ORDER OF THE MINISTER OF HEALTH OF THE REPUBLIC OF KAZAKHSTAN

of October 27, 2023 No. 157

About modification and amendments in the order of the Minister of Health of the Republic of Kazakhstan of December 8 2020agoda No. KR DSM-242/2020 "About approval of rules of purchase of services at subjects of health care in delivery of health care within the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance"

I ORDER:

1. Bring in the order of the Minister of Health of the Republic of Kazakhstan of December 8, 2020 No. KR DSM-242/2020 "About approval of rules of purchase of services at subjects of health care in delivery of health care within the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance" (it is registered in the Register of state registration of regulatory legal acts at No. 21744) the following changes and amendments:

state preamble in the following edition:

"According to the subitem 62) of article 7 of the Code of the Republic of Kazakhstan "About health of the people and health care system" and Item 1 of article 34 of the Law of the Republic of Kazakhstan "About compulsory social medical insurance" I ORDER:";

in rules of purchase of services at subjects of health care in delivery of health care within the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance, approved by appendix 1 to the specified order:

state Item 3 in the following edition:

"3. The basic concepts used in these rules:

1) the collaborator – the subject of health care included in the database of the subjects of health care applying for delivery of health care within GOBMP and (or) in the OSMS system (further – the database) with whom the supplier signed the agreement of co-execution for execution of part of obligations of the supplier under the signed agreement of purchase of services;

2) authorized body in the field of health care (further – authorized body) – the central executive body performing management and cross-industry coordination in the field of protection of public health of the Republic of Kazakhstan, medical and pharmaceutical science, medical and pharmaceutical education, sanitary and epidemiologic wellbeing of the population, drug circulation and medical products, qualities of rendering medical services (help);

3) subjects of health care – the organizations of health care, and also the physical persons practising private medicine and pharmaceutical activities;

4) the organization of health care – the legal entity performing activities in the field of health care;

5) the database – the list of the subjects of health care applying for delivery of health care within GOBMP and (or) in the OSMS system, No. KR DSM-186/2020 created according to the order of the Minister of Health of the Republic of Kazakhstan of November 6, 2020 "About approval of rules of accounting of the subjects of health care providing medical care within the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance" (it is registered in the Register of state registration of regulatory legal acts at No. 21619 (further – Rules of accounting);

6) again entered health care facility – the object for the first time accepted in operation by construction new or for the first time opened by change of the existing object according to the Law of the Republic of Kazakhstan "About architectural, town-planning and construction activities in the Republic of Kazakhstan";

7) high-technology medical service – the service rendered by profile specialists in case of the diseases requiring use of innovative, resource-intensive and (or) unique methods of diagnostics and treatment;

8) fund – the non-profit organization making accumulation of assignments and fees, and also performing purchase and fee of the subjects of health care providing medical care in amounts and on the conditions provided by the agreement of purchase of medical services and other functions determined by the laws of the Republic of Kazakhstan;

9) assets of fund – assignments and fees, the penalty fee received for delay of payment of assignments and (or) fees, investment revenue minus commission fee on ensuring activities of fund, and also other receipts in fund which are not prohibited by the legislation of the Republic of Kazakhstan;

10) reserve of fund on contingencies – the means provided by fund the current financial year for financing of contingencies in the period of covering, created on monthly basis;

11) branch of fund – the separate division of fund located out of the place of its stay and performing everything or part of its functions including functions of representation;

12) the web portal of purchase of services at subjects of health care (in relation to Rules) – the information system providing single point of access to electronic services of purchase of services at subjects of health care within GOBMP and (or) in the OSMS system (further – the web portal);

13) the electronic copy of the document – the document which is completely reproducing type and information (data) of the authentic document in electronic and digital form;

14) the supplier – the subject of health care with whom the fund or the administrator of budget programs signed the agreement of purchase of services according to these rules;

15) medical care in the OSMS system – the amount of medical care provided to consumers of medical services for the asset account of fund;

16) medical information system – the information system providing conducting processes of subjects of health care in electronic format;

17) medical care – complex of the medical services directed to preserving and recovery of population health including provision of medicines;

18) quality of medical care – the level of compliance to the provided medical care to standards of delivery of health care;

19) medical services – the actions of subjects of health care having preventive, diagnostic, medical, rehabilitation and palliative orientation in relation to the specific person;

20) state body in the field of rendering medical services (help) – the state body performing management in the field of rendering medical services (help), control of quality of medical services (help);

21) the subject of health care giving primary health care (further – the subject of PHC) – the subject of health care giving primary health care within GOBMP and (or) in the OSMS system to the attached population registered in the Registr Prikreplennogo Naseleniya portal (further – the RPN portal);

22) the agreement of public-private partnership – the written agreement determining the rights, obligations and responsibility of the parties of the agreement of public-private partnership, other terms of the contract of public-private partnership within project implementation of public-private partnership;

23) production base – the place of rendering medical services according to appendix to the license granted according to the legislation of the Republic of Kazakhstan on permissions and notifications;

24) the republican organizations of health care – the organizations of health care which are under authority of authorized body, the scientific organizations in the field of health care, the organizations of health care of the autonomous organization of education, the organization of medical education;

25) the independent expert – the physical person conforming to the requirements determined by authorized body and consisting in the register of independent experts;

26) the agreement of purchase of services in collateral security of GOBMP (further – the agreement of purchase of services) – the agreement in writing between the administrator of budget programs and the subject of health care providing delivery of health care within GOBMP;

27) the agreement of purchase of medical services within GOBMP or in the OSMS system (further – the agreement of purchase of services) – the agreement in writing between fund and the subject of health care providing delivery of health care within GOBMP and in the OSMS system;

28) the subject of digital health care (in relation to Rules) – the legal entity performing activities or entering the public relations regarding information and technical maintenance of information systems of health care including organizational and methodical work with subjects of health care;

29) the electronic document – the document in which information is provided in electronic and digital form and is certified by means of the digital signature;

30) the digital signature (further – the EDS) – set of electronic digital symbols created by means of the digital signature and confirming reliability of the electronic document, its accessory and invariance of content.";

exclude item 4;

state Item 5 in the following edition:

"5. The purchase of services within GOBMP and (or) in the OSMS system consists of the following stages:

1) planning of amounts of purchase of services within GOBMP and (or) in the OSMS system;

2) the choice of subjects of health care for rendering services within GOBMP and (or) in the OSMS system with distribution and placement of amounts of services and (or) amounts of means;

3) conclusion of the agreement of purchase of services;

4) agreement performance of purchase of services.";

state Item 7 in the following edition:

"7. Planning of amounts of medical services within GOBMP and (or) in the OSMS system is performed according to the order of the Minister of Health of the Republic of Kazakhstan of December 20, 2020 No. KR DSM-290/2020 "About approval of rules of planning of amounts of medical services within the guaranteed amount of free medical care and (or) in system of compulsory social medical insurance" (it is registered in the Register of state registration of regulatory legal acts at No. 21844).";

state Item 10 in the following edition:

"10. The structure of the commission is created by the decision of fund or the administrator of budget programs from among representatives:

1) fund;

2) authorized body for inclusion in structure of the republican commission of fund;

3) local state body health care of areas, cities of republican value and the capital (further – management of health care) for inclusion in structure of the commission in case of the administrator of budget programs or regional commission;

4) National chamber of entrepreneurs of the Republic of Kazakhstan of Atameken (further – NPP Atameken) and (or) the non-governmental organizations representing the interests of patients, subjects of health care or health workers (further – NGO);

5) territorial subdivision of state body in the field of rendering medical services (help) for inclusion in structure of regional commission and the commission in case of the administrator of budget programs;

6) subject of digital health care;

7) state body in the field of sanitary and epidemiologic wellbeing of the population.

Candidacies are presented by the official letter in writing within five working days from the date of receipt of request for forming of structure of the commission.

Candidates represent to fund in writing the information about close relatives, the spouse and the cousin-in-law (cousins-in-laws) of the candidate for inclusion in structure of the commission on the choice of subjects of health care and to placement of amounts of services within GOBMP and (or) in the OSMS system in form according to appendix 1 to these rules.";

state Item 13 in the following edition:

"13. The chairman of the republican commission under fund is the official of fund, the vice-chairman of the republican commission under fund is the representative of authorized body which position is not lower than the deputy manager of structural division.

For the commission in case of the administrator of budget programs the chairman and the vice-chairman are officials of the administrator of budget programs.

The chairman of regional commission under fund determines the representative of fund which position is not lower than the deputy director of branch of fund or the head of the structural unit of fund.

The vice-chairman of regional commission under fund determines the representative of management of health care which position is not lower than the deputy manager of management of health care.

The commission chairman directs activities of the commission, plans its work.

During absence of the chairman of its function the vice-chairman of the commission performs.";

16, of 17, of 18, 19 to state Items in the following edition:

"16. In the absence of the member of the commission on commission sessions more than three time in a row, the fund or the administrator of budget programs make the offer to the relevant representation about replacement of the candidate.

17. The choice of subjects of health care for placement of amounts of services and (or) amounts of means within GOBMP and (or) in the OSMS system, except as specified, of the these rules specified in the subitem 11) of Item 19, is performed among the subjects of health care included in the database according to Rules of accounting.

18. The choice of subjects of health care and placement of amounts of services within GOBMP and (or) in the OSMS system is performed by means of the web portal, except for purchase of services of collateral security of GOBMP performed by the administrator of budget programs who is led to paper form.

19. The amount of services and (or) amount of funds for delivery of health care within GOBMP and (or) in the OSMS system is placed without holding procedure of the choice of subjects of health care within the plan of purchase of medical services in case of:

1) change of rates for the medical services provided within GOBMP and (or) in the OSMS system, No. KR DSM-170/2020 approved according to the order of the acting minister of health care of the Republic of Kazakhstan of October 30, 2020 "About approval of rates for the medical services provided within the guaranteed amount of free medical care and in system of compulsory social medical insurance" (it is registered in the Register of state registration of regulatory legal acts at No. 21550) (further – the order No. KR DSM-170/2020) in case of placement among subjects of health care with which agreements of purchase of services are signed;

2) realization of pilot projects according to the decision of authorized body or Government of the Republic of Kazakhstan;

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