Khanh Hoa tightens management of health insurance examination and treatment costs

On October 2, Chairman of Khanh Hoa Provincial People's Committee Nguyen Khac Toan signed a document directing the implementation of solutions to manage and control health insurance (HI) examination and treatment costs in the province.

Accordingly, the Chairman of the Provincial People's Committee requested the Department of Health to direct medical examination and treatment facilities to strictly implement the provisions of the Law on Medical Examination and Treatment and the Law on Health Insurance.

In particular, focusing on implementing electronic medical records, increasing the application of information technology in medical examination and treatment activities; sending medical examination and treatment data on time; using the health insurance fund effectively and economically; striving not to exceed the assigned spending estimate.

At the same time, medical facilities must comply with regulations on bidding and drug supply, prioritize the use of domestically produced drugs, limit pharmaceuticals and drugs at unusual prices.

In addition, the health sector needs to closely coordinate with the provincial Social Insurance (SI) in advising the Provincial People's Committee on solutions to improve the effectiveness of state management of health insurance.

Inspection work needs to be strengthened regularly, suddenly or by topic to promptly detect and prevent the abuse of health services and prescriptions that are not in accordance with regulations, causing losses in the health insurance fund.

In case of exceeding the spending estimate, the health sector must assess and determine the specific cause to report to the Provincial People's Committee for direction on handling.

For the provincial Social Insurance, the Chairman of the Provincial People's Committee assigned the task of promoting propaganda and dissemination of legal policies on health insurance so that people and medical examination and treatment facilities understand correctly and strictly comply.

Social Insurance agencies need to enhance the role of appraisers in controlling expenditures, coordinating with the health sector to check the status of inpatient hospitalizations, and refusing to pay for cases that are not present in the treatment department without a valid reason.

The Chairman of the Provincial People's Committee also requested departments, branches, sectors and People's Committees of communes, wards and special zones in the province to coordinate in seriously directing and ensuring that the health insurance fund is used for the right purpose, safely and effectively.

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