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ORDER OF THE GOVERNMENT OF THE REPUBLIC OF MOLDOVA

of December 19, 2018 No. 1246

About approval of the Regulations on provision/suspension of the status of insured person in system of compulsory medical insurance

Based on part (4) article 6-1 of the Law No. 1585/1998 on compulsory medical insurance (The official monitor of the Republic of Moldova, 1998, Art. No. 38-39, 280) DECIDES: the Government

1. Approve Regulations on provision/suspension of the status of insured person in system of compulsory medical insurance it (is applied).

2. Recognize invalid:

1) paragraph two of Item 3 of the Order of the Government No. 1432/2002 on some measures for implementation of compulsory medical insurance (Official monitor of the Republic of Moldova, 2002, Art. No. 151-153, 1567);

2) the Order of the Government No. 1015/2006 about approval of some regulations (The official monitor of the Republic of Moldova, 2006, Art. No. 153-156, 1163).

3. This resolution becomes effective from the date of publication.

Prime Minister

Paweê Phillip

Countersigns:

Minister of Health, work and social protection

 

Silvius Rada

Approved by the Order of the Government of the Republic of Moldova of December 19, 2018 No. 1246

Regulations on provision/suspension of the status of insured person in system of compulsory medical insurance

I. General provisions

1. The regulations on provision/suspension of the status of insured person in system of compulsory medical insurance (further - the Provision) regulate procedure for provision/suspension of the status of insured person in system of compulsory medical insurance (further - compulsory health insurance), the mechanism of calculation of fee of compulsory health insurance in fixed amount and penalty fee on it, and also identifications of the uninsured persons obliged to be insured in individual procedure.

2. The requirement of this provision does not extend to the mechanism of calculation of fees of the compulsory health insurance estimated as a percentage of the salary and other payments and also penalty fee on them.

II. Accounting of persons insured in the compulsory health insurance system

3. The national company of medical insurance (further - NKMS) records the physical persons included in the compulsory health insurance system in the Register of accounting of persons insured in system of compulsory medical insurance, the NKMS single database organized according to requirements of the legislation, and which is component of the Automated information system "Compulsory medical insurance".

4. The insurance number is assigned to the physical person registered in the Register of accounting of persons insured in system of compulsory medical insurance. Accounting in the Register of accounting of persons insured in system of compulsory medical insurance is performed based on the state identification number (IDNP) or series and number of the identity certificate of national passport system - for people without IDNP, and number of compulsory medical insurance.

5. The status of insured person is checked by request in the Automated information system "Compulsory medical insurance" available on the HKMC (www.cnam.md) web page, in the heading "Verification of the Status in the Compulsory Health Insurance System".

6. The status of insured person in the compulsory health insurance system is the quality appropriated to physical person by inclusion in one of categories of insured persons:

1) the working insured persons:

a) according to the individual employment contract, according to the Labor code of the Republic of Moldova No. 154/2003, irrespective of the term of hiring and payment method of work for which compulsory health insurance fees in percentage ratio to the salary and other payments are paid;

b) workers of residences of parks of information technologies for whom compulsory health insurance fees based on the amounts allocated from receipts of the single tax are paid;

c) the drivers transporting people in the mode of taxi which pay monthly compulsory health insurance fees in the amount of 1/12 from compulsory health insurance fee in fixed amount;

2) persons insured by the Government - the unemployed physical persons included in one of the categories specified in part (4) article 4 of the Law No. 1585/1998 on compulsory medical insurance concerning which the Government acts as the insurer and compulsory health insurance fees for these categories are paid from the government budget (except for persons obliged to be insured according to the law in individual procedure);

3) persons insured in individual procedure - unemployed physical persons who belong to category of payers of fee of compulsory health insurance in fixed amount, the compulsory health insurances provided in appendix 2 to the Law No. 1593/2002 on the size, procedure and payment due dates of fees of compulsory medical insurance, paid fee in fixed amount in individual procedure.

7. The status of insured person is for:

1) physical person - the basis for receipt of the medical services provided by the Single program of compulsory medical insurance;

2) the supplier of medical, pharmaceutical services with whom NKMS signed the agreement - the basis for rendering medical services and issue of the compensated medicines to insured persons on the conditions provided by the Single program of compulsory medical insurance, methodological instructions for its application and also the signed agreement financed from compulsory health insurances funds;

3) NKMS - the basis for protection of interests of insured face, payment of the medical services rendered by suppliers of medical and pharmaceutical services with which the agreement, forming of information base of accounting of insured/uninsured persons in the compulsory health insurance system is signed.

III. Provision/suspension of the status of insured person

8. NKMS provides/stops the status of insured person in the compulsory health insurance system based on article 6 of the Law No. 1585/1998 on compulsory medical insurance.

9. By provision of the status of insured person, in case of belonging of physical person at the same time to categories "the persons insured by the Government", "persons, insured in individual procedure" and "the working insured persons", in priority procedure the status "the working insured person" is provided.

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