2019 № 3 Рayment for medical care provided in excess of the volumes of granting of medical aid in system of obligatory medical insurance
Сurrently, health organizations are extremely important are the issues associated with excess of volumes of granting of medical aid in system of obligatory medical insurance. This is the so-called problem of "super-planned patients". The current legislation does not provide for payment of super-planned volumes of medical care.. But the incidence rate is difficult to predict with a high level of accuracy. Within the framework of the current regulatory framework, all financial risks in this situation are assigned to the medical organization, which does not correspond to the logic of insurance. However, there are some options to mitigate this problem. This is illustrated by the court practice in this area.
сompulsory medical insurance, volumes of medical care, insurance medical organizations, medical organizations, sanctions, the Commission on development of the territorial judicial practice.
2019 № 6 New rules of obligatory medical insurance: major changes
The rules of obligatory health insurance regulate legal relations of subjects and participants of compulsory health insurance. New rules of obligatory health insurance developed by the Ministry of health of Russia in accordance with the recommendations of the Ministry of justice. The essence of these recommendations was not to make regular changes to the existing rules of obligatory health insurance, but to approve new rules of obligatory health insurance. To a large extent, these changes are associated with the Informatization of health care, with the advent of legislative regulation of the use of telemedicine technologies. Most of the changes affect the order of calculation of the value of sanctions applied to the medical organisations in the mandatory medical insurance system. In turn, these changes reflect the desire to reduce the financial burden on state (municipal) institutions and make it easier for them to achieve the level of wages provided for by the "may" presidential Decrees of 2012.