Application for nsz event 3 repair. Normalized safety stock of tfoms. Application. notification of a medical organization about the availability of funds from nsz tfoms for financial support of the implementation of measures for organizing additional professional education
Federal fund obligatory health insurance (hereinafter referred to as the Federal Fund) in connection with incoming questions on the implementation of the Rules for the use of standardized funds by medical organizations safety stock territorial compulsory health insurance fund for financial security measures for the organization of additional professional education for medical workers under professional development programs, as well as for the purchase and repair of medical equipment (hereinafter referred to as activities), approved by the Government Russian Federation from 21.04.2016 N 332, (hereinafter - the Rules), informs.
1. On the formation of an action plan. Clause 8 of the Rules establishes the duty of the executive body of the constituent entity of the Russian Federation, authorized by the supreme executive body of state power of the constituent entity of the Russian Federation (hereinafter referred to as the authorized body), to approve and agree in the prescribed manner the action plan within a period not exceeding 30 calendar days from the date of entry into force Of the Rules (until 06/03/2016), and subsequently - on a quarterly basis, until the 1st day of the first month of the next quarter (for the III quarter of 2016 - until 07/01/2016).
In accordance with clause 3 of the Rules, funds for the financial support of events are provided by the territorial fund of compulsory medical insurance (hereinafter - the territorial fund) to medical organizations within the funds of the normalized insurance stock (hereinafter - the NHA) provided for in the budget of the territorial fund for the financial support of activities.
Clause 5 of the Procedure for the use of the funds of the normalized reserve stock of the territorial compulsory medical insurance fund, approved by order of the Federal Fund dated 01.12.2010 N 227, financial support of events is carried out within the funds of the NHA of the territorial fund, formed in accordance with Part 6.3 of Article 26 of the Federal Law of 29.11.2010 N 326-FZ "On compulsory health insurance in the Russian Federation" (hereinafter - the federal law N 326-FZ).
Thus, the amount of required funding for activities plan-set measures, is determined based on the actual amount of funds in the NHA of the territorial fund, formed as of the date of coordination and approval of the action plan, and the use of funds for these purposes is carried out by the territorial fund only after amendments to the law on the budget of the territorial fund, establishing in accordance with Part 6.4 of Article 26 of Federal Law N 326-FZ, the size of the NSZ and the purpose of its use, including for the financial support of events.
In accordance with subparagraph "b" of paragraph 4 of the Rules, the authorized body approves the criteria for the selection of medical organizations for inclusion in the action plan (hereinafter - the selection criteria).
The selection criteria established by the authorized body should ensure the possibility of distributing medical organizations on the basis of their compliance with the specified selection criteria for the subsequent formation of a list of measures, based on the NHA funds actually formed in the budget of the territorial fund. These measures will create equal conditions for the inclusion of medical organizations in the action plan, regardless of their departmental affiliation and organizational and legal form.
Please note that the action plan is approved on a quarterly cumulative basis. Thus, the amount of the necessary financial support for the action plan for the current financial year should be established within the actually formed funds of the NHA of the territorial fund.
2. On the issues of financial support of contracts concluded for the implementation of activities.
The basis for the conclusion of contracts is the existence of an action plan approved using the selection criteria.
Thus, the financial support of events at the expense of the NHA of the territorial fund under contracts concluded before the date of entry into force of the Rules and approval of the action plan is illegal.
Based on the norms established by Articles 34 and 42 of the Federal Law of 05.04.2013 N 44-FZ "On the contract system in the field of procurement of goods, works, services to meet state and municipal needs" (hereinafter - Law N 44-FZ), the contract is concluded on the conditions stipulated by the notice of the procurement, which must contain information, including the source of its financial support.
Medical organizations keep separate records for operations with compulsory medical insurance funds (part 6 of article 15 of Federal Law N 326-FZ), including with funds for financial support of events (paragraph 11 of the Rules).
Thus, we believe that financial support of agreements (contracts) concluded for the implementation of activities from several sources is possible if the specified agreements (contracts) establish the size of financial support for each source, followed by separate analytical accounting of funds received from the NHA of the territorial fund. compulsory medical insurance funds received to pay for medical care (subject to the norms of part 7 of Article 35 of Federal Law N 326-FZ) and other sources of financial support for agreements (contracts).
Considering the above, the following measures should be taken in the constituent entities of the Russian Federation:
1. Bring the budgets of territorial funds in line with Federal Law N 326-FZ in terms of financial support for events.
2. Establish selection criteria to ensure a level playing field for all medical organizations.
3. When approving the action plan, ensure:
Correspondence of the amount of its financing to the size of funds actually formed as part of the NHA of the territorial fund for financial support of events;
Compliance with the deadlines established by clause 8 of the Rules;
Formation of an action plan on a cumulative basis.
4. Ensure compliance with the requirements of Federal Law No. 44-FZ and the Rules when concluding contracts in order to implement measures.
Document overview
The explanations of the FFOMS of Russia on the implementation of the Rules for the use by medical organizations of funds of the normalized safety stock (NSZ) of the TFOMS for financing measures for additional vocational education of medical workers and the purchase (repair) of medical equipment are provided.
The amount of funding is determined based on the actual amount of funds as part of the NHA of the territorial fund, formed as of the date of coordination and approval of the action plan. Funds are used by the territorial fund only after amendments to the law on the budget of the territorial fund. Therefore, the regions must bring the funds' budgets in line with the law.
The authorized body approves the criteria for the selection of medical organizations for inclusion in the action plan. This will create a level playing field for them.
The plan is approved on a quarterly cumulative basis. Therefore, the amount of funds based on the results of the current financial year is set within the limits of the funds actually formed by the NHA fund.
It is impossible to finance events at the expense of the NHA funds under government contracts concluded before the date of entry into force of the rules and approval of the action plan.
Financing government contracts from several sources is possible if they establish the size of financial security for each source, followed by a separate analytical accounting funds received from the NHA fund, compulsory medical insurance fundsreceived to pay for medical care and other sources.
Resolution of the Government of the Russian Federation of May 22, 2015 N 493
"On the approval of the Rules for the direction in 2015 of the funds of the standardized insurance stock of the Federal Fund of Compulsory Medical Insurance for additional financial support for the provision of specialized medical care by federal state institutions"
In accordance with paragraph 1 of Part 1 of Article 6 of the Federal Law "On the Budget of the Federal Mandatory Medical Insurance Fund for 2015 and for the Planning Period of 2016 and 2017", the Government of the Russian Federation decides:
1. To approve the attached Rules for the allocation in 2015 of the funds of the standardized reserve stock of the Federal Fund of Compulsory Medical Insurance for additional financial support for the provision of specialized medical care by federal state institutions.
2. To recommend the executive authorities of the constituent entities of the Russian Federation to create working groups to develop proposals for additional financial support for the provision of specialized medical care by federal state institutions, including those located in the territories of other constituent entities of the Russian Federation, for subsequent submission to the commission for the development of territorial compulsory health insurance programs , created in accordance with the established procedure, including representatives of federal state institutions in the specified working groups.
rules
allocation of funds from the standardized reserve stock of the Federal Mandatory Health Insurance Fund in 2015 for additional financial support for the provision of specialized medical care by federal state institutions
(approved by the Resolution of the Government of the Russian Federation of May 22, 2015 N 493)
1. These Rules establish the procedure and conditions for the direction in 2015 of the funds of the standardized reserve stock of the Federal Compulsory Medical Insurance Fund for additional financial support for the provision of specialized medical care by federal state institutions subordinate to the Ministry of Health of the Russian Federation, the Federal Medical and Biological Agency and the Federal Agency of Scientific Organizations ( further, respectively, the normalized safety stock, federal government agencies, federal executive bodies).
2. Additional financial support for the provision of specialized medical care by federal state institutions is carried out at the expense of the normalized insurance stock allocated to increase the subventions approved by the Federal Law "On the Budget of the Federal Mandatory Medical Insurance Fund for 2015 and for the Planning Period of 2016 and 2017" the budget of the Federal Compulsory Medical Insurance Fund (hereinafter referred to as the Fund) to the budgets of territorial compulsory medical insurance funds for financial support of expenditure obligations of the constituent entities of the Russian Federation arising from the exercise of powers transferred in the field of compulsory medical insurance (hereinafter, respectively, territorial funds, subventions).
3. The Fund makes a decision on the amount of the rationed insurance stock funds to be distributed, as well as on the direction of the rationed insurance stock funds to increase subventions on the basis of the funds provided by the federal executive authorities and territorial funds data on the volumes of specialized medical care in inpatient conditions provided by federal government agencies.
4. The distribution of the normalized safety stock is carried out according to the following method:
a) the amount of the normalized insurance stock allocated to increase the subventions provided to the budget of the territorial fund of the i-th subject of the Russian Federation () is determined by the formula:
,
The volume of reduction in specialized medical care in inpatient conditions (the number of hospitalizations) provided by federal state institutions located on the territory of the i-th subject of the Russian Federation in 2015 compared to 2014;
The volume of specialized medical care in inpatient conditions (the number of hospitalizations) provided in 2014 by federal state institutions, according to invoices presented for payment by territorial funds at the place of medical care provision to the territorial fund of the i-th subject of the Russian Federation at the place of issuance of the compulsory medical insurance policy;
NSZ - the size of the normalized safety stock to be distributed;
b) the volume of reduction in specialized medical care in inpatient conditions provided by k-th federal state institutions located on the territory of the i-th subject of the Russian Federation in 2015 compared to 2014 () is determined by the formula:
The volume of specialized medical care in inpatient conditions (number of hospitalizations) provided to insured persons of the i-th constituent entity of the Russian Federation at the expense of compulsory medical insurance funds under the basic compulsory medical insurance program in 2014 by k-th federal state institutions located in the i-th subject of the Russian Federation;
The volume of specialized medical care in inpatient conditions (the number of hospitalizations) provided by the k-th federal state institutions located on the territory of the i-th subject of the Russian Federation in 2014 in accordance with state assignments for the provision of public services (performance of work) provided for by the departmental list of public services (works) (hereinafter - the state assignment);
Planned volumes of high-tech medical care not included in the basic program of compulsory medical insurance, established by the k-th federal state institutions located on the territory of the i-th subject of the Russian Federation for 2014 (number of patients);
The volume of specialized medical care in inpatient conditions at the expense of compulsory health insurance funds within the framework of the basic compulsory health insurance program, established for 2015 by the decision of the development commission territorial program compulsory medical insurance created in the constituent entity of the Russian Federation in accordance with the established procedure (hereinafter referred to as the commission) for the k-th federal state institutions located on the territory of the i-th constituent entity of the Russian Federation (number of hospitalizations).
If< 0, то значение показателя принимается равным 0.
5. Federal executive bodies, within 5 working days from the date of entry into force of these Rules, on the basis of data received from subordinate federal state institutions, submit to the Fund information:
a) on the volume of specialized medical care in stationary conditions provided in 2014 by subordinate federal state institutions in accordance with state assignments, indicating the subject of the Russian Federation on the territory of which the corresponding federal state institution is located;
b) on the volume of high-tech medical care provided in 2014 by subordinate federal state institutions in accordance with state assignments, indicating the subject of the Russian Federation on the territory of which the corresponding federal state institution is located;
c) on the volume of specialized medical care in inpatient conditions provided in 2014 by subordinate federal state institutions at the expense of compulsory medical insurance funds within the framework of the basic compulsory medical insurance program, including to insured persons to whom compulsory medical insurance policies were issued on the territory of other subjects of the Russian Federation Federation, indicating the subject of the Russian Federation, on the territory of which the corresponding federal state institution is located.
6. Territorial funds within 5 working days from the date of entry into force of these Rules submit to the Fund information:
a) on the volume of specialized medical care in inpatient conditions at the expense of compulsory medical insurance funds within the framework of the basic compulsory medical insurance program established for 2015 by decisions of commissions for federal state institutions for each federal state institution;
b) on the volume of specialized medical care in inpatient conditions provided in 2014 to insured persons outside the territory of the constituent entity of the Russian Federation, in which the policy of compulsory medical insurance was issued, by federal state institutions according to invoices presented for payment by territorial funds at the place of rendering such medical care.
7. The conditions for the direction of the normalized safety stock are:
a) availability in the budget of the Fund of normalized insurance stock in the amount to be distributed;
b) submission to the Fund by the authorized executive body of a constituent entity of the Russian Federation of information on the creation of a working group to develop proposals for additional financial support for the provision of specialized medical care by federal state institutions, including those located on the territories of other constituent entities of the Russian Federation, with the inclusion of representatives in the specified working groups relevant federal government agencies.
8. Transfer of the normalized insurance stock funds to the budgets of territorial funds is carried out by the Fund within 10 working days from the date of its decision on the direction of these funds.
9. The Fund, within 5 working days from the date of transfer of the normalized insurance stock, sends to the territorial funds information about the reduction in specialized medical care in stationary conditions calculated in accordance with subparagraph "b" of paragraph 4 of these Rules in 2015 compared to 2014, provided by federal government agencies.
10. Territorial funds, within 30 calendar days from the date of receipt of the normalized insurance stock in the budgets of territorial funds, submit to the Fund a copy of the commission's decision on the distribution of additional volumes of specialized medical care between federal state institutions, as well as planned indicators for additional volumes of specialized medical care and planned indicators the amount of funds for settlements for medical care provided to insured persons outside the territory of the constituent entity of the Russian Federation, in which the policy of compulsory medical insurance was issued, based on the volume of receipt of funds from the normalized insurance stock.
11. Territorial funds submit monthly reports to the Fund on the expenditure of the normalized insurance stock in the form and in the manner approved by the Fund.
12. The Ministry of Health of the Russian Federation, together with the Fund, monitors the provision of specialized medical care by federal state institutions in the forms approved by the Ministry of Health of the Russian Federation.
13. Control over the targeted use of the normalized safety stock is carried out in accordance with the legislation of the Russian Federation.
From 2019, the compulsory medical insurance fund will include funds in the standardized insurance stock of Terfondov to combat the personnel shortage in primary care. Now he is going to finance medical care provided outside his native region, additional education for doctors, as well as the purchase and repair of medical equipment.
The Ministry of Health proposes to form the standardized insurance stock (NHA) of territorial compulsory health insurance funds (CHI) in a different way. Now it is intended "for the implementation of territorial compulsory medical insurance programs, payments for medical care provided to insured persons outside the territory of the subject of the Russian Federation, in which compulsory medical insurance policy, organization of additional professional education of medical workers on training programs, purchase and repair of medical equipment ”. In 2019–2024, it will also include funds for eliminating the personnel shortage in clinics providing primary medical care. The corresponding draft law, amending article 51 of the Federal Law "On compulsory health insurance in the Russian Federation", is published on the website of the Russian government.
Where to get the funds and how they will be used by medical organizations must be approved by the Ministry of Health in an additional order. , now the normalized insurance stock of TFOMS is formed from the budget revenues of the territorial fund (FFOMS subventions), money intended to pay for medical care to residents of other regions, as well as part of the funds from penalties imposed on clinics based on the results of inspections.
The government also ordered to submit to the State Duma a draft budget for the Federal MHI Fund for next year and for the planning period 2020 and 2021. According to it, the formation of the standardized safety stock of FFOMS is planned annually in the amount of 3.1 billion rubles.
For the next year, the revenues of the MHIF are provided in the amount of 2,098.2 billion rubles, for 2020 - 2,349.9 billion rubles, for 2021 - 2,495.8 billion rubles (the budget of 2018 - 1,887.9 billion rubles). It is assumed that expenses for 2019 will amount to 2,190.4 billion rubles, in 2020 - 2,350.5 billion rubles and in 2021 - 2,501.5 billion rubles (2018 budget - 1,994.1 billion rubles) ...
“The budget deficit of the Fund in 2019 will amount to 92.3 billion rubles, in 2020 - 0.5 billion rubles, in 2021 - 5.7 billion rubles. The balance of the Fund's budget will be achieved at the expense of carry-over balances at the end of the corresponding financial year, ”the Cabinet of Ministers said.
“In them (budgets of social funds - Ed.) we have laid the funds that will ensure the necessary level of social protection for people, - said Prime Minister Dmitry Medvedev at a government meeting on September 20 during the discussion of bills. - The money will be used to further improve the quality of medicine. We will also include in the basic program OMS new types of high-tech care, we will continue to eliminate the shortage of individual specialists in hospitals. "
