a commercial medical organization provides services to the public on a paid basis. The organization plans to enter into an agreement with the fund of compulsory health insurance(hereinafter referred to as the MHIF), under which, after the provision of medical services to the population, the MHIF will reimburse the organization for the cost of services rendered.
How to reflect in accounting the provision of services for compulsory health insurance, the receipt of funds for compulsory health insurance, the accounting of materials (receipt, write-offs) related to the provision of services for compulsory health insurance?

Commercial medical organizations keep accounting records according to the Chart of Accounts accounting financial and economic activities of organizations and Instructions for its application, approved by order of the Ministry of Finance of Russia dated October 31, 2000 N 94n (hereinafter referred to as the Chart of Accounts, Instructions for the application of the Chart of Accounts).
The medical services provided by the organization under compulsory medical insurance are reflected in the accounting in the general manner, similar to services on a paid basis.
Based on the fact that the provision of medical services is the main activity of the organization, the income (revenue) associated with the provision of such services is income from ordinary activities (clauses 2, 4, 5 of PBU 9/99 "Income of the organization").
In accordance with paragraph 6 of PBU 9/99, revenue is accepted for accounting in an amount calculated in monetary terms, equal to the amount of receipt Money and other property and (or) the amount accounts receivable(taking into account the provisions of clause 3 PBU 9/99).
At the same time, revenue is recognized in accounting when the conditions listed in paragraph 12 of PBU 9/99 are met, namely:
a) the entity has a right to receive the proceeds arising from a specific contract or otherwise appropriately evidenced;
b) the amount of proceeds can be determined;
c) there is confidence that as a result of a particular transaction there will be an increase in the economic benefits of the organization. There is certainty that as a result of a particular transaction there will be an increase in the economic benefits of the organization, there is a case when the organization received an asset in payment or there is no uncertainty regarding the receipt of the asset;
d) the right of ownership (possession, use and disposal) of the product (goods) has passed from the organization to the buyer or the work has been accepted by the customer (the service has been rendered);
e) the costs incurred or to be incurred in connection with this transaction can be determined.
So, in accounting, revenue is recognized regardless of whether cash was received as payment or not (accrual method).
In accordance with the Chart of Accounts, upon recognition in accounting, the amount of revenue from the provision of services is reflected in the credit of account 90 "Sales", subaccount "Revenue", and the debit of account 62 "Settlements with buyers and customers" (reflects the receivables of the buyer) as of the date provision of services (clauses 5, 6.1, 12 PBU 9/99). At the same time, the cost of services rendered is debited from account 20 "Main production" to the debit of account 90, subaccount "Cost of sales" (clauses 5, 16, 19 PBU 10/99 "Expenses of the organization").
Taking into account the fact that the MHIF will be calculated for the services provided to the population under compulsory medical insurance, in this situation, the organization should do the following: accounting records(with separate accounting for compulsory medical insurance services):
Debit 62, subaccount "Settlements for compulsory medical insurance" Credit 90, subaccount "Revenue from services for compulsory medical insurance"
- recognized income from the provision of compulsory medical insurance services;
Debit 90, sub-account "Cost of services provided for compulsory medical insurance" Credit 20, sub-account "Costs of services for compulsory medical insurance"
- written off the cost of services rendered under CHI.
The receipt and write-off of materials is reflected taking into account PBU 5/01 "Accounting for inventories" and Guidelines for accounting of MPZ, approved by order of the Ministry of Finance of Russia dated December 28, 2001 N 119n.
In accordance with paragraph 5 of PBU 5/01, MPZs are accepted for accounting at actual cost, which is the amount of the organization's actual costs for the acquisition, excluding VAT and other refundable taxes (except as provided by the legislation of the Russian Federation). The list of possible actual costs associated with the acquisition of inventory is contained in paragraph 6 of PBU 5/01.
The cost of materials is written off at a time when leaving for the provision of services (performance of work) and is attributed to expenses for ordinary species activities (clauses 7, 8 PBU 10/99).
According to the Instructions for the Application of the Chart of Accounts, accounting of materials is maintained by organizations on account 10 "Materials".
If the organization does not use accounts 15 "Procurement and acquisition material assets" and 16 "Deviation in the cost of material assets", the posting of materials is reflected in the entry on the debit of account 10 "Materials" and the credit of accounts 60 "Settlements with suppliers and contractors", 20 "Main production", 23 " Auxiliary production", 71 "Settlements with accountable persons", 76 "Settlements with different debtors and creditors", etc., depending on where these or those values ​​came from, and on the nature of the costs of procurement and delivery of materials to the organization.
The actual consumption of materials in production or for other business purposes is reflected in the credit of account 10 "Materials" in correspondence with the accounts of production costs (sales expenses) or other relevant accounts.
In this case, we believe that the organization should make the following entries:
Debit 10 Credit 60
- materials received from the supplier are credited;
Debit 20, sub-account "Costs for compulsory medical insurance services" Credit 10
- written off the cost of materials for the cost of CHI services.
As for the reimbursement by the MHIF of an organization for the cost of medical services rendered at the expense of MHI funds in accordance with the contract, based on the question, we believe that after the MHIF approves a report (act or other document) on the services provided (work performed), the MHIF will have a debt to the organization that the fund must pay.
In our opinion, in this case, the organization will have to make the following entries:
Debit 76, sub-account "Settlements with the Compulsory Medical Insurance Fund" Credit 62, sub-account "Settlements for compulsory medical insurance"
- reflected the amount of debt of the Compulsory Medical Insurance Fund according to the report (act, etc.);
Debit 51 Credit 76, sub-account "Settlements with the Compulsory Health Insurance Fund"
- Funds received from the MHIF to the current account.

Prepared answer:
Legal Consulting Service Expert GARANT
auditor, member of the Russian Board of Auditors Fedorova Liliya

Response quality control:
Reviewer of the Legal Consulting Service GARANT
auditor, member of the RAMI Gornostaev Vyacheslav

The material was prepared on the basis of an individual written consultation provided as part of the Legal Consulting service.

State medical institutions provide medical and pharmaceutical assistance at the expense of compulsory medical insurance funds in the amount and on conditions that correspond to compulsory medical insurance programs. Control over the targeted use of MHI funds is carried out by the territorial MHI fund (TFOMS) through inspections. The article deals with violations that are revealed during their implementation.

Legal relations between the healthcare institution, the medical insurance organization and the TFOMS in CHI system are regulated by the Federal Law of November 29, 2010 N 326-FZ “On Compulsory Medical Insurance in Russian Federation(hereinafter - Federal Law N 326-FZ). The norms of the mentioned Law prescribe the health care institution to spend the funds of the MHI to pay for medical care for the intended purpose.

Control over the use of non-budgetary funds of compulsory medical insurance is carried out by TFOMI for the constituent entities of the Russian Federation in accordance with Order FFOMS dated April 16, 2012 N 73, which approved the Regulation on control over the use of compulsory medical insurance funds by medical organizations (hereinafter - Regulation N 73).

In accordance with paragraph 15 of Regulation N 73, four areas of use of funds received by medical organizations are subject to verification, the list of which includes the use of funds to ensure the implementation of the territorial CHI program.

How is the verification of OMS funds carried out?

According to paragraph 4 of Regulation N 73, checks are carried out at the location of the medical organization (or at the place of actual implementation of its activities). These include:

- a comprehensive audit, which considers a set of issues related to the use of compulsory medical insurance funds for a certain period of activity of a medical organization;

— a thematic audit, which considers certain issues related to the use of CHI funds;

— a control audit, in which the medical organization considers the elimination of violations and shortcomings in the use of CHI funds previously identified during a comprehensive or thematic audit.

Inspections are carried out in accordance with the plan approved by the director of the territorial fund (scheduled inspections). The frequency of scheduled inspections is established taking into account the possibility of full coverage of issues and periods of activity of medical organizations in compulsory medical insurance but at least once every two years. Planned comprehensive inspections are carried out no more than once a year.

The Territorial Fund may conduct unscheduled inspections. Unscheduled inspections of the use of compulsory medical insurance funds are carried out by decision of the director of the territorial fund on the basis of submissions from control bodies, complaints and applications from citizens, etc.

Verification of the use of compulsory medical insurance funds can be carried out in a continuous or selective way (clause 9 of Regulation N 73). Note that the continuous method consists in conducting a control action in relation to the entire set of financial, accounting, reporting and other documents related to one issue of the verification program. With regard to the selective method, in this case, documents related to one issue of the verification program are studied. The size of the sample and its composition are determined by the head of the commission (working group) in such a way as to ensure the possibility of assessing the issue under study of the verification program.

When checking the use of CHI funds, the following are checked:

- the correctness of the reflection in the accounting registers of operations on the means of compulsory medical insurance;

— the correctness of the reflection of income and expenses in accordance with the current budget classification;

- compliance with the order of conduct cash transactions and cash accounting (in terms of CHI funds);

- the timeliness of posting cash funds from the MHI coming from the bank and other sources, as well as their intended use;

- the availability of supporting documents and the reliability of the data contained in them, which are the basis for writing off expenses on the cash desk, the legality of the expenses incurred in terms of compulsory medical insurance funds, ensuring the safety of funds.

What documents and expenses are subject to control?

As noted above, four main areas of expenditure of MHI funds are subject to verification. Let us dwell only on the first of them - on the verification of compulsory medical insurance funds going to financial support for the implementation of the territorial compulsory medical insurance program.

Note that in accordance with clause 16 of Regulation N 73, the control measure carried out by the TFOMS includes checking compliance with the requirement to maintain separate accounting for transactions with compulsory medical insurance funds:

- by type of medical care;

- according to the structure of the tariff for payment of medical care.

Checking the costs included in the tariff structure includes (clause 17.2 of Regulation N 73):

1) verification of labor costs and accruals for wage payments. During the control event, all documents confirming the validity of the payments made will be checked:

- staffing, tariff lists, documents confirming the qualifications of specialists;

- work schedules of structural divisions and employees;

- orders for personnel;

— labor agreements;

- collective agreement;

- regulation on wages;

- primary accounting documents on payroll, payment of taxes and insurance premiums established by the legislation of the Russian Federation;

2) verification of expenses for the purchase of medicines, consumables, food, soft inventory, medical instruments, reagents and chemicals, other inventories, to pay for the cost of laboratory and instrumental studies conducted in other institutions. Verification of the use of funds for the specified purposes is carried out by conducting an audit primary documents confirming the legality of the banking operations, including contracts for the supply of medicines, consumables, food, soft inventory, medical instruments, reagents and chemicals, and other inventories. Checked:

- reasonableness of prices for the purchase of goods (works, services) at the expense of compulsory medical insurance;

— compliance with the terms of delivery and payment, compliance of the amounts specified in the contracts with the actual costs incurred;

- timeliness, completeness and correctness of posting medicines and consumables, food, soft inventory, medical instruments, reagents and chemicals, other inventories;

- the procedure for storing, accounting and writing off medicines, consumables, food, soft inventory, medical instruments, reagents and chemicals, other inventories;

- availability of separate accounting for medicines purchased at the expense of compulsory medical insurance and funds received by a medical organization from other sources.

An analysis of purchased medicines is carried out (the presence of expired medicines is reflected).

Studied:

— materials of the inventory of property and financial obligations carried out by the medical organization;

— existence, duration and size of accounts receivable and accounts payable with suppliers of goods and services at the expense of compulsory medical insurance;

— timeliness of collection of receivables and repayment of accounts payable, mutual reconciliations in settlements with suppliers;

- the correctness of keeping records of these calculations, the timeliness of the recovery of the amounts of identified shortages and theft of the compulsory medical insurance funds, material assets acquired at the expense of the compulsory medical insurance funds, as well as losses from damage to these valuables attributed to the perpetrators.

What violations are revealed during inspections conducted by TFOMS?

We bring to your attention disputes in which certain types of violations identified during inspections were considered.

Implementation of expenses not included in the territorial CHI program. Medical organizations in accordance with paragraph 5 of part 2 of Art. 20 federal law N 326-FZ are obliged to use the compulsory medical insurance funds received for the provided medical care in accordance with the compulsory medical insurance programs. When conducting inspections of the TFOMS, cases are identified when the payment of expenses for the provision of medical care to citizens of the Russian Federation is not carried out at the expense of the source that is intended for their financing. As an example, let us cite the Decree of the FAS ZSO dated April 14, 2014 N A75-3259 / 2013, in which the essence of the identified violation is as follows. The medical institution, in violation of the tariff agreements and the terms of the contracts, allowed the misuse of compulsory health insurance funds, expressed in payment for the cost of equipment, furniture and equipment repair, not provided for tariff agreements, as well as in paying for the cost of consumables for the provision of high-tech medical care, which should be carried out at the expense of the budget of the constituent entity of the Russian Federation. In other words, the spending of compulsory medical insurance funds, which are strictly targeted, was carried out in areas not provided for by funding sources.

For reference. In the Letter of the Federal Compulsory Medical Insurance Fund dated 06.06.2013 N 4509/21-i, clarifications were provided on certain areas of expenditure of compulsory medical insurance funds. In particular, in accordance with the recommendations of officials, the cost of purchasing furniture, including medical and kitchen furniture, is not included in the tariff for paying for medical care under the basic CHI program. An exception is equipment that, according to the certificate (declaration) of conformity, by virtue of the Classification of fixed assets, belongs to class 14 3311320 "Equipment for offices and wards, equipment for laboratories and pharmacies" section 14 0000000 "Machinery and equipment".

According to the Decree of the Federal Antimonopoly Service of the ZSO, taking into account the provisions of Federal Law N 326-FZ on the misuse of compulsory medical insurance funds, the organization pays a fine in the amount of 10% of the amount of misuse of compulsory medical insurance funds and a penalty in the amount of 1/300 of the refinancing rate of the Bank of Russia in force on the day the sanctions are presented, for each day of delay.

In the Decree of the FAS UO dated 10.10.2013 N Ф09-10575 / 13 in case N А60-1177 / 2013, when considering a dispute over a similar violation, the arbitrators also sided with the TFOMS, indicating that the costs of medical organizations for the purchase of disinfectants should be carried out exclusively at the expense of the budget of the subject of the Russian Federation. The territorial program of state guarantees of free provision of medical care to citizens of the Russian Federation living in the territory of a constituent entity of the Russian Federation does not provide for such expenses for the corresponding year. By the definition of the Supreme Arbitration Court of the Russian Federation dated January 23, 2014 N VAC-18262/13, the institution was denied the revision of this Resolution.

A similar violation was considered in the Decree of the FAS SKO dated 01.10.2012 N A22-1961/2011. The territorial program that was in force during the period under review on the territory of a constituent entity of the Russian Federation provided for lists of diseases, types of medical care and medical institutions included in the CHI system, as well as financed from the republican budget. As follows from the designated territorial program of compulsory medical insurance, the cost of vocational training and retraining of personnel should be funded from the republican budget, medical and other services provided in the pathological and anatomical bureaus (offices) were provided at the expense of the republican and local budgets.

According to sect. III and IV of the named program, the medical institution being inspected was included both in the list of institutions included in the compulsory medical insurance system and in the list of institutions financed from the republican budget.

The FAS NKR has established that the medical services of a pathologist, in accordance with the specified territorial program of compulsory medical insurance, are not subject to financing from the funds of compulsory medical insurance. Since the payment of the pathologist's salary was also financed from the republican budget, the court concluded that the costs of paying for the advanced training of the named doctor constituted an inappropriate use of compulsory medical insurance funds, which are subject to return.

Violation of the application of the budget classification of the Russian Federation in the implementation of expenses for compulsory medical insurance. In the Decree of the FAS PO of March 25, 2014 N A12-19994 / 2013, the dispute between the Ministry of Health of the constituent entity of the Russian Federation and the FFOMS was considered.

During the audit, the fund found that, in violation of paragraph 3 of Art. 50 of the Federal Law N 326-FZ, under the state contract for the purchase of devices for medical laboratory research, the ministry, at the expense of compulsory medical insurance, purchased consumables under the healthcare modernization program. We recall that, in accordance with paragraphs. 1 of this paragraph, the funds provided in the budget of the Federal Compulsory Medical Insurance Fund for the financial support of regional programs for the modernization of healthcare of the constituent entities of the Russian Federation are directed to the following purposes:

1) to strengthen the material and technical base of state and municipal healthcare institutions, including the construction, reconstruction of facilities capital construction and (or) their stages, ensuring the completion of the construction of previously started facilities, overhaul state and municipal health care institutions, purchase of medical equipment;

2) on the introduction of modern information systems in healthcare in order to create a unified state information system in the field of healthcare, the transition to compulsory medical insurance policies of a single sample, including those provided by the federal electronic application of the universal electronic card, the introduction of telemedicine systems, electronic document management systems and the maintenance of medical records of patients in electronic form;

3) to introduce standards of medical care, increase the availability of outpatient medical care, including that provided by medical specialists.

As representatives of the FFOMS indicated, the purchased consumables cannot be recognized as medical equipment, since they do not belong to the code 3311000 “Medical and surgical equipment, orthopedic devices” OK 004-93, therefore, they are not included in the list established by paragraph 3 of Art. 50 of the Federal Law N 326-FZ.

The Ministry of Health of a constituent entity of the Russian Federation received OMS funds for the implementation of a health care modernization program, which is reflected under Article 310 “Increase in the cost of fixed assets” of KOSGU.

Consumables purchased at the expense of allocated funds (chemical reagents, laboratory glassware) are inventories, since they have a useful life of less than 12 months, and on the basis of clause 118 of Instruction N 157n<1>are subject to accounting on account 105 06 "Other inventories".

Thus, the court confirmed the fund's conclusion that the ministry committed a violation in the form of misuse of CHI funds.

Acquisition of consumables not used in medical activities. As already noted, one of the guarantees that ensure both the strictly targeted use of compulsory medical insurance funds and taking into account the rights and interests of the medical organization, the compulsory medical insurance fund and the insurer is the establishment of tariffs for paying for medical care under compulsory medical insurance in accordance with the tariff structure determined by Federal Law N 326-FZ. The indicated tariff includes a list of expenses of medical organizations that they incur in connection with the provision of medical care under compulsory medical insurance programs (Article 30, Part 7 Article 35 of Federal Law N 326-FZ). Thus, as the arbitrators noted in the Decree of the Federal Arbitration Court of the Moscow Region dated April 30, 2014 N A41-38789 / 13, the purchase of liquid technical oxygen by a healthcare institution at the expense of compulsory medical insurance is their misuse. This conclusion is based on the fact that oxygen included in the State Register of Medicines and purchased from a supplier licensed to produce it can be used for medical purposes. The purchase of technical oxygen clearly contradicts the permissible purposes of its use in medical activities, which means that it cannot be regarded as the intended use of CHI funds.

Payment of salaries to pharmacy employees at the expense of compulsory medical insurance. The essence of the violation, which was submitted to the court, was as follows. TFOMS conducted a documentary verification of the use of compulsory medical insurance funds aimed at paying for medical services provided by a medical institution under the territorial compulsory medical insurance program. The audit revealed misuse of CHI funds, expressed in the issuance of wages at the expense of CHI funds with accruals to employees of a hospital pharmacy. Since these expenses do not comply with the provisions of the territorial program of state guarantees for the free provision of medical care to citizens of the Russian Federation living in a constituent entity of the Russian Federation, the institution was ordered to restore the CHI funds spent for other purposes.

FAS UO in its Decree of 11.01.2012 N F09-8757/11 reasonably indicated that a pharmacy organization, including a structural subdivision of a healthcare institution, carries out pharmaceutical activities, that is, activities in the field of circulation of medicines, including wholesale, retail trade in medicines and their manufacture. At the same time, under pharmacy organization refers to an organization, a structural subdivision of a medical organization engaged in retail trade in medicines, their storage, manufacture and dispensing for medical use.

The arbitrators noted that the provision of medicines to citizens within the framework of the territorial program implies the purchase of medicines by medical organizations for their free provision when providing medical care to citizens, while the pharmacy of a medical institution dispenses medicines. The activities of pharmacies do not apply to medical activities, that is, to activities directly aimed at providing medical services. Under such circumstances, the court refused to satisfy the medical institution's claims to invalidate the TFOMS order.

The illegality of attracting personal funds of citizens who are insured under compulsory medical insurance when providing them with medical care under the territorial program. According to paragraphs. "b" p. 1 h. 1 art. 16 of the Federal Law N 326-FZ, insured persons are entitled to free medical care by medical organizations in the event of insured event on the territory of the subject of the Russian Federation in which the CHI policy was issued, in the amount established by the territorial CHI program.

Territorial programs of state guarantees of free provision of medical care to citizens of the constituent entities of the Russian Federation approve a list of types of medical care that is provided free of charge. This list includes primary health care, which includes, in particular, activities for the prevention, diagnosis and treatment of diseases. Primary health care is provided on an outpatient basis and in a day hospital.

During an inspection at the Republican hospital of the TFOMS, it was revealed that citizens purchased Gadovist and Omnipak medicines, which, according to their pharmacological group and pharmacological action, belong to contrast diagnostic medicines used exclusively for diagnostic purposes, for cash, which is a violation.

As noted by the arbitrators in the Decree of the FAS VSO dated 01.07.2014 N A58-5989 / 2013, the hospital is obliged to provide diagnostic drugs free of charge as part of the provision of disease diagnostic services as an integral part of primary health care provided on an outpatient basis. In this regard, the TFOMS rightfully issued an order to the hospital to reimburse the unreasonably spent amounts to citizens who bought medicines for personal money.

In Resolution No. А78-4168/2013 dated March 25, 2014, the court of the same district considered the dispute between the hospital and the TFOMS regarding the collection of fees from patients for performing an operation when providing medical care provided under the state guarantees program. As noted by the arbitrators, from the totality of the provisions of Part 1 of Art. 11, paragraph 1, part 3, art. 80 of the Federal Law N 323-FZ<2>It follows that when providing medical care within the framework of territorial programs of state guarantees for the provision of medical care, the following are not subject to payment at the expense of personal funds of citizens:

- provision of medical services;

– prescription and use of medicines included in the list of vital and essential medicines, medical devices, blood components, medical nutrition, including specialized medical nutrition products, for medical reasons in accordance with the standards of medical care.

Thus, the issued order of the TFOMS complies with the requirements of the legislation of the Russian Federation.

In conclusion, we note that for the use of funds received for the provision and payment of medical care under compulsory medical insurance, for other purposes, medical institutions pay a fine of 10% of the amount of their misuse. In addition, it will be necessary to pay penalties in the amount of 1/300 of the refinancing rate of the Bank of Russia, effective on the day the sanctions are presented, from the amount of misuse of these funds.

Funds used for other purposes must be transferred to the budget of the TFOMS within 10 working days from the date of presentation of the corresponding request by the TFOMS (clause 9, article 39 of Federal Law N 326-FZ).

In the event that a medical institution fails to fulfill the requirements of the TFOMS for the return (reimbursement) of funds, including those used for other purposes, and (or) the payment of fines, the TFOMS may send relevant information and verification materials to law enforcement and judicial authorities to bring the perpetrators to justice.

The presence of this right also does not exclude the right to demand in court to bring the medical organization to liability in the form of a fine under Part 9 of Art. 39 of the Federal Law N 326-FZ (Resolution of the FAS ZSO dated April 14, 2014 N A75-3259 / 2013).

Citizens of Russia are guaranteed free medical care by the state. A policy is issued to people - a document embodying support state system healthcare 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 state bodies, that is, 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 service 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 a complete list free services By medical policy provided to document owners. They are provided in:

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

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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. The 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 institution where the necessary services are provided under the CHI program.

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 team will go on the call based on the information of the client.

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).

Dear readers!

We describe typical ways to resolve legal issues, but each case is unique and requires individual legal assistance.

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.

Updated CHI rules directly impose on HIOs 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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Ministry of Education and Science of the Russian Federation

Federal State Educational Budgetary Institution

higher professional education "Siberian State University of Telecommunications and Informatics"

Department of Economics

Course work

according to MDK 03.01: "Settlements with the budget and extra-budgetary funds"

on the topic: "Accounting for settlements with the Compulsory Medical Insurance Fund"

Completed by: Manzhueva L.N.

Checked by: Dondukova T.Ts.

Ulan-Ude

Chapter 1. Theoretical basis accounting for settlements with the MHIF

1.1 Economic nature of the MHIF. The value and role of insurance premiums in the MHIF.

1.2 The mechanism for calculating and paying contributions to the MHIF.

1.3 Reflection of calculations of contributions to the MHIF in accounting.

1.4 Sources of formation of the federal fund of compulsory medical insurance.

Chapter 2. Accounting organization of insurance premium settlements with the Compulsory Medical Insurance Fund of MTS OJSC.

2.1 Organizational economic characteristic MTS OJSC.

2.2 Synthetic and analytical accounting of insurance premium settlements in the MHIF MTS LLC

2.3 Analysis of the dynamics of insurance premiums in the MHIF of MTS OJSC.

Conclusion

Bibliography

Introduction

The health of the nation is a prerequisite for social well-being and normal economic functioning states. Significant impact on the health of the population of Russia today continue to have the circumstances associated with ongoing economic reforms, lower health care costs, etc. Strengthening the social orientation of social development in modern conditions enhances the role of the health care system, which is a strategic sector of the economy, ensuring the reproduction of the population, social guarantees and the health of citizens.

Socially - economic reforms held in Russia in recent decades have led to radical changes in the life of society. The current economic situation dictates the need to increase the effectiveness of social policy, to concentrate efforts on solving the most pressing social problems, to develop new mechanisms for the implementation of social policy that ensure a more rational use of financial and material resources.

The introduction of compulsory medical insurance in Russia was the first step towards reforming the social insurance system in general and the healthcare system in particular. The creation of a system of compulsory medical insurance in the Russian Federation took place in the context of a global reform of the economic and political institutions of the state.

However, despite the complexity of the socio-political and socio-economic situation, the system of compulsory medical insurance has been created, is developing and has fully proved its significance. At the same time, the problems of compulsory medical insurance still remain, many aspects have not been sufficiently studied, and, as a result, the development of compulsory medical insurance in our country is fraught with many difficulties, including a shortage of financial resources allocated to healthcare, issues of the quality of medical care and rational use of financial resources OMS systems.

federal fund compulsory health insurance is an independent state non-profit financial and credit institution that ensures the implementation public policy in the field of organization and financing of the CHI system throughout the Russian Federation. The Federal Compulsory Medical Insurance Fund is accountable to the government and the Federal Assembly of the Russian Federation.

As practice shows, the availability of funds does not yet mean that the goal of compulsory health insurance will be achieved.

The movement towards the goal is hindered by too much variety of diseases and conditions of the insured. There needs to be clarity on how many and what needs need to be covered by MHI funds. Otherwise, special ways of coordinating the amount of funds and the goals set are required. The most important role in this is played by the planning tools and, above all, the system of indicators and their values.

Today, this topic is relevant, since every person directly or indirectly at least once in his life has come across the Federal Health Insurance Fund and, having studied this work, you can learn more about this structure and how it works. And profit is what not only enterprises and organizations strive for, but also every person as a whole, even just in ordinary economic life.

The object of the study is the activities of MTS OJSC regarding relations with the MHIF, the subject is the procedure for calculating insurance premiums in the MHIF.

Based on the current topic term paper is to study the features of settlements with the Compulsory Health Insurance Fund. The goal set determined the range of tasks that need to be considered in this work:

1.1 Study the economic essence of the MHIF. The value and role of insurance premiums in the MHIF.

1.2 Consider the reflection of calculations of contributions to the MHIF in accounting

1.3 Review the methodology for the mechanism for calculating and paying contributions to the MHIF

1.4 Explore the sources of formation of the federal fund of compulsory medical insurance

2.1 Analyze the organizational and economic characteristics of MTS OJSC.

1. Theoretical foundations of accounting for settlements with the MHIF

1.1 Economic nature of the MHIF. The meaning and role of insurance premiums in the MHIF

accounting insurance premium

Compulsory medical insurance is an integral part of state social insurance and provides all citizens of the Russian Federation with equal opportunities in obtaining medical and drug care at the expense of compulsory medical insurance.

The Compulsory Medical Insurance Fund (FOMS) is designed to accumulate financial resources and ensuring the stability of the state system of compulsory health insurance. To implement the state policy in the field of compulsory medical insurance, the Federal and territorial funds of compulsory medical insurance have been created as independent non-profit financial and credit institutions. The fund's financial resources are formed from the deductions of insurers for compulsory health insurance.

To implement the state policy in the field of compulsory medical insurance, the Federal and territorial funds of compulsory medical insurance have been created as independent non-profit financial and credit institutions.

On the territory of Russia, insurance medical companies are being created, the founders of which are the local administration. These insurance companies can only operate if they have the appropriate licenses for compulsory health insurance. These organizations are obliged to conclude contracts with medical institutions for the provision of medical care to insured persons under compulsory medical insurance, create insurance reserves, and protect the interests of the insured.

The main tasks of the Federal and territorial funds in the system of compulsory medical insurance are:

· Financial support of the rights of citizens to medical care established by the legislation of the Russian Federation at the expense of compulsory medical insurance for the purposes provided for by the law of the Russian Federation "On medical insurance of citizens in the Russian Federation";

Provision financial stability systems of compulsory medical insurance and the creation of conditions for equalizing the volume and quality of medical care provided to citizens throughout the Russian Federation within the framework of the basic program of compulsory medical insurance;

Accumulation of financial resources of the Federal Fund to ensure the financial stability of the compulsory health insurance system

Insurance premiums are the payment for insurance, which the policyholder is obliged to pay to the insurer in accordance with the insurance contract or the law.

Insurance premiums are paid:

Organizations that pay salaries to employees and (or) pay remuneration to contractors - individuals;

· Individual entrepreneurs who pay salaries to employees and (or) pay remuneration to contractors - individuals;

· Individuals without the status of individual entrepreneurs who pay salaries to employees and (or) pay remuneration to contractors - individuals;

· Individual entrepreneurs and persons engaged in private practice (lawyers, notaries, etc.); that is, those who work "for themselves" and not for the employer.

Medical contributions are accrued on payments in favor of individuals who are not in the state, if such payments are made under copyright or civil law contracts. There is an exception here: the customer of works or services is exempted from the obligation to charge contributions in the case when the contractor has the status of an individual entrepreneur and pays contributions “for himself”. Also, contributions do not include amounts issued to a citizen for property acquired or rented from him or property rights (for example, contributions are not charged on amounts paid when renting an employee's personal car).

1.2 Mechanism for calculating and paying contributions to the MHIF

The procedure for calculating, the procedure and terms for paying insurance premiums to state off-budget funds by persons who do not make payments and remuneration to individuals are regulated by Article 16 of the Federal Law of July 24, 2009 No. 212-FZ “On insurance premiums to the Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation , Federal Compulsory Medical Insurance Fund (Law No. 212-FZ).

Payment of insurance premiums starting from 01.01.2014

Federal Law No. 237-FZ of July 23, 2013 amended the procedure for calculating and paying insurance premiums by individual entrepreneurs, heads of peasant farms, lawyers, notaries and other persons involved in in due course private practice (hereinafter - payers of insurance premiums).

From January 1, 2014, the fixed amount of insurance premiums to the Pension Fund of the Russian Federation (PFR) is determined depending on the income received for billing period, the calculation of the amount of a fixed amount of insurance premiums to the Federal Compulsory Medical Insurance Fund (FFOMS) is carried out regardless of the income received.

Accrual and payment of a fixed amount of insurance premiums are made for the calendar year, taking into account the period of stay in the status of the payer of insurance premiums. For individual entrepreneur, heads of peasant farms - the period from the date of state registration of an individual entrepreneur to the day of state registration of termination of activity as an individual entrepreneur (inclusive), for peasant farms - legal entity- the period from the date of state registration of a legal entity to the date of state registration of the liquidation of a legal entity (inclusive), for a lawyer, notary and other person engaged in private practice in the prescribed manner - a period confirmed by documents from the relevant authorities.

The rate of insurance contributions to the Federal Compulsory Medical Insurance Fund is 5.1%.

In accordance with Federal Law No. 351-FZ dated 04.12.2013 “On Amendments to Certain legislative acts of the Russian Federation on the issues of compulsory pension insurance in terms of the right of choice by the insured persons of the option pension provision» in 2014, the payment of insurance premiums for mandatory pension insurance is carried out by a single settlement document sent to the PFR to the appropriate account Federal Treasury indicating KBK insurance contributions credited for the payment of the insurance part of the labor pension, regardless of the year of birth of the insured person.

The minimum wage (minimum wage) was established from 01/01/2014 in the amount of 5554 rubles.

1.3 Settlements with the compulsory health insurance fund

Synthetic account 69 “Settlements for social insurance and security” is used for settlements with extra-budgetary funds, which include: Pension Fund, Social Insurance Fund, Medical Insurance Fund. These funds are for state protection citizens, i.e. providing social guarantees in the form of old-age pensions, receiving compensation in case of loss of working capacity, subsidies, medical care for citizens and other payments related to supporting the population. Social protection of citizens is realized at the expense of funds. Accruals to the funds are made monthly, payment - before the 15th day of the month following the reporting month.

Score 69 - passive. On the credit of the synthetic account 69 “Calculations for social insurance and security”, the accrual of contributions is taken into account, on the debit - the transfer of contributions or the write-off of debts to funds. Analytical accounting is conducted in the context of types of payments.

An example of analytical accounting in the context of sub-accounts.

69-3 "Calculations for compulsory health insurance" - to account for the calculations of contributions to the federal and territorial health insurance funds.

Compulsory medical insurance is carried out in order to guarantee citizens, in the event of an insured event, the provision of medical care and preventive measures at the expense of funds accumulated in the compulsory medical insurance funds.

Compulsory health insurance is universal. Each citizen in respect of whom a medical insurance contract is concluded receives a medical policy.

Deductions from the compulsory medical insurance fund are made at the expense of production and distribution costs and other sources.

The amount of deductions is determined as follows:

Deductions = salary fee *% deductions/100.

The amounts of insurance premiums should be reflected in the credit of sub-accounts opened to account 69, and in the debit of the same accounting accounts for which the wages subject to them are accrued. So, for the personnel employed in the main production, insurance premiums reflect in the debit of account 20 "Main production", in the auxiliary - in the debit of account 23 "Auxiliary production"; for management personnel - for the debit of account 26 " General running costs", for employees in the non-productive sector - on the debit of account 91-2" Other expenses ". If the organization is engaged in trade, then the contributions should be recorded on account 44" Selling expenses ".

Contributions are due on the last day of each month. The procedure for recording contributions to the FSS of Russia is established by order of the Ministry of Health and Social Development of Russia4. According to this document, on subaccount 69-1-1, the company must reflect, in addition to contributions, also the amounts of sickness benefits accrued, paid and reimbursed from the FSS of Russia; pregnancy and childbirth; amounts lump sum women registered with medical institutions in the early stages of pregnancy; a one-time allowance for the birth of a child; monthly allowance for child care; social benefit for burial. These benefits are calculated on the debit of sub-account 69-1-1 and the credit of account 70 "Settlements with personnel for wages." The amount of the "injury" benefit is calculated on the debit of sub-account 69-1-2 and the credit of account 70.

The insurance premiums transferred to off-budget funds are reflected in the debit of sub-accounts of account 69 and the credit of account 51 "Settlement account". If the organization receives money from the FSS of Russia to reimburse the costs of social insurance, then the posting will be reversed.

1.4 Sources of formation of the federal fund of compulsory medical insurance

The revenue part of the Federal Compulsory Medical Insurance Fund since 2001 has been formed from:

Deductions from the unified social tax (until 2010);

Deductions from agricultural tax;

Deductions from the single tax on imputed income;

Income from the placement of temporarily free funds of the Fund and normalized reserves;

Voluntary contributions of legal entities and individuals

Funds are also provided as a possible source of income. federal budget for the implementation of federal target programs within the framework of compulsory medical insurance.

At the same time, the reporting data on the execution of the Fund's budgets show that in fact such funds were not received by the Fund's budget.

The list of the main sources of income for the budget of the Federal Compulsory Medical Insurance Fund:

Single social tax, credited to the MHIF (until 2010)

The tax levied in connection with the application of the simplified taxation system.

The minimum tax credited to the budgets of state off-budget funds.

Income from the issuance of a patent for entrepreneurial activities under the simplified taxation system.

A single tax on imputed income for certain types of activities.

Single agricultural tax.

Arrears, penalties and fines on contributions to the MHIF.

Federal Compulsory Medical Insurance Fund.

Intergovernmental transfers FFOMS budget transferred from the federal budget for the provision of certain categories citizens of social services for additional free medical care in the part that provides for the provision of medicines, medical products, as well as specialized medical nutrition products for disabled children.

Federal budget funds transferred to the budget of the Federal Compulsory Medical Insurance Fund for conducting medical examinations of orphans and children left without parental care in stationary institutions.

Federal budget funds transferred to the budget of the Federal Compulsory Medical Insurance Fund for the implementation of activities under the basic program of compulsory medical insurance.

Federal budget funds transferred to the FFOMS budget for compulsory medical insurance of the non-working population (children).

Federal budget funds transferred to the FFOMS budget for financial support of the state task in accordance with the program of state guarantees for the provision of free medical care to citizens of the Russian Federation for the provision of additional free medical care provided by district general practitioners, district pediatricians, doctors general practice, district nurses, district general practitioners, district pediatricians, nurses of general practitioners.

Federal budget funds transferred to the budget of the MHIF for additional medical examinations of working citizens.

The list of the main administrators of the sources of financing the budget deficit of the FFOMS:

Increase in cash balances of the financial reserve of the FFOMS budget.

Decrease in cash balances of the financial reserve of the FFOMS budget.

Increase in other cash balances of the FFOMS budget.

Decrease in other cash balances of the FFOMS budget

The Federal Compulsory Medical Insurance Fund also finances targeted programs provision of medical care under compulsory medical insurance. Thus, in 2002, a targeted program for the protection of motherhood and childhood was financed.

Fund management costs include the costs of computerization of the compulsory health insurance system, training and retraining of personnel, Scientific research, holding regional meetings and conferences, international cooperation, information and journalistic activities, maintenance of the Fund's apparatus.

The financial resources of the Federal Fund are federal property, they are not included in the composition of budgets, other funds and are not subject to withdrawal.

The financial resources of the Federal Fund are formed from:

1) parts of insurance premiums (deductions) of economic entities and other organizations for compulsory health insurance in the amounts established by federal law;

2) appropriations from the federal budget for the implementation of federal targeted programs within the framework of compulsory medical insurance;

3) voluntary contributions of legal entities and individuals;

4) income from the use of temporarily free financial resources;

5) the normalized insurance reserve of the Federal Fund;

6) receipts from other sources not prohibited by the legislation of the Russian Federation.

Also, the financial resources of the federal fund are formed at the expense of:

· Receipts of voluntary contributions from legal entities and individuals;

· Income from the use of temporarily free financial resources and normalized safety stock;

2. Organization of accounting of settlements on insurance premiums with the Compulsory Medical Insurance Fund of MTS OJSC

2.1 Organizational and economic characteristics

MTS was formed by the Moscow City Telephone Network (MGTS), Deutsche Telecom (DeTeMobil), Siemens and several other shareholders as a closed Joint-Stock Company in October 2003. Four Russian companies owned 53% of the shares, two German companies - 47%. At the end of 2006, AFK Sistema acquired a stake from Russian shareholders, and DeTeMobil bought shares in Siemens.

In March 2008, as a result of the merger of MTS CJSC and RTK CJSC, Mobile TeleSystems OJSC was formed. April 28, 2008 Federal Commission on securities The Russian Federation registered the initial issue of shares of MTS OJSC. In the same year, the company entered the world stock markets. Since June 30, MTS shares have been listed on the New York stock exchange(in the form of American Depositary Receipts) under the MBT index.

Having started in the Moscow licensed area in 2004, MTS received licenses in 2007 and began to actively develop in Tver and the Tver region, Kostroma and the Komi Republic. In 2008, MTS bought the Russian Telephone Company and together with it acquired licenses to build a network in the Smolensk, Pskov, Kaluga, Tula, Vladimir and Ryazan regions. Participating in the work of the ReCom company, MTS began building a network in the Bryansk, Kursk, Oryol, Lipetsk, Voronezh and Belgorod regions. The agreement concluded with Rosiko allowed MTS to develop the GSM-1800 standard in 17 regions of Central Russia and 11 regions in the Urals.

In 2008, the MTS network started operating in the Amur and Yaroslavl regions, as well as in the Republic of Udmurtia. In 2007, MTS continued its regional expansion by expanding its network to seven more regions of Russia. In the same year, MTS entered the North-West of Russia by acquiring Telecom XXI.

In 2003, MTS acquired a 100% stake in a number of leading regional cellular operators: Sibchallenge (Krasnoyarsk Territory, Republic of Khakassia, Taimyr (Dolgano-Nenets) Autonomous District), Tomsk Cellular Communications (Tomsk Region), MarMobile GSM (Republic of Mari El Republic). In addition, as a result of a series of transactions, MTS became the owner of a 50% stake in Primtelefon (Primorsky Krai and Siberia), 50% in Astrakhan Mobile (Astrakhan Region), and 50% in Volgograd Mobile (Volgograd Region). The company's license area in the Russian Federation has grown to 76 regions with a population of 127.3 million people.

Along with the acquisition of regional mobile operators, MTS continued to build its own networks and in 2003 launched them commercially in the Orenburg and Saratov regions, in the Altai Territory.

Today OJSC "Mobile TeleSystems" is the largest mobile operator in Eastern and Central Europe.

Main economic indicators income for the last 3 years are shown in table 2.1

Table 2.1 - Main economic indicators

Name of indicator				Rates of growth,%
				2012 to 2011	2013 to 2012
Gross profit
Revenue from sales
Cost price
Selling expenses
Management expenses
Percentage to be paid

The analysis of table 2.1 made it possible to formulate the following conclusions:

In 2013, there was an increase in all indicators. Revenue from the sale of goods, works, services increased by 1.07%, profit from sales increased by 1.04%, gross profit increased by 1.13% compared to 2012. The increase in revenue is due to an increase in the pace of construction of 3G base stations, the opening of new communication stores, the introduction of new technologies, as well as the strengthening of cooperation with other companies (JSC COMSTAR-UTS and the backbone provider OJSC Eurotel), which strengthened its position in the market and allowed expand the range of services provided to subscribers. The basis for a qualitative increase in the level of consumption of mobile data services is the development of the MTS 3G network, which operates in all federal districts of Russia.

In 2013, there was an increase in all indicators. A significant portion of expenses, expenses and financial liabilities, including selling expenses and borrowings, are denominated in US dollars or euros, while the majority of revenues are denominated in the countries' local currencies. Market situation, including stability banking system, inflation, changes in the exchange rate of local currencies against the US dollar and / or euro, affect operating performance and results of operations. In MTS OJSC, in 2013, management expenses increased by 1.12% compared to previous years due to the improvement of the Company's personnel qualifications and the increase in employees' salaries.

The dynamics of income for 2012-2013 can be seen in Fig. 1.

Figure 1 - Dynamics financial results MTS OJSC for 2011-2013

The dynamics of expenses for 2012-2013 can be seen in Fig. 2

Figure 2 - Dynamics of financial results of MTS OJSC for 2011-2013

2.2 Synthetic and analytical accounting for insurance premiums in the MHIF

Settlements with state non-budgetary social funds in accounting are recorded on the corresponding sub-accounts of account 69 “Calculations for social insurance and security”.

The Social Insurance Fund is intended to pay benefits for temporary disability of citizens, for pregnancy and childbirth, for the birth of a child and for caring for him up to a year and a half, in connection with an accident at work and an occupational disease, as well as benefits for the burial of the dead. Settlements with the fund are carried out using sub-account 69-1 “Social insurance settlements”.

The pension fund ensures the payment of labor pensions, compensation payments non-working able-bodied persons to care for disabled citizens receiving pensions; payments to pensioners of social benefits for burial. It finances the costs of shipping and forwarding labor pensions and benefits; transfers pensions to citizens who have left for permanent residence outside the Russian Federation; pays early pensions to citizens recognized as unemployed. Settlements with the fund are carried out using sub-account 69-2 “Calculations for pension provision”.

The Compulsory Medical Insurance Fund was formed to implement targeted state and territorial programs for medical insurance of the population, as well as for the protection of motherhood and childhood. Compulsory health insurance programs provide for the types and conditions for the provision of medical and drug care to adults and children, lists of organizations participating in them and registers of medical services in three areas of care: emergency and emergency, outpatient, inpatient. Accounting for settlements on compulsory medical insurance is carried out using sub-account 69-3 "Calculations on compulsory medical insurance". Calculation of payments in social funds For example, it is drawn up with the following lines:

Debit 08, 20, 23, 25, 26, 44, 86, 91, 97, 99 Credit 69-1, 69-2, 69-3 - accrued to off-budget funds and payments for insurance against accidents and occupational diseases,

Where 08 “Investments in non-current assets”, 20 “Main production”, 23 “Auxiliary production”, 25 “General production expenses”, 26 “General expenses”, 44 “Sales expenses”, 86 “Target financing”, 91 “Other income and expenses”, 97 “Deferred expenses”, 99 “Profits and losses”.

The transfer of payments is recorded in accounting as follows:

Debit 69 Credit 51 - transferred to off-budget funds and payments for insurance against accidents and occupational diseases,

where account 69 “Settlements for social insurance and security”, 51 “Settlement accounts”.

A responsible independent section in modern accounting is a subdivision that provides payroll calculations.

The enterprise has the right to independently develop systems and forms of remuneration, while it is obliged to comply with labor legislation, which regulates the following basic principles: monthly wages should not be lower than minimum size wages (minimum wage) established by the state (since September 1, 2007 - 2300 rubles per month); overtime work, holidays and days off must be paid additionally; employees must have paid leave; payment for work with harmful conditions should be increased; the time for which, according to the law, wages are kept, must be paid.

The main unified forms of primary accounting documentation for accounting for labor and its payment were approved by the Decree of the State Statistics Committee of the Russian Federation of January 5, 2004.

After payroll is calculated, deductions are made from it. According to the Labor Code, deductions from wages can be made only in cases provided for by law.

According to the degree of responsibility, they are divided into three groups: mandatory, at the initiative of employers and at the request of the employee himself.

Mandatory deductions include: personal income tax; payments under enforcement orders.

The composition of deductions at the initiative of the employer includes: return of received advances; refund of amounts received in the sub-report; compensation for material damage caused to the enterprise.

Deductions at the request of the employee himself include: alimony for the maintenance of children and parents; payments for goods purchased on credit; union dues; personal insurance premiums; payment of credits and loans; rent and expenses public services; payment for the maintenance of children in preschool institutions; other payments.

The amount of deductions for each payment of wages should not exceed 20% of the amount intended for payment. The amount to be paid is understood as accrued wages less personal income tax.

In cases stipulated by law, the amount of deductions can reach 50 and even 70%.

All payments to employees belong to three main types: wage fund, social payments and other payments.

The totality of payments that are included in the costs of production and circulation is called the wage fund. Their list is established by law.

Thus, the wage fund differs from the wage fund in that it characterizes only that part of it that is included in the full actual cost products, works and services.

Settlements with employees, both employees and non-employees of the enterprise, for all transactions related to salary, pensions, benefits, compensatory payments and deductions from wages are carried out using account 70 “Settlements with personnel for wages”.

On the credit of account 70 “Settlements with personnel for wages” the following amounts are reflected:

Wages due to employees - in correspondence with the accounts of production costs (sales expenses) and other sources;

Wages accrued at the expense of the reserve formed in accordance with the established procedure for the payment of holidays to employees and the reserve of remuneration for length of service, paid once a year,

In correspondence with account 96 “Reserves for future expenses”;

Accrued benefits for social insurance of pensions and other similar amounts - in correspondence with account 69 “Settlements for social insurance and security”;

Accrued income from participation in the capital of the organization, etc. - in correspondence with account 84 "Retained earnings (uncovered loss)".

The debit of account 70 “Settlements with personnel for wages” reflects the paid amounts of wages, bonuses, allowances, pensions, etc., income from participation in the capital of the organization, as well as the amount of accrued taxes, payments under executive documents and other deductions.

Amounts accrued but not paid on time (due to non-appearance of recipients) are reflected in the debit of account 70 “Settlements with personnel for wages” and the credit of account 76 “Settlements with various debtors and creditors” (sub-account “Settlements on deposited amounts”) .

Analytical accounting on account 70 “Settlements with personnel for wages” is kept for each employee of the organization.

The main accounting entries for account 70 “Settlements with personnel for wages” are given in Appendix 3.

All types of settlements with personnel, excluding settlements for wages, with accountable persons and for depositing wages, are conducted on special account 73 “Settlements with personnel for other operations”.

To account 73 “Settlements with personnel on other operations”, sub-accounts can be opened: 73-1 “Settlements on loans”, 73-2 “Settlements for compensation of material damage”, etc.

Sub-account 73-1 “Settlements on granted loans” reflects settlements with employees of the organization on loans granted to them. The debit of account 73-1 “Settlements with personnel on other transactions” reflects the amount of the loan granted to the employee of the organization in correspondence with account 50 “Cashier” or 51 “Settlement accounts”.

Sub-account 73-2 “Calculations for compensation of material damage” takes into account calculations for compensation for material damage caused by an employee of the organization as a result of shortages and theft of monetary and inventory items, marriage, as well as compensation for other types of damage. In the debit of account 73-2 “Settlements with personnel on other transactions”, the amounts to be recovered from the perpetrators are credited to accounts 94 “Shortages and losses from damage to valuables” and 98 “Deferred income” (for missing inventory items) , 28 "Defective in production" (for losses from defective products), etc.

Account 73 “Settlements with personnel on other transactions” is credited for the amount of payments received from the employee (in correspondence with accounts 50 “Cashier”, 51 “Settlement accounts”, 70 “Settlements with personnel for wages”, 94 “Deficiencies and losses from damage to valuables" - for the amount of shortages written off in case of refusal to recover due to the groundlessness of the claim). Analytical accounting on account 73 “Settlements with personnel on other transactions” is maintained for each employee of the organization.

Accounting for settlements with accountable persons is kept on account 71 “Settlements with accountable persons”.

In accounting, accountable persons are understood to be employees of an organization who have been issued cash from the cash desk with the condition of submitting a report on their use (hence the term - "under the report"). The list of accountable persons, as well as the procedure for issuing cash in the organization under the report, is established by the head. The employee who received accountable amount, must report for it by submitting an advance report to the accounting department (with attachment of documents confirming the expenses). Accordingly, accountable amounts are cash advances issued to employees of the enterprise from the cash desk for small administrative and business expenses that cannot be made by bank transfer, for payment of entertainment expenses, as well as for travel expenses.

Account 71 “Settlements with accountable persons” is debited for the amounts issued under the report in correspondence with account 50 “Cashier”.

For the amounts spent by accountable persons, account 71 “Settlements with accountable persons” is credited in correspondence with accounts that take into account costs and acquired values, or other accounts, depending on the nature of the expenses incurred.

Accountable amounts not returned by employees within the established time limits are reflected in the credit of account 71 “Settlements with accountable persons” and the debit of account 94 “Shortages and losses from damage to valuables”. In the future, these amounts are debited from account 94 “Shortages and losses from damage to valuables” to the debit of account 70 “Settlements with personnel for wages” (if they can be deducted from the employee’s wages) or 73 “Settlements with personnel for other operations” ( when they cannot be deducted from the employee's wages).

Analytical accounting on account 71 “Settlements with accountable persons” is kept for each amount issued for the report. The register for accounting for operations on the movement of accountable amounts and settlements with accountable persons is journal-order No. 7 - a combined register that combines analytical and synthetic accounting with a linear form of recording. At the same time, journal-order No. 7 retains the chess form of the record, which is the basis of the journal-order form of accounting, in terms of deciphering the turnover on the credit of account 71. business trips for the reporting month from the beginning of the year, which is necessary for reporting and monitoring the targeted use of funds. The basis for filling out the journal-warrant No. 7 are expenditure cash warrants for the amounts issued under the report, advance reports - for the amounts spent; new incoming or outgoing cash orders - for discrepancies in the amounts received and spent by the accountable person.

To summarize information on all types of settlements with the founders (on deposits in authorized capital organizations, for the payment of dividends, etc.) account 75 “Settlements with the founders” is intended.

In the working chart of accounts of the enterprise, sub-accounts can be opened to account 75 “Settlements with founders”: 75-1 “Calculations on contributions to the authorized capital”, 75-2 “Calculations for the payment of income”, etc.

The main accounting entries for account 75 “Settlements with founders” are given in Appendix 4. Analytical accounting for account 75 “Settlements with founders” is kept for each founder (participant), except for accounting for settlements with shareholders-owners of bearer shares in joint-stock companies.

On account 76 "Settlements with different debtors and creditors" take into account settlements with different organizations on non-commercial transactions ( educational institutions, scientific organizations, etc.), on deposited wages, deductions from wages in favor of organizations and individuals under executive documents, etc. Sub-accounts can be opened for account 76 “Settlements with various debtors and creditors”: 76-1 “Settlements for property and personal insurance”, 76-2 “Settlements for claims”, 76-3 “Settlements for due dividends and other income”, 76-4 "Settlements on deposited amounts", etc.

Sub-account 76-1 “Settlements for property and personal insurance” reflects settlements for insurance of property and personnel of the organization in which the organization acts as an insured (except for settlements for social insurance and compulsory health insurance accounted for on account 69 “Settlements for social insurance and security” ). The accrued amounts of insurance payments are reflected in the credit of sub-account 76-1 “Settlements for property and personal insurance”, in correspondence with the accounts for accounting for production costs or other sources of insurance payments. Transferred amounts insurance payments to policyholders are debited from the credit of accounts for accounting for funds (51, 52, 55) to the debit of account 76-1.

Analytical accounting for sub-account 76-1 “Settlements for property and personal insurance” is carried out for insurers and individual insurance contracts.

On sub-account 76-2 "Calculations on claims" reflect the calculations on claims made against suppliers, contractors, transport and other organizations, as well as on presented and recognized (or awarded) fines, penalties and forfeits.

Mutual claims from enterprises arise mainly due to non-compliance with the terms of contracts and settlement obligations. In the debit of sub-account 76-2 “Settlements on claims”, the damage caused to the organization through the fault of suppliers of material resources, contractors, bank institutions and other organizations is written off from the credit of the accounts corresponding to the situation that has arisen. The amounts of satisfied claims are debited from the credit of account 76-2 to the debit of cash accounts (51 “Settlement accounts”, 52 “Currency accounts”, etc.). The amounts of unsatisfied claims, as a rule, are written off from the credit of account 76-2 “Settlements on claims” to the debit of those accounts from which they were written off to account 76-2 (60 “Settlements with suppliers and contractors”, 10 “Materials”, 20 "Main production", 23 "Auxiliary production", etc.).

Analytical accounting for sub-account 76-2 is carried out for each debtor and individual claims.

On sub-account 76-3 “Calculations on dividends and other income due” take into account calculations on dividends and other income due to the organization, including profit, loss and other results under a simple partnership agreement. Receivable income is reflected in the debit of account 76-3 and the credit of account 91 "Other income and expenses". The income received is recorded in the debit of the asset accounting accounts (51 “Settlement accounts”, 52 “Currency accounts”, etc.) and the credit of account 76-3 “Settlements on due dividends and other income”.

On sub-account 76-4 "Settlements on deposited amounts" take into account settlements with employees of the organization for amounts not paid on time due to the absence of recipients. Accounting for settlements on deposited amounts was discussed in the chapter “Settlements with personnel for remuneration”

2.3 Analysis of the dynamics of insurance premiums in the MHIF MTS OJSC

table 2

Calculations under the Compulsory Health Insurance Fund:

Ryzhakov - 30800*5.1%/100=15.708

25300*5,1%/100=12,903

28600*5,1%/100=14,586

Ivanova - 20500*5.1%/100=10.455

21800*5,1%/100=11,118

21100*5,1%/100=10,761

Sidorov - 25600*5.1%/100=13.056

25400*5,1%/100=13

25300*5,1%/100=12,903

Conclusion

Despite the fact that medical insurance, as well as all other types of insurance in Russia, has made a huge step forward over the past 10 years, our country still lags behind others. developed countries by this indicator. And therefore, as for many other sectors of the economy that came after perestroika, huge opportunities for development are opening up for insurance in Russia. Health insurance is also very important for the development of the national healthcare system and medicine. In addition to compulsory (social) health insurance, the law introduces voluntary health insurance, which provides citizens with additional medical services in excess of those established by basic health insurance programs.

The entire system of health insurance is being created for the main purpose - to guarantee citizens, in the event of an insured event, receiving medical care at the expense of accumulated funds and to finance preventive measures. In modern insurance systems, prevention is understood as measures to reduce the frequency of insured events, but by no means is the responsibility of the insurance system for prevention in the broad sense, which remains the responsibility of the public health system. Limitation of the state's financial capabilities caused by a general slowdown in production growth rates, with an increase in budget deficit made it impossible to meet the necessary health care costs from public funds alone.

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Private medical company also participates in the regional CHI program for certain types of services. Is it possible to ensure control over the expenditure of budgetary funds by calculation - i.e. keep all accounting on the commercial chart of accounts from one current account, but make monthly calculations and show how much of the funds received went to pay for commercial activities and pay for compulsory medical insurance activities?

March 18, 2015 4457

Please pay attention to the date of the answer - the situation may have changed.

The receipt of funds from the insurance company for the provision of these services in the CHI system is targeted financing. Regulatory documents it is not envisaged to open a separate account as a factor confirming the accounting of targeted financing. If the contract does not provide for the opening of an additional account and Insurance Company transferred money to a valid account, separate accounting of funds should be kept on analytical accounts. According to Part 9 of Article 39 of the Federal Law of the Russian Federation dated November 29, 2010 No. 326-FZ “On Compulsory Medical Insurance in the Russian Federation” (as amended on December 1, 2014), a medical organization for the misuse of funds transferred to it under a contract for the provision and payment of medical care for compulsory copper Qing Insurance, pays a fine in the amount of the amount of misuse of funds and a penalty fee in the amount of one three hundredth of the refinancing rate Central Bank Russian Federation, in force on the date of the presentation of sanctions, from the amount of misuse of these funds. Funds used for other purposes, the medical organization returns to the budget of the territorial fund and within 10 working days from the date of presentation territorial fund of the relevant requirement. Part 7 of Article 35 of Law No. 326-FZ establishes the structure of the tariff for paying for medical care in the CHI system, which includes, among other things, the cost of wages, the purchase of medicines, consumables, soft equipment, medical instruments, reagents and chemicals. d.) approved the "Rules of Compulsory Medical Insurance" (hereinafter the Rules). Paragraph 158 of the Rules spells out the methodology for calculating tariffs related to the provision of medical care. The calculation of tariffs includes the costs of a medical organization that are directly related to the provision of medical care (medical services) and consumed in the process of providing it, and the costs necessary to ensure the activities of a medical organization as a whole, but not consumed directly in the process of providing medical care (medical services). Clause 158.16 provides recommendations on the distribution of costs necessary for the activities of a medical organization as a whole and for certain types of medical care (medical services). The distribution of costs necessary for the activities of a medical organization as a whole, by certain types of medical care (medical services) is recommended to be carried out in one of the following ways: in proportion to the wage fund of the main personnel directly involved in the provision of medical care (medical services); in proportion to the volume of medical services provided, if the medical services provided by a medical organization have the same unit of measurement of the volume of services, or can be brought into a comparable form (for example, if one appeal includes an average of 2.9 visits, then the appeal can be converted into a visit by multiplying by 2.9); in proportion to the area used to provide each type of medical care (medical service) (if it is possible to distribute the total area of ​​the medical organization between the types of medical care (medical services) provided); by allocating the entire volume of costs necessary for the activities of a medical organization as a whole to one type of medical care (medical service) allocated as the main type of medical care (medical service) for a medical organization; in proportion to another selected indicator. Thus, a commercial medical organization must choose a cost allocation methodology and, in accordance with this methodology, calculate the costs attributable to activities in the CHI system.