Order dated July 20, 2017 No. 1538-r. The bill provides for the improvement of the mechanism for monitoring whether a citizen has the right to CHI. The amendments proposed by the bill will make it possible to exclude the insurance of citizens, the provision of medical care financed from federal budget. Thus, the draft law aims to exclude double financing of medical care.

Draft federal law "On amendments to certain legislative acts Russian Federation on issues of personalized accounting in the field of mandatory health insurance(hereinafter referred to as the draft law) was introduced by the Ministry of Health of Russia.

The bill is aimed at improving personalized accounting in the field of compulsory medical insurance (hereinafter referred to as CHI).

The bill, in particular, provides for specifying the categories of military personnel and persons equated to them in the organization of medical care, who are not subject to CHI, determination of mechanisms for the suspension and termination of compulsory medical insurance in relation to military personnel and persons equated to them in the organization of the provision of medical care.

It is proposed to regulate the information interaction of federal government agencies and the Federal Compulsory Medical Insurance Fund (FOMI) when maintaining personalized records of information about insured persons, including determining the procedures and terms for submitting (sending) information about insured persons and persons not subject to compulsory medical insurance.

Territorial MHI funds are proposed to be empowered to verify the accuracy of personalized records of insured persons in terms of their compliance with identity documents of a citizen of the Russian Federation on the territory of Russia.

It is proposed to assign the Government of Russia the authority to approve the procedure and methodology for determining the number of insured persons for the purposes of forming the budget of the MHIF, the budgets of the constituent entities of the Federation and the budgets of the territorial CHI funds.

The bill provides for the improvement of the mechanism for monitoring whether a citizen has the right to CHI, including the introduction of duties:

• a citizen who has passed into the category of citizens not subject to compulsory medical insurance (with the exception of citizens undergoing military service on call), - to pass an invalid compulsory medical insurance policy or report its loss to any insurance medical organization or any territorial CHI fund;
• military commissariats - to transfer to the territorial funds of compulsory medical insurance information about citizens called up for military service and information about the beginning of military service on conscription;
• federal state bodies according to the list approved by the Government of Russia, whose employees belong to the category of citizens who are not subject to compulsory medical insurance, to ensure control over the fulfillment by employees and military personnel undergoing military service under a contract of the obligation to submit an invalid compulsory medical insurance policy or report its loss to any insurance medical organization or any territorial CHI fund;

• MHIF and territorial MHI funds - monthly based on information about the suspension and termination of MHI in relation to certain categories persons to ensure that information on temporarily inactive and invalid CHI policies is reflected in the unified register of insured persons in accordance with the Rules of Compulsory Medical Insurance.

The changes proposed by the bill will make it possible to exclude insurance for citizens whose medical care is financed from the federal budget. Thus, the draft law aims to exclude double financing of medical care.

Also, the purpose of the bill is to improve the personalized accounting of insured persons in compulsory medical insurance, improving the quality of planning the budget of the Compulsory Medical Insurance Fund, the budgets of the subjects of the Federation and the budgets of the territorial funds of compulsory medical insurance. Updating the personalized registration of insured persons in the field of compulsory medical insurance as a result of the implementation of the bill will help reduce the burden on regional budgets in paying insurance premiums for compulsory medical insurance.

Chapter 6. PERSONALIZED ACCOUNTING IN THE SPHERE OF COMPULSORY HEALTH INSURANCE

One of the innovations introduced by Ch. 10 of Law N 326-FZ, is a personalized account in the field of compulsory medical insurance.

A funny children's cartoon about a goat that could count to 10 pops up in memory. A simple, accessible plot for a preschooler. The kid learned to count up to 10 and began to demonstrate his ability to everyone he met. At first, everyone was angry with him, but, in the end, in a difficult situation, the goat's ability to count came in handy to save the others. Conclusion - how good it is to be able to count.

So personalized accounting has been introduced to ensure that the insured have the right to free provision of medical care of the proper quality and volume within the framework of the basic and territorial programs. It is designed to facilitate control over the use of compulsory health insurance funds, to help determine the need for the volume of medical care for the formation of future programs.

• 1. Directions of accounting

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

In addition, a personalized accounting of information about medical care provided to the insured population.

This line of accounting includes the collection, processing, transfer and storage of such information as the number of the compulsory medical insurance policy, types, conditions, terms of medical care, which medical organizations provided this assistance. In this direction, accounting will contain information on the volume of medical care provided, its cost, diagnoses made to the insured patient, and the profile of medical care. From the accounting data, it will be possible to clearly know which medical worker of which specialty and using which medical and economic standards provided assistance. Finally, the records will reflect the results of the patient's request for medical care, as well as the results of the control over the volume, timing, quality and conditions of its provision.

The law allows accounting in writing and in electronic form. The last option should guarantee the reliability (authenticity) of the data, protection against unauthorized access and possible distortions. Information about the insured person and the medical care provided to him is confidential, refers to restricted access information and is subject to protection in accordance with the law.

• 2. Processing and storage of documents

Information about working insured persons for their inclusion in regional segment the unified register of insured persons monthly transfers TFOMS to the territorial body of the PFR.

Insurance medical companies, clinics and hospitals should keep copies of paper records and electronic archives containing personalized information. After the expiration of the established period of storage in the insurance medical organization documents are to be destroyed.

Insurance companies are required to check the information entered in the register for repetitions:

- by last name, first name, patronymic, date and place of birth;

- according to the identity document;

- by date of birth and address of registration at the place of residence;

- by last name, first name and patronymic and address of registration at the place of residence;

- By insurance number individual personal account.

At least once a month Insurance Company must transfer TFOMS files with changes in information about the insured. The insured for non-working citizens also monthly, no later than the 5th day of each month, submits to the fund information about non-working insured persons. This must be done to ensure that the information in the registry is always up to date. TFOMS should receive and process such information around the clock.

Medical organizations provide TFOMS with information on medical care provided to insured persons. Within two working days, on the basis of the regional segment of the unified register of insured persons, it carries out automated processing of the information received.

At the same time, persons who received medical care outside the territory of insurance are identified, and their territory of insurance is determined. In case of difficulties, TFOMS should prepare a request to central segment a single register, where a check will be carried out within five working days and a response will be generated indicating the identified territory of insurance and the current policy number of the insured person.

Article 43. Personalized registration in the field of compulsory medical insurance

1. Personalized accounting in the field of compulsory medical insurance (hereinafter referred to as personalized accounting) - organizing and maintaining records of information about each insured person in order to exercise the rights of citizens to free medical care under compulsory medical insurance programs.

2. The purposes of personalized accounting are:

3. Personalized accounting, collection, processing, transfer and storage of information are carried out Federal Fund And territorial funds, pension fund of the Russian Federation and its territorial bodies, insurance medical organizations, medical organizations and insurers for non-working citizens in accordance with the powers provided for by this federal law.

4. For the purposes of personalized accounting, the Federal Fund and territorial funds carry out information interaction with insurers for non-working citizens, with the Pension Fund of the Russian Federation and its territorial bodies, medical organizations, medical insurance organizations and other organizations in accordance with this Federal Law.

5. The procedure for maintaining personalized records is determined by the authorized federal body executive power.

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 certain information about insured persons.

The list of information included in the registers is contained in Art. 44 of the Law, and is also duplicated in the order of the Ministry of Health and Social Development of the Russian Federation dated January 25, 2011 No. 29n “On approval of the Procedure for maintaining personalized records in the field of compulsory medical insurance”. Established order defines the rules for maintaining a personalized record of information about each insured person in the field of compulsory health insurance. In particular, the organization of personalized accounting in the field of compulsory medical insurance; maintaining a unified register of insured persons; maintaining personalized records of information about medical care provided to insured persons and the technology of information exchange when maintaining personalized records in the field of compulsory medical insurance.

The organization of personalized accounting in relation to pension insurance required the adoption of a special voluminous Federal Law of April 1, 1996 No. 27-ФЗ “On Individual (Personalized) Accounting in the System of Compulsory Pension Insurance”. In the field of compulsory health insurance, such a law has not been adopted, and the relevant legal relations are regulated by by-laws.

The Federal Compulsory Medical Insurance Fund approved the general principles for the construction and operation of information systems and the procedure information exchange in the field of compulsory health insurance (order of the MHIF dated 07.04.2011 No. 79). In order to establish uniform requirements and rules for information interaction applied by participants and subjects of the compulsory medical insurance system in the territory of the Russian Federation, the following were approved:

General requirements to the construction and functioning of information systems in the field of compulsory health insurance;

Requirements for the regional information system of compulsory medical insurance;

General requirements for the information system of the territorial fund of compulsory medical insurance;

Requirements for the subsystem for maintaining the regional segment of the Unified Register of Insured Persons;

Requirements for the subsystem for maintaining personalized records of medical care provided to insured persons in the field of compulsory medical insurance;

Requirements for the subsystem of informing citizens (the official website of the territorial fund of compulsory medical insurance on the Internet);

General requirements for the information system of an insurance medical organization;

Requirements for the subsystem of personalized accounting of information about insured persons;

Requirements for the subsystem of personalized accounting of medical care provided to insured persons in the field of compulsory medical insurance;

Requirements for the subsystem of informing citizens (the official website of the medical insurance organization on the Internet);

General requirements for the information system of a medical organization; requirements for the subsystem of personalized accounting of medical care provided to insured persons in the field of compulsory medical insurance.

In order to ensure information interaction between the Federal Fund and territorial funds, insurers for non-working citizens, with the Pension Fund of the Russian Federation and its territorial bodies, medical organizations, medical insurance organizations and other organizations, the following agreements have been concluded:

– Agreement on information exchange between the Pension Fund of the Russian Federation and the Federal Compulsory Medical Insurance Fund dated December 31, 2010, PF RF No. AD-30-32/09sog, FOMS No. 6547/20-1264;

– Agreement on information exchange between the Pension Fund of the Russian Federation and the Federal Compulsory Medical Insurance Fund dated January 31, 2011, PF RF No. AD-08-33/03sog, FOMS No. 558/91-i265.

Thus, a fully legal basis for information interaction between these bodies has not yet been created and is to be formed in the future.

The purposes of personalized accounting according to the law are:

1) creation of conditions for ensuring guarantees of the rights of insured persons to free medical care of adequate quality and in the appropriate volume within the framework of compulsory medical insurance programs;

2) creation of conditions for exercising control over the use of compulsory medical insurance funds;

3) determination of the need for the volume of medical care in order to develop compulsory medical insurance programs.

In fact, personalized accounting data will make it possible to uniquely identify a citizen, determine the volume and quality of medical care provided to him, but only within the framework of compulsory health insurance, that is, provided to him free of charge within the basic and territorial programs; will provide more accurate forecasting

determine the needs for medical care, determine the necessary costs.

The analysis of personalized accounting data is one of the conditions for organizing control over the quality of medical care provided and, accordingly, the use of compulsory medical insurance funds, which, in case of poor quality medical care: violation of the volume, timing, quality and conditions of medical care, are subject to deduction from the volume funds provided for payment for medical care provided by medical organizations, or are subject to return to the insurance medical organization in accordance with the contract for the provision and payment of medical care under compulsory medical insurance, the list of grounds for refusing to pay for medical care, or the payment for medical care is reduced.

Article 44

1. In the field of compulsory health insurance, personalized records of information about insured persons and personalized records of information about medical care provided to insured persons are maintained.

2. When maintaining a personalized record of information about insured persons, the following information about insured persons is collected, processed, transferred and stored:

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

12) data on the insurance medical organization chosen by the insured person;

13) date of registration as an insured person;

14) the status of the insured person (working, not working).

3. Personalized accounting of information about insured persons is maintained in the form of a single register of insured persons, which is a combination of its central and regional segments containing information about insured persons.

4. When maintaining a personalized record of information about medical care provided to insured persons, the following information is collected, processed, transferred and stored:

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

8) diagnosis;

11) applied medical and economic standards;

5. Information about the insured person and the medical care provided to him may be provided in the form of documents both in writing and in electronic form if there is a guarantee of their reliability (authenticity), protection against unauthorized access and distortion. In this case, the legal force of the submitted documents is confirmed by electronic digital signature in accordance with the legislation of the Russian Federation. The decision on the possibility of providing information in electronic form is taken jointly by the participants in the information exchange.

6. Information about the insured person and the medical care provided to him/her is classified as information of limited access and is subject to protection in accordance with the legislation of the Russian Federation.

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

At the stage of automated processing of personalized records of medical care provided to insured persons, the following is performed 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 territory of insurance, and determination of their territory of insurance;

3) sending in electronic form the results obtained in accordance with paragraphs 1 and 2 above to the medical organization that provided medical care to the insured persons.

Based on the results of automated processing of information about medical care provided to insured persons, the medical organization submits them to insurance medical organizations in the amount and within the time limits established by the contract for the provision and payment of medical care under compulsory medical insurance.

The exchange of data between medical organizations, insurance medical 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 an electronic digital signature in in accordance with the requirements established by the legislation of the Russian Federation for the protection of personal data.

The protection of personal data is ensured by the following mechanism provided for by Federal Law No. 152-FZ of July 27, 2006 “On Personal Data” and Decree of the Government of the Russian Federation of November 17, 2007 No. 781 “On Approval of the Regulations on Ensuring the Security of Personal Data during their Processing information systems personal data".

The insurance medical 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.

When processing personal data, the operator is obliged to take the necessary organizational and technical measures to protect personal data from unauthorized or accidental access to them, destruction, modification, blocking, copying, distribution of personal data, as well as from other illegal actions.

The implementation of the requirements for ensuring information security in information security tools is assigned to their developers.

Article 45. Compulsory medical insurance policy

1. The policy of compulsory medical insurance is a document certifying the right of the insured person to free medical care throughout the Russian Federation in the amount provided for by the basic program of compulsory medical insurance.

2. The compulsory medical insurance policy is provided by the federal electronic application contained in the universal electronic card in accordance with the Federal Law of July 27, 2010 No. 210-FZ "On the organization of the provision of state and municipal services." Uniform requirements for a compulsory medical insurance policy are established by the rules of compulsory medical insurance.

In accordance with Part 2 of Art. 50 of the commented Law since May 1, 2011 for all subjects of the Russian Federation there are policies of a single sample. Their production is organized by the Federal Compulsory Medical Insurance Fund. At the same time, the policies issued before the entry into force of the Law are valid until they are replaced by policies of a single sample.

The rules of compulsory medical insurance establish the following requirements for a compulsory medical insurance policy. The policy may be presented in the form of a paper form or in the form plastic card with electronic media. Uniform requirements have been introduced for both forms of the policy.

Firstly, the policy is a strict reporting document and, accordingly, accounting is carried out as for a strict reporting form. Secondly, both policies are bilateral (they have front and back sides reflecting the relevant information) and have a protective complex.

However, the difference in carriers causes additional requirements. So, a paper policy is an A5 sheet, on the front side of which contains information about the policy and personal data of the insured person, certified by his signature. In addition, a barcode containing general information about the policy and the insured person is placed on the front side. The reverse side of the policy contains information about the insurance medical organization chosen by the insured person, certified by the signature of its representative and seal.

plastic policy with electronic media (electronic policy) has visual (graphic) information about the policy and the insured person. In addition, for insured persons over 14 years of age, it is mandatory to place a photograph on the back of the policy. For electronic policies the possibility of placement (reading) of insurance and medical applications is provided. Through the first one, the insured person's access to receiving services in the field of compulsory health insurance is realized, as well as mutable and immutable data about the policy and the insured person are embedded. The medical application mediates the information about the insured person necessary to provide him with medical care.

In accordance with paragraph 1 of Art. 940 of the Civil Code of the Russian Federation, an insurance contract must be concluded in writing. However, Federal Law No. 326-FZ does not directly provide for the conclusion of an MHI agreement in this form. Obligatory relations between the insured, the insurer and the insured persons are formed directly by virtue of the law.

IN Civil Code The Russian Federation provides that an insurance contract can be concluded by issuing a policy by an insurer, while Federal Law No. 326-FZ establishes that a compulsory medical insurance policy is issued by an insurance medical organization.

Federal Law No. 326-FZ does not explain the legal nature of the CHI policy. An article containing the rules for issuing compulsory medical insurance policies is located in the section on personalized accounting in the field of compulsory medical insurance.

In Art. 45 of Federal Law No. 326-FZ provides that the CHI policy is provided by the federal electronic application contained in the universal electronic card in accordance with Art. 23 of the Federal Law of July 27, 2010 No. 210-FZ “On the organization of the provision of state and municipal services”.

In accordance with Art. 25 of the Federal Law "On the organization of the provision of state and municipal services" universal electronic cards are issued to citizens on the basis of applications for issuing cards from 01/01/2012 to 12/31/2013. However, the law of the subject of the Russian Federation, as well as the decree of the Government of the Russian Federation an earlier date for the issuance of such cards. The issuance of the card is free of charge.

If citizens within the specified period did not apply for the issuance of a universal electronic card and have not submitted an application for refusal to receive a card, then the right to receive a card is not lost.

Article 26 of the Federal Law "On the organization of the provision of state and municipal services" establishes that citizens who have not submitted applications for the issuance of a universal electronic card before January 1, 2014 and who have not applied for refusal to receive this card, a universal electronic card is issued on free of charge by an authorized organization of a constituent entity of the Russian Federation from January 1, 2014 (Fig. 1). If a citizen refuses to receive a universal electronic card, he will be able to use a compulsory medical insurance policy. Citizens can also refuse the card at any time after receiving it: such a card is canceled in the prescribed manner.

Rice. 1. A sample of a universal electronic card.

Article 46

1. In order to obtain a compulsory medical insurance policy, the insured person personally or through his representative submits, in accordance with the procedure established by the rules of compulsory medical insurance, an application for choosing an insurance medical organization, provided for in paragraph 2 of part 2 of Article 16 of this Federal Law, to an insurance medical organization or at its absence in the territorial fund.

2. On the day of receipt of an application for the choice of an insurance medical organization, the insurance medical organization or, in its absence, the territorial fund shall issue to the insured person or his representative a policy of compulsory medical insurance or a temporary certificate in cases and in the manner determined by the rules of compulsory medical insurance.

An application for choosing an insurance medical organization is submitted to the insurance medical organization. In the event that such an organization does not exist, then the corresponding application is submitted to the territorial fund of compulsory medical insurance.

The insured person submits an application for choosing an insurance medical organization personally or through his representative. In cases established by law, the commission of such a legally significant action as filing an application for the choice of an insurance medical organization can be carried out exclusively through a legal representative (for minors, persons recognized by the court as incompetent).

An application for the choice (replacement) of an insurance medical organization is drawn up in writing or in typewritten form and submitted (sent) to an insurance medical organization or transmitted using public information and communication networks, including the Internet, through the official website of the territorial fund or a single portal public services.

Article 47

1. Medical organizations provide information on medical care provided to insured persons, provided for in clauses 1–13 of part 4 of Article 44 of this Federal Law, to the territorial fund and insurance medical organization in accordance with the procedure for maintaining personalized records established by the authorized federal executive body.

2. Data of personalized accounting of information about medical care provided to insured persons are provided by medical organizations to insurance medical organizations in the amount and terms established by the contract for the provision and payment of medical care under compulsory medical insurance.

3. Insurance medical organizations and medical organizations, in accordance with the rules for organizing state archives, store copies of documents on paper and electronic media containing the information specified in part 1 of this article and provided to the territorial fund for personalized accounting.

4. Medical organizations, insurance medical organizations and territorial funds determine the employees allowed to work with personalized records of information about medical care provided to insured persons and ensure their confidentiality in accordance with the requirements for the protection of personal data established by the legislation of the Russian Federation.

5. After the expiration of the period established for storing copies of documents on paper and electronic media in the insurance medical organization specified in part 3 of this article, these copies 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 insurance medical organization .

6. Personalized records of information about medical care provided to insured persons, specified in Part 1 of this article, are subject to storage in accordance with the legislation of the Russian Federation.

Every citizen, in accordance with Art. 23 of the Constitution of the Russian Federation has the right to personal secrecy, which also includes information about the state of his health, past or existing diseases. Information about medical care provided to insured persons is classified as confidential information. In this regard, increased requirements are imposed on the relevant information regarding their safety and non-disclosure. Confidential Information- this is information that requires protection, access to which is limited within the established limits. Therefore, medical organizations, medical insurance organizations and territorial funds carry out the necessary protection of relevant information.

For these purposes, they are obliged to identify employees admitted to work with personalized records of information about the medical care provided, and charge them with official duties confidentiality of relevant information, as well as responsibility for their disclosure.

Confidentiality of personal data is a mandatory requirement for an operator or other person who has gained access to personal data to prevent their distribution without the consent of the subject of personal data or other legal grounds.

Specifically, the relevant organizations are obliged to ensure the confidentiality of information within the framework of the requirements established by the legislation on the protection of personal data, including by blocking access to them, depersonalization, etc.

The law establishes special periods for the storage of copies of documents on the provision of medical care by insurance organizations within the framework of compulsory medical insurance. Upon the expiration of the established storage period, copies of documents (on paper and electronic media) on the medical care provided are subject to destruction.

An appropriate act must be drawn up on the destruction of documents. An act on the allocation for destruction of cases that are not subject to storage is drawn up for the affairs of the entire organization. If the act contains the cases of several divisions, then the name of each division is indicated before the group of headings of the cases of this division. Headings of homogeneous cases selected for destruction are entered into the act under a common heading indicating the number of cases assigned to this group. Cases to be destroyed are transferred for processing (utilization). The transfer of cases is made out by an acceptance invoice, which indicates the date of transfer, the number of cases to be handed over and the weight of paper waste. Loading and removal for disposal are carried out under the control of the employee responsible for ensuring the safety of archive documents (clauses 2.4.5, 2.4.7 of the Basic Rules for the work of archives of organizations).

Based on the informational significance of certain types of archival documents, the Law on Archival Affairs in Art. 22 established the period of temporary storage in the archives of organizations of documents on personnel, which includes information about personal and family secrets, at 75 years. Therefore, personalized accounting data (information about medical care provided to insured persons) will be subject to mandatory storage during the specified period.

Article 48

1. Medical insurance organizations provide information on medical care provided to insured persons, received from medical organizations and specified in Part 4 of Article 44 of this Federal Law, to the territorial fund in accordance with the procedure for maintaining personalized records.

2. Data of personalized accounting of information about medical care provided to insured persons are provided by insurance medical organizations to the territorial fund in the amount and terms established by the contract on financial support of compulsory medical insurance, but no later than the 20th day of the month following the reporting one.

3. On the basis of the information specified in Part 1 of Article 47 of this Federal Law and Part 1 of this Article, territorial funds keep a personalized record of information about medical care provided to insured persons in accordance with this Federal Law and the procedure for maintaining personalized records.

4. Maintaining personalized records of information about medical care provided to insured persons in territorial funds is carried out on paper and (or) electronic media. If the information does not match paper media and information on electronic media, information on paper has priority.

5. The information specified in part 4 of this article is subject to storage in accordance with the rules for organizing state archives.

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

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

2) a medical organization that provided the relevant services;

3) types of medical care provided;

4) conditions for the provision of medical care;

5) the timing of the provision of medical care;

6) the volume 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 used medicines;

11) applied medical and economic standards;

12) specialty medical worker who provided medical assistance;

13) the result of applying for medical care;

14) the results of the control over the volumes, terms, quality and conditions for the provision of medical care.

Part 2 of Article 48 defines the procedure for providing personalized records of information about medical care provided to insured persons by insurance medical organizations to the territorial fund.

Conditions on the volumes and terms of provision are sent by insurance medical organizations within the time limits stipulated by the agreement on the financial support of compulsory medical insurance. The deadlines for providing information to the territorial fund can be set individually for the medical insurance organization, but no later than the 20th day of the month following the reporting one.

Part 4 of Article 48 provides that information about the insured person and about the medical care provided to him can be provided to the territorial funds both in the form of documents in writing and in electronic form, provided there are guarantees of their reliability (authenticity), protection against unauthorized access and distortion in accordance with the established requirements 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 Federal Law No. 1-FZ of January 10, 2002 "On Electronic Digital Signature".

The decision on the possibility of presenting information in electronic form is taken jointly by the participants in the information exchange.

In cases of discrepancy between the information indicated on paper and information on electronic media, information on paper will take precedence.

Part 5 of Article 48 provides that the maintenance of personalized records of information about medical care provided to insured persons in territorial funds is subject to storage in accordance with the Federal Law of the Russian Federation of October 22, 2004 No. 125-FZ "On Archiving in the Russian Federation". According to Art. 22 of the said Law, the storage period is 75 years.

Article 49

1. The territorial body of the Pension Fund of the Russian Federation, on a quarterly basis no later than the 15th day of the second month following the reporting period, shall submit to the relevant territorial fund information on working insured persons specified in clauses 1–10 and 14 of part 2 of Article 44 of this Federal Law.

2. The insured for non-working citizens monthly, no later than the 5th day of each month, submits to the relevant territorial fund information about non-working insured persons, provided for in paragraphs 1-10 and 14 of part 2 of Article 44 of this Federal Law.

3. Territorial bodies of the Pension Fund of the Russian Federation, insurers for non-working citizens exchange information with territorial funds in electronic form in the manner determined by agreements on information exchange, and in the form approved by the Federal Fund and the Pension Fund of the Russian Federation.

4. Territorial funds, within 15 working days from the date of receipt of information about the insured person, provided for in parts 1 and 2 of this article, enter them into the regional segment of the unified register of insured persons.

Article 49 is aimed at ensuring the uninterrupted functioning of the unified register of insured persons and the creation of a clear system of interaction between subjects of compulsory health insurance at the regional level.

Article 49 establishes the basis for the interaction of the territorial body of the Pension Fund of the Russian Federation, the insurer for non-working citizens and the territorial fund when maintaining personalized records of information about insured persons. In more detail, the interaction of these entities is regulated by the order of the Ministry of Health and Social Development of the Russian Federation dated January 25, 2011 No. 29n “On Approval of the Procedure for Maintaining Personified Records in the Field of Compulsory Medical Insurance” and the “Agreement on Information Exchange between the Pension Fund of the Russian Federation and the Federal Compulsory Medical Insurance Fund”.

The territorial body of the Pension Fund of the Russian Federation (hereinafter referred to as the OPFR) on a quarterly basis, no later than the 15th day of the second month following the reporting period, provides the relevant territorial fund with information about working insured persons for their inclusion in the regional segment of the unified register of insured persons. This is ensured by the Information Exchange Agreement between the Pension Fund of the Russian Federation and the Federal Compulsory Medical Insurance Fund.

The policyholder for non-working citizens monthly, no later than the 5th day of each month, provides information on non-working insured persons to the relevant territorial fund. This is carried out in accordance with agreements on information exchange between territorial funds and insurers for non-working 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.

In accordance with the Agreement on Information Exchange between the Pension Fund of the Russian Federation and the Federal Compulsory Medical Insurance Fund, the interaction between the OPFR and the TFOMS is carried out daily, monthly, quarterly and annually.

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

Judicial practice and legislation - Order of the Ministry of Health and Social Development of Russia dated January 25, 2011 N 29n (as amended on January 15, 2019) On approval of the Procedure for maintaining personalized records in the field of compulsory medical insurance

Submission of the register of invoices for payment of medical care provided to insured persons outside the subject of the Russian Federation, on the territory of which a compulsory medical insurance policy was issued, is made in electronic form in accordance with the order of the Ministry of Health and Social Development of the Russian Federation dated January 25, 2011 N 29n " On approval of the procedure for maintaining personalized records in the field of compulsory medical insurance" (registered by the Ministry of Justice of the Russian Federation on February 8, 2011, registration N 19742).