Separate accounting of OMS. The procedure for accounting for the targeted expenditure of funds by a medical organization. Rules for replacing the OMS policy

commercial medical organization provides services to the population on a paid basis and under compulsory health insurance. How to reflect in accounting: - provision of compulsory health insurance services, - receipt of compulsory medical insurance funds, - accounting of materials (receipt, write-off) related to the provision of compulsory medical insurance services, are income taken into account and expenses for compulsory medical insurance in the taxable base for the simplified tax system (income-expenses)?

A medical organization that provides services to the public under the mandatory health insurance, has the right to continue to conduct commercial activities.

At the same time, such organizations should keep separate records for operations with compulsory health insurance funds and for the provision of paid services to the population. When implementing medical services within the framework of the compulsory health insurance program, the following entries are made in accounting:

Debit 62 (76, 50) Credit 90-1

Medical services provided.

Such a posting is done on the date of signing the act of reconciliation of settlements under the contract for the provision and payment of medical care under compulsory medical insurance. All expenses are recorded on account 20 for OMS. Receipt of materials is reflected by posting:

Debit 10 Credit 60 (76)

Reflect the write-off of materials by wiring:

Debit 20 Credit 10.

Reflect the write-off of the cost by posting:

Debit 90-2 Credit 20.

Reflect the receipt of money to pay for medical care under the compulsory medical insurance by posting:

Debit 51 Credit 76 (62).

The recommendation below provides an example of reflecting operations for the implementation of medical services under the CHI program in an autonomous institution. Article KOSGU 130 corresponds to account 90 of the commercial payment of invoices, and the analytical account 0.109.00.000 "Costs for the manufacture of finished products, performance of work, services" corresponds to account 20. Funds of targeted financing (including funds of compulsory medical insurance), autonomous institutions on a simplified system are not entitled to include in income when calculating the single tax. Since the CHI funds tax base by single tax do not form, it is impossible to take into account the costs paid with these funds as part of expenses when calculating the single tax.

The rationale for this position is given below in the materials of the Glavbuh System

FEDERAL LAW OF 29.11.2010 No. 326-FZ "Medical organizations keep separate records for operations with compulsory health insurance funds "

Medical institutions are obliged to provide medical care free of charge within the framework of compulsory health insurance (CHI) programs * (clause 1 of part 2 of article 20 of the Law of November 29, 2010 No. 326-FZ).

CHI programs are subdivided into basic, which operates throughout the territory of Russia, and territorial, operating within the constituent entity of the Russian Federation, where compulsory medical insurance policy* (clause, article 3 of the Law of November 29, 2010 No. 326-FZ).

Funding programs

, p. 122 of the Rules approved).

Tariffs for paying for medical care are established in the subject of the Russian Federation by a tariff agreement. Moreover, they must be posted on the official websites of the authorized bodies of the constituent entities of the Russian Federation no later than 14 calendar days from the date of their approval *. This is stated in parts, article 30 of the Law of November 29, 2010 No. 326-FZ and.

Funding programs

Medical assistance in accordance with the basic and territorial programs is provided at the expense of compulsory medical insurance * (clause 1 of article 4 of the Law of November 29, 2010 No. 326-FZ).

Compulsory health insurance funds are sent to medical institutions in accordance with the established tariffs for paying for medical care * (part 1 of article 20 of the Law of November 29, 2010 No. 326-FZ, paragraph 122 of the Rules approved by order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n ).

Tariffs for paying for medical care are established in the subject of the Russian Federation by a tariff agreement. Moreover, they must be posted on the official websites of the authorized bodies of the constituent entities of the Russian Federation no later than 14 calendar days from the date of their approval. * This is stated in parts, article 30 of the Law of November 29, 2010 No. 326-FZ and the letter of the Ministry of Health of Russia dated December 25 2012 No. 11-9 / 10 / 2-5718.

Calculation of tariffs for compulsory medical insurance

The methodology for calculating tariffs for payment for medical care provided within the framework of the basic and territorial programs is given in Chapter XI of the Rules approved by order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n * (clause 156 of the Rules approved by order of the Ministry of Health and Social Development of Russia dated February 28, 2011 . № 158н). In this case, the calculation of tariffs includes: *

1) costs directly related to the provision of medical care (services) and consumed in the process of its provision, in particular:

• for the remuneration of personnel (including accruals for payment of wages) directly involved in the process of providing medical care (services): doctors, nurses, etc.;
• inventories consumed in the process of providing medical care (services);
• costs (depreciation) of equipment used in the process of providing medical care (services);

2) costs that are necessary to ensure the operation of a medical institution as a whole, but not consumed directly in the process of providing medical care (services):

• on utilities;
• content of objects is not movable propertyoperated in the process of providing medical care (including those obtained under a lease agreement or free use);
• maintenance of objects of movable property;
• communication services;
• transport services;
• for the remuneration of the staff of the institution (including accruals for payments for wages), not directly involved in the process of providing medical care (administrative and managerial, administrative, auxiliary, etc.);
• depreciation of equipment not involved in the provision of medical care;
• other general expenses.

Groups of costs, both consumed and not consumed in the provision of medical care (services), can be further detailed.

Basic program

The basic compulsory medical insurance program for 2014 and for the planning period of 2015 and 2016 has been approved.

As part of the implementation of the basic cHI programs and at the expense of compulsory medical insurance funds, the medical institution provides free of charge:

• primary health care (including preventive care);
• ambulance (except for air ambulance evacuation);
• specialized medical care (with the exception of high-tech medical care) for diseases specified in section III of the program, approved by the Government of the Russian Federation of October 18, 2013 No. 932. The exceptions are sexually transmitted diseases, tuberculosis, HIV infections, AIDS, mental disorders and behavioral disorders.

Also, within the framework of the implementation of the basic program, financing is carried out for:

• medical examination of certain categories of citizens;
• the use of assisted reproductive technologies (in vitro fertilization), including drug provision;
• medical rehabilitation carried out in medical institutions.

Payments for medical care provided to insured persons outside the territory of the constituent entity of the Russian Federation in which the policy was issued, in the amount established by the basic program, the medical institution makes with the territorial fund at the place of medical care (clause 133 of the Rules approved by order of the Ministry of Health and Social Development of Russia dated February 28 2011 No. 158n). To do this, the institution must submit an account (register of accounts) to the territorial fund at the place of assistance * (part 8 of article 34 of the Law of November 29, 2010 No. 326-FZ). The register form is given in the letter of FFOMS dated December 30, 2011 No. 9161 / 30-1 / and.

The exchange of data when making payments for medical care is carried out in in electronic format (in accordance with) (paragraph 136 of the Rules approved by order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n). So, the exchange of data is carried out via dedicated or open communication channels (including the Internet) using an electronic signature * (clause, the Procedure approved by order of the Ministry of Health and Social Development of Russia dated January 25, 2011 No. 29n).

The structure of the tariff for paying for medical care in terms of the basic program includes the costs specified in part 7 of Article 35 of the Law of November 29, 2010 No. 326-FZ. In particular, the tariff includes: *

• payroll costs and payroll charges;
• purchase of medicines, consumables, food, soft inventory, medical instruments, reagents and chemicals;
• the cost of paying for the cost of laboratory and instrumental studies conducted in other institutions (in the absence of a laboratory and diagnostic equipment in a medical institution);
• expenses for catering (in the absence of organized meals in a medical institution);
• purchase of fixed assets (equipment, production and household inventory) worth up to 100,000 rubles.

In addition, the composition of the cost of providing medical care may include other costs in accordance with the legislation on CHI. So, FFOMS in a letter dated June 6, 2013 No. 4509/21-i explained that other expenses may include compensation for moral and physical harm to citizens in connection with poor quality medical care, payment of taxes, fines and penalties, social Security employees of medical institutions, etc. Are not included in the tariff, which means that they cannot be paid from the funds of the compulsory medical insurance within the framework of the basic program, in particular, the cost of purchasing cars *.

Territorial program

The territorial compulsory medical insurance program is approved in each subject of the Russian Federation in the manner prescribed by the legislation of this subject * (part 1 of article 36 of the Law of November 29, 2010 No. 326-FZ). So, in the city of Moscow, the territorial program for 2013 and the planning period of 2014 and 2015 was determined by the decree of the Moscow government dated December 25, 2012 No. 799-PP, in the Khanty-Mansiysk Autonomous Okrug - Yugra - by the decree of the government of the Khanty-Mansiysk Autonomous Okrug - Yugra dated October 29, 2012 No. 426-p.

The territorial program must be posted on the official website of the authorized body of the constituent entity of the Russian Federation no later than 14 calendar days from the date of its approval * (part 12 of article 36 of the Law of November 29, 2010 No. 326-FZ).

Funds for the payment of medical care in the amount and on the terms established by the territorial compulsory medical insurance program are sent to the medical institution by the medical insurance organization. For this, a medical institution needs to conclude an agreement with an insurance medical organization for the provision and payment of medical care under compulsory medical insurance. When concluding a contract, use the standard form, which is given in the annex to the order of the Ministry of Health of Russia dated December 24, 2012 No. 1355n *.

The amount of medical care provided for the year with a quarterly breakdown and reasonable subsequent adjustments is subject to payment from the CHI funds. When adjusting, it is necessary to take into account the indicators given in paragraph 123 of the Rules, approved by order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n.

When paying a medical institution a per capita funding standard, the number of insured persons attached to it is taken into account. In addition, the amount of funds for types of assistance is taken into account in accordance with the cost items included in the territorial program *. This is stated in paragraph 124 of the Rules approved by order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n.

When determining the monthly amount of funding for an institution providing outpatient care, insurance organizations take into account:

• the number of insured persons attached to the institution (based on the number reconciliation act);
• tariffs set on the basis of per capita financing ratio. These tariffs are communicated to insurance companies by TFOMS.

Medical institutions must submit to insurance medical organizations: *

• information on the number of insured persons who have chosen a medical facility to provide assistance on an outpatient basis;
• the list of attached insured persons to receive medical care on an outpatient basis - to conclude an agreement for the provision and payment of medical care under the compulsory medical insurance (subsequent change in the list based on the reconciliation act).

At the same time, these data are submitted to TFOMS. The submission deadline is set by the commission for the development of the territorial CHI program.

To receive targeted funds, every month until the 10th, apply to insurance organization an application for advance payment (indicating the advance period and amount). The application form is given in Appendix No. 9 to the Guidelines sent) * The amount of the advance payment in the application must be indicated in the amount of no more than 40 percent of the average monthly amount of funds for payment of medical care. But in the II and III quarters the amount of the advance payment can be increased up to 20 percent of the original size. For example, if in the first quarter you announced an advance payment of 100,000 rubles, then in the second quarter you can increase it to 120,000 rubles. (100,000 rubles + (100,000 rubles? 20%)).

Together with the application to the insurance organization, submit:

• invoice for payment of medical care;
• register of accounts (the form of the register is given in Appendix No. 12 to the Methodological Instructions sent by the letter of FFOMS dated December 30, 2011 No. 9161 / 30-1 / and).

On the basis of the submitted registers of accounts, insurance organizations monitor the volumes, terms, quality and conditions for the provision of assistance under compulsory medical insurance (paragraph 127 of the Rules approved by order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n). The procedure for organizing such control is established by the Law of November 29, 2010 No. 326-FZ. If there are bills rejected from payment based on the results of the control carried out, the institution has the right to modify and submit to the insurance organization the corrected bills and account registers. This must be done no later than 25 working days from the date of receipt of the act of the insurance organization (clause 128 of the Rules approved by order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n).

If in the reporting month the amount of funds exceeds the amount of the invoice for payment of medical care (taking into account the results of control of volumes, terms, quality and conditions) in next month the amount of the advance request is reduced by the excess amount. The exception is payment for medical care due to increased morbidity, an increase in tariffs for payment of care, the number of insured persons and (or) a change in their structure by sex and age *. This is stated in clause 129 of the Rules approved by order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n, part 6 of Article 38 of the Law dated November 29, 2010 No. 326-FZ.

The CHI funds received within the framework of territorial programs should be used by health care institutions only to pay for expenses that are associated with the provision of medical care (services), at the rates established by the CHI agreement *. This conclusion follows from section VI of the program approved by Decree of the Government of the Russian Federation of October 18, 2013 No. 932, paragraph 17.2 of Appendix 2 to.

It should also be noted that the subjects of the Russian Federation can include funds for high-tech assistance in the territorial compulsory medical insurance program (part 9 of article 100 of the Law of November 21, 2011 No. 323-FZ, part 3 of article 36 of the Law of November 29, 2010 No. 326-FZ).

Liability for misuse

Attention: the direction of CHI funds for expenses that are not indicated in the program will lead to their inappropriate use (, part 9 of article 39 of the Law of November 29, 2010 No. 326-FZ, clause 17.2 of Appendix 2 to the FFOMS order of April 16, 2012 . No. 73).

Control over the use of CHI funds is carried out by the FFOMS * (Procedure approved).

Funds used not for their intended purpose, the medical institution will have to return to the budget of the TFOMI (within 10 working days from the date the fund submits the corresponding request), and pay:

• a fine of 10 percent of the amount of misuse of funds;
• a penalty in the amount of 1/300 of the refinancing rate in effect on the day of the imposition of the sanctions from the amount of inappropriate use of the specified funds for each day of delay.

See the table on responsibility for the misuse of state extra-budgetary funds.

Control in the MLA

The FFOMS controls the use of compulsory health insurance funds for their intended purpose. For this, the fund conducts audits and checks, based on the results of which the auditors will draw up an act. If during the control measures violations (shortcomings) are revealed, the act must contain information about the violated norms of the law and other regulatory legal acts, indicating:

• for what period the violations were committed;
• when and how they expressed themselves;
• amounts of inappropriate expenses;
• expenses that were incurred in violation of the law;
• amounts of unreasonably received funds.

An act with facts about revealed violations or misuse of compulsory medical insurance funds is the basis for taking measures and monitoring the implementation of inspection materials.

Also, in case of violation of the legislation on compulsory medical insurance or misuse of compulsory medical insurance funds, the head of the medical institution will be sent a written notification * (clause 29 of the Procedure approved by order of FFOMS dated December 19, 2013 No. 260).

Calculation of the cost of medical care (service)

In the calculation of the cost of medical care (service) include the following costs.

1. Expenses for the salaries of personnel directly involved in the provision of medical care (including accruals for wages). Determine the costs based on the amount of expenses for the salaries of the specified personnel, including incentive payments for medical care provided outpatiently, as well as for emergency medical care outside the medical facility.

In addition, the costs of salaries include the costs of achieving the target indicators of the level of salaries of health workers established by road maps for the development of healthcare in the constituent entities of the Russian Federation.

2. Expenses for the remuneration of personnel who are not directly related to the provision of medical care (including charges on wages). Determine such costs based on the number of staff units, taking into account the current system wages.

3. The cost of purchasing inventories, transport services and communication services directly used to provide medical care (services). These costs can be calculated based on the following factors:

• standard consumption volumes;
• actual volumes of consumption for the past years in physical or value terms.

4. Amounts of accrued depreciation of equipment worth up to 100,000 rubles. per unit used and not used in the provision of medical care (services). Determine the amount based on the book value of the equipment, the annual rate of its depreciation and the operating time of the equipment in the process of providing medical care (services).

The amount of accrued depreciation of equipment worth more than 100,000 rubles. per unit, take into account if these costs are included in the territorial compulsory medical insurance program.

5. The cost of utilities. The procedure for calculating utility costs is given in clauses 158.8-158.10 of the Rules approved by order of the Ministry of Health and Social Development of Russia dated February 28, 2011 No. 158n.

In this case, consider the costs of utilities separately by type of energy resources:

• cold water supply;
• hot water supply;
• heat supply;
• power supply.

Costs can be calculated based on the following factors:

• consumption standards taking into account the requirements of energy efficiency and energy supply;
• or actual consumption volumes for previous years, taking into account changes in the composition of movable and immovable property used in the provision of medical care (services).

The procedure for reflecting the receipt of financial support in the framework of CHI programs in accounting depends on the type of institution.

In the account of autonomous institutions:

In federal institutions, compulsory medical insurance funds are accounted for in personal accounts designed to record transactions with compulsory medical insurance funds (personal account code - 32), opened in the territorial bodies of the Treasury of Russia (Procedure approved by order of the Treasury of Russia dated December 29, 2012 No. 24n). At the regional and local level, the procedure for opening and maintaining personal accounts for accounting for transactions with CHI funds is established by the financial body of the constituent entity of the Russian Federation ( municipal formation) (part 3.3 of article 2 of the Law of November 3, 2006 No. 174n).

Income from the provision of medical care within the framework of the compulsory medical insurance is credited to the account under “Income from the provision of paid services (works)” (section V of the instructions approved by order of the Ministry of Finance of Russia dated July 1, 2013 No. 65n). Therefore, it is advisable to reflect them in accounting on the account 7.205.30.000 "Calculations for income from the provision of paid work, services." The explanations are as follows.

Secure the selected option for reflecting income on compulsory medical insurance in the accounting policy.

Accrue income on the date of signing the statement of reconciliation of settlements under the contract for the provision and payment of medical care under compulsory medical insurance *.

The accrual, receipt of income on funds within the framework of the compulsory medical insurance, as well as refunds in case of detection of misuse, reflect as follows.

Off-balance sheet account 17 1.<6>

In accounting, the costs are attributed to the cost depending on how many types of services the institution provides.

If the institution provides one type of medical services, all the costs associated with this, refer to direct (to account 7.109.60.000 "The cost of finished products, works, services").

If the institution provides several types of services, allocate costs as follows:

• costs that are not directly related to a specific service, refer to invoices (to account 7.109.70.000);
• costs that are directly related to a specific service, refer to direct and reflect on account 7.109.60.000.

Regardless of the number of types of services of the institution, general business costs (for example, the salary of the administration) are charged to account 7.109.80.000 "General business costs".

Autonomous institution on the STS

Funds of targeted financing (including compulsory medical insurance funds) autonomous institutions on a simplified tax system have the right not to include them in income when calculating the single tax (subparagraph 1 of paragraph 1.1 of article 346.15, subparagraph 14 of paragraph 1 of article 251 of the RF Tax Code). In this case, the institution must:

• keep separate records of income (expenses) received (produced) within the framework of targeted financing;
• to use the funds received strictly for the intended purpose.

Since the compulsory medical insurance funds do not form the tax base for the single tax, it is impossible to take into account the costs paid from these funds as part of expenses when calculating the single tax (clause 1 of article 252, clause 17 of article 270, clause 2 of article 346.16 of the Tax Code RF).

Accounting

The materials transferred into production (operation) should be written off as costs at the time of their release from the warehouse, that is, at the time of drawing up documents for the transfer of materials into operation (production *) (clause 93 of the Methodological Instructions approved by order of the Ministry of Finance of Russia dated December 28, 2001 . № 119н).

The chief accountant advises: to determine the moment of actual use of materials in production, you can use additional reporting forms. For example, a report on the use of materials in production. This will reduce the costs of the reporting period for the cost of materials that have not been processed.

This is also recommended by some industry guidelines (paragraphs and Methodical recommendations, approved by the order of the Ministry of Agriculture of Russia dated January 31, 2003 No. 26). In addition, the moment of actual consumption of materials is also important for tax purposes. For more information, see How to take into account material expenses when calculating income tax and How to write off expenses for the purchase of raw materials and materials under simplification.

In accounting, issue the release of materials by wiring

Debit 20 (23, 25, 26, 29, 44, 97 ...) Credit 10 (16)
- materials written off.

Sergey Razgulin

State medical institutions provide medical and drug assistance at the expense of the CHI funds in the amount and on conditions that correspond to the CHI programs. Control over the targeted use of CHI funds is carried out by the territorial CHI fund (TFOMI) through inspections. The article discusses the violations that are revealed during their implementation.

The legal relationship between a healthcare institution, an insurance medical organization and TFOMI in the CHI system is regulated by the Federal Law of November 29, 2010 N 326-FZ "On compulsory medical insurance in Russian Federation"(Hereinafter - Federal Law N 326-FZ). The norms of the said Law require the health care institution to spend cash Compulsory medical insurance for payment of medical care for the intended purpose.

Control over the use of extra-budgetary funds of compulsory medical insurance is carried out by the TFOMI for the constituent entities of the Russian Federation in accordance with the Order of the FFOMS dated 04.16.2012 N 73, which approved the Regulation on control over the use of compulsory medical insurance funds by medical organizations (hereinafter - Regulation N 73).

In accordance with clause 15 of Regulation N 73, four areas of use of funds received by medical organizations are subject to verification, the list of which includes the use of funds to ensure the implementation of the territorial CHI program.

How is CHI funds checked?

According to clause 4 of Regulation N 73, inspections are carried out at the location of the medical organization (or at the place where it actually operates). These include:

- a comprehensive check, in which a set of issues related to the use of compulsory medical insurance funds for a certain period of a medical organization's activity is considered;

- thematic check, in which certain issues related to the use of CHI funds are considered;

- control check, which considers the elimination of violations and shortcomings by a medical organization in the use of compulsory medical insurance funds previously identified during a comprehensive or thematic check

The inspections are carried out in accordance with the plan approved by the director of the territorial fund (scheduled inspections). Frequency of holding scheduled inspections It is established taking into account the possibility of full coverage of issues and periods of activity of medical organizations in the field of compulsory medical insurance, but at least once every two years. Scheduled due diligence checks are carried out no more than once a year.

The territorial fund may carry out unscheduled inspections. Unscheduled inspections of the use of compulsory medical insurance funds are carried out by decision of the director of the territorial fund on the basis of submissions from control bodies, complaints and applications of citizens, etc.

Checking the use of CHI funds can be carried out in a continuous or selective way (clause 9 of Regulation N 73). Note that the continuous method consists in carrying out a control action with respect to the entire set of financial, accounting, reporting and other documents related to one issue of the verification program. As for the selective method, in in this case examining documents related to one issue of the verification program. The size of the sample and its composition are determined by the head of the commission (working group) in such a way as to ensure the possibility of assessing the issue under study of the verification program.

When checking the use of CHI funds, the following are checked:

- the correctness of the reflection in the accounting registers of transactions with CHI funds;

- correctness of reflection of income and expenses in accordance with the current budget classification;

- compliance with the procedure for conducting cash transactions and accounting for cash (in terms of compulsory medical insurance funds);

- the timeliness of the posting of OMS cash received from the bank and other sources, as well as their intended use;

- the availability of supporting documents and the reliability of the data contained in them, which are the basis for writing off cash expenses, the legality of expenses incurred in terms of compulsory medical insurance funds, ensuring the safety of funds.

What documents and expenses are subject to control?

As noted above, there are four main areas of expenditure of MHI funds that are subject to verification. Let us dwell only on the first of them - on the verification of the CHI funds used to finance the implementation of the CHI territorial program.

Note that in accordance with clause 16 of Regulation N 73, the control measure carried out by the TFOMI includes checking compliance with the separate accounting for operations with CHI funds:

- by type of medical care;

- according to the structure of the tariff for paying for medical care.

Checking the costs included in the tariff structure includes (clause 17.2 of Regulation N 73):

1) verification of labor costs and charges for labor compensation payments. During the control event, all documents confirming the validity of the payments made will be checked:

- staffing table, tariff lists, documents confirming the qualifications of specialists;

- work schedules of structural divisions and employees;

- orders for personnel;

- labor agreements;

- collective agreement;

- regulation on remuneration;

- primary accounting documents on payroll, payment of taxes and insurance premiums established by the legislation of the Russian Federation;

2) verification of expenses for the purchase of medicines, consumables, food, soft inventory, medical instruments, reagents and chemicals, other material supplies, for payment of the cost of laboratory and instrumental studies carried out in other institutions. Checking the use of funds for the specified purposes is carried out by checking the primary documents confirming the legality of the banking operations, including contracts for the supply of medicines, consumables, food products, soft inventory, medical instruments, reagents and chemicals, other material supplies. Checked:

- reasonableness of prices when purchasing goods (works, services) at the expense of compulsory medical insurance funds;

- observance of delivery and payment terms, correspondence of the amounts specified in the contracts, actually incurred expenses;

- Timeliness, completeness and correctness of the posting of medicines and consumables, food products, soft inventory, medical instruments, reagents and chemicals, other inventories;

- the procedure for storing, accounting and writing off medicines, consumables, food products, soft inventory, medical instruments, reagents and chemicals, and other inventories;

- availability of separate accounting of medicines purchased at the expense of compulsory medical insurance funds and funds coming to a medical organization from other sources.

The analysis of purchased medicines is being carried out (the availability of medicines with expired suitability).

Studied:

- materials of an inventory of property and financial obligations, carried out by a medical organization;

- the presence, duration and size of the receivable and accounts payable with suppliers of goods and services at the expense of CHI funds;

- Timeliness of collection of accounts receivable and repayment of accounts payable, mutual reconciliation in settlements with suppliers;

- the correctness of the accounting of these calculations, the timeliness of the collection of the amounts of identified shortages and thefts of the CHI funds, material assets acquired at the expense of the CHI funds, as well as losses from damage to these valuables attributed to the perpetrators.

What violations are revealed during inspections carried out by TFOMI?

We bring to your attention disputes in which certain types of violations revealed during inspections were considered.

Implementation of expenses not included in the territorial CHI program. Medical organizations in accordance with clause 5 of part 2 of Art. 20 of the Federal Law N 326-FZ are obliged to use the CHI funds received for the provided medical care, in accordance with the CHI programs. When conducting inspections of the TFOMS, cases are revealed when the payment of expenses for the provision of medical care to citizens of the Russian Federation is not carried out at the expense of the source that is intended for their financing. As an example, let us give the Resolution of the FAS ZSO dated 04/14/2014 N A75-3259 / 2013, in which the essence of the detected violation is as follows. The medical institution, in violation of the tariff agreements and the terms of the contracts, allowed the misuse of compulsory medical insurance funds, expressed in the payment of the cost of equipment, furniture and equipment repairs not provided for in the tariff agreements, as well as in the payment of the cost of consumables for the provision of high-tech medical care, which should be carried out at the expense budget of the constituent entity of the Russian Federation. In other words, the expenditure of compulsory health insurance funds, which are strictly targeted, was carried out in areas not provided for by the funding sources.

For reference. In the Letter of FFOMS dated 06.06.2013 N 4509/21-i clarifications were given on certain areas of spending the CHI funds. In particular, in accordance with the recommendations of officials, the costs of purchasing furniture, including medical and kitchen furniture, are not included in the tariff for paying for medical care under the basic compulsory medical insurance program. An exception is equipment that, according to the certificate (declaration) of conformity by virtue of the Classification of fixed assets, belongs to class 14 3311320 "Equipment for offices and wards, equipment for laboratories and pharmacies" Section 14 0000000 "Machinery and equipment".

According to the Resolution of the FAS ZSO, taking into account the provisions of Federal Law N 326-FZ on the misuse of compulsory medical insurance funds, the organization pays a fine in the amount of 10% of the amount of inappropriate use of compulsory medical insurance funds and a penalty in the amount of 1/300 of the refinancing rate of the Bank of Russia, in effect on the day of the imposition of sanctions, for every day of delay.

In the Resolution of the FAS UO dated 10.10.2013 N F09-10575 / 13 in case N A60-1177 / 2013, when considering a dispute over a similar violation, the arbitrators also sided with TFOMI, indicating that the costs of medical organizations for the purchase of disinfectants should be carried out exclusively at the expense of funds of the budget of the constituent entity of the Russian Federation. The territorial program of state guarantees for the free provision of medical care to citizens of the Russian Federation residing in the territory of the constituent entity of the Russian Federation for the corresponding year does not provide for such expenses. By the definition of the Supreme Arbitration Court of the Russian Federation of January 23, 2014 N BAC-18262/13, the institution was refused to revise this Resolution.

A similar violation was considered in the Resolution of the Federal Antimonopoly Service of the NKR dated 01.10.2012 N A22-1961 / 2011. The territorial program that was in force in the period under review on the territory of the constituent entity of the Russian Federation provided for lists of diseases, types of medical care and medical institutions included in the compulsory medical insurance system, as well as funded from the republican budget. As follows from the designated territorial compulsory medical insurance program, the costs of vocational training and retraining of personnel should be carried out at the expense of the republican budget, medical and other services provided in the pathological and anatomical bureaus (offices) were provided at the expense of the republican and local budgets.

According to sect. III and IV of the named program, the inspected medical institution was included both in the list of institutions included in the CHI system, and in the list of institutions funded from the republican budget.

FAS NKO established that medical services of a pathologist, in accordance with the specified territorial compulsory medical insurance program, are not subject to financing from the compulsory medical insurance funds. Since the payment of the salary to the pathologist was also financed from the republican budget, the court concluded that the expenses for the advanced training of the named doctor constituted the misuse of compulsory medical insurance funds, which are subject to refund.

Violation of the application of the budgetary classification of the Russian Federation in the implementation of expenses on CHI. In the Resolution of the FAS PO dated 03.25.2014 N A12-19994 / 2013, a dispute between the Ministry of Health of a constituent entity of the Russian Federation and FFOMS was considered.

During the audit, the foundation found that, in violation of paragraph 3 of Art. 50 of the Federal Law N 326-FZ on government contract For the purchase of devices for medical laboratory research, the Ministry at the expense of the CHI acquired consumables under the program for the modernization of healthcare. Recall that in accordance with paragraphs. 1 of this clause provided in fFOMS budget 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 following purposes:

1) to strengthen the material and technical base of state and municipal healthcare institutions, including the construction, reconstruction of capital construction facilities and (or) their stages, ensuring the completion of the construction of previously started facilities, major repairs of state and municipal healthcare institutions, the purchase of medical equipment;

2) the introduction of modern information systems in health care in order to create a unified state information system in the health sector, the transition to compulsory medical insurance policies uniform sample, including the universal electronic card provided by the federal electronic application, the introduction of telemedicine systems, systems electronic document management and maintenance of patients' medical records in electronic form;

3) to introduce standards of medical care, increase the availability of outpatient medical care, including that provided by specialist doctors.

As pointed out by the FFOMS representatives, the purchased consumables cannot be recognized as medical equipment, since they do not belong to the code 3311000 "Medical and surgical equipment, orthopedic appliances" OK 004-93, therefore, they are not included in the list established by clause 3 of Art. 50 of the Federal Law N 326-FZ.

The Ministry of Health of a constituent entity of the Russian Federation received funds from the compulsory medical insurance for the implementation of the health care modernization program, which is reflected in article 310 "Increase in the cost of fixed assets" of KOSGU.

Consumables purchased at the expense of the allocated funds (chemical reagents, laboratory glassware) are inventories, since they have a term useful use less than 12 months, and on the basis of clause 118 of Instruction N 157n<1> are subject to accounting on account 105 06 "Other material reserves".

Thus, the court confirmed the conclusion of the fund that the ministry committed a violation in the form of improper use of the CHI funds.

Purchase of consumables not used in medical practice. As already noted, one of the guarantees ensuring both the strictly targeted use of compulsory medical insurance funds and taking into account the rights and interests of a medical organization, the compulsory medical insurance fund and the insurer is the establishment of tariffs for paying for medical care under compulsory medical insurance in accordance with the Federal Law N 326-FZ tariff structure. The indicated tariff includes a list of expenses of medical organizations that they incur in connection with the provision of medical care under compulsory medical insurance programs (Article 30, Part 7, Article 35 of Federal Law N 326-FZ). Thus, as noted by the arbitrators in the Resolution of the FAS MO dated 04/30/2014 N А41-38789 / 13, the acquisition of liquid technical oxygen by a health care institution at the expense of the compulsory medical insurance funds is their misuse. This conclusion is based on the fact that oxygen included in the State Register of Medicines and purchased from a supplier licensed to manufacture it can be used for medical purposes. The acquisition of technical oxygen clearly contradicts the permissible goals of its use in medical activities, which means that it cannot be regarded as the intended use of compulsory medical insurance funds.

Payment of wages to pharmacy employees at the expense of compulsory medical insurance funds. The essence of the violation, which was brought before the court, was as follows. TFOMI conducted a documentary audit of the use of CHI funds aimed at paying for medical services provided by a medical institution under the territorial CHI program. In the course of the audit, the misuse of the CHI funds was revealed, expressed in the issuance of salaries with accruals to the employees of the hospital pharmacy at the expense of the CHI funds. Since these expenses do not correspond to the provisions of the territorial program of state guarantees of free provision of medical care to citizens of the Russian Federation residing in the constituent entity of the Russian Federation, the institution was ordered to recover the compulsory medical insurance funds spent not for their intended purpose.

FAS UO in its Resolution of 11.01.2012 N F09-8757 / 11 reasonably indicated that a pharmacy organization, including a structural unit of a healthcare institution, carries out pharmaceutical activities, that is, activities in the field of circulation of medicines, including wholesale, retail means and their manufacture. In this case, a pharmacy organization is understood as an organization, a structural unit of a medical organization engaged in retail trade in medicinal products, their storage, manufacture and dispensing for medical use.

The arbitrators drew attention to the fact that providing citizens with medicines under the territorial program implies the purchase of medicines by medical organizations for their free provision when providing medical care to citizens, while the pharmacy of a medical institution dispenses medicines. The activities of pharmacies are not related to medical activities, that is, to activities directly aimed at providing medical services. In such circumstances, the court refused the medical institution to satisfy the stated requirements for invalidating the TFOMI prescription.

The illegality of attracting personal funds of citizens who are insured under the compulsory medical insurance, when providing them with medical care within the framework of the territorial program. According to paragraphs. "B" clause 1 h. 1 art. 16 of Federal Law N 326-FZ, insured persons have the right to free medical care by medical organizations upon the occurrence of insured event on the territory of the constituent entity of the Russian Federation in which the compulsory medical insurance policy was issued, in the amount established by the territorial compulsory medical insurance program.

Territorial programs of state guarantees of free provision of medical care to citizens of the constituent entities of the Russian Federation approve a list of types of medical care that is provided free of charge. This list includes primary health care, which includes, in particular, measures for the prevention, diagnosis and treatment of diseases. Primary health care is provided on an outpatient basis and in a day hospital.

During the inspection in the republican hospital TFOMS, it was revealed that citizens purchased the drugs "Gadovist" and "Omnipak", belonging to the pharmacological group and pharmacological action of contrasting diagnostic drugs used exclusively for diagnostic purposes, for cash, which is a violation ...

As noted by the arbitrators in the Resolution of the FAS VCO dated 01.07.2014 N А58-5989 / 2013, the hospital is obliged to provide diagnostic drugs free of charge as part of the provision of services for the diagnosis of diseases as an integral part of primary health care provided on an outpatient basis. In this regard, the TFOMS rightfully issued an order to the hospital to reimburse the unjustifiably spent amounts to citizens who bought medicines for their own money.

In the Decree of March 25, 2014 N А78-4168 / 2013, the court of the same district considered the dispute between the hospital and the TFOMI concerning the collection of fees from patients for conducting an operation in the provision of medical care provided under the state guarantees program. As noted by the arbitrators, from the totality of the provisions of Part 1 of Art. 11, paragraph 1, part 3 of Art. 80 of the Federal Law N 323-FZ<2> it follows that when providing medical care within the framework of territorial programs of state guarantees for the provision of medical care, they are not subject to payment at the expense of citizens' personal funds:

- provision of medical services;

- the prescription and use of medicinal products included in the list of vital and essential medicinal products, medical devices, blood components, medical nutrition, including specialized medical nutrition products, for medical reasons in accordance with the standards of medical care.

Thus, the issued order of the TFOMS meets the requirements of the legislation of the Russian Federation.

In conclusion, we note that for the use of funds received for the provision and payment of medical care under the compulsory medical insurance, medical institutions pay a fine in the amount of 10% of the amount of their inappropriate use, not for their intended purpose. In addition, it will be necessary to pay a penalty in the amount of 1/300 of the refinancing rate of the Bank of Russia, in effect on the day of the imposition of sanctions, from the amount of inappropriate use of these funds.

Funds used not for their intended purpose, the institution must be transferred to the budget of the TFOMI within 10 working days from the date of the presentation of the corresponding request by the TFOMI (clause 9 of article 39 of Federal Law N 326-FZ).

In case of non-fulfillment by the medical institution of the requirements of TFOMS for the return (reimbursement) of funds, including those used not for their intended purpose, and (or) payment of fines, penalties, TFOMS may send relevant information and verification materials to law enforcement and judicial authorities to bring the perpetrators to justice ...

The presence of this right also does not exclude the right to claim in court to bring a medical organization to justice in the form of a fine, provided for in Part 9 of Art. 39 of Federal Law N 326-FZ (Resolution of the Federal Antimonopoly Service of the ZSO dated 04.14.2014 N A75-3259 / 2013).

Report at the conference - Competition in medicine - E.Yu. Latysheva, Chairman of the Board of the Expert Group of Companies, Lipetsk

The presence of problems and a high percentage of negative attitude towards the CHI system both on the part of medical service providers and among consumers of medical services has been discussed for several years not only at medical conferences, but also at higher levels of the Ministry of Health and Government meetings.

Our organization carries out medical activities for the provision of MRI diagnostics services in 36 regions of the Russian Federation and in practice, we are faced with a large number of difficulties and problems due to regional differences the existing system OMS. Since 2013, all organizations of the federal network of MRT Expert diagnostic centers have been included in the register of legal entities entitled to work in the CHI system.

Accumulating work experience in a large number of regions, the following problems can be singled out for working in the CHI system:

1. Lack of criteria and rules for the distribution of volumes and the procedure for notifying medical organizations about the allocated volumes to TFMOS.

Given that the procedure and mechanism for inclusion in the register of medical organizations providing medical care under the system of state guarantees is very simple - by September 1, submit a notification to the regional MHIF and state what volumes you want to receive, and you will be automatically included in the register of medical organizations providing medical care on compulsory medical insurance. Further - Everything is very difficult!

For example, in terms of the procedure and timing of informing a medical organization about the allocation of volumes of medical care to it, there is no understanding of the form and timing of such notification.

And it often happens that the timing of official information on the distribution of volumes and the timing of the start of assistance have a gap of up to several months.

Usually, organizations receive information about the volumes allocated to them not earlier than February, in practice there were cases of receiving information about the volumes in March, while the beginning of the provision of services takes place already in January and many organizations, having started admitting patients under the state guarantees program, do not know whether they will the volumes are highlighted while the organization is included in the register.

It is completely unclear on what basis, according to what criteria the volumes of medical care are distributed.

The absence of rules and order creates a fertile ground for the flourishing of corruption and subjectivity in the distribution of CHI volumes.

2. The presence of regional differences in the classification of medical services and their tariffication.

Our organizations carry out medical activities in 36 regions of the Russian Federation and in practice, we are faced with a situation where in some regions (Vladivostok, Maikop, Tomsk) insured events are detailed, which are determined according to the Nomenclature of medical services approved by Order of the Ministry of Health and Social Development of the Russian Federation of December 27, 2011 No. 1664n. and for each insured event (medical service) its own tariff is calculated and established.

In other regions and most of them (Lipetsk, Khabarovsk, Orel, Novosibirsk, Petrozavodsk, Yuzhno-Sakhalinsk), the given detailing is missing. They prefer to single out only two medical services: MRI and MRI with contrast, without specifying a specific area of \u200b\u200bstudy and, accordingly, the tariff is also developed for only two types of diagnostics: MRI and MRI with contrast. At the same time, when rendering such a service as "MRI", in fact, a certain area of \u200b\u200bresearch is to be scanned, indicated in the direction of the doctor. However, the payment, no matter what the “brain” or “mammary glands” were scanned, is the same. Whereas the service "MRI of the mammary glands" is more complex, more expensive than the service "MRI of the brain".

It is clear that such a situation motivates organizations not to take on heavy research, receiving the same amount for this work as for a much easier case.

The reasons for regional differences in the classification of medical services and their tariffication are the fact that Federal Law No. 326 of November 29, 2010 "On compulsory medical insurance", order of the Ministry of Health and Social Development of Russia of February 28, 2011 No. 158n "On approval of the Compulsory medical insurance rules" 11/18/2014 No. 200 "On the Establishment of Requirements for the Structure and Content of a Tariff Agreement," authorizes the constituent entities of the Russian Federation to independently determine the volume (types) of medical care when developing a tariff agreement.

3. Lack of uniform rules for calculating tariffs for types of medical services.

The rules of compulsory health insurance approved the "Methodology for calculating the tariff for payment of medical care for compulsory health insurance." The FFOMS Order "On the Establishment of Requirements for the Structure and Content of the Tariff Agreement" also establishes the rules for establishing the size and structure of the tariff for paying for medical care.

But despite the presence of documents regulating the issue of tariffication, the above federal regulations give each region the right to independently form CHI tariffs.

And due to the lack of uniform rules for calculating tariffs in different constituent entities of Russia, there is a significant difference in the established tariffs for the same medical services.

I can give you an example, an MRI service (without specifying the scan area) in Kaliningrad costs 540 rubles. The same service in Orel costs 1,300 rubles, in Maykop the average price for an MRI is 3,400 rubles. As you can see, the difference is at times.

Many companies working in compulsory medical insurance in different regions of the Russian Federation cannot understand how the tariff for MRI is formed under the program of state guarantees for the provision of medical care.

4. The requirement for separate accounting.

In accordance with Article 20 of the Federal Law "On Compulsory Medical Insurance in the Russian Federation", medical organizations are obliged to use the funds of compulsory medical insurance received for the provided medical care in accordance with compulsory medical insurance programs.

Tariffs for medical care in the CHI system represent a separate group of price indicators in monetary terms that determine the level of reimbursement and the composition of reimbursable expenses of a medical organization at the expense of CHI funds. The items of expenditure included in the base part of the tariff include the costs of a medical organization and on "Salary".

In accordance with the established requirements of Federal Law No. 326-FZ of 11/29/2010 and territorial programs of state guarantees for free provision of medical care, organizations that work under the compulsory medical insurance system are required to open separate bank accounts and make settlements only from these accounts.

At the same time, a medical organization, providing services in the CHI system in one reporting period, receives money for the service in a different reporting period. At the same time, in order to ensure the current production and economic activities, enterprises need to timely transfer funds to pay: rent and utility payments, payroll and taxes with payroll, purchase of consumables, other expenses directly related to the economic and production activities of the enterprise.

Late payment of the above expenses entails a lack of materials for conducting compulsory medical insurance and commercial services, as well as violation of civil, tax and labor laws, which can lead to losses and legal costs.

To fulfill obligations, the organization transfers funds from the main (commercial) current account. But, in the future, in practice, we are faced with the question of the possibility of reimbursing the costs incurred by monetary funds received from an insurance medical organization for the service provided under the compulsory medical insurance.

The allocation of a separate current account for receiving money from medical insurance organizations for services provided under compulsory medical insurance and paying part of the obligations to the counterparties of a commercial organization from it, complicates accounting and relationships with contractors and suppliers.

5. Purposeful use of money for the rendered service.

All commercial organizations are talking about this problem. The current legislation prescribes strictly targeted use of funds for medical care provided.

In a number of regions, the tariff structure is presented item by item (cost items) as a percentage of the tariff.

At the same time, in all regions the cost structure is different. In some regions, under the payroll article, we are not entitled to pay the salary, only the accrual of bonuses, for example: Tver, Kaliningrad.

BUT, there are regions where there is no tariff structure (Yuzhno Sakhalinsk, Khabarovsk) !!! There are cost items for which we can spend targeted funds, but there are no requirements in what proportion.

In addition, the tariff structure does not contain a number of cost items (for example, as an investment component) that are borne by a commercial organization.

The compulsory medical insurance is inherently aimed at the availability of medical care for citizens of the Russian Federation, and not pumping and subsequent control over the spending of funds.

The contract for the provision and payment of medical care for compulsory medical insurance (Art. 39 of Law No. 326-FZ) is a type of contract for the provision of paid services (Art. 779 of the Civil Code of the Russian Federation). Under a contract for the provision of services for a fee, the contractor undertakes to provide services on the instructions of the customer (to perform certain actions or carry out certain activities), and the customer undertakes to pay for these services (part 1 of article 779 of the Civil Code of the Russian Federation). The funds received as payment for services are the property of the contractor. The owner has the right, at his discretion, to perform any actions in relation to the property belonging to him that do not contradict the law (part 2 of article 209 of the Civil Code of the Russian Federation).

In general, civil law relations are based on the principle of equivalent exchange. And by virtue of this principle, medical organizations should at least reimburse their costs associated with the provision of medical care in the CHI system.

State regulation of the use by a commercial center of funds received from the provision of a service, no matter how this service is provided under the program of state guarantees or on a paid basis by concluding an agreement, is interference in the economic activity of the entity, which contradicts both the norms of the Constitution of the Russian Federation and the norms of Civil Law.

Medical organizations provide medical care within the framework of civil law contracts, under which they must ensure the necessary volume and quality of medical care. This is what is the subject of the contract, and this is what should be controlled. And how and where to use the funds is the business of the medical organization itself.

In this situation, we believe that the analogy with federal law dated April 5, 2013 No. 44-FZ "On the contractual system in the field of procurement of goods, works, services to meet state and municipal needs", within which the state does not raise the question of how the supplier (contractor, performer) will dispose of the within the framework of a state (municipal) contract (civil contract) by means.

In connection with the above, we propose to the Ministry of Health of the Russian Federation

1. Develop rules and transparent criteria for the distribution of volumes.

2. Define and implement a unified approach to the formation of standards and an understandable system for calculating tariffs.

3. Prepare a draft amendment to the Federal Law No. 326, excluding the provision on the misuse of compulsory health insurance funds. This decision of the legislator will initiate the formation of a truly competitive environment in the healthcare sector and a significant inflow of private investment in the industry. Ultimately, the state and society will benefit from this.

4. Abolish separate accounting and control over the expenditure of funds, since a medical organization is a commercial structure and can spend funds at its discretion.

A commercial medical organization provides services to the population on a paid basis. The organization plans to conclude an agreement with the compulsory health insurance fund (hereinafter - the MHIF), under which, after the provision of medical services to the population, the MHIF will reimburse the organization for the cost of the services provided.
How to reflect in accounting the provision of compulsory health insurance services, the receipt of funds for compulsory health insurance, accounting of materials (receipt, write-off) related to the provision of compulsory health insurance services?

Commercial medical organizations maintain accounting records in accordance with the Chart of accounts for accounting of financial and economic activities of organizations and the Instructions for its use, approved by order of the Ministry of Finance of Russia dated October 31, 2000 N 94n (hereinafter - the Chart of accounts of accounting, Instructions for the use of the Chart of accounts).
The medical services provided by the organization for compulsory health insurance are reflected in the accounting in a general manner, similar to services on a paid basis.
Proceeding from the fact that the provision of medical services is the main activity of the organization, the proceeds (revenue) associated with the provision of such services are income from ordinary activities (clauses 2, 4, 5 of PBU 9/99 "Income of the organization").
In accordance with clause 6 of PBU 9/99, revenue is accepted for accounting in the amount calculated in monetary terms equal to the amount of cash and other property and (or) the amount of receivables (taking into account the provisions of clause 3 of PBU 9/99) ...
In this case, revenue is recognized in accounting when the conditions listed in clause 12 of PBU 9/99 are met, namely:
a) the organization has the right to receive this proceeds arising from a specific contract or otherwise confirmed;
b) the amount of revenue can be determined;
c) there is confidence that as a result of a particular operation, there will be an increase in the economic benefits of the organization. The assurance that as a result of a particular transaction there will be an increase in the economic benefits of the organization exists when the organization received an asset in payment, or there is no uncertainty about the receipt of the asset;
d) the right of ownership (possession, use and disposal) to the product (goods) has passed from the organization to the buyer or the work is accepted by the customer (the service is provided);
e) the costs that are or will be incurred in connection with this operation can be determined.
So, in accounting, revenue is recognized regardless of whether cash has been received in payment or not (accrual method).
In accordance with the Chart of accounts of accounting, when recognized in accounting, the amount of revenue from the provision of services is reflected in the credit of account 90 "Sales", subaccount "Revenue", and the debit of account 62 "Settlements with buyers and customers" (reflected accounts receivable the buyer) on the date of the provision of services (clauses 5, 6.1, 12 PBU 9/99). At the same time, the cost of services rendered is written off from account 20 "Main production" to the debit of account 90, subaccount "Cost of sales" (clauses 5, 16, 19 PBU 10/99 "Organization expenses").
Taking into account the fact that the MHIF will be calculated for the services provided to the population under compulsory medical insurance, in the situation under consideration the organization should do the following accounting records (with separate accounting for CHI services):
Debit 62, subaccount "Calculations for compulsory medical insurance" Credit 90, subaccount "Revenue from services under compulsory medical insurance"
- income from the provision of CHI services is recognized;
Debit 90, subaccount "Cost of services rendered under compulsory medical insurance" Credit 20, subaccount "Costs of services under compulsory medical insurance"
- the cost of the services rendered under compulsory medical insurance was written off.
Receipt and write-off of materials is reflected taking into account PBU 5/01 "Accounting for inventories" and Methodological guidelines for the accounting of inventories, approved by order of the Ministry of Finance of Russia dated December 28, 2001 N 119n.
In accordance with clause 5 of PBU 5/01, inventories are accepted for accounting at their actual cost, which is the amount of the organization's actual acquisition costs, excluding VAT and other reimbursable taxes (except as provided for by the legislation of the Russian Federation). The list of possible actual costs associated with the purchase of inventories is contained in clause 6 of PBU 5/01.
The cost of materials is written off at a time upon release for the provision of services (performance of work) and attributed to the costs of ordinary activities (clauses 7, 8 PBU 10/99).
According to the Instructions for the Application of the Chart of Accounts, accounting of materials is maintained by organizations on account 10 "Materials".
If the organization does not use accounts 15 "Procurement and acquisition of material assets" and 16 "Deviation in the cost of material assets", the posting of materials is reflected by an entry on the debit of account 10 "Materials" and credit of accounts 60 "Settlements with suppliers and contractors", 20 "Main production ", 23" Ancillary production", 71" Settlements with accountable persons ", 76" Settlements with various debtors and creditors ", etc., depending on where these or those values \u200b\u200bcame from, and on the nature of the costs of procurement and delivery of materials to the organization.
The actual consumption of materials in production or for other business purposes is reflected in the credit of account 10 "Materials" in correspondence with the accounts for accounting for production costs (sales costs) or other relevant accounts.
In this case, we believe that the organization should make the following records:
Debit 10 Credit 60
- materials received from the supplier are capitalized;
Debit 20, subaccount "Costs of OMI services" Credit 10
- the cost of materials was written off to the costs of CHI services.
As for the reimbursement by the MHIF of the organization of the cost of the provided medical services at the expense of the MHI funds in accordance with the contract, based on the issue, we believe that after the MHIF approves the report (act or other document) on the services provided (work performed), the MHIF will have a debt in front of the organization that the fund must pay for.
In our opinion, in this case, the organization will have to make the following entries:
Debit 76, subaccount "Settlements with the MHIF" Credit 62, subaccount "Settlements for MHI"
- the amount of the MHIF debt under the report (act, etc.) is reflected;
Debit 51 Credit 76, subaccount "Settlements with the MHIF"
- funds from the MHIF were transferred to the current account.

Prepared by:
Expert of the Legal Consulting Service GARANT
auditor, member of the Russian collegium of auditors Fedorova Lilia

Response quality control:
Reviewer of the Legal Consulting Service GARANT
auditor, member of RSA Gornostaev Vyacheslav

The material was prepared on the basis of an individual written consultation provided as part of the Legal Consulting service.

RF. Implementation analytical accounting it is possible either by codes of budget classification, codes of the source of financial support, or by analytical codes (including additional ones) by a synthetic account code. In accordance with Instruction No. 162n and the Budget Code of the Russian Federation, when conducting budgetary accounting, federal government institutions do not provide for the use of a financial security code for compulsory medical insurance funds. However, by virtue of clause 6 of Instruction N 157n, the accounting entity, for the purpose of organizing accounting, forms its accounting policy based on the characteristics of its structure, industry and other features of the activities performed by it in accordance with the legislation of the Russian Federation. Recall that on the basis of cl.

Accounting for settlements in the compulsory health insurance system (vasiliev yu.)

Exceptions are cases of an increase in tariffs for paying for medical care, the number of insured persons and (or) changes in their structure by sex and age. The territorial fund makes a decision on the provision or refusal to provide an insurance medical organization with funds missing from the normalized safety stock territorial fund (h.

6 tbsp. 38

Law N 326-FZ). Example 1. Suppose that the monthly funding of a medical institution is 150,000 rubles. The institution, according to the application submitted by him for advance payment for February, was allocated an amount of 150,000 rubles.

The procedure for accounting for the targeted expenditure of funds by a medical organization

Info

The time until the completion of accounting work is a constant value ... © Murphy's Laws. Reply with citation Up ▲ 05/30/2014, 11:35 am # 3 Do I understand correctly that we need all general administrative expenses - stationery, rent, etc. to pay with two bills? but what to do in the case: we took the share of the general business as equal to the consumed consumables.

Attention

The time until the completion of accounting work is a constant value ... © Murphy's Laws. Reply with citation Up ▲ 05/30/2014, 12:30 pm # 5 question about timing: we can calculate the share of earnings for April at the earliest on May 1.

Oms: accounting in "1s: accounting 8"

So, in accounting, revenue is recognized regardless of whether cash has been received in payment or not (accrual method). In accordance with the Chart of Accounts, when recognized in accounting, the amount of revenue from the provision of services is reflected in the credit of account 90 "Sales", subaccount “Revenue”, and the debit of account 62 “Settlements with buyers and customers” (reflects the buyer's receivables) as of the date of the services (clauses 5, 6.1, 12 PBU 9/99). At the same time, the cost of the services rendered is written off from account 20 "Main production" to the debit of account 90, subaccount "Cost of sales" (p.

To properly distribute data financial resources, the institution should draw up a cost estimate for the services. Note! The use of CHI funds by medical organizations to finance types of medical care that are not included in the territorial CHI program, to pay for types of expenses not included in the tariffs for paying for medical care in the CHI system, is an inappropriate use of funds, subject to recovery, and a fine is paid in the amount of 10% of the amount of misuse (Art.

39 of Law N 326-FZ). Payment for medical care The procedure for paying for medical care under compulsory medical insurance is given in section. VIII of Regulation N 158н. The amount of medical care provided for the year, with a quarterly breakdown and reasonable subsequent adjustment, taking into account (p.

How to calculate salaries for OMC in private clinics analytical accounting

Tariff Agreement B tariff agreement the composition of the tariff, its size, the directions of spending the funds received by the institution in payment for the services rendered to it within the framework of the compulsory medical insurance are determined. For example, in the tariff agreement for the provision of inpatient medical care, it may be specified that the costs of wages and salary charges can be no more than 72.2% of the total cost of compulsory medical insurance.

Expenses for the purchase of medicines, consumables, medical instruments with a service life of up to 12 months, reagents and chemicals, glass and other material supplies necessary for organizing the treatment process amount to at least 18% of the total cost of compulsory medical insurance. Thus, the funds received from an insurance medical organization should be spent by the institution in the areas and in the amount that are defined in the agreement.

Instruction N 157n, the accounting subject has the right in the manner prescribed by the specified instruction, within the framework of the formation accounting policies enter analytical codes for synthetic accounts of the Unified Chart of Accounts, as well as additional off-balance accounts. As the officials of the Ministry of Finance noted in the Letter dated July 14, 2014 N 02-06-10 / 34419, when providing medical services under the CHI program, it is advisable for state institutions to provide analytical codes in the synthetic accounts of accounting objects in the working chart of accounts, which will allow separate accounting.
At the same time, within the framework of the implementation of control measures, it is necessary to be guided by the provisions of the accounting policy of the federal government institution.
Remuneration for labor is one of the main means that allows you to strengthen the motivation of work, increase the interest of employees in the provision of quality services, and advanced training. The main regulatory legal act that establishes the principles of remuneration of employees of state medical organizations is the Decree of the Government of the Russian Federation of August 05, 2008 No. 583 (as amended on January 14, 2014). This act provides for a sectoral wage system. In private medical organizations wage the employee is established in accordance with chapter 21 Labor Code RF and depends on the volume and quality of the work performed by him. There are two forms of remuneration: time based and piecework. Time wages are determined by the amount of time worked. Labor remuneration is made on the basis of the tariff rate (official salary).
In particular, this instruction proposes to reflect the costs by the way they are attributed to the prime cost with division into direct, overhead and general business expenses on the corresponding accounts: - direct costs - on account 0 109 60 000 "Cost of finished products, works, services"; - indirect costs - on account 0 109 70 000 "Overhead costs of production of finished products, works, services"; - general business expenses - on account 0 109 80 000 "General business expenses". Thus, the use of account 1 109 00 000 "Expenses for the manufacture of finished products, performance of works, services" with the introduction of an additional analytical code into it will allow keeping separate records of transactions with CHI funds. Explain how you should reflect in the accounting information on the costs of compulsory medical insurance to state health care institutions.
Funds received by an institution under compulsory medical insurance are accounted for under the activity code 7 (clause 21 of Instruction N 157n). Accrual of income is carried out on the basis of the register of accounts.

Let us consider, using an example, how income and expenses are reflected in accounting within the framework of the compulsory medical insurance funds. Example 2. In February, a budgetary medical institution made an application for an advance payment in the amount of the established monthly volume (120,000 rubles).

The medical insurance organization transferred the requested amount to the institution's account. At the end of the month, the institution submitted to the insurance organization a register of invoices and invoices for payment. The amount to be paid was 105,000 rubles. The numbers given in the example are conditional. In the accounting records, transactions for the receipt and expenditure of compulsory medical insurance funds will be reflected as follows: Contents of the transaction Debit Credit Amount, rub.
The procedure for opening and maintaining personal accounts by the Federal Treasury and its territorial bodies, approved by Order Federal Treasury dated 07.10.2008 N 7n, operations with funds received from the budget medical institutions for CHI, are carried out on a separate personal account designed to record transactions with CHI funds received budget institution... Operations for the receipt and expenditure of compulsory medical insurance funds are reflected in the accounting records under the activity code 7 (clause 21 of Instruction N 157n<3). <3 Инструкция по применению Единого плана счетов бухгалтерского учета для органов государственной власти (государственных органов), органов местного самоуправления, органов управления государственными внебюджетными фондами, государственных академий наук, государственных (муниципальных) учреждений, утв. Приказом Минфина России от 01.12.2010 N 157н.
OMS, address, etc.); - inclusion in the register of accounts of cases of rendering medical assistance to an insured person who received an OMI policy on the territory of another constituent entity of the Russian Federation; - inclusion in the register of accounts of cases of emergency medical care to citizens who are not subject to insurance under compulsory medical insurance on the territory of the Russian Federation; c) violations related to repeated or unjustified inclusion in the register of medical care invoices: - earlier payment of the position in the register of invoices (repeated invoicing for payment of cases of medical care that were paid earlier); - duplication of cases of medical care in one register of accounts.