ORDER OF THE GOVERNMENT OF THE REPUBLIC OF MOLDOVA

of May 14, 2002 No. 594

About approval of the Regulations on procedure for creation of funds of compulsory medical insurance and management of them

According to part (4) article 16 of the Law on compulsory medical insurance No. 1585-XIII of February 27, 1998. (The official monitor of the Republic of Moldova, 1998, Art. No. 38-39, 280) DECIDES: the Government of the Republic of Moldova

Approve Regulations on procedure for creation of funds of compulsory medical insurance and management by them it (is applied).

Approved by the Order of the Government of the Republic of Moldova of May 14, 2002 No. 594

Regulations on procedure for creation of funds of compulsory medical insurance and management of them

I. General provisions

1. The regulations on procedure for creation of funds of compulsory medical insurance and management of them (further - the Provision) establish procedure for creation by the National company of medical insurance (further - the Company) the funds provided in the Law on compulsory medical insurance No. 1585-XIII of February 27, 1998 and management of them, and also procedure for distribution and use of the financial resources which are saved up in these insurance funds.

2. The financial resources accumulated in insurance funds including penalty fee and fines, are intended for implementation of activities for compulsory medical insurance and are used in strict accordance with the current legislation and this provision.

3. Receipts from all payers of fees of compulsory medical insurance accumulate on the account of the Company.

II. Procedure for creation of funds of compulsory medical insurance and management of them

4. For the purpose of realization of tasks of compulsory medical insurance the Company creates and manages without fail the following funds:

fund for payment of medical and pharmaceutical services (according to subprogrammes of medical services and separately according to the subprogrammes of pharmaceutical services intended for compensation of drugs) (further - fixed assets);

reserve fund of compulsory medical insurance (further - reserve fund);

Preventive actions fund (prevention of risks of insurance) (further - Preventive actions fund);

fund of development and upgrade of the state suppliers of medical services (further – fund of development);

fund of management of system of compulsory medical insurance (further – fund of management).

5. For ensuring the activities the Company determines the level of management (administrative) expenses which shall not exceed the limit established by this provision.

6. Funds of compulsory medical insurance are financed according to the current legislation from the financial resources received from:

paragraph two of ceased to be valid;

income gained from categories of payers of the fees of compulsory medical insurance estimated as a percentage of the salary and other payments;

transfers (subsidies) from the government budget added as fees (insurance premiums) of compulsory medical insurance of categories of persons for which (insured) act the Government of the Republic of Moldova according to the current legislation as the payer;

income gained from categories of payers of the fees of compulsory medical insurance in the form of fixed amount insured in individual procedure;

other income permitted by the legislation including the amounts of fees of compulsory medical insurance paid by the foreign citizens and persons without citizenship registered or living in the territory of the Republic of Moldova;

funds distributed from the single tax levied from residents of information and technological parks according to provisions of article 14 of the Law No. 77 of April 21, 2016 on information and technological parks;

the financial resources received as a result of application of the claims of recourse, penalties and penalty fee received from payers of fees of compulsory medical insurance.

means of special purpose - the grants, the credits or other financial resources received justly, intended directly for amendment of some funds of compulsory medical insurance or for covering of administrative expenses.

7. The fund management of compulsory medical insurance is exercised of the Company depending on their appointment provided by this provision and according to the current legislation.

8. Ceased to be valid according to the Order of the Government of the Republic of Moldova of 22.12.2020 No. 928

III. Procedure for distribution and use of the financial resources which are saved up in funds of compulsory medical insurance

9. The income which arrived into the single account of the Company within year, except for means of special purpose is distributed according to the following standard rates:

fixed assets – at least 94%;

reserve fund – to 1%;

Preventive actions fund – 1%;

fund of development – to 2%;

fund of management – to 2%.

11. The financial resources which are saved up in fixed assets are used on:

1) covering of the expenses necessary for accomplishment of the Single program of compulsory medical insurance including:

a) urgent pre-hospital medical care;

b) primary medical care;

c) specialized out-patient medical care, including dental;

d) stationary medical care;

e) highly specialized medical services;

f) communitarian services and home care;

g) palliative care;

h) the compensated drugs and medical products;

2) compensation of documentary confirmed expenses incurred by insured person on medical services which were not rendered according to the Agreement on delivery of health care (about provision of medical services) within compulsory medical insurance, with deduction of the corresponding amount due to the subsequent transfers to the supplier of medical services who did not fulfill the contractual commitments.

12. The amount and payment procedure to suppliers of medical services for rendering medical services within compulsory medical insurance to persons are established in agreements on provision of medical care (medical services) in compulsory medical insurance concluded between the company (the territorial (industry) agency) and suppliers of medical services.

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