive files and data on health insuranceaccording to law : to apply information technologyto Health insurance manaLement and establish anational database on health insurance .

1 l . To organize statistics and reporting work .provide professional Llidance orl heaItIl insurance :to make reports on the managemeitt and use of talcIlea lth insurance fund on a periodical basis or uponrequest .

12 . To organize professional training andretraining . scientific research and inWnlatianalcooperation on health insurance .

Article 42. Rights ofhealth insurance-coveredmedical care providers

l . JIo re(hleSt llcalth insurance institutions toprovide full arld accurate Inlormatioll on the insuredand talc fund allocated to the tit for tale provIsioil ofmedical care for the insured .

2 . To lx entitled to fund advance and paymentof medical care costs by health insurance

OFFICIAL GAZETTE 19

institutions in accordance with the signed healthinsurance-covered modicai care contracts .

3 . To propose competent state agencies tohandle organizations and individuals that violatethe health insurance law .

Article 43. Responsibilities of-health insurance-covered medical care providers

1 . 'Id provide quality medical caa"servicesaccording to simple and convenient procalures forthe insured .

2 . '1'o provide patient files and r"ords anddocuments off medical care and the -rment ofmedical care costs at. the request of heaIthinsuranceinstitutions and competent state agenci

3 . To ensure necessary conditionsf[lr healthinsurance institutions to conduct assexolrlent, tocoordinate with health intirtrance itlsl ltions inpropagating and explaining healthUsuranceregimes to the insured .

4 . 'lo iitspcct, detectand illfoml lie it lt Vjlsurance1nstItuttons ofthe lnnlsuse of heaItIl lrlsumrice cards ;to coordinate with health insurance institutions inrevoking and seizing health illsuranccca

iit casesdefined in Article 20 of this Law .

5 . To manage and use money frotrWie healthinsurance fund strictly according to law

6 . To make statistics and reports ;Zai healthinsurance in accordance with law .

Article 44. Rights ol'orvanizations re

scmingemployees and those representing crnptth'yers

1 .'lo request health insurance institutions, careproviders and employers to provide full andaccurate information on health insurancc foremployees .

? . To request competent state agencies to handleviolations of the health insurance law which aflcctthe lawful rights and interests of employees andemployers .


20

Article 45 . Duties oforganizations representingemployees and those representing ernployers

1 . 'I'o popularize and disseminate healthinsurance policies acrd law to employees andemployers .

2 . To participate in the formulation of healthinsurance policies and law. and proposeameadmoints or supplecncrrts (l1creto .

`~ . T04" in the sigx:rvision of enii)rcement of'the health

surance law .

('Izrrhtcr IX

MSPE0'1ON. COMI 11-Al NT,DE I

1('hATItIN, SEYFLEMEN'1' (3Ft)l&Pt ITES AND HANDLING OF

V10L~MIONS IN IIFALTH INSLJRAN(.'E

Articl"G. I lealth insurance inspectorate

The 11 ~Ath insurance inspectorate shall conductspecializr~ inspection in the health insurancedomain .

Artiei1 47 . (.'omplaint, denunciation on healthinsurance .

'The loA~'tit, and settle Inentof complairtits aboutadtriinistr-~[iive decisions and administrative actsrelated t pshcaith insurance ; the lodging, andSettlem(3i1°c)f denunciations about. violations of thehealth insurance law comply with the law oilcomplain

nd denunciations_

Artic

48. Health insurance disputes

1 . Health insurance disputes art : disputes relatedto health insurance rights, duties and liabilities ofthe following :

alThe insured defined in Aiticlc 12 of this Lawand their representatives,

hl Health insurance prcrniurn-payingorganizations and individuals defined in ("lause 1,Article 13 ofthis Law :

OFFICIAL GAZETTE Issue nos 09- 1 0,

Warch 2409(Cnr)g Sao nos 147-1481March 14, 2049] 4

cl Health insurance institutions ;

dl Health insurance-covered medical careproviders .

2 . Health insurance diSpu(CS shall be settled asfollows :

al The disputing parties shall reconcile theirdispute ..

bl In case of unsuccessful reconciliation . thedisputing parties may initiate a lawsuit at a courtin accordance with law.

Article 49. Handling of violations

1 . Any person who violates the provisiotc ofthis Law and relevant provisions of law on healthinsurance shall . depending on the nature andseverity of their violations, he disciplined,administratively sanctioned or examined for penalliability, and, if - causing damage, they shall paycompensation in accordance with law .

2 . Agencies . organizations and employers thatare responsible to pay healtfc FISLITLrrlCe premiumsbut fail to pay or fully pay Iluarn shall, according tolaw . fully pay the deficit together with the interestarising. i n the late payment period at the primeinterest rate announced by the State Bank: if falllccgto do SO, upon request n1 persons competent tohandle administrative violations, banns or othercredit institutions, the state treasury shall makedeductions from their deposit accounts to hay thearrears and interest arising on these arrears into theaccount of the health insurance fund .

(Jrajrrcr X

IMPLF.MEN'JAHON PROVISIONS

Article i() . Transitional provisions

1 . Ilealth insurance cards next free medical carecards granted to under-6 children before theel1cctive date of this l,Lrw will be valid :

al l lntil theirexpiratilm . for cards valid through

® VIETNAM LAW 8 LEGAL FORUM

Issue nes 09-10/March 2009(CdngSao nos 147-1481March 14, 2049)

Ilccember 31 . 2[X)9:

hl I intii Dcccrnbcr 31, 2tx}9, hor cards validbeyond December ? 1, 2(X)9.

2. The benefits ofpersons who were igranicdhealth insurance cards Ivfore this Law takes effectwill lx:effixtive according tocun-ent le4al provisionsoil Ircal(h Insurance until December 31 . 2[X19.

. I'ei :sons defined in Clauses 21 . 22, 23, 24and 25. Article 12 of this Law may, pending theirnplcmentation of Points b. c. d and c, Clause I'Article 51 of this Law. voluntarily participate inltcallh insurance under the Government'sregulations .

Article 51 . Effect

I . This Law takes effect oil July 1, 2(X)9.

2. 1-lic road map firr achievirig al l-people ". healthinsurance is provided for as follows:

rl/ Persons defined in C.'lauses 1 thru 20 . Article12 of this Law shall participate in health insurance

fi -orn the ef -lcctive date of this Law.

bl Persons defined in Clause 21 . Article. 12 ofthis Law shall participate in health insurance fromJanuary 1, 2{11[1 ;

cl Persons defined in Clause 22, Article 12 ofthis Law shall participate in health insurance fromJanuary 1, 2[112:

dl Persons defined in 0auses 2:3 and 24. Article12 of this I .aw shall participate in health insuranceIrorn January 1 . 2[114;

cl Pel:sons defined in Clause 25, Article 12 ofthis Law shall participate iii health insurance underthe Govern Ittent's regulations from January I, 2{114at the latest .

Article 52 . Implementation detailing and!, III ance

'Fhe Government shall detail and wide (lieimplementation of the articles and clauses of thisLaw as assifuned . and guide other necessary

OFFICIAL GAZETTE 21

provisions of this Law to meet state ntanagetwntrequirements .

This Lnv was passed on November 1-J, 2008,1» the X11'' National As.scmhlv o/' the SocialistRepublic of11ctnam at itc 4'11 wssion.

Chairman ofthe /Valionral As.wmblyNG11YEN PHLI TR(_)NG

Order No. 25120[1811,-('TN of Member28, 2008, on the promulgation ofiaw

1'H1 PIZFSIDEN'1't)1~" I -IfF.SOCtWJ5'1'KEP[1131 .IC OF VIE'I'NAN=

1'ursurnat to Anic.lcs 1(1-3 anel /00 ~11te 1992(.onslitulion of the ~ocialim Rqmhlic ~'Vietnant,which tivas anicnrler1 and supplenww(ec1 underResolution No. 5112(1111111110 of'Ik4Z~Ibel - 25,2001, r~~-Iltc hrtr Nratirlrrcrl :l .s .u " rrthlv; the 1W' .session ;

Pursuant to Article 91 of th Laiv onOrgwrization (Y'llre National Assefnhly

1'arsuunt try Article

50 of th

l,aw on1'jcnnu~rgation n/' Legal Doe3rtit0r1s,

PRf7MULC1~'V1'FS :

the Law on Excise '1ax,

which was passed on November 14, 2(X)8, bythe X11`I' National Assembly of the SocialistIZcpublic of Vietnam at its 41 " session.

l've'sidew ofthe Sex .uaILs7 Republic r1/14cmain

NGl- YEN MINf-I 'FRIE'f

C VIETNAM LAW & LEGAL FORUM

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