RESOLUTION OF THE PRESIDENT OF THE REPUBLIC OF UZBEKISTAN

of September 5, 2024 No. PP-311

About measures for implementation of mechanisms of national health insurance

For the purpose of improvement of quality of the medical services rendered to the population, consecutive continuation of the reforms realized in health care system, effective use of budgetary funds, and also implementation of works on implementation of mechanisms of national health insurance in other regions of the republic:

1. Determine that rendering free medical services and provision of medicines within national health insurance are performed at the expense of the taxes paid to the Government budget. At the same time the additional fee for national health insurance is not levied from the population.

2. Step by step to implement mechanisms of national health insurance in the Republic of Karakalpakstan, areas and the city of Tashkent according to appendix No. 1, according to which:

a) the guaranteed amounts of medical care covered at the expense of means of the Government budget affirm (further - the guaranteed packet) and the medical services and medicines included in this packet are provided by fund of national health insurance (further - Fund);

b) free use of the medical services included in the guaranteed packet requires passing of the corresponding medical examinations at the scheduled time, the address to the family doctor or medical crew (except for rendering emergency and emergency medical service). At the same time the family doctor according to standards of treatment and diagnostics issues the electronic direction to doctors of narrow profile, if necessary - in hospitals, based on this direction survey by doctors of narrow profile and (or) hospitalization of the patient are carried out. In case of non-compliance with the specified procedure medical services are rendered on paid basis;

c) between the organizations giving primary health care and attached to them by the citizens of the Republic of Uzbekistan, foreign citizens recognized as tax residents of the Republic of Uzbekistan, and also stateless persons (for minors - their parents or other legal representatives) sign the agreement.

The agreement to them assigns such obligations as observance of healthy lifestyle, disposal of addictions, increase in medical literacy, execution of doctor's instructions, passing of preventive and screening surveys at the scheduled time, to family doctors - conducting acceptance and provision of consultations (or the directions) to the population in accordance with the established procedure, timely and high-quality rendering medical services in full, the correct prescription of medicines;

d) medicines within the guaranteed packet are provided by drugstores to patients free of charge based on the electronic recipe which is drawn up by the doctor, the corresponding cost of drugstores is covered by fund (further - the program of reimbursation).

At the same time the list of the medicines provided based on the program of reimbursation affirms the Ministry of Health, procedure for determination of the amount of their covering and implementation of payments - the Supervisory board of Fund;

e) the information system "Electronic Health Care" integrated with information systems of other state bodies and including processes of activities of the medical organizations is created and started;

e) purchase included in the guaranteed packet of medical services through Fund takes root, and also on the basis of concluded between Fund and the medical organizations of the agreement financing of their activities is performed.

At the same time financing of the organizations of primary health care rendering out-patient medical services is performed on the basis of per capita financing according to the amount of works established by the agreement, hospitals (except for hospitals of republican level) - by payment at least 15 percent of the funds allocated by it for each treated case;

g) the state and non-state medical organizations are involved in rendering the medical services included in the guaranteed packet;

h) proceeding from severity of disease in case of delivery of health care in district (city), regional and republican hospitals the list of diseases which treatment is performed on free basis affirms and takes root into practice;

i) treatment of preferential category of persons is performed on doctor's orders free of charge at the expense of means of the Government budget based on the direction created by means of information system.

3. Determine that since January 1, 2026 are allocated with the right to free receipt of planned stationary medical care based on electronic queue in medical institutions of district (city) and territorial level in regions in which mechanisms of national health insurance are implemented:

a) taxpayers on the income of physical persons or the social tax;

b) persons who according to the Tax code paid the established amount of the taxes necessary for calculation of working life;

c) the minors, pupils and students of the educational organizations, expectant mothers and persons which are engaged in child care aged up to two years, persons officially registered by bodies for work as the unemployed receivers of national pension and members of the families recognized needy by means of the information system "Unified Register of Social Protection" or members of the families recognized by the poor by means of the information module "Register of Poor Families".

Since January 1, 2027 high-technology medical care is provided to persons who within last one year at least 6 months paid income tax or the social tax, and also specified in subitems "b" and "v" of this Item in system of national health insurance on free basis.

To the ministries and departments according to appendix No. 2 in case of the direction of patients in hospital to create possibility of provision online of the information about persons specified in this Item with implementation of integration of the electronic information systems with the information system "Electronic Health Care".

4. Approve:

The plan died on implementation of mechanisms of national health insurance according to appendix No. 3;

The list of the medical equipment for equipment of the public medical institutions of the city of Tashkent according to appendix No. 4;

The list of the information and communication equipment and network devices for providing the public medical institutions of the city of Tashkent according to appendix No. 4a;

The list of the medical equipment for equipment of the public medical institutions of the Republic of Karakalpakstan according to appendices No. No. 5 and 5a;

The list of the information and communication equipment and network devices for providing the public medical institutions of the Republic of Karakalpakstan according to appendix No. 5b;

The list of the medical equipment for equipment of the public medical institutions of the Syr Darya region according to appendices No. No. 6 and 6a;

The list of the information and communication equipment and network devices for providing the public medical institutions of the Syr Darya region according to appendix No. 6b;

Regulations on Fonda of national health insurance according to appendix No. 7.

Resolve purchase according to the procedure of the exception of the information and communication equipment and network devices acquired according to this Item without development of the preproject documentation and technical and economic calculation based on the signed direct contracts with suppliers by means of The Single Integrator on Creation and Support of the State Information Systems UZINFOKOM LLC within the means provided on these purposes.

5. Direct in 2024 170 billion sum to financing of actions, the stipulated in Item 4 presents of the resolution, at the expense of the following sources:

The state trust fund of development of medicine - 71 billion sum (from them 21 billion sum - residual means);

the means which are in addition allocated from the Government budget - 50 billion sum;

within the funds of the republican budget allocated to the Ministry of Health - 23 billion sum;

from the republican budget of the Republic of Karakalpakstan - 11 billion sum;

from the local budget of the city of Tashkent - 10 billion sum;

from the local budget of the Syr Darya region - 5 billion sum.

Since 2025 the necessary means connected with equipment of medical institutions the medical equipment are provided when forming parameters of the Government budget.

6. Establish procedure according to which within implementation of mechanisms of national health insurance:

a) till the end of 2024 the information systems "Electronic Polyclinic" and "Electronic Hospital" created on the basis of all medical data on patients and providing interaction of medical institutions take root into practice;

b) the information system of national health insurance giving opportunity of studying of compliance of the rendered medical services to the guaranteed packet, implementation of payments to medical institutions depending on amount of completed work and results achieved by them is developed and takes root into practice by Fund;

c) power on change of specialization of divisions and quantities of beds in them within capacity of organization, and also on establishment of number of personnel according to amount of works within allocated funds is conferred to the head of medical institution;

d) the public medical institutions financed through Fund on the basis of purchase of medical services are given the status of the receiver of budgetary funds. At the same time the procedure for collection of taxes and obligatory payments in the Government budget established for state-financed organizations extends to them;

e) the approved regular standard rates of medical institutions have advisory nature, since July 1, 2025 the separate procedure and payment terms of work of health and pharmaceutical workers take root;