Federal Compulsory Medical Insurance Fund (hereinafter referred to as the Federal Fund) in connection with incoming questions regarding the implementation of the Rules of Use medical organizations funds rationed safety stock territorial fund of compulsory medical insurance for financial support of measures for organizing additional vocational education medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment (hereinafter referred to as activities) approved by Government Decree Russian Federation dated 04/21/2016 N 332, (hereinafter referred to as the Rules), reports.
1. Regarding the formation of an action plan. Clause 8 of the Rules establishes the duty of the body executive branch subject of the Russian Federation authorized by the highest executive body state power subject of the Russian Federation (hereinafter referred to as the authorized body), upon approval and agreement in in the prescribed manner action plan within a period not exceeding 30 calendar days from the date of entry into force of the Rules (until 06/03/2016), and subsequently - quarterly, until the 1st day of the first month of the next quarter (for the third quarter of 2016 - until 07/01/2016) .
In accordance with paragraph 3 of the Rules, funds for financial support of events are provided by the territorial fund of compulsory medical insurance (hereinafter - the territorial fund) to medical organizations within the limits of the normalized safety stock (hereinafter - NSZ) provided for in the budget of the territorial fund for the financial support of events.
Clause 5 of the Procedure for using the funds of the normalized insurance reserve of the territorial compulsory health insurance fund, approved by order of the Federal Fund dated 01.12.2010 N 227, financial support for activities is carried out within the limits of the funds of the National Health Insurance Fund of the territorial fund, formed in accordance with part 6.3 of Article 26 of the Federal Law of 29.11.2010 N 326-FZ "On mandatory health insurance in the Russian Federation" (hereinafter - Federal law N 326-FZ).
Thus, the amount of necessary funding for activities established by the action plan is determined based on the actual amount of funds in the NHA of the territorial fund, formed on the date of coordination and approval of the action plan, and the use of funds for these purposes is carried out by the territorial fund only after amendments are made to the budget law territorial fund, establishing, in accordance with Part 6.4 of Article 26 of Federal Law N 326-FZ, the size of the NHS and the purposes of its use, including the financial support of events.
In accordance with subparagraph "b" of paragraph 4 of the Rules, the authorized body approves the selection criteria for medical organizations for inclusion in the action plan (hereinafter referred to as the selection criteria).
The selection criteria established by the authorized body must ensure the possibility of distributing medical organizations based on their compliance with the specified selection criteria for the subsequent formation of a list of activities based on the actual funds of the National Health Service created in the budget of the territorial fund. These measures will create equal conditions for the inclusion of medical organizations in the action plan, regardless of their departmental affiliation and organizational and legal form.
Please note that the action plan is approved quarterly on an accrual basis. Thus, the amount of necessary financial support for the action plan at the end of the current financial year should be established within the limits of the actually generated funds of the National Social Security Fund of the territorial fund.
2. On issues of financial support for contracts concluded for the implementation of activities.
The basis for concluding contracts is the existence of an action plan approved using the selection criteria.
Thus, financial support for activities at the expense of the National Health Fund of the territorial fund under contracts concluded before the date of entry into force of the Rules and approval of the action plan is unlawful.
Based on the norms established by Articles 34 and 42 of the Federal Law of 04/05/2013 N 44-FZ "On the contract system in the field of procurement of goods, works, services to meet state and municipal needs" (hereinafter referred to as Law N 44-FZ), the contract is concluded on the conditions stipulated by the notice of procurement, which must contain information, including the source of its financial support.
Medical organizations keep separate records of transactions with compulsory health insurance funds (Part 6 of Article 15 of Federal Law N 326-FZ), including funds for financial support of activities (clause 11 of the Rules).
Thus, we consider financial support for agreements (contracts) concluded for the purpose of implementing activities from several sources to be possible if the specified agreements (contracts) establish the amount of financial support for each source with the subsequent implementation of separate analytical accounting of funds received from the territorial fund's public health fund, funds from compulsory health insurance received to pay for medical care (subject to compliance with the norms of Part 7 of Article 35 of Federal Law N 326-FZ) and other sources of financial support for agreements (contracts).
Taking into account the above, the following measures must be taken in the constituent entities of the Russian Federation:
1. Bring the budgets of territorial funds into compliance with Federal Law N 326-FZ in terms of financial support for activities.
2. Establish selection criteria that ensure equal conditions for all medical organizations.
3. When approving the action plan, ensure:
Correspondence of the amount of its financing to the amount of funds actually generated within the National Health Service of the territorial fund for the financial support of activities;
Compliance with the deadlines established by paragraph 8 of the Rules;
Formation of an action plan on an accrual basis.
4. Ensure compliance with the requirements of Federal Law N 44-FZ and the Rules when concluding contracts in order to implement activities.
Document overview
Explanations are provided from the Federal Compulsory Compulsory Medical Insurance Fund of Russia on the implementation of the Rules for the use by medical organizations of funds from the normalized safety stock (NSS) of the Federal Compulsory Compulsory Medical Insurance Fund to finance activities for additional professional education of medical workers and the acquisition (repair) of medical equipment.
The amount of financing is determined based on the actual amount of funds in the NHA of the territorial fund, formed as of the date of coordination and approval of the action plan. Funds are used by the territorial fund only after amendments are made to the law on the budget of the territorial fund. Therefore, regions must bring fund budgets into compliance with the law.
The authorized body approves the criteria for selecting medical organizations for inclusion in the action plan. This will create equal conditions for them.
The plan is approved quarterly on an accrual basis. Therefore, the amount of funds based on the results of the current financial year is established within the limits of the actually generated funds of the National Health Insurance Fund.
It is impossible to finance activities at the expense of the NHS under government contracts concluded before the date of entry into force of the rules and approval of the action plan.
Financing of government contracts from several sources is possible if they establish the amount of financial support for each source, followed by separate analytical accounting of funds received from the NHS fund, compulsory medical insurance funds received to pay for medical care and other sources.
TERRITORIAL COMPULSORY HEALTH INSURANCE FUND OF THE SVERDLOVSK REGION
ORDER
ABOUT THE USE OF NHA FUNDS IN ACCORDANCE WITH BY DECREE OF THE GOVERNMENT OF THE RF OF 04/21/2016 N 332
In order to implement the Decree of the Government of the Russian Federation of April 21, 2016 N 332 “On approval of the Rules for the use by medical organizations of the funds of the normalized insurance stock of the Federal Compulsory Compulsory Medical Insurance Fund for financial support of activities for the organization of additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment” , Order of the Ministry of Health of the Russian Federation dated 06.06.2016 N 354n “On approval of the standard form and procedure for concluding an agreement between the Federal Compulsory Medical Insurance Fund and a medical organization on financial security measures for organizing additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment", Order of the Federal Compulsory Compulsory Medical Insurance Fund dated 01.12.2010 N 227 "On the Procedure for using funds from the rationed safety stock of the Federal Compulsory Compulsory Medical Insurance Fund" I order:
1. Approve:
1.1. The form “Notification of a medical organization about the availability of funds from the National Health Insurance Fund for Compulsory Compulsory Medical Insurance for financial support for the implementation of measures to organize additional professional education for medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment” (attached).
1.2. Regulations for the interaction of compulsory medical insurance participants on the use of funds from the National Health Insurance Fund by medical organizations for financial support of activities for the organization of additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment (attached).
2. Heads of structural divisions of the TFOMS shall be guided by the Regulations approved by paragraph 1.2 of this Order.
3. The Department of Information and Technical Support (Sartakov I.M.) to provide the technical ability to record funds allocated for financial support of activities for the organization of additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment, in the information analytical system TFOMS.
4. The directors of intermunicipal branches of the TFOMS should bring this Order to the attention of the heads of medical organizations operating in the field of compulsory medical insurance.
6. Entrust control over the implementation of this Order to First Deputy Director T.V. Demina.
Director
V.A. SHELYAKIN
Application. Notification of a medical organization about the availability of funds from the National Social Insurance Fund for Compulsory Compulsory Medical Insurance for financial support for the implementation of measures to organize additional professional education for medical workers under advanced training programs, and..
Form
To the manager _____________
(MO)
Notification of a medical organization about the availability of funds from the National Health Insurance Fund for financial support for the implementation of measures to organize additional professional education for medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment
In order to implement the Decree of the Government of the Russian Federation
dated 04/21/2016 N 332 “On approval of the Rules for the use of medical
organizations of funds of the standardized safety stock of TFOMS for
financial support for activities to organize additional
professional education of medical workers according to programs
advanced training, as well as acquisition and repair
medical equipment" in accordance with the Action Plan,
approved by order of the Ministry of Health of the Sverdlovsk Region dated
N ______ "On approval of the Action Plan for organizing
additional professional education for medical workers
advanced training programs, as well as for the acquisition and implementation of
repair of medical equipment", I notify you of the availability of funds
standardized safety stock of TFOMS for financial support
implementation of activities planned for ______________________________,
(name of MO)
in the amount of ________ rubles, including:
name of the event | amount, in rub. |
on the organization of additional professional education of medical workers under advanced training programs | |
for the purchase of medical equipment | |
for repair of medical equipment |
Application. REGULATIONS FOR INTERACTION OF PARTICIPANTS OF COMPLIANT CHILD MEDICAL ORGANIZATIONS ON THE USE OF FUNDS OF THE NSZ TFOMS BY MEDICAL ORGANIZATIONS FOR FINANCIAL SUPPORT OF EVENTS FOR ORGANIZING ADDITIONAL PROFESSIONAL EDUCATION OF MEDICAL WORKERS...
REGULATIONS FOR INTERACTION OF PARTICIPANTS OF CHILDHOOD INSURANCE ON THE USE OF FUNDS BY MEDICAL ORGANIZATIONS OF THE NSZ TFOMS FOR FINANCIAL SUPPORT OF EVENTS FOR THE ORGANIZATION OF ADDITIONAL PROFESSIONAL EDUCATION OF MEDICAL WORKERS UNDER PE PROGRAMS DEVELOPMENT OF QUALIFICATIONS, AS WELL AS PURCHASE AND REPAIR OF MEDICAL EQUIPMENT
1. BASIC PROVISIONS
1.1. List of abbreviations used in the Regulations:
Reduction | Definition |
Information analytical system TFOMS |
|
A medical organization operating in the field of compulsory medical insurance, included in the action plan for organizing additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment, approved by order of the Ministry of Health of the Sverdlovsk Region |
|
Events | Measures to organize additional professional education for medical workers under advanced training programs, as well as to purchase and repair medical equipment |
Normalized safety stock |
|
Compulsory health insurance |
|
Event plan | Action plan for organizing additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment, approved by order of the Ministry of Health of the Sverdlovsk Region |
Agreement | Agreement between the Federal Compulsory Compulsory Medical Insurance Fund and a medical organization on financial support for activities for organizing additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment (in accordance with the form approved By Order of the Ministry of Health of the Russian Federation dated 06.06.2016 N 354n) |
Territorial Compulsory Medical Insurance Fund of the Sverdlovsk Region |
1.2. This Regulation was developed in order to organize interaction between compulsory medical insurance participants on the use of medical funds of the National Health Insurance Fund for financial support of activities for the organization of additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment on the basis of:
Decree of the Government of the Russian Federation dated April 21, 2016 N 332 “On approval of the Rules for the use by medical organizations of the funds of the rationed safety stock of the Federal Compulsory Compulsory Medical Insurance Fund for financial support of activities for the organization of additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment”;
Order of the Ministry of Health of the Russian Federation dated 06.06.2016 N 354n "On approval of the standard form and procedure for concluding an agreement between the Federal Compulsory Medical Insurance Fund and a medical organization on financial support for activities for organizing additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment";
Order of the Federal Compulsory Compulsory Medical Insurance Fund dated December 1, 2010 N 227 “On the Procedure for using funds from the standardized safety stock of the Federal Compulsory Compulsory Medical Insurance Fund.”
2. MEDICAL ORGANIZATION
2.1. Based on the Notification of the availability of funds from the National Health Insurance Fund, the TFOMS for financial support of the implementation of measures for organizing additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment, submits to the TFOMS a package of documents with a covering letter:
Draft Agreement signed by the Ministry of Defense (standard forms of Agreements are posted on the TFOMS website in the section “Insurance and medical organizations”, “On the use of NHS funds”) in two copies;
List of documents required to conclude the Agreement (Appendix 1 to these Regulations);
Documents in accordance with the List of Documents.
2.2. Uses funds received in accordance with the Agreement to provide financial support for the Events in compliance with the conditions established by the Agreement.
2.3. If the supplier (performer) fully fulfills the obligations under the agreement (contract), he sends a letter to the director of the TFOMS (a copy to the TFOMS branch) notifying about the fulfillment of the agreement (contract) (indicating N and the date of the Agreement, N and the date of the agreement (contract) )) signed by the manager and chief accountant, with certified copies of the relevant acts on acceptance of goods (works, services) attached.
2.4. Maintains separate analytical accounting of funds for financial support of the Events. When providing financial support for agreements (contracts) concluded for the purpose of implementing the Activities, from several sources in these agreements (contracts), the amount of financial support for each source is established, followed by separate analytical accounting of funds.
2.5. Submits reports to the TFOMS on the implementation of activities and the use of funds for financial support of events in accordance with TFOMS Order No. 292 dated 07.07.2016.
2.6. Returns to the TFOMS budget funds received in accordance with the Agreement, used for purposes other than their intended purpose.
2.7. After making payments to the supplier (performer), sends it to the Department accounting and reporting on email a scanned copy of the payment order certified by the chief accountant of the medical organization.
3. TFOMS OF THE SVERDLOVSK REGION
3.1. INTERMUNICIPAL BRANCH OF TFOMS
3.1.1. Provides the Ministry of Defense with methodological assistance in preparing the package of documents necessary for signing the Agreement.
3.1.2. Interacts with the Ministry of Defense to provide reporting on the implementation of activities and the use of funds for financial support of activities in accordance with Order of the Federal Compulsory Compulsory Medical Insurance Fund dated 07/07/2016 N 292.
3.2. LEGAL DEPARTMENT
3.2.1. Ensures the signing of the Agreement in accordance with the Procedure for consideration by the departments of the TFOMS of the draft Agreement approved by the order of the TFOMS.
3.3. FINANCIAL AND ECONOMIC MANAGEMENT
3.3.1. Within 5 working days from the date of approval of the action plan, the Ministry of Defense notifies in writing about the availability of NHS funds in the TFOMS budget for financial support of the activities.
3.3.2. Forms a financial order in accordance with the schedule for transferring funds of the Agreement.
3.3.3. Provides complete and timely reflection of cash flows using the IAS-4 A55 function “ID Cash”.
3.3.4. Collects and approves reports on the implementation of activities and the use of funds for financial support of activities in accordance with Order of the Federal Compulsory Compulsory Medical Insurance Fund dated 07/07/2016 N 292.
3.4. ACCOUNTING AND REPORTING DEPARTMENT
3.4.1. Based on financial orders prepared by the financial and economic department, transfers to the Ministry of Defense cash for financial support of activities in accordance with the Agreement.
3.4.2. Keeps records of payments in accordance with schedules for transferring funds, separate analytical accounting of funds for financial support of Events.
3.5. CONTROL AND AUDIT MANAGEMENT
3.5.1. Monitors the implementation of MO activities and the use of funds received for specified purposes within the framework of scheduled inspections of the MO.
Appendix 1. LIST OF DOCUMENTS REQUIRED TO CONCLUSION OF AN AGREEMENT OF TFOMS WITH A MEDICAL ORGANIZATION ON FINANCIAL SUPPORT OF EVENTS FOR ORGANIZING ADDITIONAL PROFESSIONAL EDUCATION OF MEDICAL WORKERS UNDER IMPROVEMENT PROGRAMS ..
Appendix 1
to the Regulations
LIST OF DOCUMENTS REQUIRED FOR CONCLUSION OF AN AGREEMENT OF TFOMS WITH A MEDICAL ORGANIZATION ON FINANCIAL SUPPORT OF EVENTS FOR THE ORGANIZATION OF ADDITIONAL PROFESSIONAL EDUCATION OF MEDICAL WORKERS UNDER PROFESSIONAL ADVANCED PROGRAMS KATSIA, AS WELL AS PURCHASE AND REPAIR OF MEDICAL EQUIPMENT
Name of MO |
Document name | Number of sheets |
|
Draft Agreement between the Federal Compulsory Compulsory Medical Insurance Fund and a medical organization on financial support for activities for organizing additional professional education of medical workers under advanced training programs, as well as for the acquisition and repair of medical equipment (according to the form posted on the Federal Compulsory Compulsory Medical Insurance Fund website), in two copies, signed by the Ministry of Defense | ||
Financial and economic activity plan (introduction of changes in order to implement the Activities) | ||
Documents on the organization of additional professional education of medical workers under advanced training programs |
||
Application from a medical worker for referral to additional professional education under a continuing education program at an organization engaged in educational activities | ||
Education agreement for training in an additional professional educational program | ||
Documents for the purchase of medical equipment |
||
A document confirming the need for purchased medical equipment provided for by the procedure(s) for providing medical care approved by the Ministry of Health of the Russian Federation | ||
Documents confirming the qualifications of the medical worker(s) who have the appropriate level of education and qualifications to work on the purchased medical equipment | ||
Documents confirming the availability of premises in the Moscow Region for the installation of purchased medical equipment | ||
Contract for the supply of medical equipment | ||
Documents for repairing medical equipment |
||
A document confirming the need of the Ministry of Defense for the repair of medical equipment provided for by the procedure(s) for the provision of medical care approved by the Ministry of Health of the Russian Federation | ||
Documents confirming that the medical equipment to be repaired is owned (operational managed) by the Ministry of Defense and accepted for accounting | ||
Registration certificate for a medical device | ||
Act on putting medical equipment into operation | ||
Document confirming the failure of medical equipment | ||
A document confirming the expiration of the warranty period for medical equipment | ||
Medical equipment repair contract | ||
Head of the Ministry of Defense / Full name
From 2019, the normalized insurance stock of Compulsory Health Insurance Terfunds will include funds to combat staffing shortages in primary care. Now it is used to finance medical care provided outside the home region, additional education for doctors, as well as the purchase and repair of medical equipment.
The Ministry of Health proposes to form the normalized insurance stock (NSS) of territorial compulsory health insurance funds (CHI) differently. Now it is intended “for the implementation of territorial compulsory medical insurance programs, payments for medical care provided to insured persons outside the territory of the constituent entity of the Russian Federation in which the compulsory medical insurance policy was issued, the organization of additional professional education of medical workers under advanced training programs, the acquisition and repair of medical equipment.” In 2019–2024, it will also include funds to eliminate staffing shortages in clinics providing primary medical care. The corresponding draft law amending Article 51 of the Federal Law “On Compulsory Health Insurance in the Russian Federation” was published on the website of the Government of the Russian Federation.
Where the funds will come from and how they will be used by medical organizations must be approved by the Ministry of Health in an additional order. , now the normalized insurance stock of the TFOMS is formed from the budget revenues of the territorial fund (subventions from the FFOMS), money intended to pay for medical care for residents of other regions, as well as part of the funds from penalties imposed on clinics based on the results of inspections.
The government also ordered the submission to the State Duma of a draft budget for the Federal Compulsory Medical Insurance Fund for the next year and for the planning period of 2020 and 2021. According to it, the formation of a normalized insurance stock of the Federal Compulsory Medical Insurance Fund is planned annually in the amount of 3.1 billion rubles.
For the next year, MHIF revenues are provided in the amount of 2,098.2 billion rubles, for 2020 - 2,349.9 billion rubles, for 2021 - 2,495.8 billion rubles (2018 budget - 1,887.9 billion rubles). It is expected that expenses for 2019 will amount to 2,190.4 billion rubles, in 2020 – 2,350.5 billion rubles and in 2021 – 2,501.5 billion rubles (2018 budget – 1,994.1 billion rubles) .
“The Fund’s budget deficit in 2019 will amount to 92.3 billion rubles, in 2020 – 0.5 billion rubles, in 2021 – 5.7 billion rubles. The balance of the Fund’s budget will be achieved through the carryover balances of funds at the end of the corresponding financial year,” the Cabinet of Ministers said in its order.
"In them (budgets of social funds - Ed.) we have pledged funds that will ensure the necessary level of social protection for people,” said Prime Minister Dmitry Medvedev at a government meeting on September 20 during a discussion of bills. - The money will be used to further improve the quality of medicine. We will also include in the basic program Compulsory medical insurance new types of high-tech care, we will continue to eliminate the shortage of individual specialists in hospitals.”
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