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ORDER OF THE GOVERNMENT OF THE REPUBLIC OF KAZAKHSTAN

of June 20, 2019 No. 421

About approval of the list of medical care in system of compulsory social medical insurance

According to the subitem 1) of article 10 of the Law of the Republic of Kazakhstan of November 16, 2015 "About compulsory social medical insurance" the Government of the Republic of Kazakhstan DECIDES:

1. Approve the enclosed list of medical care in system of compulsory social medical insurance.

2. This resolution becomes effective since January 1, 2020 and is subject to official publication.

Prime Minister of the Republic of Kazakhstan

A. Mamin

Approved by the Order of the Government of the Republic of Kazakhstan of June 20, 2019

The list of medical care in system of compulsory social medical insurance

Chapter 1. General provisions

1. Medical care in system of compulsory social medical insurance (further - OSMS) - amount of the medical care provided to consumers of medical services for the asset account of fund of social medical insurance.

The foreigners and persons without citizenship who are constantly living in the territory of the Republic of Kazakhstan and also oralmans have the rights and perform duties in the OSMS system on an equal basis with citizens of the Republic of Kazakhstan if other is not provided by the Law of the Republic of Kazakhstan "About compulsory social medical insurance".

The foreigners and members of their families who are temporarily staying in the territory of the Republic of Kazakhstan in accordance with the terms of the international treaty ratified by the Republic of Kazakhstan have the rights and perform duties in the OSMS system on an equal basis with citizens of the Republic of Kazakhstan if other is not provided by the laws and international treaties.

Members of the family of foreigners are jointly the living spouses (spouse) and children.

2. Medical care in the OSMS system is provided in the form of complex of the medical services including the medicinal help, directed to preserving and recovery of population health.

3. In the OSMS system are provided:

1) the consulting and diagnostic help with the direction of the specialist of primary health care (further - PHC) and profile specialists;

2) the hospital-replacing help, except as specified treatments of diseases within the guaranteed amount of free medical care (further - GOBMP), in the direction of the specialist of PHC or the medical organization;

3) the planned stationary help, except as specified treatments of diseases within GOBMP, in the direction of the specialist of PHC or the medical organization within the planned quantity of cases of hospitalization;

4) medical rehabilitation and recovery treatment in the direction of the specialist of PHC or the medical organization for the list of diseases (conditions) approved by authorized body;

5) pathoanatomical diagnosis of the diseases which are not entering into GOBMP.

Chapter 2. The list of medical care in the OSMS system

4. Consulting and diagnostic help with the direction of the specialist of PHC and profile specialists:

1) routine medical examinations of children aged up to eighteen years and persons is more senior than eighteen years according to the procedure and with frequency, approved by authorized body, according to Item 7 of article 155 of the Code of the Republic of Kazakhstan "About health of the people and health care system" (further - the Code);

2) acceptance and consultations by profile specialists of persons with the diseases which are not subject to dynamic observation within GOBMP including:

diagnostic services, including laboratory diagnostics, in indications, in the direction of the specialist according to the procedure, approved by authorized body;

application of the high-technology medical services provided according to the procedure, approved by authorized body, according to Item 2 of article 42 of the Code;

accomplishment by profile specialists of medical manipulations and procedures according to the procedure, approved by authorized body;

rendering the hospital-replacing help according to Item 5 of this list;

the statement of recipes on medicines and medical products, including separate categories of citizens with certain diseases (conditions), providing with medicines at the out-patient level according to the list approved by authorized body according to the subitem 2) Item 1 of article 88 of the Code;

the expertize of temporary disability which is carried out according to the procedure, approved by authorized body, according to Item 2 of article 59 of the Code.

3) rendering the emergency and planned dental help to separate categories of the population according to the list approved by authorized body.

5. The hospital-replacing help is provided, except as specified treatments of diseases within GOBMP, in the direction of the specialist of PHC or the medical organization and includes:

1) survey, consultations of profile specialists;

2) diagnostic services, including laboratory diagnostics;

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