On Approval of the Rules for the public services provision "Provision of information on participation as a consumer of medical services and on the amounts of contributions and/or contributions listed in the compulsory social health insurance system"

Order of the Minister of Healthcare of the Republic of Kazakhstan dated April 2, 2020 №RK HM-26/2020. Registered with the Ministry of Justice of the Republic of Kazakhstan on April 6, 2020 № 20308.

Unofficial translation

Footnote. The title - in the wording of the order of the Minister of Healthcare of the Republic of Kazakhstan dated 17.06.2021 № RK MH - 50 (shall enter into force upon expiry of ten calendar days after the day of its first official publication).

In accordance with Article 10, subparagraph 1) of the Law of the Republic of Kazakhstan dated April 15, 2013 “On public services”, I hereby ORDER:

1. Approve the attached Rules for the public services provision "Provision of information on participation as a consumer of medical services and on the amounts of contributions and (or) contributions listed in the compulsory social healthcare insurance system.

Footnote. Paragraph 1 - in the wording of the order of the Minister of Healthcare of the Republic of Kazakhstan dated 17.06.2021 № RK MH- 50 (shall enter into force upon expiry of ten calendar days after the day of its first official publication).

2. In accordance with the procedure established by the legislation of the Republic of Kazakhstan, the Department of Coordination of Compulsory Social Health Insurance of the Ministry of Healthcare of the Republic of Kazakhstan shall:

1) ensure the state registration of this order with the Ministry of Justice of the Republic of Kazakhstan;

2) place this order on the official Internet resource of the Ministry of Health of the Republic of Kazakhstan after its official publication;

3) within ten working days after the state registration of this order, submit to the Legal Department of the Ministry of Healthcare of the Republic of Kazakhstan information on the implementation of the measures provided for in subparagraphs 1) and 2) of this paragraph.

3. Control over the execution of this order shall be entrusted to the Vice-Minister of Healthcare of the Republic of Kazakhstan L.M. Aktayev.

4. This order shall enter into force after the day of its first official publication.

Minister of Healthcare of the Republic of Kazakhstan

Е. Birtanov

"AGREED"
Ministry of Digital Development,
Innovation and Aerospace Industry
of the Republic of Kazakhstan

Annex of the Minister of Healthcare of the Republic of Kazakhstan dated April 2, 2020 № RK HM-26/2020

Rules
for the public services provision "Provision of information on participation as a consumer of medical services
and on the amounts of contributions and/or contributions listed in the compulsory social healthcare insurance system

Footnote. The title - in the wording of the order of the Minister of Healthcare of the Republic of Kazakhstan dated 17.06.2021 № RK MH - 50 (shall enter into force upon expiry of ten calendar days after the day of its first official publication).
Footnote. Appendix - as amended by the order of the Minister of Health of the Republic of Kazakhstan dated December 29, 2020 No. ҚР DSM-332/2020 (shall be enforced ten calendar days after the day of its first official publication).

Chapter 1. General provisions

1. These Rules for the public service provision "Provision of information on participation as a consumer of Medical Services and on the Amounts of Deductions Listed and (or) contributions in the system of compulsory social health insurance "(hereinafter referred to as the Rules) developed in accordance with paragraph 1) of Article 10 of the Law of the Republic of Kazakhstan "On public services" (hereinafter - the Law) and determine the procedure for the provision of state service "Provision of information on participation as a consumer of medical services and on the listed amounts of deductions and (or) contributions in the compulsory social health insurance system "(hereinafter referred to as the public service).

Footnote. Paragraph 1 - in the wording of the order of the Minister of Healthcare of the Republic of Kazakhstan dated 17.06.2021 № RK MH - 50 (shall enter into force upon expiry of ten calendar days after the day of its first official publication).

2. The state service shall be provided by the non-profit joint-stock company “Social Health Insurance Fund” (hereinafter referred to as the Fund).

The authorized healthcare body shall send information on changes and (or) additions to these Rules to the Fund, the operator of the information and communication infrastructure of “electronic government” and to the Unified Contact Center for state services provision.

Footnote. Paragraph 2 - as amended by the order of the acting Minister of Health of the Republic of Kazakhstan dated 01.11.2022 No.ҚР ДСМ-124 (shall be enforced ten calendar days after the date of its first official publication).

3. The basic concepts shall be used in these Rules:

1) deposits- money paid by employers at the expense of their own funds to the social healthcare insurance fund, giving the right to consumers of medical services, for which deposits shall be paid, to receive medical care in the compulsory social healthcare insurance system;

2) contributions - money paid to the fund by payers of contributions specified in paragraph 2 of Article 14 of the Law "On compulsory social healthcare insurance" (hereinafter referred to as the Law on Compulsory Healthcare Insurance), and giving the right to consumers of medical services to receive medical care in the system of compulsory social healthcare insurance;

3) The Fund shall be a non-profit organization that accumulates contributions and contributions, as well as purchases and payments for services of healthcare entities that provide medical care in the volumes and on the terms provided for by the agreement for the purchase of medical services, and other functions determined by the Laws of the Republic of Kazakhstan;

4) consumer of medical services - an individual who, in accordance with the Law on Compulsory healthcare insurance, shall have the right to receive medical care in the system of compulsory social healthcare insurance;

5) compulsory social healthcare insurance (hereinafter referred to as CSMI) - a set of legal, economic and organizational measures to provide medical care to consumers of medical services at the expense of the assets of the social healthcare insurance fund;

6) information system "Saqtandyrý" (hereinafter referred to as IS "Saqtandyrý") - information system of the Fund, which shall determine the status of the consumer of medical services in an automated mode;

7) electronic digital signature (hereinafter referred to as the EDS) - a set of electronic digital symbols created by means of electronic digital signature and confirming the reliability of an electronic document, its ownership and invariability of content.

Chapter 2. Procedure for public service provision
"Provision of information on participation as a consumer of medical services and on the amounts
of contributions and/or contributions listed in the compulsory social healthcare insurance system

Footnote. Paragraph 1 - in the wording of the order of the Minister of Healthcare of the Republic of Kazakhstan dated 17.06.2021 № RK MH - 50 (shall enter into force upon expiry of ten calendar days after the day of its first official publication).

4. For information on participation as a consumer of medical services and on the amounts of deductions listed and (or) an individual (hereinafter referred to as the service recipient) shall send contributions to the Fund (hereinafter referred to as the service provider) through the Electronic Government web portal (hereinafter referred to as the portal) an electronic request signed by the EDS of the service recipient or certified with a one-time password in case of registration and connection of the subscriber number of the service recipient provided by the mobile operator to the portal account.

5. The basic requirements for the state service provision, including characteristics of the process, provision form and result, as well as other information given the state service provision specifics, are listed in the list of basic requirements for the state service provision “Provision of information on participation as a consumer of medical services and on the transferred amounts of deductions and (or) contributions in the compulsory social health insurance system” in accordance with Appendix 1 to these Rules.

Footnote. Paragraph 5 - as amended by the order of the acting Minister of Health of the Republic of Kazakhstan dated 01.11.2022 No.ҚР ДСМ-124 (shall be enforced ten calendar days after the date of its first official publication).

6. The service provider shall receive information about the identity document from the relevant state information systems through the Electronic Government gateway.

7. The period of public service provision shall not be more than fifteen minutes.

8. The request shall be processed by the service provider within fifteen minutes from the moment the request is received by the Saqtandyrý IS. Based on the results of processing, information shall be generated on participation as a consumer of medical services and on the listed amounts of deductions and (or) contributions in the CSMI system in the form in accordance with Annex 2 to these Rules, which shall be sent in the form of an electronic document to the "Personal Account" of the service recipient on the portal.

9. The service provider shall ensure the entry of data on the stage of public service provision into the information system for monitoring the public service provision in accordance with the procedure established by the authorized body in the field of informatization in accordance with paragraph 11) of paragraph 2 of Article 5 of the Law.

10. A complaint about decisions, actions (inaction) of the service provider and (or) its employees regarding the state service provision shall be submitted to the head of the service provider.

A complaint from a service recipient received by the service provider directly providing the state service, in accordance with paragraph 2 of Article 25 of the Law, shall be processed within five working days from its registration date.

A service recipient's complaint received by the authorized body for assessing and supervising the state services quality shall be processed within fifteen working days from its registration date.

When applying through the portal, information on the complaint examination procedure can be learned by calling the single contact center for state services provision issues.

Pre-trial examination of the complaint about the state services provision shall be carried out by a higher administrative body, an authorized body for assessing and supervising the state services quality (hereinafter referred to as the complaint examination body).

The complaint shall be submitted to the service provider whose decision, action (inaction) is being appealed.

The service provider, whose decision, action (inaction) is being appealed, no later than three working days from the complaint receipt date, shall direct it and the administrative file to the complaint examination body.

In this case, the service provider, whose decision, action (inaction) is being appealed, has the right not to send the complaint to the complaint examination body if, within three working days, it takes a decision or other administrative action that fully satisfies the requirements specified in the complaint.

Unless otherwise provided by law, a complaint to the court is allowed after pre-trial examination of the complaint.

Footnote. Paragraph 10 - as amended by the order of the acting Minister of Health of the Republic of Kazakhstan dated 29.12.2021 №. ҚР ДСМ-137 (shall be enforced ten calendar days after the date of its first official publication).

	Appendix 1 to the Rules for the provision of the state service “Provision of information on participation
	as a consumer of medical services and on the transferred amounts of deductions and (or) contributions in the compulsory social health
	insurance system”

List of basic requirements for the provision of the state service “Provision of information on participation as a consumer of medical services and on the transferred amounts of deductions and (or) contributions in the compulsory social health insurance system”

Footnote. Appendix 1- as amended by the order of the acting Minister of Health of the Republic of Kazakhstan dated 01.11.2022 № ҚР ДСМ-124 (shall be enforced ten calendar days after the date of its first official publication).

1	Name of the service provider	Social Health Insurance Fund
2	Ways of the state service provision	Web-portal “electronic government” (further-the portal):www.egov.kz
3	State service provision term	No more than 15 minutes
4	State service provision form	Electronic (fully automated)
5	State service provision result	Information on participation as a consumer of medical services and on the transferred amounts of deductions and (or) contributions in the compulsory social health insurance system. Form of issuing the state service results: electronic
6	Fee the service recipient is charged at the state service rendering and ways of collecting it in cases stipulated by the legislation of the Republic of Kazakhstan	Free of charge
7	Work schedule of the service provider and information objects	1) Service provider – Monday to Friday inclusive, in accordance with the established work schedule from 9-00 to 18-30 with a lunch break from 13-00 to 14-30, with the exception of Saturdays, Sundays and holidays; 2) Portal - around the clock, with the exception of technical breaks due to repair work (when the service recipient contacts after the end of working hours, on weekends and holidays, in accordance with the Labor Code of the Republic of Kazakhstan, applications are accepted and the state service rendering results are issued on the next working day).
8	List of documents and information required from the service recipient for the state service provision	1) An electronic request signed with the digital signature of the service recipient or certified with a one-time password, in case of registration and connection of the service recipient’s subscriber number provided by the cellular operator to the portal account; 2) An electronic document of the service recipient with an individual identification number (for identification), which the service provider retrieves from the digital document service through the implemented integration, subject to the consent of the document owner given through the user’s cellular subscriber number registered on the portal by transmitting a one-time password or by sending a short text message as a response to the portal notification.
9	Grounds for rejecting the state service, established by the laws of the Republic of Kazakhstan	1) Established falsity of the documents submitted by the service recipient for the state service provision, and (or) of the data (information) contained in them; 2) non-compliance of the service recipient and (or) the presented materials, objects, data and information necessary for the provision of the state service with the requirements established by the regulatory legal acts of the Republic of Kazakhstan; 3) Presence of enforced court ruling (sentence) in relation to the service recipient prohibiting an activity or certain types of activity, requiring the receipt of a certain state service; 4) Presence of enforced court ruling depriving the service recipient of a special right related to the receipt of the state service; 5) lack of the service recipient’s consent, as required by Article 8 of the Law of the Republic of Kazakhstan “On Personal Data and Their Protection,” to access to restricted personal data that is necessary for the state service provision.
10	Other requirements given the state service provision specifics, including in electronic form	1. The service recipient is able to receive the state service in electronic form through the service recipient’s cellular subscriber number registered on the portal by sending a one-time password or by sending a short text message as a response to the portal notification. 2. The service recipient can receive the state service in electronic form through the portal, if he avails of EDS. 3. Contact phone numbers of help desks on the state service provision are listed on the Fund’s Internet resource – https://fms.kz/, the Fund’s contact center at toll-free number 1406. Single contact center for the state services provision: 8-800-080-7777, 1414.

Annex 2 to Rules for public service provision "Issuance of information about participation as a consumer of medical services and about listed amounts contributions and/or contributions to system of compulsory social healthcare insurance"

Form

Footnote. Right hand corner- in the wording of the order of the Minister of Healthcare of the Republic of Kazakhstan dated 17.06.2021 № RK MH- 50 (shall enter into force upon expiry of ten calendar days after the day of its first official publication).

Information on participation as a consumer of medical services and on the number of contributions and/or contributions listed in the compulsory social healthcare insurance system

Issued by: _________________________________________

(Full name (if any), IIN)

Date of issue: ______________

№	Payment date*	Number of contributions or contributions (KZT)	Type of receipt (deduction or contribution)	Period	BIN Payer (IIN)	Refund amount (if any)	Refund date (if any)
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.

Status in the CSMI system: __________________________________________

(CSMI consumer (non-CSMI consumer))

Note:

* Payment of contributions and/or contributions shall be made monthly. If there is a debt in order to qualify for medical care under the compulsory medical insurance, you must pay contributions to the Fund for the unpaid period, but not more than twelve months preceding the payment date, in the amount of 5 percent of the minimum wage established for the current fiscal year by the republican budget law (paragraph 3 of Article 5 of the compulsory medical insurance law).