Ho Chi Minh City tightens oversight of health insurance expenditure for medical treatment

The Ho Chi Minh City People’s Committee has issued Document No. 2951/UBND-VX dated April 13, 2026, on strengthening management and control of health insurance expenditure for medical examination and treatment in the locality.

Under the directive, although health insurance expenditure management has made positive progress, there remain risks of abuse and fund exploitation. Therefore, tightening management, strengthening inspections, and improving the efficiency of the fund are key tasks in 2026.

Key measures for health insurance cost management

The Department of Health is tasked with leading and coordinating with the City Social Insurance and related agencies to enhance state management of health insurance. The focus is on monitoring medical facilities, promptly detecting and addressing violations, especially abuse of indications for technical services, drugs, and medical supplies.

Healthcare facilities are required to strictly comply with relevant laws and develop clear professional processes, including explicit standards for inpatient admission. Bed allocation and treatment organization must reflect actual capacity, avoiding overload or inefficient use of resources.

Digitalization and data transparency

City leadership also calls for accelerating information technology applications in health insurance cost management for medical examination and treatment. Implementing electronic medical records and standardizing and connecting data are intended to improve transparency and support cost assessment and control.

Inspection, cost appraisal, and settlement controls

The City Social Insurance Agency is tasked with strengthening cost appraisal, fully implementing rules on advances and settlement, and coordinating closely with the health sector in periodic and unscheduled inspections.

Cost control is aimed not only at saving the budget but also at ensuring the long-term sustainability of the health insurance fund.

Health insurance card allocation and patient access

There is also a review and allocation of health insurance cards registered for initial examination and treatment. The city requires allocations to align with the capacity of each facility, ensuring residents can access health services conveniently and reducing pressure on higher-level hospitals.

Protecting patient rights alongside cost control

Beyond cost control, the city emphasizes protecting patient rights. Facilities must supply all drugs and medical supplies as required, and patients should not need to purchase items externally. The selection of technical services and drugs should be reasonable and cost-effective without compromising quality.

Public education and outreach to encourage participation in health insurance are also being strengthened to broaden coverage and improve policy effectiveness.

Overall objective for 2026

With demand for medical examination and treatment continuing to grow, strict management of health insurance costs is presented as a necessary requirement. The city aims to control the fund effectively while protecting patient rights, thereby improving the quality of health services and supporting the long-term sustainability of the social security system.