of July 21, 2016 No. 597/405
About approval of Criteria of the conclusion of contracts with medical and sanitary organizations in system of compulsory medical insurance for 2016
According to the Law on health protection No. 411-XIII of March 28, 1995, the Law on compulsory medical insurance No. 1585-XIII of February 27, 1998, the Law on funds obligatory medical insurance for 2016 No. 157 of July 1, 2016, the Order of the Government No. 1387 of December 10, 2007. "About approval of the Single program of compulsory medical insurance", with subsequent changes and amendments, the Ministry of Health, based on item 9 of the Regulations on the organization and functioning of the Ministry of Health approved by the Order of the Government No. 397 of May 31, 2011 and National medical insurance company based on the item of 29 subitems e) the Charter approved by the Order of the Government No. 156 of February 11, 2002, PRIKAZYVAYUT:
1. Approve Criteria of the conclusion of contracts with medical and sanitary organizations in system of compulsory medical insurance for 2016 (further – Criteria), according to appendix.
2. To directors of territorial agencies of National medical insurance company to provide to heads of the medical and sanitary organizations providing medical care within compulsory medical insurance respect for the Criteria approved by this order.
3. Heads of the medical and sanitary organizations providing medical care within compulsory medical insurance shall display information in the places available to patients and visitors, about agreement number and date of its conclusion with National medical insurance company, range and type of the services provided on its basis according to provisions of Criteria, and the list of services to which insured and uninsured persons, in this organization in 2016 have the right.
4. Cancel the Order of the Ministry of Health and National medical insurance company No. 1015/674-A of 29.12.2015 about approval of Methodological regulations of application in 2016 of the Single program of compulsory medical insurance.
5. We impose control over accomplishment of this order on ourselves.
Minister of Health |
Ruksanda Glavan |
Deputy. CEO of National medical insurance company |
Diana to Groce-Aksenti |
Appendix
to the Order of the Ministry of Health and National medical insurance company of July 21, 2016 No. 597/405-A
1. Criteria of the conclusion of contracts with medical and sanitary organizations in system of compulsory medical insurance for 2016 (further – Criteria) are developed according to provisions of the Law on health protection No. 411-XIII of March 28, 1995, the Law on compulsory medical insurance No. 1585-XIII of February 27, 1998, the Law on funds obligatory medical insurance for 2016 No. 157 of July 1, 2016 and the Order of the Government No. 1387 of December 10, 2007. "About approval of the Single program of compulsory medical insurance", with subsequent changes and amendments.
2. Criteria are established:
1) the principles which are the cornerstone of the conclusion of contracts with medical and sanitary organizations;
2) conditions of the conclusion of contracts with medical and sanitary organizations;
3) payment methods by the types of medical care provided by the Single program;
4) distribution of means of funds of compulsory medical insurance by types of medical care for payment of medical services;
5) features of the conclusion of contracts by the types of medical care provided by the Single program and suppliers of medical services;
6) payment methods of medical services;
7) procedure of negotiation and dispute resolution.
3. Regulation of conditions of the conclusion of supplier contracts of medical services is aimed at providing equal access to medical care of all levels, with observance of continuity and timeliness of its provision in the amount of, determined by the Single program for all persons which are in the territory of the Republic of Moldova within the law.
4. Criteria are obligatory in the course of the conclusion of contracts with suppliers of medical services in system of compulsory medical insurance.
5. The conclusion of contracts with suppliers of medical services is performed with respect for the following general principles:
1) equalization of the principles of the conclusion of contracts with provisions national the politician in the field of health care;
2) achievement of justice for the country population in the course of distribution of sources of fund for payment of the current medical services according to requirements of the population;
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