ORDER OF THE GOVERNMENT OF THE REPUBLIC OF MOLDOVA

of December 23, 2024 No. 874

About the Single program of compulsory medical insurance

Based on part (1) article 2 of the Law No. 1585/1998 on compulsory medical insurance (The official monitor of the Republic of Moldova, 1998, Art. No. 38-39, 280), with subsequent changes, DECIDES: the Government

1. Approve the Single program of compulsory medical insurance it (is applied).

2. To the Ministry of Health and National medical insurance company:

2.1. approve Methodological regulations on application of the Single program of compulsory medical insurance from the effective date of this resolution;

2.2. annually before approval of the law on funds of compulsory medical insurance to provide establishment of needs of the population for the medical services correlated to health care system opportunities;

2.3. within one month after approval of the law on funds of compulsory medical insurance to provide approval and publication in the Official monitor of the Republic of Moldova of Criteria of the conclusion of contracts with suppliers of medical services within system of compulsory medical insurance for the corresponding year, within means of funds of compulsory medical insurance;

2.4. exercise control of application of provisions of the Single program of compulsory medical insurance, Methodological regulations and Criteria of the conclusion of contracts with suppliers of medical services within system of compulsory medical insurance for the corresponding year.

3. National medical insurance company:

3.1. organize together with bodies of local public authority and suppliers of medical and pharmaceutical services process of informing the population on amount of the medical care provided in the Single program of compulsory medical insurance and also about the list of the compensated drugs and medical products;

3.2. provide transparency of management of financial resources of funds of compulsory medical insurance together with suppliers of medical and pharmaceutical services;

3.3. protect interests of faces included in system of compulsory medical insurance regarding observance by suppliers of medical and pharmaceutical services of conditions of agreements according to regulations.

4. Declare invalid the Order of the Government No. 1387/2007 about approval of the Single program of compulsory medical insurance (The official monitor of the Republic of Moldova, 2007, Art. No. 198-202, 1443), with subsequent changes.

5. This resolution becomes effective since January 1, 2025.

Approved by the Order of the Government of the Republic of Moldova of December 23, 2024 No. 874

Single program of compulsory medical insurance

Chapter I. General provisions

1. The single program of compulsory medical insurance (further - the Single program) establishes amount of medical services, the list of the diseases and conditions requiring medical care, financed by means of funds of compulsory medical insurance and also the types of medical care provided by suppliers of medical services with whom the National medical insurance company signs contracts.

2. The amount of medical services represents set of medical services about which rendering by the National medical insurance company signs contracts with suppliers of medical services and which are established within the available means approved for the corresponding year by types of medical care.

3. Types of medical care represent specific complex of medical services, and also procedure for their provision by suppliers.

4. Conditions of provision of amount of services for each type of medical care are established in the Methodological regulations on application of the Single program (further - Methodological regulations) approved by the general order of the Minister of Health and CEO of National medical insurance company.

5. The conclusion of contracts with suppliers of medical services is performed based on amount of medical services, criteria of the conclusion of contracts with suppliers of the medical services and rates approved according to regulations which can be reviewed only towards their reduction. Are not allowed provision of these services in the cost exceeding the cost provided in the agreement and the requirement of additional fare from insured person.

6. The national medical insurance company signs contracts on leave of the drugs and medical products compensated from funds of compulsory medical insurance with the suppliers of pharmaceutical services performing activities according to regulations.

7. Heads of medical institutions bear responsibility for accomplishment of the amount of medical care provided in the Single program about which rendering by the National medical insurance company signs contracts.

Chapter II. Amount of the medical care provided within system of compulsory medical insurance

8. The amount of medical services about which rendering by the National medical insurance company signs contracts with suppliers of medical services according to the Single program provided to the faces included in system of compulsory medical insurance is determined on basis:

8.1. demographic tendencies, the mortality rate characteristic of the Republic of Moldova, and priorities in the sphere of public health;

8.2. providing equal and continued access to the main, safe and high-quality medical services;

8.3. lack of discrimination on any sign by provision of medical services.

9. Urgentny pre-hospital medical care is provided to all persons irrespective of whether person is insured / uninsured, in the amount established in the Single program at the expense of means of funds of compulsory medical insurance.

10. Primary medical care is provided in the amount established in the Single program, to all citizens of the Republic of Moldova irrespective of whether person to insured / uninsured, and also foreign citizens with the right of stay in the Republic of Moldova, according to regulations is.

11. Specialized out-patient medical care, including dental, stationary medical care, highly specialized medical services, medical care at home and palliative care, is provided to insured persons in the amount established in the Single program and is financed by means of funds of compulsory medical insurance.

12. Specialized out-patient and stationary medical care in case of socially caused diseases significantly influencing public health is provided to all persons, including uninsured, and becomes covered at the expense of means of funds of compulsory medical insurance.

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