Decree No. 100 / 2022 Coll.
Decree amending Decree No. 242 / 2021 Coll., laying down the method of including compensation in the amount of compensation for services rendered in 2021
Valid
Order
Effective from 30.04.2022
Text versions:
30.04.2022
29.04.2022
100
DECLARATION
of 22 April 2022
amending Decree No 242 / 2021 Coll., laying down the method of including compensation in the amount of compensation for services rendered in 2021
According to § 1 (2) of Act No. 160 / 2021 Coll., the Ministry of Health provides for compensation to persons providing medical services covered taking into account the effects of the disease epidemic COVID-19 in 2021:
Decree No 242 / 2021 Coll., establishing the method of including compensation in the amount of compensation for services paid in 2021, is amended as follows:
1. in Paragraph 15 (1) (a), "1,13" is replaced by "1,23."
2. in Paragraph 15 (1) (b), "0,92" is replaced by "1,00."
3. In Paragraph 15 (2), "1,02 'is replaced by" 1,11'.
4. Paragraph 17 (1) and (2) reads as follows:
"(1) For comprehensive spa rehabilitation care for adults, children and adolescents, provided in the health facilities of the spa rehabilitation care provider, a payment of 107,7% of the contracted remuneration for the 1 day of stay for 2019 multiplied by the CompenzaceDPKCOVID shall be fixed. If the payment for one day's stay for 2019 has not been agreed upon by 31 December 2019 inclusive, the payment for one day's stay for 2019 shall be set at the rate of the remuneration paid to comparable providers. The payment for the accommodation and food of the insured person's guide is set at the same amount as the payment for these components for insured persons who are provided with comprehensive spa rehabilitation care for adults. The compensation coefficient DPKCOVID shall be calculated as follows for the purposes of determining the total remuneration for 2021:
CompenzaceDPKCOVID = max1; 0,93 * PDPK2019PDPK2021 * minPDK20210,705 * PDPK20193; 1
where:
CompenzaceDPKCOVID is the compensation coefficient for the provider declared and the health insurance company recognised the days of residence of the comprehensive spa rehabilitation care facility for adults, children and adolescents during the evaluation period.
PDPK2021 is the number of days of residence within the framework of a comprehensive spa rehabilitation care facility for adults, children and adolescents provided in the evaluation period, by the provider declared by 31 March 2022 and by a health insurance company recognised by 31 May 2022.
PDPK2019 is the number of days of residence within the framework of a comprehensive spa rehabilitation care facility for adults, children and adolescents provided in the reference period, by the provider declared by 31 March 2020 and by a health insurance company recognised by 31 May 2020.
(2) For the benefit of the spa rehabilitation care for adults, children and adolescents provided in the health facilities of the spa rehabilitation care provider, a remuneration of 107,7% of the contracted remuneration for the 1 day of stay for 2019 multiplied by the CompenzaceDPCOVID shall be fixed. If the payment for one day's stay for 2019 has not been agreed upon by 31 December 2019 inclusive, the payment for one day's stay for 2019 shall be set at the rate of the remuneration paid to comparable providers. The compensation coefficient DPCOVID shall be calculated as follows for the purposes of determining the total remuneration for 2021:
CompenzaceDPCOVID = max1; 0,93 * PDPP2019PDP2021 * minPDP20210,538 * PDP20193; 1
where:
CompenzaceDPCOVID is the compensation coefficient for the provider declared and the health insurance company recognised the days of residence of the contributory spa rehabilitation treatment facility for adults, children and adolescents during the period of assessment.
PDP2021 is the number of days of residence in the framework of the adult, children and youth rehabilitation and rehabilitation care allowance provided in the evaluation period, by the provider declared by 31 March 2022 and by the health insurance company recognised by 31 May 2022.
PDPP2019 shall be the number of days of residence within the framework of the adult, children and youth rehabilitation and rehabilitation care allowance provided in the reference period, the provider declared by 31 March 2020 and the health insurance undertaking recognised by 31 May 2020. ';
5. Point 2.5 of Part A of Annex 1 reads as follows:
"2.5. For hospitalisation cases with a diagnosis of U07.1 according to the international classification of diseases by the provider of recognised and health insurance, completed in the evaluation period, classified according to the classification rules, the payment to the provider shall be increased by CZK 1 000 for each OD, except for OD No 00051 to 00078 according to the list of performance, provided within 20 days of the first provision of performance No 82301 according to the list of performance or the performance of screening tests COVID-19 by the PCR method with a positive result or performance on the SARS-CoV-2 antigen with a positive result in the absence of performance No 823301 or 82302 according to the list of performance by any provider during the last 180 calendar days. This increase in remuneration shall not be included in the remuneration referred to in points 3 to 6. ';
6. In Annex No 1, Part A, point 7.2, the words "and C 'are inserted after the words" Part A, points 1 and 2'.
7. In Annex No 1, Part A, point 8, the following point 8.5 is added:
"8.5. The payment shall be increased by the amount calculated as follows to the Provider who provides day-care services under Section 8 of the Health Services Act:
Compensation JP = 0,75 * max1,02 * Reimburse2019, JPM1-4-Reimburse2021, JPM1-4; 0
where:
Reimbursement 2019, JPM1-4 is the remuneration for the provider declared and the health insurance company recognised as day care health services provided in the first 4 months of the reference period.
Reimbursement 2021, JPM1-4 is the remuneration for the provider declared and the health insurance company recognised as day care services provided in the first 4 months of the evaluation period. '
8. In Annex 1, Part B, point 1, including the title:
"1. Reimbursement of subsequent bed care, long-term bed care, nursing day 00005 and special bed care of hospice type according to § 22a of the Act
(a) The amount of the remuneration for the services paid reported from 00031, 00032, 00098 and 00099 shall be determined by the product of the number of OD declared and the flat rate per day of hospitalisation referred to in points (b) and (h). The amount of remuneration for the services covered reported from 00005 and 00021 to 00030 shall be as follows:
Reimbursement = Sejj = 15OD2021, ij * PSOD, 2021, ij
where:
The remuneration is the remuneration for the provider declared and the health insurance company recognised by OD of the type in the assessment period.
i represents types OD 00005 and 00021 to 00030 reported by the provider during the evaluation period.
PSOD, 2021, ij is the flat rate per day of hospitalisation in the evaluation period for OD type i and patient category j as referred to in points (b) to (g) and (l).
d is 1 to 5.
OD2021, ij is the number of providers declared and health insurance undertakings recognised by OD type i and category j in the assessment period.
(b) The flat rate per day of hospitalisation shall be determined for each patient category and the type of treatment day separately and shall include the value of the appropriate OD including the direction assigned to the treatment day and patient category according to the list of performance, the lump sum to be paid for the medicinal products referred to in Article 17 (6) of the Act, the performance to be reported as income and discharge tests, and the performance aggregated to the treatment day according to the list of performance.
(c) The flat rate for one day of hospitalisation in the evaluation period for OD type i and patient type j, with the exception of hospitalisation days OD 00021, 00026, 00031, 00032, 00098 and 00099, shall be fixed at:
PSOD, 2021, ij = CN * PSOD, 2020, ij * CompenzaceOdi, COVID
where:
The PSOD, 2020, ij is a flat rate per day of hospitalisation in 2020 for OD type i and patient type j, including an increase in the remuneration of non-medical health professionals with no professional supervision in alternately three-shift or continuous working arrangements for bed care providers for the treatment day, and without an increase in the remuneration resulting from the fulfilment of quality criteria in 2020.
The CN is the coefficient of increase referred to in points (d) and (e).
CompenzaceODi, COVID is the compensation coefficient of OD type i, which is determined as follows:
where:
This Regulation shall be binding in its entirety and directly applicable in all Member States.
For the purposes of this Regulation, the following definitions apply:
Coefiprop represents the production decline coefficient for OD type i according to the following table:
| Typ OD | Hodnota |
|---|---|
| 00005 | 0,85 |
| 00021 | 0,84 |
| 00022 | 0,87 |
| 00023 | 0,89 |
| 00024 | 0,86 |
| 00025 | 0,95 |
| 00026 | 0,86 |
| 00027 | 1,00 |
| 00028 | 0,58 |
| 00029 | 0,78 |
| 00030 | 0,95 |
(d) the CN is determined separately for each patient category according to the performance list, as follows:
i. For patient category 1 according to the performance list, the CN is set at 1,08,
ii. For patient category 2 according to the performance list, the CN is set at 1,08,
iii. For patient category 3, the CN is 1,09,
IV. For patient category 4, the CN is set at 1,09,
v. For patient category 5 according to the performance list, the CN is fixed at 1,09.
(e) the CN as defined in point (d) shall be further increased by 0,003 for the OD type concerned for each criterion which the provider fulfils during the evaluation period. The health insurance undertaking shall evaluate compliance with the qualitative criterion after the end of the assessment period. These are the following criteria linked to the OD type:
i. Personnel security (related to time-out at the monitored workplace):
(1) Sister of wound healing specialist - on average at least 0,4 bays per 120 beds for OD 00005, 00022, 00023, 00024 and 00030,
(2) Nutritional therapist - an average of at least 0,4 beds per 120 beds for OD 00005, 00022, 00024, 00027, 00028 and 00030,
(3) Ergotherapy - on average at least 1 time per 120 beds, for OD 00024 and 00005,
(4) Logoped - on average at least 1 time per 120 beds for OD 00024,
(5) Health psychologist - on average at least 0.4 per 120 beds for OD 00005, 00022, 00024 and 00030.
ii. Technical equipment:
(1) Average number of beds per room - maximum 2,5 beds per room at OD 00005, 00022, 00023 and 00024,
(2) Equipment for the separation of electrically adjustable beds - at least 75% of the electrically adjustable beds supported by the Protocol on Safety Technical Control at OD 00005, 00022, 00023 and 00024.
(f) The flat rate per day of hospitalisation of OD 00021 and 00026 shall be determined in accordance with subparagraph (c) for patient categories 1, 2, 3 and 4 according to the performance list, the CN value shall be 1,12 to the 24th day of hospitalisation and 1,08 from the 24th day of hospitalisation. The number of days shall be calculated from the first day of admission to the bed of the provider, including redundancies. In the event that hospitalisation began before 1 January 2021, the duration of hospitalisation shall be calculated from 1 January 2021. For patient category 5 according to the performance list, the CN value is 1,09.
(g) The determination of the flat rate of OD 00021 and OD 00026 referred to in point (f) shall be subject to the fulfilment of the transformation plan for the restructuring of beds in the context of psychiatric care reform approved by the Ministry of Health. In the event of failure to comply with this plan, the flat rate shall be fixed in accordance with point (c).
(h) The flat rate for one day of hospitalisation from 00031, 00032, 00098 and 00099 shall be fixed at the evaluation period of the amount agreed for 2020 plus 4%.
i) The amount of the remuneration is increased by CZK 1,000 for each day of hospitalisation with an insured person diagnosed with U07.1 according to the international classification of diseases, provided in the evaluation period and recognised by the health insurance company, provided within 20 days of the first provision of output No. 82301 according to the list of performance or screening testing COVID-19 by a PCR method with a positive result or performance on the SARS-CoV-2 antigen with a positive result if no performance No 82301 or 82302 according to the list of performance by any provider during the last 180 calendar days.
j) The advance payment shall be granted to the provider monthly, within the twentieth day of the end of the month on which the advance is calculated. The amount of the monthly advance shall be as follows:
where:
Backup compensation, m is the advance on compensation in the month of the evaluation period.
i is 1 to n, where n is the total number of combinations of the patient and OD type reported by the provider in the evaluation period.
PSOD, 2021, i is the flat rate per day of hospitalisation in the evaluation period for the combination of patient and OD type i, as referred to in points (b) to (h).
j represents months of the year and takes values from 1 to m, where m is the month for which the advance payment is calculated.
OD2019, ij is the number of providers declared and the health insurance undertaking of recognised treatment days of the type and category in month j of the reference period.
OD2021, ij is the number of providers declared and the health insurance company of recognised treatment days of the type and category in month j of the evaluation period.
k represents months of the year and takes values from 1 to m-1, where m is the month for which the advance payment is calculated.
Backup compensation, k is the advance on compensation in a month to the period of assessment.
(k) The advance on the compensation referred to in (j) for July 2021 shall be increased by the remuneration referred to in (i) relating to the hospitalisation dates of the provider declared before 31 July 2021 and by the health insurance undertaking recognised.
(l) In the case of the provision of paid services to foreign insured persons, the rate of the increase in the CN referred to in points (e), (f) and (g) shall not apply and the flat rate for OD 00021, 00026 shall be fixed in accordance with point (c).
(m) The medicinal products listed in Annex 12 to this Order shall be reimbursed by the health insurance company to the provider at the level of their declared unit price. ';
9. In Annex No 1, Part B, point 2 (a), "1,22 'is replaced by" 1,46' and "1,19 'is replaced by" 1,47'.
10. In Annex 1 (B) (2) (g):
"(g) For each provider declared and the health insurance undertaking recognised by OD 00015, 00020, 00033 and 00035 according to the performance list, provided in the evaluation period to patients with a diagnosis of U07.1 according to the international classification of diseases within 20 days of the first provision of performance 82301 according to the COVID screening or screening test list 19 using the PCR method with a positive result or performance on the SARSCoV-2 antigen card with a positive result if no output No 82301 or 82302 according to the performance list, by any provider within the last 180 calendar days, is increased by CZK 1 000."
11. In Annex 3, Part The first sentence of point 2 is replaced by the following: "For providers of paid services providing specialised outpatient care other than those referred to in point 1, the amount of remuneration shall be determined on the basis of the list of performances provided by remuneration with a value of CZK 1.05, with the exception of the expertise of the list of performances for which the value of the point in Part C is determined, and with the exception of the performance no. 89312 according to the list of performances for which the value of the point of CZK 1.06 is determined."
12. At the end of Annex 3, the following Part C is added:
"(C) Value of point after expertise
1. For the following competencies according to the performance list, the value of the point shall be determined:
| Odbornost podle seznamu výkonů | Hodnota bodu |
|---|---|
| 106 | 1,37 |
| 203 | 1,17 |
| 208 | 1,09 |
| 301 | 1,24 |
| 402 | 1,06 |
| 501 | 1,06 |
| 502 | 1,11 |
| 504 | 1,14 |
| 506 | 1,07 |
| 601 | 1,09 |
| 607 | 1,14 |
| 704 | 1,42 |
| 708 | 1,24 |
| 780 | 1,25 |
"
13. In Annex No 8, Part A, point 1, "0,95 'is replaced by" 0,97' and "0,79 'is replaced by" 0,81'.
Efficacy
This Decree shall take effect on the day following that of its publication.
Minister for Health:
Prof. MUDr. Válek, CSc., MBA, EBIR, v. r.
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Regulation Information
| Citation | Decree No. 100 / 2022 Coll., amending Decree No. 242 / 2021 Coll., establishing the method of including compensation in the amount of compensation for services paid in 2021 |
|---|---|
| Regulation Type | Order |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 29.04.2022 |
|---|---|
| Effective from | 30.04.2022 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
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