of July 28, 2021 No. PP-5199
About measures for further enhancement of system of rendering specialized medical care in health sector
For the purpose of forming of effective system of servicing in the sphere of rendering to the population of the highly skilled specialized medical care conforming to modern requirements on the basis of the principles of publicity, justice and transparency, and also enhancement and complete digitalization of the mechanism of issue of orders:
1. Establish procedure according to which:
a) since October 1, 2021 the procedure for issue of orders on the basis of quota of preferential category of persons in the public medical institutions (further - specialized agencies) specified in the list of appendix No. 1 to this resolution at the expense of means of the Government budget is cancelled and the electronic information system (further - information system) registrations and the directions of specified persons on treatment according to the procedure of priority on the basis of new funding mechanism takes root.
Determine that in case of the direction of preferential category of persons on treatment in specialized agencies:
proceeding from severity of disease by means of information system transparent mechanisms of priority are used;
the citizens included in category of persons from needy families are determined by means of the information system "Unified Register of Social Protection";
the possibility of receipt by patients of information on the requests, addresses and priority in real time is provided;
the direction (further - the direction) providing treatment in specialized agencies according to their diseases with indication of the cost of medical services and the put matrix barcode is issued to patients (QR code);
the direction is created in information system in automatic procedure and grants the right to medical services in the state or non-state medical organizations. At the same time, the direction voids if the patient within 60 days after approval of this direction did not address to the relevant medical organization;
after completion of treatment of the patient the State fund of medical insurance transfers to medical institution the spent funds on the basis of the documents proving the medical services rendered to the patient within basic prices at the expense of the Government budget. At the same time the actual costs incurred by the state medical organizations performing treatment of patients based on the directions when rendering emergency medical service to all persons are compensated by the State fund of medical insurance at the expense of means of the Government budget on the basis of the documents proving the rendered medical services;
b) rendering medical services of preferential category of persons at the expense of means of the Government budget is allowed to the non-state medical organizations:
since November 1, 2021 - in the direction of microsurgery of eye and urology;
since January 1, 2022 - in the direction of cardiology, traumatology and orthopedics, obstetrics and gynecology;
since July 1, 2022 - in the direction of surgery and neurosurgery;
c) till January 1, 2022 use of the orders which are drawn up according to the operating procedure for their issue is allowed;
d) since October 1, 2022 the procedure for registration and treatment of preferential category of persons in the public medical institutions specified in appendix No. 2 to this resolution according to the procedure of priority, by means of electronic information system at the expense of means of the Government budget on the basis of new funding mechanism takes root. Before entry into force of this procedure the specified public medical institutions are financed by one line of the qualifier of expenses according to the distribution approved by the Ministry of Health of the Republic of Uzbekistan through the State fund of medical insurance. At the same time medical institutions provide the monthly report on the medical services rendered at the expense of budgetary funds, to the State fund of medical insurance.
Determine that expenses on content of departments of emergency medical service, hemodialysis, delivery rooms and departments of infectious diseases of the public medical institutions provided in appendix No. 2 to this resolution are financed by the Ministry of Health based on accounting of expense budget, expenses of all other departments on rendering medical services by the patient having privileges become covered through the State fund of medical insurance for basic prices;
e) the preferential category of persons has the right to the free choice at discretion of the state or non-state medical organizations rendering medical services, having the contract with the State fund of medical insurance;
e) requirements imposed to the non-state medical organizations rendering medical services to preferential category of persons at the expense of means of the Government budget affirm the Ministry of Health;
g) rendering medical services of preferential category of persons by the non-state medical organizations is performed based on the agreement signed with the State fund of medical insurance proceeding from basic prices;
h) The Ministry of Health together with the Ministry of Finance approves the list of diseases which treatment is performed at the expense of means of the Government budget in the public medical institutions provided in appendix No. 2 to this resolution.
2. Determine that the quality evaluation and control of compliance of the medical services rendered to preferential category of persons, the approved standards, and also efficiency and effectiveness of use of allocated funds are performed by the State fund of medical insurance.
The part exceeding basic cost of expenses on the medical care provided to preferential category of patients on the basis of the diagnosis established as a result of inspection and treatment and also in the conditions of resuscitation and intensive therapy, to the patient who are in a serious condition in the state or non-state medical organizations is compensated by Fund of national health insurance according to the conclusion about consideration. The procedure for consideration of these circumstances is determined by the Cabinet of Ministers.
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