RUSSIAN FEDERATION

THE FEDERAL LAW

ABOUT COMPULSORY HEALTH INSURANCE

IN RUSSIAN FEDERATION

State Duma

Federation Council

Chapter 1. GENERAL PROVISIONS

Article 1. Subject of regulation of this Federal Law

Real the federal law regulates relations arising in connection with the implementation of compulsory health insurance, including determining the legal status of subjects of compulsory health insurance and participants in compulsory health insurance, the grounds for the emergence of their rights and obligations, guarantees for their implementation, relations and responsibilities associated with the payment of insurance premiums for compulsory health insurance the unemployed population.

Article 2. Legal basis for compulsory health insurance

1. Legislation on obligatory honey health insurance is based on the constitution Russian Federation and consists of the Fundamentals of the legislation of the Russian Federation on the protection of the health of citizens, the Federal Law of July 16, 1999 N 165-FZ "On the Fundamentals of Compulsory Social Insurance", this Federal Law, other federal laws, laws of the constituent entities of the Russian Federation. Relations related to compulsory health insurance are also regulated by other regulatory legal acts of the Russian Federation, other regulatory legal acts of the constituent entities of the Russian Federation.

2. If an international treaty of the Russian Federation establishes other rules than those provided for by this Federal Law, the rules international treaty Russian Federation.

3. For the purposes of the uniform application of this Federal Law, appropriate explanations may be issued, if necessary, in the manner established by the Government of the Russian Federation.

Article 3. Basic concepts used in this Federal Law

For the purposes of this Federal Law, the following basic concepts are used:

1) compulsory health insurance - a type of compulsory social insurance, which is a system of legal, economic and organizational measures created by the state aimed at ensuring insured event guarantees of free provision of medical care to the insured person at the expense of compulsory medical insurance within the limits of the territorial program of compulsory medical insurance and in the cases established by this Federal Law within the framework of the basic program of compulsory medical insurance;

2) the object of compulsory medical insurance - the insurance risk associated with the occurrence of an insured event;

3) insured risk - an expected event, upon the occurrence of which it becomes necessary to incur expenses for payment of medical care provided to the insured person;

4) insured event - an event that has taken place (illness, injury, other state of health of the insured person, preventive measures), upon the occurrence of which the insured person is provided with insurance coverage for compulsory medical insurance;

5) insurance coverage for compulsory medical insurance (hereinafter - insurance coverage) - the fulfillment of obligations to provide the insured person with the necessary medical care in the event of an insured event and to pay for it to a medical organization;

6) insurance premiums for compulsory health insurance - mandatory payments that are paid by insurers, have an impersonal nature and the purpose of which is to ensure the rights of the insured person to receive insurance coverage;

7) the insured person - individual covered by compulsory medical insurance in accordance with this Federal Law;

8) the basic program of compulsory medical insurance is an integral part of the program state guarantees free provision of medical care to citizens, which determines the rights of insured persons to free provision of medical care at the expense of compulsory medical insurance throughout the Russian Federation and establishes uniform requirements for territorial programs of compulsory medical insurance;

9) territorial program of compulsory medical insurance - an integral part of the territorial program of state guarantees of free provision of medical care to citizens, which determines the rights of insured persons to free provision of medical care to them on the territory of a constituent entity of the Russian Federation and meets the uniform requirements of the basic program of compulsory medical insurance.

Article 4. Basic principles for the implementation of compulsory medical insurance

The main principles for the implementation of compulsory health insurance are:

1) ensuring, at the expense of compulsory health insurance funds, guarantees of free provision of medical care to the insured person in the event of an insured event within the framework of the territorial program of compulsory medical insurance and the basic program of compulsory medical insurance (hereinafter also referred to as the compulsory medical insurance program);

2) stability financial system compulsory medical insurance, provided on the basis of the equivalence of insurance coverage to the means of compulsory medical insurance;

3) obligatory payment by insurers of insurance premiums for compulsory medical insurance in the amounts established by federal laws;

4) state guarantee of observance of the rights of insured persons to fulfill their obligations under compulsory health insurance within the framework of the basic program of compulsory health insurance, regardless of financial position insurer;

5) creation of conditions for ensuring the availability and quality of medical care provided within the framework of compulsory health insurance programs;

6) parity of representation of subjects of compulsory medical insurance and participants of compulsory medical insurance in the management bodies of compulsory medical insurance.

Chapter 2. POWERS OF THE RUSSIAN FEDERATION

AND SUBJECTS OF THE RUSSIAN FEDERATION IN THE SPHERE OF MANDATORY

HEALTH INSURANCE

Article 5. Powers of the Russian Federation in the field of compulsory medical insurance

The powers of the Russian Federation in the field of compulsory medical insurance include:

1) development and implementation of state policy in the field of compulsory health insurance;

2) organization of compulsory medical insurance on the territory of the Russian Federation;

3) establishment of the circle of persons subject to compulsory medical insurance;

4) establishment of tariffs for insurance premiums for compulsory medical insurance and the procedure for collecting insurance premiums for compulsory medical insurance;

5) approval of the basic program of compulsory medical insurance and uniform requirements for territorial programs of compulsory medical insurance;

6) establishing the procedure for distribution, provision and spending of subventions from the budget of the Federal Compulsory Medical Insurance Fund to the budgets of territorial compulsory medical insurance funds;

7) establishment of responsibility of subjects of compulsory medical insurance and participants of compulsory medical insurance for violation of the legislation on compulsory medical insurance;

8) organization of management of funds of compulsory medical insurance;

9) definition of general principles of organization information systems And information exchange in the field of compulsory medical insurance, maintaining personalized records of information about insured persons and personalized records of information about medical care provided to insured persons;

10) establishment of a system for protecting the rights of insured persons in the field of compulsory medical insurance.

Article 6

1. The powers of the Russian Federation in the field of compulsory medical insurance, transferred for implementation to the state authorities of the constituent entities of the Russian Federation, include the organization of compulsory medical insurance in the territories of the constituent entities of the Russian Federation in accordance with the requirements established by this Federal Law, including:

1) approval of territorial programs of compulsory medical insurance that meet the uniform requirements of the basic program of compulsory medical insurance, and the implementation of the basic program of compulsory medical insurance in the territories of the constituent entities of the Russian Federation within and at the expense of subventions provided from the budget of the Federal Compulsory Medical Insurance Fund to the budgets of territorial compulsory medical insurance funds insurance;

2) approval of differentiated per capita standards for the financial provision of compulsory medical insurance (hereinafter referred to as differentiated per capita standards) in the territories of the constituent entities of the Russian Federation in accordance with the rules for compulsory medical insurance approved by the federal executive body authorized by the Government of the Russian Federation (hereinafter referred to as the rules for compulsory medical insurance), for insurance medical organizations;

3) registration and deregistration of insurers for non-working citizens;

4) administration of budget revenues of the Federal Compulsory Medical Insurance Fund coming from the payment of insurance premiums for compulsory medical insurance of the non-working population in the territories of the constituent entities of the Russian Federation;

5) control over the use of compulsory medical insurance funds in the territories of the constituent entities of the Russian Federation, including the conduct of inspections and audits;

6) making payments for medical care provided to insured persons outside the constituent entity of the Russian Federation, on the territory of which a compulsory medical insurance policy was issued (hereinafter also referred to as insurance medical policy), in accordance with the uniform requirements of the basic program of compulsory medical insurance;

7) ensuring the rights of citizens in the field of compulsory medical insurance in the territories of the constituent entities of the Russian Federation;

8) maintaining a personalized record of information about insured persons in the form regional segment unified register insured persons, as well as personalized accounting of information about medical care provided to insured persons;

9) keeping records in the field of compulsory health insurance.

2. Financial support for the expenditure obligations of the constituent entities of the Russian Federation arising from the exercise of the powers delegated in accordance with Part 1 of this Article shall be carried out at the expense of subventions provided from the budget of the Federal Compulsory Medical Insurance Fund to the budgets of the territorial compulsory medical insurance funds.

3. The highest official of a constituent entity of the Russian Federation (head of the highest executive body of state power of a constituent entity of the Russian Federation) in the exercise of the powers delegated in accordance with part 1 of this article:

1) organize activities for the implementation of delegated powers in accordance with federal laws and other regulatory legal acts of the Russian Federation;

2) provides in in due course:

a) making a decision to create, in the absence of a non-profit organization in the territory of a constituent entity of the Russian Federation - a territorial fund for compulsory medical insurance (hereinafter - territorial fund);

b) approval of the management structure of the territorial fund in agreement with the Federal Compulsory Medical Insurance Fund (hereinafter - the Federal Fund);

c) appointment and dismissal of the head of the territorial fund in agreement with the Federal Fund;

3) ensure, in accordance with the established procedure, timely submission to the federal executive body authorized by the Government of the Russian Federation (hereinafter referred to as the authorized federal executive body) and the Federal Fund:

a) reporting on the implementation of delegated powers, on spending the granted subventions, on achieving target forecast indicators (if such indicators are established) in the prescribed form;

b) normative legal acts adopted by the state authorities of the constituent entities of the Russian Federation for the implementation of delegated powers, within three days after the date of their adoption;

c) information (including databases) necessary for maintaining a unified register of insured persons;

d) information on forecast indicators for the implementation of delegated powers in the prescribed form;

e) other information provided for by this Federal Law and (or) other regulatory legal acts of the Russian Federation adopted in accordance with it.

4. Control over the use of compulsory medical insurance funds that ensure the exercise of the powers transferred in accordance with Part 1 of this Article is carried out by the Federal Fund, the federal executive body exercising control and supervision in the financial and budgetary sphere, the Accounts Chamber of the Russian Federation.

Article 7

1. The authorized federal executive body shall exercise the following rights and obligations to exercise the powers delegated in accordance with Part 1 of Article 6 of this Federal Law:

1) issue normative legal acts and guidelines on the implementation by state authorities of the constituent entities of the Russian Federation of the delegated powers;

2) supervises legal regulation carried out by state authorities of the constituent entities of the Russian Federation on issues of delegated powers, with the right to send binding orders for the abolition of regulatory legal acts or for the introduction of amendments to them;

3) exercises control and supervision over the completeness and quality of the exercise by state authorities of the constituent entities of the Russian Federation of the delegated powers with the right to conduct inspections and issue binding instructions:

a) on the elimination of identified violations;

b) on bringing to responsibility established by the legislation of the Russian Federation officials of state authorities of the constituent entities of the Russian Federation and territorial funds;

4) prepares and sends to the highest official of a constituent entity of the Russian Federation (head of the supreme executive body of state power of a constituent entity of the Russian Federation) proposals for the removal from office of officials of state authorities of constituent entities of the Russian Federation and territorial funds;

5) have the right to establish target forecast indicators for the implementation of delegated powers;

6) approves the rules of compulsory medical insurance, including the methodology for calculating tariffs for paying for medical care and the procedure for paying for medical care under compulsory medical insurance;

7) determine the procedure for maintaining personalized records in the field of compulsory medical insurance;

8) prepares and sends to the Government of the Russian Federation proposals on the withdrawal of relevant powers from state authorities of the constituent entities of the Russian Federation in the manner established by the Government of the Russian Federation;

9) establishes the procedure for reimbursement of subventions provided from the budget of the Federal Fund to the budgets of territorial funds for the exercise of the relevant powers;

10) exercise other powers established by this Federal Law and other federal laws.

2. The Federal Fund shall exercise the following rights and obligations to exercise the powers delegated in accordance with Part 1 of Article 6 of this Federal Law:

1) issue normative legal acts and guidelines for the implementation of the delegated powers by territorial funds;

2) provides subventions from the budget of the Federal Fund to the budgets of territorial funds for financial support for the exercise of powers delegated in accordance with Part 1 of Article 6 of this Federal Law;

3) exercise control over the payment of insurance premiums for compulsory health insurance of the non-working population, including conducting an audit of the activities of territorial funds to perform the functions of the administrator of the budget revenues of the Federal Fund coming from the payment of insurance premiums for compulsory health insurance of the non-working population, have the right to accrue and collect from insurers for non-working citizens, arrears on the specified insurance premiums, penalties and fines;

4) establishes the forms of reporting in the field of compulsory medical insurance and the procedure for its maintenance;

5) establishes the procedure for monitoring the volumes, terms, quality and conditions for the provision of medical care under compulsory health insurance to insured persons (hereinafter also - control of the volumes, terms, quality and conditions for the provision of medical care);

6) exercise control over compliance with the legislation on compulsory medical insurance and the use of compulsory medical insurance funds, including conduct inspections and audits;

7) exercise control over the functioning of information systems and the procedure for information interaction in the field of compulsory health insurance;

8) coordinate the structure of territorial funds, the appointment and dismissal of the heads of territorial funds, as well as the standards of expenses for ensuring the performance of their functions by territorial funds.

Article 8

The powers of state authorities of the constituent entities of the Russian Federation in the field of compulsory medical insurance include:

1) payment of insurance premiums for compulsory medical insurance of the non-working population;

2) establishment in the territorial programs of compulsory medical insurance of additional volumes of insurance coverage for insured events established by the basic program of compulsory medical insurance, as well as additional species and conditions for the provision of medical care not established by the basic program of compulsory medical insurance;

3) financial support and implementation of territorial programs of compulsory medical insurance in an amount exceeding the amount of subventions provided from the budget of the Federal Fund to the budgets of territorial funds;

4) approval of the budgets of territorial funds and reports on their implementation.

Chapter 3. SUBJECTS OF COMPULSORY HEALTH INSURANCE

AND PARTICIPANTS OF MANDATORY HEALTH INSURANCE

Article 9. Subjects of compulsory medical insurance and participants in compulsory medical insurance

1. Subjects of compulsory medical insurance are:

1) insured persons;

2) policyholders;

3) Federal fund.

2. Participants of compulsory medical insurance are:

1) territorial funds;

2) insurance medical organizations;

3) medical organizations.

Article 10. Insured persons

The insured persons are citizens of the Russian Federation, foreign citizens permanently or temporarily residing in the Russian Federation, stateless persons (with the exception of highly qualified specialists and members of their families in accordance with the Federal Law of July 25, 2002 N 115-FZ "On the legal status foreign citizens in the Russian Federation"), as well as persons entitled to medical care in accordance with the Federal Law "On Refugees":

1) working under an employment contract or a civil law contract, the subject of which is the performance of work, the provision of services, as well as under an author's order agreement or a license agreement;

2) self-employed ( individual entrepreneurs involved in private practice notaries, lawyers);

3) who are members of peasant (farm) holdings;

4) who are members of family (tribal) communities of indigenous peoples of the North, Siberia and Far East Russian Federation, living in the regions of the North, Siberia and the Far East of the Russian Federation, engaged in traditional economic sectors;

5) non-working citizens:

a) children from the date of birth until they reach the age of 18;

b) non-working pensioners, regardless of the basis for assigning a pension;

c) citizens studying full-time in educational institutions primary vocational, secondary vocational and higher vocational education;

d) unemployed citizens registered in accordance with the employment legislation;

e) one of the parents or guardian who takes care of the child until the child reaches the age of three years;

f) able-bodied citizens engaged in caring for disabled children, disabled people of group I, persons who have reached the age of 80 years;

g) other citizens not working under an employment contract and not specified in subparagraphs "a" - "e" of this paragraph, with the exception of military personnel and persons equivalent to them in the organization of medical care.

Article 11. Policyholders

1. The insurers for working citizens specified in paragraphs 1 - 4 of Article 10 of this Federal Law are:

1) persons making payments and other remuneration to individuals:

a) organizations;

b) individual entrepreneurs;

c) individuals who are not recognized as individual entrepreneurs;

2) individual entrepreneurs engaged in private practice, notaries, lawyers.

2. Insurers for non-working citizens specified in paragraph 5 of Article 10 of this Federal Law are the executive authorities of the constituent entities of the Russian Federation authorized by the highest executive authorities of the constituent entities of the Russian Federation. These insurers are payers of insurance premiums for compulsory medical insurance of the non-working population.

Article 12. Insurer

1. The insurer for compulsory medical insurance is the Federal Fund as part of the implementation of the basic program of compulsory medical insurance.

2. The Federal Fund is a non-profit organization established by the Russian Federation in accordance with this Federal Law to implement the state policy in the field of compulsory medical insurance.

Article 13. Territorial funds

1. Territorial funds - non-profit organizations created by the constituent entities of the Russian Federation in accordance with this Federal Law for the implementation of state policy in the field of compulsory medical insurance in the territories of the constituent entities of the Russian Federation.

2. Territorial funds exercise certain powers of the insurer in terms of the implementation of territorial programs of compulsory medical insurance within the framework of the basic program of compulsory medical insurance in accordance with this Federal Law.

3. Territorial funds exercise the powers of the insurer in terms of the additional volumes of insurance coverage established by the territorial programs of compulsory medical insurance for insured events established by the basic program of compulsory medical insurance, as well as additional grounds, lists of insured events, types and conditions for the provision of medical care in addition to the established basic compulsory health insurance program.

4. To exercise the powers established by this Federal Law, territorial funds may create branches and representative offices.

Article 14. Insurance medical organization carrying out activities in the field of compulsory medical insurance

1. An insurance medical organization carrying out activities in the field of compulsory medical insurance (hereinafter referred to as an insurance medical organization), - insurance organization having a license issued by the federal executive body exercising the functions of control and supervision in the field of insurance activities. Features of licensing the activities of insurance medical organizations are determined by the Government of the Russian Federation. The insurance medical organization exercises certain powers of the insurer in accordance with this Federal Law and the agreement on the financial support of compulsory medical insurance concluded between the territorial fund and the insurance medical organization(hereinafter referred to as the agreement on the financial provision of compulsory medical insurance).

2. The composition of the founders (participants, shareholders) and management bodies of the insurance medical organization is not entitled to include employees federal bodies executive authorities in the field of healthcare, executive authorities of the constituent entities of the Russian Federation in the field of healthcare, local governments authorized to manage the healthcare sector, the Federal Fund and territorial funds, medical organizations providing medical care under compulsory medical insurance.

3. Insurance medical organizations are not entitled to carry out other activities, except for the activities of compulsory and voluntary medical insurance, activities.

4. Medical insurance organizations keep separate records of operations with compulsory medical insurance funds and voluntary medical insurance funds, taking into account the specifics established by the regulatory legal acts of the federal executive body that performs the functions of legal regulation in the field of insurance activities, and the Federal Fund.

5. Insurance medical organizations keep separate records own funds and means of compulsory health insurance intended to pay for medical care.

Article 50

1. In the period 2011 - 2012, in order to improve the quality and accessibility of medical care provided to insured persons, the implementation of regional programs for the modernization of healthcare of the constituent entities of the Russian Federation and programs for the modernization of federal state institutions providing medical care (hereinafter also - programs for the modernization of healthcare) is being carried out.

2. Financial provision of regional programs for the modernization of health care of the constituent entities of the Russian Federation is carried out at the expense of income received by the budget of the Federal Fund from the funds of insurance premiums for compulsory medical insurance in the amount of two percentage points in accordance with Federal Law of July 24, 2009 N 212-FZ "On insurance premiums in Pension Fund of the Russian Federation, the Social Insurance Fund of the Russian Federation, the Federal Compulsory Medical Insurance Fund and the Territorial Funds of Compulsory Medical Insurance", funds from the budgets of the constituent entities of the Russian Federation and the budgets of territorial funds.

3. The funds provided in the budget of the Federal 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) strengthening the material and technical base of state and municipal healthcare institutions, including ensuring the completion of the construction of previously started facilities (the technical readiness of these facilities as of January 1, 2011 should be at least 80 percent of the costs actually incurred by the developer of the estimated cost of building the facility), current And overhaul state and municipal health care institutions, purchase of medical equipment;

2) the introduction of modern information systems in healthcare in order to switch to policies of compulsory medical insurance 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) introduction of standards of medical care, increasing the availability of outpatient medical care, including that provided by medical specialists.

4. The regional healthcare modernization program of a constituent entity of the Russian Federation includes a passport of the healthcare system of a constituent entity of the Russian Federation, a list and cost of measures aimed at achieving the goals specified in Part 3 of this Article, target values ​​​​of indicators for the implementation of the healthcare modernization program, as well as indicators for the implementation of measures of the specified programs.

5. The executive authorities of the constituent entities of the Russian Federation shall be responsible in accordance with the legislation of the Russian Federation for the reasonableness of the cost of measures established by the regional programs for the modernization of healthcare of the constituent entities of the Russian Federation.

6. The funds provided in the budget of the Federal Fund for the financial support of regional programs for the modernization of health care of the constituent entities of the Russian Federation are provided from the budget of the Federal Fund to the budgets of territorial funds in the form of subsidies. From the budgets of territorial funds, these funds are provided:

1) to the budget of a constituent entity of the Russian Federation in the form of other interbudgetary transfers for the purposes established by clauses 1 and 2 of part 3 of this article, for subsequent use by state and municipal health care institutions participating in the implementation of territorial programs of compulsory medical insurance within the framework of the basic program of compulsory medical insurance;

2) to insurance medical organizations for the purposes established by clause 3 of part 3 of this article, for subsequent provision to medical organizations participating in the implementation of territorial programs of compulsory medical insurance within the framework of the basic program of compulsory medical insurance.

7. The funds provided in the budget of the Federal Fund for the financial support of regional programs for the modernization of healthcare in the constituent entities of the Russian Federation are provided and spent in the manner established by the Government of the Russian Federation. In order to provide financial support for regional programs for the modernization of healthcare in the constituent entities of the Russian Federation, agreements are concluded between the highest executive bodies of state power of the constituent entities of the Russian Federation with the authorized federal executive body and the Federal Fund in the manner determined by the authorized federal executive body.

8. The procedure for implementing measures to increase the availability of outpatient medical care, including that provided by medical specialists, is established by the Government of the Russian Federation.

9. Funds for the financial support of regional healthcare modernization programs of the subjects of the Russian Federation are provided by the Federal Fund in 2011 and 2012, provided that the budgets of the constituent entities of the Russian Federation establish health care costs in the amount not less than the actual health care costs in 2010 (with the exception of expenses incurred at the expense of earmarked funds provided from the federal budget) and the existence of concluded agreements provided for by part 7 of this article.

10. The balance of funds as of January 1, 2012, formed in the budgets of territorial funds as a result of incomplete use in 2011 of funds for the financial support of regional healthcare modernization programs of the subjects of the Russian Federation, shall be directed to the purposes specified in part 3 of this article in 2012. The balance of funds as of January 1, 2013, formed in the budgets of territorial funds as a result of incomplete use in 2012 of funds for the financial support of regional healthcare modernization programs of the subjects of the Russian Federation, are directed to the purposes specified in part 3 of this article in 2013.

11. The balance of funds as of January 1, 2012, formed in the budget of the Federal Fund as a result of incomplete use in 2011 of funds for the financial support of regional programs for the modernization of healthcare in the constituent entities of the Russian Federation, will be allocated for the same purposes in 2012. The balance of funds as of January 1, 2013, formed in the budget of the Federal Fund as a result of incomplete use in 2011 and 2012 of funds for the financial support of regional healthcare modernization programs of the subjects of the Russian Federation, are used to increase the normalized safety stock Federal Fund in 2013.

12. The authorized federal executive body develops and approves programs for the modernization of federal state institutions that provide medical care and the powers of the owner of which are exercised by the federal executive body that carries out the functions of developing state policy and legal regulation in the field of healthcare, and subordinate federal executive authorities, for the purposes established by paragraphs 1 (in relation to state healthcare institutions) and 2 of part 3 of this article. Financial support for the implementation of programs for the modernization of federal state institutions providing medical care is carried out by sending the Federal Fund to federal budget intergovernmental transfers to increase budget appropriations provided for by the federal executive body implementing public policy in the field of healthcare, and subordinate federal executive bodies, to provide budgetary allocations to federal state institutions providing medical care subordinate to them, for financial support for the implementation of programs for the modernization of federal state institutions providing medical care.

13. The procedure and form for reporting on the implementation of activities of healthcare modernization programs are established by the authorized federal executive body, the procedure and form for reporting on the use of funds for the purposes specified in parts 1 and 12 of this article are established by the Federal Fund.

14. Control over the use of funds provided for the financial support of healthcare modernization programs is carried out by the Federal Fund, the federal executive body exercising control and supervision in the financial and budgetary sphere, the Accounts Chamber of the Russian Federation.

15. Control over the implementation of activities of healthcare modernization programs is carried out by the authorized federal executive body and the Federal Fund.

Article 51. Final provisions

1. Persons insured under compulsory medical insurance prior to the date of entry into force of this Federal Law shall have the rights of insured persons in accordance with this Federal Law.

2. Policies of compulsory medical insurance issued to persons insured under compulsory medical insurance prior to the date of entry into force of this Federal Law shall be valid until they are replaced by compulsory medical insurance policies of a single sample in accordance with this Federal Law. From May 1, 2011 until the introduction in the territories of the constituent entities of the Russian Federation of universal electronic cards Mandatory medical insurance policies are prepared by the Federal Fund, and they are issued to insured persons in accordance with the procedure established by the rules of compulsory medical insurance. Until May 1, 2011, the issuance of compulsory medical insurance policies is carried out in accordance with the regulatory legal acts governing the issuance of compulsory medical insurance policies and in force until the day this Federal Law enters into force.

1) in terms of the basic program of compulsory medical insurance, includes expenses determined by the Program of state guarantees for the provision of free medical care to citizens of the Russian Federation, approved by the Government of the Russian Federation;

2) in terms of territorial programs of compulsory medical insurance, it may include a part of the costs of wages, accruals for payments on wages (in terms of other payments), expenses for payment for communication services, transport and utilities, works and services for the maintenance of property, expenses for rent for the use of property, payment for software and other services, social security for employees of medical organizations established by the legislation of the Russian Federation, other expenses, expenses for the purchase of equipment worth up to one hundred thousand rubles per unit.

4. From January 1, 2011 to December 31, 2012, the territorial program of compulsory medical insurance in the constituent entities of the Russian Federation may include the provision of medical care for certain diseases and health conditions not included in the basic program of compulsory medical insurance, without complying with the condition for compliance with the standards, established by the basic program of compulsory medical insurance, while maintaining the volume of financial support of the territorial program of compulsory medical insurance not lower than the level of 2010, including within the framework of the basic program of compulsory medical insurance. Additional grounds, types and conditions for the provision of medical care, a list of insured events, as well as the volumes of insurance coverage associated with them are approved by the territorial program of compulsory medical insurance separately from the established grounds, types, conditions for the provision of medical care, the list of insured events, the volumes of the corresponding insurance coverage of the basic program compulsory health insurance.

5. Financial support for emergency medical care (with the exception of specialized (sanitary and aviation) emergency medical care) is carried out at the expense of compulsory medical insurance from January 1, 2013. The procedure for the transfer of budget appropriations of budgets budget system of the Russian Federation to the budgets of compulsory medical insurance funds for the financial support of emergency medical care (with the exception of specialized (sanitary and aviation) emergency medical care) is established by a federal law that determines the rate of insurance premium for compulsory medical insurance of the non-working population.

6. Financial provision of high-tech medical care is carried out at the expense of compulsory medical insurance from January 1, 2015.

7. In the period 2012 - 2014, the amount of insurance premiums for compulsory medical insurance of the non-working population in a constituent entity of the Russian Federation is determined in the following order:

1) in 2012, the amount of insurance premiums for compulsory health insurance of the non-working population cannot be less than the actual amount of insurance premiums for compulsory health insurance of the non-working population in 2010 and 25 percent of the difference between the amount of insurance premiums for compulsory health insurance of the non-working population, calculated in accordance with Part 2 of Article 23 of this Federal Law, and the actual amount of insurance premiums for compulsory medical insurance of the non-working population in 2010;

2) in 2013, the amount of insurance premiums for compulsory health insurance of the non-working population cannot be less than the actual amount of insurance premiums for compulsory health insurance of the non-working population in 2010 and 50 percent of the difference between the amount of insurance premiums for compulsory health insurance of the non-working population, calculated in accordance with Part 2 of Article 23 of this Federal Law, and the actual amount of insurance premiums for compulsory medical insurance of the non-working population in 2010;

3) in 2014, the amount of insurance premiums for compulsory health insurance of the non-working population cannot be less than the actual amount of insurance premiums for compulsory health insurance of the non-working population in 2010 and 75 percent of the difference between the amount of insurance premiums for compulsory health insurance of the non-working population, calculated in accordance with Part 2 of Article 23 of this Federal Law, and the actual amount of insurance premiums for compulsory medical insurance of the non-working population in 2010;

4) in 2012 - 2014, the rate of insurance premiums for compulsory medical insurance of the non-working population in accordance with Part 2 of Article 23 of this Federal Law is established taking into account the transferable expenses of the consolidated budget of the constituent entity of the Russian Federation to be included in the territorial program of compulsory medical insurance as part of the basic program compulsory medical insurance, expenses of the budget of the constituent entity of the Russian Federation for the maintenance of medical organizations in accordance with Part 7 of Article 35 of this Federal Law and expenses for the financial support of emergency medical care.

8. In 2012, the amount of subventions from the budget of the Federal Fund to the budget of the territorial fund is calculated as the sum of insurance premiums for compulsory health insurance of the non-working population of the corresponding subject of the Russian Federation, insurance premiums for compulsory health insurance of the working population, calculated on the territory of the corresponding subject of the Russian Federation at a rate of two percent , and the amount of subsidies provided for in the budget of the Federal Fund of the corresponding subject of the Russian Federation for 2011.

9. Federal property assigned to territorial funds on the basis of operational management prior to the day this Federal Law enters into force shall be transferred to the ownership of the relevant constituent entities of the Russian Federation before July 1, 2011 and used by territorial funds on the basis of operational management.

10. In 2011, the amount of budget allocations for financial support for the implementation of the basic program of compulsory medical insurance, established by the law on the budget of the relevant constituent entity of the Russian Federation, must be no less than the amount of insurance premiums for compulsory medical insurance of the non-working population and interbudgetary transfers from the budget of the constituent entity of the Russian Federation to the budget territorial funds established by the law on the budget of the corresponding subject of the Russian Federation for 2010.

11. In 2011:

1) payment of insurance premiums for compulsory medical insurance of the non-working population is carried out by insurers by transferring the amount of the monthly mandatory payment to the budgets of territorial funds;

2) insurers for non-working citizens are required to keep records of funds transferred for compulsory medical insurance of the non-working population to territorial funds;

3) the amounts of accrued arrears on contributions, tax payments, accrued penalties and fines are subject to payment to the budgets of territorial funds in accordance with the legislation of the Russian Federation;

4) insurers for non-working citizens independently accrue penalties for the entire amount of arrears for the period of delay and reflect it in the form of calculation of accrued and paid insurance premiums for compulsory health insurance of the non-working population, approved by the authorized federal executive body;

5) funds from the budget of the Federal Fund for financial support for the implementation of territorial programs of compulsory medical insurance within the framework of the basic program of compulsory medical insurance are provided in the form of subsidies in the amount established by the federal law on the budget of the Federal Fund for the next financial year and for the planning period.

12. From 2011, the amount of budget allocations for the payment of insurance premiums for compulsory health insurance of the non-working population should include full financial support for the types of medical care and items of expenditure included in the tariff for paying for medical care in accordance with the basic program of compulsory medical insurance for the corresponding year, previously financed from the consolidated budget of the constituent entity of the Russian Federation.

13. Until the date of entry into force of the federal law on state social funds legal status:

1) of the Federal Fund is determined by the Charter of the Federal Compulsory Medical Insurance Fund valid until the date of entry into force of the said federal law;

2) the territorial fund is determined by the regulation on the territorial fund, adopted in accordance with the model regulation on the territorial fund, approved by the authorized federal executive body, and valid until the day the said federal law enters into force.

14. In 2011, the conclusion of contracts of territorial funds with insurance medical organizations and their execution are carried out in accordance with the rules of compulsory medical insurance.

Article 52

Recognize as invalid from the date of entry into force of this Federal Law:

1) Law of the Russian Federation of June 28, 1991 N 1499-1 "On the health insurance of citizens in the Russian Federation" (Bulletin of the Congress of People's Deputies of the RSFSR and the Supreme Council of the RSFSR, 1991, N 27, art. 920);

2) Decree of the Supreme Council of the RSFSR of June 28, 1991 N 1500-1 "On the procedure for enacting the Law of the RSFSR "On medical insurance of citizens in the RSFSR" (Bulletin of the Congress of People's Deputies of the RSFSR and the Supreme Council of the RSFSR, 1991, N 27, art. 921 );

3) Decree of the Supreme Council of the Russian Federation of February 24, 1993 N 4543-1 "On the procedure for financing compulsory medical insurance of citizens for 1993" (Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation, 1993, N 17, art. 591) ;

4) Law of the Russian Federation of April 2, 1993 N 4741-1 "On Amendments and Additions to the Law of the RSFSR "On Medical Insurance of Citizens in the RSFSR" (Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation, 1993, N 17, Art. .602);

5) Decree of the Supreme Council of the Russian Federation of April 2, 1993 N 4742-1 "On the reconsideration of the Law of the Russian Federation "On the introduction of amendments and additions to the Law of the RSFSR "On medical insurance of citizens in the RSFSR" (Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Council Russian Federation, 1993, N 17, item 604);

6) Decree of the Supreme Council of the Russian Federation of April 2, 1993 N 4743-1 "On the procedure for enacting the Law of the Russian Federation" On introducing amendments and additions to the Law of the RSFSR "On medical insurance of citizens in the RSFSR" (Bulletin of the Congress of People's Deputies of the Russian Federation and Supreme Council of the Russian Federation, 1993, N 17, item 603);

7) Article 1 of the Federal Law of December 23, 2003 N 185-FZ "On Amendments to legislative acts Russian Federation in terms of improving the procedures for state registration and registration legal entities and individual entrepreneurs" (Sobraniye zakonodatelstva Rossiyskoy Federatsii, 2003, N 52, art. 5037);

8) Article 5 of the Federal Law of July 27, 2006 N 137-FZ "On Amendments to Part One and Part Two tax code of the Russian Federation and to certain legislative acts of the Russian Federation in connection with the implementation of measures to improve tax administration" (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2006, No. 31, Art. 3436);

9) Article 1 of the Federal Law of December 29, 2006 N 258-FZ "On Amendments to Certain Legislative Acts of the Russian Federation in Connection with the Improvement of the Separation of Powers" (Collected Legislation of the Russian Federation, 2007, N 1, Article 21);

10) Article 4 of the Federal Law of July 23, 2008 N 160-FZ "On Amendments to Certain Legislative Acts of the Russian Federation in Connection with Improving the Exercise of the Powers of the Government of the Russian Federation" (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2008, N 30, Art. 3616) ;

11) Article 1 of the Federal Law of July 18, 2009 N 185-FZ "On Amending Articles 2 and 9.1 of the Law of the Russian Federation "On Health Insurance of Citizens in the Russian Federation" and Article 11 of the Federal Law "On Compulsory Pension Insurance in the Russian Federation" (Sobraniye zakonodatelstva Rossiyskoy Federatsii, 2009, N 29, item 3622).

Article 53

1. This Federal Law shall enter into force on January 1, 2011, except for the provisions for which this article establishes a different date for their entry into force.

2. Articles 5 - 8, part 6 of article 14, part 7 of article 17, part 7 of article 24, paragraph 1 of part 4 of article 26, articles 27, 28, 35, 36, part 1, paragraphs 3 - 5 and 14 of part 2, Clauses 1 - 3 of Part 4, Parts 7 - 9, 11 and 12 of Article 38 of this Federal Law shall enter into force on January 1, 2012.

The president

Russian Federation

D. MEDVEDEV

Moscow Kremlin

Announcement. Compulsory health insurance in the Russian Federation in 2020. Design features and necessary knowledge.

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Many citizens have already appreciated the value of compulsory health insurance. That is why he does not save on his health and actively pays for the pole.

So what is compulsory health insurance in Russia? And what are the main nuances of this procedure?

What you need to know

In accordance with the law, all citizens included in the system are entitled to receive free medical care throughout the Russian Federation.

How is the organization and financing of the fund

The Compulsory Medical Insurance Fund is an independent state credit company that implements state policy in the medical industry.

Such organizations are designed to accumulate insurance premiums, as well as ensure financial stability.

This is already regulated by an additional agreement on the part of the medical institution and the applicant.

In the clauses of the contract, you need to display:

• date of conclusion;
• the name of the insurer;
• basis for activity;
• subject of the contract;
• volume of medical care;
• date and signature.

Required documents

For registration you will need:

• passport of a citizen of Russia;
• birth certificate, if it is a minor citizen;
• statement of the established form.

For refugees, you must provide an additional certificate of recognition as such. A foreigner must provide a residence permit or a passport.

Stateless persons must provide registration and passport details.

Calculation procedure

How to calculate compulsory health insurance, according to the Federal Law, payment for medical care is carried out after the medical organization provides a register of accounts and an invoice for payment within the established limit.

Insurance Company:

• submits to the territorial body an application for receiving a target remuneration with an advance payment;
• apply for a refund for services rendered.

Then the territorial body considers the application and satisfies it, transferring the required amount.

Detailed information about insurance premiums for compulsory health insurance (CHI)

The duration of the billing period is determined for each year of hours worked. This is how accounting works.

The duration of the provision of the service is the entire life of the insured person. Paying insurance premiums - an individual or an employer.

If a person is not employed, then he can independently contribute money to the FSS. Insurance premiums enrolled in federal fund.

Federal Law 326 regulates and controls legal relations between citizens and insurance companies. With the help of obligatory honey. insurance state establishes certain financial and organizational measures to improve the efficiency and protection and safety of the population. At the same time, according to the described law, the state guarantees the population the timely provision of medical care of the highest level.

General provisions of the law

Federal Law 326 on compulsory medical insurance of the Russian Federation was adopted by the State Duma on November 19, 2010, and approved by the Federation Council on November 24, 2010. It was last updated on December 28, 2016. It has 11 chapters and 53 articles. a brief description of Federal Law on compulsory health insurance - regulation and control of legal relations between citizens and institutions conducting compulsory medical insurance(FZ on insurance in the Russian Federation), regulation of the provisions, rights and obligations of employees and the public, the amount of payment of contributions, processes and methods of implementation, the nuances of holding events.

Summary of Federal Law 326 "On Compulsory Medical Insurance":

• The first chapter describes general provisions law. The goals, objectives and what area the law affects are described. Other laws, regulations and acts affecting this area have been drawn up. A list of concepts and terms used in the text and definitions of these terms is given. The main obligations and principles for the implementation of honey are described. insurance;
• Chapter two lists the rights, duties and powers of state bodies. authorities and federal bodies of the constituent entities of the Russian Federation in the field of providing honey to the population. insurance;
• Chapter three outlines the categories of persons and entities liable to insurance. Descriptions of categories of persons, details of purchasing insurance for each category are given. The institutions located in different territories of the country where you can get medical insurance are described;
• In the fourth chapter lists of rights and obligations of citizens receiving insurance, persons providing it and all medical organizations where it can be purchased are given;
• In ch. five framed the economic side of this law. The lists of the cost of different types of insurance are provided, the methods of payment, the amount of contributions, the terms and procedure for payment are described. The liability of citizens in case of refusal to pay and receive medical insurance has been formalized. The budgets of funds and organizations, ways of replenishing reserves, tariffs for payment, etc. are described;
• The sixth gives and describes other laws and regulations governing the Federal and Territorial Funds;
• The seventh describes the basic and territorial processes, activities and programs for honey. insurance;
• In the eighth chapter, lists and categories are drawn up with a description of contracts in the field of honey. insurance;
• Chapter nine describes the methods and processes for monitoring organizations and institutions that provide health insurance. Reasons for filing a complaint, methods and form of filing are formalized;
• Chapter number ten describes the policies and unified accounting of citizens who have received insurance. Legal relations between honey. institutions and foundations;
• In ch. 11 gives the final and additional requirements, provisions and conditions of the law.

Medical insurance on the territory of the Russian Federation is mandatory for every citizen. During insured events, with the help of the policy, a citizen can receive free medical care.

The latest amendments to the Federal Law on environmental expertise can be found

What changes have been made?

The latest changes to the Federal Law on medical insurance were made on December 28, 2016, when the Federal Law No. 493 was adopted. Changes have taken place in Article 31 , in its first part, the phrase “treatment of the insured person immediately after a severe accident at work)” was replaced by the phrase “medical care (primary health care, specialized, including high-tech, medical care) to the insured person immediately after a severe accident in production." And in article 32 all words about the treatment of insured persons were changed to the phrase "medical assistance to the insured person".

In Art. 10 of Law 326 FZ, the last changes were introduced in 2013. This article provides a list of persons who are considered insured:

• Employees who have entered into employment contract, including the sole heads of organizations. Persons who have entered into other types of contracts related to the performance of work or services, including copyright orders, etc.;
• Citizens who do not have a job, but who are minors, caring for incompetent relatives or disabled people, pensioners, guardians or one of the parents of a child under three years old, studying in the state. educational institutions registered in accordance with the law on employment;
• Self-employed workers, as self-employed or private legal consultants;
• Family members related to small nations North and living in the respective territories, engaged in traditional farming;
• Members of peasant communities and farms.

According to article 16 of the described law, there is a list of certain rights and obligations of persons who are considered insured. Such persons have the right:

• For free honey. help;
• To protect their own rights when receiving health insurance;
• Choosing an insurance category when applying;
• To compensate for the damage caused of any kind, in case of poor-quality performance of duties or failure to perform duties in general by medical organizations;
• To change the medical institution once a year;
• On the confidentiality of personal data;
• At the choice of an insurance medical organization;
• For information about the types and quality of honey. help;
• Choice of doctor when applying.

However, persons considered to be insured have the obligation to:

• When providing medical care by a doctor, show the policy;
• In case of relocation or other change of residence, apply to a new organization to select an insurance institution;
• Present new personal data when they change, if it is full name, address or passport data;
• Apply for medical insurance.

In 326 FZ, article 35 the basic program of honey is described. citizen insurance. This program is confirmed and approved by the Government of the Russian Federation every year. This program lists cases covered by insurance, it spells out the categories of care, rates and payment methods. The government also approves the quality of medical care provided to citizens in this program. It is in the basic program that the requirements are established for citizens submitting applications, citizens receiving medical care under insurance, and for employees of insurance medical organizations. Article 35 "On Compulsory Medical Insurance" of Law 326 defines the standards and procedures.

The text of the new edition of 326 FZ

The law on CHI was created in accordance with the Constitution of the Russian Federation. It is thanks to this law adopted by the state that Russian citizens can receive high-quality free and timely medical care. If it seems to a person that his rights or guarantees given by law have been violated, it is recommended to study it. The law defines the rights and obligations, as well as the scope of authority of employees not only of insurance institutions, but also of other medical organizations.

One of the important conditions social protection population of the country - providing its citizens with the necessary medical care. Health care services that allow you to receive timely medical intervention are based on health insurance. The state provides an opportunity for its citizens and other persons to receive compulsory health insurance (CHI) with a sufficient range of services that can support people's health in the event of insured events. So what is compulsory health insurance (CHI)? How are the rights of citizens to free medical care constitutionally protected? What does the CHI system guarantee to citizens? We will answer these and other questions in this article.

CHI basics

Compulsory health insurance is a set of measures to protect health, provide free medical care within the framework of the current legislation, as well as the implementation of preventive measures. Insurance provides citizens with equal opportunities when medical intervention is needed. Article 41 of the Constitution of the Russian Federation guarantees every citizen the right to health care and free medical care in state (municipal) institutions, which is provided through the payment of insurance premiums, funds from the budget and other revenues. The provision of medical services is carried out at the expense of previously formed funds. Key guaranteed services include:

• Ambulance (this does not include sanitary and aviation services);
• Primary provision of medical care;
• Therapeutic and preventive measures;
• Specialized assistance;
• Provision of services within the framework of the current CHI.

The implementation of the work of compulsory health insurance takes place through specialized legal organizations - Insurance companies. Among the main tasks is to provide the population with the necessary medical care through the conclusion of contracts. In addition, through the funds, payment is made for the services rendered to insured persons (patients) to medical institutions, protection of the rights of the population.

Source of health insurance funding

To implement the program of providing free medical care, it is necessary to have a substantial financial base. battery Money V CHI system is the Federal Compulsory Medical Insurance Fund (FOMS). The main goal of the fund is presented as providing all persons participating in insurance with the necessary medical and medicinal assistance. Funding comes from the following sources:

• Contributions to the MHIF of employers for their employees;
• Receipts in the form of fixed payments from individual entrepreneurs and self-employed persons;
• Receipts from the budgets of the constituent entities of the Russian Federation for the unemployed.

Insurance premiums as income from employers are charged at established rates for wages hired workers. Payers are the majority of organizations and employers-entrepreneurs, with the exception of some representatives of small businesses, which are exempt from paying such payments.

Formerly fund compulsory insurance was divided into federal and territorial, payments had to be transferred to each of these structures. Starting from 2012, the territorial MHIF was abolished. Currently, payments are made only to the federal MHIF at the basic rate of 5.1%.

CHI policy

Guaranteed medical care is confirmed by the presence of a policy. This document can be obtained from the insurance medical company after the conclusion of the relevant agreement with it. The issuance of these documents in the MHI system is carried out for almost all persons, including:

• Citizens of the country;
• Non-working population and persons under the age of majority;
• Temporarily or permanently residing on the territory of the Russian Federation;
• Persons without citizenship;
• Refugees.

The duration of the policy depends on the status of the insured person. For citizens of the Russian Federation and those permanently residing on the territory of the country, the document is open-ended. For temporary residents, including refugees, the policy is limited to a fixed period of stay within the country.

The provisions on the rights of insured persons in the presence of a policy are listed in the law dated November 29, 2010 No. 326-FZ “On Compulsory Medical Insurance in the Territory of the Russian Federation”. Without presenting a document, an individual can only count on emergency free medical care. The policy covers the entire territory of the Russian Federation. In case of refusal of medical institutions to provide free services within the framework of CHI, it is allowed to file a complaint at the location of the insurance company. Availability compulsory medical insurance policy gives some rights to its owners. With the help of the document become available the following types medical care:

• Emergency medical services;
• Outpatient treatment in polyclinics, including diagnostic procedures and clinical examination, while free provision of medicines in this case, as a rule, is not provided;
• Inpatient treatment, including emergency hospitalization in order to maintain health, including during childbirth and exacerbation of chronic diseases.

Often, a medical policy provides an opportunity to diagnose diseases using special equipment. The owner of the document, if indicated, can become a participant in rehabilitation, preventive and recreational activities. For privileged categories of the population, a policy is required to confirm the right to free medicines. In addition, the owners CHI document the right to receive routine vaccination and undergo a fluorographic examination. The presence of a compulsory medical insurance policy makes basic medical services for the general population. This factor is especially important for the poor and socially unprotected persons.

How to get an OMS policy?

The policy as a document confirming the right of its owner to receive free medical care must be carried with you. It is presented for treatment in hospitals, clinics and ambulance services.

The policy is issued by insurance companies in any region of the country. The choice of the insurance company itself is the right of any citizen and other person. Although, as a rule, the result is determined by the territorial presence of the insurance company. At the same time, there are no significant differences in the choice of companies. The range of services provided is the same, although some insurance companies have the right to attract customers with various bonus programs. To obtain a CHI policy, you must provide insurance companies with the following documents:

• Identification;
• SNILS;
• Other documents, depending on the status of the insured person (birth certificate, proof of temporary residence, etc.).

Often, when applying initially, insurance companies issue a temporary policy. Its action is limited to a period of 1 month, after which the current document is replaced with a current sample. A temporary policy has the same powers as a permanent one. In case of loss of the policy, change of the name of the owner, a replacement is assumed.

The policy, as a document of compulsory health insurance, is best done in advance. In this case, when unexpected health problems appear, there will be no bureaucratic obstacles in obtaining medical care.

What does free medical care include?

Free medical care, which citizens insured in the MHI system can count on, is included in the basic program. The list of diseases in connection with the occurrence of which assistance is available under the CHI system is quite extensive. This includes the following insured events:

• Pregnancy, childbirth, childcare;
• Infectious and bacterial diseases;
• Diseases of the endocrine system;
• Problems with the digestive organs;
• Diseases of the ears, eyes;
• Diseases resulting from chromosomal abnormalities;
• Decreased immune forces of the body;
• poisoning;
• Diseases of the nervous system;
• Other insured events.

Eligibility free help is regulated by the legislation of the Russian Federation, and the assistance included in the basic program (preventive, special, high-tech, ambulance) is regulated by Article 35 of the Federal Law of November 29, 2010 No. Federation".

Conclusion

The rights of citizens to receive free medical care are regulated by the Constitution of the Russian Federation, according to which there are special programs to protect the health of the population of Russia. The general CHI mechanism is an obligation imposed on certain persons by law to make contributions to CHI fund for insurance and protection of interests related to the costs of medical care. For the working population, such persons are employers, for the unemployed - regional authorities.

On January 1, 2011, the Federal Law "On Compulsory Medical Insurance in the Russian Federation" dated November 29, 2010 No. 326-FZ came into force. Let's see what changes have taken place in the system of compulsory health insurance (hereinafter referred to as CHI) and what are the rights of citizens now.

Rights and obligations of the insured persons

Federal Law No. 326-FZ includes Russian citizens, foreigners (having temporary registration or residence permit), stateless persons and refugees (in accordance with Federal Law No. 4528-1 of February 19, 1993 "On Refugees") as insured persons.

The rights of all the above persons are enshrined in Article 16 of Federal Law No. 326-FZ. Thus, insured persons have the right to receive medical care free of charge throughout Russia, but only in the amount established by the basic CHI program, and in the territory of the constituent entity of the Russian Federation in which the policy was issued - in the amount established by the territorial CHI program of this subject (specify this You can contact the local branch of the Mandatory Medical Insurance Fund or your insurance company).

There is a right to choose an insurance medical organization and replace it once a year, no later than November 1, or more often in case of a change of residence. To do this, you need to submit an application to the selected insurance organization.

Also, the insured person has the right to choose a medical institution from among those participating in the implementation of the territorial CHI programs, as well as the choice of a doctor, for which you need to submit an application in person or through your representative addressed to the head of the medical institution.

There is also a right to compensation for damages caused by non-performance or improper performance insurance or medical institution their duties, to receive reliable information from the territorial fund, medical insurance organization and medical organizations about the types, quality and conditions for the provision of medical care, to protect personal data.

However, along with rights come responsibilities.

Thus, insured persons must:

1. Present a compulsory health insurance policy when applying for medical care, except in cases of emergency medical care.
2. Submit to the insurance medical organization personally or through your representative an application for the choice of an insurance medical organization in accordance with the rules of compulsory medical insurance
   (if you are already insured and have a policy, if you do not apply, you will remain in the same insurance organization as before).
3. Notify the health insurance organization of the change in last name, first name, patronymic, place of residence within one month from the day these changes occurred.
4. To carry out the choice of an insurance medical organization at a new place of residence within one month in case of a change in the place of residence and the absence of an insurance medical organization in which the citizen was previously insured.

CHI programs

The law provides for the development of basic and territorial CHI programs. Based on the provisions of Art. 35 and Art. 36 of Federal Law N 326-FZ, the basic program is valid throughout Russia, and the territorial program is valid within the subject of the Federation where a medical policy is issued, and the latter can be omitted if emergency medical care is required.

Thus, having a policy, you can get medical care throughout the Russian Federation, but only within the framework of the basic CHI program. You can get help under the territorial program only under the local policy.

Getting a policy

To obtain a compulsory medical insurance policy, you need to contact the insurance medical organization of interest with the appropriate application. If there is no such organization, then you need to contact the territorial compulsory health insurance fund.

On the same day, the insured person must be issued a policy or, in certain cases provided for by the rules of compulsory medical insurance, a temporary certificate.

As for working citizens, the obligation to issue a policy remains with employers until May 1, 2011, and after that employees will have to receive policies on their own (Clause 4, Part 1, Article 16, Article 46 of the Law).

Children are insured from the date of birth until the day of state registration of birth by an insurance medical organization in which their mothers or other legal representatives are insured, and after such registration - by an organization of the choice of one of the parents.