Nghị định 92/2011/ND-CP

DECREE

DEFINING ON ADMINISTRATIVE SANCTIONS IN THE FIELD OF HEALTH INSURANCE

THE GOVERMENT

Pursuant to the Law on Governmental Organization dated December 25, 2001;

Pursuant to the Law on Health Insurance dated November 14, 2008;

Pursuant to Ordinance No.44/2002/PL-UBTVQH10 dated July 02, 2002 of the National Assembly Standing Committee on Handling of Administrative Violations, Ordinance No.04/2008/UBTVQH12 dated April 02, 2008 of the National Assembly Standing Committee amending and supplementing some Articles of Ordinance No.44/2002/PL-UBTVQH10 dated July 02, 2002 of the National Assembly Standing Committee on Handling of administrative Violations;

At the proposal of the Minister of Health,

DECREES:

Chapter 1.

GENERAL PROVISIONS

Article 1. Scope of governing

1. This Decree provides for the administrative violations, forms, and levels of sanction, remedies, competence to sanction administrative violations in the field of health insurance (HI).

2. Act of administrative violation on HI is an act committed intentionally or unintentionally by individuals, agencies and organizations (hereinafter referred to as individuals and organizations) the violations of the provisions of law on HI that are not crimes and as prescribed by law, must be handled for administrative violations.

3. The administrative violations in the field of HI, include:

a) Violation of regulations on payment for HI premium and collection of HI premium;

b) Violation of regulations on the grant, re-grant, renewal of card and use of HI card;

c) Violation of regulations on organization of HI medical examination, treatment, HI appraisal;

d) Violation of regulations on management and use of HI;

đ) Violation of regulations on report, provision for information and data on HI;

e) Violation of regulations on inspection, examination, obstruction of state management activities on HI.

Article 2. Interpretation of terms

1. Abuse of health services means the appointment and use of drugs, chemicals, medical materials, technical services and other health services in medical examination and treatment in excess of the necessary level compared to the provisions of medical technical expertise damaging the patients with HI cards, HI fund, and establishments of medical examination and treatment.

2. Information on HI card relating to HI benefits and benefit levels means the information specified by numbers, symbols, characters, or other forms on HI card for used as a basis for determining the HI benefits and benefit levels for each object participating in HI.

3. Acts of obstructing or causing difficulties mean the acts failing to cooperate or failing to implement requirement of cooperation or self-regulating, making unlawful requirements in the implementation of HI for the parties involved in HI.

4. The level of administrative violations prescribed in this Decree means the level of financial losses (in Vietnam dong) for individuals and organizations related to HI.

Article 3. The principles for sanctioning, the prescription for sanctioning and time limit considered as not yet sanctioned for administrative violations

1. Principles for sanctioning administrative violations in the field of HI shall comply with the provisions of Article 3 of the Ordinance on Handling of Administrative Violations No.44/2002/PL-UBTVQH10 dated July 02, 2002 and Article 3 of Decree No.128/2008/ND-CP dated December 16, 2008 of the Government detailing the implementation of some Articles of the 2002 Ordinance on Handling of Administrative Violations and the Ordinance  amending and supplementing some Articles of the 2008 Ordinance on Handling of administrative violations.

2. The sanctione of administrative violations in the field of HI implemented by the competent persons shall comply with the provisions of Articles 45, 46, 47, 48 and 49 of this Decree.

3. The extenuating, aggravating circumstances applied to sanction of administrative violations on HI are reviewed and processed under the provisions of Article 8 and Article 9 of the 2002 Ordinance on Handling of Administrative Violations and Article  6 of Decree No.128/2008/ND-CP dated December 16, 2008 of the Government detailing the implementation of some Articles of the 2002 Ordinance on Handling of Administrative Violations and the Ordinance amending and supplementing a number of Articles of the 2008 Ordinance on Handling of Administrative Violations.

4. Prescription for sanctioning administrative violations in the field of HI is 12 months from the date that administrative violation is made. For administrative violations related to the collection, payment, and management, use of HI fund, the prescription shall be 24 months from the date of the administrative violation. If the time limit is over, the violating individuals and organizations shall not be sanctioned, but still subject to the remedies prescribed in Clause 3, Article 4 of this Decree.

5. Within the time limit provided for in Clause 4 of this Article, individuals and organizations commit new act of administrative violations in the field of HI or deliberately evade or delay the sanction shall not apply to the above prescription, the prescription for sanctioning administrative violation shall be recalculated from the time of the new administrative violations or time of termination of the act of evasion, delay of sanction.

6. For individuals to be sued, prosecuted or had a decision to bring the case to trial in accordance with criminal proceedings that have decided to suspend the investigation or suspend the case, they shall be subject to administrative sanctions if there is evidence of administrative violation, in this case, the prescription for sanctioning shall be 03 months from the date of the decision to suspend the investigation or suspend the case.

7. Organizations and individuals sanctioned for administrative violations of HI law if after 12 months from the date of completely serving the sanctioning decisions or from the date of expiry of prescription for execution of sanctioning decisions that they do not violate again, they shall be considered as not yet been sanctioned for administrative violations in the field of HI.

Article 4. The forms of sanction and remedies

1. Form of main sanction

Individuals and organizations committing acts of administrative violations in the field of HI shall be subject to one of the following sanctions:

a) Warning;

b) Fine: The maximum fine level of handling of administrative violations in the field of HI is 40,000,000 VND (forty million VND).

2. Form of additional sanction: Confiscating material evidences and means used for administrative violations in the field of HI;

3. Remedies:

In addition to the forms of sanction specified in Clauses 1 and Clause 2 of this Article, individuals and organizations committing acts of administrative violations, shall be subject to one or more following remedies:

a) Withdrawn HI cards; temporarily kept HI cards;

b) Forced to retrospectively pay, refund the violated amounts according to provisions of law on HI into revenue account of HI fund within 10 working days from the date of delivery of the decision to sanction for violation of HI premium payment;

c) Forced to pay interest of the HI premium not yet been paid, or paid late according to the basic interest rate announced by the state bank at the time of handling administrative violations;

d) Forced to reimburse the violated amounts to the affected individuals and organizations within 10 working days from the date of delivery of the decision to sanction;

đ) Forced to regrant the HI cards, renew the HI cards in accordance with regulations;

e) Forced to report, provide for accurate information and data on HI;

g) Forced to observe the inspection, examination, and the provisions of the competent authorities on HI.

Chapter 2.

VIOLATIONS, FORMS AND LEVELS OF SANCTION

SECTION 1. VIOLATIONS OF PAYMENT, COLLECTION OF HI PREMIUM

Article 5. Acts of failing to pay HI premium of the objects who are responsible for participating HI

1. A warning shall be imposed;

2. A fine of between VND 50,000 and 100,000 shall be imposed.

3. Remedies:

a) Forced to participating in HI in accordance with the law provisions on HI;

b) Forced to pay the payable amount into the revenue accounts of HI fund.

Article 6. Acts of failing to pay HI premium for all the employees who are responsible for participating in the health insurance of employers

1. A fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000, when committing violation from 01 to 10 employees;

b) Between VND 1,000,000 and 5,000,000 when committing violation from 11 to 50 employees;

c) Between VND 5,000,000 and 10,000,000 when committing violation from 51 to 100 employees;

d) Between VND 10,000,000 and 15,000,000 when committing violation from 101 to 500 employees;

đ) Between VND 15,000,000 and 20,000,000 when committing violation from 501 to 1,000 employees;

e) Between VND 20,000,000 and 30,000,000 when committing violation from 1001 employees or more.

2. Remedies:

a) Forced to pay HI premium for all the employees who are responsible for participating in the health insurance according to law provisions on HI;

b) Forced to reimburse expenses of medical examination and treatment under HI benefits and benefit levels that HI participants had to be paid (if any);

c) Forced to make payment for the unpaid anount and interest accrued by the unpaid amount, amount of late payment into revenue account of the HI fund.

Article 7. The acts of paying health insurance premium of inadequate number of persons who are responsible for participating in the health insurance of employers

1. A fine of between 300,000 VND and 1,000,000 VND shall be imposed when committing violation of failing to pay HI premium for each employee.

2. Remedies:

a) Forced to pay for inadequate number of laborers who are responsible for participating in the health insurance under the provisions of the law on HI;

b) Forced to reimburse expenses of medical examination and treatment under HI benefits and benefit levels that HI participants had to be paid (if any).

c) Forced to make payment for the payable amount and interest accrued by the payable amount into revenue account of the HI fund.

Article 8. The acts of paying health insurance of inadequate number of payable amount

1. A fine shall be imposed by the following levels:

a) Between VND 300,000 and 500,000 for the violation valued at less than VND 5,000,000;

b) Between VND 500,000 and 1,000,000 for the violations valued at VND 5,000,000 to less than VND 10,000,000;

c) Between VND 1,000,000 and 2,000,000 for the violations valued at VND 10,000,000 to less than VND 20,000,000;

d) Between VND 2,000,000 and 4,000,000 for the violations valued at VND 20,000,000 to less than VND 40,000,000;

đ) Between VND 4,000,000 and VND 8,000,000 for the violations valued at VND 40,000,000 to less than VND 60,000,000;

e) Between VND 8,000,000 and 12,000,000 for the violations valued at VND 60,000,000 to less than VND 80,000,000;

g) Between VND 12,000,000 and 16,000,000 VND for the violations valued at VND 80,000,000 to less than VND 120,000,000;

h) Between VND 16,000,000 and 24,000,000 VND for the violations valued at VND 120,000,000 to less than VND 160,000,000;

i) Of between VND 24,000,000 and VND 32,000,000 VND for the violation valued at VND 160,000,000 or more.

2. Remedies:

a) Forced to pay the full payable health insurance premium for the entire number of employees;

b) Forced to make payment for the payable amount and interest accrued by the payable amount into revenue account of the HI fund.

Article 9. The acts of permitting persons who are not belong to the management responsibilities to the lists of agencies and organizations to participate in health insurance

1. Fine shall be imposed for agencies and organizations permitting participants of HI not in compliance with provisions by the following levels:

a) Between VND 500,000 and 1,000,000 calculated on each HI card in case of violation but not harming the HI fund;

b) Between VND 1,000,000 and 2,000,000 calculated on each HI card in case of used in the medical examination, treatment of HI causing damage to HI fund.

2. Fine shall be imposed for individuals participating in HI at the agency, organization not in compliance with provisions by the following levels:

a) Between VND 300,000 and 1,000,000 VND calculated on each person having HI card but not using HI card for medical examination, treatment of HI;

b) Between VND 1,000,000 and 2,000,000 calculated on each person having HI card and used HI card for medical examination, treatment of HI.

3. Remedies:

a) Withdrawn HI card;

b) Forced to reimburse the amount paid to HI fund in medical examination, treatment of HI.

Article 10. Acts of confirming improper payment level of participants in health insurance

1. A fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations valued at less than VND 10,000,000;

b) Between VND 1,000,000 and 2,000,000 VND for the violations valued at VND 10,000,000 to less than VND 20,000,000;

c) Between VND 2,000,000 and 4,000,000 for the violations valued at VND 20,000,000 to less than VND 40,000,000;

d) Between VND 4,000,000 and 8,000,000 VND for the violations valued at VND 40,000,000 to less than VND 60,000,000;

đ) Between VND 8,000,000 and 12,000,000 for the violations valued at VND 60,000,000 to less than VND 80,000,000;

e) Between VND 12,000,000 and 16,000,000 VND for the violations valued at VND 80,000,000 to less than VND 100,000,000;

g) Between VND 16,000,000 and 24,000,000 VND for the violations valued at between VND 100,000,000 to less than VND 120,000,000;

h) Between VND 24,000,000 and 32,000,000 VND for the violations valued at VND 120,000,000 to less than VND 150,000,000;

i) Between VND 32,000,000 and 40,000,000 VND for the violations valued at VND 150,000,000 or more.

2. Remedies: Forced to determine the correct payable amount of premium and to make payment for the payable amount of premium in accordance with provisions as well as interest accrued by unpaid amount into revenue account of the HI fund.

Article 11. Acts of grant, transfer of funds from the state budget for paying health insurance not in compliance with the specified amount

1. A warning shall be imposed for first violations and not causing damage to the health insurance fund, the interests of the objects participating in HI.

2. A fine of between 500,000 VND and 1,000,000 VND shall be imposed for the cases of recidivism, but not harming the health insurance fund, the interests of the objects participating in HI.

3. A fine shall be imposed for the violations causing damage to the health insurance fund, the interests of the objects participating in HI:

a) Between VND 1,000,000 and 2,000,000 VND for the violations valued at less than VND 500,000,000;

b) Between VND 2,000,000 and 4,000,000 VND for the violations valued at VND 500,000,000 to less than 1.000.000.000 VND;

c) Between VND 4,000,000 and VND 8,000,000 for the violations valued at VND 1,000,000,000 VND to less than 5.000.000.000 VND;

d) Between VND 8,000,000 and 16,000,000 for the violations valued at VND 5,000,000,000 VND or more.

4. Remedies:

a) Forced to grant, transfer fully funding according to the premiums and the number of objects participating in HI;

b) Forced to reimburse the violated amounts, including interest incurred in revenue account of the health insurance fund (if any).

Article 12. The acts of granting, transferring funds from the state budget 30 days later than the prescribed time after having all the procedures for the issuance, transfer of funds according to provisions for paying HI premiums

1. Warning shall be imposed in case of first violations and not causing damage to the interests of health insurance fund, health insurance participants.

2. A fine of between 100,000 VND and 300,000 VND shall be imposed for the cases of recidivism, but not harming the health insurance fund, the interests of health insurance participants.

3. Fine shall be imposed for violations causing damage to the interests of the health insurance fund, the interests of health insurance participants by the following levels:

a) Between VND 1,000,000 and 2,000,000 VND for the violations valued at less than VND 500,000,000;

b) Between 2,000,000 and 4,000,000 for the violations valued at VND 500,000,000 to less than 1,000,000,000 VND;

c) Between VND 4,000,000 and VND 8,000,000 for the violations valued at 1,000,000,000 to less than 10,000,000,000 VND;

d) Between VND 8,000,000 and 16,000,000 for the violation valued at 10,000,000,000 VND or more.

4. Remedies:

a) Forced to grant, transfer funding to pay the HI in accordance with the prescribed time;

b) Forced to reimburse expenses for medical examination and treatment under health insurance benefits and benefit levels that HI participants had to be paid (if any);

c) Forced to transfer the amount of interest of the late payment into the revenue account of HI fund (if any) within 10 days from the date of the sanctioning decision.

SECTION 2. VIOLATIONS ON ISSUANCE OF CARDS, RENEWAL OF CARDS, AND USE OF CARDS OF HI

Article 13. The acts of making and transferring the list of issuance of health insurance cards to the participants in health insurance who are belong to the management responsibility slower than the prescribed time

1. Warning shall be imposed in case of first violations and not causing damage to the interests of health insurance fund, health insurance participants.

2. A fine of between 100,000 VND and 300,000 VND shall be imposed for the cases of recidivism, but not harming the interests of health insurance participants.

3. Fine shall be imposed for violations causing damage to the interests of health insurance participants by the following levels:

a) Between VND 300,000 and 500,000 in case of late less than 10 working days as prescribed;

b) Between VND 500,000 and 1,000,000 VND in case of late from 10 working days or more as prescribed.

4. Remedies:

a) Force to make and transfer timely the list of HI participants under the provisions;

b) Forced to reimburse expenses for medical examination and treatment under health insurance benefits and benefit levels that HI participants had to be paid (if any).

Article 14. The acts of making and transferring the list of issuance of health insurance cards to the participants in health insurance who are belong to their management responsibility inadequate number of persons as prescribed

1. Warning shall be imposed in case of first violations and not causing damage to the interests of health insurance participants.

2. A fine of between 100,000 VND and 300,000 VND shall be imposed for the cases of recidivism, but not harming the interests of health insurance participants.

3. A fine shall be imposed for violations causing damage to the interests of health insurance participants by the following levels:

a) Between VND 300,000 and 500,000 VND for the case of missing less than 50 persons in the list;

b) Between VND 500,000 and 1,000,000 for the case of missing 50 persons to less than 100 persons in the list;

c) Between VND 1,000,000 and 2,000,000 for the case of missing 100 persons to less than 500 persons in the list;

d) Between VND 2,000,000 and 4,000,000 for the case of missing 500 persons to less than 1.000 persons in the list;

đ) Between VND 4,000,000 and 8,000,000 for the case of missing 1,000 persons or more in the list.

4. Remedies:

a) Force to make and transfer timely the list of HI participants under the provisions;

b) Forced to reimburse expenses for medical examination and treatment under health insurance benefits and benefit levels that HI participants had to be paid (if any).

Article 15. The acts of issuing health insurance cards slower than the specified time

1. Caution shall be imposed in case of issuing health insurance cards late less than 10 working days compared with the prescribed time.

2. A fine shall be imposed in case of issuing health insurance cards late from 10 working days or more compared with the specified time, by the following levels:

a) Between VND 300,000 and 500,000 in case of late issuance of 01 to less than 50 cards;

b) Between VND 500,000 and 1,000,000 in case of late issuance of 50 to less than 100 cards;

c) Between VND 1,000,000 and 2,000,000 in case of late issuance of 100 to less than 500 cards;

d) Between VND 2,000,000 and 4,000,000 in case of late issuance of 500 to less than 1,000 cards;

đ) Between VND 4,000,000 and VND 8,000,000 in case of late issuance of 1,000 cards or more.

2. Remedies:

a) Forced to issue health insurance cards for the HI participants within 10 working days from the date of delivery of the decision to handle violations;

b) Forced to reimburse expenses for medical examination and treatment under health insurance benefits and benefit levels that HI participants had to be paid (if any).

Article 16. The acts of re-grant or renewal of health insurance cards slower than the specified time

1. Warning shall be imposed in case of late re-grant or renewal of health insurance cards less than 10 working days compared with the prescribed time.

2. A fine shall be imposed in case of late re-grant or renewal of health insurance cards from 10 working days or more compared with the specified time, by the following levels:

a) Between VND 300,000 and 500,000 in case of late re-grant or renewal of health insurance cards at less than 50 cards;

b) Between VND 500,000 and 1,000,000 in case of late re-grant or renewal of health insurance cards from 50 to less than 100 cards;

c) Between VND 1,000,000 and 2,000,000 in case of late re-grant or renewal of health insurance cards from 100 to less than 500 cards;

d) Between VND 2,000,000 and 4,000,000 in case of late re-grant or renewal of health insurance cards from 500 to less than 1,000 cards;

đ) Between VND 4,000,000 and 8,000,000 in case of late re-grant or renewal of health insurance cards from 1,000 cards or more.

3. Remedies:

a) Forced to issue health insurance cards for the HI participants within 10 working days from the date of delivery of the decision to handle violations;

b) Forced to reimburse expenses for medical examination and treatment under health insurance benefits and benefit levels that HI participants had to be paid (if any).

Article 17. The acts of issuing health insurance cards to improper objects to be issued health insurance cards

1. A fine shall be imposed by the following levels:

a) Between VND 1,000,000 and 2,000,000 on each health insurance card not yet used for medical examination, treatment of health insurance;

b) Between VND 2,000,000 and 4,000,000 on each health insurance card used for medical examination, treatment of health insurance.

2. Remedies:

a) Withdrawn health insurance cards;

b) Forced to reimburse amount of medical examination, treatment that health insurance fund has already paid (if any) to the revenue account of the health insurance fund.

Article 18. Acts of issuing HI cards wrongly on benefits, the levels of benefit of the HI participants

1. A fine shall be imposed by the following levels:

a) Between VND 300,000 and 500,000 on each health insurance card not yet used for medical examination, treatment of health insurance;

b) Between VND 500,000 and 1,000,000 on each health insurance card used for medical examination, treatment of health insurance.

2. Remedies:

a) Withdrawn health insurance cards;

b) Forced to re-grant health insurance card according to the correct information regarding rights and levels of benefit for the HI participants;

c) Forced to reimburse expenses for medical examination and treatment under the scope of rights and levels of HI benefit that the HI participants had to be paid (if any);

d) Forced to refund the difference of paid health insurance fund (if any) to the revenue account of the health insurance fund.

Article 19. The acts of issuing health insurance cards with use validity not in compliance with the participation time of HI participants

1. A fine shall be imposed by the following levels:

a) Between VND 300,000 and 500,000 on each health insurance card not yet used for medical examination, treatment of health insurance;

b) Between VND 500,000 and 1,000,000 on each health insurance card used for medical examination, treatment of health insurance.

2. Remedies:

a) Withdrawn health insurance cards;

b) Forced to re-grant health insurance card with use validity in compliance with provisions;

c) Forced to reimburse expenses for medical examination and treatment under the scope of rights and levels of HI benefit that the HI participants had to be paid (if any);

d) Forced to reimburse the amount used during the time of medical examination, treatment outside the valid time of using health insurance card (if any) to the revenue account of the health insurance fund.

Article 20. The acts of erasing, fixing the health insurance cards for use in medical examination and treatment of health insurance

1. A fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations but not harming the health insurance fund;

b) Between VND 1,000,000 and 2,000,000 VND for the violations causing damage to the health insurance fund.

2. Remedies:

a) Withdrawn health insurance cards;

b) Forced to reimburse the amounts that health insurance fund has paid (if any) to the revenue account of the health insurance fund.

Article 21. The acts of permitting other people to borrow health insurance cards or using health insurance cards for others to use in the medical examination and treatment

1. A fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations but not harming the health insurance fund;

b) Between VND 1,000,000 and 2,000,000 VND for the violations causing damage to the health insurance fund.

2. Remedies:

a) Temporarily keep health insurance cards within 30 days;

b) HI card users are responsible for paying the full cost of medical examination, treatment paid by health insurance fund (if any) to the revenue account of the health insurance fund;

c) The HI card lenders are enjoyed benefits of HI only after the time limit of 30 days from the date of temporary seizure of the card and fine was paid according to regulations.

SECTION 3. VIOLATION ON ORGANIZATION OF MEDICAL EXAMINATION AND TREATMENT, APPRAISAL OF HEALTH INSURANCE

Article 22. The acts of setting up the case history, making prescription of drug without patients in reality but not serious enough for criminal prosecution

1. Warning shall be imposed for the first violations and the violations valued at less than VND 1,000,000;

2. A fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations valued at VND 1,000,000 to less than VND 2,000,000;

b) Between VND 1,000,000 and 2,000,000 VND for the violations valued at VND 2,000,000 to less than VND 4,000,000;

c) Between VND 2,000,000 and 4,000,000 for the violations valued at VND 4,000,000 to less than VND 8,000,000;

d) Between VND 4,000,000 and 8,000,000 VND for the violations valued at VND 8,000,000 to less than VND 12,000,000;

đ) Between VND 8,000,000 and 12,000,000 for the violations valued at VND 12,000,000 to less than VND 24,000,000;

e) Between VND 12,000,000 and 16,000,000 for the violations valued at VND 24,000,000 to less than VND 48,000,000;

g) Between VND 16,000,000 and 20,000,000 for the violations valued at VND 48,000,000 to less than VND 72,000,000;

h) Between VND 20,000,000 and 24,000,000 for the violations valued at VND 72,000,000 or more.

3. Remedies: Forced to reimburse the full violated amount into the revenue account of HI fund.

Article 23. The act of recording increase for the amount or adding volume or drugs, medical materials, technical services, costs of hospital beds and other expenses that patients do not use in reality

1. Warning shall be imposed for first violations and the violations valued at less than VND 1,000,000.

2. A fine of between 300,000 VND and 500,000 VND shall be imposed for the cases of recidivism and the violations valued at less than VND 1,000,000.

3. A fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations valued at VND 1,000,000 to less than VND 2,000,000;

b) Between VND 1,000,000 and 2,000,000 for the violations valued at VND 2,000,000 to less than VND 5,000,000;

c) Between VND 2,000,000 and 4,000,000 for the violations valued at VND 5,000,000 to less than VND 10,000,000;

d) Between VND 4,000,000 and 8,000,000 for the violations valued at VND 10,000,000 to less than VND 20,000,000;

đ) Between VND 8,000,000 and 12,000,000 for the violations valued at VND 20,000,000 to less than VND 30,000,000;

e) Between VND 12,000,000 and 16,000,000 VND for the violations valued at VND 30,000,000 to less than VND 40,000,000;

g) Between VND 16,000,000 and 20,000,000 VND for the violations valued at VND 40,000,000 to less than VND 50,000,000;

h) Between VND 20,000,000 and 30,000,000 VND for the violations valued at VND 50,000,000 to less than VND 60,000,000;

i) Between VND 30,000,000 and 40,000,000 VND for the violations valued at VND 60,000,000 or more.

4. Remedies:

a) Forced to reimburse the violated amount to revenue accounts of the health insurance fund;

b) Forced to reimburse expenses for medical examination and treatment under the scope of rights and benefit level of health insurance which the objects had to be paid (if any).

Article 24. The acts of violating the benefit level of the participants in health insurance

1. Warning shall be imposed for first violations and valued at less than VND 1,000,000.

2. Fine of between 300,000 VND and 500,000 VND shall be imposed for the case of recidivism and the violations valued at less than VND 1,000,000.

3. Fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations valued at VND 1,000,000 to less than VND 5,000,000;

b) Between VND 1,000,000 and 2,000,000 for the violations valued at VND 5,000,000 to less than VND 10,000,000;

c) Between VND 2,000,000 and 3,000,000 for the violations valued at VND 10,000,000 to less than VND 15,000,000;

d) Between VND 3,000,000 and 4,000,000 for the violations valued at VND 15,000,000 to less than VND 20,000,000;

đ) Between VND 4,000,000 and 5,000,000 for the violations valued at VND 20,000,000 to less than VND 40,000,000;

e) Between VND 5,000,000 and 6,000,000 for the violations valued at VND 40,000,000 or more.

4. Remedies:

a) Forced to reimburse expenses for medical examination and treatment under the scope of benefit which the objects had to be paid (if any);

b) Forced to reimburse the amount that HI fund was damaged (if any) to revenue account of the health insurance fund.

Article 25. The acts of committing violations on the HI levels of participants in health insurance

1. Warning shall be imposed for first violations and valued at less than VND 1,000,000.

2. Fine of between 300,000 VND and 500,000 VND shall be imposed for the case of recidivism and the violations valued at less than VND 1,000,000.

3. Fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations valued at VND 1,000,000 to less than VND 2,000,000;

b) Between VND 1,000,000 and 2,000,000 for the violations valued at VND 2,000,000 to less than VND 5,000,000;

c) Between VND 2,000,000 and 3,000,000 for the violations valued at VND 5,000,000 to less than VND 10,000,000;

d) Between VND 3,000,000 and 4,000,000 for the violations valued at VND 10,000,000 to less than VND 20,000,000;

đ) Between VND 4,000,000 and 5,000,000 for the violations valued at VND 20,000,000 to less than VND 40,000,000;

e) Between VND 5,000,000 and 6,000,000 for the violations valued at VND 40,000,000 or more.

4. Remedies:

a) Forced to reimburse expenses for medical examination and treatment under the level of HI benefit which the objects had to be paid (if any);

b) Forced to reimburse the amount that HI fund was damaged (if any) to revenue account of the health insurance fund.

Article 26. Acts of incomplete supply of drugs, chemicals, medical materials, technical services in medical examination and treatment of health insurance

1. Warning shall be imposed for first violations and valued at less than VND 1,000,000.

2. Fine of between 300,000 VND and 500,000 VND shall be imposed for the case of recidivism and the violations valued at less than VND 1,000,000.

3. Fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations valued at VND 1,000,000 to less than VND 10,000,000;

b) Between VND 1,000,000 and 2,000,000 for the violations valued at VND 10,000,000 to less than VND 20,000,000;

c) Between VND 2,000,000 and 4,000,000 for the violations valued at VND 20,000,000 to less than VND 40,000,000;

d) Between VND 4,000,000 and 8,000,000 for the violations valued at VND 40,000,000 to less than VND 80,000,000;

đ) Between VND 8,000,000 and 16,000,000 for the violations valued at VND 80,000,000 to less than VND 120,000,000;

e) Between VND 16,000,000 and 32,000,000 for the violations valued at VND 120,000,000 to less than VND 160,000,000;

g) Between VND 32,000,000 and 40,000,000 for the violations valued at VND 160,000,000 or more.

4. Remedies:

a) Forced to supply fully drugs, chemicals, medical materials, technical service as prescribed;

b) Forced to reimburse expenses for medical examination and treatment which the objects had to be paid (if any).

Article 27. The acts of abusing medical services in the medical examination and treatment of health insurance

1. Warning shall be imposed for first violations and valued at less than VND 1,000,000.

2. A fine of between 300,000 VND and 500,000 VND shall be imposed for the case of recidivism and the violations valued at less than VND 1,000,000.

3. A fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations valued at VND 1,000,000 to less than VND 5,000,000;

b) Between VND 1,000,000 and 2,000,000 for the violations valued at VND 5,000,000 to less than VND 10,000,000;

c) Between VND 2,000,000 and 4,000,000 for the violations valued at VND 10,000,000 to less than VND 20,000,000;

d) Between VND 4,000,000 and 8,000,000 for the violations valued at VND 20,000,000 to less than VND 40,000,000;

đ) Between VND 8,000,000 and 16,000,000 for the the violations valued at VND 40,000,000 to less than VND 60,000,000;

e) Between VND 16,000,000 and 32,000,000 VND for the violations valued at VND 60,000,000 to less than VND 80,000,000;

g) Between VND 32,000,000 and 40,000,000 VND for the violations valued at VND 80,000,000 or more.

4. Remedies:

a) Forced to reimburse the amount that HI participants were damaged (if any);

b) Forced to reimburse the violated amount into the revenue account of the health insurance fund (if any).

Article 28. The acts of applying false prices, writing wrong category, unit, name of technical services in payment of the costs and medical examination, treatment of health insurance

1. Warning shall be imposed for first violations and valued at less than VND 1,000,000.

2. A fine of between 300,000 VND and 500,000 VND shall be imposed for the case of recidivism and the violations valued at less than VND 1,000,000.

3. A fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations valued at VND 1,000,000 to less than VND 5,000,000;

b) Between VND 1,000,000 and 2,000,000 for the violations valued at VND 5,000,000 to less than VND 10,000,000;

c) Between VND 2,000,000 and 4,000,000 for the violations valued at VND 10,000,000 to less than VND 20,000,000;

d) Between VND 4,000,000 and 8,000,000 for the violations valued at VND 20,000,000 to less than VND 40,000,000;

đ) Between VND 8,000,000 and 16,000,000 for the violations valued at VND 40,000,000 to less than VND 80,000,000;

e) Between VND 16,000,000 and 32,000,000 for the violations valued at VND 80,000,000 to less than VND 120,000,000;

g) Between VND 32,000,000 and 40,000,000 for the violations valued at VND 120,000,000 or more.

4. Remedies:

a) Forced to reimburse the violated amount into the revenue account of the health insurance fund;

b) Forced to reimburse expenses for medical examination and treatment under the scope of right and benefit level of HI which the objects had to be paid (if any).

Article 29. The acts of wrong determination of benefits in the medical examination, treatment of medical insurance compared with information in the HI card

1. Warning shall be imposed for first violations and valued at less than VND 1,000,000.

2. A fine of between 300,000 VND and 500,000 VND shall be imposed for the case of recidivism and the violations valued at less than VND 1,000,000.

3. Fine shall be imposed by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations valued at VND 1,000,000 to less than VND 5,000,000;

b) Between VND 1,000,000 and 2,000,000 for the violations valued at VND 5,000,000 to less than VND 10,000,000;

c) Between VND 2,000,000 and 3,000,000 for the violations valued at VND 10,000,000 to less than VND 15,000,000;

d) Between VND 3,000,000 and 4,000,000 for the violations valued at VND 15,000,000 to less than VND 20,000,000;

đ) Between VND 4,000,000 and 5,000,000 for the violations valued at VND 20,000,000 to less than VND 40,000,000;

e) Between VND 5,000,000 and 6,000,000 for the violations valued at VND 40,000,000 or more.

4. Remedies:

a) Forced to reimburse expenses for medical examination and treatment under the scope of right which the objects had to be paid (if any);

b) Forced to reimburse the amount that the establishments of medical examination and treatment are damaged (if any);

c) Forced to reimburse the violated amount into the revenue account of the health insurance fund (if any).

Article 30. The acts of causing difficulties or obstacles to medical examination and treatment of health insurance

1. Warning shall be imposed for first violations and not harming the interests of the HI participants, establishments of medical examination and treatment of health insurance.

2. A fine of between 300,000 VND and 500,000 VND shall be imposed for cases of recidivism, but not harming the interests of the HI participants, establishments of medical examination and treatment of health insurance.

3. A fine shall be imposed for violations of causing damage by the following levels:

a) Between VND 500,000 and 1,000,000 for the violations valued at VND 1,000,000 to less than VND 5,000,000;

b) Between VND 1,000,000 and 2,000,000 for the violations valued at VND 5,000,000 to less than VND 10,000,000;

c) Between VND 2,000,000 and 3,000,000 for the violations valued at VND 10,000,000 to less than VND 15,000,000;

d) Between VND 3,000,000 and 4,000,000 for the violations valued at VND 15,000,000 to less than VND 20,000,000;

đ) Between VND 4,000,000 and 5,000,000 for the violations valued at VND 20,000,000 to less than VND 40,000,000;

e) Between VND 5,000,000 and 6,000,000 for the violations valued at VND 40,000,000 or more.

4. Remedies:

a) Forced to reimburse expenses for medical examination and treatment under the scope of right and benefit level which the objects had to be paid (if any);

b) Forced to reimburse the amount that the establishments of medical examination and treatment are damaged (if any).

Article 31. Acts of violation of regulations, specialized regulations in the establishments of medical examination and treatment when conducting appraisal of health insurance

1. Warning shall be imposed for first violations and not harming the interests of the HI participants, establishments of medical examination and treatment.

2. A fine of between 300,000 VND and 500,000 VND shall be imposed for cases of recidivism, but not harming the interests of the HI participants, establishments of medical examination and treatment.

3. A fine of between 500,000 VND and 2,000,000 VND shall be imposed for the violations harming the interests of the HI participants, establishments of medical examination and treatment.

4. Remedies:

a) Forced to comply with regulations and provisions;

b) Forced to reimburse the violated amounts to the establishments of medical examination and treatment (if any).

Article 32. The acts of not publicizing, not being transparent when conducting appraisal of health insurance

1. Warning shall be imposed for first violations and not harming the interests of the HI participants, establishments of medical examination and treatment and HI fund.

2. Fine of between 300,000 VND and 500,000 VND shall be imposed for cases of recidivism, but not harming the interests of the HI participants, establishments of medical examination and treatment and HI fund.

3. A fine of between 500,000 VND and 2,000,000 VND shall be imposed for the violations harming the interests of the HI participants, establishments of medical examination and treatment or HI fund.

4. Remedies:

a) Forced to comply with regulations and provisions;

b) Forced to reimburse the violated amounts to the establishments of medical examination and treatment (if any);

c) Forced to reimburse the violated amounts to the HI participants (if any);

d) Forced to reimburse the violated amounts to the revenue accounts of the health insurance fund (if any).

Article 33. The acts of obstructing the appraisal of health insurance

1. Warning shall be imposed for first violations and not harming the interests of the HI participants, establishments of medical examination and treatment and HI fund.

2. Fine of between 300,000 VND and 500,000 VND shall be imposed for cases of recidivism, but not harming the interests of the HI participants, establishments of medical examination and treatment and HI fund.

3. A fine of between 500,000 VND and 2,000,000 VND shall be imposed for the violations harming the interests of the HI participants, establishments of medical examination and treatment or HI fund.

4. Remedies:

a) Forced to comply with the appraisal of HI in accordance with provisions;

b) Forced to reimburse expenses for medical examination and treatment under the scope of right and benefit level of HI which the objects had to be paid (if any);

c) Forced to reimburse the violated amounts to the revenue account of HI fund (if any).

Article 34. The acts of putting the contents contrary to the provisions of law into the contract of medical examination and treatment of health insurance

1. Warning shall be imposed for first violations and not harming the interests of the HI participants, establishments of medical examination and treatment and HI fund.

2. A fine shall be imposed for violations by the following levels:

a) Between VND 1,000,000 and 5,000,000 for the violations valued at less than VND 50,000,000;

b) Between VND 5,000,000 and 10,000,000 for the violations valued at VND 50,000,000 to less than VND 100,000,000;

c) Between VND 10,000,000 and 15,000,000 for the violations valued at VND 100,000,000 to less than VND 500,000,000;

d) Between VND 15,000,000 and 20,000,000 for the violations valued at VND 500,000,000 to less than VND 1,000,000,000;

đ) Between VND 20,000,000 and 30,000,000 for the violations valued at VND 1,000,000,000 to less than VND 10,000,000,000;

e) Between VND 30,000,000 and 40,000,000 for the violations valued at VND 10,000,000,000 or more.

3. Remedies:

a) Forced to cancel the contents in the contract of HI medical examination and treatment contrary to regulations;

b) Forced to reimburse the violated amounts (if any) to the revenue account of the health insurance fund;

c) Forced to reimburse the amounts that the establishments of medical examination and treatment are damaged (if any);

d) Forced to reimburse expenses for medical examination and treatment under the scope of right and benefit level of HI which the objects had to be paid (if any).

Article 35. The acts of unilaterally terminating contract of medical examination and treatment of health insurance

1. Warning shall be imposed for first violations and not harming the interests of the HI participants, establishments of medical examination and treatment and HI fund.

2. A fine of between 500,000 VND and 1,000,000 VND shall be imposed for cases of recidivism, but not harming the interests of the HI participants, establishments of medical examination and treatment and HI fund.

3. Fine shall be imposed for cases of violation harming the interests of the HI participants, establishments of medical examination and treatment or HI fund by the following levels:

a) Between VND 1,000,000 and 5,000,000 for the violations valued at less than VND 50,000,000;

b) Between VND 5,000,000 and 10,000,000 for the violations valued at VND 50,000,000 to less than VND 1,000,000,000;

c) Between VND 10,000,000 and 15,000,000 for the violations valued at VND 100,000,000 to less than VND 500,000,000;

d) Between VND 15,000,000 and 20,000,000 for the violations valued at VND 500,000,000 to less than VND 1,000,000,000;

đ) Between VND 20,000,000 and 30,000,000 for the violations valued at VND 1,000,000,000 to less than VND 10,000,000,000;

e) Between VND 30,000,000 and 40,000,000 for the violations valued at VND 10,000,000,000 or more.

4. Remedies:

a) Forced to comply with the contents of signed contract;

b) Forced to comply with the decision of the competent authority on settlement of dispute of contract of HI medical examination, treatment;

c) Forced to reimburse the damaged amount to revenue account of the health insurance fund or medical examination and treatment (if any);

d) Forced to reimburse the amounts that HI participants are damaged (if any).

SECTION 4. VIOLATIONS OF MANAGEMENT AND USE OF HEALTH INSURANCE FUND

Article 36. The acts of advance, payment of the costs of medical examination, treatment of health insurance to the establishments of medical examination, and treatment not in compliance with the correct amount as prescribed

1. Warning shall be imposed for first violations and the violation valued at less than VND 20,000,000.

2. A fine of between VND 500,000 and VND 1,000,000 for the cases of recidivism and the violations are valued at less than VND 20,000,000.

3. A fine shall be imposed by the following levels:

a) Between VND 1,000,000 and 2,000,000 for the violations valued at VND 20,000,000 to less than VND 40.000.000;

b) Between VND 2,000,000 and 4,000,000 for the violations valued at VND 40,000,000 to less than VND 80.000.000;

c) Between VND 4,000,000 and 8,000,000 for the violations valued at VND 80,000,000 to less than VND 100.000.000;

d) Between VND 8,000,000 and 12,000,000 for the violations valued at VND 100,000,000 to less than VND 500.000.000;

đ) Between VND 12,000,000 and 16,000,000 for the violations valued at VND 500,000,000 or more.

4. Remedies:

a) Forced to make advance, payment for costs of HI medical examination, treatment according to regulations;

b) Forced to reimburse the amounts that the establishments of medical examination and treatment are damaged (if any).

Article 37. The acts of advance, payment for the costs of medical examination, treatment of health insurance for the establishments of medical examination and treatment slower than the specified time

1. Warning shall be imposed for first violations and not harming the interests of establishments of medical examination and treatment, HI participants.

2. A fine of between 1,000,000 VND and 5,000,000 VND shall be imposed for cases of recidivism, but not harming the interests of establishments of medical examination and treatment, HI participants.

3. A fine shall be imposed for cases of violation harming the interests of establishments of medical examination and treatment, HI participants by the following levels:

a) Between VND 5,000,000 and 10,000,000 for the cases slower than the specified time 30 days;

b) Between VND 10,000,000 and 20,000,000 for the cases slower than the specified time 30 days or more.

4. Remedies:

a) Forced to make advance, payment for costs of HI medical examination, treatment according to the prescribed time;

b) Forced to reimburse expenses for medical examination and treatment under the scope of right and benefit level of HI which the objects had to be paid (if any).

Article 38. The acts of using the health insurance fund not in compliance with provisions

1. A fine of between VND 500,000 and 1,000,000 shall be imposed for the first violations and not causing harm to the health insurance fund.

2. A fine of between 1,000,000 VND and 2,000,000 VND shall be imposed for cases of recidivism, but not harming the health insurance fund.

3. A fine shall be imposed for the violations damaging the health insurance fund by the following levels:

a) Between VND 2,000,000 and 5,000,000 for the violations valued at less than VND 50,000,000;

b) Between VND 5,000,000 and 10,000,000 for the violations valued at VND 50,000,000 to less than VND 100,000,000;

c) Between VND 10,000,000 and 20,000,000 for the violations valued at VND 100,000,000 to less than VND 500,000,000;

d) Between VND 20,000,000 and less than VND 30,000,000 for the violations valued at VND 500,000,000 to less than VND 1,000,000,000;

đ) Between VND 30,000,000 and 40,000,000 for the violations valued at VND 1,000,000,000 or more.

4. Remedies:

a) Forced to use health insurance fund in compliance with regulations;

b) Forced to remit the violated amount to the revenue account of the health insurance fund (if any).

SECTION 5. VIOLATIONS ON REPORT, PROVISION FOR INFORMATION AND DATA OF HEALTH INSURANCE

Article 39. The acts of reporting the implementation of health insurance not in compliance with the specified time, failing to provide for data and providing inaccurate data to the competent state agencies.

1. Warning shall be imposed for first violations and not affecting the management, implementation organization, and formation of health insurance policies.

2. A fine of between 1,000,000 VND and 5,000,000 VND shall be imposed for cases of recidivism, but not affecting the management, implementation organization, and formation of health insurance policies.

3. A fine of between 5,000,000 VND and 10,000,000 VND shall be imposed for the violations affecting the management, implementation organization, and formation of health insurance policies.

4. Remedies:

a) Forced to comply with the provisions on report of the competent state agencies;

b) Forced to provide for sufficient, accurate content, correct forms and correct data within 10 working days from the date of delivery of sanctioning decisions.

Article 40. The acts of failing to provide for information, providing for false information, providing for information not promptly on the HI participants, funds of HI medical examination and treatment used at the establishments of medical examination and treatment

1. Warning shall be imposed for first violations and not causing damages to funds of HI medical examination and treatment used at the establishments of medical examination and treatment.

2. A fine of between 300,000 VND and 500,000 VND shall be imposed for cases of recidivism, but not causing damages to funds of HI medical examination and treatment used at the establishments of medical examination and treatment.

3. A fine shall be imposed for the violations causing damages to funds of HI medical examination and treatment used at the establishments of medical examination and treatment by the following levels:

a) Between VND 1,000,000 and 2,000,000 for the violations valued at less than VND 50,000,000;

b) Between 2,000,000 and 4,000,000 for the violations valued at VND 50,000,000 to less than VND 100,000,000;

c) Between 4,000,000 and 8,000,000 for the violations valued at VND 100,000,000 to less than VND 200,000,000;

d) Between 8,000,000 and 16,000,000 for the violations valued at VND 200,000,000 or more.

4. Remedies:

Forced to provide for adequate and accurate information on the HI participants, funds of HI medical examination and treatment used at the establishments of medical examination and treatment.

Article 41. The acts of failing to provide for information, providing for misleading information in settling the interests of patients at the establishments of medical examination and treatment or direct payment for the participants in health insurance

1. Warning shall be imposed for first violations and not causing damages to the benefits of the HI participants.

2. A fine of between 100,000 VND and 300,000 VND shall be imposed for cases of recidivism, but not causing damages to the interests of the HI participants.

3. A fine of between 500,000 VND and 1,000,000 VND shall be imposed for the violations harming the interests of the HI participants.

4. Remedies:

a) Forced to provide for adequate and accurate contents of information relating to the settlement of benefits of the HI participants at the establishments of medical examination and treatment or direct payment for the HI participants;

b) Forced to reimburse expenses for medical examination and treatment under the scope of right and benefit level of HI which the objects had to be paid (if any).

Article 42. The acts of sending settlement report of costs of HI medical examination and treatment slower than the specified time

1. Warning shall be imposed for the first violations.

2. A fine shall be imposed in case of recidivism by the following levels:

a) Between VND 5,000,000 and 10,000,000 for the cases slower than the specified time 15 days;

b) Between VND 10,000,000 and 20,000,000 for the cases slower than the specified time 15 days or more.

3. Remedies:

Forced to send settlement report on expenses for medical examination and treatment of health insurance according to the prescribed time.

SECTION 6. VIOLATION OF PROVISIONS ON INSPECTION, EXAMINATION CAUSING INTERFERENCE FOR THE OPERATION OF STATE MANAGEMENT ON HEALTH INSURANCE

Article 43. The acts of failing to comply with or obstructing the inspection, examination of the implementation of provisions of law on health insurance

1. Warning shall be imposed for first violations.

2. A fine of between 1,000,000 VND and 5,000,000 VND shall be imposed for the cases of recidivism.

3. Remedies: Forced to comply with the inspection, examination of the competent authorities under the provisions of law on inspection.

Article 44. The acts of failing to comply with provisions of the competent state agencies

1. Warning shall be imposed for first violations and not causing damages to the benefits of the HI participants, the establishments of medical examination and treatment and health insurance fund.

2. A fine of between 300,000 VND and 500,000 VND shall be imposed for cases of recidivism, but not causing damages to the interests of the HI participants, the establishments of medical examination and treatment and health insurance fund.

3. Fine shall be imposed for the violations damaging the interests of the HI participants, the establishments of medical examination and treatment and health insurance fund by the following levels:

a) Between VND 1,000,000 and 5,000,000 for the violations valued at less than VND 20,000,000;

b) Between 5,000,000 and 10,000,000 for the violations valued at VND 20,000,000 to less than VND 40,000,000;

c) Between 10,000,000 and 20,000,000 for the violations valued at VND 40,000,000 to less than VND 80,000,000;

d) Between 20,000,000 and 30,000,000 for the violations valued at VND 80,000,000 to less than VND 160,000,000;

đ) Between 30,000,000 and 40,000,000 for the violations valued at VND 160,000,000 or more.

4. Remedies:

a) Forced to comply with provisions of the competent state agencies;

b) Forced to reimburse the damage caused to individuals and organizations (if any).

Chapter 3.

COMPETENCE, PROCEDURES FOR SANCTIONING ADMINISTRATIVE VIOLATIONS

Article 45. Competence to sanction administrative violations in the field of HI of the Presidents of the People's Committees at all levels

Presidents of People's Committees at all levels are competent to sanction administrative violations in the field of health insurance under their management scope, as follows:

1. Presidents of commune-level People's Committees are competent to:

a) Impose warning;

b) Impose a fine of up to VND 2,000,000;

c) Confiscate material evidences and means used for administrative violations in the field of health insurance valued at up to VND 2,000,000;

d) Withdraw and temporary keep health insurance cards.

2. Presidents of district-level People's Committees are competent to:

a) Impose warning;

b) Impose a fine of up to VND 30,000,000;

c) Confiscate material evidences and means used for administrative violations in the field of health insurance;

d) Withdraw and temporary keep health insurance cards;

đ) Force to apply the remedies prescribed at Points a, b and c, Clause 3, Article 4 of this Decree.

3. Presidents of provincial-level People's Committees are competent to:

a) Impose warning;

b) Impose a fine of up to VND 40,000,000;

c) Confiscate material evidences and means used for administrative violations in the field of health insurance;

d) Withdraw and temporary keep health insurance cards;

đ) Force to apply the remedies prescribed in Clause 3, Article 4 of this Decree.

Article 46. Competence to sanction administrative violations in the field of health insurance of health inspectorate

1. Health inspectors who are on duty may:

a) Impose warning;

b) Impose a fine of up to VND 500,000;

c) Confiscate material evidences and means used for administrative violations in the field of health insurance valued at up to VND 2,000,000;

d) Withdraw and temporary keep health insurance cards;

đ) Force to apply the remedies prescribed in Clause 3, Article 4 of this Decree.

2. Chief inspector of Health Department may:

a) Impose warning;

b) Impose a fine of up to VND 30,000,000;

c) Confiscate material evidences and means used for administrative violations in the field of health insurance;

d) Withdraw and temporary keep health insurance cards;

đ) Force to apply the remedies prescribed in Clause 3, Article 4 of this Decree.

3. Chief Inspector of the Ministry of Health may:

a) Impose warning;

b) Impose a fine of up to VND 40,000,000;

c) Confiscate material evidences and means used for administrative violations in the field of health insurance;

d) Withdraw and temporary keep health insurance cards;

đ) Force to apply the remedies prescribed in Clause 3, Article 4 of this Decree.

Article 47. Competence to sanction administrative violations of financial regime for health insurance, health insurance fund of financial inspectorate

1. Financial inspectors who are on duty within their scope of functions may:

a) Impose warning;

b) Impose a fine of up to VND 500,000;

c) Confiscate material evidences and means used for administrative violations in the field of health insurance valued at up to VND 2,000,000;

d) Withdraw and temporary keep health insurance cards;

đ) Force to apply the remedies prescribed in Clause 3, Article 4 of this Decree.

2. Chief Inspector of the Department of Finance may:

a) Impose warning;

b) Impose a fine of up to VND 30,000,000;

c) Confiscate material evidences and means used for administrative violations in the field of health insurance;

d) Withdraw and temporary keep health insurance cards;

đ) Force to apply the remedies prescribed in Clause 3, Article 4 of this Decree.

3. Chief Inspector of the Ministry of Finance:

a) Impose warning;

b) Impose a fine of up to VND 40,000,000;

c) Confiscate material evidences and means used for administrative violations in the field of health insurance;

d) Withdraw and temporary keep health insurance cards;

đ) Force to apply the remedies prescribed in Clause 3, Article 4 of this Decree.

Article 48. Competence to sanction administrative violations in the field of health insurance of other agencies

1. In addition to the sanctioning competence prescribed in Article 45 and Article 46 and Article 47 of this Decree, other competent persons under the provisions of the Ordinance on Handling of Administrative Violations within their functions, tasks assigned detect the administrative violations stipulated in this Decree, under the field or area of their management may sanction.

2. In cases of administrative violations under the jurisdiction of many agencies, the handling shall be conducted by the agency which first received.

3. Within the implementation of health insurance if Vietnam Social Insurance, Social Insurance at provincial and district levels detect administrative violations in the field of health insurance, they shall make minutes and recommend to the competent agencies to sanction administrative violations according to regulations. Upon receipt of the minute of administrative violation and a written request for sanctioning of Social Insurance, within 10 days the competent authorities shall handle the violations as prescribed.

Article 49. Authorization to sanction administrative violations

In the case of absence of persons who are competent to sanction administrative violations specified in Article 45, Article 46, Article 47 and Article 48 of this Decree, their authorized deputies shall have competence to sanction administrative violations and must take responsibility for their decisions.

Article 50. Procedures for sanctioning administrative violations and execution of the sanctioning decisions

1. Procedures for sanctioning administrative violations and the execution of decisions to sanction administrative violations in the field of health insurance shall comply with the Ordinance No.44/2002/PL-UBTVQH10 dated July 02, 2002 of the National Assembly Standing Committee on Handling of Administrative Violations, Ordinance No.04/2008/UBTVQH12 dated April 02, 2008 amending and supplementing some Articles of Ordinance No.44/2002/PL-UBTVQH10 dated July 02, 2002 and Decree No.128/2008/ND-CP of the Government detailing the implementation of some Articles of the Ordinance on Handling of Administrative Violations No.04/2008/UBTVQH12 dated April 02, 2008.

2. Forms of minutes, decisions used in the sanction of administrative violations in the field of health insurance are issued with this Decree.

Article 51. Deduction of money from deposit accounts of agencies, organizations, employers who are responsible for paying health insurance premiums for remittance of unpaid amount and interest of this amount to health insurance fund

1. Upon the expiry of 10 days from the date of delivery of decision to sanction  administrative violations that agencies, organizations and employers who are responsible for paying health insurance premiums do not voluntarily pay or paid voluntarily but not enough unpaid money, amount of late payment and interest incurred by them to health insurance fund, the persons who are competent to handle administrative violations require the banks, state treasuries, credit institutions to deduct money from deposit accounts of agencies, organizations, employers who are responsible for paying health insurance premiums to remit unpaid money, amount of late payment and interest incurred by them to the revenue account of the MI fund.

2. Persons who are competent to request banks, state treasuries, credit institutions to deduct money from deposit accounts of agencies, organizations, employers who are responsible for paying health insurance premiums as prescribed in Clause 1 of this Article are:

a) The Presidents of district-level People's Committees;

b) The Presidents of provincial-level People's Committees;

c) The Chief Inspectors of the Departments of Health;

d) The Chief Inspector of the Ministry of Health;

đ) The chief inspectors of the Departments of Finance;

e) The Chief Inspector of the Ministry of Finance;

g) Other competent persons as prescribed.

3. Ministry of Health shall coordinate with the Ministry of Finance, State Bank to specifically guide the order and procedures for deducting money from deposit accounts of agencies, organizations, employers who are responsible for paying health insurance premiums as prescribed in Clause 1, Clause 2 of this Article.

Chapter 4.

IMPLEMENTATION PROVISIONS

Article 52. Effect

This Decree takes effect from December 01, 2011.

Article 53. Responsibility for implementation

1. Minister of Health is responsible for organizing and supervising the implementation of this Decree.

2. Ministers, heads of ministerial-level agencies, heads of governmental agencies, the presidents of the People’s Committees of provinces and cities directly under the Central Government shall implement this Decree./.