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BAO HIEM XA HOI VIT NAM BAO HIEM XA HOI TiNH HlsLU GIANG so:/1405 - /BHXH-GDBHYT V/v giài quy6t, tra led kin, kien nghi caa cong clan coNG HOA xA HO! CHU NGHTA VII' NAM DO 10p - Tv do - H#nh phtic Hau Giang, ngay.ath6ng 11 nam 2017 Kinh giri: - Hi dOng nhan dan tinh H'4.0 Giang; - t'Jy ban nhan dan tinh Hu Giang. Thi,rc hien COng van sO 2065/UBND-TH ngay 17/11/2017 cila tiy ban nhan dan (UBND) tinh H.0 Giang v viec giai quyk kin, kin nghi cir tri trtrOc hop thd Bay Hi dOng nhan dan tinh Kh6a IX. Sau khi nghien ciru cac vAn 6 thuOc trach nhi'em cüa Bao him xä hi tinh theo Bao cao sO 30/13C-UBND ngay 14/11/2017 cim Hi dOng nhan dan tinh ve viec tOng hop kin, kin nghi cir tri trirOc Ky hop th* Bay HOi dOng nhan clan tinh Khoa IX. Bao him xa hOi (BHXH) tinh 1-141 Giang xin bac, cao nOi dung tra 16i mOt so kin, kin nghi tri nhu sau: 1. Ve kin "Cer tri loan tinh co phan ChM: Viec van clang toan dan tham gia biro hiim y te (BHYT) loan dan la mat Chinh scich rat tat, tuy nhien hien nay dank muc thuk clip cho benh nhan có BHYT qua kin chl, ngwbi benh phiii bo them tin mua thick ben ngoai khci nhidu hoc có trwbng hyp ra toa nhwng khong có thuk, hen ngay horn sau din thy thick nhwng ngwoi phi trcich cap thuk noi toa thick ra ngay horn trwbc nen horn nay khong clip dwvc, didu nay It nhidu iinh hwong din tam lfl ngui tham gia BHYT cria ngwbi dan. Kiln nghi Y ti, BHXH khdo sat, kiln, Ira xem CO phai danh muc thuk cap cho benh nhan BHYT con qua hun chi hay co vein di gi khcic? Neu that sr danh muc thuk cbn qua kin chi thi kiln nghi BHXH Viet Nam va Ba Y ml nen CO giái phcip tich gee how, tat hen dl BHYT loan dan that sr di vao cuac song : Danh mvc thueic thuOc pham vi thanh toan cüa quy BHYT thqc hien theo ThOng tu se') 40/2014/TT-BYT ngay 17/11/2014 dm BO Y te' bao Om 1.064 thuOc tan duqc va &rot sir dung then - 1g nh i at teen plwm vi toan quOc, cac co so . khan', chira benh (KCB) can cu theo phan h#ng benh vin va nhu cu dieu tri xay dung danh muc thuOc sir dung tai don vi d mua s'am. Di Vori thuOc dugc Bac si chi dinh sir dung cho benh nhan BHYT, co s6 KCB phai c6 trach nhiem cung irng dAy dü, khong d nguOi b'enh BHYT phai mua thuOc ben ngoai. Di voi thuOc kh'Ong duqc Bac si chi dinh ma benh nhan yeu c'au thi nguoi benh phai tvr chi tra.

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BAO HIEM XA HOI VIT NAM BAO HIEM XA HOI TiNH HlsLU GIANG

so:/1405- /BHXH-GDBHYT V/v giài quy6t, tra led kin,

kien nghi caa cong clan

coNG HOA xA HO! CHU NGHTA VII' NAM DO 10p - Tv do - H#nh phtic

Hau Giang, ngay.ath6ng 11 nam 2017

Kinh giri: - Hi dOng nhan dan tinh H'4.0 Giang; - t'Jy ban nhan dan tinh Hu Giang.

Thi,rc hien COng van sO 2065/UBND-TH ngay 17/11/2017 cila tiy ban nhan dan (UBND) tinh H.0 Giang v viec giai quyk kin, kin nghi cir tri trtrOc hop thd Bay Hi dOng nhan dan tinh Kh6a IX.

Sau khi nghien ciru cac vAn 6 thuOc trach nhi'em cüa Bao him xä hi tinh theo Bao cao sO 30/13C-UBND ngay 14/11/2017 cim Hi dOng nhan dan tinh ve viec tOng hop kin, kin nghi cir tri trirOc Ky hop th* Bay HOi dOng nhan clan tinh Khoa IX. Bao him xa hOi (BHXH) tinh 1-141 Giang xin bac, cao nOi dung tra 16i mOt so kin, kin nghi tri nhu sau:

1. Ve kin "Cer tri loan tinh co phan ChM: Viec van clang toan dan tham gia biro hiim y te (BHYT) loan dan la mat Chinh scich rat tat, tuy nhien hien nay dank muc thuk clip cho benh nhan có BHYT qua kin chl, ngwbi benh phiii bo them tin mua thick ben ngoai khci nhidu hoc có trwbng hyp ra toa nhwng khong có thuk, hen ngay horn sau din thy thick nhwng ngwoi phi trcich cap thuk noi toa thick ra ngay horn trwbc nen horn nay khong clip dwvc, didu nay It nhidu iinh hwong din tam lfl ngui tham gia BHYT cria ngwbi dan. Kiln nghi Y ti, BHXH khdo sat, kiln, Ira xem CO phai danh muc thuk cap cho benh nhan BHYT con qua hun chi hay co vein di gi khcic? Neu that sr danh muc thuk cbn qua kin chi thi kiln nghi BHXH Viet Nam va Ba Y ml nen CO giái phcip tich gee how, tat hen dl BHYT loan dan that sr di vao cuac song :

Danh mvc thueic thuOc pham vi thanh toan cüa quy BHYT thqc hien theo ThOng tu se') 40/2014/TT-BYT ngay 17/11/2014 dm BO Y te' bao Om 1.064 thuOc tan duqc va &rot sir dung then-1g nhiat teen plwm vi toan quOc, cac co so. khan', chira benh (KCB) can cu theo phan h#ng benh vin va nhu cu dieu tri xay dung danh muc thuOc sir dung tai don vi d mua s'am. Di Vori thuOc dugc Bac si chi dinh sir dung cho benh nhan BHYT, co s6 KCB phai c6 trach nhiem cung irng dAy dü, khong d nguOi b'enh BHYT phai mua thuOc ben ngoai. Di voi thuOc kh'Ong duqc Bac si chi dinh ma benh nhan yeu c'au thi nguoi benh phai tvr chi tra.

TruOng hop cac Ca so. KCB khong cung dng day dü thuOc cho ngueri benh BHYT theo quy dinh hoac d nguei benh phai tu mua thuOc c6 trong danh muc thuOc trong ch dO BHYT, BITCH tinh dê nghi cir tri c6 phan ánh ,cu the de BITCH tinh phi hop cang Si Y tê va ca so' KCB de dam bao quyen lçii cho nguOi benh theo quy dinh.

Ve kin "Cik In Dang Thynh, huyen Chau Thanh khan rinh: Hien nay O xâ có 02 Piro Cong an nhung chi dwyc cap 01 xuat BHYT nen rat kho cho phrrang".

Can dr Diem a Khoan 2 Dieu 1 Quyet dinh s 05/QD-UBND ngay 09/01/2012 dm UBND tinh Hau Giang ve viec quy dinh chirc danh, sO luong va mitc ph u cap cho nhang ngueri boat dOng khOng chuyen trach a xa, phuong, thj tran va khu vuc; s luong nhang nguoi hoat dOng khong chuyen trach xä Dong Thanh khong qua 20 ngueyi. Theo do, UBND xa chi throe 01 chitc danh Ph6 Cong an tham gia BHXH, BHYT bat buOc nh6m ngireti hog dOng khOng chuyen trach cap xa tit ngay 01/01/2016 theo quy dinh cua Luat BHXH 58/2014/QH13 va Luat BHYT hien hanh. Con lai 01 chirc danh chi tham gia BHYT nhit nh6m hO gia dinh va duqc Ngan sach tinh h tro 3% mirc (tong theo Quyet dinh sO 04/2012/QD-UBND ngdy 09/01/2012 dm UBND tinh Hu Giang ve viec quy dinh sa luong và mitc tro cap cho luc luong Dan quan tu ve, COng an vien, Pho Chu tich Hi Chit thap do O. xä, phiterng, thj tan va cac chirc danh doan the a p, khu vuc.

Ve kin "Cu. tri xd Vinh Viln A, huyen Long my phan anh trtrowg hyp the BHYT khong ghi rô ngay, thcing bat diiu drive sir' dung va ngay het hyn sir. dung the BHYT, bit con Ming biet khi nao the BHYT het hyn anh &rang den viec KCB cita ba con. De nghi BHXH tinh kiem Ira va giiii thich nguyen nhiin sty viec tren cho ngirai thorn gia BHYT dui& bier:

Thuc hien Quyet dinh se') 595/QD-BHXH ngay 14/4/2017 cua TOng Giam dc BHXH Viet Nam ban hanh Quy trinh thu BHXH, BHYT, bao him that nghiep (BHTN), bao him tai nan lao dOng - benh nghe nghiep (BHTNLD - BNN); quan 1 sO BHXH, the BHYT; Cong van sa 3340/BHXH-ST ngay 08/8/2017 ve viec cap sO BHXH, the BHYT theo ma sO BHXH. Theo do, thei han six dung the BHYT: chi in "Gia tri sir dung tir ngay, thang, nate khong ghi ngay ket thüc, tin tai cap sO BHXH, the BHYT din tit, nham day manh cong tac cai each thu tic hanh chinh, thuc hien img dung cong nghe thong tin thanh cong trong viec quan 1 dir 1iu ngueti tham gia BHXH, BHYT theo yeu cu cüa Chinh phü va Quoc hi, nang cao chat luong phuc viii nhan dan.

Hien tai, ca quan BHXH cung cap danh sach ngirei dan tham gia BHYT den han phai &mg ten tirng dia ban cho h thOng Dail'Y thu de thong bao va van dOng ngueri dan tham gia BHYT; &Ong thoi, tap huan, huang dn cho nhan vien

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1. GIAM DOC , PHO GIAM DOC

Quich Thi Bich Phuyng

D4i 1 thu ghi ci th'e thed hp sir diving the BHYT tir ngay - thang - nam bat dau den ngay - thang - nam ket thitc teen phieu thu tin &mg BHYT d ngtred dan biet dugc khi nao the BHYT het hp sir dipg d tham gia.

Tren day la kin tra led cua BHXH tinh HP Giang, kinh bao cao UBND tinh va Hi dong nhan dan tinh HP Giang./.

Noi nh(in: - Nhu teen; - Giám d6e, the Ph6 Giam dc BHXH tinh; - BHXH cac huy0, thi xä, thanh ph6; - Phong: QLT, GDBHYT; - Luu: VT, Vp„,

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