Compulsory medical insurance personalized accounting. On approval of the procedure for maintaining personalized records in the field of compulsory health insurance

APPROVED

by order of the Ministry of Health and Social Development Russian Federation dated January 25, 2011

Order

maintaining personalized records

in the field of compulsory health insurance

I.General provisions

1. This Procedure defines the rules for maintaining personalized records of information about each insured person in the field of compulsory health insurance, including:

1) organization of personalized accounting in the field of compulsory health insurance;

2) maintaining a unified register of insured persons;

3) maintaining personalized records of information about medical care services provided to the insured persons;

4) technology for information exchange when maintaining personalized records in the field of compulsory health insurance.

2. The goals of personalized accounting in the field of compulsory health insurance are:

1) creation of conditions to ensure guarantees of the rights of insured persons to free provision of medical care of adequate quality and volume within the framework of basic and territorial compulsory health insurance programs;

2) creating conditions for monitoring the use of compulsory health insurance funds;

3) determining the need for volumes of medical care in order to form basic and territorial compulsory health insurance programs.

II. Organization of personalized accounting

3. Personalized accounting of information about insured persons is maintained in the form of a unified register of insured persons, which is a combination of its central and regional segments, and includes the collection, processing, transfer and storage of the following information about insured persons:

1) last name, first name, patronymic;

3) date of birth;

4) place of birth;

5) citizenship;

6) details of the identity document;

7) place of residence;

8) place of registration;

9) date of registration;

10) insurance number of an individual personal account (SNILS), adopted in accordance with the legislation of the Russian Federation on individual (personalized) accounting in the compulsory pension insurance system;

11) number of the compulsory health insurance policy of the insured person;

12) information about the medical insurance organization chosen by the insured person;

13) date of registration as an insured person;

14) status of the insured person (working, non-working).

4. Personalized recording of information about medical care provided to insured persons includes the collection, processing, transfer and storage of the following information:

1) number of the compulsory health insurance policy of the insured person;

2) medical organization who provided the relevant services;

3) types of medical care provided;

4) conditions for providing medical care;

5) timing of medical care;

6) volumes of medical care provided;

7) the cost of medical care provided;

8) diagnosis;

9) profile of medical care;

10) medical services provided to the insured person and medications used;

11) applied medical and economic standards;

12) specialty of the medical worker who provided medical care;

13) the result of seeking medical help;

14) the results of monitoring of the volumes, timing, quality and conditions of medical care.

5. Information about the insured person and the medical care provided to him can be provided both in the form of documents in writing and electronic form subject to guarantees of their reliability (authenticity), protection from unauthorized access and distortion in accordance with the requirements established by the legislation of the Russian Federation for the protection of personal data. In this case, the legal force of the submitted documents is confirmed by an electronic digital signature in accordance with the legislation of the Russian Federation. The decision on the possibility of presenting information in electronic form is made jointly by the participants in the information exchange.

6. Medical insurance organizations and medical organizations keep copies of paper documents and electronic archives, containing personalized information about the insured persons and the medical care provided to them, submitted in territorial fund compulsory health insurance (hereinafter referred to as the territorial fund) for personalized accounting, according to the rules for organizing state archival affairs.

7. After the expiration of the period established for storing copies of documents on paper and electronic media in a medical insurance organization, they are subject to destruction in accordance with the legislation of the Russian Federation on the basis of an act of their destruction, approved by the head of the medical insurance organization.

8. Information about the insured person and the medical care provided to him is classified as restricted information and is subject to protection in accordance with the legislation of the Russian Federation.

III. Maintaining the regional segment of the unified register of insured persons

9. Information about each insured person specified in paragraph 3 of this Procedure is entered into the unified register of insured persons.

10. The regional segment of the unified register of insured persons is maintained by the territorial fund on the basis of information about insured persons provided by the medical insurance organization.

11. The medical insurance organization and the territorial fund, by orders, determine the employees admitted to work with the regional segment of the unified register of insured persons, and comply with the requirements of the legislation of the Russian Federation on the protection of personal data.

12. When entering information about an insured person into the regional segment of the unified register of insured persons, the insurance medical organization ensures the accuracy and correctness of the entered information and carries out checks to prevent the appearance of duplicate entries in the regional segment of the unified register of insured persons:

1) for the presence of repetitions of last name, first name, patronymic, date and place of birth;

2) for the presence of repetitions according to the identity document data;

3) correct indication of the gender of the insured person;

4) for the presence of repetitions by date of birth and address of registration at the place of residence;

5) for the presence of repetitions of last name, first name and patronymic and registration address at the place of residence;

6) for the presence of repetitions insurance number individual personal account (SNILS).

13. In order to update the regional segment of the unified register of insured persons and enter information about insured persons into it, the insurance medical organization generates and transmits information files with changes in information about insured persons provided for in paragraph 3 of this Procedure (hereinafter referred to as files with changes) to the territorial fund as necessary, but at least once a day if there are changes in information about the insured persons, in accordance with the agreement on financial support for compulsory health insurance.

14. The territorial fund provides round-the-clock reception and processing of files with changes received from medical insurance organizations.

15. When processing files with changes in the territorial fund, format-logical control of data, identification of records in the regional segment of the unified register of insured persons, and entry of information about insured persons are carried out.

17. The territorial body of the Pension Fund of the Russian Federation, quarterly no later than the 15th day of the second month following the reporting period, provides in accordance with the Agreement on information exchange between Pension Fund of the Russian Federation and the Federal Compulsory Medical Insurance Fund to the relevant territorial fund, information about working insured persons for inclusion in the regional segment of the unified register of insured persons.

18. Territorial fund on a monthly basis on the basis of information on state registration of death provided by civil registry authorities in accordance with Article 12 of the Federal Law of 01.01.01. “On acts of civil status” (Collected Legislation of the Russian Federation, 1997, No. 47, Art. 5340; 2001, No. 44, Art. 4149; 2003, No. 17, Art. 1553; No. 50, Art. 4855; 2009, No. 51 , Art. 6154; 2010, No. 15, Art. 1748), updates the regional segment of the unified register of insured persons, notifies medical insurance organizations on the territory of a constituent entity of the Russian Federation about this and sends information files with information on the state registration of death on the territory of a constituent entity of the Russian Federation for persons whose information is not available in the regional segment of the unified register of insured persons, in Federal Fund compulsory health insurance (hereinafter referred to as the Federal Fund) to update the central segment of the unified register of insured persons.

19. The territorial fund quarterly updates the regional segment of the unified register of insured persons based on information about working insured persons and sends information files with information about working insured persons, information about which is not in the regional segment of the unified register of insured persons, to the Federal Fund for updating the central segment of the unified register of insured persons.

20. The insurer for non-working citizens monthly, no later than the 5th day of each month, provides to the relevant territorial fund information about non-working insured persons, provided for in subparagraphs 1-10, 14 of paragraph 3 of this Procedure, in accordance with agreements on information exchange between territorial funds and policyholders for unemployed citizens in the constituent entities of the Russian Federation, and in the form approved by the Federal Fund and the Pension Fund of the Russian Federation.

21. The territorial fund updates the regional segment of the unified register of insured persons on the basis of information received from the Federal Fund from the central segment of the unified register of insured persons.

22. If the deadlines for providing data on insured persons, as well as information about changes in this data, established by the agreement on financial support for compulsory medical insurance are violated, the medical insurance organization is obliged to pay the territorial fund at the expense of own funds a fine in the amount established by Part 10 of Article 38 of the Federal Law of November 29, 2010 “On Compulsory Health Insurance in the Russian Federation” (hereinafter referred to as the federal law“On compulsory health insurance in the Russian Federation”).

23. The territorial fund exercises general control over the regional segment of the unified register of insured persons. If errors and inconsistencies are detected, the territorial fund sends the relevant information to the medical insurance organization indicating the list of inconsistencies and the time frame for their correction.

IV. Maintaining the central segment of the unified register of insured persons

24. When making changes to the regional segment of the unified register of insured persons, the territorial fund generates files with changes, which it sends to the Federal Fund to update the central segment of the unified register of insured persons as necessary, but at least once a day if there are changes in information about the insured faces.

The files with changes include all newly entered and changed information about insured persons since the last submission.

25. The Federal Fund provides round-the-clock reception and processing of files with changes from territorial funds.

26. When processing files with changes, a check is ensured to ensure that the insured person has a previously issued valid policy compulsory medical insurance of a uniform standard in the central segment of the unified register of insured persons.

27. In the central segment of the unified register of insured persons, information files are processed with information on the state registration of death and information on the status of insured persons (working, non-working), sent by territorial funds for persons whose information is not available in their regional segments of the unified register of insured persons, the results of which are sent to the territorial funds at the place of insurance.

28. Federal Fund Leads central segment unified register of insured persons, provides general control over the updating and use of the unified register of insured persons.

29. Data exchange between medical insurance organizations, territorial funds and the Federal Fund for the purpose of maintaining personalized records of information about insured persons is carried out electronically via dedicated or open communication channels, including the Internet, using electronic digital signature in accordance with the requirements established by the legislation of the Russian Federation for the protection of personal data.

V. The procedure for maintaining personalized records of information about medical care provided to insured persons

30. Personalized records of information about medical care provided to insured persons are maintained electronically by medical organizations and medical insurance organizations operating in the compulsory health insurance system, and by territorial funds.

31. A medical organization, an insurance medical organization and a territorial fund, by order, determine the employees who are allowed to work with information about personalized records of medical care provided to insured persons, and ensure their confidentiality in accordance with the requirements of the legislation of the Russian Federation on the protection of personal data.

32. Medical organizations provide information on medical care provided to insured persons, provided for in subparagraphs 1 - 13 of paragraph 4 of this Procedure, to the territorial fund.

33. The territorial fund, within two working days, based on the regional segment of the unified register of insured persons, carries out automated processing of information received from medical organizations about medical care provided to insured persons.

34. At the stage of automated processing of information about personalized records of medical care provided to insured persons, the following is carried out in the territorial fund:

1) identification of the insured person according to the regional segment of the unified register of insured persons, determination of the medical insurance organization responsible for paying the bill;

2) identification of insured persons who received medical care outside the insurance territory and determination of their insurance territory;

3) sending electronically the results obtained in accordance with subparagraphs 1 and 2 of this paragraph to the medical organization that provided medical care to the insured persons.

35. Based on the results of automated processing of information about medical care provided to insured persons, carried out in accordance with paragraph 34 of this Procedure, a medical organization submits it to medical insurance organizations in the amount and within the time frame established by the contract for the provision and payment of medical care under compulsory health insurance.

36. After monitoring the volume, timing, quality and conditions of providing medical care in accordance with Article 40 of the Federal Law “On Compulsory Medical Insurance in the Russian Federation”, the information specified in paragraph 4 of this Procedure in the form of information files is transferred by the insurance medical organization to medical organizations and territorial fund within the time limits stipulated by the agreement on financial support for compulsory health insurance.

37. In case of difficulties in determining the insurance territory of a person who received medical care outside the insurance territory, the territorial fund generates an electronic request to the central segment of the unified register of insured persons, where within 5 working days a check is carried out and a response is generated indicating the identified insurance territory and the current policy number of the insured person.

38. Data exchange between medical organizations, medical insurance organizations, territorial funds and the Federal Fund for the purpose of maintaining personalized records of information about medical care provided to insured persons is carried out electronically via dedicated or open communication channels, including the Internet, using electronic digital signatures in accordance with the requirements established by the legislation of the Russian Federation for the protection of personal data.

Registration N 19742

Approve the attached Procedure for maintaining personalized records in the field of compulsory health insurance.

Minister T. Golikova

The procedure for maintaining personalized records in the field of compulsory health insurance

I. General provisions

1. This Procedure defines the rules for maintaining personalized records of information about each insured person in the field of compulsory health insurance, including:

1) organization of personalized accounting in the field of compulsory health insurance;

2) maintaining a unified register of insured persons;

3) maintaining personalized records of information about medical care provided to insured persons;

4) technology for information exchange when maintaining personalized records in the field of compulsory health insurance.

2. The goals of personalized accounting in the field of compulsory health insurance are:

2) creating conditions for monitoring the use of compulsory health insurance funds;

3) determining the need for volumes of medical care in order to form basic and territorial compulsory health insurance programs.

II. Organization of personalized accounting

1) last name, first name, patronymic;

3) date of birth;

4) place of birth;

5) citizenship;

6) details of the identity document;

7) place of residence;

8) place of registration;

9) date of registration;

11) number of the compulsory health insurance policy of the insured person;

12) information about the medical insurance organization chosen by the insured person;

13) date of registration as an insured person;

14) status of the insured person (working, non-working).

4. Personalized recording of information about medical care provided to insured persons includes the collection, processing, transfer and storage of the following information:

1) number of the compulsory health insurance policy of the insured person;

2) the medical organization that provided the relevant services;

3) types of medical care provided;

4) conditions for providing medical care;

5) timing of medical care;

6) volumes of medical care provided;

7) the cost of medical care provided;

8) diagnosis;

9) profile of medical care;

10) medical services provided to the insured person and medications used;

11) applied medical and economic standards;

12) specialty of the medical worker who provided medical care;

13) the result of seeking medical help;

14) the results of monitoring of the volumes, timing, quality and conditions of medical care.

5. Information about the insured person and the medical care provided to him can be provided both in the form of documents in written form and in electronic form, subject to guarantees of their reliability (authenticity), protection from unauthorized access and distortion in accordance with the requirements established by the legislation of the Russian Federation on the protection of personal data. In this case, the legal force of the submitted documents is confirmed by an electronic digital signature in accordance with the legislation of the Russian Federation. The decision on the possibility of presenting information in electronic form is made jointly by the participants in the information exchange.

6. Insurance medical organizations and medical organizations store copies of paper documents and electronic archives containing personalized information about insured persons and the medical care provided to them, submitted to the territorial compulsory health insurance fund (hereinafter referred to as the territorial fund) for personalized accounting, according to the rules of the organization of the state archival affairs.

III. Maintaining the regional segment of the unified register of insured persons

9. Information about each insured person specified in paragraph 3 of this Procedure is entered into the unified register of insured persons.

1) for the presence of repetitions of last name, first name, patronymic, date and place of birth;

2) for the presence of repetitions according to the identity document data;

3) correct indication of the gender of the insured person;

4) for the presence of repetitions by date of birth and address of registration at the place of residence;

5) for the presence of repetitions of last name, first name and patronymic and registration address at the place of residence;

6) for the presence of repetitions according to the insurance number of the individual personal account (SNILS).

13. In order to update the regional segment of the unified register of insured persons and enter information about insured persons into it, the insurance medical organization creates and transmits information files with changes in information about insured persons provided for in paragraph 3 of this Procedure (hereinafter referred to as files with changes) to the territorial fund as necessary, but at least once a day if there are changes in information about the insured persons, in accordance with the agreement on financial support for compulsory health insurance.

14. The territorial fund provides round-the-clock reception and processing of files with changes received from medical insurance organizations.

17. The territorial body of the Pension Fund of the Russian Federation, quarterly no later than the 15th day of the second month following the reporting period, provides, in accordance with the Agreement on information exchange between the Pension Fund of the Russian Federation and the Federal Compulsory Medical Insurance Fund, information about working insured persons to the corresponding territorial fund persons for inclusion in the regional segment of the unified register of insured persons.

18. Territorial fund monthly on the basis of information on state registration of death provided by civil registry authorities in accordance with Article 12 of the Federal Law of November 15, 1997 N 143-FZ “On Acts of Civil Status” (Collection of Legislation of the Russian Federation, 1997, N 47, Art. 5340; 2001, N 44, Art. 4149; 2003, N 17, Art. 1553; N 50, Art. 4855; 2009, N 51, Art. 6154; 2010, N 15, Art. 1748) , updates the regional segment of the unified register of insured persons, notifies medical insurance organizations on the territory of the constituent entity of the Russian Federation about this and sends information files with information on the state registration of death in the territory of the constituent entity of the Russian Federation for persons whose information is not available in the regional segment of the unified register of insured persons , to the Federal Compulsory Medical Insurance Fund (hereinafter referred to as the Federal Fund) to update the central segment of the unified register of insured persons.

22. If the deadlines for providing data on insured persons, as well as information about changes in this data, established by the agreement on financial support for compulsory health insurance are violated, the insurance medical organization is obliged to pay the territorial fund at its own expense a fine in the amount established by Part 10 of Article 38 of the Federal Law dated 29 November 2010 N 326-FZ “On compulsory health insurance in the Russian Federation” (hereinafter referred to as the Federal Law “On compulsory health insurance in the Russian Federation”).

IV. Maintaining the central segment of the unified register of insured persons

The files with changes include all newly entered and changed information about insured persons since the last submission.

25. The Federal Fund provides round-the-clock reception and processing of files with changes from territorial funds.

26. When processing files with changes, a check is made to ensure that the insured person has a previously issued valid compulsory medical insurance policy of a single sample in the central segment of the unified register of insured persons.

28. The Federal Fund maintains the central segment of the unified register of insured persons and provides general control over the updating and use of the unified register of insured persons.

29. Data exchange between medical insurance organizations, territorial funds and the Federal Fund for the purpose of maintaining personalized records of information about insured persons is carried out electronically via dedicated or open communication channels, including the Internet, using an electronic digital signature in accordance with the requirements established by the legislation of the Russian Federation on the protection of personal data.

V. The procedure for maintaining personalized records of information about medical care provided to insured persons

32. Medical organizations provide information on medical care provided to insured persons, provided for in subparagraphs 1 - 13 of paragraph 4 of this Procedure, to the territorial fund.

34. At the stage of automated processing of information about personalized records of medical care provided to insured persons, the following is carried out in the territorial fund:

2) identification of insured persons who received medical care outside the insurance territory and determination of their insurance territory;

3) sending electronically the results obtained in accordance with subparagraphs 1 and 2 of this paragraph to the medical organization that provided medical care to the insured persons.

MINISTRY OF HEALTH AND SOCIAL DEVELOPMENT OF THE RUSSIAN FEDERATION

ORDER

On approval of the Procedure for maintaining personalized records in the field of compulsory health insurance

Document with changes made:
(Official Internet portal of legal information www.pravo.gov.ru, 02/03/2017, N 0001201702030009);
(Official Internet portal of legal information www.pravo.gov.ru, 01/31/2019, N 0001201901310031).
____________________________________________________________________

In accordance with Article 43 of the Federal Law of November 29, 2010 N 326-FZ “On Compulsory Health Insurance in the Russian Federation” (Collected Legislation of the Russian Federation, 2010, N 49, Art. 6422)

I order:

Approve the attached Procedure for maintaining personalized records in the field of compulsory health insurance.

Minister
T. Golikova

Registered
at the Ministry of Justice
Russian Federation
February 8, 2011,
registration N 19742

The procedure for maintaining personalized records in the field of compulsory health insurance

I. General provisions

1. This Procedure defines the rules for maintaining personalized records of information about each insured person in the field of compulsory health insurance, including:

1) organization of personalized accounting in the field of compulsory health insurance;

2) maintaining a unified register of insured persons;

3) maintaining personalized records of information about medical care provided to insured persons;

4) technology for information exchange when maintaining personalized records in the field of compulsory health insurance.

2. The goals of personalized accounting in the field of compulsory health insurance are:

2) creating conditions for monitoring the use of compulsory health insurance funds;

3) determining the need for volumes of medical care in order to form basic and territorial compulsory health insurance programs.

II. Organization of personalized accounting

1) last name, first name, patronymic;

3) date of birth;

4) place of birth;

5) citizenship;

6) details of the identity document;

7) place of residence;

8) place of registration;

9) date of registration;

11) number of the compulsory health insurance policy of the insured person;

12) information about the medical insurance organization chosen by the insured person;

13) date of registration as an insured person;

14) status of the insured person (working, non-working);

15) information about the medical organization chosen by the insured person in accordance with the legislation of the Russian Federation to receive primary health care;
by order of the Ministry of Health of Russia dated January 15, 2019 N 12n)

16) information about the medical worker selected by the insured person in accordance with the legislation of the Russian Federation to receive primary health care.
(The subparagraph was additionally included on February 11, 2019 by order of the Russian Ministry of Health dated January 15, 2019 N 12n)

4. Personalized recording of information about medical care provided to insured persons includes the collection, processing, transfer and storage of the following information:

1) number of the compulsory health insurance policy of the insured person;

2) information about the medical organization that provided medical services;
by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

3) types of medical care provided;

4) conditions for providing medical care;

4_1) forms of medical care;
(The subparagraph was additionally included on February 11, 2019 by order of the Russian Ministry of Health dated January 15, 2019 N 12n)

5) timing of medical care;

6) volumes of medical care provided;

7) the cost of medical care provided;

8) diagnosis;

9) profile of medical care;

10) information about medical services services provided to the insured person and the medications used;
(Subparagraph as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

11) applied standards of medical care;
(Subparagraph as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

12) information about the medical worker or medical workers who provided medical services;
(Subparagraph as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

13) the result of seeking medical help;

14) the results of monitoring of the volumes, timing, quality and conditions of medical care.

III. Maintaining the regional segment of the unified register of insured persons

9. Information about each insured person specified in paragraph 3 of this Procedure is entered into the unified register of insured persons.

10. Maintaining the regional segment of the unified register of insured persons is carried out by the territorial fund on the basis of information about insured persons provided by an insurance medical organization, medical organization, tax authorities, military commissariats, as well as on the basis of information provided within the framework of interdepartmental interaction from other state information systems in in accordance with this Procedure.
by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

11. The insurance medical organization, medical organization and territorial fund, by orders, determine the employees allowed to work with the regional segment of the unified register of insured persons, and comply with the requirements of the legislation of the Russian Federation on the protection of personal data.
(Clause as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

1) for the presence of repetitions of last name, first name, patronymic, date and place of birth;

2) for the presence of repetitions according to the identity document data;

3) correct indication of the gender of the insured person;

4) for the presence of repetitions by date of birth and address of registration at the place of residence;

5) for the presence of repetitions of last name, first name and patronymic and registration address at the place of residence;

6) for the presence of repetitions according to the insurance number of the individual personal account (SNILS).

13. In order to update the regional segment of the unified register of insured persons and enter information about insured persons into it, the insurance medical organization generates and transmits information files with changes in information about insured persons provided for in subparagraphs 1-13 of paragraph 3 of this Procedure (hereinafter referred to as files with changes) , to the territorial fund as needed, but at least once a day if there are changes in information about the insured persons, in accordance with the agreement on financial support for compulsory health insurance.

In order to update information about the medical organization and medical worker selected by the insured person in accordance with the legislation of the Russian Federation to receive primary health care, the medical organization generates and transmits information files with changes in information about the insured persons provided for in subparagraphs 1, 3, 11, 15 and 16 of paragraph 3 of this Procedure, to medical insurance organizations and the territorial fund as necessary, but at least once a day if there are changes in information about the insured persons.

(Clause as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

14. The territorial fund provides round-the-clock reception and processing of files with changes received from insurance medical organizations and medical organizations.
(Clause as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

16. After processing files with changes in the territorial fund, files confirming and/or rejecting changes are generated, which are sent to the relevant insurance medical organizations and medical organizations to adjust information about insured persons.
(Clause as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

17. Tax authorities quarterly, no later than the 15th day of the second month following the reporting period, provided in accordance with the Agreement on information exchange between the Federal Compulsory Health Insurance Fund (hereinafter referred to as the Federal Fund) and the federal executive body authorized for control and supervision in the field of taxes and fees, to the relevant territorial fund, information about working insured persons, provided for in subparagraphs 1-10 and 14 of paragraph 3 of this Procedure, for entering them into the regional segment of the unified register of insured persons.
(Clause as amended, put into effect on February 14, 2017 by order of the Ministry of Health of Russia dated December 8, 2016 N 941n; as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

18. Military commissariats quarterly, no later than the 15th day of the month following the reporting period, transfer to the territorial funds information about citizens called up for military service, provided for in paragraphs 1 and 6 of part 2 of Article 44 of the Federal Law of November 29, 2010 N 326- Federal Law "On Compulsory Medical Insurance in the Russian Federation" (Collected Legislation of the Russian Federation, 2010, No. 49, Art. 6422; 2012, No. 31, Art. 4322, No. 49, Art. 6758; 2013, No. 48, Art. 6165; 2014, N 11, Art. 1098; 2015, N 51, Art. 7245; 2018, N 31, Art. 4857) (hereinafter referred to as the Federal Law “On Compulsory Health Insurance in the Russian Federation”), and information about the beginning, term and completion military service in accordance with Part 8 of Article 49 of the Federal Law "On Compulsory Health Insurance in the Russian Federation".
(Clause as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

19. Territorial fund:

1) as necessary, but at least once a day, checks the accuracy of information about the insured person received from the medical insurance organization by sending requests to the authorities that issue and replace identification documents of a citizen of the Russian Federation on the territory of the Russian Federation, and if inconsistencies are identified in the information about the insured person, sends information files to the medical insurance organization indicating them;

2) weekly on the basis of information on state registration of marriage or divorce, establishment of paternity, change of name contained in the Unified State Register of Civil Status Records, provided as part of interdepartmental interaction in accordance with (Collected Legislation of the Russian Federation, 1997, No. 47, Art. .5340; 2016, N 26, Art. 3888; 2018, N 31, Art. 4857, 4861, N 53, Art. 8454), identifies the insured person in the regional segment of the unified register of insured persons in order to determine the insurance medical organization, in with which it is insured, and in case of changes in information about the insured person, sends the specified information to the medical insurance organization to ensure control over changes in information about the identity document of the insured person, re-issuance of the compulsory health insurance policy and further sending of information files to the territorial fund for updating the regional segment unified register of insured persons within 30 days from the date of state registration of marriage or divorce, establishment of paternity, change of name;

3) monthly:

a) on the basis of information on state registration of death contained in the Unified State Register of Civil Status Records, provided as part of interdepartmental interaction in accordance with Article 13_2 of the Federal Law of November 15, 1997 N 143-FZ “On Civil Status Acts” (Meeting Legislation of the Russian Federation, 1997, No. 47, Article 5340; 2016, No. 26, Article 3888; 2018, No. 31, Article 4857, 4861, No. 53, Article 8454):

Terminates the compulsory health insurance policy for persons whose information is available in the regional segment of the unified register of insured persons;

Sends information files to the Federal Fund with information on state registration of death for persons whose information is not available in the regional segment of the unified register of insured persons;

b) makes a request to the Federal Fund to obtain information about persons whose information is available in the regional segment of the unified register of insured persons, but who died outside the territory of the subject of the Russian Federation in which he is insured;

c) on the basis of information received from the Federal Fund, recognizes the compulsory health insurance policy as invalid in the event of:

Termination of citizenship of the Russian Federation in the absence of grounds for recognizing a person as an insured person in accordance with Part 1 of Article 10 of the Federal Law “On Compulsory Health Insurance in the Russian Federation” - from the date of receipt of information in accordance with subparagraph 1 of paragraph 27_1 of this Procedure;

Cancellation of a residence permit in relation to foreign citizens, stateless persons - from the date of receipt of information in accordance with subparagraph 2 of paragraph 27_1 of this Procedure;

Cancellation of a temporary residence permit in relation to foreign citizens and stateless persons - from the date of receipt of information in accordance with subparagraph 3 of paragraph 27_1 of this Procedure;

Loss or deprivation of refugee status - from the date of receipt of information in accordance with subparagraph 4 of paragraph 27_1 of this Procedure;

4) quarterly:

a) based on information about the insured person provided for in paragraph 17 of this Procedure, within 15 working days from the date of receipt:

Updates the regional segment of the unified register of insured persons and sends information files with information about working insured persons to the Federal Fund;

Sends information files to the Federal Fund with information about working insured persons, information about which is not available in the regional segment of the unified register of insured persons;

b) no later than the 15th day of the third month following the reporting period, provides the policyholder for non-working citizens with information about insured persons who are registered as non-working insured persons, and information about which is provided for in subparagraphs 1-10, 14 of paragraph 3 of this Procedure, not provided in accordance with paragraph 17 of this Procedure;

c) on the basis of the information provided for in paragraph 18 of this Procedure, suspends the compulsory health insurance policy.
(Clause 19 as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

20. The territorial fund ensures the updating of the regional segment of the unified register of insured persons on the basis of information in accordance with subparagraphs 2-4 of clause 19 of this Procedure, notifies medical insurance organizations about this and sends information files to the Federal Fund for updating the central segment of the unified register of insured persons.
(Clause as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

22. In case of violation of the deadlines established by the agreement on financial support for compulsory medical insurance for the provision of data on insured persons, as well as information about changes in this data, the insurance medical organization is obliged to pay the territorial fund at its own expense a fine in the amount established by Part 10 of Article 38 of the Federal Law "On compulsory health insurance in the Russian Federation".
(Clause as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

23. The territorial fund exercises general control over the regional segment of the unified register of insured persons. If errors and inconsistencies are detected, the territorial fund sends the relevant information to the insurance medical organization and the medical organization indicating a list of inconsistencies.
(Clause as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

IV. Maintaining the central segment of the unified register of insured persons

25. The Federal Fund provides round-the-clock reception and processing of files with changes from territorial funds.

27. In the central segment of the unified register of insured persons, information files with information about the insured person are processed, including on the suspension of the compulsory health insurance policy, on the invalidation of the compulsory health insurance policy, on state registration of death, on the status of insured persons (working, unemployed), about medical organizations and medical workers chosen by the insured persons.
(Clause as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

27_1. The Federal Fund ensures the processing of information received from federal body executive power in the field of internal affairs, provided for in subparagraphs 1 and 6 of paragraph 3 of this Procedure:

1) about persons whose citizenship of the Russian Federation has been terminated;

2) about foreign citizens, stateless persons in respect of whom the residence permit has been canceled in accordance with (Collection of Legislation of the Russian Federation, 2002, N 30, Art. 3032; 2018, N 1, Art. 77, Art. 82, N 27 , Art. 3951, N 30, Art. 4537, Art. 4551);

3) about foreign citizens, stateless persons in respect of whom a temporary residence permit has been canceled in accordance with Federal Law of July 25, 2002 N 115-FZ “On the legal status of foreign citizens in the Russian Federation” (Collection of Legislation of the Russian Federation, 2002, N 30, art. 3032; 2018, N 1, art. 77, art. 82, N 27, art. 3951, N 30, art. 4537, art. 4551);

4) on persons recognized as refugees on the territory of the Russian Federation, if they lose their refugee status or are deprived of their refugee status in accordance with Federal Law of February 19, 1993 N 4528-1 “On Refugees” (Collection of Legislation of the Russian Federation, 1997, N 26, Art. 2956; 1998, N 30, Art. 3613; 2000, N 33, Art. 3348, N 46, Art. 4537; 2003, N 27, Art. 2700; 2004, N27, Art. 2711, N 35, Art. 3607; 2006, N 31, Art. 3420; 2007, N 1, Art. 29; 2008, N 30, Art. 3616; 2011, N 1, Art. 29, N 27, Art. 3880; 2012 , N 10, art. 1166, N 47, art. 6397, N 53, art. 7647; 2013, N 27, art. 3477; 2014, N 52, art. 7557; 2018, N 1, art. 82).
(Clause 27_1 was additionally included from February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n)

28. The Federal Fund maintains the central segment of the unified register of insured persons and provides general control over the updating and use of the unified register of insured persons.

29. The exchange of data between insurance medical organizations, medical organizations, territorial funds and the Federal Fund for the purpose of maintaining personalized records of information about insured persons provided for in paragraph 3 of this Procedure is carried out electronically via dedicated or open communication channels, including the Internet, using electronic digital signature in accordance with the requirements established by the legislation of the Russian Federation for the protection of personal data.
(Clause as amended, put into effect on February 11, 2019 by order of the Ministry of Health of Russia dated January 15, 2019 N 12n.

V. The procedure for maintaining personalized records of information about medical care provided to insured persons

32. Medical organizations provide information on medical care provided to insured persons, provided for in subparagraphs 1-13 of paragraph 4 of this Procedure, to the territorial fund.

34. At the stage of automated processing of information about personalized records of medical care provided to insured persons, the following is carried out in the territorial fund:

2) identification of insured persons who received medical care outside the insurance territory and determination of their insurance territory;

3) sending electronically the results obtained in accordance with subparagraphs 1 and 2 of this paragraph to the medical organization that provided medical care to the insured persons.

Revision of the document taking into account
changes and additions prepared
JSC "Kodeks"

February 5, 2020, Changes in legislation on criminal liability The government has submitted to the State Duma a bill to mitigate the punishment of pregnant women and women with children under three years of age for crimes of minor gravity. Order No. 196-r dated February 4, 2020

December 30, 2019, Domestic and inbound tourism The government has submitted bills to the State Duma on the introduction of a unified federal register of travel agents Orders of December 27, 2019 No. 3232-r, No. 3233-r. From January 2021, it is proposed to introduce a unified federal register of travel agents in the form of a subsystem of the information system “Unified Federal Register of Tour Operators”. The adoption and implementation of bills are aimed at increasing the protection of the interests of consumers of tourism services, creating a transparent and controlled market for travel agency activities.

December 26, 2019 The government has submitted to the State Duma a bill to improve the procedure for considering applications for state registration results of intellectual activity Order No. 3175-r dated December 25, 2019. The bill provides for the possibility of Rospatent carrying out activities related to the legal protection of the results of intellectual activity, directly or through an institution subordinate to it.

December 17, 2019, Domestic and inbound tourism The government has submitted to the State Duma a bill on improving the legal regulation of the activities of tour guides, guides-translators and instructors-guides Order of December 14, 2019 No. 3047-r. It is proposed to establish the main criteria for the certification of tour guides (guides), guides-translators and instructors-guides and requirements for their education, work experience, as well as the availability of professional knowledge and skills. The changes proposed by the bill are aimed at increasing the protection of the interests of consumers of tourism services, streamlining the activities of tour guides (guides), guides-translators, instructors-guides, ensuring the safety of tourists when passing high-risk tourist routes, and creating a transparent and controlled market for excursion services.

December 13, 2019, Higher, postgraduate and continuing education The government has submitted to the State Duma a bill on changing the procedure for training scientific and pedagogical personnel in graduate school Order of November 12, 2019 No. 2986-r. In particular, it is proposed that instead of federal state educational standards in the areas of training highly qualified personnel in graduate school, we establish federal government requirements to train highly qualified personnel in postgraduate programs and, as a result, cancel state accreditation of educational activities in postgraduate programs. The requirements for final certification for postgraduate programs are also being clarified.

December 12, 2019, National program “Digital Economy of the Russian Federation” The government has submitted to the State Duma a bill on conducting an experiment on the introduction of electronic personnel document management Order of December 11, 2019 No. 2976-r. It is proposed to conduct an experiment on conducting from April 1 to December 31, 2020 electronic documents, relating to labor relations with employees, in respect of which it is provided for registration in paper form or familiarization with the employee’s signature, without duplicating them on paper.

December 2, 2019 The government introduced a bill on biological safety to the State Duma Order of November 30, 2019 No. 2859-r. The adoption and implementation of the bill are aimed at protecting the population and protecting the environment from the effects of hazardous biological factors, preventing biological threats, and creating and developing a system for monitoring biological risks. This will ensure the maintenance of an acceptable level of risk of negative impacts of hazardous biological factors on the population and the environment, which is the main goal of state policy in the field of ensuring biological safety.

December 2, 2019, The government has submitted to the State Duma a bill on improving the mechanism of state and municipal control Order of November 30, 2019 No. 2861-r. The adoption of the bill will make it possible to create a systemic procedural regulation of control and supervisory activities aimed at minimizing administrative pressure on business entities.

December 2, 2019, System of state control and supervision The government has submitted to the State Duma a bill on mandatory requirements, compliance with which is subject to verification as part of control and supervisory activities Order of November 30, 2019 No. 2860-r. The adoption of the bill will make it possible to legislatively consolidate the basis for establishing and assessing the application of mandatory requirements contained in regulatory legal acts, and will help reduce administrative pressure on business entities.

November 27, 2019, Maternity capital The government has submitted to the State Duma a bill to expand the possibilities for using funds maternity capital Order No. 2799-r dated November 26, 2019. The bill proposes to extend the possibility of directing maternity capital funds for the construction or reconstruction of an individual housing construction on a garden plot.

November 19, 2019, Cultural heritage The government has submitted to the State Duma a bill on changes to legal regulation issues of preservation of historical and cultural monuments Order of November 16, 2019 No. 2712-r. The bill proposes to eliminate the redundancy of requirements for permits when carrying out work to preserve the site cultural heritage, included in a single State Register objects of cultural heritage of the peoples of the Russian Federation, as well as the identified object of cultural heritage.

November 6, 2019, Small and medium-sized enterprises The government has submitted to the State Duma a bill on changes in the legal regulation of the participation of “self-employed” citizens in the procurement of goods, works, and services Order No. 2594-r dated October 31, 2019. The bill proposes to extend the support measures provided for by law in relation to small and medium-sized businesses to “self-employed” citizens.

October 8, 2019, Family policy. Child protection and education The government has submitted to the State Duma a bill on changes in the legal regulation of issues of parental participation in additional costs for children Order of October 7, 2019 No. 2291-r. The adoption of the bill will ensure the protection of the housing rights of a minor child in the event of a parental divorce, including by involving a parent living separately from the child to participate in additional obligations related to providing the minor with housing.

October 8, 2019, Anti-corruption regulation The government has submitted to the State Duma a bill to approve standard additional professional programs to combat corruption Order of October 7, 2019 No. 2294-r. The bill is aimed at ensuring uniform approaches to additional professional education of state and municipal employees in the field of anti-corruption.

October 8, 2019, Nature Conservation. Nature reserves, national parks The government has submitted to the State Duma a bill on changes in the legal regulation of issues of conservation of hunting resources Order of October 7, 2019 No. 2295-r. The bill proposes to expand the range of subjects of law regulating the number of hunting resources in publicly accessible hunting grounds, and to grant the right to hunt in order to regulate the number of hunting resources to hunters, information about which is contained in the state hunting register.

October 8, 2019 , Housing and communal services The government has submitted to the State Duma a bill on changes in the legal regulation of management of apartment buildings Order of October 7, 2019 No. 2297-r. The bill proposes to establish that the management of apartment buildings, all premises in which are in federal, regional or municipal ownership, is carried out on the basis of an agreement concluded with managing organization, selected based on the results of an open competition. This will contribute to the development of a competitive environment in the multi-apartment building management market.

The government has submitted to the State Duma a bill on improving mechanisms for relocating citizens from dilapidated housing Order of October 7, 2019 No. 2292-r. Prepared in pursuance of the instructions of the President of Russia following a meeting with members of the Government on the issue of relocating citizens from emergency housing stock.

September 30, 2019, Federal Budget The government has submitted to the State Duma a bill on federal budget for 2020 and for the planning period 2021 and 2022 Order of September 30, 2019 No. 2211-r. Main characteristics of the draft budget: revenues in 2020 - 20379.4 billion rubles, in 2021 - 21246.5 billion rubles, in 2022 - 22058.3 billion rubles. Expenses in 2020 – 19,503.3 billion rubles, in 2021 – 20,634 billion rubles, in 2022 – 21,763.3 billion rubles. The surplus in 2020 is 876.1 billion rubles, in 2021 – 612.5 billion rubles, in 2022 – 295 billion rubles.

September 30, 2019, Social insurance The government has submitted to the State Duma a bill on insurance tariffs for compulsory social insurance against industrial accidents and occupational diseases for 2020 and for the planning period of 2021 and 2022 Order of September 30, 2019 No. 2215-r. 32 insurance rates for compulsory social insurance against industrial accidents and occupational diseases are maintained in accordance with the types economic activity by occupational risk classes. The benefit for the payment of insurance premiums for compulsory social insurance against accidents at work and occupational diseases is maintained. The adoption of the bill will make it possible to generate the revenue side of the budget of the Social Insurance Fund, which will ensure full payments for compulsory social insurance against accidents at work and occupational diseases in 2020 and the planning period of 2021 and 2022.

personalized accounting of services for mandatory

health insurance

annotation

The article is devoted to the analysis of the effectiveness of the system of personalized accounting of medical services provided under compulsory health insurance.

Key words: medical services, personalized accounting, insurance coverage, subject of personalized accounting, insured event, insurer

Until now, the main tasks of accounting in the compulsory medical insurance system have been the issues of operational data collection for accounting and statistical tasks, institutional activities and accounting, and ensuring mutual settlements between compulsory medical insurance participants. For these purposes, mainly two main sources of information are used - the base of the insured population (registration of service consumers) and the base of the “treated population” (record of services provided to the consumer).

In the compulsory health insurance system, it is necessary to create not only personalized records of medical services provided, but also information about the insurance coverage received by the insured person upon the occurrence of an insured event.

System of personalized accounting of medical services

Based on the goals and objectives of personalized accounting, there is also a need to consider the subjects of the personalized accounting system from the point of view of their influence

Krestyaninova Olga Gennadievna

Postgraduate student, Faculty of Finance, St. Petersburg State University of Service and Economics [email protected]

in system

Mandatory

Medical

Insurance

It is necessary to create \only personalized records of services rendered

medical services,

But also information

About insurance

provision,

received

When advancing

insured event

on guarantee insurance coverage for compulsory medical insurance, the insurer's costs and directly for personalized accounting. A citizen is a recipient of compulsory medical insurance coverage and, accordingly, a subject of personal data.

It should be noted that a citizen is endowed with significant rights. In particular, the right to independently demand medical services (for example, consultations with other specialists) or compensation for material damage caused by the fault of the insurance organization. We would like to add that the exercise of these rights can significantly influence the volume of insurance coverage under compulsory medical insurance and, accordingly, financial stability compulsory medical insurance systems, which may lead to a decrease in insurance coverage guarantees for other insured persons. Compulsory medical insurance coverage belongs to the individual. Data about him is personal and, accordingly, the recording of this data is personalized.

This information is necessary for insurance to ensure the implementation and protection of the rights and legitimate interests of the insured for health protection and free medical care in the compulsory medical insurance system.

Thus, the system of personalized accounting of medical services is a system of recording information about insured events and the amounts of insurance coverage received by each person insured in the compulsory health insurance system.

To successfully fulfill the tasks of compulsory medical insurance, this activity must be effective. This involves using up-to-date and reliable information about the medical care received by the insured. Based on the wide variety of medical services and their consumers, it is necessary to develop a special system for effectively recording these indicators. The consumer of these benefits is the link that allows systematizing the accounting of the medical care provided. This necessitates personalized accounting of medical services in compulsory medical insurance.

Principles of a personalized accounting system for medical services

In the current economic conditions, the system of personalized accounting of medical services should be based on the following principles:

1) unity of compulsory medical insurance in the Russian Federation;

2) the universality of compulsory health insurance and the obligation to record information about insured persons;

3) availability for each insured person of information about him that is available to the Compulsory Medical Insurance Funds that carry out personalized accounting;

4) use of information generated in the system of personalized accounting of medical services exclusively for the purposes of compulsory health insurance, and, above all, to exercise the rights of citizens to receive free medical care throughout the Russian Federation;

5) implementation of the functioning of a personalized accounting system throughout the entire period of insurance of a person. It should be noted that the procedure for providing specialized medical care requires a referral from the attending physician of a polyclinic or primary-level hospital. The problem is the lack of mandatory feedback. In addition, the patient receives a document about counseling and other medical services received in a specialized institution, and often does not inform the attending physician about this.

Thus, the rule of law, according to which the recommendations of consultants are implemented only in agreement with the attending physician, is not fulfilled. The only exceptions are emergency cases that threaten the patient's life. The situation is complicated by the fact that inconsistency and lack of continuity in the treatment of the patient, which arises due to the informational disunity between the two levels of medical care, entails unnecessary

Citizen is endowed

significant

In particular, the right to independently demand medical services... or compensation for material damage caused by the fault of the insurance organization

insurance

personification system

medical services is an accounting system

Information

insurance cases insurance amounts

Provisions,

Received

Every face

insured _in the system

mandatory

Medical

Insurance

new insurance costs and large accounting errors. Within the framework of current legislation, a solution to this problem is possible by sending personal data about the diagnosis and medical services received in a specialized institution from this institution directly to the attending physician providing primary health care. In this case, medical insurance organizations (hereinafter referred to as HMOs) and compulsory medical insurance funds receive complete, organized information about each insured event. The main work of insurers will be focused on improving links with primary health care institutions, which will simplify the solution of insurance problems.

Legal and information issues

The relationship of insurance medical organizations with medical institutions is regulated by an agreement for the provision of treatment and preventive care (medical servants) under compulsory medical insurance, which provides, among other things, for the health insurance company to control the information provided by the medical institution and transfer it to compulsory medical insurance funds. As part of its activities, the CMO uses the following information resources directly related to the system of personalized accounting of medical services:

1) updated data on the insured population;

2) information about compulsory medical insurance received from the TF and spent on paying for medical services financial means;

3) reporting and analytical information on the fulfillment of insurance obligations;

4) information characterizing the activities of medical institutions in providing medical care.

The relationship between territorial compulsory medical insurance funds and health insurance organizations is regulated by the contract on compulsory medical insurance financing and other regulatory legal acts governing the compulsory health insurance system. From the functions of TFOMS

We can highlight a number of functions related to the task of personalized accounting of medical services in the subject of the federation:

Maintaining a consolidated register of the population of a constituent entity of the Russian Federation insured under compulsory medical insurance;

Maintaining a consolidated personalized database of medical services provided;

Financing of health insurance according to differentiated per capita standards, taking into account the size of the insured population

Ensuring control over the activities of the CMO;

Ensuring mutual settlements between the Federal Compulsory Medical Insurance Fund of the subjects of the Federation for medical care (in the amount of basic compulsory medical insurance programs) provided to Russian citizens outside the insurance territory;

Calculation of insurance coverage standards and financing standards for the territorial compulsory medical insurance program for the population;

Solving issues of protecting the rights of the insured. The Federal Compulsory Medical Insurance Fund implements public policy in the field of compulsory health insurance of citizens.

Compulsory medical insurance and health insurance funds maintain databases of insured citizens, which they are required to keep up to date. When updating databases, information about insured citizens is exchanged between TFOMS and SMO, as well as other information carriers.

Personalized accounting as a multi-level system for collecting and processing information

Thus, the system of personalized accounting of medical services is a multi-level system of sequential collection and processing of information.

Level 1 - the attending physician who records all medical services provided to the patient by himself or at his direction by specialists from his institution or other specialized services and diagnostic centers. This is the only source of primary information in the system about the services provided to the patient. 2nd level - medical institution providing primary health care - formi-

promotion

efficiency

management

financial

streams

required in compulsory medical insurance

proper accounting

medical care,

provided

insured

insurance

provides complete information about primary and specialized medical care provided to patients insured under compulsory medical insurance who contacted him.

Level 3 - medical insurance organization - generates generalized information about medical services received by persons insured under the compulsory medical insurance of this health insurance company.

Level 4 - territorial compulsory medical insurance fund - generates generalized information about medical services received by persons insured under compulsory medical insurance in a constituent entity of the Russian Federation.

Level 5 - Federal Compulsory Medical Insurance Fund - generates generalized information about medical services received by persons insured under compulsory medical insurance in the Russian Federation, determines the procedure for creating an accounting and reporting system, as well as the procedure and conditions for maintaining databases and other information resources in the compulsory medical insurance system.

At the first and second levels, the generated information includes both personal data of patients and medical information (diagnoses and medical services). the remaining levels must be transferred for processing information containing information about the medical services provided and the identification number of the insured person to whom these services were provided. To carry out the functions of protecting the rights of the insured and to conduct a medical and economic examination of the quality of medical care provided, the insurer (CHI and CHI funds) personalizes the information necessary for these tasks based on identification number the insured, using our own databases of insured citizens.

Conclusion

Increasing the efficiency of financial flow management in compulsory medical insurance requires proper accounting of the medical care provided to the insured. Complete and reliable information about the actual medical services provided will allow for proactive forecasting of problem situations, promptly identifying cost-intensive centers, performing a multidimensional analysis of the need for medical care, etc.

Literature

1. Federal Law of November 29, 2010 No. 326-FZ “On Compulsory Health Insurance in the Russian Federation.”

2. Federal Law of July 27, 2006 No. 152-FZ “On Personal Data” (as amended on July 25, 2011).

3. Federal Law of November 21, 011 No. 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation.”

4. Order of the Federal Compulsory Medical Insurance Fund dated 04/07/20011 No. 79 “On approval of the general principles for the construction and operation of information systems and the procedure for information interaction in the field of compulsory health insurance” (as amended. Order of the FFOMS dated August 22, 2011 No. 154).

5. Order of the Ministry of Health and Social Development dated January 25, 2011 No. 29n “On approval of the procedure for maintaining personalized records in the field of compulsory health insurance.”

6. Information letter of the Ministry of Health and Social Development of Russia dated January 30, 2012 “To the heads of executive authorities of the constituent entities of the Russian Federation in the field of healthcare.”

Olga G. Krestyaninova

Postgraduate Student, Department of Finance and Credit, St Petersburg State University of Service and Economics

Personalized Registration of Compulsory Health Insurance Services

The article studies the effectiveness of the system of personified registration of medical services provided by the compulsory health insurance. Keywords: medical services, personified registration, insurance coverage, subject of personified registration, insurance case, insurer