Articles with tag: «medical insurance organizations»
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2021 № 4 NEW SYSTEM OF CONTRACTS WITHIN THE FRAMEWORK OF COMPULSORY HEALTH INSURANCE
The system of compulsory health insurance is regulated by a large number of regulatory legal acts. Nevertheless, many issues related to the relationship between the participants of the MHI system, and above all – financial, are determined by the content of the contracts concluded between them. This article analyzes the new system of contracts that has developed in the system of compulsory medical insurance in connection with the adoption of Federal Law No. 430-FZ of December 8, 2020 “On Amendments to the Federal Law “On Compulsory Medical Insurance in the Russian Federation”, as well as other related regulatory legal acts. There have been changes not only in the content of the contracts, but also in the composition of their participants. In addition, there is a new, previously absent type of contract. The purpose of the work is to analyze changes in contracts in the MHI system and their possible consequences.
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2020 № 8 Changes in the procedure for financial support of medical organizations in the system of compulsory medical insurance at the present stage of the spread of coronavirus infection
In the context of the spread of coronavirus infection, the main problem of medical organizations is not an obvious increase in the cost of providing medical care associated with ensuring the sanitary and epidemiological regime (personal protective equipment, disinfection, etc.), but a decrease in income due to a drop in the volume of planned medical care, suspension of preventive measures, downtime (during the period of re-profiling, etc.).
The state quickly responded to this situation by making changes to the relevant legislation and adopting a number of special regulatory legal acts. However, the implementation of these rather varied measures tied to a number of factors, such as the presence or absence of restrictive measures on the territory of the Russian Federation; participation or non-participation in the care of patients with coronavirus infection; periods within which the one or the other order advances, etc.
All this causes difficulties in understanding what financial security mechanism is applied to this particular situation, what should be the actions of medical organizations.
This article is devoted to the analysis of ways of financial support of medical organizations in the system of compulsory medical insurance at various stages of the fight against coronavirus infection. -
2023 № 7 On the issue of the effectiveness of the maintenance of insurance medical organizations in the healthcare system of the Russian Federation.
The problems of domestic healthcare are associated with a number of factors that are influenced by the indicators of the economic state of the country, while the main problem is insufficient funding, largely related to the participation of insurance medical organizations in healthcare. A comparison of the cost of maintaining the CFR and the Pension Fund of Russia over a long period of time clearly shows that the effectiveness of the healthcare system with the participation of the CFR is significantly less than the effectiveness of the Pension Fund.
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2014 № 9 Promising model of medical aid management on in Russian Federation (Ministry of Health Care of Novosibirsk region, Novosibirsk, Russia)
This article describes a promising model of medical insurance system implemented on the territory of Russian Federation. Its benefits and disadvantages were analyzed and there were given additional recommendations on reforming the system of healthcare.
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2015 № 8 On certain questions relating to interterritorial accounting in the system of compulsory medical insurance
Issues of interterritorial accounting for provided care to citizens registered with a compulsory medical insurance plan yet outside of the insurance territory is relevant and needs further and deeper analysis. It is safe to conclude that insurance medical organizations should participate in interritorial accounting process along with conducting control check of volumes and conditions at which medical care is provided and completing a medical aid quality check.
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2015 № 2 On certain issues occurring in medical insurance organizations functioning in the mandatory medical insurance system
Modernization of mandatory medical insurance system should imply a broader usage of reserves from medical insurance organizations (MIO). These reserves are interlinked with changes in the legislation, regulating the responsibilities and obligations of insured citizens, commitment of MIO in covering expenses for medical aid, provided outside of the region, the order of utilizing assets of MIO.