Article 21 federal law dated November 21, 2011 No. 323-FZ “On the basics of protecting the health of citizens in Russian Federation", when providing a citizen medical care within the program state guarantees free provision of medical care to citizens, he has the right to choose a medical organization in the manner approved by the authorized federal agency executive power, and the choice of a doctor subject to the consent of the doctor.

When providing medical care to a citizen within the framework of the program of state guarantees of free provision of medical care to citizens, the choice of a medical organization (with the exception of cases of emergency medical care) outside the territory of the subject of the Russian Federation in which the citizen lives is carried out in the manner established by the authorized federal executive body.

In accordance with the order of the Moscow Department of Health and the Moscow City Compulsory Medical Insurance Fund dated October 11, 2010 No. 1794/130 “On approval of the procedure and conditions for the provision of medical care under the Moscow City Compulsory Medical Insurance Program”, the exercise of the right of citizens insured under compulsory medical insurance in the city of Moscow to choose medical -prophylactic institution in the system CHI city Moscow is carried out on the basis of a written application addressed to the chief physician in accordance with the resource capabilities of the institution.

The provision of primary health care is carried out on the basis of the order of the Ministry of Health and Social Development of Russia dated May 15, 2012 N 543n (as amended on September 30, 2015) "On approval of the Regulations on the organization of the provision of primary health care to the adult population" (Registered in the Ministry of Justice of Russia on June 27, 2012 N 24726)

According to the order of the Ministry of Health of the Russian Federation dated December 21, 2012 No. 1342n “On approval of the procedure for choosing a medical organization by a citizen (with the exception of cases of emergency medical care) outside the subject of the Russian Federation in which the citizen lives, when providing him with medical care under the program of state guarantees free medical care” for the provision of medical care outside the territory of the subject of the Russian Federation in which the citizen lives, the citizen personally or through his representative applies to the medical organization of his choice with a written application for the choice of the medical organization, presenting the originals or certified copies of the following documents:

• a passport of a citizen of the Russian Federation or a temporary identity card of a citizen of the Russian Federation, issued for the period of issuing a passport;
• compulsory medical insurance policy (temporary compulsory medical insurance policy);
• SNILS (if available).

Citizens insured under compulsory medical insurance in the city of Moscow receive medical assistance upon presentation of the compulsory medical insurance policy (when you first apply to a medical institution, in addition to the compulsory medical insurance policy, you must present a passport). In the absence of a compulsory medical insurance policy for patients (in case they apply on an emergency basis), medical institutions take measures to identify the patient in order to identify the insurer or classify him (according to his passport) as a non-resident citizen or unidentified patient.

Planned inpatient medical care for citizens insured under compulsory medical insurance in the city of Moscow is provided in the direction of the outpatient clinic to which they are attached for medical care.

To receive specialized medical care in a planned form, the choice of a medical organization is carried out in the direction of the attending physician.

Ambulance and emergency medical care, including inpatient care, is provided to all citizens in Moscow free of charge, at the expense of the city budget, regardless of the presence of a certificate of registration in Moscow and a compulsory medical insurance policy.

The Department of Health of the city of Moscow in connection with the numerous appeals of citizens on the provision of medical care in medical organizations state system health care of the city of Moscow informs

In accordance with the order of the Department of Health of the city of Moscow dated 11.10.2012 No. 1090 “On Amendments to the Order of the Department of Health of the City of Moscow dated 02.11.2009 No. 1400”, the decision on the possibility of providing planned consultative, diagnostic and inpatient medical care foreign citizens at the expense of the budget of the city of Moscow (scheduled medical care that is not included in the basic program of compulsory medical insurance, scheduled medical care in medical organizations that do not work in the system of compulsory medical insurance, program and peritoneal dialysis, hemosorption, organ and/or tissue transplantation, chemotherapeutic treatment, receiving expensive drugs for blood diseases, multiple sclerosis, systemic collagenoses, after organ and / or tissue transplantation) is accepted by the Moscow City Health Department upon a written application by the patient or his legal representative addressed to the head of the Moscow City Health Department.

The written application of the patient (legal representative of the patient) must contain the following information: last name, first name, patronymic of the patient, date of birth, citizenship, address of registration at the place of residence, postal address at the place of actual residence (stay), Contact phone numbers, information about the legal representative of the patient (if any), the essence of the appeal. The following documents are attached to the written application: copies of identification documents, citizenship and registration at the place of residence (stay) of the patient, a copy of the patient's compulsory medical insurance policy (if any), a copy of a certificate confirming the presence of a disability (if any), an extract from medical records , the results of the studies carried out on the profile of the patient's disease, other medical documentation (if any).

If the patient's legal representative applies, the set of documents additionally includes: a copy of the identity document of the patient's legal representative, a copy of the document confirming the authority of the patient's legal representative.

The receipt by citizens of Russia of free medical care is regulated by the order of the Ministry of Health and Social Development No. 406n and the Federal Law "On the Protection of the Health of Citizens". Data legislative acts clearly formulate the possibility for a citizen of Russia to receive free medical care in a polyclinic or other medical institution in any region of the country, regardless of the place of registration.

This means that the patient has the right to be attached to a polyclinic in any city or region, regardless of the place of residence. The only restriction enshrined in law is that the choice or replacement of a medical institution can be made no more than once a year. However, this restriction does not apply in the event of a change of place of permanent residence. Persons with out-of-town registration and wishing to be served at the selected polyclinic institution must update the "attachment" procedure annually.

The order of attachment to the clinic

To attach to the selected clinic, you must write an application addressed to the head physician, as well as provide the registry with a passport or birth certificate (for persons under 14 years old), SNILS and a medical insurance policy. In the application for attachment, a citizen must indicate the following information:

• Surname, name, patronymic;
• Passport data;
• Address of the actual residence;
• Health insurance policy number;
• Details of the previous clinic.

The medical institution has 2 days to consider the received application, which consists in verifying the information provided. In case of passing the check, the management of the polyclinic notifies the applicant of acceptance for medical care. The document flow for deregistration in one medical institution and registration in another will take about 1 more week. Thus, the minimum period required for the full procedure of attachment to the new clinic is 12 days.

If the patient needs immediate medical attention, the doctor state polyclinic is obliged to accept it, regardless of the place of registration of the patient and whether he is attached to this medical institution or not. A scheduled or emergency examination is possible if a citizen has a compulsory medical insurance policy.

Refusal to attach to a medical institution

If all of the above conditions are met, they have no right to refuse to attach a patient to a polyclinic, or to provide emergency / planned medical care. However, there are cases of illegal refusals or demands that the patient provide additional documents. In cases of violations of the law by medical institutions, you should contact insurance company, territorial MHIF or Department of Health. Phones can be used hotline or trust services, which are organized by territorial branches of compulsory health insurance funds. The coordinates and numbers of the relevant organizations can be found on the official websites of the TFOMS and various reference resources on the Internet.

1. Everyone has the right to medical care.

2. Everyone has the right to medical care in a guaranteed volume, provided free of charge in accordance with the program of state guarantees of free provision of medical care to citizens, as well as to receive paid medical services and other services, including in accordance with a voluntary medical insurance contract.

3. The right to medical care for foreign citizens residing and staying on the territory of the Russian Federation is established by the legislation of the Russian Federation and the relevant international treaties of the Russian Federation. Stateless persons permanently residing in the Russian Federation enjoy the right to medical care on an equal footing with citizens of the Russian Federation, unless otherwise provided by international treaties of the Russian Federation.

4. The procedure for rendering medical assistance to foreign citizens is determined by the Government of the Russian Federation.

5. The patient has the right to:

1) the choice of a doctor and the choice of a medical organization in accordance with this Federal Law;

2) prevention, diagnosis, treatment, medical rehabilitation in medical organizations in conditions that meet sanitary and hygienic requirements;

3) obtaining advice from medical specialists;

4) relief of pain associated with the disease and (or) medical intervention, available methods and drugs;

5) obtaining information about their rights and obligations, the state of their health, the choice of persons to whom, in the interests of the patient, information about the state of his health can be transferred;

6) receiving therapeutic nutrition in the event that the patient is being treated in stationary conditions;

7) protection of information constituting a medical secret;

8) refusal of medical intervention;

9) compensation for harm caused to health during the provision of medical care to him;

10) admission to him of a lawyer or legal representative to protect his rights;

11) the admission of a clergyman to him, and in the case of a patient being treated in a hospital, to the provision of conditions for the performance of religious rites, which can be carried out in a hospital, including the provision of a separate room, if this does not violate the internal regulations of the medical organization.

Rules for the provision of medical care to foreign citizens on the territory of the Russian Federation

(Decree of the Government of the Russian Federation of March 6, 2013 N 186 Moscow "On approval of the Rules for the provision of medical care to foreign citizens on the territory of the Russian Federation")

1. These Rules determine the procedure for providing medical care to foreign citizens on the territory of the Russian Federation.

2. Medical assistance to foreign citizens temporarily staying (temporarily residing) or permanently residing in the Russian Federation is provided by medical and other medical activity organizations, regardless of their organizational and legal form, as well as individual entrepreneurs carrying out medical activities (hereinafter referred to as medical organizations).

3. Emergency medical assistance in case of sudden acute diseases, conditions, exacerbation of chronic diseases that pose a threat to the patient's life is provided to foreign citizens by medical organizations free of charge.

4. Foreign citizens who are insured persons in accordance with the Federal Law "On Compulsory Medical Insurance in the Russian Federation" are entitled to free medical care within the framework of compulsory medical insurance.

5. Emergency, including emergency specialized, medical care is provided to foreign citizens in case of diseases, accidents, injuries, poisoning and other conditions requiring urgent medical intervention.

Medical organizations of the state and municipal health care systems provide this medical care to foreign citizens free of charge.

6. Medical assistance in an emergency form (with the exception of emergency, including emergency specialized medical care) and planned form is provided to foreign citizens in accordance with contracts for the provision of paid medical services or voluntary medical insurance contracts and (or) concluded in favor of foreign citizens specified in paragraph 4 of these Rules, contracts in the field of compulsory medical insurance.

7. Medical assistance in a planned form is provided subject to the submission by a foreign citizen of written guarantees of fulfillment of the obligation to pay the actual cost of medical services or prepayment for medical services based on the expected volume of these services (except for cases of medical assistance in accordance with paragraph 4 of these Rules), as well as the necessary medical documentation (extract from the medical history, data from clinical, radiological, laboratory and other studies), if any.

8. After the completion of the treatment of a foreign citizen in his address or the address of a legal or individual representing the interests of a foreign citizen, in agreement with the specified citizen, an extract from the medical documentation is sent indicating the term for the provision of medical care in a medical organization, as well as the measures taken for prevention, diagnosis, treatment and medical rehabilitation.

Medical documentation sent from the Russian Federation to another state is completed in Russian.

9. Invoices for actually provided medical care within 10 days after the end of treatment are sent to medical organization to the address of a foreign citizen or a legal or natural person representing the interests of a foreign citizen, unless otherwise provided by the contract in accordance with which it was provided (with the exception of cases of medical care in accordance with paragraph 4 of these Rules).

10. Disputes related to the provision of medical care or late payment of invoices for actually provided medical care are resolved in the manner prescribed by the legislation of the Russian Federation.

11. In case international treaty The Russian Federation has established a different procedure for providing medical care to foreign citizens, the rules of an international treaty are applied.

Emergency and emergency medical care is provided to citizens who are outside the territory of the subject of the Russian Federation in which the citizen lives (hereinafter referred to as non-resident citizens) immediately and free of charge.
In other cases, in accordance with Article 35 of the Federal Law of November 29, 2010 No. 326-FZ “On Compulsory Medical Insurance in the Russian Federation”, all citizens have the right to receive medical care included in the basic program of compulsory medical insurance (link), including outside the subject of the Russian Federation in which the CHI policy was issued.

emergency medical care, including specialized	Sudden acute diseases and conditions; exacerbation of chronic diseases that threaten the life of the patient		ALWAYS FREE!
Emergency medical care including specialized	Sudden acute diseases and conditions; exacerbation of chronic diseases without obvious signs of a threat to the patient's life	When calling an ambulance or when contacting a medical organization on your own	ALWAYS FREE!
Planned medical care	It turns out during preventive measures, in diseases and conditions that are not accompanied by a threat to the life of the patient, that do not require emergency and urgent medical care, the delay in the provision of which for a certain time will not entail a deterioration in the patient's condition, a threat to his life and health	Must be affiliated with a healthcare organization	FREE OF CHARGE for insured persons within the framework of compulsory health insurance

In order to attach to a medical organization for receiving medical care outside the territory of the subject of the Russian Federation in which the citizen lives, the citizen must apply to the medical organization of his choice with a written application (application).
When choosing a medical organization, a nonresident citizen also has the right to choose an attending physician.
If the clinic refuses to enroll or choose a doctor, you have every reason to file a complaint.

PROCEDURE AND TERMS OF CONSIDERATION OF THE APPLICATION OF A NON-RESIDENT CITIZEN

		Personally
	Independently, without the participation of a citizen	Requests confirmation of the information specified in the application in the medical organization in which the citizen is receiving medical care at the time of application	Sends a letter by regular or e-mail Within 2 days after receiving the application
Medical organization in which the citizen is receiving medical care at the time of filing the application Independently, without the participation of the citizen			Within 2 days after receiving the request
Medical organization that accepted the application		In writing or orally through any available communication channels	Within 2 days after receiving a response to the request
Citizen or his legal representative	Applies to the selected medical organization with a written application	Personally	The application is accepted on the day of application
Medical organization that accepted the application Independently without the participation of a citizen	Requests confirmation of the information specified in the application to the medical organization in which the citizen is receiving medical care at the time of application	Sends a letter by regular mail or e-mail	Within 2 days after receiving the application
Medical organization in which the citizen is receiving medical care at the time of filing the application Independently without the participation of the citizen	Prepares and sends a response to a medical organization	Sends a letter by regular mail or e-mail	Within 2 days after receiving the request
Medical organization that accepted the application	After receiving a confirmation letter from the previous medical organization, informs the citizen about acceptance for medical care.	In writing or orally through any available means of communication	Within 2 days after receiving a response to the request

Citizens of Russia are guaranteed free medical care by the state. People are given a policy in their hands - a document that embodies the support of the state healthcare system in case of illness.

And what does it really mean? What types of services in the clinic are required to provide without additional payment, and for which you have to pay yourself? Under what circumstances is a free medical examination carried out? Let's look at all the questions in detail.

About free medicine

The 41st article of the Constitution of the Russian Federation lists guarantees to citizens of the country from the state. In particular, it says:

“Everyone has the right to health care and medical care. Medical assistance in state and municipal health care institutions is provided to citizens free of charge at the expense of the relevant budget, insurance premiums, and other revenues.

Thus, the list of free medical services should be determined by the relevant government bodies i.e. the healthcare system. This happens on two levels:

• federal;
• regional.

Important! The budget fund for the development of medical institutions is formed from several sources. One of them is tax revenues from citizens.

What types of services are guaranteed by the state

By virtue of the current legislative acts, patients are guaranteed the right to the following types medical care:

• emergency ( ambulance), including special
• outpatient treatment, including examination;
• hospital services:
  • gynecological, pregnancy and childbirth;
  • with exacerbation of ailments, ordinary and chronic;
  • in cases of acute poisoning, in case of injury, when intensive care is required, associated with round-the-clock supervision;
• planned outpatient care:
  • high-tech, including the use of complex, unique methods;
  • medical care for citizens with incurable ailments.

Important! If the disease does not fall under one of the options, you will have to pay for medical services.

Medicines are issued at the expense of the budget to people suffering from the following types of diseases:

• shortening life;
• rare;
• leading to disability.

Attention! A complete and detailed list of drugs is approved by a government decree.

Do you need on the subject? and our lawyers will contact you shortly.

New in legislation since 2017

The government decree of December 19, 2016 N 1403 provides a more detailed breakdown of medical services provided free of charge. In particular, primary health care is deciphered. It is divided into subspecies. Namely, the primary

• pre-medical (primary);
• ambulance;
• specialized;
• palliative.

Attention! As part of the program, palliative care has been added to the list of free medical care.

In addition, the text of the document contains a list of medical professionals who are subject to the obligation to treat patients without charging money.

These include:

• paramedics;
• obstetricians;
• other health workers with secondary specialized education;
• general practitioners of all profiles, including doctors of family medicine and pediatricians;
• doctors-specialists of medical organizations providing specialized, including high-tech, medical care.

Attention! The document contains a list of diseases that doctors are required to treat free of charge.

Medical policy

A document guaranteeing the provision of assistance to patients is called a compulsory medical insurance policy (CHI). This paper confirms that the bearer is insured by the state, that is, all the professionals listed above are required to provide services to him.

Important! Not only citizens of the Russian Federation have the right to issue a compulsory medical insurance policy. It is issued (for a small fee) to foreigners permanently residing in the country.

The MHI policy has the following semantic content:

• the citizen is guaranteed medical support;
• medical organizations perceive it as a client identifier (for it, the hospital will transfer funds from the Compulsory Medical Insurance Fund).

Important! The described document is issued only by licensed insurance companies. They are allowed to be changed, but not more than once a year (until November 1 of the current period).

How to get an OMS policy

The document is issued by the relevant companies operating within the framework of the legislation of the Russian Federation. Their rating is regularly printed on official websites, allowing citizens to make their choice.

To be issued a CHI policy, you must provide a minimum number of documents.

Namely:

• for children under 14:
  • birth certificate;
  • parent's (guardian's) passport;
  • SNILS (if any);
• for citizens over 14 years old:
  • passport;
  • SNILS (if available).

Important! For citizens of the Russian Federation, the policy is valid indefinitely. Only foreigners are provided with a temporary document:

• refugees;
• temporarily residing in the country.

Rules for replacing the compulsory medical insurance policy

In some situations, the document is supposed to be changed to a new one. These include the following:

• when moving to a region where the insurer does not work;
• in case of filling out the paper with errors or inaccuracies;
• in case of loss or damage to the document;
• when it fell into disrepair (dilapidated) and it is impossible to make out the text;
• in the event of a change in personal data (marriage, for example);
• in the case of a planned update of the sample form.

Attention! New policy OMS is issued without paying a fee.

What is included in the free service under the MHI policy

Paragraph 6 of Article 35 of Federal Law No. 326-FZ provides complete list free services By medical policy provided to document owners. They are provided in:

• polyclinic;
• dispensaries;
• hospital;
• Ambulance.

Download for viewing and printing:

What can OMS policy holders expect?

In particular, patients are entitled to free medical care and treatment in the following situations:

Dentists, like other professionals, are required to work with patients without pay.

They provide the following types of assistance:

• treatment of caries, pulpitis and other diseases (enamel, inflammation of the body and roots of the tooth, gums, connective tissues);
• surgical intervention;
• dislocations of the jaws;
• preventive actions;
• research and diagnostics.

Important! Services for children are provided free of charge:

• to correct an overbite;
• enamel strengthening;
• treatment of other lesions not related to carious.

How to apply the CHI policy

In order to organize the treatment of patients, they are attached to the clinic. The choice of a medical institution is given to the choice of the client.

It is defined:

• convenience of visiting;
• location (near the house);
• other factors.

Important! It is allowed to change the medical institution no more than once a year. An exception is a change of residence.

How to "attach" to the clinic

You can do this with the help of an insurer (choose an institution when receiving a policy) or on your own.

To attach to the clinic, you should go to the institution and write an application there. Copies of the following documents are attached to the paper:

• identity cards:
  • passports for citizens over 14 years old;
  • birth certificates of a child under 14 years of age and passports of a legal representative;
• compulsory medical insurance policy (original is also required);
• SNILS.

Important! Citizens registered in another region can legally refuse to attach to a polyclinic if the institution is overcrowded (the maximum norm of patients has been exceeded).

In case of refusal, it should be requested in writing. You can complain about a medical institution to the Ministry of Health of the Russian Federation or Roszdravnadzor.

Visit to the doctor

In order to get help from a specialist, you must register with him through the registry. This department issues admission vouchers. Terms and rules of registration, patient care are established on regional level. They can be found in the same registry.

In addition, the insurer must provide this information to customers (you need to call the number indicated on the policy form).

For example, in the capital there are such rules for providing patients with medical services:

• referral to an initial appointment with a therapist, pediatrician - on the day of treatment;
• coupon to specialist doctors - up to 7 working days;
• carrying out laboratory and other types of examination - also up to 7 days (in some cases up to 20).

Important! If the polyclinic is unable to meet the needs of the patient, he should be referred to the nearest facility that provides the necessary services under the CHI programs.

Ambulance

All people in the country can use emergency medical services (the presence of a CHI policy is optional).

There are regulations governing the activities of ambulance crews. They are:

• the ambulance service responds to emergency calls within 20 minutes in case of a threat to people's lives:
  • accidents;
  • wounds and injuries;
  • exacerbation of the disease;
  • poisoning, burns and so on.
• emergency care arrives within two hours if there is no threat to life.

Important! The dispatcher decides which crew will go on the call based on the client's information.

How to call an ambulance

There are several options for seeking emergency medical care. They are:

1. From a landline, dial 03.
2. By mobile connection:
   • 103;

Important! The last number is universal - 112. This is the coordination center for all emergency services: hide, fire, emergency and others. This number works on all devices if there is a network connection:

• with zero balance;
• with the absence or blocking of the SIM card.

Ambulance Response Rules

The service operator determines if the call is justified. An ambulance will arrive if:

• the patient has signs of an acute illness (regardless of its location);
• there was a catastrophe, a mass disaster;
• received information about the accident: injuries, burns, frostbite, and so on;
• violation of the activity of the main body systems, life-threatening;
• if childbirth or termination of pregnancy has begun;
• the disorder of the neuropsychiatric patient threatens the lives of other people.

Important! For children under the age of one year, the service leaves for any reason.

Calls due to such factors are considered unreasonable:

• the patient's alcoholism;
• non-critical deterioration of the patient's condition of the clinic;
• dental diseases;
• carrying out procedures in the order of planned treatment (dressings, injections, etc.);
• organization of workflow (issuance of sick leave, certificates, drawing up an act of death);
• the need to transport the patient to another place (clinic, home).

Attention! The ambulance only provides emergency care. If necessary, can deliver the patient to a hospital.

Where to file medical complaints

In the event of conflict situations, rude treatment, insufficient level of services provided, you can complain to the doctor:

• chief physician (in writing);
• to the insurance company (by phone and in writing);
• to the Ministry of Health (in writing, via the Internet);
• Prosecutor's office (also).

Attention! The term for consideration of the complaint is 30 working days. Based on the results of the check, the patient is required to send a reasoned response in writing.

If necessary, the attending doctor can be changed to another specialist. To do this, write an application addressed to the head physician of the hospital. However, the change of specialists is allowed to be carried out no more than once a year (except in cases of relocation).

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For a prompt resolution of your problem, we recommend contacting qualified lawyers of our site.

Last changes

On May 28, 2019, new CHI rules came into force, which provide for the introduction in Russia of policies of a single sample (paper or electronic format). At the same time, there is no need to replace the previously issued policy. In addition, if it is technically possible to uniquely identify the insured person in single register insured persons, then instead of a compulsory medical insurance policy, a passport is allowed (order of the Ministry of Health of Russia dated February 28, 2019 No. 108n “On Approval of the Rules for Compulsory Medical Insurance“).

The new Rules provide for stricter control over the observance of the rights of the insured, as well as close electronic interaction between the territorial MHIF, insurance organizations and medical organizations:

• polyclinics every year until January 31 will have to report to the TFOMS (through a single portal) the number of those attached, the number of people under dispensary observation, schedules of professional examinations / medical examinations with a quarterly / monthly breakdown by therapeutic areas; work schedules);
• polyclinics every day on working days before 9 am must report (through the TFOMS portal) on insured persons who have passed a medical examination, as well as on persons undergoing medical examination;
• medical organizations, medical insurance organization (HIO) and TFOMS will exchange information every day in electronic form on the TFOMS portal: hospitals must update data on the implementation of the volume of medical care, free beds, admitted/non-admitted patients by 9 am; polyclinics update information on hospital referrals issued yesterday until 9 am; medical organizations providing specialized, including high-tech, medical care, post information about patients who have had a telemedicine consultation, and the CMO is obliged to monitor the implementation of the recommendations received from the doctors of the NMIC, and has the right to conduct an in-person examination within the next 2 working days ;
• regardless of the mentioned interaction, every day no later than 10 am, the CMO informs hospitals about patients referred to such hospitals the day before, and also every day no later than 10 am informs medical organizations about the number of free beds in the context of profiles / departments, about patients whose hospitalization did not take place;
• On the basis of the database from the TFOMS portal, the HMO checks during the working day whether the patients were correctly referred to specialized medical organizations. If hospitalization took place out of time, not according to the profile, the HMO must file a complaint with the head physician of the violating medical organization and the regional Ministry of Health, and, if necessary, take measures and transfer the patient;
• insurance representatives of HIOs received a wide range of responsibilities - working with citizens' complaints, organizing examinations of the quality of medical care, informing and accompanying them when providing them with medical care, inviting them to medical examination, monitoring its passage, forming lists of "persons for medical examination" and lists of citizens who fell under dispensary observation;
• patients will be able to see when and what medical services were provided to them, and at what cost: in personal account on the portal of public services or through the TFOMS - by means of authorization in the ESIA;
• for oncological patients, the HMO undertakes to create (on the TFOMS portal) an individual history of insurance events (based on registers-accounts) throughout all stages of medical care.

The updated CHI Rules directly impose on the CMO the obligation to carry out pre-trial protection of the rights of insured persons. When they file complaints about poor-quality medical care or charging for services under the compulsory medical insurance program, the CMO registers written appeals, conducts a medical and economic examination and an examination of the quality of medical care.

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In accordance with the Law of the Russian Federation "On Health Insurance of Citizens in the Russian Federation", the Rules of Compulsory Medical Insurance for the Population of the City of Moscow, the Territorial Program of State Guarantees for the Provision of Free Medical Care to the Population of the City of Moscow and in order to improve the organization of the provision of medical care under the Moscow City Program of Compulsory Medical insurance we order:

1. Approve the Procedure and conditions for the provision of medical care under the Moscow city compulsory medical insurance program ().

2. Heads of health departments of administrative districts of Moscow, heads of medical institutions to bring this document to the attention of subordinate medical institutions and structural divisions for management and execution.

3. To ensure that the Moscow City Compulsory Medical Insurance Fund informs the population of Moscow about the procedure and conditions for providing medical care under the Moscow City Compulsory Medical Insurance Program.

4. To consider invalid the order of the Department of Health of the city of Moscow and the Moscow City Fund for Compulsory Medical Insurance dated November 14, 2008 No. 931/131 “On Approval of the Procedure and Conditions for the Provision of Medical Assistance under the Moscow City Compulsory Medical Insurance Program”

5. Control over the execution of this order shall be entrusted to the First Deputy Head of the Department of Health of the City of Moscow Polyakov S.V. and Deputy Executive Director of the Moscow City Compulsory Medical Insurance Fund Yuryev T.I.

Application
to the Department
health care in Moscow
and the Moscow City Compulsory Medical Insurance Fund
dated October 11, 2010 N 1794/130

Terms and Conditions
provision of medical care under the Moscow city CHI program

1. Medical assistance under the Moscow City Compulsory Medical Insurance Program (OMI) is provided by medical institutions operating in CHI system Moscow, citizens subject to mandatory health insurance:

Citizens insured under compulsory medical insurance in Moscow;

Citizens insured under compulsory medical insurance in the territory of other constituent entities of the Russian Federation (hereinafter referred to as "non-resident citizens");

Patients who, for objective reasons, are not identified (under the compulsory medical insurance policy) when they are provided with primary health care and specialized medical care for emergency indications, on an outpatient or inpatient basis (hereinafter referred to as "unidentified patients").

2. Citizens insured under compulsory medical insurance in Moscow receive medical assistance upon presentation of the compulsory medical insurance policy (when you first apply to a medical institution, in addition to the compulsory medical insurance policy, you must present a passport).

In the absence of a compulsory medical insurance policy for patients (in case they apply on an emergency basis), medical institutions take measures to identify the patient in order to identify the insurer or classify him (according to his passport) as a non-resident citizen or unidentified patient.

Planned inpatient medical care for citizens insured under compulsory medical insurance in Moscow is provided at the direction of the outpatient clinic to which they are attached for medical care.

Medical assistance to citizens insured under compulsory medical insurance in Moscow, in departmental and non-state medical institutions participating in the implementation of the Moscow city compulsory medical insurance program is provided taking into account the volumes (types) of medical care planned by the medical institution and approved by the Department of Health of the city of Moscow.

3. For non-resident citizens, planned medical care in the scope of the Moscow city CHI program is provided at medical institutions of the Moscow Department of Health upon presentation of a territorial CHI policy and a passport (in the absence of a CHI policy for objective reasons, only a passport, and for children - a passport of one of the parents or other legal representatives).

In order to implement the principle of accessibility of free medical care, non-resident citizens living in Moscow are attached to medical care with entry into the register of the attached population of a medical institution on the basis of a written application addressed to the head physician.

Planned inpatient medical care for nonresident citizens is provided on the basis of referrals issued by the Moscow Department of Health, the health departments of the administrative districts of Moscow (in accordance with the subordination of the institution), as well as referrals issued by medical institutions in the presence of nonresident citizens attached to them, incl. h. children and pregnant women for medical care.

4. Diagnostic examinations and advisory assistance are carried out according to medical indications and are prescribed by the attending physician.

The attending physician selects specialists for consultations and selects medicines, materials and medical products.

If the standard workload of a specialist and/or a medical institution is exceeded, consultative, diagnostic and planned medical care under the CHI program is carried out in order of priority.

5. Realization of the right of citizens insured under compulsory medical insurance in Moscow to choose a medical institution in the compulsory medical insurance system of Moscow is carried out on the basis of a written application addressed to the head physician, in accordance with the resource capabilities of the institution: capacity, staffing of medical personnel and the Procedure organization of medical care for the population according to the district principle, approved by order of the Ministry of Health and Social Development of Russia dated 04.08.06 N 584.

Help at home is provided medical workers institutions located in the territory of actual residence of citizens.

Realization of the right of those insured under MHI to choose a doctor, including a family doctor and a doctor, is carried out subject to his consent.

6. Medical institutions provide citizens with free and accessible information:

On the types of medical services provided free of charge within the framework of targeted programs development of the capital's healthcare and the Territorial program of state guarantees for the provision of free medical care to the population of the city of Moscow, a component of which is the Moscow City Program of Compulsory Medical Insurance;

On the types of medical services provided by a medical institution at the expense of personal funds of citizens or other sources of funding within the framework of voluntary medical insurance;

On the possibilities of a medical institution to provide services at the request of citizens for a fee, at prices that reflect the full cost medical service, and (or) provide services for an additional fee (without paying the full cost of the medical service);

On the conditions for the provision and receipt of paid services;

About benefits for certain categories citizens.

7. The medical insurance organization that issued the CHI policy considers the applications of the insured in order to ensure and protect their rights to receive medical care under the Moscow city CHI program. If in the application of a citizen insured under MHI there are claims to the organization and (or) quality of medical care provided, the insurance medical organization is obliged to organize an examination of the quality of medical care in the manner and within the time limits stipulated by the Regulations on medical and economic control of the volumes and examination of the quality of medical care provided under the OMS program.

If necessary, the insurance medical organization takes measures to provide certain types of medical care to the insured under compulsory medical insurance in other medical institutions that are in contractual relations with it.

8. Citizens insured under MHI in Moscow, citizens from other cities and unidentified patients, when receiving free medical care, have the rights established by the Fundamentals of the Legislation of the Russian Federation on the protection of the health of citizens and the Law of the Russian Federation "On medical insurance of citizens in the Russian Federation".

In case of violation of the rights, the patient can contact:

Directly to the head or other official of the medical institution in which he received medical care;

To the health department of the corresponding administrative district of Moscow;

To the Department of Health of the city of Moscow;

To the insurance medical organization that issued the compulsory medical insurance policy to the insured and assumed obligations to protect his interests;

To the City Arbitration Expert Commission (GAEC) in case the patient's claims have already been considered by the insurance medical organization and the requirements of the insured have not been satisfied (applications for transfer to the GAEC are accepted by the Management of the organization OMS of Moscow city ​​fund of obligatory medical insurance);

9. Unreasonable refusals to provide citizens insured under compulsory medical insurance with free medical care in medical institutions participating in the implementation of the Moscow city compulsory medical insurance program are not allowed.

Note.

1. In accordance with Decree of the Government of Moscow dated March 4, 2008 N 145-PP, the Moscow City Health Department issues a referral for hospitalization (consultation), including those insured under compulsory health insurance in the city of Moscow and on the territory of other constituent entities of the Russian Federation, within the framework of Territorial program of state guarantees for the provision of free medical care to the population of the city of Moscow to citizens, as well as citizens living in the territory of the CIS countries, at the expense of the Healthcare industry within the framework of existing intergovernmental agreements (contracts) that determine the procedure for interaction in the field of healthcare.

2. In accordance with Decree of the Government of the Russian Federation of 01.09.2005 N 546, emergency medical assistance to foreign citizens is provided by medical institutions of the state and municipal health care system in the event of conditions that pose a direct threat to their lives or require urgent medical intervention free of charge (at the expense of budget). After exiting from these states, foreign citizens can be provided with planned medical care on a paid basis. If an international treaty of the Russian Federation establishes a different procedure for the provision of medical care to foreign citizens, the rules of the international treaty shall apply.

Order of the Department of Health of Moscow and the Moscow City Compulsory Medical Insurance Fund dated October 11, 2010 N 1794/130 “On approval of the Procedure and conditions for the provision of medical care under the Moscow city CHI program”

Document overview

It has been established that medical care under the Moscow city CHI program is provided by medical institutions operating in the CHI system to citizens subject to compulsory medical insurance: those insured under CHI in Moscow; insured in the territory of other subjects of the Russian Federation; patients for objective reasons not identified (according to the CHI policy) when providing them with primary health care and specialized medical care for emergency indications.

Citizens insured under compulsory medical insurance have the right to choose a medical institution in the compulsory medical insurance system. To do this, they need to apply to the head physician.

Unreasonable refusals to provide citizens insured under compulsory medical insurance with free medical care in medical institutions participating in the implementation of the Moscow city compulsory medical insurance program are not allowed.