Hospitals have their health insurance settlement of nearly 2,500 billion VND suspended: request for advance payment

Propose that Vietnam Social Security direct the advance payment of health insurance medical examination and treatment costs according to the prescribed rate and number of advances to ensure funding for health insurance medical examination and treatment activities for the people.

Ensuring the rights of health insurance patients

Regarding the fact that hospitals in Ho Chi Minh City have not yet been paid nearly 2,500 billion VND in health insurance in 2 years, on August 13, the Department of Health Insurance, Ministry of Health , said that the ministry has sent an official dispatch to Vietnam Social Security, requesting to direct social security of provinces and cities to make advances for health insurance medical examination and treatment costs according to the rate and number of advances as prescribed in Article 32 of the Law on Health Insurance to ensure funding for health insurance medical examination and treatment activities.

Request social insurance to advance unpaid expenses, ensure funding for medical examination and treatment under health insurance

PHOTO: TUAN MINH

Previously, the Ministry of Health received a dispatch from the Ho Chi Minh City Department of Health regarding overpayment of health insurance medical examination and treatment expenses and failure to recover technical service costs performed on medical equipment that had not completed the establishment of public ownership before March 4, 2023.

According to the report, in 2023, health insurance medical examination and treatment facilities in the city had health insurance medical examination and treatment costs exceeding the estimate of VND 557.5 billion, which was appraised and submitted to the Vietnam Social Security by Ho Chi Minh City Social Security.

In 2024, health insurance medical examination and treatment costs will still increase, exceeding the estimated expenditure by about 1,950 billion VND.

At the same time, Ho Chi Minh City Social Insurance is recovering health insurance medical examination and treatment costs incurred on medical equipment that has not completed the establishment of public ownership before March 4, 2023.

The unpaid and long waiting time for payment of health insurance medical examination and treatment costs exceeding the budget of hospitals makes it difficult for units to ensure operating funds and balance financial revenues and expenditures when the price of medical examination and treatment services is not calculated correctly and fully, and there is debt for medicine from the providing enterprises, which has a certain impact on the medical examination and treatment activities of medical examination and treatment facilities and the rights of health insurance participants.

Presenting solutions to the above problems, the Ministry of Health said that, regarding the cost of medical examination and treatment covered by health insurance for medical services performed on medical equipment that has not completed the establishment of national ownership, since February 2025, the Ministry of Health has sent an official dispatch to the Vietnam Social Security requesting not to recover the cost of medical examination and treatment covered by health insurance for technical services performed on medical equipment that has not completed the establishment of national ownership.

The Ministry of Health is synthesizing and reporting to the Government on this content.

The Ministry of Health requested the Vietnam Social Security to direct the social security agencies of provinces and cities not to recover this expense until there is a decision from the Government and the Prime Minister.

Regarding the cost of medical examination and treatment under health insurance exceeding the estimate in 2023, Since May 2025, the Vietnam Social Security Management Board has issued a resolution unanimously approving in principle the 2023 Financial Finalization Report of Vietnam Social Security. Therefore, the Ministry of Health requests that Vietnam Social Security urgently report to the Ministry of Finance and submit to the Government for consideration and approval of health insurance medical examination and treatment costs exceeding the 2023 estimate to pay for medical examination and treatment facilities, including medical examination and treatment facilities in Ho Chi Minh City.

Regarding the cost of medical examination and treatment under health insurance in 2024, on July 25, the Ministry of Health issued an official dispatch to review the amount of excess expenditure, requesting the Vietnam Social Security to direct social insurance agencies of provinces and cities to promptly implement in accordance with the provisions of the Law on Health Insurance and the Government's decrees detailing and guiding the implementation of a number of articles of the Law on Health Insurance.

Source: https://thanhnien.vn/cac-benh-vien-bi-trèo-quyet-toan-gan-2500-ti-dong-bao-hiem-y-te-de-nghi-tam-ung-tien-185250813143202471.htm