Proper Practices under the Health Care Voucher Scheme/使用醫療券的守則
To all Enrolled Health Care Providers:
Paragraphs 1 to 4 below contain a set of directions given by the Government of the Hong Kong Special Administrative Region pursuant to Clause 46 of the “Definitions, and Terms and Conditions of Agreement” ("the Agreement") of Health Care Voucher Scheme ("HCVS"). All enrolled health care providers ("EHCPs") are required to duly observe and comply with the directions set out herein, which are conducive to the effective administration of the HCVS. Non-compliance with the directions may result in termination of the Agreement. Where applicable, expressions used herein shall have the meaning assigned to them under the Agreement.
1. Use of health care vouchers
- Only healthcare professionals already enrolled under the HCVS can accept the use of Vouchers by voucher recipients ("VRs"). EHCPs are liable for all the claims made under their EHCP account and responsible for the safekeeping of the authentication token for accessing eHS(S). EHCPs shall NOT allow leave relief service providers to use their EHCP Account to claim Vouchers for the healthcare services provided by them to the VRs.
- EHCPs should make available the use of Vouchers by VRs with eHealth (Subsidies) Account created to settle EHCP Fees.
- Neither an EHCP nor an Associated Organization may charge any person any fees for creating an eHealth (Subsidies) Account, or pairing or un-pairing of two eHealth (Subsidies) Accounts, or using Vouchers in an account.
- Vouchers can only be used to settle the EHCP Fees for the provision of healthcare services including preventive and curative services (e.g. Designated Services under the Reward Scheme) and rehabilitative services.
- Vouchers are NOT applicable to inpatient services, pre-paid healthcare services and day surgery procedures, such as cataract surgery or endoscopy services.
- Vouchers shall NOT be used by VRs to employ staff or only to purchase products not otherwise provided/ prescribed by EHCPs, such as medication, spectacles, dried seafood, personal care products, food products or medical equipment. However, Vouchers can be used for the treatments or services prescribed and provided by EHCPs in their professional capacities to meet the healthcare needs of VRs after consultation, as well as the medications, healthcare products and medical equipment, etc. provided to VRs during the course of treatment. In this regard, EHCPs should assume professional responsibility towards VRs.
- Unless otherwise specified, Vouchers CANNOT be used for public healthcare services or services subsidized by the Government, such as the subsidized services under the various Public-Private-Partnership Programmes of the Hospital Authority and the Colorectal Cancer Screening Programme of the Department of Health, etc.
- Vouchers are NOT allowed for settling the service charges of healthcare services provided by the EHCP to himself/ herself (i.e. the EHCP cannot be the VR at the same time for any voucher claims). It is however allowed where a VR uses the Vouchers in the Paired Up eHealth (Subsidies) Account of his Spouse who is also the EHCP providing healthcare services to the VR.
- The total amount of Vouchers used by a VR (including Reward, if any, in the VR’s eHealth (Subsidies) Account (applicable where the EHCP Fees are for the Designated Services) and any Voucher in the Paired Up eHealth (Subsidies) Account of his Spouse) for the service provision shall NOT exceed the amount of EHCP Fees and the VR’s unused Quota (if applicable). When Vouchers are used to settle the EHCP Fees, for the avoidance of doubt, the EHCP Fees (whether they are for the Designated Services or not) shall NOT be charged at a higher rate (whether directly or indirectly) than the fees of equivalent health care services provided by the EHCP to a person who does not use any Voucher/ who is not a VR.
- Neither an EHCP nor an Associated Organization shall enter into any agreement or arrangement with a VR (whether directly or indirectly) which has the effect of sharing the value of any Voucher or any Reward with the VR or (in the case where the Voucher Recipient uses the Voucher in the Paired Up eHealth (Subsidies) Account of his Spouse) the Spouse of the VR. Any advantage, whether in cash/ kind/ coupons/ bonus points/ other equivalent which carries a cash value, offered by the EHCP or the Associated Organization to a VR or a Spouse of the VR in such agreement or arrangement shall be considered as having the effect of sharing the value hereunder. In this regard, no advertisement or publicity or offer to such effect under the HCVS shall be allowed.
- VRs shall produce their Hong Kong Identity Cards ("HKICs") or Certificates of Exemption ("CoEs") issued by the Immigration Department to the EHCPs and receive in person the healthcare services provided by the EHCPs before they can use their vouchers to settle the relevant service fees. For medical laboratory technologists ("MLTs") enrolled under the HCVS, it means that the relevant laboratory tests shall be performed by the enrolled MLT for the VR himself/ herself. Vouchers CANNOT be used to pay for those healthcare services received or medication obtained through VR’s family member or his/ her proxy. EHCPs shall verify the VRs’ identity by checking against the particulars in their HKICs or CoEs and ensure that they are the one holding the identity documents. In the case where the VR has notified the EHCP that he would use Vouchers in the Paired Up eHealth (Subsidies) Account of his Spouse to settle the relevant service fees, a copy of the HKIC or CoE of the Spouse shall also be produced.
- No MLT enrolled under the HCVS shall accept the use of the Vouchers to perform any laboratory tests for a VR in the absence of a referral from (i) registered medical practitioner, (ii) registered dentist, or (iii) a person registered in respect of a medical clinic exempted under Section 8(1) of the Medical Clinics Ordinance, Cap. 343. If Vouchers are to be accepted for settling payment of laboratory services offered by enrolled MLTs, the laboratory investigations must be conducted based on proper referral from qualified health care professionals mentioned in (i), (ii) and (iii) above.
- Voucher claims shall not be made by optometrists under the HCVS for services unrelated to eye or vision care.
2. Consent of Voucher Recipient
- Each Voucher claim transaction shall be supported by a valid Consent of Voucher Recipient.
- If the VR is illiterate, the witness shall, if consent of Voucher Recipient is provided in paper form, confirm that he has read the Consent of Voucher Recipient to the VR and provide the witness information (including name and HKIC number of the witness). If the VR is mentally incapacitated, the guardian shall complete the Consent of Voucher Recipient in paper form in the capacity as the VR’s guardian and the guardian information (including name and HKIC number of the guardian) shall be provided.
- The Voucher amount claimed for each claim transaction in the Consent of Voucher Recipient shall be properly checked and completed.
- To facilitate verification of claim transactions, the VR shall be requested to provide a Hong Kong contact telephone number (which can belong to the VR or his/her family member/carer) which can receive SMS.
- The “Notice on Use of Health Care Voucher” showing Voucher balance shall be given to the VR for retention.
- An EHCP shall keep at the EHCP’s place proper and full record of all Consent of Voucher Recipient given in paper form and the Shared Use Consent until the expiry of 7 complete financial years from the calendar year in which the relevant reimbursements are made or until any dispute between the parties in relation to the HCVS is settled or adjudicated, whichever is the later. To protect personal data, the aforesaid documents shall be kept in locked cabinets.
- When disposing documents or records holding personal data, EHCPs shall comply with relevant sections of Personal Data (Privacy) Ordinance (Cap. 486) and the guidance notes issued by Office of the Privacy Commissioner for Personal Data including the "Guidance on Personal Data Erasure and Anonymisation".
3. Submission and confirmation of voucher claims
- EHCPs shall input claims in the eHS(S) on the date of provision of the related healthcare services for VRs and their Spouses whose Vouchers are used, if any holding HKIC with a symbol “C” or “U” on it. In any other cases, EHCPs shall input claims in eHS(S) within 7 calendar days counting from the date of provision of the related health care services to the VRs. Late submission of claims may not be reimbursed.
- Before confirming the claims under the EHCP Account in the eHS(S) for reimbursement, the EHCP should check carefully the details of these claims to ensure that all the information submitted to the Government through the eHS(S) is true and correct. EHCPs should regularly review the voucher claims made under their account to ensure that such claims are solely related to the healthcare services for which they are responsible.
- Improperly made claims will not be reimbursed. Some examples of improper Voucher claims are provided in the Annex. However, these are by no means exhaustive and EHCPs are advised to duly comply with all relevant clauses in the Agreement.
4. Use of HCVS logo
- Neither the EHCP nor his Associated Organization shall make any copies of the logo or display the logo at any places other than at that specified by the Director of Health.
5. Recommendation
- To avoid potential complaints or disputes, EHCPs are recommended to increase the price transparency of his/ her services as much as possible, for example, by displaying notices at their clinic(s) informing patients of their right to ask for quotation of the fees involved before receiving treatment; informing clearly the charges to patients on request before provision of services; and allowing patients to make informed choices of different management plans which may have different service charges.
- EHCPs should make use of the Smart ID card reader for verifying VR’s identity, obtaining the Consent of Voucher Recipient and any other consent, declaration and understanding in connection with the use of Voucher, and for making voucher claims for VRs. Otherwise, EHCPs are required to account for, in eHS(S), why Smart ID card reader is not used.
- To facilitate prompt reimbursement of claimed Voucher amount (and/or Reward, if applicable), EHCPs are recommended to review duly the claims pending completion/confirmation under the "Task List" in the eHS(S), and complete and confirm these claims on or before the last day of a month. EHCPs can view the details of claims reimbursed in the "Monthly Statement" in the eHS(S).
Department of Health
June 2026
*This version supersedes and replaces any and all previous versions of Proper Practices under the Health Care Voucher Scheme.
Annex
The following are cases of improper claims. Please note that in accordance with Clause 42 of the "Definitions, and Terms and Conditions of Agreement” ("the Agreement") of Health Care Voucher Scheme ("HCVS"), the Government of the Hong Kong Special Administrative Region shall not have any obligation to pay an enrolled health care provider (“EHCP”) or his/her medical organization the amount of any health care voucher that a voucher recipient has consented to use if the EHCP or his/her medical organization is in breach of any provisions in the Agreement.
Detailed information of the Agreement can be accessible at www.hcv.gov.hk.
Example 1
Mr. X and Ms. Y both worked for the same medical organization. Mr. X had been enrolled in the HCVS but Ms. Y had not. In a routine inspection of voucher claims processed by EHCPs working under that medical organization, the Health Care Voucher Division found that the healthcare services for some claims processed under Mr. X’s “EHCP account” in the eHealth System (Subsidies) were not provided by Mr. X himself but by Ms. Y. Mr. X and his medical organization both did not realize that this practice was inappropriate.
Points to note
- Only EHCP can process voucher claims under his/ her “EHCP account”, and the concerned healthcare service must be directly delivered by him/her to the voucher recipient (Note (1)).
- Medical organizations should encourage their non-enrolled healthcare professionals to enroll in the HCVS and provide the necessary support to their enrolment. Upon successful enrolment, these healthcare professionals will then be allocated their own “EHCP account” in the eHealth System (Subsidies) to process voucher claims for the elderly.
- The name(s) of EHCP(s) should be displayed in the clinic for the reference of voucher recipients.
Example 2
An EHCP claimed vouchers for elderly persons. Investigation however revealed that the vouchers in some claims were used for buying medication / herbs / dried seafood without obtaining any healthcare services from the EHCP.
Such act of claiming health care vouchers solely for buying medication or other items without provision of healthcare services is in breach of the Agreement.
Points to note
- Health care vouchers can only be used to settle the EHCP fees for the provision of healthcare services including preventive and curative services (e.g. Designated Services under the Reward Scheme) and rehabilitative services (Note (2)).
- Health care vouchers shall not be used for solely buying drugs, Chinese medicines, spectacles, personal care products, food products or other items.
Example 3
An EHCP processed voucher claims with the total amount of vouchers used by the elderly person exceeding the EHCP fees for that episode of healthcare service (e.g. the charge for the consultation provided is HK$130 but the EHCP deducted the voucher amount of HK$350 for that claim). The EHCP explained that the excessively deducted voucher amount would be used for settling EHCP fees of subsequent consultations to the same elderly person as the elderly person visited him regularly.
Such act of using vouchers for settling the consultation fees in advance is in breach of the Agreement.
Points to note
- The amount of vouchers used by the voucher recipient shall not exceed the consultation fee (e.g. if the consultation fee is HK$130, the amount of vouchers that can be deducted shall be HK$130 or less with the remaining fee balance paid by the elderly person) (Note (3)).
- Claims for use of vouchers shall only be based on individual episode of healthcare service provided.
Example 4
An EHCP claimed vouchers for elderly persons A and B. Investigation on the related transactions however revealed that elderly person A had not physically attended the practice of the EHCP to receive healthcare services. Instead, elderly person A told the EHCP his symptoms over the phone and asked his family member to obtain the medicine and use vouchers for him. For elderly person B, she had attended the clinic of the EHCP once for consultation and used voucher. After that, her relative attended the clinic of the EHCP and used her vouchers for obtaining medication. Investigation found that the vouchers were claimed without the notice of elderly person B.
Such act of claiming health care vouchers for a voucher recipient without the EHCP verifying his/her identity in physical presence with the voucher recipient is in breach of the Agreement.
Points to note
- In assisting an elderly person to use vouchers, the EHCP shall request the elderly person to produce his/her Hong Kong Identity Card or Certificate of Exemption for verification of his/her personal particulars (Note (4)).
- Elderly persons using the vouchers shall receive the healthcare services in person provided by the EHCPs before they can use their vouchers to settle the relevant service fees. For medical laboratory technologists (MLTs) enrolled under the HCVS, it means that the relevant laboratory tests shall be performed by the enrolled MLT for the VR himself/ herself. Vouchers cannot be used to pay for those healthcare services received or medication obtained through voucher recipient’s family member or his/her proxy.
- This is different from the scenario where an elderly couple has agreed to use their vouchers in each other’s eHealth (Subsidies) Account that has been paired up when the vouchers in his/her own eHealth (Subsidies) Account has been exhausted.
Example 5
An EHCP had records of claiming vouchers on the days when he was on leave. Investigation revealed that the EHCP had allowed a leave relief service provider not yet enrolled in the HCVS to use his “EHCP account” in the eHealth System (Subsidies) on the days when he was on leave to claim vouchers for the healthcare services provided by the leave relief service provider to elderly persons.
Such act of allowing leave relief service providers, irrespective of whether they have been enrolled in the HCVS, to use one’s “EHCP account” to make voucher claims for healthcare services not provided by him/her is in breach of the Agreement.
Points to note
- An EHCP should process voucher claims under his/her “EHCP account”, and the concerned healthcare service must be directly delivered by him/her to the voucher recipient (Note (1)).
- EHCPs should encourage the non-enrolled leave relief service providers to enroll in the HCVS. Upon successful enrolment, these leave relief service providers will be allocated their own “EHCP account” in the eHealth System (Subsidies) to process voucher claims.
- Details of the leave relief service providers, including the name and whether health care vouchers can be used, should be displayed in the clinic for the reference of voucher recipients.
Example 6
An EHCP made a voucher claim after he has provided healthcare service to an elderly person. While the charge for the consultation is $250, the EHCP inadvertently deducted a voucher amount of $520 for that claim. The EHCP later found that the claim amount was incorrect and agreed with the elderly person that $270 overcharged voucher amount be refunded in cash to the elderly person.
Such act of redemption of vouchers for cash is in breach of the Agreement.
Points to note
- Vouchers cannot be redeemed for cash (Note (5)).
- The EHCP should cancel the wrong voucher claim in the eHS(S) within 24 hours of confirming the claim.
- If the voucher claim was confirmed for more than 24 hours, the EHCP should submit a request to the Health Care Voucher Division as soon as possible for cancellation of the wrong claim together with the justification(s) and relevant supporting documents.
Example 7
Due to malfunctioning of the smart ID card reader, an EHCP could not use the electronic consent form for making voucher claims. He then switched to using the paper consent form. As he was busy, he took out a blank “Consent of Voucher Recipient to Use Vouchers” (consent form) after he had provided healthcare service in person and requested the voucher recipient to sign on it. He explained to the voucher recipient that he would fill in the consent form details when he had time later.
Such act of requesting voucher recipients to sign a blank consent form is in breach of the Agreement and does not constitute a valid consent.
Points to note
- If voucher recipients wish to use vouchers after they have received the healthcare services in person provided by EHCPs, EHCPs should obtain valid consent from voucher recipients before deduction of vouchers.
- When using a paper consent form, the EHCP should either
- use the print function of eHS(S) to print the consent form such that all necessary information are filled in the printed consent form; or
- (in special circumstances that the aforesaid print function cannot be used) use blank consent form and fill in all necessary information [including name of the EHCP, voucher amount, reward amount (if applicable), voucher amount from the spouse’s account (if applicable), etc.]
Note
(1) According to Clauses 23, and 29 to 31 of the Agreement, the healthcare service to a voucher recipient shall be provided by an EHCP. The ECHP shall log on his/her own EHCP account in the eHealth System (Subsidies) when assisting the voucher recipient to use vouchers to settle the EHCP fees for the healthcare services he/she provided.
(2) According to Clauses 28 to 30 of the Agreement, vouchers are to settle “EHCP fees” which is defined as the fees charged by an EHCP or his/her medical organization for the healthcare service provided by the EHCP to a voucher recipient.
(3) According to Clause 32 of the Agreement, vouchers are used to settle the EHCP fees after provision of healthcare service by the EHCP to the voucher recipient and the EHCP shall ensure that the total amount of vouchers used by a voucher recipient to settle the EHCP fees shall not exceed the amount of the EHCP fees.
(4) According to Clause 31 of the Agreement, in assisting the voucher recipient to use vouchers, the EHCP shall request the voucher recipient to produce his/her Hong Kong Identity Card or Certificate of Exemption for verification of personal particulars.
(5) According to Clause 43 of the Agreement, the EHCP and his Associated Organization shall not pay any voucher recipient whether directly or indirectly all or part of the amount paid or payable by the Government to the EHCP or the Associated Organization pursuant to the Agreement.
致所有已登記醫療服務提供者:
香港特別行政區政府根據《醫療券計劃定義附表及協議的條款和條件》(下稱《協議》)第46條的規定發出下文第1至第4項所列的指示。為使醫療券計劃有效推行,所有已登記醫療服務提供者必須遵守並遵從該等指示,違規者或被終止協議。本守則的用語,與協議內有關用語(如適用)的涵義相同。
1. 醫療券的使用
- 只有已經在計劃下登記的醫療服務提供者方可接受醫療券使用者使用醫療券。醫療服務提供者須就通過他們的服務提供者戶口所作的一切申報負上責任,並且有責任妥善保管用以登入醫健通(資助)系統的認證保安編碼器。醫療服務提供者不可讓替假服務提供者使用他們的「已登記醫療服務提供者戶口」申報醫療券,以支付由他們提供給醫療券使用者的醫療服務的費用。
- 醫療券使用者若已擁有可用以支付醫療服務提供者收費的醫健通(資助)戶口,醫療服務提供者應接受他們使用醫療券。
- 無論是已登記醫療服務提供者或是相關機構,均不得為開設醫健通(資助)戶口,將兩個醫健通(資助)戶口連結或取消連結,或使用該戶口內的醫療券而向任何人士收取任何費用。
- 醫療券只可用作繳付已登記醫療服務提供者提供的醫療服務的費用,包括預防疾病和治療服務(如獎賞計劃下的特定服務)和復康服務。
- 醫療券不可用於住院服務、須預先繳費的醫療服務及日間手術程序,例如白內障手術或內窺鏡檢查服務。
- 醫療券使用者不可將醫療券用於僱用員工或純粹購買(即並非由已登記醫療服務提供者在療程中所提供/處方)物品,例如藥物、眼鏡、海味、個人護理用品、食品或其他醫療用品。但醫療券可用於由醫療服務提供者經看診後,因應長者的健康需要而在其專業執業範圍内處方並提供的治療或服務,及療程中所提供予長者的藥物、醫療用品及醫療設備等;而服務提供者應承擔對長者的專業責任。
- 除特別註明外,醫療券不可用於公營醫療服務及政府資助的服務,例如醫院管理局推行的各項公私營協作計劃下的資助服務,及衞生署推行的大腸癌篩查計劃等。
- 醫療券不可用於支付已登記醫療服務提供者為自己提供的醫療服務(換句話說:在任何醫療券申報交易中,醫療服務提供者不能同時是有關服務的提供者,又是該宗申報的醫療券使用者),但如醫療券使用者的配偶是向醫療券使用者提供醫療服務的已登記醫療服務提供者,則醫療券使用者亦可使用已連結的配偶的醫健通(資助)戶口內的醫療券。
- 醫療券使用者用以繳付醫療服務收費的醫療券總額(包括其醫健通(資助)戶口內的獎賞(如有)(適用於繳付使用特定服務所需的已登記醫療服務提供者服務收費)及已連結的配偶的醫健通(資助)戶口內的任何醫療券),不得超出已登記醫療服務提供者服務的收費及醫療券使用者未使用的配額(如適用)。當醫療券使用者以醫療券繳付已登記醫療服務提供者收費(不論是否就提供特定服務而收取)時,為免生疑問,該收費不得高於(不論直接還是間接)該已登記醫療服務提供者向沒有使用醫療券人士/非醫療券使用者提供同等醫療服務而收取的費用。
- 無論是已登記醫療服務提供者或是相關機構,均不可與醫療券使用者直接地或間接地訂立任何協議或安排,以令與該醫療券使用者或其配偶(如該醫療券使用者使用已連結的配偶的醫健通(資助)戶口內的醫療券)共享任何醫療券或獎賞的價值。該已登記醫療服務提供者或相關機構在此類協議或安排中,向醫療券使用者或其配偶提供任何利益,不論是現金或有現金價值的實物、贈券、積分還是其他等值物,均視作與他們共享任何本段所述的價值。就此,在醫療券計劃下任何可達致有關效力的廣告或宣傳或要約均不獲准許。
- 醫療券使用者必須向已登記醫療服務提供者出示他們的香港身份證或由入境事務處簽發的《豁免登記證明書》,並在親身接受已登記醫療服務提供者所提供的醫療服務後,才可使用醫療券支付有關醫療服務費用。就已登記參與醫療券計劃的醫務化驗師而言,是指有關化驗服務需由已登記的醫務化驗師為醫療券使用者本人而提供。醫療券不可用以支付醫療券使用者家人或其委托人士代為到診的醫療服務或配藥的費用。醫療服務提供者必須核對醫療券使用者的香港身份證或《豁免登記證明書》上的個人資料,確認他們是身份證明文件的持有人。如醫療券使用者已通知已登記醫療服務提供者,他將使用已連結的配偶的醫健通(資助)戶口內的醫療券支付有關醫療服務費用,則醫療券使用者亦須出示其配偶的香港身份證或《豁免登記證明書》副本。
- 任何已登記參與醫療券計劃的醫務化驗師,均不得在沒有經(i)註冊醫生、(ii)註冊牙醫或(iii)根據香港法例第343章診療所條例第8(1)條豁免診療所註冊人士的轉介下,收取醫療券為醫療券使用者進行任何化驗。倘若已登記醫務化驗師收取醫療券為醫療券使用者提供化驗服務,有關的化驗必須經由以上(i)、(ii)及(iii)所述的合資格醫療專業人員適當的轉介才可進行。
- 視光師在計劃下所作出的醫療券申報,不得用作支付與眼睛或視力護理無關的服務費用。
2. 醫療券使用者同意通知
- 每一項醫療券申報交易均必須備有有效的醫療券使用者同意通知作為依據。
- 如醫療券使用者不會讀寫但利用紙本醫療券使用者同意通知,見證人須確認他已向醫療券使用者閱讀醫療券使用者同意通知,並須提供見證人資料(包括見證人的姓名及香港身份證號碼)。如醫療券使用者屬精神上無行為能力的人士,監護人須以醫療券使用者監護人的身分填妥紙本醫療券使用者同意通知,並須提供監護人資料(包括監護人的姓名及香港身份證號碼)。
- 醫療券使用者同意通知上每項申報交易所涉及的醫療券金額必須經過確實核對及填妥。
- 為方便日後查核申報交易,醫療券使用者須提供可接收短訊的香港聯絡電話號碼(該電話號碼可屬於醫療券使用者、其家人或照顧者)。
- 顯示醫療券結餘的「醫療券使用記錄」須交給醫療券使用者作保留。
- 已登記醫療服務提供者須於已登記醫療服務提供者地點備存妥當和詳細的紙本醫療券使用者同意通知和共用醫療券同意書。為保障個人資料,上述文件須存放於已上鎖的櫃內,由獲發還相關費用的曆年起計,至七個完整財政年度完結,或有關各方就醫療券計劃的爭議獲得解決或裁定為止(以較後的日期為準)。
- 於銷毀載有個人資料的文件或記錄時,醫療服務提供者須遵從《個人資料(私隱)條例》的相關條文,以及個人資料私隱專員公署的指引資料,包括「個人資料的刪除與匿名化指引」。
3. 醫療券申報的提交和確認
- 如任何醫療券使用者或允許其使用自己醫療券的配偶所持有的香港身份證上有符號標記「C」或「U」,醫療服務提供者須於提供服務當日,於醫健通(資助)系統為其輸入相關醫療券申報。如屬其他情況,醫療服務提供者須於向其提供服務當日起計的七個曆日內,於醫健通(資助)系統輸入相關醫療券申報。逾期提交的醫療券申報,相關醫療券款項或不會獲付還。
- 請醫療服務提供者小心核對在醫健通(資助)系統內,以他的「已登記醫療服務提供者戶口」作出的申報詳情,然後才確認申報,以確保所有經系統提供予政府的資料均屬真實和正確。醫療服務提供者應定期覆檢就通過其服務提供者戶口所提交的醫療券申報,以確定各項申報均與其負責的醫療服務有關。
- 不當的醫療券申報將不會獲政府付還相關的款項。隨附件列出若干不當申報醫療券的例子,以供參考。然而,這些例子並非鉅細無遺,因此醫療服務提供者最好是嚴格遵守協議中的相關條文。
4. 計劃標誌
- 無論是已登記醫療服務提供者或是其相關機構,均不得印製計劃標誌的任何副本或把該標誌張貼於不屬衞生署署長所指定的任何地方。
5. 建議
- 為免引起病人投訴或不滿,我們建議已登記醫療服務提供者盡量提高其服務收費的透明度。例如:在醫務所展示告示,通知病人在接受治療前,享有查詢所涉及的收費價目的權利;在提供服務前因應要求向病人清楚透露所需的費用;以及容許病人經醫護人員解釋後,可選擇不同價目的服務計劃。
- 已登記醫療服務提供者在核對醫療券使用者的身分,或獲取醫療券使用者同意通知及任何其他有關醫療券的使用的同意、聲明及確定通知,以及為醫療券使用者作出醫療券申報時應使用智能身份證閱讀器,否則須於醫健通(資助)系統解釋為何沒有使用智能身份證閱讀器。
- 為使已申報的醫療券(及/或獎賞(如適用))款項得以及時付還,我們建議已登記醫療服務提供者適時檢視系統內「工作列」下有待完成或有待確認的申報,並於每月最後一天或之前完成及確認所有申報資料。有關付還的申報詳情可瀏覽系統內的「月結單」。
衞生署
二零二六年六月
*此「使用醫療券的守則」更新版本已取代所有先前版本。
附錄
以下為不當醫療券申報的個案。請注意,根據《醫療券計劃定義附表及協議的條款和條件》(下稱《協議》)第42條的規定,倘若已登記醫療服務提供者或其醫療機構違反「協議」中的任何條文,香港特別行政區政府沒有義務支付已登記醫療服務提供者或其醫療機構任何醫療券使用者同意使用的醫療券金額。
協議的詳細資料上載於www.hcv.gov.hk。
例子一
X先生和Y女士同服務於一間醫療機構。X先生已登記參加醫療券計劃,而Y女士沒有。醫療券事務科在例行審查該醫療機構已登記醫療服務提供者所處理的醫療券申報時,發現多宗經由X先生的醫健通(資助)系統 「已登記醫療服務提供者戶口」處理的申報中,所涉及的醫療服務其實是由Y女士提供,而非X先生本人。X先生及其醫療機構均未有察覺此做法並不恰當。
注意事項
- 只有已登記醫療服務提供者可經由他/她的「已登記醫療服務提供者戶口」處理醫療券的申報,而涉及的醫療服務須由他/她直接向醫療券使用者提供(註1)。
- 醫療機構應鼓勵其尚未登記的醫護人員登記參加醫療券計劃,並在他們登記時提供所需支援。成功登記後,醫護人員會獲發其在醫健通(資助)系統的「已登記醫療服務提供者戶口」,以處理長者的醫療券申報。
- 在診所內展示已登記醫療服務提供者名字供醫療券使用者參考。
例子二
一名已登記醫療服務提供者為長者申領使用醫療券,但調查顯示在部份申領交易中,所涉及的醫療券只用作購買藥物/中藥/海味,而長者並沒有接受任何由該名已登記醫療服務提供者提供的醫療服務。
此等純粹把醫療券用作購買藥物或其他物品而未有提供醫療服務的申領違反了協議的相關規定。
注意事項
- 醫療券只可用作繳付已登記醫療服務提供者就提供的醫療服務,包括預防疾病和治療服務(如獎賞計劃下的特定服務)和復康服務所收取的費用(註2)。
- 醫療券不可純粹用作購買藥物、中藥、眼鏡、個人護理用品、食品或其他物品。
例子三
一名已登記醫療服務提供者所處理的醫療券申報中,長者所使用醫療券的總額超出了是次診症中服務提供者的收費(例如:某次診症的費用為港幣130元,但該名已登記醫療服務提供者在該次申報中扣減的醫療券金額為港幣350元)。該名已登記醫療服務提供者解釋因長者會定期到訪,多扣減的醫療券金額會用作支付有關長者日後診症的費用。
此種使用醫療券預繳尚未提供的醫療服務的申領違反了協議的相關規定。
注意事項
- 醫療券使用者在使用醫療券去繳付醫療服務收費時,所使用的醫療券總額不得超出服務提供者所收取的費用(例如:若診金為港幣130元,可扣減的醫療券金額應為港幣130元或以下,而長者應繳付診金的餘額)(註3)。
- 已登記醫療服務提供者所作的醫療券申領交易只可基於個別已提供的醫療服務。
例子四
一名已登記醫療服務提供者為長者A和長者B申領使用醫療券,但醫療券事務科調查有關的申領交易時發現,長者A並沒有親身到該名已登記醫療服務提供者的執業地點接受醫療服務,而是於電話向該名已登記醫療服務提供者講述病徵後,授權家人到該已登記醫療服務提供者診所代為獲取藥材並申報醫療券。至於長者B,她曾到該名已登記醫療服務提供者的診所看病並使用醫療券;及後,其家人到診所使用醫療券配藥。調查發現長者B對其醫療券被使用一事毫不知情。
已登記醫療服務提供者沒有當面核實醫療券使用者的個人資料便替其申報使用醫療券,違反了協議的相關規定。
注意事項
- 在協助長者使用醫療券時,已登記醫療服務提供者應要求長者出示其香港身分證或豁免證明書,以核實其個人資料(註4)。
- 醫療券使用者必須在親身接受已登記醫療服務提供者所提供的醫療服務後,才可使用醫療券支付有關醫療服務費用。就已登記參與醫療券計劃的醫務化驗師而言,是指有關化驗服務需由已登記的醫務化驗師為醫療券使用者本人而提供。醫療券不可用以支付醫療券使用者家人或其委托人士代為到診的醫療服務或配藥的費用。上述情況與長者夫婦同意連結雙方的醫健通(資助)戶口共用醫療券,讓一方在其醫健通(資助)戶口內的醫療券耗盡時,可使用另一方醫健通(資助)戶口內的醫療券的情況不同。
例子五
一名已登記醫療服務提供者於休假期間有為長者申領使用醫療券的記錄。調查顯示該名已登記醫療服務提供者於休假期間,曾讓一名替假服務提供者使用其「已登記醫療服務提供者戶口」,為長者診症後申報醫療券。
讓替假服務提供者(不論該名服務提供者是否已登記參加醫療券計劃)使用自己的「已登記醫療服務提供者戶口」申報醫療券以支付並非由自己提供的醫療服務屬違反協議的行為。
注意事項
- 只有已登記醫療服務提供者可經由他/她的「已登記醫療服務提供者戶口」處理醫療券的申報,而涉及的醫療服務須由他/她直接向醫療券使用者提供(註1)。
- 已登記醫療服務提供者應鼓勵尚未登記的替假服務提供者登記參加醫療券計劃。成功登記後,替假服務提供者會獲發其在醫健通(資助)系統的「已登記醫療服務提供者戶口」,以處理醫療券申報。
- 在診所內展示替假服務提供者的資料,包括姓名及可否使用醫療券,供醫療券使用者參考。
例子六
一名已登記醫療服務提供者為長者提供醫療服務後申報醫療券。該次診症的費用應為港幣250元,但該名已登記醫療服務提供者卻在申報時不小心地錯誤扣減了港幣520元醫療券金額。該名已登記醫療服務提供者其後發現申報金額錯誤,並在有關長者同意下把多扣除的港幣270元醫療券金額以現金形式退還予長者。
此等以醫療券兌換現金的行為違反了協議的相關規定。
注意事項
- 醫療券不可以兌換現金(註5)。
- 該已登記醫療服務提供者應於錯誤確認醫療券申報後的24小時內在醫健通(資助)系統取消該宗申報。
- 若該宗醫療券申報已確認超過24小時,該已登記醫療服務提供者應盡快向醫療券事務科提出取消該宗錯誤申報的要求,並附以理由及相關證明文件。
例子七
因智能身份證閱讀器故障,一名已登記醫療服務提供者未能使用電子同意書申報醫療券,於是改用紙本同意書。由於該已登記醫療服務提供者當時很忙碌,所以在親自提供醫療服務後,要求醫療券使用者在一份空白的「醫療券使用者使用醫療券同意書」(同意書)上先簽署,並解釋待他稍後有空時,會補填同意書上的所需資料。
此種要求醫療券使用者在一份空白的同意書上簽署的行為已違反了協議規定,而所簽署的同意書並沒有效。
注意事項
- 當醫療券使用者同意使用其醫療券支付醫療服務費用時,該已登記醫療服務提供者便須於扣減醫療券前取得醫療券使用者的有效同意。
- 當使用紙本同意書時,已登記醫療服務提供者應
- 使用醫健通(資助)系統中的列印功能列印已填妥所需資料的同意書;或
- (在無法使用上述列印功能的特殊情況下)先在空白的同意書上填寫所有必要資料(包括已登記醫療服務提供者的姓名、扣減的醫療券金額、使用的獎賞金額(如適用)、使用配偶醫療券的金額(如適用)等)
註:
(1) 根據協議第23及29至31條的規定,提供醫療服務給醫療券使用者的人士必須是已登記的醫療服務提供者。已登記醫療服務提供者在協助醫療券使用者使用醫療券時,應登入其在醫健通(資助)系統內的已登記醫療服務提供者戶口,為醫療券使用者使用醫療券,以支付其提供的醫療服務所收取的已登記醫療服務提供者收費。
(2) 根據協議第28至30條的規定,醫療券是用作支付已登記醫療服務提供者的收費,其定義指已登記醫療服務提供者或其醫療機構,就該名已登記醫療服務提供者提供予醫療券使用者的醫療服務所收取的費用。
(3) 根據協議第32條的規定,醫療券是用作支付已登記醫療服務提供者在提供醫療服務後的收費,而已登記醫療服務提供者須確保,醫療券使用者用以支付已登記醫療服務提供者的收費的醫療券總額不得超出已登記醫療服務提供者的收費金額。
(4) 根據協議第31條的規定,在協助醫療券使用者使用醫療券時,已登記醫療服務提供者應要求醫療券使用者出示其香港身分證或豁免證明書,以核實其個人資料。
(5) 根據協議第43條的規定,該已登記醫療服務提供者及其相關機構均不得向任何醫療券使用者支付政府根據協議付予或應付予該已登記醫療服務提供者或其相關機構的款項的全數或部分金額,不論是直接支付還是間接支付者。
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