Thông tư 39/2017/TT-BYT gói dịch vụ y tế cơ bản cho tuyến cơ sở

THE MINISTRY OF HEALTH

Circular No. 39/2017/TT-BYT dated October 18, 2017 of the Ministry of Health on basic package of health services applied to grassroots health facilities

Pursuant to the Law on Health Insurance No. 25/2008/QH12 dated November 14, 2008 amended by the Law No. 46/2014/QH13 dated June 13, 2014;

Pursuant to the Government’s Decree No. 75/2017/ND-CP dated June 20, 2017 defining Functions, Tasks, Powers and Organizational Structure of Ministry of Health;

Pursuant to the Resolution No. 68/2013/QH13 dated November 29, 2013 by the National Assembly on strict enforcement of regulations and policies on health insurance towards the universal health coverage;

At the request of the Director of the Department of Planning and Finance;

Minister of Health promulgates a Circular stipulating basic package of health services applied to grassroots health facilities.

Article 1. Scope of adjustment and subject of application

This Circular stipulates the basic package of health services, comprising medical procedures, drugs, chemicals and supplies used for providing initial health care, health improvement, preventive and curative services, applied to grassroots health facilities (i.e. commune-level and district-level health facilities) and all citizens of Vietnam.

Article 2. Basic package of health services

The basic package of health services comprises “basic package of health services covered by health insurance fund” and “basic package of health services for initial health care, preventive and health improvement purposes". To be specific:

1. “Basic package of health services covered by health insurance fund” comprises medical procedures specified in the Appendix I and the list of drugs used by commune-level health facilities mentioned in the Appendix II enclosed herewith and is applied to medical stations of communes, wards, towns and equivalents, private GP or family clinics, military-civilian medical stations and military – civilian clinics (hereinafter referred to as “commune-level health facilities).

2. “Basic package of health services for initial health care, preventive and health improvement purposes” comprises essential medical services prescribed in the Appendix III enclosed herewith and is applied to medical centers of urban/sub-urban districts, towns or provincial cities (hereinafter referred to as "district-level medical centers”) and medical stations of communes, wards or towns so as to provide healthcare services, preventive and health improvement services.    

3. The basic package of health services shall be updated for every 1-2 years or at the request of a competent authority.

Article 3. Payment for health services in the “Basic package of health services covered by health insurance fund” (Appendix I and Appendix II)

1. When a holder of health insurance card uses health services in the basic package of health services, he/she may enjoy health insurance benefits according to the insurance coverage scope and levels prescribed by the Law on Health Insurance and the regulations herein.

2. A holder of health insurance card may receive payments for his/her use of any medical procedures, drugs and supplies or any other services, which are not included in the basic package of health services as prescribed herein at any health facilities nationwide, from the relevant social insurance agencies in accordance with regulations of the Law on Health Insurance.

3. Prices of medical procedures shall be set in accordance with regulations on prices of medical services and the Joint Circular No. 37/2015/TTLT-BYT-BTC dated October 29, 2015 by Ministry of Health and Ministry of Finance on prices of medical services covered by health insurance fund and consistently applied to hospitals of same levels nationwide.

4. Prices of drugs or medical supplies shall be set in accordance with regulations on bidding for purchase of medicines and medical supplies.

Article 4. Payment for health services in the “Basic package of health services for initial health care, preventive and health improvement purposes” (Appendix III)

1. Healthcare, preventive and health improvement services that are provided as duties of the Population & Health Target Program shall be covered by funding of the Population & Health Target Program as prescribed in the Decision No. 1125/QD-TTg dated July 31, 2017 by the Prime Minister giving approval for the Population & Health Target Program in the 2016 – 2020 period. Sources of funding, expenditure items and levels shall be governed by regulations of the Ministry of Finance.

2. Payment for healthcare, preventive and health improvement services provided for persons who are eligible to have medical expenses paid by the Government in accordance with applicable laws shall be paid in accordance with the regulations of Ministry of Finance.

3. Healthcare, preventive and health improvement services other than those prescribed in Clauses 1, 2 of this Article shall be covered by the funding for healthcare services allocated by local-government budgets in accordance with regulations in the Prime Minister’s Decision No. 46/2016/QD-TTg dated October 19, 2016 on provision of estimates of recurrent expenditures of the state budget in 2017.

4. Health services other than those prescribed in Clauses 1, 2, 3 of this Article shall be covered by users in accordance with applicable regulations, private contributions and other legal sources of funding.

Article 5. Implementationorganization

1. The Social Security Administration of Vietnam shall instruct social insurance agencies at all levels to make full payments for health services in the “basic package of health services covered by health insurance fund” actually provided for patients who holding health insurance cards by health facilities in accordance with guidelines herein and relevant laws.

2. People’s Committees of provinces or central-affiliated cities shall instruct People’s Committees at lower levels, Provincial Departments of Health and related departments to:

a) allocate funding from local-government budget, funding of the National target program for development of advanced rural areas and other legal sources of funding (if any) to invest in material facilities and equipment of medical stations of communes, wards or towns in an effective manner. To be specific:

- give priority to medical stations capable of providing health services in both basic packages of health services, especially medical stations in remote regions or disadvantaged regions; limit investments in medical stations of communes, wards or towns near to two-functions medical centers of districts or near to hospitals;

- conform to local existing conditions and regulations in the Decision No. 4667/QD-BYT dated November 07, 2014 by Ministry of Health on promulgation of national criteria for health facilities of communes by 2020 (hereinafter referred to as the Decision No. 4667/QD-BYT).

b) arrange human resources for health facilities to provide health services in the basic package of health services. Instruct the application of two-ways rotation of medical staff in conformity with local conditions to improve knowledge and professional skills of medical staff of health facilities. Establish principles for arrangement of working schedule for medical staff that medical staff of medical centers of urban/sub-urban districts, towns or provincial cities must work at medical stations of communes or wards in certain days of the week and medical staff of medical stations of communes, wards or towns must work on rotation at medical centers of districts according to the plan and ensure financial resources to implement duties of the Decision No. 14/2013/QD-TTg dated February 20, 2013 by the Prime Minister on application of mechanism for fixed-term rotation of medical staff of health facilities;

c) With regard to the basic package of health services covered by health insurance fund, People’s Committees of provinces or central-affiliated cities shall:

- Instruct health facilities to provide the basic package of health services for holders of health insurance cards under the scope of its management;

- Instruct Provincial Departments of Health and Provincial Social Insurance Agencies to make payments for health services in the basic package of health services provided by health facilities in accordance with regulations herein and relevant laws;

d) With regard to the basic package of health services for initial health care, preventive and health improvement purposes, People’s Committees of provinces or central-affiliated cities shall:

- Ensure funding and instruct local health facilities to provide health services for initial health care, preventive and health improvement purposes for people as well as healthcare services for persons given priority as regulated by laws;

- Request the Provincial-level People’s Councils to make decision within their competence on use of funding from state budget and other legal sources of funding to provide health services in the basic package of health services prescribed in the Appendix III enclosed herewith.

- Mobilize contributions from private sectors to provide healthcare, preventive and health improvement services.

3. Provincial Departments of Health shall:

a) With regard to the basic package of health services covered by health insurance fund:

- Instruct health facilities of communes to provide services in the basic package of health services in compliance with regulations herein;

- Ensure that health facilities shall have enough drugs, medical supplies and chemicals to provide health services in the basic package of health services;   

- Cooperate with provincial departments, competent authorities and social insurance agencies at all levels to make payments for health services in the basic package of health services provided by health facilities in accordance with regulations herein and relevant laws;

b) With regard to basic package of health services covered by state budget and other legal sources of funding:

- Instruct the provision of basic package of health services at grassroots health facilities;

- Cooperate with provincial departments and competent authorities at all levels to ensure funding to make payments for health services in the basic package of health services provided by health facilities in accordance with relevant laws;

c) Give advice to Provincial People s Committees about setting up the route for investment in material facilities and equipment of health facilities in conformity with current status of each health facility as well as regulations in the Decision No. 4667/QD-BYT;

d) Instruct and inspect health facilities so as to ensure that health services in the basic package of health services shall be provided in conformity with their professional and technical conditions and relevant laws;

dd) Cooperate with health facilities that are licensed and granted training codes to organize training or drilling courses so as to improve professional knowledge and skills of medical staff of health facilities providing basic package of health services.

4. Medical centers and health facilities of districts shall:

a) Provide health services in the basic package of health services in accordance with regulations herein;

b) Instruct medical stations of communes under the scope of their management to provide enough drugs, medical supplies and services in the basic package of health services;

c) Manage and inspect medical stations in providing health services in the basic package of health services to people, managing and using drugs and medical supplies, and make payment for medical stations in accordance with relevant laws.

5. Health facilities prescribed herein shall provide health services in the basic package of health services in accordance with the law.

Article 6.Effect

This Circular takes effect on December 01, 2017.

Article 7. Referenceprovisions

If legislative documents referred to herein are superseded or amended, the new ones shall prevail.

Any difficulties arising in the course of implementation of this Circular shall promptly reported to the Ministry of Health (via Department of Planning & Finance) for consideration./.

The Minister

Nguyen Thi Kim Tien

APPENDIX I

LIST OF MEDICAL PROCEDURES IN THE BASIC PACKAGE OF HEALTH SERVICES
(Attached with the Circular No. 39/2017/TT-BYT dated October 18, 2017 by Minister of Health)

APPENDIX II

LIST OF DRUGS IN THE BASIC PACKAGE OF HEALTH SERVICES
(Attached with the Circular No. 39/2017/TT-BYT dated October 18, 2017 by Minister of Health)

I. LIST OF DRUGS IN THE BASIC PACKAGE OF HEALTH SERVICES