1. These Rules determine the procedure and conditions for the provision of paid medical services to the population (in addition to the guaranteed volume of free medical care) by medical institutions, regardless of departmental subordination and form of ownership, including research institutes and state medical educational institutions of higher professional education ( hereinafter referred to as - medical institutions), and are binding on all medical institutions.
2. Paid medical services to the population are provided by medical institutions in the form of preventive, medical and diagnostic, rehabilitation, prosthetic and orthopedic and dental care. Paid medical services to the population are carried out by medical institutions under contracts with citizens or organizations for the provision of medical services to workers and their families.
3. The provision of paid medical services to the population by medical institutions is carried out if they have a certificate and license for the chosen type of activity.
4. State and municipal medical institutions provide paid medical services to the population by special permission of the relevant health management body.
5. Medical institutions are obliged to ensure the compliance of the provided paid medical services to the population with the requirements for the methods of diagnosis, prevention and treatment permitted on the territory of the Russian Federation.
6. Medical institutions are obliged to keep statistical and accounting records of the results of paid medical services provided to the population, draw up the required reports and submit them in the manner and terms established by laws and other legal acts Russian Federation.
7. State and municipal medical institutions that provide the population with paid medical services are obliged to keep statistical and accounting records and reporting separately for the main activity and paid medical services.
8. Control over the organization and quality of the provision of paid medical services to the population, as well as the correct collection of payments from the population, is exercised within the limits of their competence by health management bodies and other state bodies and organizations, which, in accordance with the laws and other legal acts of the Russian Federation, are entrusted with the verification of activities medical institutions.
9. Prices for medical services provided to the population for a fee are established in accordance with the legislation of the Russian Federation.
10. Medical institutions are obliged to provide citizens with free, accessible and reliable information, including information about the location of the institution (place of its state registration), operating hours, a list of paid medical services with an indication of their cost, the conditions for the provision and receipt of these services, including information on benefits for certain categories of citizens, as well as information on the qualifications and certification of specialists.
11. The provision of paid medical services is formalized by an agreement, which regulates the conditions and terms of their receipt, the procedure for settlements, the rights, obligations and responsibilities of the parties.
12. Payment for medical services is made at bank institutions or at a medical institution.
Settlements with the population for the provision of paid services are carried out by medical institutions using cash registers.
When making payments to the population without the use of cash registers, medical institutions must use a form, which is a document of strict accountability, approved in accordance with the established procedure.
Medical institutions are required to issue the consumer (cash) receipt or a copy of the form confirming the receipt of cash.
13. Consumers using paid medical services have the right to demand the provision of services of adequate quality, information on the availability of a license and certificate, on the calculation of the cost of the service provided.
14. Consumers using paid medical services are obliged to:
pay the cost of the provided medical service;
comply with the requirements ensuring the quality provision of paid medical services, including the provision of the information necessary for this.
15. In accordance with the legislation of the Russian Federation, medical institutions are liable to the consumer for non-fulfillment or improper fulfillment of the terms of the contract, non-compliance with the requirements for diagnostic, prevention and treatment methods permitted on the territory of the Russian Federation, as well as in case of harm to the health and life of the consumer ...
16. Consumers using paid medical services have the right to claim compensation for losses caused by non-fulfillment or improper fulfillment of the terms of the contract, compensation for damage in case of harm to health and life, as well as compensation for causing moral harm in accordance with the legislation of the Russian Federation and these Rules.
17. If the medical institution fails to comply with the obligations on the terms of the performance of services, the consumer has the right, at his choice:
set a new term for the provision of the service;
demand a reduction in the cost of the service provided;
request the performance of the service by another specialist;
terminate the contract and claim damages.
Violation of the terms for the performance of services established by the contract must be accompanied by the payment of a penalty to the consumer in the manner and amount determined by the Law of the Russian Federation "On Protection of Consumer Rights" or the contract.
By agreement (contract) of the parties, the specified forfeit can be paid by reducing the cost of the provided medical service, providing the consumer with additional services without payment, returning a part of the previously paid advance.
18. Claims and disputes arising between the consumer and the medical institution are resolved by agreement of the parties or in court in accordance with the legislation of the Russian Federation.
19. A medical institution is released from liability for non-performance or improper performance of a paid medical service if it proves that non-performance or improper performance was due to force majeure, as well as on other grounds provided for by law.
20. For failure to comply with these Rules, a medical institution may be deprived of a license or the right to provide paid medical services to the population in accordance with the established procedure.
The definition of private medical practice is given in Article 56 of the Fundamentals of the Legislation of the Russian Federation on the Protection of Citizens' Health (hereinafter - the Fundamentals). In accordance with this article, private medical practice is defined as the provision of medical services by medical workers outside the institutions of the state and municipal health systems at the expense of citizens' personal funds or at the expense of enterprises, institutions and organizations, including medical insurance organizations, in accordance with concluded contracts. This practice is carried out in accordance with the legislation on the protection of the health of citizens. Based on the foregoing, the following conclusions can be drawn:
Only medical professionals have the right to engage in private medical activity, who must have:
a) higher or secondary medical and pharmaceutical education, as well as a special title; b) specialist certificate; c) a license for a selected type of activity included in the list established by the Ministry of Health of the Russian Federation.
Individuals engaged in private medical practice and private pharmaceutical activities belong to the private health care system.
Private medical practice and private pharmaceutical activities are a type of entrepreneurial activity.
Thus, the main condition for the legality of these types of activities is to obtain an appropriate license, since these types of activities are classified by law as licensed (Article 17 of the Federal Law "On Licensing Certain Types of Activities"). Licensing, being one of the types of state regulation of the economy, presupposes the implementation by the state of a control function in relation to entities engaged in entrepreneurial activity, which, due to its specificity (affecting the interests of a large number of consumers of state and public security, health and morality of the population, etc.) requires such control. All of the above can certainly be attributed to private medical practice and pharmaceutical activities. To obtain a license to carry out medical activities, persons who applied for it must meet certain requirements, namely:
Have appropriate professional training or have employees with such training (in the case of legal entities)
Possess the necessary regulatory and methodological support, organizational and technical capabilities and material and technical equipment to carry out the relevant types of medical activities.
As already noted, the professional training of persons engaged in private medical practice and pharmaceutical activities must be confirmed by a diploma of higher or secondary medical or pharmaceutical education, as well as a specialist certificate. Obtaining a license to carry out pharmaceutical activities is associated with the need to comply with the following requirements for persons applying for such:
The presence of a specialist certificate or the presence in the staff of employees who have such a certificate (if we are talking about legal entities).
The presence of a technically prepared room for the storage of poisonous and potent substances that meets the requirements of fire safety and sanitary rules, equipped with a burglar alarm.
For both private medical practice and pharmaceutical activities, general requirements for a specialist certificate have been established. A specialist certificate is issued on the basis of:
postgraduate vocational education(graduate school, residency),
additional education ( training, specialization),
a verification test conducted by the commissions of professional medical and pharmaceutical associations on the theory and practice of the chosen specialty, issues of legislation in the field of public health protection.
In addition, for the implementation of both private medical practice and pharmaceutical activities, as well as for all licensed activities, it is also required:
Registration as a legal entity or individual entrepreneur;
Tax registration;
Payment for the consideration of the application.
A specific requirement for private medical practice and pharmaceutical activities associated with the potential danger to humans of such activities is the need to obtain a sanitary and epidemiological conclusion on compliance with sanitary rules (clause 2 of article 40 of the Federal Law of 30.03.99 ј 52-FZ "On sanitary - epidemiological well-being of the population ") License holders (licensees) may be:
Commercial organizations, the constituent and documents of which do not limit their legal capacity in terms of the implementation of private medical practice and pharmaceutical activities
Non-profit organizations, if in accordance with the constituent documents they are entitled to carry out entrepreneurial activities
Individuals with the status of an individual entrepreneur.
Carrying out medical (pharmaceutical) activities without a license (lack of a license) can be considered in the following cases:
failure to obtain a license in the prescribed manner;
availability of a license for another type of medical (pharmaceutical) activity or for another type of licensed activity;
termination of the license;
suspension of the license (in this case, although the license formally exists, it does not provide the right to carry out the type of activity specified in it);
revocation of the license.
The license is considered not obtained in cases when the person carrying out the type of activity subject to licensing:
a) did not apply to the licensing authority for a license;
b) has received a license in an unspecified manner or from an unauthorized licensing authority;
c) applied for a license, but this was refused. Even in the event of an unlawful refusal to issue a license, the license applicant does not have the right to carry out the licensed type of activity until the final decision of this issue in court.
Article 235 of the Criminal Code of the Russian Federation.Illegal practice of private medical practice or private pharmaceutical activity. 1. Engaging in private medical practice or private pharmaceutical activity by a person who does not have a license for the chosen type of activity, if this has entailed, by negligence, causing harm to human health, -
shall be punishable by a fine in the amount of up to one hundred and twenty thousand rubles, or in the amount of the wage or salary, or any other income of the convicted person for a period of up to one year, or restraint of liberty for a term of up to three years, or imprisonment for a term of up to three years.
2. The same act, which, through negligence, entailed the death of a person -
shall be punishable by restraint of liberty for a term of up to five years, or imprisonment for the same term.
Article 173 of the Civil Code of the Russian Federation. Invalidity of the transaction of a legal entity that goes beyond the limits of its legal capacity. A transaction made by a legal entity in contradiction with the goals of activity, definitely limited in its constituent documents, or by a legal entity that does not have a license to engage in the relevant activity, may be declared invalid by a court at the suit of this legal entity, its founder (participant) or a state body, exercising control or supervision over the activities of a legal entity, if it is proved that the other party to the transaction knew or knowingly should have known about its illegality.
Article 169 of the Civil Code of the Russian Federation. Invalidity of a transaction made for a purpose contrary to the foundations of law and order and morality. A transaction made for a purpose that is obviously contrary to the foundations of law and order or morality is void. If both parties to such a transaction have intent - if the transaction is executed by both parties - everything received by them under the transaction is recovered to the income of the Russian Federation, and if the transaction is executed by one party on the other side, everything received by it and everything due from it is collected to the income of the Russian Federation. to the first party in compensation received. If there is intent only on one of the parties to such a transaction, everything received by it under the transaction must be returned to the other party, and what the latter received or owed to it in compensation for the executed, shall be recovered to the income of the Russian Federation.
PRACTICAL PART
As an example, I will cite a surgeon with a higher education, as well as a special title and certificate of a specialist who decided to engage in private medical activity without a license.
There are various options for the responsibility that he may incur:
Administrative legislation to date does not establish administrative responsibility for the practice of private medical practice or private pharmaceutical activity by a person in the absence of a license. Consequently, given the non-criminal nature of this act (no harm to health caused by negligence), it cannot be considered an administrative offense. The maximum possible legal consequences in this case are fixed in civil law- this is the recognition of transactions concluded by a person engaged in private medical practice or private pharmaceutical activity by a person in the absence of a license, invalid in accordance with Art. 173 of the Civil Code of the Russian Federation. A more stringent civil law consequence of carrying out such activities without a license is the recognition of such transactions as null and void as committed with a purpose contrary to the foundations of law and order and morality on the basis of Art. 169 of the Civil Code of the Russian Federation. (the texts of the articles are given in the previous part).
Criminal the same responsibility occurs if the doctor in question causes harm to the health of his patients through negligence, or as a result of negligence, the death of his patient occurs (in accordance with Art. 235 of the Criminal Code of the Russian Federation).
BIBLIOGRAPHY
Regulations:
The government of Moscow
DEPARTMENT OF HEALTHCARE OF THE CITY OF MOSCOW
ORDER
On the approval of the Rules for the provision of paid services citizens and legal entities by state organizations of the health care system of the city of Moscow
Document with changes made:
by order of the Moscow Department of Healthcare of September 9, 2015 N 764;
by order of the Moscow Department of Healthcare of March 2, 2017 N 148;
;
by order of the Moscow City Health Department of June 14, 2017 N 427.
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Pursuant to the decrees of the Government of the Russian Federation of October 4, 2012 N 1006 "On approval of the Rules for the provision of paid medical services by medical organizations" and of August 15, 2013 N 706 "On the approval of the Rules for the provision of paid educational services", as well as the Resolution of the Moscow Government of December 21, 2010 1076-PP "On the procedure for the implementation by the executive authorities of the city of Moscow of the functions and powers of the founder of state institutions of the city of Moscow"
(Preamble as amended by order of the Moscow Health Department of April 14, 2017 N 283.
I order:
1. To approve the Rules for the provision of paid services to citizens and legal entities by state organizations of the health care system of the city of Moscow (hereinafter referred to as the Rules) (annex to this order).
2. The heads of the organizations of the state healthcare system of the city of Moscow, when providing paid services, should be guided by the rules approved by the decrees of the Government of the Russian Federation of 04.10.2012 N 1006, of 15.08.2013 N 706.
by order of the Moscow Department of Healthcare of April 14, 2017 N 283.
3. The head of the Department of Affairs and Coordination of Activities, E.L. Nikonov, ensure that this order is posted on the official website of the Moscow City Health Department.
(Clause as amended by order of the Moscow Health Department of April 14, 2017 N 283.
4. To consider as invalid the orders of the Moscow Department of Health:
- dated December 9, 2011 N 1608 "On Approval of the Rules for the Provision of Paid Services to Citizens and Legal Entities by State Institutions of All Types of the Moscow City Health Department";
- dated 04.07.2013 N 677 "On amendments to the order of the Department of Health of the city of Moscow dated 09.12.2011 N 1608"
5. Control over the execution of this order shall be entrusted to the first deputy head of the Moscow City Health Department, VV Pavlov.
(Clause as amended by order of the Moscow Health Department of April 14, 2017 N 283.
Minister of the Moscow Government,
head of department
health care of the city of Moscow
G.N. Golukhov
Application. Rules for the provision of paid services to citizens and legal entities by state organizations of the health care system of the city of Moscow
Application
to the order of the Department
health care of the city of Moscow
dated October 2, 2013 N 944
These Rules establish the procedure for the provision of paid services to citizens and legal entities by medical, educational and other state organizations of the health care system of the city of Moscow.
The rules are developed in accordance with the current legislative and regulatory acts of the federal and regional levels.
1. Paid services are provided by medical, educational and other state organizations of the Moscow healthcare system (hereinafter referred to as state organizations) to citizens and legal entities in accordance with the legislation of the Russian Federation and types of income-generating activities permitted by the statutes of state organizations. The provision of paid medical, educational and other services subject to licensing is carried out on the basis of the list of works, services that constitute medical, educational and other activities and specified in the license to carry out activities issued in accordance with the established procedure.
The Moscow City Health Department maintains a register of subordinate government organizations that provide paid services (official website www.mosgorzdrav.ru) ".
2. The date of commencement of the provision of paid services, the list of paid services rendered by the state organization, prices (tariffs) for paid services, as well as changes in the list of paid services and changes in prices (tariffs) for paid services are approved by the order of the state organization. Lists of paid services and price lists of prices (tariffs) for paid services are drawn up indicating the codes of the paid services provided in accordance with the approved nomenclature of medical and educational services.
Prior to the issuance of an order from a state organization approving the list of paid services or amending this order, the list of paid services that the state organization intends to provide is subject to approval by the Moscow City Health Department.
In case of termination of the provision of paid services, state organizations within 3 days send the relevant information to the Moscow Department of Health in order to amend the register of state organizations that provide paid services on the official website of the Moscow Department of Health.
3. The provision of paid services to citizens is carried out with the voluntary informed consent of the patient. The fact of voluntary informed consent to the provision of paid medical services is recorded in the patient's medical record.
4. State medical organizations of the Moscow Healthcare Department (hereinafter referred to as medical organizations) that provide the appropriate types and volumes of medical care without charging a fee under the Program of State Guarantees of Free Provision of Medical Care to Citizens and the Territorial Program of State Guarantees of Free Provision of Medical Care to Citizens (hereinafter referred to as Program, Territorial Program), have the right to provide paid medical services:
a) on other terms than provided for by the Program, territorial programs and (or) targeted programs, at the request of the consumer (customer), including but not limited to:
- the establishment of an individual post of medical supervision during treatment in a hospital;
- application drugs not included in the list of vital and essential medicinal products, if their appointment and use is not due to vital indications or replacement due to individual intolerance to medicinal products included in the specified list, as well as the use of medical devices, medical food, including specialized products medical nutrition not provided for by the standards of medical care;
b) when providing medical services anonymously, with the exception of cases provided for by the legislation of the Russian Federation;
c) citizens of foreign states, stateless persons, with the exception of persons insured under compulsory health insurance, and citizens of the Russian Federation who do not reside permanently on its territory and who are not insured under compulsory health insurance, unless otherwise provided by international treaties of the Russian Federation;
d) when self-applying for medical services, with the exception of the cases and procedures provided for in Article 21 of the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation", and cases of providing an ambulance, including an ambulance specialized medical care and medical care provided in an emergency or urgent form. "
5. Medical organizations can provide medical services for a fee: an individual medical post, the provision of medical services at home (except for cases when medical care at home is provided for medical reasons), medical and social assistance and other services, as well as additional services provided in the process of providing medical care, including household and service: delivery of medicines, rental of medical products, individual preparation or ordering of meals at the request of the patient, accommodation in a superior ward and other services provided in addition to the provision of medical care.
6. Paid services, their types, volumes and conditions of provision must comply with licensing requirements, the terms of the Agreement, standards and procedures for the provision of medical care, educational and other services, regulatory documents (requirements) established by the Ministry of Health of the Russian Federation, the Ministry of Education and Science of the Russian Federation and other requirements established by law.
7. Paid medical and educational services can be provided in full scope of the standard of medical care, state educational standards, or as one-time consultations, procedures, diagnostic studies and other services, including those in excess of the standards being fulfilled.
8. Requirements for the provision of paid services, including the content of standards, procedures and conditions for the provision of medical care, service, educational and other services are determined by agreement of the parties and may be higher than that provided for by standards, procedures and other regulatory documents (requirements) approved by the Ministry of Health of the Russian Federation, the Ministry of Education and Science of the Russian Federation, as well as standards, procedures, conditions and requirements established on their basis by other federal and regional executive authorities.
9. When providing paid services, the operating mode of a state organization may be established according to a separate schedule, subject to its agreement with the Founder.
At the same time, the availability, quality and volume of medical services provided under the Program, the Territorial Program of state guarantees for the provision of free medical care to the population of the city of Moscow, targeted comprehensive programs and, in terms of educational services, provided free of charge in accordance with federal state educational standards, should not deteriorate.
10. The procedure for the provision of paid services in state organizations is regulated by the Regulations on the procedure and conditions for the provision of paid services in a state organization, developed on the basis of these Rules and approved by the head of a state organization, internal regulatory documents (orders, internal labor regulations, collective agreements, work schedules, etc. etc.), as well as other requirements of the current legislation.
11. To provide paid services, taking into account the demand of the population for the relevant types of services and the availability of the necessary funds, it is possible to organize special structural units (departments, chambers, offices for the provision of paid services), which are created by order of the head of a state organization. To carry out work on the provision of paid services, additional positions of medical and other personnel may be introduced, contained at the expense of funds from the sale of paid services, as well as specialist consultants from other medical institutions, research institutes, higher educational institutions with which employment contracts or contracts of a civil nature are concluded.
12. When rendering paid medical services, methods of prevention, diagnostics, treatment, medical technologies, medicines, immunobiological preparations and disinfectants permitted for use in accordance with the procedure established by law must be applied.
13. Paid services (work) are provided under contracts at the expense of personal funds of citizens, insurance premiums for voluntary medical insurance, funds of enterprises, institutions and organizations and other means permitted by law.
14. The conclusion of contracts by state organizations for intermediary services for attracting patients by third-party organizations is not allowed.
15. Medical services cannot be provided for a fee in the provision of emergency medical care, which is provided immediately in conditions requiring medical intervention for urgent indications (in case of accidents, injuries, poisoning and other conditions and diseases); as well as during forensic medical examination and forensic psychiatric examination (with the exception of examinations carried out in civil and arbitration cases, cases of administrative offenses); pathological and anatomical autopsy of corpses and military medical examination.
16. Upon receipt of medical care within the framework of the Territorial program for the provision of free medical care, the following services are not subject to payment:
- the appointment and use of medicinal products for medical indications (in cases of their replacement due to intolerance, rejection) that are not included in the list of vital and essential medicinal products;
- accommodation in small wards (boxes) of patients for medical and (or) epidemiological indications;
- joint stay of one of the parents (another legal representative) or another family member in a medical institution when providing medical care in inpatient conditions with a child under the age of four years inclusive throughout the entire period of treatment, and with a child over four years old - if indicated;
- medical and transport services in the provision of medical care within the framework of the standards of medical care (examination and treatment of a patient in a 24-hour hospital) in the absence of the possibility of their implementation by a medical or other organization providing medical care to the patient;
- transportation, storage in the morgue of biological material received for research, corpses of patients who died in medical and other organizations, utilization of biological material.
17. The provider of paid services is obliged to provide information about the provider of paid services and the services provided by him in accordance with the list approved by federal legislation on the procedure for the provision of paid medical and educational services.
Information posted on information stands (counters) should be available to an unlimited number of persons during the entire working hours of the state organization providing paid services. Information stands (counters) are located in an accessible place for visitors and are designed in such a way that one can freely familiarize themselves with the information posted on them.
In addition, at the request of the consumer and (or) the customer, the service provider provides for review:
a) a copy of the constituent document of the state organization, regulations on its branch participating in the provision of paid services;
b) a copy of the license to carry out medical, educational and other activities subject to licensing, with the attachment of a list of works (services) in accordance with the license.
When concluding a contract, at the request of the consumer and (or) the customer, they must be provided in an accessible form with information about paid services, containing the following information:
a) the procedures for the provision of medical care and the standards of medical care used in the provision of paid medical services;
b) information about a specific medical worker providing an appropriate paid medical service (his professional education and qualifications);
c) information on the methods of providing medical care, associated risks, possible types of medical intervention, their consequences and the expected results of providing medical care;
d) a list of categories of consumers entitled to benefits, as well as a list of benefits provided in the provision of paid medical, educational, including paid additional educational services in accordance with federal laws and other regulatory legal acts.
e) basic and additional educational programs, the cost of educational services for which is included in the basic fee under the contract;
f) additional educational programs, special courses, cycles of disciplines and other additional educational services provided for a fee only with the consent of the consumer.
The contractor is obliged to inform the consumer at his request of other information related to the contract.
18. Paid services cannot be provided by the contractor in exchange for services performed within the framework of a state (municipal) assignment.
19. State organizations have no right to provide additional services for a fee without the consent of citizens, as well as condition the provision of some services on the mandatory execution of others.
20. The procedure for concluding contracts for the provision of paid services and the requirements for their content are established by federal legislation on the procedure for the provision of paid services by state organizations.
21. When concluding an agreement, the consumer (customer) is provided in an accessible form with information about the possibility of obtaining the appropriate types and volumes of medical care, educational services without charging a fee within the framework of state guarantees established by the legislation of the Russian Federation.
The consumer's refusal to conclude a contract for the provision of paid services cannot be the reason for a decrease in the types and volumes of medical care provided to such a consumer without charging a fee.
22. The prices at which state organizations (except for autonomous ones) provide paid services, with the exception of those specified in paragraph 23 of these Rules, are established in accordance with the procedure approved by a separate order of the Moscow City Health Department.
23. Prices for orthopedic dental services rendered in dental clinics and denture departments of medical organizations of the privileged category of citizens at the expense of the budget of the city of Moscow are subject to state regulation in the manner established by the Government of Moscow.
24. Payment for services is carried out by non-cash settlements through credit organizations or by depositing cash directly into the cash office of a state organization with the issuance of a document confirming payment to the patient, client (cash register receipt, receipt or other form of strict reporting (document of the established form).
25. At the request of the person who paid for the services, the medical organization is obliged to issue a Certificate of payment for medical services to be submitted to the tax authorities of the Russian Federation in the form established by order of the Ministry of Health of the Russian Federation and the Ministry of the Russian Federation for taxes and duties of July 25, 2001 N 289 / BG-3-04 / 256 "On the implementation of the decree of the Government of the Russian Federation of March 19, 2001 N 201" On approval of the lists of medical services and expensive types of treatment in medical organizations of the Russian Federation, medicines, the amounts of payment of which at the expense of the taxpayer's own funds are taken into account when determining the amount of social tax deduction ".
26. The accounting of funds received by state organizations from the provision of paid services is carried out in accordance with the procedure established by the budgetary legislation of the Russian Federation, the Government of Moscow, the provisions of the Budget Code of the Russian Federation.
27. Government organizations that provide paid services are obliged to keep accounting separately for the main activity and for the provision of paid services.
28. State organizations have the right to carry out income-generating activities consistent with these goals, only insofar as it serves to achieve the goals for which they were created, provided that such activities are specified in their constituent documents.
The income received by the state organization from these activities goes to the budget of the city of Moscow.
The income received by the state budgetary and autonomous organizations from the specified activities and the property acquired at the expense of these incomes go to the independent disposal of the organization.
29. Item excluded - order of the Moscow City Health Department dated June 14, 2017 N 427 ..
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Clauses 29, 30 and 31 of the previous edition are considered, respectively, clauses 30, 31 and 32 of this edition - order of the Moscow Health Department of September 9, 2015 N 764.
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30. In accordance with the legislation of the Russian Federation, state healthcare organizations are responsible for non-fulfillment or improper fulfillment of the conditions for the provision of paid services, non-compliance with the requirements for methods of diagnosis, prevention and treatment, training, as well as for causing harm to the health and life of the patient.
31. The Federal Service for Supervision of Consumer Rights Protection and Human Welfare, the Moscow City Health Department, as well as other state bodies that, in accordance with laws and other legal acts of the federal and regional level, are entrusted with checking the activities of state organizations.
32. The harm caused to the life and health of the patient as a result of the provision of low-quality paid medical services is subject to compensation by the contractor in accordance with the legislation of the Russian Federation.
Document revision taking into account
changes and additions prepared
JSC "Codex"
Resolution of the Government of the Russian Federation of October 4, 2012 N 1006
"On approval of the Rules for the provision of paid medical services by medical organizations"
In accordance with Part 7 of Article 84 of the Federal Law "On the Fundamentals of Health Protection of Citizens in the Russian Federation" and Article 39.1 of the Law of the Russian Federation "On Protection of Consumer Rights", the Government of the Russian Federation decides:
2. To recognize as invalid the resolution of the Government of the Russian Federation of January 13, 1996 N 27 "On approval of the Rules for the provision of paid medical services to the population by medical institutions" (Collected Legislation of the Russian Federation, 1996, N 3, Art. 194).
rules
provision of paid medical services by medical organizations
(approved by the decree of the Government of the Russian Federation of October 4, 2012 N 1006)
I. General Provisions
1. These Rules determine the procedure and conditions for the provision of paid medical services by medical organizations to citizens.
2. For the purposes of these Rules, the following basic concepts are used:
"paid medical services"- medical services provided on a reimbursable basis at the expense of personal funds of citizens, funds of legal entities and other funds on the basis of contracts, including voluntary medical insurance contracts (hereinafter referred to as the contract);
"consumer" - an individual who intends to receive or receives paid medical services personally in accordance with the contract. A consumer receiving paid medical services is a patient who is subject to the Federal Law "On the Fundamentals of Health Protection of Citizens in the Russian Federation";
"customer" - an individual (legal entity) intending to order (purchase) or ordering (purchasing) paid medical services in accordance with the contract in favor of the consumer;
"performer" - a medical organization that provides paid medical services to consumers.
Concept "medical organization" is used in these Rules in the meaning defined in the Federal Law
3. Paid medical services are provided by medical organizations on the basis of the list of works (services) constituting medical activity and specified in the license to carry out medical activities issued in accordance with the established procedure.
4. Requirements for paid medical services, including their volume and terms of provision, are determined by agreement of the parties to the contract, unless other requirements are provided for by federal laws and other regulatory legal acts of the Russian Federation.
5. These Rules in a visual and accessible form are brought by the performer to the attention of the consumer (customer).
II. Conditions for the provision of paid medical services
6. When concluding a contract, the consumer (customer) is provided in an accessible form with information on the possibility of obtaining the appropriate types and volumes of medical care without charging a fee within the framework of the program of state guarantees of free provision of medical care to citizens and the territorial program of state guarantees of free provision of medical care to citizens (hereinafter - respectively program, territorial program).
The consumer's refusal to conclude an agreement cannot be a reason for a decrease in the types and volumes of medical care provided to such a consumer without charging a fee under the program and territorial program.
7. Medical organizations participating in the implementation of the program and territorial program have the right to provide paid medical services:
a) on other terms than provided for by the program, territorial programs and (or) targeted programs, at the request of the consumer (customer), including but not limited to:
the establishment of an individual post of medical supervision during treatment in a hospital;
the use of drugs that are not included in the list of vital and essential drugs, if their appointment and use is not due to vital indications or replacement due to individual intolerance to drugs included in the specified list, as well as the use of medical devices, medical nutrition, including the number of specialized health food products not provided for by the standards of medical care;
b) when providing medical services anonymously, with the exception of cases provided for by the legislation of the Russian Federation;
c) citizens of foreign states, stateless persons, with the exception of persons insured under compulsory health insurance, and citizens of the Russian Federation who do not reside permanently on its territory and who are not insured under compulsory health insurance, unless otherwise provided by international treaties of the Russian Federation;
d) when self-applying for medical services, except for the cases and procedures provided for in Article 21 of the Federal Law "On the Fundamentals of Health Protection of Citizens in the Russian Federation" in an urgent or emergency form.
8. The procedure for determining prices (tariffs) for medical services provided by medical organizations that are budgetary and state-owned state (municipal) institutions is established by the bodies exercising the functions and powers of the founders.
Medical organizations of other organizational and legal forms determine prices (tariffs) for the provided paid medical services independently.
9. When providing paid medical services, the procedures for providing medical care approved by the Ministry of Health of the Russian Federation must be observed.
10. Paid medical services can be provided in full of the standard of medical care approved by the Ministry of Health of the Russian Federation, or at the request of the consumer in the form of individual consultations or medical interventions, including in an amount exceeding the volume of the standard of medical care being performed.
III. Information about the contractor and the medical services provided by him
11. The Contractor is obliged to provide by posting on the website of the medical organization in the information and telecommunication network "Internet", as well as on information stands (counters) of the medical organization, information containing the following information:
a) for a legal entity - name and company name (if any);
for an individual entrepreneur - surname, name and patronymic (if any);
b) the address of the location of the legal entity, data of the document confirming the fact of entering information about legal entity to the Unified State Register of Legal Entities, indicating the authority that carried out the state registration;
the address of the place of residence and the address of the place of implementation of medical activities of an individual entrepreneur, data of the document confirming the fact of entering information about the individual entrepreneur in the Unified State Register of Individual Entrepreneurs, indicating the body that carried out the state registration;
c) information on the license to carry out medical activities (number and date of registration, list of works (services) that constitute medical activities of a medical organization in accordance with the license, name, address of location and telephone number of the licensing authority that issued it);
d) a list of paid medical services with an indication of prices in rubles, information on the conditions, procedure, form of providing medical services and the procedure for their payment;
e) the procedure and conditions for the provision of medical care in accordance with the program and the territorial program;
f) information about medical workers involved in the provision of paid medical services, about the level of their professional education and qualifications;
g) the working hours of the medical organization, the working hours of medical workers involved in the provision of paid medical services;
h) the addresses and telephones of the executive authority of the constituent entity of the Russian Federation in the field of public health protection, the territorial body of the Federal Service for Surveillance in Healthcare and the territorial body of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare.
12. Information posted on information stands (counters) should be available to an unlimited number of persons during the entire working hours of a medical organization providing paid medical services. Information stands (counters) are located in an accessible place for visitors and are designed in such a way that one can freely familiarize themselves with the information posted on them.
13. The Contractor provides for review at the request of the consumer and (or) the customer:
a) a copy of the constituent document of a medical organization - a legal entity, regulations on its branch (department, other geographically separate structural unit) participating in the provision of paid medical services, or a copy of the certificate of state registration of an individual as an individual entrepreneur;
b) a copy of the license to carry out medical activities with the attachment of a list of works (services) that constitute the medical activities of a medical organization in accordance with the license.
14. When concluding a contract, at the request of the consumer and (or) the customer, they must be provided in an accessible form with information about paid medical services, containing the following information:
a) the procedures for the provision of medical care and the standards of medical care used in the provision of paid medical services;
b) information about a specific medical worker providing an appropriate paid medical service (his professional education and qualifications);
c) information on the methods of providing medical care, associated risks, possible types of medical intervention, their consequences and the expected results of providing medical care;
d) other information related to the subject of the contract.
15. Before the conclusion of the contract, the performer notifies the consumer (customer) in writing that non-compliance with the instructions (recommendations) of the performer (a medical worker providing a paid medical service), including the prescribed treatment regimen, may reduce the quality of the paid medical service provided, entail for itself the impossibility of its completion on time or adversely affect the health of the consumer.
IV. The procedure for concluding a contract and payment for medical services
16. The contract is concluded by the consumer (customer) and the contractor in writing.
17. The contract must contain:
a) information about the performer:
name and firm name (if any) of a medical organization - a legal entity, address of location, data of a document confirming the fact of entering information about a legal entity in the Unified State Register of Legal Entities, indicating the body that carried out state registration;
surname, first name and patronymic (if any) of an individual entrepreneur, address of residence and address of the place of medical activity, data of a document confirming the fact of entering information about an individual entrepreneur in the Unified State Register of Individual Entrepreneurs, indicating the body that carried out state registration;
the number of the license to carry out medical activities, the date of its registration, indicating the list of works (services) that constitute the medical activities of the medical organization in accordance with the license, the name, address of the location and telephone number of the licensing authority that issued it;
b) last name, first name and patronymic (if any), address of residence and telephone number of the consumer (legal representative of the consumer);
surname, first name and patronymic (if any), address of residence and telephone number of the customer - an individual;
name and address of the location of the customer - legal entity;
c) a list of paid medical services provided in accordance with the contract;
d) the cost of paid medical services, the terms and procedure for their payment;
e) conditions and terms for the provision of paid medical services;
f) position, last name, first name, patronymic (if any) of the person concluding the contract on behalf of the contractor, and his signature, last name, first name, patronymic (if any) of the consumer (customer) and his signature. If the customer is a legal entity, the position of the person concluding the contract on behalf of the customer is indicated;
g) responsibility of the parties for failure to comply with the terms of the contract;
h) the procedure for changing and terminating the contract;
i) other conditions determined by agreement of the parties.
18. The contract is drawn up in 3 copies, one of which is with the contractor, the second - with the customer, the third - with the consumer. If the contract is concluded by the consumer and the contractor, it is drawn up in 2 copies.
19. An estimate can be drawn up for the provision of paid medical services. Its drawing up at the request of the consumer (customer) or contractor is mandatory, while it is an integral part of the contract.
20. If the provision of paid medical services requires the provision of additional medical services on a reimbursable basis that are not provided for by the contract, the contractor is obliged to notify the consumer (customer) about this.
Without the consent of the consumer (customer), the contractor is not entitled to provide additional medical services on a reimbursable basis.
21. If the provision of paid medical services requires the provision of additional medical services for emergency indications to eliminate the threat to the life of the consumer in case of sudden acute diseases, conditions, exacerbations chronic diseases, such medical services are rendered free of charge in accordance with the Federal Law "On the Fundamentals of Health Protection of Citizens in the Russian Federation".
22. If the consumer refuses to receive medical services after the conclusion of the contract, the contract is terminated. The contractor informs the consumer (customer) about the termination of the contract at the initiative of the consumer, while the consumer (customer) pays the contractor the expenses actually incurred by the contractor related to the fulfillment of obligations under the contract.
23. The consumer (customer) is obliged to pay for the medical service provided by the contractor within the time frame and in the manner determined by the contract.
24. The consumer (customer) in accordance with the legislation of the Russian Federation is issued a document confirming the payment made for the provided medical services (cash register receipt, receipt or other form of strict reporting (document of the established form)).
25. After the execution of the contract, the Contractor issues to the consumer (legal representative of the consumer) medical documents (copies of medical documents, extracts from medical documents) reflecting his state of health after receiving paid medical services.
26. The conclusion of a voluntary medical insurance contract and payment for medical services provided in accordance with this contract are carried out in accordance with the Civil Code of the Russian Federation and the Law of the Russian Federation "On the organization of insurance business in the Russian Federation".
V. Procedure for the provision of paid medical services
27. The Contractor provides paid medical services, the quality of which must comply with the terms of the contract, and in the absence of conditions on their quality in the contract, the requirements for services of the corresponding type.
If federal law, other regulatory legal acts of the Russian Federation provide for mandatory requirements for the quality of medical services, the quality of paid medical services provided must comply with these requirements.
28. Paid medical services are provided with informed voluntary consent of the consumer (legal representative of the consumer), given in the manner prescribed by the legislation of the Russian Federation on the protection of citizens' health.
29. The Contractor provides the consumer (legal representative of the consumer) at his request and in a form accessible to him information:
about the state of his health, including information about the results of the examination, diagnosis, methods of treatment, associated risk, possible options and the consequences of the medical intervention, the expected results of the treatment;
on drugs and medical devices used in the provision of paid medical services, including their shelf life (warranty periods), indications (contraindications) for use.
30. The Contractor is obliged, when providing paid medical services, to comply with the requirements established by the legislation of the Russian Federation for the preparation and maintenance of medical documentation and accounting and reporting statistical forms, the procedure and deadlines for their submission.
Vi. Responsibility of the contractor and control over the provision of paid medical services
31. For non-fulfillment or improper fulfillment of obligations under the contract, the performer shall be liable as provided for by the legislation of the Russian Federation.
32. The harm caused to the life or health of the patient as a result of the provision of low-quality paid medical services is subject to compensation by the contractor in accordance with the legislation of the Russian Federation.
33. Compliance with these Rules is monitored by the Federal Service for Supervision of Consumer Rights Protection and Human Welfare within the framework of the established powers.
Posted: 08/26/2014
RULES FOR PROVIDING PAID MEDICAL SERVICES
The procedure for the provision of paid medical services is regulated by the Decree of the Government of the Russian Federation of 04.10.2012 No. 1006 "On approval of the Rules for the provision of paid medical services by medical organizations" (hereinafter the Rules), the Federal Law of the Russian Federation of 21.11.2011. No. 323 "On the Fundamentals of Health Protection of Citizens in the Russian Federation", the Law of the Russian Federation dated 07.02.1992. No. 2300-1 "On Protection of Consumer Rights".
Paid medical services are an addition to the legally guaranteed volume of free medical care to citizens within the framework of the program of state guarantees for the free provision of medical care to citizens and the corresponding territorial programs approved on its basis in the constituent entities of the Russian Federation. In accordance with these programs, the citizens of the Russian Federation are provided free of charge emergency medical care, outpatient and inpatient care (for acute diseases, poisoning, injuries, etc.). When concluding a contract, the provider of medical services must provide the consumer with information about the possibility of obtaining the appropriate types of free medical care.
According to clause 7 of the Rules, medical organizations have the right to provide on a paid basis such types of medical services as an individual medical post in a hospital; use for the treatment of drugs that are not included in the list of vital and essential drugs; the use of medical devices and medical nutrition that are not provided for by the standards of medical care; anonymous provision of medical services. Medical services are rendered for a fee to foreign citizens who are not insured under compulsory health insurance. Also, a fee is charged for self-applying for medical services (except for cases of emergency medical care and medical care provided in an emergency or emergency form).
Paid medical services are provided only with informed voluntary consent of the consumer.
To avoid violations in this area, the consumer needs to know:
The provision of paid medical services is carried out with the obligatory presence of a license for each type of activity in a medical institution (Article 12 of the Federal Law of 04.05.2011 No. 99 "On licensing certain types of activities").
The provider of medical services is obliged to provide the consumer with the following information:
A) the name of the legal entity; address of the location, data of the document on entering information about the legal entity in the Unified State Register of Legal Entities (USRLE) with an indication of the authority that carried out the state registration;
B) last name, first name and patronymic (for an individual entrepreneur); the address of the place of residence and the address of the place of medical activity; data of the document on entering information about an individual entrepreneur into the Unified State Register of Individual Entrepreneurs (EGRIP), indicating the body that carried out the state registration;
C) information about the license (number and date of registration, list of works (services) that constitute medical activity, address of location and telephone number of the licensing authority that issued it);
D) a list of paid medical services with an indication of prices in rubles, information on the conditions, procedure, form of providing medical services and the procedure for their payment;
E) information about medical workers who provide paid medical services, about the level of their professional education and qualifications;
G) the working hours of the medical organization, the working hours of medical workers who provide paid medical services;
H) addresses and telephones of regulatory authorities (health department, territorial body of the Federal Service for Supervision of Healthcare, territorial body of the Federal Service for Supervision of Consumer Rights Protection and Human Welfare).
The procedure for determining prices for paid medical services for medical organizations that are budgetary and state-owned state institutions is established by their founding bodies. Medical organizations of other organizational and legal forms (LLC, CJSC, etc.) determine prices for medical services independently.
All of the above information is posted on the website of a medical organization on the Internet and at an information stand (stand). The information stand is located in an accessible place for visitors and is designed in such a way that you can freely familiarize yourself with the information posted on it.
Pay attention! According to clause 13 of the Rules, the consumer has the right to request for review:
A) a copy of the constituent document of the medical organization; a copy of the certificate of state registration (for an individual entrepreneur);
b) a copy of the license to carry out medical activities with the attachment of a list of works (services).
Procedure and conditions for concluding an agreement
When providing paid medical services between the contractor and the consumer, an agreement must be concluded in writing in two copies.
The contract must contain:
a) a list of paid medical services provided in accordance with the contract;
b) the cost of medical services, terms and procedure for their payment;
c) conditions and terms for the provision of paid medical services;
g) responsibility of the parties for failure to comply with the terms of the contract.
The following data must also be indicated in the contract:
Information about the contractor - a legal entity or an individual entrepreneur; license details;
information about the consumer (surname, name and patronymic, place of residence, telephone);
The procedure for changing and terminating the contract; as well as other conditions determined by agreement of the parties.
At the request of the consumer, an estimate can be drawn up for the provision of paid medical services, which is an integral part of the contract.
When providing paid medical services, the contractor is not entitled to provide additional medical services on a reimbursable basis without the consent of the consumer. Note that if, when providing paid medical services, it is necessary to provide medical services on an emergency basis to eliminate the threat to the life of a consumer in case of sudden acute illnesses, conditions, exacerbations of chronic diseases, such services are rendered free of charge.
When concluding a contract, the consumer, at his request, must be provided with information about the procedure for providing medical care, about a specific medical worker providing medical services, about the possible risks and consequences, as well as the expected results of medical care.
Before the conclusion of the contract, the contractor notifies the consumer in writing that failure to comply with the instructions (recommendations) of the medical worker providing paid medical services, including the prescribed treatment regimen, may reduce the quality of the paid medical services provided, entail the impossibility of completing it on time, or adversely affect the health of the consumer.
After receiving paid medical services, the consumer is issued medical documents (extracts from medical documents), reflecting the state of his health (clause 24 of the Rules).
The consumer must also be issued a document confirming the payment made for the services provided (cash register receipt, receipt, etc.).
The consumer has the right, after the conclusion of the contract, to refuse to receive medical services, subject to the payment to the contractor of the actually incurred costs associated with the fulfillment of obligations under the contract.
Responsibility of the contractor in the provision of paid medical services
In case of non-fulfillment or improper fulfillment of obligations under the contract, the consumer should contact the contractor with a written claim indicating one of the requirements provided for in Art. 29 of the Law of the Russian Federation of 07.02.1992 No. 2300-1 "On Protection of Consumer Rights", namely: gratuitous elimination of deficiencies in the service provided; a corresponding reduction in the price of the service rendered; re-doing work; reimbursement of the costs incurred to eliminate the defects of the service provided on their own or by third parties.
According to Art. 14 of the Law of the Russian Federation of 07.02.1992 No. 2300-1 "On Protection of Consumer Rights" harm caused to the life or health of the consumer as a result of the provision of low-quality paid medical services is subject to compensation by the contractor in full.
In case of violation of his rights in the provision of paid medical services, a consumer can submit a written complaint to:
- Moscow Department of Health (quality and safety control of medical services provided);
- Territorial body of the Federal Service for Surveillance in Healthcare in Moscow and the Moscow Region (quality control and safety of medical activities at facilities of federal significance);
- Office of Rospotrebnadzor in Moscow (territorial departments in administrative districts) (control over the observance of consumer rights to reliable information about the provided paid medical services).