ORDER OF THE MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of December 8, 2020 No. KR DSM-242/2020

About approval of rules of purchase of services at subjects of health care in delivery of health care within the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance

According to the subitem 62) article 7 of the Code of the Republic of Kazakhstan of July 7, 2020 "About health of the people and health care system" and Item 1 of article 34 of the Law of the Republic of Kazakhstan of November 16, 2015 "About compulsory social medical insurance" PRIKAZYVAYU:

1. Approve rules of purchase of services at subjects of health care in delivery of health care within the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance according to appendix 1 to this order.

2. Recognize invalid some orders of the Ministry of Health of the Republic of Kazakhstan according to appendix 2 to this order.

3. To provide to department of coordination of compulsory social medical insurance of the Republic of Kazakhstan in the procedure established by the legislation of the Republic of Kazakhstan:

1) state registration of this order in the Ministry of Justice of the Republic of Kazakhstan;

2) placement of this order on Internet resource of the Ministry of Health of the Republic of Kazakhstan after its official publication;

3) within ten working days after state registration of this order in the Ministry of Justice of the Republic of Kazakhstan provision in Legal department of the Ministry of Health of the Republic of Kazakhstan of data on execution of the actions provided by subitems 1) and 2) of this Item.

4. To impose control of execution of this order on the first vice-Minister of Health of the Republic of Kazakhstan Shoranov M. E.

5. This order becomes effective since January 1, 2021 and is subject to official publication.

It is approved Ministry of national economy of the Republic of Kazakhstan

 

Appendix 1

to the Order Minister of Health of the Republic of Kazakhstan of December 8, 2020 No. KR DSM-242/2020

Rules of purchase of services at subjects of health care in delivery of health care within the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance

Chapter 1. General provisions

1. These rules of purchase of services at subjects of health care in delivery of health care within the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance (further – Rules) are developed according to the subitem 62) of article 7 of the Code of the Republic of Kazakhstan "About health of the people and health care system" (further – the Code) and Item 1 of article 34 of the Law of the Republic of Kazakhstan "About compulsory social medical insurance" (further – the Law on OSMS) and determine procedure for purchase of services at subjects of health care within the guaranteed amount of free medical care (further – GOBMP) and (or) in system of compulsory social medical insurance (further – OSMS).

2. The purchase of services at subjects of health care within GOBMP is performed by fund of social medical insurance (further - fund) and (or) administrators of the budget programs.

The purchase of services at subjects of health care in the OSMS system is performed by fund.

The purchase of services at subjects of health care within GOBMP and (or) in the OSMS system is performed by the choice of subjects of health care and placement of amounts of services and (or) amounts of means (further - purchase of services).

3. The basic concepts used in these rules:

1) the appeal commission – the permanent body created by fund or the administrator of the budget programs for consideration of the questions arising on purchase of services in delivery of health care within GOBMP and in the OSMS system;

2) the collaborator – the subject of health care included in the database of the subjects of health care applying for delivery of health care within GOBMP and (or) in the OSMS system (further – the database) with whom the supplier signed the agreement of co-execution for execution of part of obligations of the supplier under the signed agreement of purchase of services;

3) authorized body in the field of health care (further – authorized body) – the central executive body performing management and cross-industry coordination in the field of protection of public health of the Republic of Kazakhstan, medical and pharmaceutical science, medical and pharmaceutical education, sanitary and epidemiologic wellbeing of the population, drug circulation and medical products, qualities of rendering medical services (help);

4) subjects of health care – the organizations of health care, and also the physical persons practising private medicine and pharmaceutical activities;

5) the organization of health care – the legal entity performing activities in the field of health care;

6) the database – the list of the subjects of health care applying for delivery of health care within GOBMP and (or) in the OSMS system, created according to the procedure for accounting of the subjects of health care providing medical care within GOBMP and (or) in the OSMS system, approved in compliance with the subitem 67) of article 7 of the Code (further – Rules of accounting);

7) again entered health care facility – the object for the first time accepted in operation by construction new or for the first time opened by change of the existing object according to the Law of the Republic of Kazakhstan "About architectural, town-planning and construction activities in the Republic of Kazakhstan";

8) high-technology medical service – the service rendered by profile specialists in case of the diseases requiring use of innovative, resource-intensive and (or) unique methods of diagnostics and treatment;

9) fund – the non-profit organization making accumulation of assignments and fees, and also performing purchase and fee of the subjects of health care providing medical care in amounts and on the conditions provided by the agreement of purchase of medical services and other functions determined by the laws of the Republic of Kazakhstan;

10) assets of fund – assignments and fees, the penalty fee received for delay of payment of assignments and (or) fees, investment revenue minus commission fee on ensuring activities of fund, and also other receipts in fund which are not forbidden by the legislation of the Republic of Kazakhstan;

11) reserve of fund on contingencies – the means provided by fund the current financial year for financing of contingencies in the period of covering, created on monthly basis;

12) branch of fund – the separate division of fund located out of the place of its stay and performing everything or part of its functions including functions of representation;

13) the web portal of purchase of services at subjects of health care (in relation to Rules) – the information system providing single point of access to electronic services of purchase of services at subjects of health care within GOBMP and (or) in the OSMS system (further – the web portal);

14) the electronic copy of the document – the document which is completely reproducing type and information (data) of the authentic document in electronic and digital form;

15) the supplier – the subject of health care with whom the fund or the administrator of the budget programs signed the agreement of purchase of services according to these rules;

16) medical care in the OSMS system – the amount of medical care provided to consumers of medical services for the asset account of fund;

17) medical information system – the information system providing conducting processes of subjects of health care in electronic format;

18) medical care – complex of the medical services directed to preserving and recovery of population health including provision of medicines;

19) quality of medical care – the level of compliance to the provided medical care to standards of delivery of health care;

20) medical services – the actions of subjects of health care having preventive, diagnostic, medical, rehabilitation and palliative orientation in relation to the specific person;

21) state body in the sphere of rendering medical services (help) – the state body performing management in the sphere of rendering medical services (help), control of quality of medical services (help);

22) the subject of health care giving primary health care (further – the subject of PHC) – the subject of health care giving primary health care within GOBMP and (or) in the OSMS system to the attached population registered in the Registr Prikreplennogo Naseleniya portal (further – the RPN portal);

23) the agreement of public-private partnership – the written agreement determining the rights, obligations and responsibility of the parties of the agreement of public-private partnership, other terms of the contract of public-private partnership within project implementation of public-private partnership;

24) production base – the place of rendering medical services according to appendix to the license granted according to the legislation of the Republic of Kazakhstan on permissions and notifications;

25) the republican organizations of health care – the organizations of health care which are under authority of authorized body, organization of health care of the autonomous organization of education, the organizations of medical education;

26) the independent expert – the physical person conforming to the requirements determined by authorized body and consisting in the register of independent experts;

27) the agreement of purchase of services in collateral security of GOBMP (further – the agreement of purchase of services) – the agreement in writing between the administrator of the budget programs and the subject of health care providing delivery of health care within GOBMP;

28) the agreement of purchase of medical services within GOBMP or in the OSMS system (further – the agreement of purchase of services) – the agreement in writing between fund and the subject of health care providing delivery of health care within GOBMP and in the OSMS system;

29) the subject of digital health care (in relation to Rules) – the legal entity performing activities or entering the public relations in the field of digital health care regarding information and technical maintenance of information systems of health care including ensuring information security and organizational and methodical work with subjects of health care;

30) the electronic document – the document in which information is provided in electronic and digital form and is certified by means of the digital signature;

31) the digital signature (further – the EDS) – set of electronic digital symbols created by means of the digital signature and confirming reliability of the electronic document, its accessory and invariance of content.

Chapter 2. Procedure for purchase of services at subjects of health care in delivery of health care within the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance

4. The purchase of services at the subjects of health care performing rendering services in prevention of spread of coronavirus of COVID-19 and (or) to treatment of patients with COVID-19, coronavirus with suspicion of COVID-19, coronavirus according to the list determined by local state body health care of areas, cities of republican value and the capital (further – management of health care) in coordination with territorial subdivision of state body in the sphere of sanitary and epidemiologic wellbeing of the population, is performed by fund without holding procedures of the choice of subjects of health care within the plan of purchase of medical services.

Management of health care within three working days from the date of approval of the list specified in part one of this Item sends it to branch of fund.

Validity of purchase of services on rendering services in prevention of spread of coronavirus of COVID-19 and (or) to treatment of patients with coronavirus of COVID-19, including with suspicion of coronavirus of COVID-19 and (or) viral pneumonia, extends to the period from start date of rendering services.

5. The purchase of services within GOBMP and (or) in the OSMS system consists of the following stages:

1) planning of amounts of purchase of services within GOBMP and (or) in the OSMS system;

2) the choice of subjects of health care for rendering services within GOBMP and (or) in the OSMS system;

3) conclusion of the agreement of purchase of services;

4) agreement performance of purchase of services.

6. The purchase of services in delivery of health care is performed based on plans of purchase of medical services within GOBMP or in the OSMS system.

7. Rules of planning of amounts of medical services within GOBMP and (or) affirm as the OSMS system based on the subitem 63) of article 7 of the Code.

8. For the choice of subjects of health care and placement of amounts of services among them the fund or the administrator of the budget programs create the commissions on the choice of subjects of health care and placement of amounts of services (further - the commission).

Under central office of fund the republican commission is created, under branches of fund - regional commissions.

9. The total quantity of members of the commission constitutes odd number.

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