In particular, during the assessment of sickness and maternity records in some places, irregularities were detected in the issuance of certificates of leave to enjoy social insurance (GCN) with the following expressions: Issuance of birth certificates, birth certificates born at the wrong time the actual incident occurred; a large number of issued certificates in a short time; the number of days off per certificate is unusually high; granting the certificate of wrong health status, pregnancy status… The number of certificates issued by one doctor per day is very large, far exceeding the maximum number of visits allowed for one examination table. After that, the employee submits a dossier to the employer to request the social insurance agency to pay the sickness and maternity benefits.
Vietnam Social Security requests to stop paying immediately for documents that have been determined to be unreasonable or invalid, and recover the amount already paid to the fund with the wrongly issued certificate
In order to prevent, prevent and handle violations of the law on medical examination and treatment, the law on social insurance, causing losses, waste, and profiteering from social insurance funds, Vietnam Social Insurance requires social insurance of provinces and cities to continue strictly follow the instructions of this agency.
Specifically, on the basis of existing data, strengthen supervision, inspection and inspection of the issuance of certificates at medical examination and treatment establishments that have issued certificates with the above-mentioned abnormal signs or other abnormal signs. ; stop paying immediately for vouchers that have been determined to be unreasonable or invalid, by all measures to recover the funds already paid to the regime with the wrongly issued Certificates as mentioned above; fully exploit software applications when reviewing and enjoying sickness and maternity benefits and in post-audit work.
In addition, the Vietnam Social Security requested the local social insurance agency to review the issuance of certificates of medical examination and treatment facilities in the area; if any violation is detected, it shall promptly report it to the People’s Committee of the province or city and coordinate with the Department of Health and relevant agencies in conducting examination and inspection.
In case of necessity, it shall be transferred to a police agency for investigation, verification and clarification in accordance with law; advise the Steering Committee for the implementation of social insurance and health insurance policies in the locality on the management, fight, prevention and strict handling of violations of the law on social insurance; identify this as a central, regular and ongoing task; strengthen communication to employers and employees to receive reports on unusual manifestations of absenteeism for social insurance benefits of medical examination and treatment in the unit.
Over the past time, despite being affected by the Covid-19 pandemic, in the first 4 months of 2021, Vietnam Social Security has settled new sick and maternity benefits for nearly 3 million people. The management of social insurance payments (sickness, maternity …) and the management of beneficiaries of social insurance benefits in recent years have always been paid special attention by the Vietnamese social insurance industry.
Many management measures have been strengthened by the Vietnam Social Security, such as the application of information technology; the synchronous and effective coordination of the Party committees, authorities at all levels and branches has well organized the payment of social insurance benefits in a timely manner, to the right beneficiaries; payment and beneficiary management processes and procedures are simplified in the direction of creating the most favorable conditions for participants and beneficiaries.
Le Kim Lien