HCM City cracks down on health insurance frauds

The city's Department of Health and the Vietnam Social Security as well as other agencies are addressing violations and abuse of the fund in the remaining months of the year.

Any facility found violating the country’s criminal code related to health insurance will be investigated and punished.

The Government, for the first time, has allocated a certain level of funds to health facilities under the health insurance fund for coverage of treatment of insured patients.

The Vietnam Social Security in the city has reported that expenditures from the fund covering treatment of insured patients at health facilities in HCM City totalled 13 trillion VND (560 million USD) in the first eight months of the year, accounting for 72 percent of the estimated funds which the Government had allocated.

Phan Van Men, Director of Vietnam Social Security in the city, told Sai Gon Giai Phong newspaper that many hospitals had prescribed many high-tech tests and treatments for their patients.

The number of inpatients and outpatients in the city rose by 9.3 percent and 5 percent, respectively, in the first eight months compared to the same period last year. This led to increased costs that had to be covered by the fund.

In the first eight months, the city had nearly 7.3 million people with health insurance cards, an increase of 490,000 against the same period last year.

Many insured patients from other provinces also visited city hospitals for treatment. According to the Department of Health, the number of insured patients from other provinces rose by 6 percent in the first half of the year against the same period last year.

Men said he was concerned that the city’s fund would lack 1.8 trillion VND to cover treatment of insured patients by the end of the year.

Dr Tang Chi Thuong, deputy head of the department, told hospital directors to refrain from abuse of unnecessary high-tech treatments but to ensure quality. They were also told to prescribe medicine properly and follow the Ministry of Health’s protocols for hospitalisation, including the length of stays in hospitals, among others.

Men said that hospitals should use software that is part of the health insurance assessment system to strictly manage their allocated funds.

The Vietnam Social Security in the city would refuse payments to hospitals that abuse the fund and wrongfully charge for expenditures to cover insured patients, he added.