This proposal is part of the draft Circular amending and supplementing several articles of Circular 01/2025/TT-BYT, which details and guides the implementation of the Health Insurance Law (BHYT). The Ministry of Health is currently soliciting widespread public feedback on this draft, which promises significant changes for health insurance participants.

Under current regulations, health insurance participants register for initial medical care at a designated facility. To receive treatment at a higher-level facility, a patient must obtain a transfer referral. This referral ensures full health insurance coverage; otherwise, patients are responsible for a portion of their hospital fees.

Currently, transfer referrals, available in both paper and electronic formats, are valid for 10 working days. Extending this period to 20 days will provide patients with additional time for preparation and travel, particularly benefiting those from remote areas or facing mobility challenges.

However, this extended validity does not apply to chronic diseases or disease groups detailed in Appendix III of Circular 01/2025, which include conditions like asthma, psoriasis, and osteoarthritis. For these specific cases, the referral remains valid for one year from its signing date.

Patients wait for examination at Ho Chi Minh City Oncology Hospital, facility 2. *Photo: Quynh Tran*

In an effort to accelerate digital transformation in healthcare, the Ministry of Health also proposes enabling patients to utilize transfer referrals via multiple electronic formats. Patients will be able to access their referral information using the VNeID application, the health insurance assessment information system, digitally signed electronic documents, or paper copies equipped with QR codes.

Referrals displayed within a healthcare facility's electronic health management application will be considered equivalent to their paper counterparts. This initiative aims to reduce dependence on physical documents, thereby streamlining the patient transfer process between medical facilities.

For follow-up appointment slips, the draft specifies that patients must attend the medical facility within three working days from the date noted on the slip. Should a patient be unable to keep their scheduled appointment, they are required to contact their doctor or treatment facility to arrange a new one. Current regulations do not provide specific guidance on this timeframe.

Significantly, the draft also proposes that patient transfers between medical facilities will now be determined by professional requirements and treatment capabilities, moving away from previous reliance on hospital rankings and technical specialization levels. This change aims to introduce greater flexibility into the treatment process.

For patients with chronic conditions, once their treatment is stabilized at either a basic or specialized medical facility, they may be transferred back to their initial facility for ongoing monitoring and health management. Should a reassessment of treatment outcomes be necessary, patients will return to the previously treated facility, with visits limited to a maximum of once every 6 months. This approach aims to ensure continuous healthcare for those with chronic diseases.

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