Unofficial translation
Under sub-paragraph 62 of Article 7 of the Code of the Repuhblic of Kazakhstan “On Public Health and Healthcare System” and paragraph 1 of Article 34 of the Law of the Republic of Kazakhstan “On Compulsory Social Medical Insurance”, I HEREBY ORDER:
Footnote. The Preamble - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall come into effect ten calendar days after the date of its first official publication).1. To approve the rules for procuring services from healthcare entities for the provision of medical care within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance in accordance with Appendix 1 to this order.
2. To invalidate some orders of the Ministry of Healthcare of the Republic of Kazakhstan in accordance with Appendix 2 to this order.
3. In accordance with the procedure established by the legislation of the Republic of Kazakhstan, the Department for Coordination of Compulsory Social Health Insurance of the Republic of Kazakhstan shall ensure:
1) the state registration of this order with the Ministry of Justice of the Republic of Kazakhstan;
2) the posting of this order on the website of the Ministry of Healthcare of the Republic of Kazakhstan after its official publication;
3) the submission of information on the implementation of the measures provided for in subparagraphs 1) and 2) of this paragraph to the Legal Department of the Ministry of Healthcare of the Republic of Kazakhstan within ten working days of the state registration of this order with the Ministry of Justice of the Republic of Kazakhstan.
4. Control over the execution of this order shall be entrusted to M.Y.Shoranov, the first deputy minister of healthcare of the Republic of Kazakhstan.
5. This order comes into force on January 1, 2021 and is subject to official publication.
Minister of Healthcare of the Republic of Kazakhstan |
A.Tsoi |
"APPROVED" by
the Ministry of National Economy of
the Republic of Kazakhstan
Appendix 1 to Order № KR DSM-242/2020 of the Minister of Healthcare of the Republic of Kazakhstan as of December 8, 2020 |
Rules
for procuring services from healthcare entities for the provision of medical care within
the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance
Chapter 1. General provisions
1. These Rules for Procuring Services from Healthcare Entities for the Provision of Medical Care within the Guaranteed Volume of Free Medical Care and (or) in the System of Compulsory Social Health Insurance (hereinafter - the Rules) have been elaborated under sub-paragraph 62) of Article 7 of the Code of the Republic of Kazakhstan “On People's Health and the Healthcare System” (hereinafter - the Code) and paragraph 1 of Article 34 of the Law of the Republic of Kazakhstan “On Compulsory Social Medical Insurance” (hereinafter - the Law on Compulsory Social Medical Insurance) and specify the procedure for purchasing services from healthcare entities within the guaranteed volume of free medical care (hereinafter -GVFMC) and (or) in the system of compulsory social medical insurance (hereinafter - CSHI).
Footnote. Paragraph 1 - as revised by order of the Minister of Health of the Republic of Kazakhstan № KP DSM-8 of 29.01.2022 (shall become effective after the day of its first official publication).2. Services are purchased within the GVFMC framework from healthcare entities by the social health insurance fund (hereinafter referred to as the fund) and (or) administrators of budget programs.
The services from healthcare entities in the CSHI system are purchased by the fund.
The services from healthcare entities within the GVFMC and (or) in the CSHI system are procured by selecting healthcare entities and placing the volume of services and (or) the amount of funds (hereinafter referred to as the procurement of services).
3. Basic concepts and definitions used herein:
1) co-executor is a healthcare entity included in the database of healthcare entities eligible for rendering medical care within the framework of the GVFMC and (or) in the CSHI system (hereinafter referred to as the database), whereby the provider has entered into a co-execution contract to fulfil part of the provider's obligations under the concluded agreement for the procurement of services;
2) designated authority in the field of healthcare (hereinafter - designated authority) is a central executive body exercising management and inter-sectoral coordination in the field of health protection of citizens of the Republic of Kazakhstan, medical and pharmaceutical science, medical and pharmaceutical education, sanitary and epidemiological welfare of the population, circulation of medicines and medical devices, quality of medical services (care) provision;
3) healthcare entities are healthcare enterpreises, as well as individuals engaged in private medical practice and pharmaceutical activities;
4) healthcare organisation is a legal entity involved in healthcare activities;
5) database is a list of healthcare entities applying for medical care within the framework of the GVFMC and (or) in the CSHI system, formed pursuant to order № KR DSM-186/2020 of the Minister of Health of the Republic of Kazakhstan of November 6, 2020 “On Approval of the Rules for Keeping Records of Healthcare Entities Rendering Medical Care within the Guaranteed Volume of Free Medical Care and (or) in the System of Compulsory Social Health Insurance” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21619 (hereinafter referred to as the Recording Rules);
6) a newly commissioned healthcare facility is a facility first put into operation by erecting a new facility or first opened by changing an existing facility under the Law of the Republic of Kazakhstan “On Architectural, Urban Planning and Construction Activities in the Republic of Kazakhstan”;
7) high-tech medical service is a service offered by specialised experts for diseases requiring innovative, resource-intensive and (or) unique methods of diagnosis and treatment;
8) fund is a non-profit organisation accumulating deductions and contributions, as well as procuring and paying for the services of healthcare entities offering medical care in the amounts and on the terms stipulated in the contract for the procurement of medical services, and other functions defined by the laws of the Republic of Kazakhstan;
9) assets of the fund are charges and contributions, penalties received for late payment of charges and (or) contributions, investment income, minus commission for ensuring the fund's activity, as well as other receipts to the fund, not prohibited by the laws of the Republic of Kazakhstan;
10) contingency fund reserve means funds envisaged by the fund for the current financial year to finance unanticipated expenditures during the coverage period, formed on a monthly basis;
11) branch of the fund is a separate unit of the fund located outside the fund's location and performing all or part of its functions, including the functions of a representative office;
12) web portal for the procurement of services from healthcare entities (in respect to the Rules) is an information system offering a single point of access to electronic services for the procurement of services from healthcare entities within the framework of the GVFMC and (or) in the CSHI system (hereinafter referred to as the web portal);
13) an electronic copy of a document is a document which completely reproduces the form and information (data) of the original document in electronic digital form;
14) supplier is a healthcare entity with which the fund or budget programme administrator has entered into a service procurement agreement as specified herein;
15) medical care in the CSHI system is the volume of medical care offered to consumers of medical services at the expense of the fund's assets;
16) medical information system is an information system ensuring the maintenance of processes of healthcare entities in electronic format;
17) medical care is a complex of medical services aimed at preserving and restoring the health of the population including medicinal supply;
18) quality of medical care is the level of conformance of the medical care offered to the standards of medical care provision;
19) medical services are actions of healthcare entities with preventive, diagnostic, therapeutic, rehabilitative and palliative focus in relation to a specific person;
20) public authority responsible for the delivery of medical services (care is a public authority that manages the delivery of medical services (care) and controls the quality of medical services (care);
21) healthcare entity delivering primary healthcare (hereinafter referred to as PHC entity) is a healthcare entity offering primary health care within the framework of GVFMC and (or) in the CSHI system to the population registered in the “Register of the Attached Population” portal (hereinafter referred to as the PHC portal);
22) public-private partnership agreement is a written agreement establishing the rights, obligations and liabilities of the parties to a public-private partnership agreement, other terms and conditions of a public-private partnership agreement as part of the implementation of a public-private partnership project;
23) production base is a place of rendering medical services as per the annex to the licence issued in line with the legislation of the Republic of Kazakhstan on permits and notifications;
24) republican healthcare institutions are healthcare organisations managed by the designated authority, scientific organisations in the field of healthcare, healthcare organisations of autonomous educational organisation, medical education organisations;
25) independent expert is a natural person complying with the requirements specified by the designated authority and included in the register of independent experts;
26) agreement for the purchase of services for the supplementary provision of the GVFMC (hereinafter referred to as the services purchase agreement) is an agreement in writing between the administrator of budget programmes and a healthcare entity, envisaging the delivery of medical care within the framework of the GVFMC;
27) agreement for the purchase of medical services within the framework of the GVFMC or the CSHI system (hereinafter referred to as the service purchase agreement) is a written agreement between the Fund and a healthcare entity envisaging the delivery of medical care within the framework of the GVFMC and the CSHI system;
28) digital health entity (in reference to the Rules) is a legal entity engaged in activities or entering into social relations in terms of information and technical support of health information systems, including organisational and methodological work with healthcare entities;
29) electronic document is a document wherein information is presented in electronic digital form and certified by means of an electronic digital signature;
30) electronic digital signature (hereinafter – EDS) is a complex of electronic digital symbols created via electronic digital signature means and confirming the authenticity of an electronic document, its ownership and invariability of its content.
Footnote. Paragraph 3 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be put into effect upon expiry of ten calendar days after the day of its first official publication). Chapter 2.
The procedure for procuring services from healthcare entities for the provision of medical care within
the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance
4. Excluded by order of the Minister of Health of the Republic of Kazakhstan № 157 dated 27.10.2023 (shall be enforced upon expiry of ten calendar days after the date of its first official publication).
5. Procurement of services within the GVFMC and (or) in the CSHI system shall include the following stages:
1) planning the volume of services to be procured within the framework of the GVFMC and (or) in the CSHI system;
2) selection of healthcare entities to deliver services within the GVFMC and (or) in the CSHI system with the distribution and allocation of the volume of services and (or) the volume of funds;
3) conclusion of the service procurement agreement;
4) execution of the service procurement agreement.
Footnote. Paragraph 5 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 dated 27.10.2023 (shall take effect ten calendar days after the date of its first official publication).6. Medical care services are procured on the basis of plans for the procurement of medical services within the GVFMC or in the CSHI system.
7. The volume of healthcare services within the framework of the guaranteed volume of free medical care and (or) in the system of compulsory social medical insurance shall be planned as provided for by order of the Minister of Health of the Republic of Kazakhstan № KR DSM-290/2020 of December 20, 2020 “On Approval of the Rules for Planning the Volume of Medical Services within the Framework of the Guaranteed Volume of Free Medical Care and (or) in the System of Compulsory Social Medical Insurance” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21844).
Footnote. Paragraph 7 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective ten calendar days after the date of its first official publication).8. For the selection of healthcare entities and placement of the volume of services with them, the fund or the administrator of budget programs set up commissions for the selection of healthcare entities and the placement of the volume of services (hereinafter - the commission).
The central office of the fund sets up a republican commission, the branches of the fund - regional commissions.
9. The total number of members of the commission shall be odd.
10. The membership of the commission shall be formed by a decision of the fund or budget programme administrator from among the representatives of:
1) the fund;
2) the designated authority to be included in the republican commission of the fund;
3) the local body of the public healthcare office of oblasts, cities of national importance and the capital city (hereinafter – healthcare office) for inclusion in the composition of the commission under the administrator of budget programmes or regional commission;
4) Atameken National Chamber of Entrepreneurs of the Republic of Kazakhstan (hereinafter referred to as Atameken) and (or) non-governmental organisations representing the interests of patients, healthcare entities or healthcare workers (hereinafter referred to as NGO);
5) the territorial unit of the public authority responsible for the delivery of medical services (care) for inclusion in the regional commission and the commission under the administrator of budget programmes;
6) the digital healthcare entity;
7) the public authority in the sphere of sanitary and epidemiological well-being of the population.
Candidates shall be presented by official letter in writing within five working days from the date of receipt of the request to form the composition of the commission.
Candidates shall present to the fund in writing data on close relatives, spouse and in-laws (in-laws) of the candidate for inclusion in the commission for selection of healthcare providers and allocation of services within the framework of the GVFMC and (or) in the CSHI system in the form as per Appendix 1 hereto.
Footnote. Paragraph 10 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be enforced upon expiry of ten calendar days after the day of its first official publication).11. During a year, members of the commission are introduced in it or removed from it on the basis of a written confirmation of the organization represented by the member of the commission.
12. A member of the commission, who has the right to make a decision and is (or his/her close relatives, spouse or in-laws) a founder, participant or shareholder of the healthcare entity applying for the procurement, submits a written statement to exclude him/her from the procedure for selecting healthcare entities and placing the volume of services for which an application has been submitted from this healthcare entity.
13. The chairman of the Republican Commission under the Fund shall be an official of the Fund, the deputy chairman of the Republican Commission under the Fund shall be a representative of the designated authority, whose position is not lower than the deputy head of the structural unit.
Officials of the administrator of budget programmes shall be the chairperson and deputy chairperson of the commission under the administrator of budget programmes.
The chairman of the regional commission under the fund shall be a representative of the fund, whose position shall not be lower than deputy director of a branch of the fund or head of a structural unit of the fund.
The deputy chairman of the regional commission under the fund shall be a representative of the healthcare office, whose position shall not be lower than the deputy head of the healthcare office.
The chairman of the commission shall manage the activities of the commission and plan its work.
In the absence of the chairman, his/her functions shall be performed by the deputy chairman of the commission.
Footnote. Paragraph 13 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall go into effect ten calendar days after the date of its first official publication).14. The organizational activity of the republican or regional commission is provided by the secretary from among the employees of the fund, of the commission under the administrator of budget programs - from among the employees of the administrator of budget programs. The secretary of the commission is not a member of the commission and does not have the right to vote when the commission makes decisions.
15. A decision of the Commission shall be deemed competent if two thirds of its members participated in the decision-making.
Decisions of the Commission shall be formalised by minutes.
A decision of the Commission shall be taken by voting and shall be deemed adopted if a simple majority of votes of the total number of participating members of the Commission are in favour.
If there is an equality of votes, the decision voted in favour by the chairman of the Commission or, in case of his absence, by the deputy chairman of the Commission shall be deemed adopted.
Footnote. Paragraph 15 - as revised by order of the Minister of Health of the Republic of Kazakhstan № KP DSM-8 of 29.01.2022 (shall become effective after the day of its first official publication).16. If a member of the Commission is absent from the meetings of the Commission for more than three consecutive times, the fund or the budget programme administrator shall propose to the respective representative office that the candidate be replaced.
Footnote. Paragraph 16 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective ten calendar days after the date of its first official publication).17. Healthcare facilities shall be selected to place the volume of services and (or) the volume of funds within the framework of the GVFMC and (or) in the CSHI system, excluding the cases stated in sub-paragraph 11) of paragraph 19 hereof, among the healthcare facilities included in the database as per the Recording Rules.
Footnote. Paragraph 17 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective ten calendar days after the date of its first official publication).18. Healthcare entities shall be selected and the volume of services shall be placed within the framework of the GVFMC and (or) in the CSHI system via the web-portal, excluding the procurement of services of additional support of the GVFMC, implemented by the administrator of budget programmes, which shall be conducted in paper form.
Footnote. Paragraph 18 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be entered into force ten calendar days after the date of its first official publication).19. The volume of services and (or) the volume of funds for the delivery of medical care within the framework of the GVFMC and (or) in the CSHI system shall be placed without conducting the procedure for selecting healthcare entities within the framework of the plan for the procurement of medical services when:
1) changes in tariffs for medical services rendered within the framework of the GVFMC and (or) in the CSHI system, approved pursuant to order № KR DSM-170/2020 of the Acting Minister of Health of the Republic of Kazakhstan of October 30, 2020 “On Approval of Tariffs for Medical Services Rendered within the Guaranteed Volume of Free Medical Care and in the System of Compulsory Social Health Insurance” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21550) (hereinafter referred to as Order № KR DSM-170/2020) at allocation among healthcare entities with which agreements for the purchase of services have been concluded;
2) implementation of pilot projects by decision of the designated authority or the Government of the Republic of Kazakhstan;
3) participation in the procurement of services of a PHC entity with a newly commissioned healthcare facility, based on the order of the healthcare office on the distribution of the population service area and in compliance with the normative legal acts in the field of healthcare, for the provision of PHC, services for screening tests and preventive medical examinations of target population groups as per order № KR DSM-174/2020 of the Acting Minister of Health of the Republic of Kazakhstan of October 30, 2020 “On the Approval of Target Groups of Persons Subject to Screening Tests, as well as the Rules, Scope and Frequency of Conducting These Tests” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21572) and consultative-diagnostic services that are offered per attached population, including services for schoolchildren if they are registered with a primary healthcare provider based on a decision of the healthcare office, if there are unallocated volumes and funds available;
4) reorganisation of the provider in case of succession of its obligations under the Civil Code of the Republic of Kazakhstan to a healthcare entity included in the database;
5) increase in the number of the attached population and (or) changes in the sex and age structure of the population attached to a PHC provider, inter alia, in terms of the right to freely choose a healthcare organisation in the provision of medical care paid for on a per capita basis;
6) changes in the number of schoolchildren and the volume of funds for the delivery of services to schoolchildren assigned to a PHC provider based on a decision of the healthcare office;
7) increase in the number of patients in the delivery of healthcare paid for at a comprehensive tariff or an increase in the population in the delivery of healthcare paid for at a per capita rate;
8) increase in the volume of services or funds included in the comprehensive per capita rate, as well as services and expenses paid at actual costs in the delivery of healthcare, the allocation thereof is performed on a per population basis using the comprehensive tariff or per capita rate;
9) increase in the volume of funds in the plan of procurement of healthcare services for medical care in hospital and (or) hospital care replacing conditions rendered to the population by a provider, which under the Law of the Republic of Kazakhstan “On Administrative-Territorial Structure of the Republic of Kazakhstan” (hereinafter - the Law on Administrative-Territorial Structure) belongs to a rural locality, payment thereof is made based on the complex per capita normative rate;
10) procurement of services for the delivery of healthcare to the citizens of the Republic of Kazakhstan for treatment abroad and (or) engagement of foreign experts for treatment in domestic healthcare organisations within the framework of GVFMC, which is implemented as per order № KR DSM-45 of the Minister of Healthcare of the Republic of Kazakhstan of May 26, 2021 “On Approval of the Rules of Referral of Citizens of the Republic of Kazakhstan for Treatment Abroad and (or) Attraction of Foreign Experts for Treatment in Domestic Healthcare Organisations within the Guaranteed Volume of Free Medical Care” (recorded in the Register of State Registration of Regulatory Legal Acts under № 22866);
11) delivery of services by federal healthcare organisations of the Russian Federation to citizens of the Republic of Kazakhstan residing in the town of Baikonyr, Toretam and Akay settlements, who are not employees of Russian organisations of the Baikonur complex, as well as temporarily staying on the territory of the Baikonur complex, under the Treaty between the Government of the Republic of Kazakhstan and the Government of the Russian Federation on the procedure of healthcare of the Baikonur Cosmodrome personnel, residents of the town of Baikonur, Toretam and Akay settlements under the lease of the Baikonur complex by the Russian Federation, ratified by the Law of the Republic of Kazakhstan on May 31, 2010;
12) delivery of services by healthcare entities at the expense of the contingency fund reserve;
13) delivery of services during the state of emergency on the entire territory of the Republic of Kazakhstan or in some of its localities;
14) by decision of the local representative body, reimbursement from the local budget of oblasts, cities of national importance and the capital city of expenses for payment of the cost of goods, works and services when the need for these expenses exceeds the amount of the service procurement agreement of healthcare entities in the organisational and legal form of state enterprises, with which the fund has concluded these agreements;
15) rendering specialized medical care in outpatient conditions under the Rules of Rendering Specialized Medical Care in Outpatient Conditions, approved by order № KR DSM-37 of the Minister of Health of the Republic of Kazakhstan of April 27, 2022, (recorded in the Register of State Registration of Regulatory Legal Acts under № 27833) (hereinafter - Order № KR DSM-37) by military-medical (medical) units of the central executive bodies and other central state bodies and their territorial units, as well as military-medical (medical) institutions (organisations), other units engaged in military-medical (medical) support;
16) changing or supplementing the list of guaranteed volume of free medical care approved by the Decree of the Government of the Republic of Kazakhstan № 672 of October 16, 2020 and (or) the list of medical care in the system of compulsory social medical insurance approved by Decree of the Government of the Republic of Kazakhstan № 421 of June 20, 2019. However, the released volume of services due to changes in the above lists shall be allocated to the same healthcare entities in the amount not exceeding the released funds;
17) allocating funds to the PHC entities to be unbundled, as per the list of PHC entities approved by the healthcare office, per the number of attached urban population;
18) increase in the number of attached population of the PHC provider due to redistribution of the PHC provider's service area as decided by the healthcare office;
19) increase in the volume of services and (or) the volume of funds for procuring, processing, storage and sale of blood and its components, production of blood products when placed among suppliers of these services;
20) change in administrative-territorial structure under the Law on Administrative-Territorial Structure, provided that the norms of normative legal acts in the field of healthcare are met.
The volume of services and (or) the volume of funds for the delivery of medical care within the framework of the GVFMC and (or) in the CSHI system for the cases mentioned in sub-paragraphs 1), 2), 4), 5), 6), 7), 8), 8), 9), 12), 13), 18), 19) and 20) of part one of this paragraph shall be placed in the form of conclusion of service procurement agreements or an addendum to the service procurement agreement without formalizing the decision of the commission based on the minutes on the results of allocation (reduction) of the volume of services for the delivery of medical care within the framework of the GVFMC, and (or) in the CSHI system without a procedure of selection of healthcare entities (hereinafter - minutes on the results of allocation without a selection procedure) in the form as per Appendix 1-1 hereto, excluding cases envisaged in sub-paragraphs 3), 11), 15), 16) and 17) of part one of this paragraph, regarding which the volume of services and (or) the volume of funds is placed based on the decision of the commission.
Footnote. Paragraph 19 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall come into effect ten calendar days after the date of its first official publication).20. Healthcare entities shall be selected for allocation of volumes of services and (or) volumes of funds within the framework of the GVFMC and (or) in the CSHI system (hereinafter - volumes of services) from the database for the forthcoming fiscal year on an annual basis and shall comprise a set of the following consecutive stages:
1) at the first stage the following activities shall be implemented:
determination by the regional commission of PHC entities that are admitted (not admitted) to the procedure for selecting healthcare entities based on the results of the attachment campaign (when purchasing PHC services);
notification by announcement of the procedure of allocation of the volume of services within the framework of the GVFMC and (or) in the CSHI system among the healthcare entities included in the database;
submission by healthcare entities of an application for the planned volumes of medical care services within the framework of the GVFMC and (or) in the CSHI system accompanied by the documents mentioned in paragraph 27 hereof (hereinafter referred to as the application for planned volumes) for the declared period;
examination by the commission of applications for planned volumes for conformity with the requirements specified in paragraph 3 of Article 34 of the Law on CSHI (when applying for services in the CSHI system), the requirements specified in paragraphs 26, 27, 28, 33, 34 and 37 hereof, required for admission to the procedure of allocation of volumes of services in the framework of GVFMC and (or) in the CSHI system and for correspondence to the requirements for the medical care organisation established by the Code and other normative legal acts in the field of healthcare (hereinafter - requirements for admission to the allocation of volumes);
selection of healthcare entities and signing of the minutes of conformity (non-conformity) of healthcare entities to the requirements for admission to volume allocation;
re-acceptance and registration of applications for planned volumes adjusted to meet the requirements for admission to volume allocation;
review by the commission of the applications provided by healthcare entities after their repeated reception and admission of healthcare entities to the procedure of allocation of the volume of services within the framework of the GVFMC and (or) in the CSHI system;
2) the following activities shall be implemented at the second stage:
allocation of service volumes and signing of the minutes on the results of allocation (non-allocation) of service volumes for the delivery of healthcare within the framework of the GVFMC and (or) in the CSHI system;
conclusion of service procurement agreements with healthcare entities based on the minutes on the results of allocation (non-allocation) of the scope of services for medical care within the framework of the GVFMC and (or) in the CSHI system;
execution of the service procurement agreement.
Footnote. Paragraph 20 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (see p. 4 for the procedure of enactment).21. When procuring services from PHC entities, the allocation of PHC service volumes within the framework of the GVFMC and (or) in the CSHI system shall involve an annual attachment campaign with the participation of PHC entities included in the database in the period from September 15 to November 15 of the year preceding the financial year in which PHC services are rendered, under order of the Minister of Health of the Republic of Kazakhstan № KR DSM-194/2020 of November 13, 2020 “On Approval of the Rules for Attaching Individuals to Healthcare Providers Offering Primary Health Care” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21642) (hereinafter referred to as the Attachment Rules).
Footnote. Paragraph 21 - as revised by order of the Minister of Health of the Republic of Kazakhstan № KP DSM-8 of 29.01.2022 (shall become effective after the day of its first official publication).22. Information on the commencement of the registration campaign is posted on the websites of the fund and health authorities.
23. Following the results of the attachment campaign, given the decision of the healthcare office on the distribution of the territory, showing the number of the attached population to the PHC entities, the decision of the healthcare office on the distribution of children residing in orphanages, boarding schools, specialised organisations for children, as well as persons residing in health and social organisations, and on the distribution of persons held in penitentiary system institutions, as per the Attachment Rules, based on the data confirmed by the digital health entity on the number of attached population in the RAP portal for each PHC entity, within ten working days from the end of the attachment campaign, the regional commission of the fund shall determine the list of PHC entities that are admitted (not admitted) to the procedure of selecting healthcare entities and shall take a decision in the form of minutes on the results of the attachment campaign to healthcare entities rendering primary health care in the form as per Appendix 1-2 hereto (hereinafter referred to as the minutes on the results of the attachment campaign).
The following healthcare entities shall be admitted to the procedure for selecting healthcare entities:
1) PHC entities with attached population not less than the number determined for the organisation of a legally independent medical outpatient clinic at the district or city level as per order of the Acting Minister of Health of the Republic of Kazakhstan № KR DSM - 133/2020 of October 15, 2020 “On Approval of the State Standard of the Network of Healthcare Providers” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21452);
2) PHC entities with more than one year of experience in providing PHC services within the framework of GVFMC with an attached population of at least two sites of a general practitioner/family physician (in total at least 3,000 people) as per order № 49 of the Acting Minister of Health of the Republic of Kazakhstan of March 30, 2023, “On Approval of the Standard for Organising the Provision of Primary Health Care in the Republic of Kazakhstan” (recorded in the Register of State Registration of Regulatory Legal Acts under № 32160), excluding PHC entities that are the only healthcare entity offering PHC services in the respective administrative-territorial unit (village, settlement).
A statement shall be sent on the web portal to the PHC entities mentioned in the minutes of the results of the attachment campaign no later than one working day from the date of its signing.
Footnote. Paragraph 23 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective ten calendar days after the date of its first official publication).24. Excluded by order of the Minister of Health of the Republic of Kazakhstan № KP DSM-8 of 29.01.2022 (shall take effect after the day of its first official publication).
25. The fund or the administrator of budget programs on the web portal places an announcement on the procedure for placing the volumes of services for the provision of medical care within the GVFMC and (or) in the CSHI system among healthcare entities included in the database (hereinafter - the announcement).
When carrying out the procedure for placing volumes of services within the GVFMC and (or) in the CSHI system in paper form, the website of the fund or the administrator of budget programs posts an announcement about the procedure for placing volumes of services for the provision of medical care within the GVFMC and (or) in the CSHI system among healthcare entities included in the database of healthcare entities applying for the provision of medical care within the GVFMC and (or) in the CSHI system in accordance with the form in Appendix 2 to these Rules.
Health authorities inform healthcare entities about the procedure for placing volumes of services within the GVFMC and (or) in the CSHI system on their websites by posting a link to the web portal or the fund’s website.
26. Healthcare entities, including PHC entities, admitted by the minutes of the results of the attachment campaign to the procedure of selection of healthcare entities and healthcare entities referred to in sub-paragraphs 3) and 15) of the first part of paragraph 19 hereof, shall submit an application for the planned volume of services for the delivery of medical care within the framework of the GVFMC and (or) in the CSHI system in the form as per Appendix 3 hereto in hard copy or in electronic form via the web portal upon:
1) availability of a licence for medical activities and its enclosures confirming the right to render healthcare services for which the application has been filed for the planned volumes, at the location of the production base(s) of the healthcare entity under the Law of the Republic of Kazakhstan “On Permits and Notifications” (hereinafter - the Law on Permits and Notifications), recorded in the E-licensing State Database (hereinafter - E-licensing SDB) information system (hereinafter - the licence for medical activities);
2) availability of a licence for handling of devices and installations generating ionising radiation and its enclosure, confirming the right to use them at the location of the production base(s) of the healthcare entity under the Law on Permits and Notifications, registered in the E-Licensing SDB for rendering the services stated in the application for the planned volumes (if required) (licence for handling of devices and installations generating ionising radiation) (for the types of medical care, for rendering of which this licence is a mandatory document);
3) availability of a licence for handling of devices and installations generating ionising radiation and its enclosure, confirming the right to use them at the location of the production base(s) of the healthcare entity under the Law on Permits and Notifications, recorded in the E-licensing SDB for rendering the services stated in the application for the planned volumes (if required) (hereinafter - licence for handling of devices and installations generating ionising radiation) (for types of medical care, for rendering of which this licence is a mandatory document); (if required) (hereinafter - licence to engage in activities in the sphere of trafficking in narcotic drugs, psychotropic substances and precursors) (for types of medical care for the delivery thereof this licence is a mandatory document);
4) availability of a licence for pharmaceutical activities and its enclosures for the relevant subsectors of its activities, proving the right to manufacture medicinal products and (or) retail sale of pharmaceuticals at the location of the production base(s) of the healthcare entity under the Law on Permits and Notifications, registered in the E-licensing SDB for rendering the services mentioned in the application for the planned volumes (if required) (hereinafter - the licence for pharmaceutical activity) (for types of medical care for which this licence is a mandatory document);
5) availability of a permit document in the sphere of sanitary-epidemiological well-being of the population for all declared types of medical care, issued pursuant to the Rules of Rendering State Services on Issuance of Sanitary-Epidemiological Conclusions, approved by order of the Minister of Health of the Republic of Kazakhstan № KR DSM-336/2020 of December 30, 2020 “On Some Issues of Provision of State Services in the Sphere of Sanitary and Epidemiological Welfare of the Population” (recorded in the Register of State Registration of Regulatory Legal Acts under № 22004) (hereinafter - Order № KR DSM-336/2020) (for a facility of high epidemic significance - availability of sanitary and epidemiological opinion on the conformity of a facility of high epidemic significance to normative legal acts in the field of sanitary and epidemiological well-being of the population or its electronic form from the state electronic register of permits and notifications; for a facility of minor epidemic significance - availability of notification on the commencement of activities (operation) of a facility of minor epidemic significance from the state electronic register of permits and notifications) for the delivery of services listed in the application for planned volumes, at the location of the production base(s) of the healthcare entity (hereinafter - a permit document in the field of sanitary and epidemiological well-being of the population).
Herewith, the application for planned volumes for the forthcoming fiscal year shall be filed by healthcare entities that have updated the data on the database as per paragraph 15 of the Recording Rules.
The application for planned volumes shall be filed by the head of the healthcare entity or a person authorised by him/her.
An application for planned volumes shall be deemed approved at the moment when the web portal automatically sends the relevant notification to the healthcare entity that filed the application.
Footnote. Paragraph 26 - as revised by order of the Minister of Health of the RK № 157 dated 27.10.2023 (shall take effect on 01.12.2023).27. The following documents shall be enclosed with the application for the planned volumes:
1) a certificate of state registration (re-registration) of a legal entity (for a legal entity) or a copy of a certificate (certificate) of registration as an individual entrepreneur and a copy of an identity document (for an individual);
2) documents mentioned in sub-paragraphs 1), 2), 3) and 4) of paragraph 26 hereof, which shall be appended to the application for the planned volumes via integration with the E-licensing SDB;
3) a copy of the public-private partnership agreement (hereinafter referred to as PPP) (to be filed by the healthcare entity implemented under PPP);
4) a copy of the accreditation certificate (to be filed by the healthcare entity, if available);
5) a copy of the conclusion on the eligibility of the healthcare institution to provide high-tech medical care (hereinafter - HTMC), issued under order of the Minister of Health of the Republic of Kazakhstan № KR DSM-238/2020 of December 8, 2020 “On Approval of the Rules of Rendering Specialised, including High-Tech Medical Care” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21746), for the relevant technologies for which an application for the planned volumes has been filed (provided by the healthcare entity applying for the provision of HTMC;
6) details of the volumes and amounts for rendering medical aid mentioned in the application for planned volumes of medical aid services within the guaranteed volume of free medical aid and (or) in the system of compulsory social health insurance in the relevant form as per Appendix 4 hereto;
7) a copy of the authorisation document in the sphere of sanitary and epidemiological well-being of the population;
8) obligation not to render services on a paid basis for the types of medical care (activities) covered by the service procurement agreements within the framework of the GVFMC and (or) in the CSHI system, excluding cases specified by order № KR DSM-170/2020 of the Minister of Health of the Republic of Kazakhstan of October 29, 2020 “On Approval of the Rules for Rendering Paid Services by Healthcare Entities and the Standard Form of Agreement on Rendering Paid Medical Services (Aid)” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21559) (hereinafter referred to as the Rules for Rendering Paid Services), in an arbitrary form;
9) the list of production bases, where it is planned to render the claimed types of medical care, in the form as per Appendix 4-1 hereto;
10) a copy of the property lease (rent) agreement for the building (if required);
11) a copy of the order for the acting head (in case of reallocation of the head);
12) an original of the power of attorney (when filing the application for planned volumes in paper form) or its electronic copy (when filing the application in electronic form) in case of signing and (or) filing the application by an authorised person of the manager.
Footnote. Paragraph 27 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be effective on 01.12.2023).27-1. Excluded by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be enforced on 01.12.2023).
28. If healthcare entities are selected in paper form, the application for the planned volumes is submitted in a bound and numbered form, without corrections and blots, while the last page certified by the signature of the head or his/her attorney.
By the decision of the head of the healthcare entity, applications and the documents attached thereto are provided by the authorized person of the healthcare entity on the basis of a power of attorney issued for the right to submit an application for planned volumes, certified by the signature of the head or his/her authorized representative, or delivered using postal services.
29. The healthcare entity withdraws the application for the planned volumes before the deadline for its submission.
30. Members of the commission, healthcare entities who have submitted applications for the planned volumes are sent automatic notifications about the opening of applications for the planned volumes by the web portal.
31. In case of accepting applications in paper form, the fund or the administrator of budget programs register applications in the register of applications for the planned volumes of medical care services within the GVFMC and (or) in the CSHI system in accordance with the form in Appendix 5 to these Rules, which is maintained by calendar year, bound and numbered.
32. An application for planned volumes received after the deadline for their acceptance is not considered.
33. An application for the planned volumes is submitted to the republican commission by healthcare entities included in the database and seeking to provide HTMC.
34. Healthcare entities applying for placement of volumes of services within the GVFMC and (or) in the CSHI system, except for HTMC, submit an application for the planned volumes to the regional commission or to the commission under the administrator of budget programs at the location of the production base for the provision of services at the regional level for the services indicated in the corresponding announcement.
At the same time, healthcare entities that are under the jurisdiction of local executive bodies submit an application for the planned volumes to the regional commission or to the commission under the administrator of budget programs in the territory of local executive bodies, regardless of the location of the production base.
35. The commission shall place the volume of services within the framework of the GVFMC and (or) in the CSHI system among the healthcare entities included in the database based on the plan for the procurement of healthcare services.
Footnote. Paragraph 35 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective on 01.12.2023).36. For holding a session of the commission, the secretary of the commission shall notify the members of the commission in writing (electronically) on holding the session at least one calendar day prior to the date of the session of the commission.
Footnote. Paragraph 36 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall take effect on 01.12.2023).37. From the day after the day of receipt of the automatic notification of the opening of applications for planned volumes on the web portal (in the case of applications in paper form - from the day after the final deadline for their receipt), within ten working days, members of the commission shall verify for the conformity with the requirements for admission to the allocation of volumes, including the requirements for the organisation of medical care, established by the Code and other normative legal acts in the field of healthcare and for the presence of:
1) an application for the planned volumes (in paper form - in the form as per Appendix 3 hereto);
2) a certificate of state registration (re-registration) of a legal entity (for a legal entity) or a copy of a certificate of registration as an individual entrepreneur and a copy of an identity document (for an individual);
3) a licence for healthcare activities;
4) a licence to handle devices and installations generating ionising radiation (for types of healthcare for the delivery of which this licence is a mandatory document);
5) a licence to implement activities in the sphere of turnover of narcotic drugs, psychotropic substances and precursors (for types of healthcare, for the provision thereof this licence is a mandatory document);
6) a licence for pharmaceutical activities (for types of healthcare for the delivery thereof this licence is a mandatory document);
7) a copy of the PPP agreement, which is presented by the healthcare entity participating in the implementation of the project within the framework of public-private partnership (hereinafter - PPP);
8) a copy of the accreditation certificate, to be provided by the healthcare entity, if any;
9) a copy of the conclusion on the eligibility of the healthcare institution to provide HTMC, issued under order № KR DSM-238/2020, for the relevant technologies covered by the application for the planned volumes (provided by the healthcare entity applying for the provision of HTMC);
10) details of the volumes and amounts of healthcare services stated in the application for the planned volumes of medical care services within the framework of GVFMC and (or) in the CSHI in the appropriate form as per Appendix 4 hereto;
11) a copy of the authorisation document in the sphere of sanitary and epidemiological well-being of the population);
12) obligations not to render services on a paid basis for the types of healthcare (activities), covered by the service procurement agreements within the GVFMC and (or) in the CSHI system, excluding cases specified in the Rules of Rendering Paid Services, in an arbitrary form;
13) a list of production bases, where it is planned to deliver the claimed types of healthcare, in the form as per Appendix 4-1 hereto;
14) a copy of the property lease (rent) agreement for the building (if any);
15) a copy of the order for the acting head (in case of reallocation of the head);
16) an original of the power of attorney (when filing an application for planned volumes in paper form) or its electronic copy (when filing an application for planned volumes in electronic form) in case of signing and (or) submission of the application by the manager's attorney).
The members of the commission shall verify:
the data stated in the application for the planned volumes with the data stated in the attached documents, including conformity with the terms of the announcement;
on the internet resource of the designated authority exercising control over bankruptcy or liquidation procedures (www.kgd.gov.kz), details on non-involvement of the healthcare entity that filed the application in bankruptcy or liquidation procedures;
on conformity of the healthcare entity to the Standard for Provision of Medical Care in Hospital Reallocation Conditions in the Republic of Kazakhstan, approved by order of the Minister of Health of the Republic of Kazakhstan № 106 of June 7, 2023 (recorded in the Register of State Registration of Regulatory Legal Acts under № 32740) (hereinafter referred to as the hospital care replacing standard (HCRS)), when placing specialised medical care in inpatient reallocation conditions;
presence or absence of experience in rendering services based on data obtained from the information systems of the designated authority or fund (hereinafter referred to as Health IS);
the condition that the healthcare entity is the only healthcare entity rendering services for the claimed types of medical care, services and conditions of provision of medical service(s) as per the plan of procurement of medical services in the relevant administrative-territorial unit (village, settlement, district in the city, town, district, region);
inclusion of a healthcare entity in the list of healthcare entities for delivery of medical care in emergency and (or) urgent form (urgency) based on the decision of the healthcare office;
the presence of a court decision, which has entered into legal force, on suspension or termination of medical activity;
presence or absence of a healthcare entity in the decision of the healthcare office on determining the bed stock of healthcare entities, including the bed stock in terms of bed profiles in hospital and (or) hospital care replacing conditions within the framework of the GVFMC and (or) in the CSHI system.
While examining applications for planned volumes and the documents enclosed thereto, representatives of the healthcare office, who are members of the commission, present data on the process of changing the legal and (or) property status of healthcare entities under its authority.
The commission shall apply the data available in the Health Information System (HIS), or, where it is not available in the Health Information System (HIS), shall use data obtained by request from public authorities and organisations.
While examining applications for planned volumes, members of the commission may visit healthcare entities that have not previously entered into procurement contracts with the fund for types or conditions of medical care in respect of which an application for planned volumes has been filed, to verify the availability of production bases, medical personnel and medical equipment as per the data specified in the application for planned volumes, with notification of the healthcare entity not later than one calendar day prior to the day of the visit.
The notification shall be forwarded in one of the following ways:
electronically if the healthcare entity has an electronic document flow;
by registered mail with notification of delivery;
electronically in the personal cabinet on the web portal.
Following the results of the visit, the members of the commission shall form a report on the results of the visit to a healthcare entity claiming to render medical care services within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance in the form as per Appendix 5-1 hereto (hereinafter referred to as the report on the results of the visit to the healthcare entity).
The report shall be the ground for the commission members to make a decision on conformity (non-conformity) of the healthcare entity with the requirements for admission to the allocation of the volume of services and funds.
Footnote. Paragraph 37 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be effective on 01.12.2023).37-1. The members of the commission shall make one of the following decisions:
1) on conformity of the healthcare entity with the requirements for admission to volume allocation in case of:
meeting the conditions under paragraphs 26, 27, 28, 33 and 34 hereof;
filing an application for the planned volumes and the documents enclosed thereto as per the terms and conditions of the announcement;
determination of compliance of the documents filed by the healthcare entity and (or) data (information) contained therein with the data stated in the application or their authenticity;
conformity of the healthcare entity to the requirements for the organisation of medical care, established by the Code and other normative legal acts in the field of healthcare;
a favourable report based on the results of a visit to the healthcare entity;
absence of bankruptcy or liquidation proceedings at the healthcare entity;
availability of experience in rendering services as per the data received from the HIS;
provided that the healthcare entity is the only healthcare entity rendering services for the claimed types of medical care, services and conditions of delivery of medical service(s) pursuant to the plan of procurement of medical services in the relevant administrative-territorial unit (village, settlement, district in the city, town, district, region);
inclusion of the healthcare entity in the list of healthcare entities for the delivery of medical care in emergency and (or) urgent form (urgency) on the grounds of the decision of the healthcare office;
the presence of the healthcare entity in the decision of the healthcare office on determining the bed stock of healthcare entities, including the bed stock by bed profile in hospital and (or) hospital care replacing conditions within the framework of the GVFMC and (or) in the CSHI system.
2) on failure of the healthcare entity to meet the requirements for admission to volume allocation in case of:
non-fulfilment of the requirements pursuant to paragraphs 26, 27, 28, 33 and 34 hereof;
filing an application for the planned volumes and the documents enclosed thereto that do not correspond to the terms and conditions of the announcement;
determination that the documents filed by the healthcare entity and (or) the data (information) contained therein do not correspond to the data specified in the application, or are unreliable;
conducting bankruptcy or liquidation proceedings against the healthcare entity;
changing the legal and (or) property status of a healthcare entity, if the activity of the healthcare entity is terminated under the laws of the Republic of Kazakhstan;
failure of healthcare entities to conform to the requirements for organising the delivery of medical care set out in the Code and other regulatory legal acts in the field of healthcare;
if an official of the fund (or his or her close relatives, spouse or in-laws), who has the right to make a decision, is their founder, participant or shareholder;
if financial and economic activities of healthcare entities are suspended under the laws of the Republic of Kazakhstan;
if unreliable data and (or) information containing false information on the activities of a legal entity is presented;
non- conformity of the facility to the sanitary and epidemiological requirements for healthcare facilities as per order of the Minister of Health of the Republic of Kazakhstan № KR DSM-96/2020 of August 11, 2020 “On Approval of the Sanitary Rules “Sanitary and Epidemiological Requirements for Healthcare Facilities” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21080);
the presence of a court decision, which has entered into legal force, on suspension or termination of medical activity;
non-conformity of the healthcare entity with the HCR Standard for the allocation of specialised medical care in hospital care replacing conditions;
lack of free production capacity of healthcare entities, including bed capacity;
absence of a healthcare entity in the decision of the healthcare office to determine the bed fund of healthcare entities, including the bed fund in terms of bed profiles in hospital and (or) hospital replacing conditions within the framework of the GVFMC and (or) in the CSHI system;
based on the opinion following the results of the commission's visit.
In case of rejection of applications for planned volumes of healthcare entities, the minutes on the results of allocation (non-allocation) of volumes of services for the delivery of medical care within the framework of the GVFMC and (or) in the CSHI system shall include the grounds for rejection, a reference to a specific paragraph of a regulatory legal act in the field of healthcare (if there is a corresponding norm of a regulatory legal act in the field of healthcare).
Footnote. The Rules are supplemented by paragraph 37-1 under order of the Minister of Health of the Republic of Kazakhstan № KP DSM-8 of 29.01.2022 (shall become effective after the day of its first official publication); as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective on 01.12.2023).38. Based on the results of the commission’s consideration of applications for the planned volumes and the documents attached thereto for compliance with the requirements for admission to the placement of volumes within ten working days of the day following the last day of accepting applications for the planned volumes, a protocol is drawn up and signed on the compliance (non-compliance) of healthcare entities with the requirements for admission to the procedure for placing volumes of medical care services within the GVFMC and (or) in the CSHI system in accordance with the form in Appendix 6 to these Rules (hereinafter referred to as the compliance (non-compliance) protocol).
An extract from the specified protocol is sent to healthcare entities that do not meet the requirements for admission to the procedure for placing volumes of services within one working day of its signing.
When healthcare entities are selected for the placement of volumes of services within the GVFMC and (or) in the CSHI system via the web portal, healthcare entities are automatically notified of the posting of the compliance (non-compliance) protocol.
39. Healthcare entities that do not meet the requirements for admission to the procedure for placing volumes are given the opportunity to bring applications for the planned volumes and the documents attached thereto in accordance with the specified requirements within three working days of receipt of an extract from the protocol or notification of the posting of the compliance (non-compliance) protocol.
39-1. Following the results of the commission's repeated examination of applications for planned volumes and the documents enclosed thereto, filed under paragraph 39 hereof for meeting the requirements for admission to the allocation of volumes, the minutes of compliance (non-compliance) of healthcare entities with the requirements for admission to the procedure of allocation of the volume of services for the delivery of medical care within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance on the supplements presented to the rejected applications and (or) attached documents shall be drawn up and signed in the form as per Appendix 6-1 hereto.
At the same time, it shall be permitted to form the said minutes earlier than three working days, provided that applications for planned volumes and (or) documents enclosed thereto have been filed by all healthcare entities that have had an opportunity to bring them into compliance as per paragraph 39 hereof.
Healthcare entities that fail to comply with the requirements for admission to the procedure for allocation of the volume of services shall be notified with an extract from the said minutes not later than one working day from the date of its signing.
When healthcare entities are selected for allocation of service volumes within the framework of the GVFMC and (or) in the CSHI system via the web-portal, healthcare entities shall be automatically notified of the allocation of the compliance (non-compliance) minutes.
Footnote. The Rules are supplemented by paragraph 39-1 pursuant to order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be effective on 01.12.2023).40. Should the refiled application and (or) the documents enclosed thereto again fail to meet the requirements for admission to the volume allocation procedure, the application shall be rejected on the grounds mentioned in sub-paragraph 2) of paragraph 37-1 hereof.
The commission shall make a decision on allocation (non-allocation) of volumes of medical care services within the framework of the GVFMC for primary healthcare entities, with due regard to the requirements for admission to the procedure for allocation of volumes based on the plan for the procurement of medical services.
Footnote. Paragraph 40 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective on 01.12.2023).41. Within the current year, procedures for selection of healthcare entities hereunder shall be performed among the providers having concluded service procurement agreements for the current financial year, and (or) with the involvement of new healthcare entities from the database within the scope of the healthcare services procurement plan in the following cases:
1) availability of unplaced volume of services;
2) availability of released volumes of services;
3) changes in the health services procurement plan in the current financial year.
Footnote. Paragraph 41 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall come into effect ten calendar days after the date of its first official publication).42. The commission for the placement of volumes of services within the GVFMC and in the CSHI system considers applications of healthcare entities or providers for the planned volumes of services within the GVFMC and in the CSHI system, who are admitted to the procedure for placement of volumes of services, within ten working days of the day following by the day of the end of second accepting of documents.
43. When selecting healthcare entities to place volumes of services within the GVFMC and in the CSHI system, the commission uses the data available in information systems, as well as information obtained through a request from healthcare entities, providers, state bodies and organizations if they are not available in the open information systems.
The commission is not allowed to make inquiries related to supplementing the application for planned volumes with missing documents and (or) replacing documents.
44. In order to obtain a competent opinion on the decision of the commission when choosing healthcare entities to place the volume of services within the GVFMC and in the CSHI system, independent experts, specialized health professionals (hereinafter referred to as experts) are involved.
45. The expert opinion is drawn up in writing, signed by the expert and attached to the minutes of the meeting of the commission.
46. The expert opinion is considered by the commission when considering applications, placing the volume of services.
47. Accredited medical facilities have the preferential right to conclude contracts within the GVFMC and (or) in the CSHI system in accordance with paragraph 6 of Article 69 of the Code.
Healthcare entities that have the preferential right when purchasing medical care services in the CSHI system are those:
1) accredited in the field of healthcare in accordance with the Code;
2) with experience in providing appropriate medical care in the territory of the Republic of Kazakhstan continuously for three years preceding the month of the procurement of the services.
48. The commission shall allocate the volume of services and (or) the volume of funds within the framework of the GVFMC and (or) in the CSHI system among healthcare entities, with due account of the following:
1) Methodology of distribution of volumes of services and (or) funds to the healthcare entities for the delivery of medical care within the guaranteed volume of free medical care and (or) in the system of compulsory social insurance, elaborated under sub-paragraph 323-14) of paragraph 15 hereof on the Ministry of Health of the Republic of Kazakhstan, approved by Decree of the Government of the Republic of Kazakhstan №71 of February 17, 2017 “On Some Issues of the Ministries of Health and National Economy of the Republic of Kazakhstan” (hereinafter - the Regulation on the MH RK);-
2) pre-emptive right as per paragraph 47 hereof;
3) production capacity of healthcare entities, including the bed fund pursuant to the decision of the healthcare office on determining the bed fund of healthcare entities, including the bed fund in terms of bed profiles in hospital and (or) hospital replacing conditions within the framework of the GVFMC and (or) in the CSHI system in line with paragraph 11 of the Recording Rules;
4) experience of service delivery as measured by data from the health information system (HIS);
5) the results of monitoring of contractual obligations, including the quality and volume of medical services under the service procurement agreements under order № KR DSM-321/2020 of the Acting Minister of Healthcare of the Republic of Kazakhstan of December 24, 2020 “On Approval of the Rules for Monitoring the Fulfilment of the Conditions of the Agreement for the Purchase of Medical Services from Healthcare Entities within the Guaranteed Amount of Free Medical Care and (or) in the Compulsory Social Health Insurance System” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21904) (hereinafter referred to as the Monitoring Rules);
6) substantiated complaints from healthcare entities on the quality and accessibility of medical care as per the Monitoring Rules;
7) the results of the attachment campaign, given the changes in the number and sex and age composition of the attached population for the allocation period as per the final data presented by the digital healthcare entity (when distributing the volume of primary health care services);
8) availability of the PPP agreement;
9) inclusion of a healthcare entity in the list of healthcare entities to deliver medical care in emergency and (or) urgent form (urgency) on the grounds of a decision of the healthcare office;
10) rating evaluation of the activity of healthcare entities claiming to deliver medical care within the framework of the GVFMC and (or) in the CSHI system, calculated pursuant to the Methodology for the Calculation of Indicators and Rating Evaluation of the Activity of Healthcare Entities Claiming to Offer Medical Care within the Guaranteed Amount of Free Medical Care and (or) in the System of Compulsory Social Health Insurance, approved in line with sub-paragraph 323-15) of paragraph 15 of the Regulations on the Ministry of Health of the Republic of Kazakhstan.
The commission shall use a free-form service volume allocation table to allocate service volumes and/or fund volumes.
Footnote. Paragraph 48 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 dated 27.10.2023 (shall enter into force on 01.12.2023).49. The grounds for non-allocation by the commission of volumes of services to healthcare entities after the first stage procedures mentioned in paragraph 20 hereof shall be insufficiency of volumes of services and (or) volumes of funds under the plan of purchase of medical services to provide all declared volumes of services and (or) volumes of funds pursuant to submitted applications and (or) non-compliance of healthcare entities with the requirements to the organisation of medical care, established by the Code and other normative legal acts in the field of healthcare.
Footnote. Paragraph 49 – as reworded by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall come into effect on 01.12.2023).50. The commission makes a decision in the form of a protocol on the results of placement (not placement) of volumes of services for the provision of medical care within the GVFMC and (or) the CSHI system in accordance with the form in Appendix 7 to these Rules (hereinafter referred to as the protocol of placement of volumes of services).
51. At the request of a healthcare entity or its representative, on the basis of an appropriate power of attorney, the fund or the administrator of budget programs, within five working days of its signing, issues an extract from the protocol of placement of volumes of services and registers its issuance.
52. In case of selection of healthcare entities for allocation of service volumes, as well as in case of allocation of service volumes without the procedure of selection of healthcare entities within the framework of the plan for procurement of medical services in cases referred to in paragraph 19 hereof, the minutes of allocation of service volumes or minutes on the results of allocation without the selection procedure shall be automatically transferred to the HIS after signing via the web-portal for conclusion of service procurement agreements or addendums to the service procurement agreement.
The minutes of the allocation of the scope of services and the minutes on the results of the allocation without the selection procedure shall be published in general access on the web portal on the day of its signing by the commission.
Footnote. Paragraph 52 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective ten calendar days after the date of its first official publication).53. Service procurement agreements shall be concluded based on the minutes of allocation of the scope of services or minutes on the results of allocation without a selection procedure using the standard form approved by the fund or the administrator of budget programmes.
When a healthcare entity concludes an agreement for the procurement of services with the fund, it shall be deemed to have joined the agreement of accession to the procurement of services for the delivery of medical care within the framework of the GVFMC and (or) in the CSHI system approved by the fund (hereinafter referred to as the accession agreement).
The draft accession agreement shall be prepared by the fund and sent to the designated authority and Atameken NCE for submission of proposals, as well as posted on the internet resource of the fund for public discussion at least one month prior to its approval.
The said accession agreement shall be placed on the Internet resource of the fund or the administrator of budget programmes and (or) web-portal.
Amendments and (or) additions made to the accession agreement shall be published in the form of the full text of the agreement considering the amendments and (or) additions on the Internet resource of the fund or the administrator of budget programmes and (or) on the web portal not later than three working days prior to the entry into force of the amendments and (or) additions.
Footnote. Paragraph 53 - as reworded by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective ten calendar days after the date of its first official publication).54. By decision of the commission, agreements for the purchase of services under the GVFMC and (or) in the CSHI system shall be concluded:
1) for a period of one to three years with rural entities that are the only service providers in a given administrative-territorial unit, and with PHC entities;
2) for a period from three to five years:
with healthcare entities implemented within the framework of public-private partnership;
with healthcare entities for the delivery of certain types of diagnostic and treatment services using medical equipment purchased within the framework of public-private partnership.
The amounts of service purchase agreements are determined on an annual basis.
Footnote. Paragraph 54 as amended by order of the Minister of Health of the Republic of Kazakhstan № KR DSM-112 dated 11.10.2022 (shall be enacted ten calendar days after the date of its first official publication).55. Healthcare entities shall be selected for the coming year prior to the end of the current calendar year.
Footnote. Paragraph 55 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective ten calendar days after the date of its first official publication).56. Following the results of the procedure of selection and allocation of service volumes by the regional commission, within fifteen working days after signing the minutes of allocation of service volumes, a draft agreement for procurement of services (draft addendum to the existing service procurement agreement) shall be forwarded to the healthcare entity via the HIS with the use of EDS in case of procurement on the web-portal or sent by the fund or the administrator of budget programmes in paper form in case of procurement in paper format.
Upon the results of the procedure of selection of healthcare entities by the national commission, within ten working days after amending the plan for procurement of medical services based on the minutes, a draft service procurement agreement (draft addendum to the existing service procurement agreement) shall be directed to the healthcare entity via the HIS with the use of an EDS.
Within no more than three working days from the date of receipt of the said draft service procurement agreement (draft addendum to the existing service procurement agreement), the healthcare entity shall approve and sign it via the HIS with the use of EDS in case of procurement on the web portal or with submission of the signed service procurement agreement (addendum to the existing service procurement agreement) to the fund or budget programme administrator in case of paper procurement.
Footnote. Paragraph 56 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall take effect ten calendar days after the date of its first official publication).57. If the healthcare entity rejects the contract for the purchase of services within the period specified in paragraph 56 of these Rules, the healthcare entity is deemed to have evaded the conclusion of the contract for the purchase of services, and the volume of GVFMC and (or) in the CSHI system provided for under this contract refers to the unplaced volume.
58. The contract for the purchase of services is registered electronically automatically or in paper format.
59. Based on the concluded service procurement agreements, the Fund shall form a list of suppliers who have concluded service procurement agreements within the framework of the GVFMC and (or) in the CSHI system with the fund or service procurement agreements for additional support of the GVFMC with the administrator of budget programmes (hereinafter referred to as the list of suppliers) in the form pursuant to Appendix 7-1 hereto, which shall be placed and updated on the Fund's Internet resource not later than the tenth day of the month following the reporting month.
Footnote. Paragraph 59 - as reworded by order of the Minister of Health of the Republic of Kazakhstan № 157 dated 27.10.2023 (shall be put into effect ten calendar days after the day of its first official publication).60. Suppliers for the performance of part of the services under the contract for the purchase of services enter into co-performance agreements with co-executors included in the database, except for healthcare entities provided for in paragraph 63 of these Rules, which are not included in the database, regardless of the location of their production base or production base their representative office (branch).
Such a supplier’s choice of a co-executor from the database is considered to be coordinated with the fund or with the administrator of budget programs.
When choosing co-executors, the fund supplier is guided by the norms of these Rules.
61. Healthcare entities as co-executors shall ensure the delivery of services to patients within the framework of the GVFMC and (or) in the CSHI system in the exercise of their right to freely choose a medical organisation and a doctor, in case of indications and referral from a PHC physician or a specialised medical professional of the given healthcare entity, apart from cases when services are rendered without a referral from a physician and specialised medical professional under order № KR DSM-37, where services entered into medical information systems are the basis for the conclusion of a co-performance agreement.
If the PHC entity and the selected organisation rendering consultative and diagnostic care (hereinafter referred to as the CDC organisation) have not concluded a co-implementation agreement to engage it as a co-implementer, the referral from the PHC physician or profile specialist of the given PHC entity shall be the basis for the formation of an automated co-implementation agreement between the PHC entity and the CDC organisation included in the database as a co-implementer for the delivery of these services upon referral.
Footnote. Paragraph 61 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be put into effect ten calendar days after the date of its first official publication).62. Conclusion of a co-implementation agreement by a provider when rendering services within the framework of the GVFMC and (or) in the CSHI system shall not be made in cases of rendering services:
1) services by PHC experts as per the order of the Minister of Health of the Republic of Kazakhstan № KR DSM-90 of August 24, 2021 “On Approval of the Rules for Rendering Primary Health Care” (recorded in the Register of State Registration of Regulatory Legal Acts under № 24094);
2) HTMC, when the delivery of these services is the basis for allocation of volumes to the provider, excluding the delivery of certain types of consultative and diagnostic aid, which are not available in the Republic of Kazakhstan and are required for the provision of HTMC, including medical services in the examination of bone marrow donor and (or) haematopoietic stem cells during the selection and activation of bone marrow donor and (or) haematopoietic stem cells;
3) programme haemodialysis or peritoneal dialysis services, when rendering of these services is the basis for allocation of volumes to the provider;
4) specialised medical care in hospital and (or) hospital replacing conditions, when the delivery of such care is the basis for placing volumes to the supplier;
5) medical rehabilitation, when the delivery of this care is the basis for the allocation of volumes to the provider;
6) palliative care in hospital conditions;
7) dental care, when the delivery of this care is the basis for placing volumes to the provider.
When rendering the services envisaged by part one of this paragraph, at the provider's decision, the provider shall conclude a co-execution agreement with a co-executor for rendering certain types of consultative and diagnostic services, (including laboratory services) and therapeutic measures, which are not the basis for placing the scope of services to the provider.
The volume of funds for the delivery of consultative and diagnostic services (hereinafter referred to as CDS) in hospital replacing conditions (a complex of CDS per one attached resident) within the framework of the GVFMC and (or) in the CSHI system, allocated to PHC entities with a population of 30,000 (thirty thousand) or more under concluded service procurement agreements, may be transferred for co-implementation in an amount not exceeding the following:
at the district level - 60 per cent of the total amount of the procurement agreement for the provision of CDS (CDS complex per one attached resident).
at the city level - 50 % of the total amount of the procurement contract for the provision of CDS (CDS complex per one attached resident).
Footnote. Paragraph 62 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 dated 27.10.2023 (see paragraph 4 for the procedure of enactment).63. For the provision of certain types of services that are not provided in the Republic of Kazakhstan, the supplier engages foreign healthcare entities as co-executors.
Involvement of foreign healthcare entities as co-executors not included in the database is carried out in agreement with the fund or with the administrator of budget programs.
Approval is carried out within three working days and experts are involved by the decision of the fund or the administrator of budget programs.
64. The involvement of co-executors by the supplier does not relieve the supplier of obligations under the contract for the purchase of services and liability for its failure to perform, improper and untimely performance.
65. When changing or adding the norms of the current legislation of the Republic of Kazakhstan governing legal relations related to the procurement of services within the GVFMC and (or) in the CSHI system, the validity of the contract for the procurement of services is brought in line with these legal norms. In this case, the validity of the contract for the purchase of services is terminated or changed from the date of entry into force of such changes or additions unless otherwise established by the legislation of the Republic of Kazakhstan.
66. Execution of the contract for the purchase of services within the GVFMC and in the CSHI system includes the performance of contractual obligations:
1) by suppliers through the provision of services and compliance with the terms of the contract for the purchase of services;
2) a fund or an administrator of budget programs by paying for services to healthcare entities.
67. Services provided within the GVFMC are paid for by the fund and (or) administrators of budget programs.
Services provided as medical care in the CSHI system are paid for by the fund.
68. Excluded by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall enter into force ten calendar days after the date of its first official publication).69. Excluded by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be put into effect upon expiry of ten calendar days after the date of its first official publication).
Appendix 1 to the Rules for procuring services from healthcare entities for the provision of medical care within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance |
Data on close relatives, spouse and in-laws of the candidate for inclusion in the commission for selection
of healthcare entities and allocation of volumes of services within the guaranteed volume of free medical care
and (or) in the compulsory social health insurance system
Footnote. Appendix 1 - as reworded by order of the Minister of Health of the Republic of Kazakhstan № KR DSM-8 of 29.01.2022 (shall be enforced upon the day of its first official publication).
________________________________________________________________________
(the full name of the commission is specified)
________________________________________________________________________
(Full name of the candidate of the commission, IIN)
№ |
Full name | Kinship to a candidate to the commission | ID card № | IIN | Details of affiliated persons (those who directly and (or) indirectly make decisions and (or) influence decisions made by each other (one of the persons), including by virtue of the concluded agreement for the purchase of medical services within the framework of the GVFMC and (or) in the CSHI system) with specification of their current place of work |
1 | 2 | 3 | 4 | 5 | 6 |
I hereby confirm the accuracy of the above data presented by me and I understand that the provision of unreliable information may serve as grounds for refusal to include my candidacy in the commission for the selection of healthcare entities and allocation of the volume of services within the guaranteed volume of free medical care and in the system of compulsory social health insurance of the Social Health Insurance Fund NJSC.
I hereby give my consent to the verification of the accuracy of the information provided by me, as well as to the collection, processing and storage of my personal data when I am included in the commission for the selection of healthcare entities and allocation of the volume of services within the guaranteed volume of free medical care and in the compulsory social health insurance system of the Social Health Insurance Fund NJSC.
________________ "___" ________ 20__ (surname, name, patronymic (if any) of the candidate) (signature)
Note:
* Under the Law of the Republic of Kazakhstan "On Combating Corruption", close relatives shall mean parents (parent), children, adoptive parents (adoptive parents), adopted children, full and half brothers and sisters, grandparents, grandchildren; in-laws shall mean brothers, sisters, parents and children of a spouse).
Appendix 1-1 to the Rules for Procuring Services from Healthcare Entities for the Provision of Medical Care within the Guaranteed Volume of Free Medical Care and (or) in the System of Compulsory Social Health Insurance |
Document form
Minutes on the results of allocation (reduction) of the volume of services and (or) the volume
of funds for the delivery of medical care within the guaranteed volume of free medical care and (or)
in the system of compulsory social health insurance without the procedure for selecting healthcare entities
Footnote. The Rules are supplemented by paragraph 1-1 as per order of the Minister of Health of the Republic of Kazakhstan № KR DSM-8 dated 29.01.2022 (shall enter into force after the day of its first official publication).
___________________ | "__" _________ 20__ |
The branch of the Social Health Insurance Fund NJSC for ______________________________________________________
(specify the name of the region)
represented by
_____________________________________________________________________
(name, surname, first name, patronymic (if any) and position of the fund representative)
calculated volumes of medical services and (or) volumes of funds:
1) to the allocation of volumes of services and (or) volumes of funds for the delivery of medical care within the guaranteed volume of free medical care (hereinafter - GVFMC) and (or) in the system of compulsory social health insurance (hereinafter - CSHI) without the procedure of selection of healthcare entities as per paragraph 19 of the Rules for Procuring Services from Healthcare Entities for the Delivery of Medical Care within the Guaranteed Volume of Free Medical Care (hereinafter - GVFMC) and (or) in the system of compulsory social health insurance (hereinafter - CSHI), approved by order of the Minister of Health of the Republic of Kazakhstan № KR DSM-242/2020 of December 8, 2020 “On Approval of the Rules for Procuring Services from Healthcare Entities for the Provision of Medical Care within the Guaranteed Volume of Free Medical Care and (or) in the System of Mandatory Social Health Insurance” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21744) (hereinafter referred to as the Procuring Rules):
_____________________________________________________________________
(specify the grounds under the Procuring Rules) for the following type(s)
of medical care:_____________________________________________________________________
(specify the name of the type of medical care)
_____________________________________________________________________,
(specify: as part of the GVFMC or the CSHI system)
for the amount of KZT: ________________________________________________________,
(sum in figures and words)
as per the calculation of the volume of services and (or) the volume of funds for allocation:
№ | BIN (IIN) | Name of the healthcare entity | Legal address of the healthcare entity | Place of service provision (specify region, city of national importance, capital) | Amount (KZT) | Volumes of medical services |
1 | 2 | 3 | 4 | 5 | 6 | 7 |
2) to a reduction in the volume of services and (or) the volume of funds for the delivery of medical care within the framework of the GVFMC or in the CSHI system system as per the Procuring Rules:
_____________________________________________________________________,
(specify the grounds as per the Procuring Rules)
for the following type(s) of medical care:______________________________________
(specify the name of the type of medical care)
_____________________________________________________________________,
(specify: within the framework of the GVFMC or in the CSHI system)
for the amount of KZT: ________________________________________________________,
(amount in figures and words)
as per the calculation of the volume of services and (or) the volume of funds to be reduced:
№ | BIN (IIN)) | Name of the healthcare entity | Legal address of the healthcare entity | Place of service provision (specify region, city of national importance, capital) | Amount (KZT) | Volumes of medical services |
1 | 2 | 3 | 4 | 5 | 6 | 7 |
_____________________________________________________, ________________
(surname, first name, patronymic (if any)
and position of the representative of the Social Health Insurance Fund NJSC, signature)
Minutes on the results of the campaign of attaching the population to healthcare entities rendering primary medical and sanitary care № _________
Footnote. The Rules are supplemented by paragraph 1-2 in compliance with order of the Minister of Health of the Republic of Kazakhstan № KR DSM-8 dated 29.01.2022 (shall come into effect after the day of its first official publication); as reworded by order of the Minister of Health of the Republic of Kazakhstan № 157 dated 27.10.2023 (shall come into effect upon expiry of ten calendar days after the day of its first official publication).
________________ | "___" _________ 20__ |
1. Commission for the selection of healthcare entities and allocation of the volume of services
(hereinafter referred to as the Commission) with its members:__________________________________________________________________
(surname, first name, patronymic (if any) and position of the chairperson and other members of the commission)
examined the results of the campaign of attachment to healthcare entities rendering primary medical and sanitary assistance (hereinafter - PHC entities), held in compliance with the Rules for Attaching Individuals to Healthcare Institutions Rendering Primary Health Care, approved by order of the Minister of Health of the Republic of Kazakhstan № KR DSM-194/2020 of November 13, 2020 (recorded in the Register of State Registration of Regulatory Legal Acts under № 21642) (hereinafter referred to as the attachment campaign) presented by the digital healthcare entity.
2. By considering the results of the attachment campaign as of _____________
by open ballot, the Commission hereby RESOLVED:
(specify the date)
that the following list of PHC entities included in the database of healthcare entities applying for medical care shall be determined within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance (hereinafter referred to as the database), admitted to the procedure of selection of healthcare entities:
s/o № | BIN (IIN) | Name of the PHC entity | Legal address | Number of attached population registered in the portal Register of Attached Population |
1 | 2 | 3 | 4 | 5 |
3. Based on the results of the examination of the results of the attachment campaign by open voting, the Commission RESOLVED:
that the following list of PHC entities included in the database, which are not eligible for the selection procedure of healthcare entities, shall be established:
s/o № | BIN (IIN) | Name of the PHC entity | Legal address | Number of attached population registered in the portal Register of Attached Population | Specify the reasons |
1 | 2 | 3 | 4 | 5 | 6 |
4. Republican Centre for e-Health RSE on PHC of the Ministry of Digital Development, Innovation and Aerospace Industry of the Republic of Kazakhstan for PHC entities, which are not eligible for the procedure of selection of healthcare entities, to remove the “PHC” sign in the information system Register of Attached Population.
The following voted in favour of this resolution:
In favour ______________ votes;
Against _________ votes.
Details of the signing of the minutes on the results of the population attachment campaign with PHC entities by the commission members and the secretary of the commission:
Surname, first name, patronymic (if any) of a commission member, commission secretary | Place of employment | Position of the commission member | Signature | Date of signature |
1 | 2 | 3 | 4 | 5 |
Signed / Absent | ||||
QR-code
Appendix 2 to the Rules for procuring services from healthcare entities for the provision of medical care within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance |
|
Form |
Announcement of the procedure for placing the volume of services for the provision
of medical care within the guaranteed volume of free medical care and (or) in the system
of compulsory social health insurance among healthcare entities included in the database
of healthcare entities seeking to provide medical care within the GVFMC and (or) )
in the CSHI system within the guaranteed volume of free medical care and
in the compulsory social health insurance system
____________________________________________________________________________
____________________________________________________________________________
(indicate the name of the fund (branch) or the administrator of budget programs)
announces the procedure for placing the volumes of medical services in accordance with
____________________________________________________________________________
(indicate the paragraph (subparagraph) and the legal act)
______________________________________________________________________________
(indicate only the required: within the guaranteed volume of free medical care and (or) in the
system of compulsory social health insurance) by type (s)/conditions for the provision of medical
care/service:
______________________________________________________________________________
for the year 20__ among healthcare entities with whom contracts for the purchase of medical
services have been concluded within the guaranteed volume of free medical care and (or) in the
system of compulsory social health insurance or contracts for the purchase of services for additional
provision of the guaranteed volume of free medical care for the current financial year, and (or)
with the involvement of new healthcare entities included in the database (specify the required option)
The specified types/conditions for the provision of medical care/services (hereinafter - medical services)
are provided in the territory
_______________________________________________________________________________
(indicate the name of a region, a city of republican significance or the capital/district of a region)
at the production base (s) specified in the annex (es) to the license for medical activities.
Applications for the planned volumes of the specified medical services (hereinafter referred to as
applications) are submitted by healthcare entities included in the database of healthcare entities
seeking to provide medical care within the guaranteed volume of free medical care and in the system
of compulsory social health insurance in
_______________________________________________________________________________
(indicate the required: name of the fund/ branch of the fund or the administrator of budget programs)
at the address: ___________________________ room № _________________ (if any).
(indicate the address)
Start date of accepting applications is “__” ______ 20__ __ hrs __ min.
The deadline for submitting the applications for participation and the documents attached thereto
is until _______ hrs of “___” ____________20__ .
Additional information and reference can be obtained by phone (s)
___________________________________________.
(area code and phone number (s)
Note*
Note:
* to be indicated if necessary.
Appendix 3 to the Rules for procuring services from healthcare entities for the provision of medical care within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance |
|
Form |
Application for the planned volume of medical services within the guaranteed volume
of free medical care and (or) in the system of compulsory social health insurance
At __________________________________________________________________________
(the name and location of the fund/branch of the fund or the administrator of budget programs)
__________________________________________________________________________
(name of the healthcare entity)
submits an application for the provision of services
_________________________________________________________________________
(indicate the required:
within the guaranteed volume of free medical care;
in the system of compulsory social health insurance for the following types/conditions for the
provision of medical care *:
_________________________________________________________________________
(indicate the type (s) of medical care/conditions for the provision of medical care/services,
for the provision of which (s) the healthcare entity seeks).
With this application, the healthcare entity agrees to receive information thereon
confirming compliance with the norms and requirements established by regulatory
legal acts in the field of healthcare.
With this application, the healthcare entity confirms:
the reliability of the information provided;
compliance of the license for medical activities;
availability of human resources that meet the requirements of regulatory legal acts in
the field of healthcare required to fulfill the declared volumes of medical services;
availability of medical equipment necessary to perform the declared volumes of medical services;
familiarization with the terms of the announcement.
This application will be valid for the period required by the announcement.
the following documents are attached to this application:
1. ____________________________________ (___________________________sheets)
(indicate the name of documents) (indicate the number of sheets)
2. _____________________________________ (___________________________sheets)
______________________________________________________________/__________
(position, surname, name, patronymic (if any) of the head of the healthcare entity
or a person authorized by him/her, signature)
Stamp (if any) here
Filled out on ______________
Note:
* indicated according to the announcement of the procedure for placing the volume of services
within the guaranteed volume of free medical care and (or) in the system of compulsory social
health insurance among healthcare entities included in the database of healthcare entities applying
for medical care within the guaranteed volume of free medical care and in the system of
compulsory social health insurance.
Appendix 4 to the Rules for procuring services from healthcare entities for the provision of medical care within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance |
Data on the volumes and amounts for the delivery of medical assistance specified in the application
for the planned volumes of services for rendering medical assistance within the guaranteed volume
of free medical assistance and (or) in the system of compulsory social health insurance Data on volumes and amounts of primary medical and sanitary care for the attached population
Footnote. Appendix 4 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be enacted upon expiration of ten calendar days after the date of its first official publication).
Volumes included in the comprehensive per capita standard
№ | Type of medical care | Volume for the previous period * | Volumes claimed* | ||
20___ | 20___ | 20___ | 20___ | ||
Number of attached population | Number of attached population | Number of attached population | Number of attached population | ||
1 | 2 | 3 | 4 | 5 | 6 |
Expenditures, on actual costs of rendering medical care per population size **
№ | Type of medical care | Amount for the previous period, KZT * | Volumes claimed, KZT* | ||
20___ | 20___ | 20___ | 20___ | ||
1 | 2 | 3 | 4 | 5 | 6 |
Target groups of people from rural populations for screening tests***
№ | Type of medical care | Volume for the previous period* | Volumes claimed* | ||||||
20___ | 20___ | 20___ | 20___ | ||||||
Number of population eligible for screening tests | Number of services | Number of population eligible for screening tests | Number of services | Number of population eligible for screening tests | Number of services | Number of population eligible for screening tests | Number of services | ||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Total |
Expenses, on actual costs for special labour conditions ****
№ | Type of medical care | Amount for the previous period, KZT* | Volumes claimed, KZT* | ||
20___ | 20___ | 20___ | 20___ | ||
1 | 2 | 3 | 4 | 5 | 6 |
Annex to this information on __________ sheets *****
______________________________________________________________________,
(position, surname, name, patronymic (if any) of the head of the healthcare entity
or person authorised by him/her, signature)
Stamp here (if any)
Date of completion ______________
Note:
* to be filled in when applying for planned volumes for the coming year and when participating for the first time in the procurement of services from healthcare entities;
** to be filled in when providing specialised therapeutic low-protein and low-phenylalanine foods;
*** to be filled in in case of submission for preventive examinations of village residents;
**** to be filled in if there are drivers of ambulance stations;
***** a calculation of the amount claimed as per the annex to this information in free form, indicating:
the claimed number of the attached population;
tariffs for medical services provided within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance, approved under order of the Acting Minister of Health of the Republic of Kazakhstan № KR DSM-170/2020 of October 30, 2020 “On Approval of Tariffs for Medical Services Rendered within the Guaranteed Volume of Free Medical Care and in the System of Compulsory Social Health Insurance” (recorded in the Register of State Registration of Regulatory Legal Acts under № 21550) (hereinafter - tariffs); the amount claimed; the total amount.
Data on volumes and amounts for the delivery of specialised medical care in hospital replacing conditions
№ | Type of medical care | Volume for the previous period* | Volumes claimed* | ||
20___ | 20___ | 20___ | 20___ | ||
Number of services | Number of services | Number of services | Number of services | ||
1 | 2 | 3 | 4 | 5 | 6 |
Delivery of medical care in secondary education institutions **
№ | BIN of a secondary education institution | Name of a secondary education institution | Address of the production base *** | Order of the local public health authority of the region | Claimed number of schoolchildren |
1 | 2 | 3 | 4 | 5 | 6 |
Target groups of people to be screened by tests****
№ | Type of medical care | Volume for the previous period* | Volumes claimed* | ||||||
20___ | 20___ | 20___ | 20___ | ||||||
Number of population liable to screening tests | Number of services | Number of population liable to screening tests | Number of services | Number of population liable to screening tests | Number of services | Number of population liable to screening tests | Number of services | ||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Total |
Data on the availability of medical equipment - computer tomographs, magnetic resonance tomographs (if available) *****
№ | Serial number | Name of medical equipment (computer tomograph, magnetic resonance tomograph) | Maximum number of services per day as per the technical specification of the medical equipment |
1 | 2 | 3 | 4 |
Total | Х |
Data on availability of dental unit, including dentist's unit, dental chair, dental hydroblock, with hoover and saliva ejector, dental operating light (if available) *****
№ | Serial number | Name of medical equipment (dental unit) | Maximum number of services per day based on the technical specification of the medical equipment |
1 | 2 | 3 | 4 |
Total | Х |
Details of the availability of a mobile medical unit (if any) *****
№ | Serial number | Road transport |
1 | 2 | 3 |
Total | Х |
Details of the planned provision of medical assistance to the rural population based on a mobile medical complex on the territory of the Republic of Kazakhstan *****
№ | Name of the region | Location code of the district according to CATO (Classifier of Administrative-Territorial Objects) |
1 | 2 | 3 |
Total | Х |
Details of the number of working days per year, based on the production calendar: ___________ days.*****
Annex to this information on __________sheets.******
_____________________________________________________,________________
(position, surname, name, patronymic (if any) of the head of the healthcare entity or his/her authorised person, signature)
Stamp here (if any)
Date of completion ______________
Note:
* to be filled in when applying for planned volumes for the coming year and when participating in the procurement of services from healthcare entities for the first time;
** to be filled in if there is an assigned secondary education institution;
*** in small schools with up to 50 schoolchildren, medical care for students is delivered by a primary health care provider serving the territory where the school is located;
**** to be filled in by PHC entities in relation to the target groups of persons subject to screening tests from among the attached population;
***** to be is filled in if needed;
****** a free-form calculation of the amount claimed is enclosed as per the annex to this information, broken down by services, specifying:
name of services;
cost of services as per tariffs (average cost);
amount of services;
total amount of services.
Data on volumes and amounts for the provision of high-tech medical services
№ | HTMS code* | HTMS name | Volume for the previous period** | Volumes claimed** | ||
20___ | 20___ | 20___ | 20___ | |||
Number | Number | Number | Number | |||
1 | 2 | 3 | 4 | 5 | 6 | 7 |
Annex to this information on ______________ sheets. ***
__________________________________________________, _________________
(position, surname, name, patronymic (if any) of the head of the healthcare entity or his/her authorised person, signature)
Stamp here (if any)
Date of completion ______________
Note:
* HTMS – high-tech medical services;
** to be filled in when applying for the planned volumes for the coming year and when participating in the procurement of services from healthcare entities for the first time;
*** the calculation of the claimed amount is enclosed as per the annex to this information in any form by services, indicating:
name of HTMS;
cost of services according to tariffs;
the amount of HTMS;
total amount of HTMS.
Information on volumes and amounts for provision of programme haemodialysis services
№ | Type of medical care | Volume for the previous period* | Volumes claimed* | ||||||
20___ | 20___ | 20___ | 20___ | ||||||
Number of cases | Number of treatment sessions | Number of cases | Number of treatment sessions | Number of cases | Number of treatment sessions | Number of cases | Number of treatment sessions | ||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Total |
Data on the number of dialysis machines
№ | Serial number | Name of dialysis machine | Number of services per shift | Number of shifts per day |
1 | 2 | 3 | 4 | 5 |
Total | Х |
Information on the number of working days per year based on the production calendar ___________ days.
Annex to this information on ______________ sheets. **
__________________________________________________________________,
(position, surname, name, patronymic (if any) of the head of the healthcare entity or his/her authorised person, signature)
Stamp here (if any)
Date of completion ______________
Note:
* to be filled in when applying for the planned volumes for the coming year and when participating for the first time in the procurement of services from healthcare entities;
** the calculation of the claimed amount is enclosed as per the annex to this information in free form, specifying:
number of patients;
number of treatment sessions;
cost of services according to tariffs;
the amount claimed;
total amount.
Data on volumes and amounts for the delivery of peritoneal haemodialysis services
№ | Type of medical care | Volume and amount for the previous period* | Volumes and amounts claimed* | ||||||
20___ | 20___ | 20___ | 20___ | ||||||
Number of cases | Amount, KZT | Number of cases | Amount, KZT | Number of cases | Amount, KZT | Number of cases | Amount, KZT | ||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Annex to this information on ______________ sheets. **
__________________________________________________________________,
(position, surname, name, patronymic (if any) of the head of the healthcare entity or his/her authorised person, signature)
Stamp here (if any)
Date of completion ______________
Note:
* to be filled in when applying for the planned volumes for the coming year and when participating for the first time in the procurement of services from healthcare entities;
** the calculation of the claimed amount is enclosed as per the annex to this information in free form, specifying:
number of patients;
number of treatment sessions;
cost of services as per tariffs;
the amount claimed;
total amount.
Data on volumes and amounts for the delivery of specialised medical care in hospital and (or) hospital replacing conditions*
№ | Type of medical care | Volume for the previous period** | Volumes claimed** | |||
20___ | 20___ | 20___ | 20___ | |||
Number of cases treated (bed days) | Number of cases treated (bed days) | Number of cases treated (bed days) | Number of cases treated (bed days) | Number of beds or bed places** | ||
1 | 2 | 3 | 4 | 5 | 6 | 7 |
Details on the number of working days per year, taking into account the production calendar of day care centre ___________ days.
Information on the number of day care centre shifts per day:_____ shift(s).
Annex to this information on ______________ sheets. **
__________________________________________________________________,
(position, surname, name, patronymic (if any) of the head of the healthcare entity or his/her authorised person, signature)
Stamp here (if any)
Date of completion ______________
Note:
* to be filled in in case of applying for specialised medical care paid at the rate per treated case by clinical-cost groups, by estimated average cost, by bed-days, by medical-economic tariffs; by actual costs;
** to be filled in when applying for planned volumes for the coming year and when participating for the first time in the procurement of services from healthcare entities rendering specialised medical care under hospital replacing conditions;
*** a calculation of the amount claimed is enclosed as per the free-form annex to this information, specifying:
number of cases (bed days);
cost of services according to tariffs (average cost);
the amount claimed;
total amount.
Data on volumes and amounts of emergency medical care or medical care related to the transportation of medical professionals and (or) the patient by sanitary transport
№ | Type of medical care | Volume for the previous period* | Volumes claimed* | ||
20___ | 20___ | 20___ | 20___ | ||
Number of attached population | Number of attached population | Number of attached population | Number of attached population | ||
1 | 2 | 3 | 4 | 5 | 6 |
Expenses, on actual costs for special labour conditions **
№ | Type of medical care | Amount for the previous period, KZT * | Amounts claimed, KZT * | ||
20___ | 20___ | 20___ | 20___ | ||
1 | 2 | 3 | 4 | 5 | 6 |
Annex to this information on ______________ sheets. **
__________________________________________________________________,
(position, surname, name, patronymic (if any) of the head of the healthcare entity or his/her authorised person, signature)
Stamp here (if any)
Date of completion ______________
Note:
* to be filled in when applying for planned volumes for the coming year and when participating in procurement of services from healthcare entities for the first time;
** to be filled in if there are ambulance station drivers;
*** a calculation of the declared amount for the provision of emergency medical care or medical care related to the transportation of qualified specialists and (or) a patient by ambulance transport is enclosed as per the annex to this information in free form, indicating:
the declared number of the attached population;
the cost according to tariffs (average cost);
the amount claimed;
total amount.
Data on claimed volumes and amounts for the delivery of medical care paid under the integrated tariff*
№ | Type of medical care | Volumes for the previous period ** | Volumes claimed** | ||||||
20___ | 20___ | 20___ | 20___ | ||||||
Number of registered patients | Amount, KZT |
Number of registered patients | Amount, KZT |
Number of registered patients | Amount, KZT |
Number of registered patients | Amount, KZT | ||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Expenditure on actual costs of rendering medical care per number of registered patients ****
№ | Type of medical care | Amount for the previous period, KZT * | Amounts claimed, KZT * | ||
20___ | 20___ | 20___ | 20___ | ||
1 | 2 | 3 | 4 | 5 | 6 |
Specialised inpatient medical care for patients with socially significant diseases at tertiary level *****
№ | Type of medical care | Volume and amount for the previous period ** | Claimed volumes and amount ** | ||||||
20___ | 20___ | 20___ | 20___ | ||||||
Number of cases (bed days, services) | Amount, KZT | Number of cases (bed days, services) | Amount, KZT | Number of cases (bed days, services) | Amount, KZT | Number of cases (bed days, services) | Amount, KZT | ||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Annex to this information on ______________ sheets. **
__________________________________________________________________,
(position, surname, name, patronymic (if any) of the head of the healthcare entity or his/her authorised person, signature)
Stamp here (if any)
Date of completion ______________
Note:
* to be filled in in case of applying for medical care rendered to patients with tuberculosis, HIV-infected and (or) patients with acquired immunodeficiency syndrome, persons with mental, behavioural disorders (diseases) related to the use of psychoactive substances;
** to be filled in when applying for planned volumes for the coming year and when participating in the procurement of services from healthcare providers for the first time;
*** to be filled in by healthcare providers working in the field of HIV prevention, established in cities of national importance and the capital and at the oblast level;
**** to be filled in in case of application for TB medicines or antiretroviral medicines;
***** to be filled in in case of applying for medical care at the tertiary level;
****** the calculation of the claimed amount for the provision of medical care paid at the integrated tariff is enclosed as per the annex to this information in arbitrary form, specifying:
the claimed number of registered patients;
the cost as per tariffs (average cost);
the amount claimed;
total amount.
Data on the volumes and amounts claimed for oncological medical care*
Specialised medical care in hospital and hospital replacing conditions for patients with neoplasms, excluding malignant neoplasms of lymphoid and hematopoietic tissues, and in outpatient conditions for the diagnosis of neoplasms and dynamic follow-up of cancer patients at the secondary level
№ | Type of medical care | Volume for the previous period** | Volumes claimed** | ||||||
20___ | 20___ | 20___ | 20___ | ||||||
Number of registered patients | Number of cases (services) | Number of registered patients | Number of cases (services) | Number of registered patients | Number of cases (services) | Number of registered patients | Number of cases (services) | ||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Data on availability of medical equipment - positron emission tomography (if any)
№ | Serial number | Name of medical equipment (positron emission tomography) | Maximum number of services per day based on the technical specification of the medical equipment |
1 | 2 | 3 | 4 |
Total |
Expenditure on recharge and maintenance services for ionising radiation at actual costs ***
№ | Type of medical care | Amount for the previous period, KZT | Amount claimed, KZT ** | ||
20___ | 20___ | 20___ | 20___ | ||
1 | 2 | 3 | 4 | 5 | 6 |
Specialised medical care in hospital and hospital replacing conditions for patients with neoplasms, excluding malignant neoplasms of lymphoid and hematopoietic tissues, and in outpatient conditions for the diagnosis of neoplasms and dynamic monitoring of oncological patients at the tertiary level
№ | Type of medical care | Volume for the previous period** | Claimed volumes and amount ** | ||||||
20___ | 20___ | 20___ | 20___ | ||||||
Number of cases (services) | Amount, KZT | Number of cases (services) | Amount, KZT | Number of cases (services) | Amount, KZT | Number of cases (services) | Amount, KZT | ||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Annex to this information on ______________ sheets. **
__________________________________________________________________,
(position, surname, name, patronymic (if any) of the head of the healthcare entity or his/her authorised person, signature)
Stamp here (if any)
Date of completion ______________
Note:
* to be filled in when applying for medical care rendered to oncological patients;
** to be filled in when applying for planned volumes for the coming year and when participating in the procurement of services from healthcare entities for the first time;
*** to be filled in by coordinators of oncological care in the regions in case of application for rendering services on reallocation of ionising radiation sources;
**** a calculation of the amount claimed for the delivery of medical care paid at the integrated tariff is enclosed as per the annex to this information in any form, stating:
the claimed number of registered patients;
cost according to tariffs (average cost);
the amount claimed;
total amount.
Details of the volumes and amounts claimed for services rendered by the blood service
№ | Type of medical care | Volume and amount for the previous period * | Claimed volumes and amount * | ||||||
20___ | 20___ | 20___ | 20___ | ||||||
Number of services | Amount, KZT | Number of services | Amount, KZT | Number of services | Amount, KZT | Number of services | Amount, KZT | ||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 |
Annex to this information on ______________ sheets. **
__________________________________________________________________,
(position, surname, name, patronymic (if any) of the head of the healthcare entity or his/her authorised person, signature)
Stamp here (if any)
Date of completion ______________
Note:
* to be filled in when applying for planned volumes for the coming year and when participating for the first time in the procurement of services from healthcare entities;
** a calculation of the amount claimed for the provision of services rendered by the blood service is enclosed as per the annex to this information in free form, indicating:
claimed quantity of services;
cost according to tariffs (average cost);
the amount claimed;
total amount.
List of production bases where it is planned to render the claimed types of medical care
Footnote. The Rules are supplemented by Appendix 4-1 in line with order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall enter into force from 01.12.2023).
№ s/o | Location code by CATO (classifier of administrative-territorial objects) | Address of the location of the production base(s) |
1 | 2 | 3 |
Appendix 5 to the Rules for procuring services from healthcare entities for the provision of medical care within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance |
|
Form |
Log of applications for the planned volumes of services for the provision of medical care within
the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance*
Item № | Date, time (hrs, min) | BIN/IIN | Name of a healthcare entity | Number of sheets of the application and documents attached thereto | Surname, name, patronymic (if any) of the head or the authorized person of the healthcare entity | № of the power of attorney and its validity (if any) ** | № of the identity document of the authorized person of the healthcare entity, issued by …, the date of issue (if any) | Signature of the head or authorized representative of the healthcare entity | Signature of the commission’s secretary | Note |
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 |
Note:
* when submitting an application by mail, columns 1 to 6 are filled in, the number and date of registration of the postal item with the application in the office are registered in the note
** the power of attorney is valid if there is an identity document of the authorized person.
Appendix 5-1 to the Rules for Procuring Services from Healthcare Entities for the Provision of Medical Care within the Guaranteed Volume of Free Medical Care and (or) in the System of Compulsory Social Health Insurance |
Opinion on the results of a visit to a healthcare entity claiming to render medical care within the guaranteed
scope of free medical care and (or) in the system of compulsory social health insurance* (delete as appropriate)
Footnote. Rules are supplemented by Appendix 5-1 pursuant to order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall be effective since 01.12.2023).
___________________ | "___" ______________ _______ |
1. Commission for the selection of healthcare entities and allocation of the volume of services
(hereinafter referred to as the Commission) with its members:
_____________________________________________________________________
(Surname, first name, patronymic (if any) and position of the commission members who visited the healthcare entity)
within the framework of examining the application for planned volumes of medical services within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance (hereinafter referred to as the application for planned volumes) when conducting the procedure for selecting healthcare entities to place volumes of services for the provision of
_______________________________________________________________________
(types/forms or conditions of rendering) services (lot) as per the application for planned volumes)
as per the announcement _____________________________ (the number of the announcement shall be specified)
visited the production facility(ies) ________________________________
(insert name of healthcare entity) at the address:
_____________________________________________________________________
(the address of the production base(s) shall be specified)
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
_____________________________________________________________________
Based on the results of the visit, the Commission hereby RESOLVED:
№ s/o | Name of the healthcare entity | The following voted in favour of this resolution | Resolution | ||||||
BIN/IIN | In favour, votes | Against, votes | Confirms (does not confirm) the availability of production bases, medical staff and medical equipment as per the data specified in the application for planned volumes | ||||||
1 | 2 | 3 | 4 | 5 | 6 | ||||
Surname, first name, patronymic (if any) of the commission member | Place of employment | Position of the commission member | Signature | Date of signing | |||||
1 | 2 | 3 | 4 | 5 | |||||
Note:
* The Commission shall verify the availability of production bases, medical personnel and medical equipment as per the data specified in the application for planned volumes.
Minutes of conformity (non-conformity) of healthcare entities to the requirements for admission
to the procedure of allocation of the volume of services for the delivery of medical care within
the guaranteed volume of free medical care and (or) in the system of compulsory
social health insurance №_____
Footnote. Appendix 6 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective ten calendar days after the date of its first official publication).
___________________ | "__" _________ 20__ |
1. Commission for the selection of healthcare entities and allocation of the volume of services among healthcare entities (hereinafter referred to as the Commission) with its members:
____________________________________________________________________
(Surname, first name, patronymic (if any) and position of the chairman and other members of the commission) examined the application for the planned volumes of medical services within the framework of the GVFMC and (or) in the CSHI system (hereinafter referred to as the application) of the following healthcare entity(ies):
№ s/o | BIN/IIN | Name of the healthcare entity |
1 | 2 | 3 |
2. The application(s) have been examined and contain(s) the following documents that are not in conformity with the requirements of the Procuring Rules:
№ s/o | BIN/IIN | Name of the healthcare entity | Name of the document | Reason for non-compliance |
1 | 2 | 3 | 4 | 5 |
3. Based on the results of examination of the application by open voting, the Commission hereby RESOLVED:
№ s/o | BIN/IIN | Name of the healthcare entity | The following voted in favour of this resolution | ||
In favour, votes | Against, votes | Meets (does not meet) the requirements for admission to the procedure for allocation of volumes of medical services within the framework of the GVFMC and (or) in the CSHI system | |||
the number of votes that voted that it complies | the number of votes that voted that it does not comply | ||||
1 | 2 | 3 | 4 | 5 | 6 |
Data on signing of the minutes of conformity (non-conformity) of healthcare entities by the members of the commission and the secretary of the commission:
Surname, first name, patronymic (if any) of a commission member, commission secretary | Place of employment | Position of the commission member | Signature | Date of signing |
1 | 2 | 3 | 4 | 5 |
Signed / Absent | ||||
Minutes of conformity (non-conformity) of healthcare entities to the requirements for admission
to the procedure of allocation of the scope of services for the provision of medical care within the guaranteed volume of free medical care and (or) in the system of compulsory social health insurance
on the presented addenda to the rejected applications and (or) documents enclosed thereto
№ ______
Footnote. The Rules are supplemented by Appendix 6-1 as per order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall take effect on 01.12.2023).
________________ | "__" _________ 20__ |
1. Commission for the selection of healthcare entities and allocation of the scope
of services among healthcare entities (hereinafter referred to as the Commission) with
its members:___________________________________________________________
(Surname, first name, patronymic (if any) and position of the chairman and other members of the commission) examined addenda to the application(s) for the planned volumes of medical services within the framework of the GVFMC and (or) in the CSHI system (hereinafter referred to as the application) of the following healthcare entity(ies):
№ s/o | BIN/IIN | Name of the healthcare entity |
1 | 2 | 3 |
2. The application(s) have been examined and contain(s) the following documents that are not in conformity with the requirements of the Procuring Rules:
№ s/o | BIN/IIN | Name of the healthcare entity | Name of the document | Reason for non-compliance |
1 | 2 | 3 | 4 | 5 |
3. Following the examination of the application(s) by open voting, the Commission hereby RESOLVED:
№ s/o | BIN/IIN | Name of the healthcare entity | The following voted in favour of this resolution | Meets (does not meet) the requirements for admission to the procedure for allocation of volumes of medical services within the framework of the GVFMC and (or) in the CSHI system | |
In favour, votes | Against, votes | ||||
1 | 2 | 3 | 4 | 5 | 6 |
Data on signing of the minutes of conformity (non-conformity) of healthcare entities by the members of the commission and the secretary of the commission:
Surname, first name, patronymic (if any) of a commission member, commission secretary | Place of employment | Position of the commission member | Signature | Date of signing |
1 | 2 | 3 | 4 | 5 |
Signed / Absent | ||||
Minutes on the results of allocation (non-allocation) of the volume of services to render
medical care within the guaranteed volume of free medical care and (or) in the system
of compulsory social health insurance
Footnote. Appendix 7 - as revised by order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall become effective ten calendar days after the date of its first official publication).
________________ | "__"_________ 20__ |
1. Commission for the selection of healthcare entities and allocation of the volume of services
(hereinafter referred to as the Commission) with its members:
____________________________________________________________________
(Name, surname, patronymic (if any) and position of the chairman and other members of the commission) examined the claimed volumes and amounts of medical services:
____________________________________________________________________,
(underline: within the guaranteed volume of free medical care and (or) in the system of compulsory social medical insurance) presented by healthcare entities included in the database of healthcare entities applying for medical care within the guaranteed volume of free medical care (hereinafter - GVFMC) and in the system of compulsory social healthcare insurance (hereinafter - CSHI), by types/conditions of medical care:__________________________________________________________________
2. Amount to be allocated under the GVFMC KZT* _____ (__________).
(sum in figures and words)
Amount to be distributed in the CSHI system KZT*_________(_________).
(sum in figures and words)
3. The Commission by open voting hereby RESOLVED:
1) that the volumes and amounts for the delivery of medical care shall be placed within the GVFMC and (or) in the CSHI system for the following type(s)/conditions for the delivery of medical care: ___________________________________________________,
№ s/o | BIN/IIN | Name of the healthcare entity included in the database | Legal address of the healthcare entity | Place of rendering services (specify region, city of national importance, capital) | Amount (KZT) | Volumes of medical services |
1 | 2 | 3 | 4 | 5 | 6 | 7 |
2) _______________________________________________________________
(name of the fund branch or budget programme administrator)
within the period until "___" _______ ______ to enter into agreements for the purchase of medical services and (or) addendums to agreements for the purchase of medical services within the framework of the GVFMC and (or) in the system of CSHI system (agreements for the purchase of services to supplement the GVFMC) with a validity period from ____ ________ 20___ to ____ ________ 20___.
to ____ ________ 20___ year;
3) not to place the volume of services for the provision of medical care within the framework of the GVFMC and (or) in the system of CSHI system):
№ s/o | BIN/IIN | Name of the healthcare entity included in the database | Legal address of the healthcare entity | Place of service provision (specify region, city of national importance, capital) | Types/conditions of medical care | Reason (grounds) |
1 | 2 | 3 | 4 | 5 | 6 | 7 |
The amount KZT ______________(____________________) has not been placed for type(s)/conditions of medical care provision
(amount in figures and words)
and (or) volumes of medical services in amount ________________. *
Details of signing of the minutes on the results of allocation (non-allocation) of the volumes of services on rendering medical care within the framework of GVFMC and (or) in the system of CSHI by members of the commission and the secretary of the commission:
№ | Surname, first name, patronymic (if any) of the commission member | Place of employment | Position of member of the Commission | The following voted in favour of this decision | Signature | Signature date | |
In favour, votes | Against, votes | ||||||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
Signed / Absent | |||||||
Total votes |
______________________________________________,_______________
(Surname, first name, patronymic (if any) of the secretary of the commission)
Note:
* to be filled in if required.*
Appendix 7-1 to the Rules for Procuring Services from Healthcare Entities for the Provision of Medical Care within the Guaranteed Volume of Free Medical Care and (or) in the System of Compulsory Social Health Insurance |
List of providers having concluded agreements for the purchase of medical services within the guaranteed
volume of free medical care and (or) in the system of compulsory social health insurance with the fund
or agreements for the purchase of services to supplement the guaranteed volume of free medical care with
the administrator of budget programmes as of "__" ________ _____
Footnote. The Rules are supplemented by Appendix 7-1 pursuant to order of the Minister of Health of the Republic of Kazakhstan № 157 of 27.10.2023 (shall come into force on 01.12.2023).
№ | Region where services will be provided to the population | Type of medical care, services, conditions of medical care as per the plan for procurement of medical services for the year ____ | BIN (IIN) | Provider's name | Legal address | Address of the location of the production base* | Surname, first name, patronymic (if any) of the head | Contact details (phone number, email address) | Form of ownership | Funding source | |
GVFMC | CSHI | ||||||||||
1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 | 9 | 10 | 11 | 12 |
Note:
* address(es) of the production base(es) shall be specified as per the annex to the medical activity licence.
Appendix 2 to Order № KR DSM-242/2020 of the Minister of Healthcare of the Republic of Kazakhstan as of December 8, 2020 |
List of some invalidated orders of the Ministry of Healthcare of the Republic of Kazakhstan
1. Order № 591 of the Minister of Healthcare of the Republic of Kazakhstan as of August 7, 2017 “On approval of the Rules for procuring services from healthcare entities within the guaranteed volume of free medical care and in the system of compulsory social health insurance” (registered in the State Registration Register of Regulatory Legal Acts under № 15604, published on September 6, 2017 in the Reference Control Bank of Regulatory Legal Acts of the Republic of Kazakhstan);
2. order № KR DSM-112 of the Acting Minister of Healthcare of the Republic of Kazakhstan as of August 12, 2019 “On amending Order № 591 of the Minister of Healthcare of the Republic of Kazakhstan as of August 7, 2017 “On approval of the Rules for procuring services from healthcare entities within the guaranteed volume of free medical care and in the system of compulsory social health insurance” (registered in the State Registration Register of Regulatory Legal Acts under № 19256, published on August 27, 2019 in the Reference Control Bank of Regulatory Legal Acts of the Republic of Kazakhstan);
3. order № KR DSM-145 of the Minister of Healthcare of the Republic of Kazakhstan as of November 20, 2019 “On amending Order № 591 of the Minister of Healthcare of the Republic of Kazakhstan as of August 7, 2017 “On approval of the Rules for procuring services from healthcare entities within the guaranteed volume of free medical care and in the system of compulsory social health insurance” (registered in the State Registration Register of Regulatory Legal Acts under № 19623, published on November 27, 2019 in the Reference Control Bank of Regulatory Legal Acts of the Republic of Kazakhstan);
4. paragraph 2 of the list of some orders in the field of healthcare, which are amended and supplemented by Order № KR DSM-21/2020 of the Minister of Healthcare of the Republic of Kazakhstan as of March 27, 2020 “On amending some orders in the field of healthcare” (registered in the State Registration Register of Regulatory Legal Acts № 20182, published on April 2, 2020 in the Reference Control Bank of Regulatory Legal Acts of the Republic of Kazakhstan);
5. order № KR DSM-73/2020 of the Acting Minister of Healthcare of the Republic of Kazakhstan as of June 23, 2020 “On amending Order № 591 of the Minister of Healthcare of the Republic of Kazakhstan as of August 7, 2017 “On approval of the Rules for procuring services from healthcare entities within the guaranteed volume of free medical care and in the system of compulsory social health insurance” (registered in the State Registration Register of Regulatory Legal Acts under № 20895, published on June 24, 2020 in the Reference Control Bank of Regulatory Legal Acts of the Republic of Kazakhstan).