326 the law on health insurance read. General provisions of the law

1. The insured persons are citizens Russian Federationforeign citizens permanently or temporarily residing in the Russian Federation, stateless persons (with the exception of highly qualified specialists and members of their families, as well as foreign citizens carrying out labor activities in the Russian Federation in accordance with Article 13.5 Federal law of July 25, 2002 N 115-FZ "On the legal status of foreign citizens in the Russian Federation"), as well as persons entitled to medical assistance in accordance with the Federal Law "On Refugees":

1) those working under an employment contract, including heads of organizations who are the only participants (founders), members of organizations, owners of their property, or a civil law contract, the subject of which is the performance of work, the provision of services, under a copyright contract, as well as authors works receiving payments and other remuneration under agreements on the alienation of the exclusive right to works of science, literature, art, publishing licensing agreements, licensing agreements on granting the right to use a work of science, literature, art;

2) self-supporting work: individual entrepreneurs, lawyers, mediators, notaries engaged in private practice, arbitration managers, appraisers, patent attorneys, individuals using a special tax regime "Tax on professional income", registered individuals tax authorities in accordance with clause 7.3 of article 83 Of the Tax Code The Russian Federation, and other persons engaged in private practice in accordance with the procedure established by the legislation of the Russian Federation;

3) who are members of peasant (farm) households;

4) who are members of family (tribal) communities of the indigenous peoples of the North, Siberia and the Far East of the Russian Federation, living in places of their traditional residence and traditional economic activities and carrying out traditional economic activities;

5) non-working citizens:

A) children from birth until they reach the age of 18;

B) non-working pensioners, regardless of the basis for granting a pension;

C) citizens studying full-time in professional educational institutions and educational institutions of higher education;

D) unemployed citizens registered in accordance with the employment legislation;

E) one of the parents or guardian taking care of the child until the child reaches the age of three;

E) able-bodied citizens caring for disabled children, disabled people of group I, persons who have reached the age of 80;

G) other citizens who do not work under an employment contract and are not specified in subparagraphs "a" - "e" of this paragraph, with the exception of military personnel and those equated to them in the organization of rendering medical care persons.

2. The procedure and methodology for determining the number of insured persons, including unemployed, in order to form a budget Federal Fund, budgets of the constituent entities of the Russian Federation and the budgets of territorial funds are established by the Government of the Russian Federation.

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Federal Law 326 regulates and controls legal relations between citizens and insurance companies. With the help of obligatory honey. insurance, the state establishes certain financial and organizational measures to improve the efficiency and protection and safety of the population. At the same time, according to the described law, the state guarantees the population the timely provision of medical care of the highest level.

General provisions of the law

Federal Law 326 on compulsory health insurance RF was adopted The State Duma November 19, 2010, and approved by the Federation Council on November 24, 2010. The last changes took place on December 28, 2016. It has 11 chapters and 53 articles. a brief description of Federal Law on compulsory health insurance - regulation and control of legal relations between citizens and institutions conducting compulsory medical insurance (Federal Law on insurance in the Russian Federation), regulation of the provisions, rights and obligations of employees and the public, the amount of payment of contributions, processes and methods of implementation, the nuances of events.

Summary of Federal Law 326 "On Compulsory Health Insurance":

The first chapter describes the general provisions of the law. The goals, objectives and what area the law affects are described. Other laws, regulations and acts have been formalized that affect this area. A list of concepts and terms used in the text and definitions of these terms is given. The basic obligations and principles of implementation of honey are described. insurance;
Chapter two lists the rights, duties and powers of state bodies. authorities and federal bodies of the subjects of the Russian Federation in the field of providing the population with honey. insurance;
In chapter number three, the categories of persons and entities obliged to insurance are formalized. Descriptions of categories of persons are given, details of purchasing insurance for each category. Describes the institutions located in different territories of the country, where you can get health insurance;
In the fourth chapter. lists of the rights and obligations of citizens receiving insurance, persons providing it and all medical organizations where it can be purchased;
In ch. five formalized the economic side of this law. Cost Lists Provided different types insurance, methods of payment, the size of contributions, terms and procedure of payment are described. Responsibility of citizens in case of refusal to pay and receive health insurance has been formalized. The budgets of funds and organizations, methods of replenishing reserves, tariffs for payment, etc. are described;
The sixth gives and describes other laws and regulations governing the Federal and Territorial Foundations;
The seventh describes the basic and territorial processes, activities and programs for honey. insurance;
The eighth chapter contains lists and categories with a description of contracts in the field of medical insurance;
Chapter Nine describes the methods and processes for monitoring organizations and institutions that provide health insurance. The reasons for filing a complaint, methods and form of filing have been formalized;
Chapter number ten describes policies and a single record of citizens who have received insurance. Legal relationship between honey. institutions and foundations;
In ch. 11 provides the final and additional requirements, terms and conditions of the law.

Medical insurance on the territory of the Russian Federation is compulsory for every citizen. During insured events, with the help of a policy, a citizen can receive free medical care.

The latest amendments to the Federal Law on environmental impact assessment can be found

What changes have been made?

The latest amendments to the Federal Law on medical insurance were introduced on December 28, 2016, when Federal Law No. 493 was adopted. Changes have occurred in article 31 , in the first part of it, the phrase "treatment of the insured person immediately after the serious accident at work)" was replaced by the phrase "medical care (primary health care, specialized, including high-tech, medical care) to the insured person immediately after the serious accident in production ". And in article 32 all words about the treatment of insured persons were changed to the phrase “medical assistance to the insured person”.

In Art. 10 of Law 326 FZ, the last changes were introduced in 2013. This article provides a list of persons considered to be insured:

Employees who have entered into an employment contract, including the sole managers of organizations. Persons who have entered into other types of contracts related to the performance of work or services, including copyright orders, etc .;
Citizens who do not have a job, but who are minors, caring for incapacitated relatives or disabled people, retirees, guardians or one of the parents of a child under three years old, studying in the state. educational institutions registered in accordance with the employment law;
Self-employed workers, such as sole proprietorships or private legal consultants;
Family members belonging to the small peoples of the North and living in the corresponding territories, engaged in traditional farming;
Members of peasant communities and farms.

According to Article 16 of the described law, there is a list of certain rights and obligations of persons considered to be insured. Such persons have the right:

For free honey. help;
To protect their own rights when obtaining health insurance;
Choice of the category of insurance when applying;
To compensate for damage of any kind, in case of poor-quality performance of duties or non-performance of duties in general medical organizations;
For changing medical institution once a year;
Confidentiality of personal data;
At the choice of an insurance medical organization;
To receive information about the types and quality of honey. help;
At the choice of a doctor when applying.

However, the persons considered to be insured have obligations:

Show the policy when the doctor provides medical assistance;
In case of relocation or other change of residence, contact new organization to select an insurance institution;
Submit new personal data when they change, if it is name, address or passport data;
Apply for honey. insurance.

FZ 326, article 35 the basic program of honey is described. insurance of citizens. This program is confirmed and approved by the Government of the Russian Federation every year. This program lists the cases covered by the insurance, it contains the categories of medical care, rates and payment methods. The government also approves in this program the quality of medical care provided to citizens. It is in the basic program that the requirements are established for citizens applying, citizens receiving medical care under insurance and for employees of insurance medical organizations. Article 35 "On Compulsory Medical Insurance" of Law 326 defines the standards and procedures.

The text of the new edition 326 ФЗ

The law on compulsory medical insurance was created in accordance with the Constitution of the Russian Federation. It is thanks to this law adopted by the state that Russian citizens can receive high-quality free and timely medical care. If a person thinks that his rights or guarantees given by law have been violated, it is recommended to study it. The law defines the rights and obligations, as well as the scope of authority of employees of not only insurance institutions, but also other medical organizations.

RUSSIAN FEDERATION

THE FEDERAL LAW

ABOUT MANDATORY HEALTH INSURANCE

IN THE RUSSIAN FEDERATION

The State Duma

Federation Council

Chapter 1. GENERAL PROVISIONS

Article 1. Subject of regulation of this Federal Law

This Federal Law regulates relations arising in connection with the implementation of compulsory health insurance, including determining the legal status of subjects of compulsory health insurance and participants in compulsory health insurance, the grounds for the emergence of their rights and obligations, guarantees for their implementation, relations and liability associated with the payment of insurance contributions for compulsory health insurance of the non-working population.

Article 2. Legal basis for compulsory health insurance

1. Legislation on compulsory health insurance is based on the Constitution of the Russian Federation and consists of the Fundamentals of Legislation of the Russian Federation on the Protection of Citizens' Health, Federal Law of July 16, 1999 N 165-FZ "On the Fundamentals of Compulsory Social Insurance", this Federal Law, and other federal laws , laws of the constituent entities of the Russian Federation. Relationships associated with compulsory health insurance are also governed by other regulatory legal acts of the Russian Federation, other regulatory legal acts of the constituent entities of the Russian Federation.

2. In the event that an international treaty of the Russian Federation establishes rules other than those provided for by this Federal Law, the rules of the international treaty of the Russian Federation shall apply.

3. For the purpose of uniform application of this Federal Law, if necessary, appropriate explanations may be issued in the manner established by the Government of the Russian Federation.

Article 3. Basic concepts used in this Federal Law

For the purposes of this Federal Law, the following basic concepts are used:

1) compulsory health insurance - a type of compulsory social insurance, which is a system of legal, economic and organizational measures created by the state aimed at ensuring insured event guarantees of free provision of medical care to the insured person at the expense of compulsory medical insurance funds within the territorial compulsory medical insurance program and in the cases established by this Federal Law within the framework of the basic compulsory medical insurance program;

2) the object of compulsory medical insurance - insurance risk associated with the occurrence of an insured event;

3) insurance risk - an anticipated event, upon the occurrence of which it becomes necessary to incur expenses for payment of medical care provided to the insured person;

4) insured event - an event that has occurred (illness, injury, other state of health of the insured person, preventive measures), upon the occurrence of which the insured person is provided insurance coverage for compulsory health insurance;

5) insurance coverage for compulsory health insurance (hereinafter - insurance coverage) - the fulfillment of obligations to provide the insured person with the necessary medical care in the event of an insured event and to pay for it to a medical organization;

6) insurance premiums for compulsory health insurance - compulsory payments, which are paid by policyholders, have an impersonal nature and the purpose of which is to ensure the rights of the insured person to receive insurance coverage;

7) the insured person - individualwhich is covered by compulsory health insurance in accordance with this Federal Law;

8) the basic program of compulsory medical insurance - an integral part of the program of state guarantees for the free provision of medical care to citizens, which determines the rights of insured persons to provide them free medical care at the expense of compulsory medical insurance funds throughout the Russian Federation and establishes uniform requirements for territorial compulsory medical insurance programs ;

9) a territorial compulsory health insurance program - an integral part of a territorial program of state guarantees for free provision of medical care to citizens, which determines the rights of insured persons to free medical care in the territory of a constituent entity of the Russian Federation and complies with the uniform requirements of the basic compulsory medical insurance program.

Article 4. Basic principles of compulsory health insurance

The main principles of compulsory health insurance are:

1) ensuring, at the expense of compulsory health insurance funds, guarantees of free provision of medical care to the insured person in the event of an insured event within the framework of the territorial compulsory health insurance program and the basic compulsory health insurance program (hereinafter also referred to as the compulsory health insurance program);

2) stability financial system compulsory health insurance, provided on the basis of the equivalence of insurance coverage with the means of compulsory health insurance;

3) the obligation for insurers to pay insurance premiums for compulsory health insurance in the amount established by federal laws;

4) the state guarantee of the observance of the rights of insured persons to fulfill obligations for compulsory health insurance under the basic compulsory health insurance program, regardless of financial situation insurer;

5) creating conditions for ensuring the availability and quality of medical care provided within the framework of compulsory health insurance programs;

6) parity of representation of subjects of compulsory health insurance and participants of compulsory health insurance in the governing bodies of compulsory health insurance.

Chapter 2. POWERS OF THE RUSSIAN FEDERATION

AND SUBJECTS OF THE RUSSIAN FEDERATION IN THE SPHERE OF MANDATORY

HEALTH INSURANCE

Article 5. Powers of the Russian Federation in the field of compulsory health insurance

The powers of the Russian Federation in the field of compulsory health insurance include:

1) development and implementation of state policy in the field of compulsory health insurance;

2) organization of compulsory medical insurance on the territory of the Russian Federation;

3) determination of the circle of persons subject to compulsory health insurance;

4) establishment of tariffs for insurance premiums for compulsory health insurance and the procedure for collecting insurance premiums for compulsory health insurance;

5) approval of the basic compulsory health insurance program and uniform requirements for territorial compulsory health insurance programs;

6) establishing the procedure for the distribution, provision and spending of subventions from the budget of the Federal Fund for Compulsory Health Insurance to the budgets of territorial funds for compulsory health insurance;

7) establishment of liability of subjects of compulsory health insurance and participants of compulsory health insurance for violation of the legislation on compulsory health insurance;

8) organization of management of compulsory health insurance funds;

9) definition general principles organization information systems and communication in the field of compulsory health insurance, maintaining personalized records of information about insured persons and personified records of information about medical care provided to insured persons;

10) establishing a system for protecting the rights of insured persons in the field of compulsory health insurance.

Article 6. Powers of the Russian Federation in the field of compulsory medical insurance transferred for exercise to state authorities of the constituent entities of the Russian Federation

1. The powers of the Russian Federation in the field of compulsory health insurance, transferred for implementation to state authorities of the constituent entities of the Russian Federation, include the organization of compulsory medical insurance in the territories of constituent entities of the Russian Federation in accordance with the requirements established by this Federal Law, including:

1) statement territorial programs compulsory medical insurance that meet the uniform requirements of the basic compulsory medical insurance program, and the implementation of the basic compulsory medical insurance program in the territories of the constituent entities of the Russian Federation within and at the expense of subventions provided from the budget of the Federal Compulsory Medical Insurance Fund to the budgets of territorial compulsory medical insurance funds;

2) approval of differentiated per capita standards for the financial provision of compulsory health insurance (hereinafter referred to as differentiated per capita rates) in the territories of the constituent entities of the Russian Federation in accordance with the rules of compulsory medical insurance approved by the federal executive body authorized by the Government of the Russian Federation (hereinafter referred to as the rules of compulsory medical insurance), for insurance medical organizations;

3) registration and deregistration of policyholders for non-working citizens;

4) administration of budget revenues of the Federal Fund for Compulsory Medical Insurance, received from the payment of insurance premiums for compulsory medical insurance of the unemployed population in the territories of the constituent entities of the Russian Federation;

5) control over the use of compulsory medical insurance funds in the territories of the constituent entities of the Russian Federation, including the conduct of inspections and audits;

6) making payments for medical care provided to insured persons outside the constituent entity of the Russian Federation, on the territory of which a compulsory medical insurance policy was issued (hereinafter also referred to as insurance medical policy), in accordance with the uniform requirements of the basic compulsory health insurance program;

7) ensuring the rights of citizens in the field of compulsory health insurance in the territories of the constituent entities of the Russian Federation;

8) maintaining personalized records of information about insured persons in the form regional segment single register insured persons, as well as personalized accounting of information about medical care provided to insured persons;

9) keeping records in the field of compulsory health insurance.

2. Financial support for the expenditure obligations of the constituent entities of the Russian Federation arising from the exercise of powers transferred in accordance with Part 1 of this Article shall be carried out at the expense of subventions provided from the budget of the Federal Compulsory Medical Insurance Fund to the budgets of territorial compulsory medical insurance funds.

3. The highest official of the constituent entity of the Russian Federation (the head of the supreme executive body of state power of the constituent entity of the Russian Federation) in the exercise of powers transferred in accordance with part 1 of this article:

1) organizes activities to implement the delegated powers in accordance with federal laws and other regulatory legal acts of the Russian Federation;

2) provides in the prescribed manner:

a) making a decision on the establishment, in the absence of a non-profit organization on the territory of a constituent entity of the Russian Federation, a territorial fund of compulsory medical insurance (hereinafter referred to as a territorial fund);

b) approval of the management structure of the territorial fund in agreement with the Federal Compulsory Medical Insurance Fund (hereinafter - the Federal Fund);

c) appointment and dismissal of the head of the territorial fund in agreement with the Federal Fund;

3) ensure, in the prescribed manner, the timely submission to the federal executive body authorized by the Government of the Russian Federation (hereinafter referred to as the authorized federal executive body) and the Federal Fund:

a) reporting on the implementation of the delegated powers, on the expenditure of the provided subventions, on the achievement of target forecast indicators (if such indicators are established) in the prescribed form;

b) regulatory legal acts adopted by the state authorities of the constituent entities of the Russian Federation for the implementation of the transferred powers, within three days after the day of their adoption;

c) information (including databases) necessary for maintaining a unified register of insured persons;

d) information about forecast indicators for the implementation of the delegated powers in the prescribed form;

e) other information provided for by this Federal Law and (or) other regulatory legal acts of the Russian Federation adopted in accordance with it.

4. Control over the use of compulsory medical insurance funds that ensure the exercise of powers transferred in accordance with Part 1 of this Article is carried out by the Federal Fund, the federal executive body exercising control and supervision functions in the financial and budgetary sphere, the Accounts Chamber of the Russian Federation.

Article 7. Rights and obligations of the authorized federal executive body and the Federal Fund to exercise the delegated powers of the Russian Federation in the field of compulsory medical insurance by public authorities of the constituent entities of the Russian Federation

1. The authorized federal executive body shall exercise the following rights and obligations to exercise the powers transferred in accordance with Part 1 of Article 6 of this Federal Law:

1) issues normative legal acts and methodological instructions on the implementation of the delegated powers by the state authorities of the constituent entities of the Russian Federation;

2) supervises the legal regulation carried out by the state authorities of the constituent entities of the Russian Federation on the issues of delegated powers, with the right to send binding orders to abolish regulatory legal acts or to amend them;

3) exercise control and supervision over the completeness and quality of the implementation by the state authorities of the constituent entities of the Russian Federation of the delegated powers with the right to conduct inspections and issue binding orders:

a) on the elimination of the revealed violations;

b) on bringing to responsibility established by the legislation of the Russian Federation officials of state power bodies of the constituent entities of the Russian Federation and territorial funds;

4) prepares and sends to the top official of the constituent entity of the Russian Federation (the head of the supreme executive body of state power of the constituent entity of the Russian Federation) proposals on the removal from office of officials of state power bodies of the constituent entities of the Russian Federation and territorial funds;

5) has the right to set target forecast indicators for the implementation of the delegated powers;

6) approves the rules of compulsory health insurance, including the methodology for calculating tariffs for payment for medical care and the procedure for paying for medical care for compulsory health insurance;

7) determines the procedure for maintaining personalized records in the field of compulsory health insurance;

8) prepares and sends to the Government of the Russian Federation proposals on the withdrawal of the relevant powers from the bodies of state power of the constituent entities of the Russian Federation in the manner established by the Government of the Russian Federation;

9) establishes the procedure for reimbursing subventions provided from the budget of the Federal Fund to the budgets of territorial funds for the exercise of the relevant powers;

10) exercise other powers established by this Federal Law and other federal laws.

2. The Federal Fund shall exercise the following rights and obligations to exercise the powers transferred in accordance with Part 1 of Article 6 of this Federal Law:

1) issues normative legal acts and methodological instructions on the implementation of the delegated powers by territorial funds;

2) provides subventions from the budget of the Federal Fund to the budgets of territorial funds for financial support for the exercise of powers transferred in accordance with Part 1 of Article 6 of this Federal Law;

3) exercises control over the payment of insurance premiums for compulsory medical insurance of the unemployed population, including checking the activities of territorial funds to fulfill the functions of the administrator of the federal fund budget revenues received from the payment of insurance premiums for compulsory medical insurance of the unemployed population, is entitled to charge and collect for non-working citizens, arrears on the specified insurance premiums, penalties and fines;

4) establish the forms of reporting in the field of compulsory health insurance and the procedure for its conduct;

5) establishes the procedure for monitoring the volumes, terms, quality and conditions for the provision of medical care for compulsory health insurance to insured persons (hereinafter also - control of the volumes, terms, quality and conditions for the provision of medical care);

6) monitors compliance with the legislation on compulsory health insurance and the use of compulsory health insurance funds, including conducting inspections and audits;

7) exercises control over the functioning of information systems and the procedure for information interaction in the field of compulsory health insurance;

8) coordinates the structure of territorial funds, the appointment and dismissal of the heads of territorial funds, as well as the standards of expenditures for ensuring the performance of territorial funds of their functions.

Article 8. Powers of state authorities of the constituent entities of the Russian Federation in the field of compulsory health insurance

The powers of state authorities of the constituent entities of the Russian Federation in the field of compulsory health insurance include:

1) payment of insurance premiums for compulsory health insurance of the non-working population;

2) the establishment in territorial compulsory health insurance programs of additional volumes of insurance coverage for insured events established by the basic compulsory health insurance program, as well as additional types and conditions for the provision of medical care not established by the basic compulsory health insurance program;

3) financial security and implementation of territorial compulsory health insurance programs in an amount exceeding the amount of subventions provided from the budget of the Federal Fund to the budgets of territorial funds;

4) approval of the budgets of territorial funds and reports on their implementation.

Chapter 3. SUBJECTS OF MANDATORY HEALTH INSURANCE

AND PARTICIPANTS OF MANDATORY HEALTH INSURANCE

Article 9. Subjects of compulsory health insurance and participants of compulsory health insurance

1. The subjects of compulsory health insurance are:

1) insured persons;

2) policyholders;

3) Federal Fund.

2. Participants of compulsory health insurance are:

1) territorial funds;

2) medical insurance organizations;

3) medical organizations.

Article 10. Insured persons

Insured persons are citizens of the Russian Federation, foreign citizens permanently or temporarily residing in the Russian Federation, stateless persons (with the exception of highly qualified specialists and their family members in accordance with Federal Law No. 115-FZ of July 25, 2002 "On the Legal Status of Foreign Citizens in Russian Federation "), as well as persons entitled to medical assistance in accordance with the Federal Law" On Refugees ":

1) those working under an employment contract or a civil law contract, the subject of which is the performance of work, the provision of services, as well as under a copyright contract or a license contract;

2) self-supporting work (individual entrepreneurs, notaries in private practice, lawyers);

3) who are members of peasant (farm) households;

4) who are members of the family (tribal) communities of the indigenous small-numbered peoples of the North, Siberia and the Far East of the Russian Federation, living in the regions of the North, Siberia and the Far East of the Russian Federation, engaged in traditional economic sectors;

5) non-working citizens:

a) children from birth until they reach the age of 18;

b) non-working pensioners, regardless of the basis for granting a pension;

c) citizens studying full-time in educational institutions of primary vocational, secondary vocational and higher vocational education;

d) unemployed citizens registered in accordance with the employment legislation;

e) one of the parents or guardian taking care of the child until the child reaches the age of three;

f) able-bodied citizens caring for disabled children, disabled people of group I, persons who have reached the age of 80;

g) other citizens who do not work under an employment contract and are not specified in subparagraphs "a" - "f" of this paragraph, with the exception of military personnel and persons equated to them in the organization of medical care.

Article 11. Policyholders

1. The policyholders for working citizens specified in clauses 1-4 of Article 10 of this Federal Law are:

1) persons making payments and other remuneration to individuals:

a) organizations;

b) individual entrepreneurs;

c) individuals who are not recognized as individual entrepreneurs;

2) individual entrepreneurs in private practice, notaries, lawyers.

2. The policyholders for non-working citizens specified in paragraph 5 of Article 10 of this Federal Law are the executive authorities of the constituent entities of the Russian Federation, authorized by the supreme executive bodies of state power of the constituent entities of the Russian Federation. These policyholders are payers of insurance premiums for compulsory health insurance of the non-working population.

Article 12. Insurer

1. The insurer for compulsory health insurance is the Federal Fund within the framework of the basic compulsory health insurance program.

2. Federal Fund - a non-profit organization created by the Russian Federation in accordance with this Federal Law to implement the state policy in the field of compulsory health insurance.

Article 13. Territorial funds

1. Territorial funds are non-profit organizations created by the constituent entities of the Russian Federation in accordance with this Federal Law to implement the state policy in the field of compulsory health insurance in the territories of the constituent entities of the Russian Federation.

2. Territorial funds exercise separate powers of the insurer in terms of implementing territorial compulsory health insurance programs within the basic compulsory health insurance program in accordance with this Federal Law.

3. Territorial funds exercise the powers of the insurer in terms of the additional volumes of insurance coverage for insured events established by the territorial compulsory health insurance programs established by the basic compulsory health insurance program, as well as additional grounds, lists of insured events, types and conditions of medical care in addition to the established basic compulsory health insurance program.

4. To exercise the powers established by this Federal Law, territorial funds may create branches and representative offices.

Article 14. Medical insurance organization carrying out activities in the field of compulsory health insurance

1. An insurance medical organization operating in the field of compulsory medical insurance (hereinafter - an insurance medical organization) - insurance organization, which has a license issued by the federal executive body in charge of control and supervision in the field of insurance activities. The specifics of licensing the activities of medical insurance organizations are determined by the Government of the Russian Federation. An insurance medical organization exercises certain powers of the insurer in accordance with this Federal Law and the agreement on financial support of compulsory medical insurance concluded between the territorial fund and the insurance medical organization (hereinafter - the agreement on financial support of compulsory medical insurance).

2. The founders (participants, shareholders) and management bodies of an insurance medical organization may not include employees of federal executive bodies in the field of healthcare, executive bodies of the constituent entities of the Russian Federation in the field of healthcare, bodies local governmentauthorized to carry out management in the field of health care, the Federal Fund and territorial funds, medical organizations providing medical care for compulsory health insurance.

3. Insurance medical organizations are not entitled to carry out other activities, with the exception of activities related to compulsory and voluntary medical insurance.

4. Medical insurance organizations shall keep separate records of operations with compulsory medical insurance funds and voluntary medical insurance funds, taking into account the specifics established by the regulatory legal acts of the federal executive body in charge of legal regulation in the field of insurance activities and the Federal Fund.

5. Insurance medical organizations shall keep separate records of their own funds and funds of compulsory medical insurance intended to pay for medical care.

Article 50. Healthcare modernization programs

1. In the period 2011 - 2012, in order to improve the quality and availability of medical care provided to insured persons, regional programs for the modernization of healthcare in the constituent entities of the Russian Federation and programs for the modernization of federal state institutions providing medical care (hereinafter also referred to as healthcare modernization programs) are being implemented.

2. Financial support of regional programs for the modernization of health care of the constituent entities of the Russian Federation is carried out at the expense of incomes received by the budget of the Federal Fund from insurance premiums for compulsory health insurance in the amount of two percentage points in accordance with Federal Law of July 24, 2009 N 212-FZ "On insurance contributions to the Pension Fund of the Russian Federation, Social Insurance Fund of the Russian Federation, Federal Compulsory Medical Insurance Fund and Territorial Compulsory Health Insurance Funds ", funds from the budgets of the constituent entities of the Russian Federation and the budgets of territorial funds.

3. The funds provided for in the budget of the Federal Fund for the financial support of regional programs for the modernization of healthcare in the constituent entities of the Russian Federation shall be directed to the following purposes:

1) strengthening the material and technical base of state and municipal health care institutions, including ensuring the completion of the construction of previously started facilities (the technical readiness of these facilities as of January 1, 2011 must be at least 80 percent of the costs actually incurred by the developer from estimated cost construction of the facility), current and major repairs of state and municipal health care institutions, the purchase of medical equipment;

2) the introduction of modern information systems in healthcare in order to switch to compulsory medical insurance policies of a single sample, including those provided by the federal electronic application of a universal electronic card, the introduction of telemedicine systems, systems electronic document management and maintenance of patients' medical records in electronic form;

3) introduction of standards of medical care, increasing the availability of outpatient medical care, including that provided by specialist doctors.

4. The regional health care modernization program of the constituent entity of the Russian Federation includes a passport of the health care system of the constituent entity of the Russian Federation, a list and cost of measures aimed at achieving the goals specified in part 3 of this article, target values \u200b\u200bof indicators for the implementation of the health care modernization program, as well as indicators of the implementation of measures indicated programs.

5. The executive authorities of the constituent entities of the Russian Federation are responsible in accordance with the legislation of the Russian Federation for the reasonableness of the cost of measures established by regional programs for the modernization of healthcare in the constituent entities of the Russian Federation.

6. The funds provided for in the budget of the Federal Fund for the financial support of regional programs for the modernization of healthcare in the constituent entities of the Russian Federation are provided from the budget of the Federal Fund to the budgets of territorial funds in the form of subsidies. These funds are provided from the budgets of territorial funds:

1) to the budget of a constituent entity of the Russian Federation in the form of other interbudgetary transfers for the purposes established by clauses 1 and 2 of part 3 of this article, for subsequent use by state and municipal health care institutions participating in the implementation of territorial compulsory health insurance programs within the framework of the basic compulsory health insurance program;

2) to medical insurance organizations for the purposes established by paragraph 3 of part 3 of this article, for subsequent provision to medical organizations participating in the implementation of territorial compulsory health insurance programs within the framework of the basic compulsory health insurance program.

7. The funds provided for in the budget of the Federal Fund for financial support of regional programs for the modernization of healthcare in the constituent entities of the Russian Federation shall be provided and spent in the manner established by the Government of the Russian Federation. In order to provide financial support for regional programs for the modernization of healthcare in the constituent entities of the Russian Federation, agreements are concluded between the supreme executive bodies of state power of the constituent entities of the Russian Federation with the authorized federal executive body and the Federal Fund in the manner determined by the authorized federal executive body.

8. The procedure for implementing measures to increase the availability of outpatient medical care, including that provided by specialist doctors, is established by the Government of the Russian Federation.

9. Funds for financial support of regional programs for the modernization of health care of the constituent entities of the Russian Federation are provided by the Federal Fund in 2011 and 2012, provided that the budgets of the constituent entities of the Russian Federation establish health expenditures in an amount not less than actual health care expenditures in 2010 (excluding expenditures earmarked fundsprovided from the federal budget) and the presence of concluded agreements provided for by part 7 of this article.

10. The balances of funds as of January 1, 2012, formed in the budgets of territorial funds as a result of the incomplete use in 2011 of funds for the financial support of regional programs for the modernization of health care of the constituent entities of the Russian Federation, are directed to the purposes specified in part 3 of this article in 2012. The balances of funds as of January 1, 2013, formed in the budgets of territorial funds as a result of the incomplete use of funds in 2012 for the financial support of regional programs for the modernization of health care of the constituent entities of the Russian Federation, are directed to the purposes specified in part 3 of this article in 2013.

11. The balances of funds as of January 1, 2012, formed in the budget of the Federal Fund as a result of the incomplete use in 2011 of funds for the financial support of regional programs for the modernization of healthcare in the constituent entities of the Russian Federation, are directed to the same purposes in 2012. The balances of funds as of January 1, 2013, formed in the budget of the Federal Fund as a result of the incomplete use of funds in 2011 and 2012 for the financial provision of regional programs for the modernization of health care of the constituent entities of the Russian Federation, are directed to increase the normalized safety stock Federal Fund in 2013.

12. The authorized federal executive body develops and approves programs for the modernization of federal state institutions that provide medical care and the powers of the owner of which are exercised by the federal executive body responsible for the development of state policy and legal regulation in the field of healthcare, and the federal bodies subordinate to it. executive authorities, for the purposes established by paragraphs 1 (in relation to state health care institutions) and 2 of part 3 of this article. Financial support for the implementation of programs for the modernization of federal state institutions providing medical care is carried out by sending the Federal Fund to federal budget inter-budgetary transfers to increase budgetary allocations provided for by the federal executive body implementing public policy in the field of health care, and the federal executive bodies subordinate to it, to provide budgetary allocations to the subordinate federal state institutions providing medical care, for financial support for the implementation of modernization programs for federal state institutions providing medical care.

13. The procedure and form of reporting on the implementation of measures of health care modernization programs are established by the authorized federal executive body, the procedure and form of reporting on the use of funds for the purposes specified in parts 1 and 12 of this article are established by the Federal Fund.

14. Control over the use of funds provided for the financial support of healthcare modernization programs is carried out by the Federal Fund, the federal executive authority exercising control and supervision functions in the financial and budgetary sphere, the Accounts Chamber of the Russian Federation.

15. Control over the implementation of measures for the modernization of health care is carried out by the authorized federal executive body and the Federal Fund.

Article 51. Final provisions

1. Persons insured under compulsory health insurance prior to the date of entry into force of this Federal Law shall have the rights of insured persons in accordance with this Federal Law.

2. Compulsory health insurance policies issued to persons insured under compulsory health insurance prior to the date of entry into force of this Federal Law shall be valid until they are replaced by compulsory health insurance policies of a single sample in accordance with this Federal Law. From May 1, 2011 until the introduction of universal electronic cards in the territories of the constituent entities of the Russian Federation, the production of compulsory health insurance policies is organized by the Federal Fund, their issuance to insured persons is carried out in the manner prescribed by the rules of compulsory health insurance. Until May 1, 2011, the issuance of compulsory health insurance policies is carried out in accordance with the regulatory legal acts governing the issuance of compulsory health insurance policies and effective until the date this Federal Law comes into force.

1) in terms of the basic program of compulsory medical insurance, it includes expenses determined by the Program of state guarantees for the provision of free medical care to citizens of the Russian Federation, approved by the Government of the Russian Federation;

2) in terms of territorial programs of compulsory medical insurance, it may include a part of labor costs, accruals for payments for labor remuneration (in terms of other payments), expenses for payment of communication services, transport and utilities, works and services for the maintenance of property, the cost of rent for the use of property, payment software and other services, social Security employees of medical organizations, established by the legislation of the Russian Federation, other expenses, expenses for the purchase of equipment worth up to one hundred thousand rubles per unit.

4.From January 1, 2011 to December 31, 2012, the territorial compulsory health insurance program in the constituent entities of the Russian Federation may include the provision of medical care for certain diseases and health conditions that are not included in the basic compulsory health insurance program, without observing the conditions for fulfilling the standards, established by the basic program of compulsory health insurance, while maintaining the volume of financial support for the territorial compulsory health insurance program not lower than the level of 2010, including within the framework of the basic program of compulsory health insurance. Additional grounds, types and conditions for the provision of medical care, the list of insured events, as well as the volumes of insurance coverage related to them, are approved by the territorial compulsory health insurance program separately from the established grounds, types, conditions for the provision of medical care, the list of insured events, the volume of the corresponding insurance coverage by the basic program compulsory health insurance.

5. Financial support of emergency medical care (with the exception of specialized (medical and aviation) emergency medical care) is carried out at the expense of compulsory medical insurance funds from January 1, 2013. The procedure for transferring budgetary appropriations to budgets budgetary system Of the Russian Federation to the budgets of compulsory medical insurance funds for the financial provision of emergency medical care (with the exception of specialized (sanitary and aviation) emergency medical care) is established by the federal law determining the size of the tariff insurance premium for compulsory medical insurance of the non-working population.

6. The financial support of high-tech medical care is carried out at the expense of compulsory medical insurance funds from January 1, 2015.

7. In the period 2012 - 2014, the amount of insurance premiums for compulsory medical insurance of the unemployed population in the constituent entity of the Russian Federation is determined in the following order:

1) in 2012, the amount of insurance premiums for compulsory health insurance of the non-working population cannot be less than the actual amount of insurance premiums for compulsory health insurance of the non-working population in 2010 and 25 percent of the difference between the amount of insurance premiums for compulsory health insurance of the non-working population, calculated in accordance with Part 2 of Article 23 of this Federal Law, and the actual amount of insurance premiums for compulsory medical insurance of the non-working population in 2010;

2) in 2013, the amount of insurance premiums for compulsory health insurance of the unemployed population cannot be less than the actual amount of insurance premiums for compulsory health insurance of the unemployed population in 2010 and 50 percent of the difference between the amount of insurance premiums for compulsory health insurance of the unemployed population, calculated in accordance with Part 2 of Article 23 of this Federal Law, and the actual amount of insurance premiums for compulsory medical insurance of the non-working population in 2010;

3) in 2014, the amount of insurance contributions for compulsory health insurance of the non-working population cannot be less than the actual amount of insurance contributions for compulsory health insurance of the non-working population in 2010 and 75 percent of the difference between the amount of insurance contributions for compulsory health insurance of the non-working population, calculated in accordance with Part 2 of Article 23 of this Federal Law, and the actual amount of insurance premiums for compulsory medical insurance of the non-working population in 2010;

4) in 2012-2014, the rate of insurance premiums for compulsory medical insurance of the non-working population in accordance with Part 2 of Article 23 of this Federal Law is established taking into account the transferred expenses of the consolidated budget of the constituent entity of the Russian Federation, subject to inclusion in the territorial program of compulsory medical insurance under the basic program compulsory medical insurance, expenses of the budget of the constituent entity of the Russian Federation for the maintenance of medical organizations in accordance with part 7 of Article 35 of this Federal Law and expenses for the financial provision of emergency medical care.

8. In 2012, the amount of subventions from the budget of the Federal Fund to the budget of the territorial fund is calculated as the sum of insurance premiums for compulsory medical insurance of the non-working population of the corresponding constituent entity of the Russian Federation, insurance premiums for compulsory medical insurance of the working population, calculated in the territory of the corresponding constituent entity of the Russian Federation at a rate of two percent , and the amount of subsidies provided in the budget of the Federal Fund of the corresponding constituent entity of the Russian Federation for 2011.

9. Federal property assigned to territorial funds on the basis of the right of operational management until the date of entry into force of this Federal Law shall be transferred to the ownership of the respective constituent entities of the Russian Federation before July 1, 2011 and used by the territorial funds on the basis of operational management.

10. In 2011, the amount of budget allocations for financial support for the implementation of the basic program of compulsory medical insurance, established by the law on the budget of the corresponding constituent entity of the Russian Federation, must be at least the amount of insurance contributions for compulsory medical insurance of the non-working population and inter-budgetary transfers from the budget of the constituent entity of the Russian Federation to the budget territorial funds, established by law on the budget of the corresponding constituent entity of the Russian Federation for 2010.

11. In 2011:

1) payment of insurance premiums for compulsory medical insurance of the non-working population is carried out by the insured by transferring the amount of the monthly compulsory payment to the budgets of territorial funds;

2) insurers for non-working citizens are required to keep records of funds transferred for compulsory medical insurance of the non-working population to territorial funds;

3) the amounts of accrued arrears on contributions, tax payments, accrued penalties and fines are payable to the budgets of territorial funds in accordance with the legislation of the Russian Federation;

4) insurers for non-working citizens independently accrue penalties for the entire amount of arrears for the period of delay and reflect it in the form of calculation of accrued and paid insurance premiums for compulsory health insurance of the non-working population, approved by the authorized federal executive body;

5) funds from the budget of the Federal Fund for financial support of the implementation of territorial compulsory health insurance programs within the framework of the basic compulsory health insurance program are provided in the form of subsidies in the amount established by the federal law on the budget of the Federal Fund for the next financial year and for the planning period.

12.From 2011, the amount of budgetary allocations for the payment of insurance premiums for compulsory health insurance of the non-working population should include in full financial support for types of medical care and items of expenditure included in the tariff for paying for medical care in accordance with the basic program of compulsory health insurance for the corresponding year, previously financed from the consolidated budget of the subject of the Russian Federation.

13. Until the date of entry into force of the federal law on state social funds, the legal status:

1) The Federal Fund is determined by the Charter of the Federal Compulsory Medical Insurance Fund, effective until the date of entry into force of the specified federal law;

2) the territorial fund is determined by the statute on the territorial fund, adopted in accordance with the model statute on the territorial fund, approved by the authorized federal executive body, and in effect until the day the specified federal law enters into force.

14. In 2011, the conclusion of contracts of territorial funds with medical insurance organizations and their execution are carried out in accordance with the rules of compulsory medical insurance.

Article 52. On recognition as invalid of certain legislative acts (provisions of legislative acts) of the Russian Federation

To recognize as invalid from the date of entry into force of this Federal Law:

1) Law of the Russian Federation of June 28, 1991 N 1499-1 "On medical insurance of citizens in the Russian Federation" (Bulletin of the Congress of People's Deputies of the RSFSR and the Supreme Soviet of the RSFSR, 1991, N 27, art. 920);

2) Resolution of the Supreme Soviet of the RSFSR of June 28, 1991 N 1500-1 "On the procedure for the enactment of the Law of the RSFSR" On medical insurance of citizens in the RSFSR "(Bulletin of the Congress of People's Deputies of the RSFSR and the Supreme Soviet of the RSFSR, 1991, N 27, art. 921 );

3) Resolution of the Supreme Soviet of the Russian Federation of February 24, 1993 N 4543-1 "On the procedure for financing compulsory medical insurance of citizens for 1993" (Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Soviet of the Russian Federation, 1993, N 17, art. 591) ;

4) Law of the Russian Federation of April 2, 1993 N 4741-1 "On Amendments and Additions to the Law of the RSFSR" On Medical Insurance of Citizens in the RSFSR "(Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Council of the Russian Federation, 1993, N 17, art. . 602);

5) Decree of the Supreme Council of the Russian Federation of April 2, 1993 N 4742-1 "On re-consideration of the Law of the Russian Federation" On amendments and additions to the Law of the RSFSR "On medical insurance of citizens in the RSFSR" (Bulletin of the Congress of People's Deputies of the Russian Federation and the Supreme Council Russian Federation, 1993, N 17, art. 604);

6) Resolution of the Supreme Soviet of the Russian Federation of April 2, 1993 N 4743-1 "On the procedure for enactment of the Law of the Russian Federation" On amendments and additions to the Law of the RSFSR "On medical insurance of citizens in the RSFSR" (Bulletin of the Congress of People's Deputies of the Russian Federation and The Supreme Council of the Russian Federation, 1993, N 17, Art. 603);

7) Article 1 of the Federal Law of December 23, 2003 N 185-FZ "On Amendments to the Legislative Acts of the Russian Federation in terms of improving the procedures for state registration and registration legal entities and individual entrepreneurs"(Collected Legislation of the Russian Federation, 2003, No. 52, Art. 5037);

8) Article 5 of the Federal Law of July 27, 2006 N 137-FZ "On Amendments to Part One and Part Two of the Tax Code of the Russian Federation and to certain legislative acts of the Russian Federation in connection with the implementation of measures to improve tax administration" (Collected Legislation of the Russian Federation Federation, 2006, N 31, Art. 3436);

9) Article 1 of the Federal Law of December 29, 2006 N 258-FZ "On Amendments to Certain Legislative Acts of the Russian Federation in Connection with Improving the Delimitation of Powers" (Collected Legislation of the Russian Federation, 2007, N 1, Art. 21);

10) Article 4 of the Federal Law of July 23, 2008 N 160-FZ "On Amendments to Certain Legislative Acts of the Russian Federation in Connection with Improving the Exercise of the Powers of the Government of the Russian Federation" (Collected Legislation of the Russian Federation, 2008, N 30, Art. 3616) ;

11) Article 1 of the Federal Law of July 18, 2009 N 185-FZ "On Amendments to Articles 2 and 9.1 of the Law of the Russian Federation" On Health Insurance of Citizens in the Russian Federation "and Article 11 of the Federal Law" On Compulsory pension insurance in the Russian Federation "(Collected Legislation of the Russian Federation, 2009, N 29, Art. 3622).

Article 53. Procedure for the entry into force of this Federal Law

1. This Federal Law shall enter into force on January 1, 2011, with the exception of provisions for which this article establishes a different date for their entry into force.

2. Articles 5 - 8, part 6 of article 14, part 7 of article 17, part 7 of article 24, paragraph 1 of part 4 of article 26, articles 27, 28, 35, 36, part 1, paragraphs 3 - 5 and 14 of part 2, Clauses 1 - 3 of Part 4, Parts 7 - 9, 11 and 12 of Article 38 of this Federal Law shall enter into force on January 1, 2012.

The president

Russian Federation

D. MEDVEDEV

Moscow Kremlin

GUARANTOR's comment

See graphic copy of the official publication

Federal Law of November 29, 2010 N 326-fz "On Compulsory Health Insurance in the Russian Federation" (as amended on June 14, November 30, December 3, 2011)

GUARANTOR's comment

Cm. commentsto this Federal Law

Chapter 1. General provisions

Article 1.The subject of regulation of this Federal Law

This Federal Law regulates relations arising in connection with the implementation of compulsory health insurance, including determining the legal status of subjects of compulsory health insurance and participants of compulsory health insurance, the grounds for the emergence of their rights and obligations, guarantees for their implementation, relations and liability associated with the payment of insurance contributions to the non-working population.

GUARANTOR's comment

Cm. commentsto Article 1 of this Federal Law

Article 2.Legal basis for compulsory health insurance

1. Legislation on compulsory health insurance is based on The ConstitutionRussian Federation and consists of Fundamentals of legislationThe Russian Federation on the protection of the health of citizens, Federal lawof July 16, 1999 N 165-FZ "On the basis of compulsory social insurance", this Federal Law, other federal laws, laws of the constituent entities of the Russian Federation. Relationships associated with compulsory health insurance are also governed by other regulatory legal acts of the Russian Federation, other regulatory legal acts of the constituent entities of the Russian Federation.

GUARANTOR's comment

Cm. the federal lawof November 21, 2011 N 323-FZ "On the basics of health protection of citizens in the Russian Federation"

3. For the purpose of uniform application of this Federal Law, if necessary, appropriate explanations may be issued in okayestablished by the Government of the Russian Federation.

GUARANTOR's comment

Cm. commentsto Article 2 of this Federal Law

Article 3.Basic concepts used in this Federal Law

For the purposes of this Federal Law, the following basic concepts are used:

1)compulsory health insurance- a type of compulsory social insurance, which is a system of legal, economic and organizational measures created by the state aimed at ensuring, in the event of an insured event, guarantees of free provision of medical care to the insured person at the expense of compulsory health insurance funds within the territorial compulsory health insurance program and in accordance with this Federal cases within the framework of the basic compulsory health insurance program;

2)compulsory health insurance object-insurance riskassociated with the occurrence insured event;

3)insurance risk- the anticipated event, upon the occurrence of which it becomes necessary to incur expenses for the payment of medical care provided to the insured person;

4)insurance case- an event that has taken place (illness, injury, other state of health of the insured person, preventive measures), upon the occurrence of which the insured person is provided with insurance coverage for compulsory health insurance;

5)insurance coverage for compulsory health insurance(hereinafter - insurance coverage) - fulfillment of obligations to provide the insured person with the necessary medical care in the event of an insured event and to pay for it to a medical organization;

6)insurance premiums for compulsory health insurance- compulsory payments, which are paid by the insured, have an impersonal nature and the purpose of which is to ensure the rights of the insured person to receive insurance coverage;

7)insured person- an individual to whom the compulsory health insurancein accordance with this Federal Law;

8)basic compulsory health insurance program- an integral part of the program of state guarantees for free provision of medical care to citizens, which determines the rights of insured persons to provide them free medical care at the expense of compulsory medical insurance throughout the Russian Federation and establishes uniform requirements for territorial compulsory medical insurance programs;

9)territorial compulsory health insurance program- an integral part of the territorial program of state guarantees of free provision of medical care to citizens, which determines the rights of insured persons to provide them with free medical care on the territory of the subject of the Russian Federation and meets the uniform requirements of the basic compulsory medical insurance program.

GUARANTOR's comment

See graphic copy of the official publication

Federal Law of November 29, 2010 N 326-fz "On Compulsory Health Insurance in the Russian Federation" (as amended on June 14, November 30, December 3, 2011)

GUARANTOR's comment

Cm. commentsto this Federal Law

Chapter 1. General provisions

Article 1.The subject of regulation of this Federal Law

This Federal Law regulates relations arising in connection with the implementation of compulsory health insurance, including determining the legal status of subjects of compulsory health insurance and participants of compulsory health insurance, the grounds for the emergence of their rights and obligations, guarantees for their implementation, relations and liability associated with the payment of insurance contributions to the non-working population.

GUARANTOR's comment

Cm. commentsto Article 1 of this Federal Law

Article 2.Legal basis for compulsory health insurance

GUARANTOR's comment

Cm. the federal lawof November 21, 2011 N 323-FZ "On the basics of health protection of citizens in the Russian Federation"

3. For the purpose of uniform application of this Federal Law, if necessary, appropriate explanations may be issued in okayestablished by the Government of the Russian Federation.

GUARANTOR's comment

Cm. commentsto Article 2 of this Federal Law

Article 3.Basic concepts used in this Federal Law

For the purposes of this Federal Law, the following basic concepts are used:

2)compulsory health insurance object-insurance riskassociated with the occurrence insured event;

3)insurance risk- the anticipated event, upon the occurrence of which it becomes necessary to incur expenses for the payment of medical care provided to the insured person;

7)insured person- an individual to whom the compulsory health insurancein accordance with this Federal Law;