Health Insurance Law. Legal framework and regulation of VMI insurance. The budget of the territorial fund is formed on the basis of

OMS is one of several types of compulsory social insurance for residents of the Russian Federation. To provide insurance to every citizen, a complex of economic, legal and organizational methods is applied. They are aimed at ensuring guarantees for the provision of free medical care to the insured person at a high level, in accordance with the volume and established terms. The payment is made at the expense of the state insurance company.

The current Federal Law was created on the basis of the Constitution of the Russian Federation. It regulates the relationship that is formed in the process of obtaining a compulsory insurance policy (OMS). The law defines the rights of such citizens, their obligations, as well as guarantees, thanks to which the state insurance company is still operating.

The law was adopted by the State Duma on November 19, 2010, and approved by the Federation Council 6 days later. The last changes were made on December 28, 2016.

General provisions of the Federal Law;
Enumeration of the powers of the subjects of the Russian Federation in the provision of compulsory insurance services;
Identification of participants and subjects;
Revealing the rights and obligations of the insured persons;
Determination of the amount of compulsory health insurance payments;
Description of the legal position of the law;
List of programs in the field of CHI;
Signing contracts in the field of compulsory medical insurance;
Control of the volume of conditions, quality and timing of assistance;
Registration of each member of the CHI according to the law;
Final information.

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The law "On Compulsory Health Insurance in the Russian Federation" consists of 11 chapters and 53 articles. It lists the main principles.

What do you know about compulsory pension insurance? Details

These are:

Provision of medical care at the expense of the state insurance company. When an insured event occurs, you can use such services;
High stability of the financial system for compulsory health insurance;
Obligation to policyholders to pay insurance premiums. The amount of contributions is established in accordance with Federal legislation;
Compliance with the rights of the state side of the insured clients. All obligations for health insurance between the parties must be fulfilled within the period specified in the contract;
Compliance with the conditions to ensure the quality of care and general accessibility to the services of the insurance company.

To download the latest version of the law as amended, supplemented and amended, go to the following.

In addition, you should know the basics of social services for citizens in the Russian Federation. To do this, study.

Recent changes made to the Federal Law "On compulsory health insurance in the Russian Federation"

The last changes were made as of December 28, 2016. Part 1 of Article 31, title of Article 32, Part 1 of Article 32 and Part 2 of Article 32 were amended.

H 1 st 31

Part 1 of Article 31 of the Law describes the methods of calculating expenses, including funds for the purchase of a health insurance policy. The client is provided with a payment after a serious accident at work or at home. If the company proves that the harm to health was not an accident, then the person who caused the harm to the health of the insured citizen must reimburse the money for the treatment.

Article 32

The title was changed in Article 32 of the Law. Now it reads like “Payment of medical care costs to the insured person immediately after a serious accident at work”.

Part 1 article 32

The sentence was changed from "treatment of the insured person" to "medical assistance to the insured person".

Part 2 article 32

In part 2 of article 32 of the law, the proposal was changed from "treatment of the insured person" to "medical assistance to the insured person."

Another article is discussed below.

Article 16

Article 16 of 326-FZ lists the rights and obligations of the insured person.

This law guarantees free medical care to Russian citizens by creating a compulsory health insurance system. A regulatory document (Federal Law of the Russian Federation 326 on compulsory health insurance) regulates relations between structural divisions, the procedure for financing and control.

The structure of the social system for providing the population with medical services

The system of compulsory health insurance (CHI), as well as, includes policyholders, the insurer and the insured.

OMC participants:

citizens;
organizations and enterprises;
medical institutions;
insurance organizations;
Social Insurance Fund;
territorial funds.

The insurer is the state represented by the Government of the Russian Federation. It delegates part of its functions to the localities, to the heads of the subjects of the federation. The regulatory framework, including tariffs, determination of the list of services, is established by the Government.

The video simply and clearly tells about compulsory health insurance:

On the basis of the State Program, territorial conditions are developed and implemented.

The essence of the system is the receipt of the basic package of medical care at the place of residence. An emergency ambulance is available throughout the territory.

Insured - legal entities, individual entrepreneurs who pay insurance premiums to the FSS.

It can be:

state;
municipal;
private enterprises.

Insured persons are working citizens with a compulsory medical insurance policy.

The Social Insurance Fund was created as a non-profit organization and has its own structural units in the form of territorial funds. Its functions include the accumulation of insurance premiums, co-financing of regional programs.

The rights and obligations of the FSS:

is one of the developers of the state program of guaranteed receipt of free medical care;
monitors and manages financial assets;
keeps records of all insured persons;
determines the number of regional insurance organizations;
medical institutions providing services;
checks the competence of territorial funds;
cooperates with international organizations in the field of compulsory medical insurance.

Territorial funds are representatives of a regional insurer, which is the highest body of local executive power.

Functions of territorial funds:

collection, accounting and spending of social insurance funds;
development of regional programs based on federal, including per capita standards;
formation of a register of policyholders;
insured persons;
protection of the rights of citizens when receiving low-quality assistance;
audit of the activities of medical institutions and medical insurance organizations.

The medical insurance organization is an intermediate link between the terfond and medical institutions, between the insured persons and the polyclinic (hospital).

She concludes an agreement on the provision of services with each institution and monitors their implementation. Based on the data provided, the regional fund allocates funds for a health insurance company, which subsequently disposes of them in accordance with the agreed conditions.

To provide outpatient, inpatient, emergency services, you must obtain a state license.

If you ask yourself a question, then to participate in the state CHI program you need to submit an application to the terfond. Organizations of all types of ownership have the right to be included in the register of medical institutions that provide compulsory medical services.

Legal guarantees and obligations of medical organizations:

timely and full receipt of funds for the insurance services provided;
appeal against actions of insurance companies;
provision of free medical care in accordance with the compulsory medical insurance, in some cases the patient is provided;
providing the necessary information to patients about the services provided, the mode of operation;
keeping records of insured persons;
informing the territorial fund about the services provided.

In the case of incomplete assistance, poor quality funding is reduced, or the issue of license revocation is resolved.

The video explains the difference between compulsory and voluntary health insurance:

Financing of the state program of compulsory medical insurance in accordance with federal law

Contributions for each insured person to the insurance fund are made by enterprises and organizations registered in the territory of the Russian Federation. Do you need OSAGO, if there is a comprehensive insurance, find out.

The amount of contributions is approved in each subject on the basis of an agreement between the executive branch, the territorial fund, the insurance organization and the medical institution. The structure of the tariff (cost items) is determined by the federal executive body.

It includes:

staff salaries and accruals;
the cost of drugs, tools, consumables;
nutrition of patients;
payment for diagnostics in other institutions;
communal payments;
social contributions for health workers;
communication services, Internet;
software installation and support;
purchase of equipment up to 100 thousand rubles.

The established rate of reimbursement for the service rendered to the insured person in the clinic (hospital) is constant for all insurance companies in the region. He will tell you about car insurance without life insurance.

On the video Financing of the State MHI Program:

The income part of the Federal Fund consists of:

from compulsory insurance premiums;
amounts of fines and penalties;
outstanding payments;
subsidies from the federal budget;
profits from free funds placed with credit or investment organizations. Find out how to add a driver to the electronic OSAGO policy in.

Expenditure items of the Federal Insurance Fund:

subventions to territorial funds;
fulfillment of the obligations of the Government;
the contents of the apparatus.

The budget of the territorial fund is formed on the basis of:

additional deductions for compulsory health insurance from enterprises and organizations;
regional payments for the provision of services not included in the basic program;
subsidies from the Social Insurance Fund;
accrued arrears, fines, penalties.

In case of insufficient own funds, territorial funds receive subventions (grants) from the Federal Fund.

Financial support is provided under the following conditions:

fulfillment of the requirement for insurance of the non-working population in the amount specified in the regional budget;
its compliance with the indicator calculated according to the federal standard;
monthly transfer of 1/12 of the approved annual amount to the FSS.

Territorial funds' expenses are mainly related to the implementation of regional CHI programs.

As part of the Federal and territorial funds, a standardized reserve is created, which is necessary for stable financing, the size and procedure for using which are determined by the highest federal and regional authorities. Read about the compulsory medical insurance policy from Rosgosstrakh.

Basic program of compulsory health insurance of citizens in accordance with the Federal Law of the Russian Federation 326

The federal standard laid down in the CHI is adjusted at the level of the constituent entities of the federation, based on local conditions: age categories, health status of the population and infrastructure. Learn about life and health insurance for a child athlete at.

Territorial programs should ensure a reduction in mortality from diseases and an improvement in the quality of medical services.

The insured citizens who have applied for are entitled to receive all types of assistance free of charge: from emergency to preventive, using modern diagnostic equipment and instruments.

The video shows the basic compulsory health insurance program:

Federal Law 326-FZ, adopted in 2010, is the basis for the functioning of the compulsory health insurance system. The purpose of the document is to establish legal relations between the participants, determine the basic Program, sources of funding and responsibilities of the parties, which is mandatory for.

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Russian legislation provides for the implementation of certain measures of social protection of citizens in order to protect their health. Such measures are manifested, including in health insurance. According to the Federal Law of the Russian Federation 326, it is mandatory for all citizens. On the basis of it, each insured person can count on receiving the necessary medical care when certain circumstances occur. This assistance will be paid from the funds of the insurer.

General provisions of the Federal Law of the Russian Federation on CHI

This federal law (fz) is based on the mandatory provisions of the country's main law of the Constitution and cannot contradict them. The basic concept (OSMS) is understood as one of the types of insurance relations aimed at providing free medical care to insured citizens of the country in the event of certain insured events that are regulated by this law.

The object in these legal relations is the risk of the occurrence of these insured events, it is understood as a possible event, in the event of which it becomes necessary to compensate for the costs of providing medical care.

The event itself is considered an insured event in which medical care is directly provided and the costs of it are reimbursed. Such cases are provided only for individuals who are insured. All these definitions are specified in Article 3 of this Law.

And article 4 regulates the basic principles of this insurance system. These include:

Provision of guarantees for the provision of free medical care.
Obligation to pay insurance premiums for policyholders.
Financial stability guarantees of the formed system.
Respect for the rights of all participants in these legal relationships.
Parity in all subjects in the governing bodies of the insurance system.
Creation of good conditions and quality medicine.

Due to these principles, the current insurance system has been formed, which provides free medical care to insured citizens.

The Russian Federation, its constituent entities and federal and local government bodies are responsible for the development of the legislative framework and their implementation. Their powers are detailed in Chapter 2 of this law.

Participants in legal relations

In these insurance relations, Article 9 of this legislative act identifies 3 types of entities:

policyholders;
insured citizens;
Federal Fund.

In addition, various medical organizations providing medical assistance to insured citizens are also participants in these legal relations.

It also includes medical insurance organizations and territorial funds of the constituent entities of the Russian Federation.

The following people can be insured:

citizens of the Russian Federation;
foreign citizens;
stateless persons.

But on the condition that they fit into one of the following categories:

work officially under an employment contract;
independently provide themselves with work, and are registered in the prescribed manner;
members of peasant farms;
peoples of the Far North;
minor children;
pensioners;
persons studying full-time;
unemployed citizens registered at the labor exchange;
other persons who do not work under an employment contract;
a parent caring for a child until the age of 3;
citizens caring for or elderly people.

These categories of citizens are subject to compulsory insurance and have the right to count on the provision of free medical care if they have a proof of the status of an insured person.

Article 11 of this law defines the list of policyholders who are obliged to insure citizens and pay insurance premiums for them in accordance with this legislation. These include:

all legal entities and individuals who legally pay wages and other remuneration to citizens;
individuals in private practice;
regional executive authorities authorized by this legislation.

According to Article 12, the Federal Fund is determined as the insurer, which operates within the limits established by the basic program. This body has additional territorial funds. They are created by the constituent entities of the Russian Federation in order to exercise the powers of the insurer in this region.

On the basis of Article 13, territorial funds can create their branches and representative offices to exercise their powers.

In addition, medical insurance organizations have been created to conclude contracts with citizens. These organizations are required to obtain a license to carry out their activities. In addition to compulsory health insurance, these organizations are not entitled to engage in any other type of activity.

Funds associated with compulsory insurance have a separate accounting, which does not overlap with voluntary insurance funds. These legal entities are responsible for their obligations with these funds. Such insurance companies are obliged to publish all information about their financial activities on the Internet and in the media.

All such organizations are registered in the register. Inclusion and exclusion from this register is carried out through notifications sent by the territorial Fund.

Another participant in these legal relations is medical organizations that directly provide medical assistance to citizens. To do this, they must also have an appropriate license and must be included in the register of medical organizations. The organizational and legal form can be any:

in the form of a legal entity;
in the form of an individual entrepreneur.

These medical institutions keep separate records for transactions with compulsory insurance funds.

Rights and obligations of subjects

In any agreement, the rights and obligations of all participants in these legal relations are fixed. This insurance contract also contains the basic rights and obligations that are defined by this legislation in Chapter 4. According to Article 16, all insured people have the following rights:

receiving free medical care throughout the country;
choose an insurance medical organization with which the insurance contract will be directly concluded;
choose medical organizations from the general register in which they will provide medical care;
replace an insurance organization with any other from the register of insurance companies;
choose a doctor yourself or through a representative;
has the right to the protection of his personal data;
protect their legitimate interests and rights;
claim damage from a medical organization for failure to fulfill its obligations.

The obligations of the insured person include the following:

Submit an application for choosing an insurance company and conclude an insurance contract with it, in case of moving to another region, re-select an organization in a new entity.
Notify the insurance company about the change in personal data.
Submit a policy confirming insurance to receive free medical services.

Newborn babies receive medical care under the mother's policy for the first 30 days, and after that time, their legal representatives must receive for them. From the moment of filing the application, the insurance organization is obliged to issue a policy within 3 days.

Article 17 defines the right of the policyholder to receive information on the procedure for paying insurance premiums and registering it in the register. Responsibilities include the following:

without fail to register and withdraw from it in accordance with the law;
timely pay in full the established insurance premiums;
provide mandatory reporting on paid contributions.

Tax registration is carried out within 30 days from the date of filing an application for registration, and deregistration within 10 days. To do this, you must submit an application.

For violation of the established requirements of compulsory registration, administrative liability is provided in the form of a fine of 5,000 rubles.

Also, for violation of other legislative norms, policyholders provide for fines in other amounts. These amounts are credited to the budget of the Federal Fund.

Insurance medical organizations have the rights and obligations that are prescribed by contracts between them and the insured, as well as between them and the territorial funds.

Article 20 specifies the rights of medical institutions that actually provide assistance to citizens. These include 2 basic rights:

receive funds for the assistance provided;
to appeal against the conclusions of the medical insurance company on the actually expended volume of work.

The duties of this article include the following:

Provide free medical care to all insured persons.
Keep records of the assistance provided.
Provide information about the insured persons and the assistance provided to them to the authorities specified by law.
Provide reports on their financial activities, as well as publish information on the procedure for the provision of medical care and work schedule on the Internet.

Also, legislation may establish other obligations and rights of participants in these legal relations.

Financial system

Article 21 defines the main types of income, due to which the budget is formed, from which the payment for medical care is made. These include:

collection of fines and penalties from policyholders;
arrears on tax payments and contributions;
financing from the federal budget and the budgets of the subjects;
income from temporary placement of funds;
other permitted sources.

These funds are used to pay for medical support to the insured. If the services provided exceed the established cost of the basic program, these services may not be paid by the insurance company.

Payment of insurance premiums

The size and procedure for calculating tariffs are established by the legislation of the Russian Federation. The settlement period is considered to be one calendar year. Policyholders must submit a quarterly report on premiums paid.

If the policyholder has become obliged to pay contributions not from the beginning of the year, then he must submit information and pay contributions only for the quarter in which he has this obligation. Similarly, it is considered in case of termination of obligations before the end of the calendar year.

Responsibility for violation of these requirements is provided in the form of arrears, as well as penalties and fines. Penalties are charged for each day overdue in accordance with the established procedure by the policyholder himself. The rate for calculating the penalty interest is one three hundredth of the rate of the Bank of Russia. Penalty interest is payable together with the principal amount owed.

If the policyholder does not independently account for a penalty, then the collection of all penalties is provided for in court.

Compulsory health insurance programs

Article 35 of this legislative act is spelled out, which forms the basis of those guarantees that citizens can count on in the event of an insured event. It lists the main types of medical care that can be provided to citizens free of charge. Also this program includes:

a list of the insured events themselves;
methods of payment for medical care;
calculation of tariffs;
criteria for the quality and availability of this type of assistance;
standards for the volume of medical care per one insured person.

Types of medical assistance

The basic program sets the standards for insurance coverage based on the standards and procedure for the provision of medical services. This program includes the following types of medical care:

primary;
ambulance;
preventive;
specialized;
high-tech.

Also, under the OMS policy, you can get and.

Territorial programs are established on the basis of this basic program. Article 36 regulates the procedure for drawing up territorial programs that are part of the basic program, but are established taking into account the characteristics of diseases in a particular subject.

Financial coverage for certain illnesses or injuries may exceed the baseline if required for a specific region.

But the cost of the territorial program cannot exceed the amount of budgetary financial injections from the federal and other budgets.

System of contracts for obtaining a policy

To exercise the rights of the insured person, contracts are concluded in his favor. These are two types of contracts:

about financial support;
for the provision and payment of medical care.

Under the first type of contract, an insurance medical organization undertakes to pay for medical care provided to insured citizens by a medical institution.

This agreement must contain the basic obligatory rights of the obligation of the insurance company to other participants in these legal relations. It is concluded directly with the policyholder.

The second type of contract is concluded by an insurance company with a medical institution included in the register. This agreement fixes the basic rights and obligations of the medical institution and the insurance company.

Control

For the full implementation of compulsory health insurance, regular monitoring should be carried out over:

The expert examines the compliance of the actual terms and volumes of services rendered with the documents provided. The examination is carried out by a specialist who is a doctor with the necessary five-year experience and the necessary expert training.

Economic control determines the compliance of information on the amount of assistance provided, based on the documents provided for payment. With the help of the quality examination, violations are revealed, as well as the timeliness and the chosen treatment method.

In the event of a discrepancy between the services provided, the insurance company may refuse to pay for these services, and certain sanctions may also be applied to violators.

Organization of accounting actions

Article 43 of this legislative act obliges to keep a personalized record of all insured citizens. Its main goals are:

creation of the necessary conditions to provide guarantees to citizens;
determination of needs for honey. help;
creating conditions for quality control over the work of the entire health insurance system.

In the process of maintaining personalized records of insured citizens, the mandatory collection of information, its processing and subsequent storage is carried out.

Article 45 specifies the obligation of an insurance organization to issue an insurance policy to each insured citizen. Upon its presentation, he will be able to count on rendering him free assistance.

Video: On compulsory social health insurance of a citizen of the Russian Federation

Final and transitional provisions

Within the framework of this system, it is envisaged that additional regional programs, financed additionally from funds, be put into operation. The procedure and form of reporting on the implementation of these programs is established by federal authorities.

The provision of free high-tech assistance, which is not included in the basic program, is possible with the allocation of additional budget infusions into the territorial program.

This legislation applies to all persons included in the list. This law came into force at the beginning of 2011 and is valid to this day.

1. The basic program of compulsory medical insurance is an integral part of the program of state guarantees for the provision of free medical care to citizens, approved by the Government of the Russian Federation.

2. The basic program of compulsory health insurance defines the types of medical care (including a list of types of high-tech medical care, which includes, among other things, methods of treatment), the list of insured events, the structure of the tariff for paying for medical care, methods of paying for medical care provided to insured persons for compulsory medical insurance in the Russian Federation at the expense of compulsory medical insurance, as well as criteria for the availability and quality of medical care.

3. The basic compulsory health insurance program establishes the requirements for the conditions for the provision of medical care, the standards for the volume of medical care per one insured person, the standards for financial costs per unit of the volume of medical care, the standards for the financial support of the basic compulsory health insurance program per one the insured person, as well as the calculation of the coefficient of appreciation of the basic compulsory health insurance program. The standards for financial costs per unit volume of medical care specified in this part are also established according to the list of types of high-tech medical care, which includes, among other things, treatment methods.

4. Insurance coverage in accordance with the basic program of compulsory medical insurance is established based on the standards of medical care and procedures for the provision of medical care established by the authorized federal executive body.

5. The rights of insured persons to free medical care, established by the basic program of compulsory medical insurance, are uniform throughout the Russian Federation.

6. Within the framework of the basic program of compulsory medical insurance, primary health care is provided, including preventive care, emergency medical care (with the exception of airborne evacuation carried out by aircraft), specialized medical care, including high-tech medical care, in the following cases :

2) neoplasms;

3) diseases of the endocrine system;

4) eating disorders and metabolic disorders;

5) diseases of the nervous system;

6) diseases of the blood, blood-forming organs;

7) certain disorders involving the immune mechanism;

8) diseases of the eye and its accessory apparatus;

9) diseases of the ear and mastoid;

10) diseases of the circulatory system;

11) respiratory diseases;

12) diseases of the digestive system;

13) diseases of the genitourinary system;

14) diseases of the skin and subcutaneous tissue;

15) diseases of the musculoskeletal system and connective tissue;

16) trauma, poisoning and some other consequences of external causes;

17) congenital anomalies (malformations);

18) deformations and chromosomal abnormalities;

19) pregnancy, childbirth, postpartum period and abortion;

20) certain conditions that occur in children during the perinatal period.

7. The structure of the tariff for payment of medical care includes wages, salary charges, other payments, the purchase of medicines, consumables, food, soft inventory, medical instruments, reagents and chemicals, other material supplies, expenses for payment of the cost of laboratory and instrumental studies carried out in other institutions (in the absence of a laboratory and diagnostic equipment in a medical organization), catering (in the absence of organized meals in a medical organization), expenses for payment of communication services, transport services, utilities, works and services for the maintenance of property, expenses for rent for the use of property, payment for software and other services, social security for employees of medical organizations established by the legislation of the Russian Federation, other expenses, expenses for the acquisition of fixed assets (equipment, production household and household inventory) costing up to one hundred thousand rubles per unit.

8. The Government of the Russian Federation, when approving the basic program of compulsory medical insurance, has the right to establish an additional list of diseases and conditions included in the basic program of compulsory medical insurance as cases of medical care, and additional elements of the structure of the tariff for paying for medical care to those established by this Federal Law.

9. The basic compulsory health insurance program sets out the requirements for territorial compulsory health insurance programs.

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 medical insurance of the Russian Federation was adopted by the State Duma on 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 the Federal Law on compulsory health insurance - regulation and control of legal relations between citizens and institutions conducting compulsory health insurance (Federal Law on insurance in the Russian Federation), regulation of the provisions, rights and obligations of employees and the population, the amount of payment of contributions, processes and methods of implementation, the nuances of activities.

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

The first chapter describes the general provisions of the law. The goals, objectives and which 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 honey implementation 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. Lists of the cost of different types of insurance are provided, payment methods, 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 foundations and organizations, methods of replenishing reserves, tariffs for payment, etc. are described;
The sixth gives and describes other laws and regulations that govern the Federal and Territorial Foundations;
The seventh describes the basic and territorial processes, activities and programs for honey. insurance;
In the eighth chapter lists and categories are drawn up with a description of contracts in the field of honey. 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 unified record of citizens who have received insurance. Legal relationship between honey. institutions and foundations;
In ch. 11 gives 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, pensioners, 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 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 any damage caused, in case of poor-quality performance of duties or non-performance of duties in general by medical organizations;
Change of 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, apply to a new organization to choose an insurance institution;
Submit new personal data when they change, if it is name, address or passport data;
Apply for honey. insurance.

In 326 FZ, article 35 the basic program of honey is described. insurance of citizens. This program is confirmed and approved every year by the Government of the Russian Federation. 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 for citizens applying, citizens receiving medical care under insurance and for employees of insurance medical organizations are established. Article 35 "On Compulsory Medical Insurance" of Law 326 defines the standards and procedures.

The text of the new edition 326 FZ

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.