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LAW OF THE KYRGYZ REPUBLIC

of July 30, 2003 No. 159

About system of the single payer in financing of health care of the Kyrgyz Republic

Accepted by General Court of Jogorku Kenesh of the Kyrgyz Republic on June 24, 2003

(as amended on 22-08-2020)

This Law determines legal, organizational and financial basis of functioning of system of the Single payer when financing health care in the Kyrgyz Republic.

Chapter I. General provisions

Article 1. Concept of system of the Single payer

System of the Single payer - consolidation of financial resources of health care from means of basic national health insurance and compulsory medical insurance for the purpose of the subsequent carrying out single-channel financing by calculations for the medical and sanitary and pharmaceutical services rendered to the population by the organizations of health care.

Functioning of system of the Single payer provides determination in the Kyrgyz Republic of the single financing body of health care with transfer of powers of management of means of basic national health insurance and compulsory medical insurance to it.

Article 2. The basic concepts and determinations used in this Law

The program of the state guarantees for providing citizens with the medical and sanitary help (further - the Program of the state guarantees) - the guaranteed amounts, types and conditions of provision of the medical and sanitary help to citizens providing realization of their rights to the medical and sanitary help in the organizations of health care irrespective of patterns of ownership, according to the legislation of the Kyrgyz Republic in health sector, basic state and compulsory medical insurance.

Average cost of the treated case - the average settlement value reflecting the sizes of the means of basic national health insurance, compulsory medical insurance and copayment of the population directed for each treated patient.

The per capita standard rate - average settlement value of financing of primary and specialized medical and sanitary help on one served or attached inhabitant with adjustment on the correction coefficients considering gender and age structure of the population, geographical and economic regional features.

The standard rate of financing of ambulance crew - average settlement value of financing of one ambulance crew in the year reflecting average total costs on provision of the ambulance and emergency aid.

The consolidated budget of health care of the Kyrgyz Republic - set of means of the government budget, basic national health insurance, compulsory medical insurance, external borrowings and grant help of donors, and also the means accumulated on special treasurer accounts, the means received from copayment of the population in health care system and other means which are not forbidden by the legislation of the Kyrgyz Republic.

The supplier - the physical person or legal entity providing medical and other services in system of the Single payer on the basis of the signed agreements.

State body, authorized to perform financing of programs basic state and compulsory medical insurance, - the state body realizing state policy in the sphere basic state and compulsory medical insurance.

Article 3. Purpose and basic principles of system of the Single payer

The purpose of introduction of system of the Single payer is consolidation of the budget of health care for resource ensuring execution of the Program of the state guarantees and enhancement of methods of financing in health care.

Basic principles of functioning of system of the Single payer:

- equal availability to citizens in receipt of the medical and sanitary help according to the Program of the state guarantees;

- equal access for suppliers to financial resources of industry of health care;

- contractual relations between the bodies performing functions of the Single payer and the Supplier;

- step-by-step equalization of the amounts of financing of health care of regions of the republic;

- use by the Supplier in case of program implementation of the state guarantees of single methods of forming of rates (prices) of the provided services;

- economic autonomy of the Supplier in use of means of basic national health insurance, compulsory medical insurance and copayment.

The means of basic national health insurance, compulsory medical insurance, copayment of the population and special means received by the Supplier by calculations in system of the Single payer are not subject to the taxation and withdrawal in the government budget.

Article 4. State body, authorized to perform functions of the Single payer

Single payer in the Kyrgyz Republic is the state body realizing state policy in the sphere basic state and compulsory medical insurance and authorized to perform financing of programs basic state and compulsory medical insurance.

Article 5. Financial bases of functioning of system of the Single payer

The system of the Single payer functions by the territorial principle.

Means of basic national health insurance are transferred to the control to Fund of medical insurance and to its territorial subdivisions.

Management of means of basic national health insurance provides the right of the Single payer to dispose of them in case of distribution of budgetary funds between suppliers.

The single payer based on the agreements signed with the Supplier performs payment of their services from means basic state and compulsory medical insurance by carrying out single-channel financing.

The payment procedure of the medical, preventive and pharmaceutical services rendered to citizens in system of the Single payer consists of basic standard rates of payment with adjustment on the correction coefficients determined by the Government of the Kyrgyz Republic.

The basic standard rate of payment of medical, preventive and pharmaceutical services is determined by types of the medical and sanitary help taking into account the predicted financial performance and amounts of the medical and sanitary help.

When forming the budget of health care and carrying out settlings with the Supplier the following standard rates of financing are used:

- fast emergency medical service - according to the standard rate of content of one crew in year;

- primary health care - according to the per capita standard rate on one attached inhabitant;

- the specialized medical and sanitary help in out-patient conditions - according to the per capita standard rate on one inhabitant of the served region;

- the specialized medical and sanitary help provided by out-patient and diagnostic departments of hospitals of general profilyapo to the per capita standard rate on one inhabitant of the served region;

- the specialized medical and sanitary help in hospitals - on average cost of the treated case;

- sanitary and hygienic and anti-epidemic actions - according to the per capita standard rate on one inhabitant of the served region;

- the medico-public assistance, medical rehabilitation and servicing in hospitals of long stay - in volume of funds for their content under Articles of budget classification of costs.

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