Kingdom of Cambodia Nation Religion King

 

Ministry of Labour and Vocational Training  No.: 184 KB/Br.K Prakas On Amendment to Article 2, Article 4, Article 5, Article 6, Article 7, Article 8 and Article 10 of Prakas 109 K.B/Br.K dated 17 March 2016  On   Health Care Benefits 

 

Ministry of Labour and Vocational Training

 

• Having seen the Constitution of the Kingdom of Cambodia
• Having seen Royal Code NS/RKT/0913/903 dated 24 September 2013 on

Appointment of the Royal Government of the Kingdom of Cambodia 

• Having seen Royal Decree NS/RKT/1213/1393 dated 21 December 2013 on

Adjustment to the Composition of the Royal Government of the Kingdom of Cambodia

• Having Royal Code NS/RKT/0416/368 dated 04 April 2016 on Adjustment to the

Composition of the Royal Government of the Kingdom of Cambodia  

• Having seen Royal Code 02/NS/94 dated 20 July 1994 promulgating the Law on

Organization and Functioning of the Council of Ministers 

• Having seen Royal Code NS/RKM/0613 dated 20 June 2013 promulgating the Law on Amendment to Article 28 of the Law on Organization and Functioning of the Council of Ministers
• Having seen Royal Code NS/RKM/0105/003 dated 17 January 2005 promulgating the

Law on Establishment of Ministry of Labour and Vocational Training

• Having seen Royal Code ChN/RKM 0397/01 dated 13 March 1997 promulgating the Labour Law   
• Having seen Royal Code NS/RKM/0902/018 dated 25 September 2002 promulgating the Law on Social Security Scheme for Persons Defined by the Provisions of the Labour Law 
• Having seen Royal Code NS/RKT/0815/872 dated 08 August 2015 on Judicial Statute of Public Administrative Establishment 
• Having seen Sub-decree 283 OrNKr.BK dated 14 November 2014 on Organization and Functioning of the Ministry of Labour and Vocational Training 
• Having seen Sub-decree 16 OrNKr.BK dated 02 March 2007 on Establishment of National Social Security Scheme
• Having seen Sub-decree 01 OrNKr.BK dated 06 January 2016 on Establishment of

Social Security Scheme on Health Care for Person Covered by the Provisions of the Labour Law 

• According to the request of the Governing Council of the National Social Security Fund, 

 

Decide Article One 

Article 2, Article 4, Article 5, Article 6, Article 7, Article 8 and Article 10 of Prakas 109 K.B/Br.K dated 17 March 2016 on Health Care Benefits shall be amended as follows:   

 

New Article 2

Terminologies used in this Prakas are as follows: 

• Health care benefit: refers to an insurance scheme that provides a package of health benefits and protection service as set out.  
• Package of health benefit: refers to medical care and treatment, transportation of victim service, transportation of body service and daily allowance. 
• Health protection service: refers to timely diagnosis, identification of those who have a health risk and have a specific health problem, provision of consultation and other interventions to prevent health problem such as research for disease, education on health and vaccination program.  
• Medical care and treatment service: refers to medical, paramedical and medical aid services.
• Medical service: refers to outpatient and inpatient consultation service. 
• Paramedical service: refers to laboratory service and medical picture. 
• Medical aid service: refers to treatment by heating and physical therapy. 
• Medical profession technicality: refers to ways of diagnosis, care and treatment service provided by those who have graduated in health sector and have registered with the Medical Profession Council and are allowed to do business as per the profession by the Ministry of Health. 
• Rehabilitation service: is the medical care and treatment service for health care scheme for the purpose of helping victims to maintain or rehabilitate the skill capacity and occupation for a daily living and communication skill that has been lost or damaged due to a disease, injury or disability. 
• Surgery: refers to a surgery in a scientific way for the purpose of treatment. 
• Health base: refers to a public or private health organization recognized by the Ministry of Health. 
• Maternity leave: refers to the leave taken before and after giving birth. 
• Outpatient consultation service: refers to disease examination and consultation service that is excluded from staying for treatment in hospital.
• Giving birth: refers to giving birth to a baby aged from 26 (twenty-six) weeks in the health base. 
• Daily allowance: refers to the money provided for the period of not working due to being sick, sustaining an accident or taking maternity leave.     
• Self-treatment: refers to any treatment without a prescription issued by the doctor contracted with NSSF except emergency case. 
• Artificial eye aid equipment: refers to glasses equipment or contact lens.   
• Essential medicine: refers to medicine items on the essential medicine list determined by the Ministry of Health for public health base. 
• Victim or patient representative: refers to relatives or spouse of the concerned person. 

 

New Article 4   

The services excluded from the medical treatment service are: 

1. Free medical treatment set out in public health policy                    
2. Dental care (teeth cleaning, tooth filling, and tooth implanting) 
3. Transsexual surgery and treatment 
4. Organ transplantation or change (bone marrow, kidney, liver, heart and pancreas ... ) 
5. Artificial insemination 
6. Self treatment
7. Cosmetic surgery and medical implants
8. Contact lens and eye-laser treatment
9. Treatment of alcoholism or drug abuse 
10. Infertility treatment 
11. Artificial globe ocular operation 
12. Heart and cardio vascular surgery 
13. Hemodialysis 
14. General health checkup 

 

In case of emergency, the service as stated above is provided.

 

New Article 5

The provision of services for a chronic disease takes place only in the public health base and must use only essential medicines. For medicines other than those on the list of essential medicines are the burden of the patient except the medicines for treating diabetes and high blood pressure which are not on the list of essential medicines and treatment of cancer by chemo therapy which must be paid as per each treatment.  

 

New Article 6: 

6.1      To get medical treatment and care, all workers/employees must meet the following requirements: 

• are performing work in the enterprise/establishment that has been registered with the Natinal Social Security Fund (NSSF) for health care scheme and have NSSF membership card although the employer has not paid contribution fee for the first month.  
• Have paid for at least 06 (six) months during the last 12 (twelve) months up to the month of the existence of health problem or maternity leave. 

 

In case the member has paid the contribution fee for 02 (two) consecutive months but run out of the obligation to pay the contribution fee, the member has the right to receive medical treatment and care within 02 (two) more months from the date of the end of obligation to pay contribution fee.  

 

6.2      To get a daily allowance, all workers/employees must meet the following requirements: 

• Have paid the contribution fee on health care for 2 (two) consecutive months or have paid for at least 06 (six) months during the last 12 (twelve) months up to the month of the existence of health problem and is performing work.
• Have paid the contribution fee for 09 months during the last 12 (twelve) months up to the month of giving birth. 

  

New Article 7

7.1    Workers/employees who have met the requirement as stipulated in Article 6, Point

6.2, are entitled to: 

• Free of charge treatment in the health bases that have been contracted with the National Social Security Fund (NSSF) for the period of not exceeding 180 (one hundred eighty) days for inpatient only.   
• Daily allowance of 70% (seventy percent) of the contributory daily average wage of the person in question for the period of being unable to go to work due to treatment of the disease or injury as per the prescription for more than 07 (seven) consecutive days counting from the first day the worker/employee goes to the health base. This allowance is provided for not exceeding 180 (one hundred eighty) days during the last 12 (twelve) months excluding maternity leave of 90 (ninety) days.     
• Daily allowance of 70% (seventy percent) of the contributory daily average wage of the person in question for 90 (ninety) days of the maternity leave before and after giving birth.  

7.2  Transportation of patient or victim service and transportation of body service: - Transportation of patient or victim service is provided only in the case of emergency and by the ambulance of the health base or by other means with a certified letter.    - The service of transportation of body or patient who is in serious condition and cannot be treated is provided according to the transportation means of the health base or other actual means.  

 

New Article 8 

8.1  Average wage is the division of the average of the contributory wages of not exceeding 6 (six) months before the existence of health problem or giving birth. The contributory wage shall be set in the table as stipulated in Annex 1 of this Prakas. 

8.2  Daily average wage is the division of the average wages as stipulated in Point 8.1 by 30 (thirty) days. 

8.3  The calculation of average wage determined in this Prakas applies to only the calculation of social security benefits. 

 

New Article 10

10.1  The member of NSSF shall use the health services at the health bases that have been contracted with NSSF. The NSSF will be responsible for the settlement of the service fee as stipulated in the package of health benefits. If the NSSF member uses services other than the services of the health bases that have been contracted with NSSF, NSSF will reimburse for only emergency case. The claim for benefit shall be made as per the form: “Medical Care and Treatment Benefit” or called Form “4.02” as stipulated in Annex 2 of this Prakas. The formality of this claim shall be accompanied by medical documents and other invoices as well as other necessary documents. 

10.2  The claim for daily allowance shall be made by the patient or victim or representative as per Form “Daily Allowance on Health Care” or called “4.03” as stipulated in Annex 3 of this Prakas. The formality of this claim shall be accompanied by a letter of hospital discharge issued by the NSSF-contracted health base that the victim has received treatment service. The permission letter for taking leave can be issued by the enterprise’s physician with approval from the employer or representative of the enterprise/establishment. 

10.3  The rights to claim for medical care and treatment and daily allowance is valid for 12 (twelve) months only from the date of the existence of the health problem.  

 

Article Two

This Prakas takes effect from the date of signature. 

Phnom Penh, 25 April 2018 Minister 

(Signed and stamped)

Ith Sam Heng

 

Place to receive: 

• Office of the Council of Ministers 
• Ministry of Economy and Finance 
• General Secretary of the Royal Government 
• Cabinet of Samdech Akka Monha Sena Padei Techo Prime Minister 
• Cabinet of Samdech, Excellency, Lok Chumteav Deputy Prime Minister 
• All relevant ministries and institutions 
• Governing Council of NSSF 

            “for info.” 

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