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There will be no complications with the provision of medical care to Russians in 2014, says Health Minister Veronika Skvortsova. The Ministry of Health considered it necessary to make clarifications in connection with changes in the financing of certain types of high-tech medical care, which will occur from January 1 next year.
Now many types of complex operations and other, including non-surgical, types of medical care are included in the program of high-tech medical care. For patients, VMP is free (except for the fact that sometimes you have to pay extra for medical products that are more expensive than included in the program - the same artificial joints or lenses, for example). And medical institutions are paid for work performed from the federal budget on the principle of “the quota follows the patient.”
For the patient, the procedure looks like this: he receives a referral from the attending physician, contacts the clinic where he will have the operation, receives a “quota” and waits for a call for hospitalization. Over the course of several years, it was possible to make the flow of patients transparent, the number of patients who received such assistance increased many times, and the queues decreased.
Starting next year, the order will change: financing of a fairly large list of operations will be carried out not from the budget, but from the compulsory health insurance fund.
In theory, the mechanism for obtaining high-quality treatment for a patient should now be simplified: there is no need to worry about the “quota” or wait for it to be allocated. The doctor gives a referral for surgery, the patient is treated, the clinic “reports” to the compulsory medical insurance fund and receives payment. But it is too early to say how smoothly this mechanism will work from 2014.
When discussing the draft federal budget in the State Duma, the newly appointed head of the Accounts Chamber, Tatyana Golikova, expressed concern that difficulties would arise in federal medical centers, which “live” mainly on “quota” patients. The reason is that the decision to change the method of financing has been made, but mechanisms have not yet been created that would compensate for the decrease in budget spending on high-tech medical care.
Doctors are also worried: everyone has learned to live with “quotas” (although they constantly complained that they do not cover all the expenses of a medical institution for “expensive” patients). But at what cost and on what terms the MHIF will pay for this or that operation is still unclear. One thing is clear: if there is less money, fewer people will be able to receive help.
The Ministry of Health, however, believes that fears are unfounded. “I can firmly say that in 2014 there will be no complications with the provision of quality medical care,” said Veronika Skvortsova, answering questions from journalists.
The RG ministry explained that a reduction in budget funding for federal medical centers will indeed occur. But at the same time, cash receipts from the Compulsory Medical Insurance Fund will increase. The fund received an additional 200 billion rubles from funds that previously went under the heading “modernization of healthcare.” The Ministry of Health also reassures us regarding tariffs: when calculating them, the Compulsory Medical Insurance Fund took the cost of the corresponding “quota” as a basis.
Help "RG"
What types of operations are included in the compulsory health insurance program:
- coronary myocardial revascularization using angioplasty and stenting for coronary heart disease,
- primary hip replacement,
- widespread treatment methods in abdominal surgery, neurosurgery, oncology, otorhinolaryngology, ophthalmology, thoracic surgery, traumatology and orthopedics, urology, maxillofacial surgery,
- some expensive types of treatment in the areas of obstetrics and gynecology, neonatology, and pediatrics.
By the way
Foreigners will be able to undergo expensive operations in the best Russian medical centers.
Russia has ratified the EurAsEC agreement on cooperation in the field of providing high-tech assistance to citizens of the community countries, the law was signed by Vladimir Putin.
Now foreign citizens will have the opportunity to receive treatment in Russia at the expense of their states. Such agreements between Russia and other states that are members of the EurAsEC will be concluded after the cooperation agreement is ratified by other member countries of the community.
And now there are many foreigners from neighboring countries in Russian clinics, but they are treated exclusively on a commercial basis, paying for their stay in the clinic themselves.
“After the agreement is ratified by other states that are members of the EurAsEC, the conditions and principles of such cooperation will be developed,” the Ministry of Health explained to RG. — There is no talk of additional expenses of the Russian budget. Treatment of foreign citizens will be at the expense of their states. The Ministry of Health will determine a list of medical centers that will operate under this agreement. For example: when we send Russians abroad for treatment, the decision on this is made by the Ministry of Health, an agreement is concluded with a foreign clinic, and the necessary funds for payment are also allocated by the ministry.”
There are situations when conventional treatment does not help. At such moments, unique techniques, expensive drugs and the latest equipment, which are part of VMP, save you.
What is it? How is it different from conventional medicine? How to get quotas for high-tech medical equipment in 2018, what documents to prepare?
Look for answers to these and other questions in our next article.
What is VMP, and for what high-tech medical care are quotas allocated in 2018?
It should be noted right away that VMP is an expensive pleasure. And an ordinary person does not have enough money for some medications or operations under the RMS.
To solve the problem, the concept of VMP was introduced.
What is VMP?
- Firstly, VMP is an abbreviation formed from the initial letters of three words - high-tech medical care.
- Secondly, this abbreviation stands for state-of-the-art medical care. It is provided in the case of complex diseases such as oncology, leukemia and other serious pathologies, in the treatment of which highly professional specialists perform operations and other manipulations, using high medical technologies, minimizing the risk to the health and life of the patient.
What distinguishes high-tech medical care from conventional care is:
- Methodology.
- Treatment approach.
- A (wider) list of services provided.
By quota we mean the amount of money that the Compulsory Health Insurance Fund allocates each year for the treatment of a specific number of people living in a particular region.
State support in the form of a quota covers citizens’ expenses for treatment, incl. - stay in a specialized clinic, rehabilitation and provision of medications.
NEED TO KNOW: A common disease is not subject to quotas. Only that type of assistance that requires specialized equipment and certain training of specialists.
What high-tech medical care will receive quotas in 2018?
For the state to allocate funds to rid a person of a disease, only compelling reasons are needed.
The list of diseases subject to quotas published by the Ministry of Health contains up to 140 diseases. We will name only a few of them. And we're talking about:
- Internal organ transplantation.
- Neurosurgical operations.
- Treatment of hereditary diseases, including leukemia, oncology, etc.
- Diseases of the thyroid gland.
- Problems with the liver and kidneys.
- Operations on the eyes, spine, etc., which require specialized equipment, etc.
BY THE WAY: The Russian Ministry of Health determines the number of quotas for each medical institution operating under the appropriate license, i.e. which will accept only a certain number of patients for budgetary treatment.
Sources of financing quotas for high-tech medical care in 2018 - are treatment and operations completely free under quotas?
Until recently, VMP was financed from the federal budget.
And after 2014, high-tech medical care was divided into 2 main parts, which financed:
- Federal Compulsory Medical Insurance Fund (i.e., which was included in the state compulsory medical insurance program).
- Only the federal budget.
Due to this, the availability of treatment has become higher and the waiting time for hospitalization has become shorter.
In 2018, all high-tech assistance is financed only from the MHIF budget. And the principle of financial support is simple.
On VMP:
- Which is part of the basic compulsory medical insurance program, finances are received by transferring amounts as part of subventions to territorial funds.
- Which is not part of the state program, finances within the framework of fulfilling the state task for providing treatment are directly transferred by federal government agencies.
Some types of treatment are paid for by the regional budget of territorial units of the Russian Federation. There is co-financing of expenses of Russian entities that arise when providing such high-tech assistance from the Compulsory Medical Insurance Fund.
The Ministry of Health fully determines:
- List of clinics with the latest equipment and specialists of the highest category.
- Number of patients who will receive VMP in 2018
- Calculation of the base rate.
The medical institution is determined taking into account whether the therapy the patient needs is included in the basic program:
- The therapy, which is included in the state compulsory medical insurance program, will be carried out where they work under the terms of this type of insurance.
- If VMP is not included in the basic system, then it is provided in private centers and government institutions of the Ministry of Health.
BY THE WAY: VMP is also provided to small patients. Thus, consultations with a uroandrologist, endocrinologist and gynecologist will be provided by the Center for Reproductive Health of Children and Adolescents at Morozov Children's.
How to get high-tech medical care under the compulsory medical insurance policy in 2018 - what to do if high-tech medical care is not included in the compulsory medical insurance policy?
This process is not as simple as we would like. At each of the three main stages, the patient must undergo a specialized commission.
First, they pay a visit to the doctor and inform him of their decision.
Stages of registration
To apply for a quota for surgery or treatment when providing high-tech medical care in 2018, you must:
- Get a referral from a doctor.
- If necessary, undergo additional manipulations and examinations.
- Obtain a certificate from the doctor indicating the diagnosis, treatment method, diagnostic measures, and general condition of the patient.
- Submit the certificates to the commission of the medical institution involved in quotas for consideration.
- Wait 3 days and get a decision.
The decision by the health department of a particular entity is made within 10 days.
If it is positive, the commission remains:
- Indicate the medical institution where high-tech care is provided in 2018.
- Send a package of patient documents.
- Tell him about your decision.
IMPORTANT TO KNOW: Most patients are matched with a clinic located closer to their place of residence.
This medical institution, operating under a license to perform VMP in 2018, sends:
- Voucher for the provision of high-tech medical care.
- Copy of the protocol.
- Information about the patient's condition.
Within ten days, the quota commission of the clinic to which the documents were sent makes a decision after the meeting.
BY THE WAY: If the money was used to treat the patient, the voucher for VMP remains in the clinic as proof of funding from the budget.
It may take about 23 days. For a very long time. And it’s not a fact that the decision will be positive. This is for situations where you can’t wait, it’s just a disaster.
But there is another option for obtaining a quota. Those. — go to the clinic yourself, licensed for high-tech treatment.
The algorithm of actions is as follows:
- Sign the documents at the local clinic (with the attending physician and the head physician) where the diagnosis was made.
- Go to the clinic with these papers.
- Write an application for a quota.
- If the decision is positive, then you need to go again with the coupon to the health department.
If VMP is not included in the compulsory medical insurance policy, you must make an appointment with the department.
The procedure for obtaining a quota for surgical VMP in 2018 - list of documents and registration stages
The main document for referring Russian residents to specialized clinics for the provision of primary care is the corresponding order of the Ministry of Health and Social Development of the Russian Federation.
The procedure for applying for a quota is as follows.
The Ministry of Health distributes “quotas” for treatment to specified regional clinics. And each region has the right to send residents only to where the quota has been allocated.
To receive the so-called coupon-referral for VMP, the person applies to the local Department of Health or the regional ministry of the Ministry of Health.
List of documents
After visiting the doctor who confirmed the diagnosis, the patient in need of treatment must collect a number of documents.
The regional health department expects him to submit:
- Passports and their copies.
- Statements.
- Written consent to the processing of personal data.
- Minutes of the commission meeting from the medical institution whose specialists made the initial diagnosis.
- Extracts from the medical record, where examinations and diagnosis are entered.
- Compulsory medical insurance policy and its photocopies.
- Insurance certificate.
- Certificates of disability (if any).
Modern high-tech medicine is not available to a wide range of people due to its high cost. For this reason, the state annually allocates funds through which assistance is provided free of charge to a limited number of patients. Today we will talk about how to get a quota for surgery and what medical services are provided by the state program.
What is high-tech medicine?
High-tech medical care (hereinafter referred to as HTMC) is diagnostic and treatment services provided by highly qualified personnel using the latest equipment and the latest scientific achievements. Not all medical institutions have the right to provide VMP, but only those that have received a special license for this particular type of medical care. The Ministry of Health of the Russian Federation controls the number of these institutions, as well as the types of diseases for which VMP is used, annually approving the corresponding lists.
The basis of high medical care consists of medical services of a high degree of complexity:
- open heart surgery;
- internal organ transplantation;
- neurosurgery;
- eye surgeries;
- treatment of genetic diseases, etc.
Another distinctive feature of VMP is the high cost of procedures, based on the salaries of highly qualified doctors, the purchase of expensive equipment and rare medications. To make this segment accessible to ordinary citizens, the state has provided the opportunity to receive free medical care subject to certain conditions.
Who is entitled to free VMP services?
The state guarantee program for the provision of high medical care was first launched in 1994. Since then, it has been revised several times, and the latest version can be found in. The document reflects the main directions of providing high-tech medical care for 2017, 2018 and 2019.
The right to free medical care is enshrined in the Constitution of the Russian Federation; any citizen of Russia has it if there are appropriate indications for this. Art. 19 states that medical institutions are obliged to provide citizens with a free volume of medical services within the framework of the State Guarantee Program, which, among other things, provides for high medical care.
A certain amount of funds is annually allocated from the federal budget to carry out free operations and provide other services within the framework of VMP. The amount of funding for the treatment of one patient is called a quota. It covers the entire treatment process, including payment for hospital stay, medications and consumables.
The number of quotas is limited, as are the types of free medical care provided. The latter are divided into 2 groups.
- Basic list of VMP. These services can be used by any citizen of the Russian Federation who has a compulsory medical insurance policy. Assistance is provided free of charge both in the region of residence and in any other subject of the Russian Federation.
- List of VMP not included in the basic compulsory medical insurance program. These services are financed from the budgets of the constituent entities of the Russian Federation, and therefore you can only receive them in your region of residence.
Let's take a closer look at what services are included in each of these lists.
Basic VMP program
VMP within the framework of the basic compulsory medical insurance program includes the following types of medical services.
- Abdominal surgery (all kinds of abdominal surgeries).
- Obstetric and gynecological services. Therapeutic treatment for threatened miscarriage using genetically engineered drugs, as well as surgery on the muscles and organs of the pelvis.
- Gastroenterology. Treatment of severe forms of ulcerative colitis and autoimmune hepatitis.
- Hematology. Complex treatment of disorders of the composition and functions of the blood, including the use of hormonal therapy.
- Surgery on newborn children with congenital defects of the respiratory and digestive systems.
- Dermatovenerology. Combined treatment of patients with severe forms of psoriasis, various types of dermatitis and other skin diseases.
- Neurosurgery. Removal of malignant and benign tumors of the brain, soft tissues of the head and neck, and skull bones. Microsurgery of blood vessels of the brain and spinal cord. Reconstructive interventions for injuries and defects of the skull.
- Neonatology. Nursing of newborns with low body weight.
- Oncology. Surgery of cancer tumors of all stages, including relapses.
- Otorhinolaryngology. Reconstructive operations of the hearing organs, restoration of vocal cord functions, treatment of Meniere's disease and other vestibular disorders.
- Ophthalmology. Surgical treatment of glaucoma, fibroplasia. Restoring visual function in case of eye injuries.
- Pediatrics. Chemotherapy treatment of Wilson's disease, Gaucher disease, malabsorption. Multicomponent treatment of systemic sclerosis, nephrotic syndrome, myocardial damage.
- Rheumatology. Treatment of muscle and joint diseases with a high degree of inflammation or resistance to standard therapy.
- Cardiovascular surgery for acute myocardial infarction, angina pectoris.
- Thoracic surgery. Operations on the chest organs.
- Traumatology and orthopedics. Reconstructive recovery after spinal injuries. Joint endoprosthetics.
- Urology. Intestinal plastic surgery, elimination of fistulas, removal of neoplasms of the genitourinary system.
- Maxillofacial surgery. Plastic surgery for congenital malformations of the maxillofacial region.
- Endocrinology. Comprehensive treatment of diabetes mellitus in severe forms, with kidney damage, ischemia, diabetic foot and other consequences.
A more detailed basic composition of the VMP can be found in the first section of the Appendix to Resolution No. 1403.
VMP through regional funding
VMP, which is not included in the basic compulsory medical insurance program, includes the following types of treatment.
- Surgical intervention for diseases of the gastrointestinal tract, liver, biliary tract, organ prolapse due to pelvic prolapse, etc.
- Treatment of newborns. Operations to eliminate congenital malformations, hydrops fetalis.
- Therapeutic procedures and operations for gynecological problems (endometriosis, cysts, uterine fibroids, delayed puberty).
- Combined treatment of blood diseases.
- Treatment of burns affecting more than 30% of the body surface.
- Neurosurgery.
- Surgery and therapy of oncological diseases.
- Elimination of chronic otitis media and hearing loss.
- Complex treatment of diseases of the cornea of the eye, restoration of vision.
- Hormonal therapy for premature sexual development in adolescents.
- Surgical treatment of coronary heart disease, congenital defects, damage to the valve apparatus.
- Reconstructive operations on the chest for tuberculosis and congenital anomalies.
- Surgical restoration of the spine after injuries, with hernia and scoliosis of 3 and 4 degrees.
- Transplantation of organs and tissues.
- Multicomponent treatment of bronchial asthma, multiple sclerosis, severe forms of diabetes mellitus, congenital immunodeficiency and many other diseases.
A complete list of operations and other medical services financed by the regions can be found in the second section of the Appendix to Resolution No. 1403.
How to get a quota for treatment?
The procedure for referring patients for high-tech treatment is fixed. The regional health department is responsible for issuing quotas for receiving high medical care. There you must provide a referral from the clinic where the initial examination was carried out. The referral must be accompanied by an extract from the medical history and the results of examinations and tests. All documents are certified by the signature of the chief physician.
Review of the submitted package of documents is carried out by a special commission under the Department of Health. It must include a specialist from the medical field corresponding to the patient’s diagnosis. The commission meeting usually takes place without the presence of the patient, but in a controversial situation he may be invited to participate. If a positive decision is made, the experts of the VMP department select a suitable medical institution for the patient.
The patient has the right to independently choose the place of treatment. In this case, the procedure changes somewhat, and you must first contact the organization of interest. If there are medical services suitable for the disease and the appropriate quotas have been allocated, the patient will be given a conclusion according to which he is advised to undergo treatment in this particular institution. And with this conclusion you must then contact the Department of Health.
It is not necessary to visit the clinic in person to receive an opinion. If it is located in another region, you can contact it remotely by sending copies of documents by email or fax. The opposite situation is also possible, when the patient independently goes to another region, confirms his diagnosis in the clinic, and sends a copy of the medical report for consideration to the regional commission in electronic form.
How long should I wait for treatment?
If the conclusion of the medical institution was received in advance, then all that remains is to issue a VMP coupon at the regional health authority, which usually takes 1-2 days. If there are free places in the clinic, hospitalization is possible the very next day after receiving the coupon.
When choosing a place of treatment by experts from the Department of Health, the patient will have to undergo another commission - this time directly at the institution to which he was sent. Clinic specialists can confirm or deny the presence of indications for high-tech treatment. When reviewing documents remotely, the decision must be made within 10 days, and when a patient visits the facility in person - within 3 days.
If a positive decision is made, a date for hospitalization is set, about which the authority that issued the coupon is informed. He, in turn, sends a notification to the patient. In addition, you can track the process of obtaining a quota for an operation on the Internet, since the VMP coupon has an electronic form and information about it is regularly updated. This can be done on a special one.
From the moment of diagnosis to receiving medical care, it can take several days or several months. It all depends on the availability of space in the clinic and how urgently the treatment is needed. The only way to reduce the time it takes to obtain a quota for medical treatment is to independently search for a suitable medical institution and obtain a preliminary conclusion from it.
The treatment of some diseases is so complex and expensive that citizens are not able to pay for it and organize it themselves. But every citizen of the Russian Federation has guarantees from the state, written down in the Basic Law. They are ensured by quotas for specialized medical services.
You just need to know how to get a quota for treatment in 2019-2020. This is a complex process regulated by law.
What is a quota and who is eligible for it?
Do you need information on this issue? and our lawyers will contact you shortly.
Diseases subject to quotas
The state does not issue money to relieve a citizen of any illness. To obtain a quota, compelling reasons are required.
The Ministry of Health issues a document containing a list of diseases that can be treated at public expense. The list is extensive, it contains up to 140 ailments.
Here are some of them:
- Heart diseases for which surgical intervention (including repeated surgery) is indicated.
- Internal organ transplantation.
- Joint replacement, if endoprosthesis replacement is necessary.
- Neurosurgical intervention.
- In vitro fertilization (IVF).
- Treatment of severe hereditary diseases, including leukemia.
- Surgical intervention requiring specialized equipment, that is, high-tech medical care (HTMC):
- before our eyes;
- on the spine and so on.
The procedure for obtaining a preferential place in the clinic
The path to a medical facility that can cure is not easy. The patient will have to wait for a positive decision from three commissions. This procedure for obtaining a quota was established by the Ministry of Health of the Russian Federation.
There is a workaround. We'll describe it a little later. Any application for a quota should begin with the attending physician.
To receive preferential treatment, you must confirm the diagnosis. This may require paid tests and examinations. The patient will have to do them at his own expense.
The first commission is at the patient’s place of observation
- Contact your doctor and describe your intention.
- Get a referral from him if you need to undergo additional testing. Failure to do so will result in non-receipt of the quota.
- The doctor draws up a certificate indicating the following information:
- about the diagnosis;
- about treatment;
- about diagnostic measures;
- about the general condition of the patient.
- The certificate is reviewed by a commission responsible for resolving quota issues created at the given medical institution.
- This body has three days to make a decision.
Decision of the first commission
If the patient needs specialized services, the hospital commission decides to send the documents to the next authority - the regional health department. At this stage, a package of documents is formed, which includes:
- An extract from the minutes of the meeting with the rationale for the positive decision;
- A photocopy of the passport (or birth certificate if we are talking about a child under 14 years old);
- A statement that must include:
- registration address;
- passport details;
- citizenship;
- contact information;
- A copy of the OM C policy;
- Pension insurance policy;
- Insurance account information (in some cases);
- Data on examinations and analyzes (originals);
- An extract from the medical record with a detailed diagnosis (prepared by the doctor).
Second stage of decision making
The regional-level commission includes five specialists. Its activities are supervised by the head of the relevant department. This body is given ten days to make a decision.
If a positive decision is made, this commission:
- determines the medical institution in which treatment will be carried out;
- sends a package of documents there;
- informs the applicant.
The work of this body is recorded. The paper reflects the following data:
- basis for creating a commission of a constituent entity of the Russian Federation;
- specific composition of the sitting persons;
- information about the patient whose application has been reviewed;
- conclusion, which deciphers:
- complete data on the indications for the provision of a quota;
- diagnosis, including its code;
- reasons for referral to the clinic;
- the need for additional examination;
- grounds for refusal upon receipt of VMP.
The following are sent to the medical institution where the patient will receive VMP:
- voucher for the provision of medical treatment;
- copy of the protocol;
- medical information about human health.
The third stage is the final one
The medical institution chosen for treatment also has a quota commission. Having received the documents, she holds her own meeting, in which at least three people must take part.
This body:
- Examines the information provided to determine the possibility of providing the treatment necessary for the patient.
- Makes a decision on its provision.
- Defines specific deadlines.
- He is given ten days for this work.
Thus, the decision to include a person in the quota program takes at least 23 days (the time for sending documentation should also be taken into account).
Features of quota services
State funds provide only those medical services that cannot be obtained in a local hospital.
Their types are:
- surgical intervention;
- treatment.
Operation
This type of support is provided to people whose diagnosis matches the list of the Ministry of Health. They are sent to a clinic capable of performing the necessary manipulation. All treatment is provided to them free of charge.
Some citizens are also paid for travel to the place of assistance.
VMP
This type of service involves the use of high technology to get rid of the disease. This is an expensive procedure. All necessary expenses are covered by the budget.
However, to provide VMP, compelling medical reasons are necessary.
Treatment
This type of government support involves the purchase of expensive drugs that the patient himself is not able to pay for. Its procedure is determined by Federal Law No. 323 (Article 34). The Government of the Russian Federation specifies the implementation of the provisions of this regulatory act into practice through its regulations.
ECO
Women diagnosed with infertility are referred for this operation. In vitro fertilization is a high-cost and lengthy procedure.
Many women are unable to experience the joy of motherhood without such an operation. But referrals for IVF are given only to patients who have gone through a difficult preliminary period of examination and treatment.
Not all types of assistance in restoring health and preserving the life of a citizen of the Russian Federation are described. There are many ailments, almost all of them fall under one of the described areas of medical technology. But there are also exceptions.
How to reduce the time it takes to receive support
Often people do not have the opportunity to wait. Help is needed urgently.
It is not easy to speed up the decision-making process of three commissions.
In the first case, you can put “pressure” on the people responsible for allocating quotas:
- call them to find out about the progress of resolving the issue;
- go to meetings with managers;
- write letters and so on.
The second option is to contact the clinic directly that provides the required services. To do this you need:
- collect a package of documents (described above);
- bring it to the hospital and write a statement on the spot.
Documents from the local hospital where the patient was initially diagnosed must be certified by:
- attending doctor;
- chief physician;
- seal of the organization.
Unfortunately, without complying with formalities, a clinic operating under quotas will not be able to provide assistance. This medical institution has yet to account for the use of budget funds.
March 2, 2017, 12:15 Oct 5, 2019 23:07 
