Articles with tag: «compulsory medical insurance»

    Medical science
  • 2018 № 8 The application of leasing in state (municipal) health care institutions

    Difficult economic conditions lead to the fact that the expenditures of budgets of all levels for the purchase of equipment are highly reduced. State (municipal) institutions are forced to look for other sources and channels for financing equipment purchases. In this respect, leasing at the expense of compulsory medical insurance is an interesting, but incomprehensible tool. Especially, given the variety of its forms. Moreover, the use of leasing in the system of compulsory medical insurance encounters a number of serious limitations. Meanwhile, the competent conclusion of leasing contracts, in fact, in a number of cases makes it possible to solve problems of obtaining equipment worth more than 100,000 rubles at the expense of compulsory medical insurance.

    Authors: Kadyrov F. N. [95]

    Tags: compulsory medical insurance9 contract2 financial lease1 leasing1 purchase of equipment1 state procurements1

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  • Manager of healthcare consults
  • 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.

    Authors: Kadyrov F. N. [95] Kuftova Yu. V. [2]

    Tags: compulsory health insurance policy2 compulsory medical insurance9 healthcare  organizations1 health  insurance  organizations3 penalties1 sanctions2 telemedicine  technology1 the  rules  of  compulsory  medical  insurance1

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  • 2019 № 5 The procedure for co-financing of salary for newly hired employees in primary care

    In his Decree No. 204 of May 7, 2018 “On the national goals and strategic objectives of the development of the Russian Federation for the period up to 2024”, the President set the task to ensure the achievement of a number of goals and targets in the health sector. These include the elimination of personnel shortages in medical organizations that provide primary health care.
    To help solve this problem, a mechanism has been developed to co-Finance the salary costs of state (municipal) institutions, which provide an increase in the staffing of employees.
    Corresponding changes were made to Federal Law of November 29, 2010 № 326-ФЗ “On Compulsory Medical Insurance in the Russian Federation” (Part 6.6. Of Article 26).
    This article is devoted to the order of formation, the conditions of provision to medical organizations of the state health system and the municipal health care system, providing primary health care in accordance with the territorial programs of compulsory health insurance, the funds of the normalized insurance stock of the territorial Fund of compulsory medical insurance provided for co-financing of expenses of the medical organizations for compensation of doctors and average medical personnel.

    Authors: F.  N.  Kadyrov [9]

    Tags: co-financing1 compulsory medical insurance9 health  personnel2 normalized  insurance  reserve1 state  (municipal)  health  care  institutions.1 territorial  funds  of  compulsory  medical  insurance1

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  • Manager of health care consults
  • 2020 № 3 The problems of paying for medical care provided to residents of other subjects of the Russian Federation within the framework of compulsory medical insurance

    The legislation guarantees citizens the right to receive medical care under a compulsory health insurance policy (CHI) throughout the Russian Federation. But in some cases, in accordance with current legislation, a referral is required to receive medical care. This also applies to situations where a citizen receives medical care outside of the subject of the Russian Federation where the citizen is insured. The system of such referrals to medical organizations located in another region is more or less regulated only when they are sent to Federal medical organizations. The situation is further compounded by the fact that the Supreme court contrary to law, making decisions, actually leveling a direction. At the same time, payment for medical care provided outside the region in which the MHI policy is issued depends on the payment of this assistance from the Territorial Fund of this region. This leads to numerous delays in payment and, as a result, reduces the interest of medical organizations in providing medical care to "nonresidents". Patients suffer as a result. All this raises the question of the need to improve the current mechanism for conducting inter-territorial settlements in the MHI system.

    Authors: F.  N.  Kadyrov [9] O.  V.  Obukhova [3] Yu. V. Endovitskaya [6]

    Tags: compulsory medical insurance9 federal  compulsory  medical  insurance  fund1 insurance medical organizations3 inter- territorial  settlements1 medical organizations15 payment for medical care4 standardized  insurance  stock.1 territorial  compulsory  medical   insurance  funds1

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  • 2015 № 8 Regulatory control of state-private (municipal-private) partne

    The article examines a legislation, related to the state-private partnership and municipal-private partnerships, specifics of its application in the state system. There is also analysis done of a possible impact of the new legislation on investment activity in circumstances of current economic crisis. There are demonstrated legislation opportunities and limitations for realizing state-private partnership projects with participation of state (municipal) institutions in health care.

    Authors: Kadyrov F. N. [95]

    Tags: compulsory medical insurance9 efficiency9 financing10 investments1 legislation4 municipal-private partnership1 state (municipal) institutions6 state-private partnership1

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  • 2019 № 1 Financing health care in 2019: new priorities and channels for the movement of funds

    Analysis of the future financing of health care shows that in 2019–2021, despite the difficult financial situation, the volume of financial support for the industry will continue to grow. Thus, the size of health care spending from the Federal budget is growing not only in absolute terms, but also occupies all a large share in the structure of Federal budget expenditures. The increase in expenses in the system of compulsory health insurance (CHI) in absolute terms is still quite large. Among the priorities of 2019 are the increase in funding for cancer care, as well as high-tech medical care, which directly follows from the provisions of the Decree of the President of the Russian Federation May 7, 2018 № 204 "The national goals and strategic objectives of the Russian Federation for the period up to 2024" (presidential Decree № 204). The distribution of funds to the compulsory medical insurance system is based on these priorities, and based on the results of implementation of decrees of the President 2012 for leveling a series of problems, such as unreasonable reductions in personnel. All this should have a positive impact on the further development of health care.

    Authors: Kadyrov F. N. [95] Obukhova O. V. [18] Brutova A. C. [2]

    Tags: compulsory medical insurance9 deficit5 expenses5 federal budget6 federal fund of chi1 financing10 health care20 income5 insurance contributions1 inter-budgetary transfers1

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  • Management in healthcare
  • 2018 № 9 Influence of activity of the medical organization, providing medical assistance to children, on the economy of the region

    The analysis of 46 7122 entries in the medical information system of the organization for 2016 characterizing the treatment of children for the purpose of medical care, 9533 cases when the sheet can not work (SNW) was issued. The costs of territorial funds of compulsory medical insurance (CMI) and social insurance fund, an internal regional product for the treatment of a child, are estimated. It is established that the budget of the region loses 8,9 times more than the amount of CMI funds that was spent for the treatment of the child, if issued by the SNW. This requires active prophylactic measures for children.

    Authors: Choloyan S. B. [7] AEkimov. K. [1] Pavlovskaya O. G. [7] Sheenkova M. V. [7] Danilova L. V. [4]

    Tags: compulsory medical insurance9 compulsory social insurance1 gross domestic product1 payment of a disability certificate1 preventive measures for children1

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  • Law
  • 2018 № 3 Topical issues of arbitration practice in the CHI system (the experience of Saint-Petersburg)

    The current legislation in the system of compulsory health insurance has opened wide opportunities for participation in this system of medical organizations of any organizational and legal form. However, this has led to an increase in the number of economic disputes in the compulsory health insurance system. In particular, the number of lawsuits is increasing on new grounds: the amount of medical care; payment for medical care provided in excess of these volumes. The defendants in the claims are not only the insurance medical organizations and territorial funds of the MLA, but also the Commission, which develop territorial programs of compulsory medical insurance and are not legal entities. Court practice in many cases violates the logic of legislation on compulsory health insurance. This article is devoted to the consideration of these problems for recommendations to improve the legislation

    Authors: Gordeev A. E. [1]

    Tags: commission  on  the  elaboration  of  territorial  programmes1 compulsory medical insurance9 health  insurance  organizations3 litigation1 the  volume  of  medical  care2

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  • Financial management
  • 2019 № 5 Providing income activities as a conscious necessary for functioning of the state (municipal) medical providers

    Realization of the rights of citizens to health care and medical care free of charge, enshrined in the Constitution of the Russian Federation, carried out by state and municipal health care institutions «… at the expense of the relevant budget, insurance premiums and other income». Analysis of the dynamics of the volume of financial sources for 2014–2017 showed a significant increase in revenues of medical organizations, which are state budgetary institutions, funds from income-gener- ating activities.
    The article describes the main financial sources that a medical organization – a state (municipal) institution may have for providing medical care, as well as for implementing the Program of state guarantees of free medical care to citizens. The rationale for the insufficiency of public funds to ensure the necessary level of wages for medical workers is given on the example of comparing tariffs of the compulsory health insurance system and prices (tariffs) of private medical organizations in the city of Moscow.
    The regulatory and legislative conditions for obtaining funds from various financial sources by a public institution are con- sidered, the relevance of developing measures to attract additional financial sources, which include revenues from providing paid medical services to the population, including through voluntary medical insurance, is justified.

    Authors: A. Sh. Senenko [5] O.  V.  Obukhova [3] D.  I.  Nitsenko [1] V. Ch.  Tsydypov [1] A.  M.  Chililov [2]

    Tags: compulsory medical insurance9 financial  sources1 incomegenerating  activities1 paid medical services15 state  provider1 the  program  of  state  guarantees  of  free  medical  care  to  citizens1 voluntary medical insurance2

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