Unofficial translation
In accordance with subclause 11) of article 8 of the Code of the Republic of Kazakhstan dated July 7, 2020 "On Public Health and Health Care System" I HEREBY ORDER:
1. To approve the attached Rules for payment for an independent examination of the quality of healthcare services (assistance) carried out by accredited healthcare entities.
2. Committee for Quality Control and Safety of Goods and Services of the Ministry of Healthcare of the Republic of Kazakhstan in accordance with the procedure, established by the legislation of the Republic of Kazakhstan, shall ensure:
1) state registration of this order with the Ministry of Justice of the Republic of Kazakhstan;
2) placement of this order on the Internet resource of the Ministry of Healthcare of the Republic of Kazakhstan after its official publication;
3) within ten working days after the state registration of this order, submission to the Legal Department of the Ministry of Healthcare of the Republic of Kazakhstan of information about implementation of measures stipulated by subclauses 1) and 2) of this clause.
3. Control over execution of this order shall be entrusted to the supervising Vice Minister of Healthcare of the Republic of Kazakhstan.
4. This order shall come into force upon expiry of ten calendar days after the date of its first official publication.
|
Minister of Healthcare of the Republic of Kazakhstan |
A. Tsoy |
| Approved by the order of the Minister of Healthcare of the Republic of Kazakhstan dated October 12, 2020 № ҚР ДСМ-126/2020 |
Rules for payment for an independent examination of the quality of healthcare services (assistance), carried out by accredited healthcare entities
Chapter 1. General Provisions
1. These Rules for payment for an independent examination of the quality of healthcare services (assistance), carried out by accredited healthcare entities (hereinafter referred to as the Rules) have been developed in accordance with subclause 11) of article 8 of the Code of the Republic of Kazakhstan dated July 7, 2020 "On Public Health and Health Care System" (hereinafter referred to as the Code) and shall determine the procedure for the payment for an independent examination of the quality of healthcare services (assistance), carried out by accredited healthcare entities, (hereinafter referred to as the service payment for an independent examination).
2. The following concepts are used in these Rules:
1) Social Health Insurance Fund (hereinafter referred to as the Fund) – a noncommercial organization that accumulates deductions and contributions, as well as carries out procurement and payment for the services of healthcare entities providing medical care in the volumes and on the terms provided for by the contract for the purchase of medical services, and other functions determined by the laws of the Republic of Kazakhstan;
2) route of delivery of health care to the patient– the process of the patient's route when receiving medical services (assistance) at all levels of medical care;
3) independent expert – an individual, who meets the requirements, determined by the authorized body, and included to the register of independent experts.
Chapter 2. Procedure for service payment for an independent examination
3. Independent examination services shall be procured by the following customers:
1) state body in the field of provision of medical services (care) (hereinafter referred to as the state body);
2) the Fund;
3) individuals or legal entities.
4. The state body shall procure the independent examination services in accordance with the Law of the Republic of Kazakhstan dated December 4, 2015 "On Public Procurement".
The Fund, individuals and legal entities shall procure the independent examination services in accordance with the civil law, by concluding civil law contracts.
5. Payment for the services of an independent examination rendered shall be made upon acceptance by the customer of the expert opinion of an independent expert (hereinafter referred to as the opinion), and shall be paid within the funds for the current financial year provided for the involvement of independent experts.
6. the accredited healthcare entity, via email or through the automated integrated information system "Electronic Procurement (hereinafter referred to as the AIIIS EP), or by personal delivery, shall send to the customer, within 5 (five) working days, an opinion and a services completion certificate.
7. In case if the services of an independent examination rendered for are not provided in the full volume, specified in the contract, the customer (representative of the customer) within 3 (three) working days rejects the services completion certificate and returns the opinion with comments for revision, to the accredited healthcare entity by e-mail, or through the AIIIS EP, or by personal delivery.
8. The accredited healthcare entity, after receiving the opinion and comments of the customer (representative of the customer) for revision, within 2 (two) working days finalizes the conclusion and sends it to the customer (representative of the customer) for payment in accordance with clause 4 of these Rules.
Therewith, the accredited healthcare entity shall date the services completion certificate by the day the revised opinion is sent.
9. The customer (representative of the customer) upon receipt of the opinion, approves (signs) the services completion certificate within 3 (three) working days.
After the approval (signing) of the act of performed services, the customer (representative of the customer), within 30 (thirty) calendar days, shall pay for the services of an independent examination to an accredited healthcare entity by transferring the sum to its current account.
10. Payment for independent examination services procured from an accredited healthcare entity shall be made depending on the form of service provision - with or without visiting the place of the independent examination, and includes the following conditions:
1) when providing a service without visiting the place of an independent examination or with a visit to the place of an independent examination located in one settlement, the base official salary established by the resolution of the Government of the Republic of Kazakhstan dated December 31, 2015 No. 1193 "On the system of remuneration of civil servants, employees of organizations maintained at the expense of the state budget, employees of state-owned enterprises" (hereinafter referred to as the Resolution), the coefficient of work experience in the specialty established for the B2 level in the healthcare sector in accordance with Appendix 2 to the Resolution , the rate of hourly wages established for consultants of health and social security institutions, regardless of the availability of an academic degree and title, in accordance with Appendix 19 to the Resolution and the period of time (hours / minutes) spent on conducting an independent examination.
In addition, as a period (hours / minutes) spent on an independent examination, taking into account the specifics of the volume and terms of the contract:
the Fund shall take a period of time (minutes) used by the independent expert for examination of medical documentation per one treated case, and depends on the type and form of medical care, type of medical activities, as well as the number of examined medical records.
The state body shall take a period of time (hours) used by the independent expert to conduct an examination, including the volume (complexity) of an independent examination, The volume of an independent examination depends on the complexity of the study and is indicated in the terms of contracts (technical specifications).
2) When providing a service with a visit to the place of an independent examination, located outside the place of his residence of an independent expert, the conditions (costs) provided for in subclause 1) of this clause and travel expenses (daily allowance, rent of living quarters, travel to the place of the independent examination) shall be taken into account in accordance with the Rules for reimbursement of business travel expenses at the expense of budgetary funds, including to foreign countries, approved by the resolution of the Government of the Republic of Kazakhstan dated May 11, 2018 No. 256.
The payment for an independent examination service rendered by an accredited healthcare entity (with or without visiting the place of the independent examination) shall also include organizational costs (overhead costs).
11. The norms of articles 257, 317, 342, 484, 485 of the Code of the Republic of Kazakhstan dated December 25, 2017 "On Taxes and Other Obligatory Payments to the Budget (Tax Code)" shall be taken into account when paying for the services of an independent examination.