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Social security fund to increase payments for health services

The National Social Security Fund (NSSF) will pay more to hospitals for health services following a new agreement reached between the fund and participating hospitals yesterday.

The money will be paid in a lump sum, with some hospitals receiving as much as 130,000 kip to allocate to one beneficiary per year, while 110,000 kip will be given to provincial hospitals to pay for health services provided for one beneficiary per year.

The NSSF will also pay an additional 1 million kip to hospitals to cover the treatment of a beneficiary injured in a road accident. The Fund will also cover 50 percent of the cost of transportation by land or by air of a seriously injured beneficiary.

Health service providers are required to provide treatment through medical expertise, medicines, medical equipment, and other essentials, while doctors and other medical staff must provide full and adequate treatment.

If the hospital cannot provide the medication prescribed by a doctor and the beneficiary has to buy it from a private pharmacy, the hospital must compensate the patient for the expense incurred.

If the cost does not exceed 100,000 kip the hospital must pay the patient immediately. If the cost is between 100,000 kip and 1 million kip, the hospital must reimburse the patient payment within 15 days.

The hospital must reimburse the patient within 30 days if his or her expenses exceed 1 million kip.

Those beneficiar ies who fall ill due to intentional self-harm or abortion will not be paid more than 100,000 kip to cover the cost of emergency treatment. Beneficiaries injured as a result of drug abuse or fighting will not receive any payment for treatment.

Four hospitals at the central level, 17 provincial hospitals, and 132 other hospitals throughout the country are parties to the agreement.

Central hospitals were previously paid 85,000 kip to 125,000 kip for health services provided to one beneficiary over the course of one year.

Provincial hospitals previously received 75,000 kip to 105,000 kip for services such as health checks, diagnosis, treatment, medicine, the use of an ordinary room, surgery and other essential treatment, as well as for administrative costs.

According to the NSSF, the Fund made payments to about 624,000 beneficiaries last year. Of these, about 500,000 had regular health checks, about 112,000 had emergency treatment, about 45,000 were admitted for overnight treatment, and more than 2,600 underwent surgery.

The hospitals that are parties to the agreement claimed they suffered losses in complying with the agreement for the provision of services last year, while the NSSF found that more than 2,900 beneficiaries complained they were not satisfied with the services and treatment they received.

The provision of cheap medicines and the need to buy medicines from a private drug store were common complaints expressed by the beneficiaries of the social security fund.

By Times Reporters
(Latest Update March 30, 2017)


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