ORDER OF THE MINISTER OF HEALTH AND SOCIAL DEVELOPMENT OF THE REPUBLIC OF KAZAKHSTAN

of June 30, 2015 No. 544

About approval of Rules of the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds

According to the subitem 80) of Item 1 of article 7 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system" I ORDER:

1. Approve the enclosed Rules of the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds.

2. Procedure to provide to department of the organization of medical care of the Ministry of health and social development of the Republic of Kazakhstan in the established legislation:

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

2) within ten calendar days after state registration of this order in the Ministry of Justice of the Republic of Kazakhstan the direction on official publication in periodic printing editions and information system of law of Ad_let;

3) placement of this order on Internet resource of the Ministry of health and social development of the Republic of Kazakhstan;

4) within ten working days after state registration of this order in the Ministry of Justice of the Republic of Kazakhstan submission to Department of legal service of the Ministry of health and social development of the Republic of Kazakhstan of data on execution of the actions provided by subitems 1), 2), 3) of this Item.

3. To impose control of execution of this order on the vice-Minister of health and social development of the Republic of Kazakhstan Tsoi A. V.

4. This order becomes effective after day of its first official publication.

Approved by the Order of the Minister of health and social development of the Republic of Kazakhstan of June 30, 2015 No. 544

Rules of the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds

Chapter 1. General provisions

1. These rules of the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds (further - Rules) are developed according to the subitem 80) of Item 1 of article 7 of the Code of the Republic of Kazakhstan of September 18, 2009 "About health of the people and health care system" and determine procedure for the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds.

These rules do not extend to cases in case of which patients at the expense of personal means independently leave on treatment in the foreign medical organizations.

2. The basic concepts used in these rules:

1) authorized body in the field of health care (further - authorized body) - the state body performing management in the field of protection of public health, medical and pharmaceutical science, medical and pharmaceutical education, drug circulation, products of medical appointment and medical equipment, control of quality of medical services;

2) working body of the commission - the coordinating body for questions of the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds (further - working body);

3) the commission on the direction of citizens of the Republic of Kazakhstan on treatment in the foreign medical organizations at the expense of budgetary funds (further - the commission) - the commission for the direction of citizens on treatment abroad at the expense of budgetary funds which is created by authorized body which part representatives of authorized body, doctors of narrow specialties, representatives of non-governmental organizations are;

4) the republican organization of health care - the organizations of health care which are under authority of authorized body, organization of health care of the autonomous organization of education, the organizations of medical education.

Chapter 2. Procedure for the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds

3. The direction of citizens of the Republic of Kazakhstan on treatment is abroad performed in compliance:

1) with the list of diseases in case of which citizens of the Republic of Kazakhstan go for treatment abroad at the expense of budgetary funds according to appendix 1 to these rules;

2) with the list of separate categories of the citizens of the Republic of Kazakhstan directed to treatment abroad at the expense of budgetary funds according to appendix 2 to these rules.

4. For the solution of question of the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds, the republican organization of health care submits for consideration to working body, the following documents:

1) copy of the identity document of the patient;

2) the statement from the clinical record of the patient provided by the medical organization, containing results of the conducted researches and consultations according to clinical protocols of diagnostics and treatment prescriptive limit no more than 30 (thirty) working days;

3) the conclusion of the republican organization of health care about the direction of the patient on treatment abroad at the expense of budgetary funds according to appendix 3 to these rules.

The working body creates the list of the foreign medical organizations for the direction on treatment at the expense of budgetary funds and approves it with the commission.

The working body within one working day from the date of receipt of the conclusion of the republican organization of health care about the direction of the patient on treatment abroad enters data on the patient in the list of the patients applying for treatment abroad with their introduction in the information system "waiting list" posted on the website of working body.

5. For pronouncement of the conclusion about the direction of citizens at treatment abroad, working body:

1) considers the documents specified in item 4 of these rules, provided by the republican organization of health care within two working days from the date of their obtaining;

Requests 2) from the date of receipt of the conclusion of the republican organization of health care from the profile foreign medical organizations brought in the list of working body, the program of treatment of the patient and calculation of expenses on its rendering (further - the price offer) within 15 (fifteen) working days;

3) involves doctors of the republican medical organization recommending medical treatment abroad in working off of the program of treatment of patients in foreign clinic;

4) in case of request of specialists of the foreign medical organizations of the additional information about the patient's condition, within 5 (five) working days from the date of receipt of request holds telemedicine consultations with the foreign medical organizations with provision of necessary results of the researches conducted in the medical organizations of the Republic of Kazakhstan.

By results of implementation of the actions provided by subitems 1) 2), 3) and 4) of this Item the working body represents the commissions during 25 (twenty five working days) from the date of obtaining from the republican organization of health care the conclusion about the direction of the patient on treatment abroad at the expense of budgetary funds, the recommendation of working body of the direction of the patient on treatment abroad at the expense of budgetary funds in form according to appendix 4 to these rules, the list of the documents specified in subitems 1), 2) and 3) of item 4 of these rules.

6. Management of activities of the commission is performed by the commission chairman who presides over commission sessions, and in case of its absence the vice-chairman.

Functions of the secretary of the commission are performed by the specialist of authorized body who is not the member of the commission.

The commission consists of the odd number of members from among representatives of authorized body, doctors of profile specialties, representatives of the non-governmental organizations performing the activities for assistance to citizens in case of different diseases.

Members of the commission take part in its activities without the replacement right.

The secretary of the commission in time at least in 3 (three) calendar days prior to commission session directs to members of the commission by e-mail document package about the direction of the patient to treatment abroad at the expense of budgetary funds.

Commission session is considered competent with the participation of more than a half from total number of members of the commission.

The decision of the commission is made by a majority vote from total number participating in commission session.

In case of equality of votes the decision for which the commission chairman voted is deemed accepted.

The commission chairman appoints the regular meeting of the commission, in case of emergency convenes emergency meeting.

7. The commission makes the decision:

about the direction of the patient on treatment abroad;

about refusal in the direction on treatment abroad;

about prolongation of terms of consideration of documents of the patient with reasons;

about performing treatment of the patient applying for treatment abroad in the domestic medical organizations within master class with involvement of foreign specialists;

about refusal in the direction on treatment within master class in the domestic medical organizations with involvement of foreign specialists;

about issue by working body of the commission of the guaranty letter in foreign clinics about the obligation on treatment payment;

about need of continuation of treatment with change of the program of treatment and the amount of the agreement during finding of the patient on treatment.

8. The decision of the commission is drawn up by the protocol in any form.

The protocol of the decision of the commission goes to working body within 5 (five) working days from the date of carrying out commission session by e-mail (the scanned option) and the original through the courier.

9. The working body based on the legal decision of the commission on the direction of the patient on treatment abroad signs the contract with the foreign medical organization for provision of medical services to citizens of the Republic of Kazakhstan within 10 (ten) working days from the date of signing of the minutes of the commission.

10. The working body makes payment of expenses of the patient and accompanying person (the children and (or) persons needing foreign leaving) on treatment and journey.

The working body pays the foreign medical organization advance payment for treatment of the patient at the rate to 50% of the total amount of the agreement within fifteen working days from the date of the conclusion of the agreement.

Final payment is performed after representation by the foreign medical organization of the final act of the performed works (in any form).

In case of long-term treatment by working body payment under intermediate acts of the performed works is made.

11. In case of the direction of the patient in the foreign medical organization on treatment of the requiring step-by-step intervention, step-by-step treatment is provided.

In case of step-by-step treatment payment for journey of the patient, and also accompanying person is performed by working body and made according to the decision of the commission.

In case of long-term treatment on each stage of treatment of the requiring step-by-step intervention, the working body signs the supplementary agreement. If necessary to the patient of repeated transplantation the new agreement is signed.

12. The duration of the agreement, concluded with the foreign medical organization, is established depending on methods and duration of treatment.

13. By provision to working body of the recommendation of the foreign medical organization of need of continuation of treatment during finding of the patient abroad, the working body considers and approves the program of treatment with profile specialists republican the organizations of health care.

The working body for results of approval submits for consideration of the commission the medical documents submitted by the foreign medical organization and the conclusion about feasibility of continuation of treatment in this foreign clinic. The working body notifies the foreign medical organization on the decision made by the commission within five working days from the date of its acceptance.

Appendix 1

to Rules of the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds

The list of diseases in case of which citizens of the Republic of Kazakhstan go for treatment abroad at the expense of budgetary funds

1. The Arteriovenozny malformation and tumors requiring radio surgical method of treatment (gamma knife) in view of localization in surgically unavailable functionally significant areas of brain.

2. Arteriovenozny malformation of vessels of trunk of brain, spinal cord and arterial aneurisms for endovascular treatment.

3. Skull basis tumors for transoral removal.

4. The malignant new growths of eye requiring radio surgical treatment (gamma knife, radioactive applicators).

5. Keratoprotezirovaniye.

6. The diseases requiring transplantation of fabrics (part of fabric) or bodies (part of bodies), except for autologous and related transplantations of haematopoietic stem cells of adults and children, and also transplantation of cornea.

7. Throat stenoses.

8. Trachea stenoses.

Appendix 2

to Rules of the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds

The list of separate categories of the citizens of the Republic of Kazakhstan directed to treatment abroad at the expense of budgetary funds

1. Children aged up to 18 years in the presence of indications and concerning which all methods of diagnostics and treatment allowed for use in the organizations of health care of the Republic of Kazakhstan without positive medical effect were used.

2. In exceptional cases at the request of the President of the Republic of Kazakhstan, the Prime Minister of the Republic of Kazakhstan, the law enforcement officers who are serving Armed Forces of the Republic of Kazakhstan, sustained severe injuries and injuries on duty concerning whom all methods of diagnostics and treatment allowed for use in the organizations of health care of the Republic of Kazakhstan without positive effect were used.

Appendix 3

to Rules of the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds

Form

The conclusion of the republican organization of health care about the direction of the patient on treatment abroad at the expense of budgetary funds

№	Data of the patient
1	Surname, name, middle name (in case of its availability)
2	Birth date
3	Address
4	Complete clinical diagnosis
5	The accompanying diagnosis
6	Recommended treatment (to specify specifically manipulation)
7	The decision on need of the direction of the patient on treatment abroad	1. Needs 2. Does not need (necessary to emphasize)
8	Confirmation that this technology is not carried out in one medical organization of the Republic of Kazakhstan
9	The expected effect of treatment
10	In case of the direction on organ and tissue transplantation data on availability/absence of donors are attached	1. These typings (are applied) – yes/no 2. The data confirming absence of related donors (are attached) – yes/no 3. The data confirming absence of donors in the country (are attached) – yes/no 4. Data of preliminary search in the international registers (are attached) – yes/no
11	Date of filling of the conclusion

Signing this conclusion, the head of the medical organization bears responsibility for reliability of provided data

Head of the republican organization of health care

/____________/___________________________/

M.P.'s (signature) (First name, middle initial, last name (in case of its availability))

Appendix 4

to Rules of the direction of citizens of the Republic of Kazakhstan on treatment abroad at the expense of budgetary funds

Form

The recommendation of working body of the direction of the patient on treatment abroad at the expense of budgetary funds

№	Data of the patient	Note
1	2	3
1	Surname, name, middle name (in case of its availability)
2	Year of birth
3	Address
4	Clinical diagnosis
5	The accompanying diagnosis
6	The carried-out treatment
7	The conducted laboratory diagnostic testings
8	The conclusion of the republican organization of health care about need of the direction of the patient on treatment abroad	1. Needs 2. Does not need (necessary to emphasize)
9	Treatment cost in the medical centers abroad	1.
		2.
		3.
10	The program of treatment with calculation (is attached)
11	Recommended foreign medical organization (country)
12	Needs in maintenance (to specify the reason)
13	Priority of the direction
14	Direction terms on hospitalization
15	Note

Head of working body /____________/___________________________/

                                             M.P.'s (signature) \(First name, middle initial, last name (in case of its availability))

 

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