LAW OF THE REPUBLIC OF KAZAKHSTAN

of November 16, 2015 No. 405-V ZRK

About compulsory social medical insurance

This Law governs the public relations arising in system of compulsory social medical insurance for the purpose of realization of constitutional right of citizens on health protection.

Chapter 1. General provisions

Article 1. The basic concepts used in this Law

In this Law the following basic concepts are used:

1) The Government for Citizens State corporation (further - the State corporation) - the legal entity created according to the decision of the Government of the Republic of Kazakhstan for rendering the state services according to the legislation of the Republic of Kazakhstan, the organization of work on reception of applications on rendering the state services and issue of their results to uslugopoluchatel by the principle of "one window", ensuring rendering the state services electronically;

1-1) assignments - the money paid by employers at the expense of own means to fund of social medical insurance, granting the right to consumers of medical services for whom payment of assignments was performed to receive medical care in system of compulsory social medical insurance;

2) payers of assignments and (or) fees (further - payers) - persons performing calculation, deduction, transfer, payment of assignments and (or) fees in fund of social medical insurance according to the procedure, established by this Law;

3) fund of social medical insurance (further - 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;

4) 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);

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

6) purchase of services at subjects of health care - planning, the choice, the conclusion and agreement performance of purchase of medical services;

7) fees - the money paid to fund by the payers of fees specified in Item 2 of article 14 of this Law, and granting the right to consumers of medical services to receive medical care in system of compulsory social medical insurance;

7-1) person who is engaged in private practice - the private notary, the private legal executive, the lawyer, professional mediator;

7-2) investment revenue - the increments of assets of fund in terms of money received as a result of their investment;

8) 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;

9) the joint commission on quality of medical services (further - the joint commission) - the advisory advisory body under authorized body created for development of recommendations about enhancement of clinical protocols, standards of medical education, provision of medicines, standards of quality control system and availability of services in the field of health care;

10) the agreement of purchase of medical services (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 the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance;

11) the consumer of medical services - the physical person having according to this Law the right to medical care in system of compulsory social medical insurance;

12) compulsory social medical insurance - complex of legal, economic and organizational measures on delivery of health care to consumers of medical services for the asset account of fund of social medical insurance;

13) system of compulsory social medical insurance - set of the regulations and rules established by the state, governing the relations between participants of system of compulsory social medical insurance;

14) medical care in system of compulsory social medical insurance - the amount of medical care provided to consumers of medical services for the asset account of fund of social medical insurance;

15) No. 80-VI ZRK is excluded according to the Law of the Republic of Kazakhstan of 30.06.2017;

16) No. 80-VI ZRK is excluded according to the Law of the Republic of Kazakhstan of 30.06.2017;

17) No. 50-VIII ZRK is excluded according to the Law of the Republic of Kazakhstan of 23.12.2023

Article 2. Coverage of this Law

1. No. 80-VI ZRK is excluded according to the Law of the Republic of Kazakhstan of 30.06.2017.

2. The foreigners and persons without citizenship who are constantly living in the territory of the Republic of Kazakhstan and also kandasa have the rights and perform duties in system of compulsory social medical insurance on an equal basis with citizens of the Republic of Kazakhstan if other is not provided by this Law.

3. The foreigners and members of their families who are temporarily staying in the territory of the Republic of Kazakhstan in accordance with the terms of the international treaty ratified by the Republic of Kazakhstan have the rights and perform duties in system of compulsory social medical insurance on an equal basis with citizens of the Republic of Kazakhstan if other is not provided by the laws or international treaties.

Members of the family of foreigners are jointly the living spouses (spouse) and children.

Article 3. Legislation of the Republic of Kazakhstan on compulsory social medical insurance

1. The legislation of the Republic of Kazakhstan on compulsory social medical insurance is based on the Constitution of the Republic of Kazakhstan and consists of this Law and other regulatory legal acts of the Republic of Kazakhstan.

2. If the international treaty ratified by the Republic of Kazakhstan establishes other rules, than those which contain in this Law then are applied rules of the international treaty.

3. Operation of the legislation of the Republic of Kazakhstan on insurance and insurance activity does not extend to the legal relationship settled by the legislation of the Republic of Kazakhstan on compulsory social medical insurance.

Article 4. Principles of compulsory social medical insurance

Compulsory social medical insurance is based on the principles:

1) observance and execution of the legislation of the Republic of Kazakhstan on compulsory social medical insurance;

2) obligation of payment of assignments and (or) fees;

3) joint liability of the state, employers and citizens;

4) availability and quality of the provided medical care;

5) uses of assets of fund only on delivery of health care in system of compulsory social medical insurance;

6) publicity of activities of fund.

Article 5. The right to medical care in system of compulsory social medical insurance

1. In system of compulsory social medical insurance persons for whom it was performed the payment of assignments and (or) fees in fund and also exempted from payment of fees in fund according to Item 7 of article 28 of this Law have the right to medical care.

2. In case of failure to pay assignments and (or) fees persons receive medical care in system of compulsory social medical insurance no more than three months from the moment of the termination of payment of such assignments and (or) fees. This right does not exempt persons from obligation of payment of fees in fund for the unpaid period.

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