Act No. 117 / 2006 Coll.
Law amending certain public health insurance laws
Valid
Effective from 01.04.2006
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117
THE LAW
of 14 March 2006
amending certain public health insurance laws
Parliament has decided on this law of the Czech Republic:
Amendment to the Public Health Insurance Act
Act No. 48 / 1997 Coll., on Public Health Insurance and on the amendment and addition of certain related laws, as amended by Act No. 242 / 1997 Coll., Act No. 2 / 1998 Coll., Act No. 127 / 1998 Coll., Act No. 225 / 1999 Coll., Act No. 24 / 1999 Coll., Act No. 425 / 2003 Coll., Act No. 18 / 2000 Coll., Act No. 132 / 2000 Coll., Act No. 155 / 2000 Coll., Act No. 274 / 2003 Coll., Act No. 167 / 2000 Coll., Act No. 220 / 2002 Coll., Act No. 459 / 2002 Coll., Act No. 176 / 2002 Coll., Act No. 198 / 2002 Coll.
1. In the second sentence of Article 17 (2), the words "to ensure the quality and availability of health care, the functioning of the health system and its stability within the financial possibilities of the public health insurance system (hereinafter referred to as the public interest) 'shall be inserted after the words" public interest'.
2. Paragraph 17 (4) reads as follows:
"(4) The list of health performance with points is drawn up in conciliation with representatives
(a) General health insurance companies of the Czech Republic and other health insurance companies,
(b) the relevant professional associations of healthcare providers as representatives of contractual health establishments;
(c) professional organisations established by law;
(d) professional scientific societies;
(e) interest associations of insured persons.
If an agreement is reached, the list of health performance with points is submitted to the Ministry of Health for assessment in terms of compliance with legislation and public interest. If the outcome of the agreement is in accordance with legislation and public interest, the Ministry of Health shall issue it as a decree. If there is no agreement or if the Ministry of Health finds that the agreement is not in accordance with legislation or public interest, it shall decide on the list of health performance with points of the Ministry of Health and issue it by decree. ';
3. Paragraph 17 (5) reads as follows:
"(5) The values of the point, the amount of health care payments paid from health insurance and the regulatory limitation of the amount of public health care provided shall always be agreed for the following calendar year in the conciliation procedure of representatives of the General Health Insurance Company of the Czech Republic and other health insurance companies and relevant professional associations of providers as representatives of contractual health establishments. The Ministry of Health is the author and guarantor of the proper conduct of the conciliation procedure. If an agreement is reached, the Ministry of Health will assess its content in terms of compliance with legislation and public interest. If the outcome of the agreement is in accordance with legislation and public interest, the Ministry of Health shall issue it as a decree. If the conciliation procedure fails to result within 90 days of the end of the relevant calendar year, or if the Ministry of Health finds that the outcome of the conciliation procedure is not in accordance with legislation or public interest, the value of the point, the amount of health care payments paid from health insurance and the regulatory limitation of the amount of healthcare provided paid from public health insurance for the following calendar year shall be determined by the Ministry of Health by decree. ';
4. In Article 17, paragraphs 6 to 11 are deleted.
Paragraphs 12 to 14 shall become paragraphs 6 to 8.
5. Paragraph 17 (8) is deleted.
6. In Article 40 (2), "(Article 17 (13)) 'is replaced by" (Article 17 (7))';
7. in § 41 (6) (a) to (e):
"(a) within 10 hours, its recalculated number is equal to zero,
(b) within 100 hours, its recalculated number shall be equal to 0,25,
(c) within 200 hours, its recalculated number shall be 0,50;
(d) within 300 hours, its recalculated number shall be 0,75,
(e) over 300 hours, its recalculated number is equal to one. "
8. In the second sentence of Paragraph 41 (7), "12 'is replaced by" 10'.
Amendment to the General Health Insurance Insurance Act
Act No. 592 / 1992 Coll., on Insurance against General Health Insurance, as amended by Act No. 10 / 1993 Coll., Act No. 15 / 1993 Coll., Act No. 161 / 1993 Coll., Act No. 324 / 1993 Coll., Act No. 42 / 1994 Coll., Act No. 123 / 1994 Coll., Act No. 54 / 1995 Coll., Act No. 149 / 1996 Coll., Act No. 48 / 1997 Coll., Act No. 53 / 2004 Coll., Act No. 54 / 2002 Coll., Act No. 176 / 2002 Coll., Act No. 118 / 2000 Coll., Act No. 309 / 2002 Coll., Act No. 492 / 2000 Coll., Act No. 138 / 2001 Coll., Act No. 49 / 2002 Coll., Act No. 176 / 2002 Coll.
1. Paragraph 3a (2), including footnote 21a, reads as follows:
"(2) The self-employed person shall be obliged to pay the premium on the assessment basis referred to in paragraph 1, but not more than the maximum assessment basis. Where the assessment basis referred to in paragraph 1 is lower than the minimum assessment basis, the self-employed person shall be obliged to pay the premium on the minimum assessment basis, unless otherwise specified. The minimum assessment basis shall be 12 times 50% of the average monthly wage in the national economy; the maximum measurement base is CZK 486 000. For the purposes of this Act, the average monthly wage on the national economy shall be the amount calculated as the product of the general assessment base established by the Government's pension regulation for the calendar year preceding the calendar year for which the average wage is ascertained and the conversion rate established by the Government's pension regulation for the adjustment of that general assessment basis21a); The calculated amount shall be rounded up to the full crown.
21a) § 17 paragraphs 2 and 4 of Act No. 155 / 1995 Coll., as amended. '
2. In Article 3b, the words "the insurance State, 37) 'are replaced by the words" the insurance State (§ 3c)' and footnote 37 is deleted.
3. Paragraph 3c, including footnote 37, reads:
The assessment basis for an insurance premium paid by the State per person for which, under the special legislation, he is a payee of the insurance State 37) shall be established for the calendar year. The basis of the first sentence is 25% of the average monthly wage in the national economy (Section 3a (2)). The calculated amount shall be rounded up to the whole crown.
37) Act No. 48 / 1997 Coll., as amended. '
4. In Article 14 (3), the words "60% of the overpaid amount returned 'are replaced by the words" overpaid'.
Amendment to Act No. 438 / 2004 Coll., amending Act No. 551 / 1991 Coll., on the General Health Insurance Company of the Czech Republic, as amended, Act No. 280 / 1992 Coll., on departmental, branch, corporate and other health insurance companies, as amended, Act No. 592 / 1992 Coll., on Insurance against General Health Insurance, as amended, and Act No. 48 / 1997 Coll., on Public Health Insurance and on the amendment and addition of certain related laws, as amended
Act No. 438 / 2004 Coll., amending Act No. 551 / 1991 Coll., on the General Health Insurance Company of the Czech Republic, as amended, Act No. 280 / 1992 Coll., on departmental, occupational, corporate and other health insurance companies, as amended, Act No. 592 / 1992 Coll., on Insurance against General Health Insurance, as amended, and Act No. 48 / 1997 Coll., on Public Health Insurance and amending and supplementing certain related laws, as amended, is amended as follows:
1. in Article VI, point 4 is deleted;
2. in point 5 of Article VI, the words "and point 4 (b) 'are deleted;
Amendment of the Act on the General Health Insurance Company of the Czech Republic
Act No. 551 / 1991 Coll., on the General Health Insurance Company of the Czech Republic, as amended by Act No. 592 / 1992 Coll., Act No. 10 / 1993 Coll., Act No. 60 / 1995 Coll., Act No. 149 / 1996 Coll., Act No. 48 / 1997 Coll., Act No. 305 / 1997 Coll., Act No. 93 / 1998 Coll., Act No. 127 / 1998 Coll., Act No. 69 / 2000 Coll., Act No. 132 / 2000 Coll., Act No. 220 / 2000 Coll., Act No. 49 / 2002 Coll., Act No. 420 / 2003 Coll., Act No. 455 / 2003 Coll., and Act No. 438 / 2004 Coll., is amended as follows:
1. Paragraph 6 (4) reads as follows:
"(4) On a proposal from the Government, the House of Deputies shall approve the health insurance plan, the accounts and the annual report referred to in paragraph 3 last year, following the dates of the consideration of the draft State budget and the State Final Account. The approved health insurance plan and the approved annual report and the approved accounts shall be published by the insurance undertaking in a way that allows remote access. ';
2. In Article 6, paragraphs 8 to 11 are added:
"(8) The insurance company submits the draft health insurance plan to the Ministry of Health and through it to the Ministry of Finance.
(9) The Ministry of Health and the Ministry of Finance will examine the submitted health insurance plan in terms of compliance with the legislation and compliance with the public interest.
(10) If the draft health insurance plan is contrary to legislation or public interest, the Ministry of Health shall return the draft health insurance plan to the insurance undertaking.
(11) Where the Ministry of Health and the Ministry of Finance, after assessing the compliance of the health insurance plan with legislation and the public interest, finds that the draft health insurance plan is not in conflict with these aspects, it shall submit the draft health insurance plan to the Government. ';
3. Paragraph 7a (2) reads as follows:
"(2) In the case of forced administration, decisions and legal acts of the Director of Insurance and other bodies of Insurance shall be subject to the approval of the forced administrator, otherwise they shall be invalid. The forced administrator shall be entitled to take decisions and legal acts which are otherwise the responsibility of the Director of the Insurance Company or of another Insurance Institution. ';
4. In the first sentence of Article 8 (1), the words "and the Ministry of Finance 'shall be inserted after the words" and the Ministry of Health'; in the second sentence, the words "in agreement with the Ministry of Finance 'shall be replaced by the words" the Ministry of Health and the Ministry of Finance';
5. Paragraph 8 (3) reads as follows:
"(3) The volume of refundable financial assistance from the state budget may amount to a maximum of 50% of the proven lack of funds due to an increased range of healthcare services provided. The government, acting on a proposal from the Minister for Health, shall decide on the granting of repayable financial assistance. ';
6. Article 14, including the title, reads:
Directors
(1) The statutory body of the Insurance Company is the Director of the Insurance Company, elected by the Chamber of Deputies of Parliament on a proposal from the Government.
(2) The Director of Insurance refers to Parliament's Chamber of Deputies on a proposal from the Government.
(3) The head of the Regional Branch is the Director appointed and removed by the Director of the Insurance Company. '
7.
(1) The Director of Insurance is elected for a term of 4 years. The Director of Insurance may be dismissed before the expiry of the period to which he was elected.
(2) Only a citizen of the Czech Republic may be the Director of the Insurance Company, who
(a) is fully eligible for legal action;
(b) is righteous;
(c) has completed a university education.
(3) For the purposes of this Act, a person who has not been convicted of a criminal offence of a property nature or an intentional offence shall be deemed to be righteous.
(4) The office of Director of Insurance is terminated
(a) the expiry of the term of office;
(b) an appeal by the Chamber of Deputies,
(c) on the date of service of the written declaration of resignation to the President of the Chamber of Deputies of Parliament,
(d) the date on which he became legally competent in a judgment which deprived him of legal capacity or restricted him to legal capacity;
(e) the date on which the judgment which sentenced him for the offence referred to in paragraph 3 became final;
(f) death.
(5) The election of the Director of the Insurance Corporation shall take place within a period commencing on the 60th day before the end of the term of office of the former Director of Insurance.
(6) If, before the expiry of its term of office, the performance of the Director of the Insurance Corporation is terminated within a period longer than the period referred to in paragraph 5, the selection of the Director of the Insurance Company shall take place within 60 days of the end of the term of office of the former Director of the Insurance Company.
(7) If the Director of the Insurance Company has not been elected by the end of the term of office of the former Director of Insurance, a new choice shall take place within 60 days. Until such time as the new Director of Insurance is elected, the Head of the Insurance Employee shall act as Director of the Insurance Undertaking and shall be entrusted to him by the Management Board of Insurance; This shall apply mutatis mutandis if the Director of the Insurance Corporation is not elected within the time limit referred to in paragraph 6.
(8) The function of the Director of the Insurance Company, the Director of the Regional Branch of the Insurance Company or any other function of the Head of the Insurance Company cannot be held by a person who, because of a conflict of interest,
(a) is a member of the statutory body, supervisory board, a member of a legal entity which is a supplier of goods or services to the insurance undertaking or is an employee or in a similar legal relationship to that legal entity;
(b) as a natural person who supplies goods or services to the Insurance Company;
(c) be in the position of a person close to the persons referred to in points (a) and (b). ";
8. Paragraph 18 (1) reads as follows:
"(1) Only an upstanding citizen of the Czech Republic with permanent residence in the Czech Republic who has reached the age of at least 25 years and is fully competent to do legal acts may be a member of the insurance institution or its alternate. A member of the insurance institution and a head of the head office or, where appropriate, a senior of the lower organisational unit or their representative shall not be a person who, because of a conflict of interest,
(a) is a member of the statutory body, supervisory board, a member of a legal entity that supplies goods or services to the Insurance Corporation;
(b) as a natural person who supplies goods or services to the Insurance Company;
(c) be in the position of a person close to the persons referred to in points (a) and (b). ";
9. In Paragraph 18 (4), the second sentence is deleted.
10.Paragraph 20 (2) reads as follows:
"(2) The Management Board shall consist of 10 members appointed by the Government and 20 members elected by the Chamber of Deputies of Parliament according to the principle of proportional representation of political parties in the Chamber of Deputies of Parliament. The members of the Administrative Board appointed by the Government shall be appointed and dismissed by the Government on a proposal from the Minister for Health. The members of the Administrative Board elected by the Chamber of Deputies elect and dismiss Parliament's Chamber of Deputies. '
11. Paragraph 20 (5) reads as follows:
"(5) The Management Board shall act by a vote. The decision of the Management Board shall require the consent of an absolute majority of all the members of the Management Board. '.
12. in Article 20, paragraphs 6 and 7 are deleted;
13. in Paragraph 21 (3):
"(3) The Supervisory Board shall consist of:
(a) three members appointed and withdrawn by the Government on a proposal from the Minister of Finance, the Minister for Labour and Social Affairs and the Minister for Health;
(b) 10 members elected and withdrawn by Parliament's Chamber of Deputies; the duties of the members of the Supervisory Board shall be exercised in accordance with the principle of proportional representation of political parties in the Chamber of Deputies of Parliament. '.
14. In Article 21, the following paragraph 4 is added:
"(4) The Supervisory Board shall decide by voting. The decision of the Supervisory Board shall require the consent of an absolute majority of all members of the Supervisory Board. '
15. in Paragraph 24a, the following paragraph 4 is added:
"(4) The provision of information to the Ministry of Health or the Ministry of Finance to ensure the performance of the tasks laid down by law shall not be regarded as a breach of the obligation of confidentiality. ';
Transitional provisions
1. The performance of the function of Director of the General Health Insurance Corporation of the Czech Republic (hereinafter referred to as the "Insurance Company '), who performs this function on the date of entry into force of this Act, shall cease on the last day of the calendar month in which the Act became effective. Until such time as the new Director of Insurance is elected, the Director of the Insurance Employee shall act as Director and shall be entrusted to him by the Management Board of Insurance.
2. The term of office of the members of the insurance undertaking's bodies who exercise their duties as a member of the insurance undertaking's body on the date of entry into force of this Act shall end on the last day of the calendar month in which that law became effective.
Amendment of the Act on departmental, branch, corporate and other health insurance companies
Act No. 280 / 1992 Coll., on departmental, branch, corporate and other health insurance companies, as amended by Act No. 10 / 1993 Coll., Act No. 15 / 1993 Coll., Act No. 60 / 1995 Coll., Act No. 149 / 1996 Coll., Act No. 48 / 1997 Coll., Act No. 93 / 1998 Coll., Act No. 127 / 1998 Coll., Act No. 225 / 1999 Coll., Act No. 220 / 2000 Coll., Act No. 49 / 2002 Coll., Act No. 420 / 2003 Coll., Act No. 438 / 2004 Coll., is amended as follows:
1. In Paragraph 7 (1), the second sentence "to this Ministry 'is replaced by" to the Ministry of Health and the Ministry of Finance' and in the third sentence "to the Ministry of Health 'is replaced by" to the Agreement with the Ministry of Finance'.
2. Paragraph 7 (2) reads as follows:
"(2) In the case of forced administration, decisions and legal acts of the director of the employee insurance undertaking and other bodies of the employee insurance undertaking shall be subject to the approval of the forced administrator, otherwise they shall be invalid. The forced administrator shall be entitled to take decisions and legal acts which are otherwise the responsibility of the director of the occupational insurance undertaking or of another occupational insurance undertaking. ';
3. the following Section 9a is inserted after Section 9:
(1) The Director is the statutory body of the occupational insurance undertaking. The Director of the Employee Insurance Corporation shall be appointed and removed by the Administrative Board of the Employee Insurance Corporation.
(2) The Director of the Employee Insurance Corporation shall be appointed for a term of 4 years. The Director of the Employee Insurance Corporation may be removed before the expiry of the period for which he was appointed.
(3) A citizen of the Czech Republic may be appointed director of the occupational insurance company, who
(a) is fully eligible for legal action;
(b) is fair, and
(c) has completed a university education.
(4) For the purposes of this law, a person who has not been convicted of a criminal offence of a property nature or of an intentional offence shall be deemed to be righteous if he is not treated as if he had not been convicted. The integrity shall be evidenced by a record of the Register of Penalties which shall not be more than 3 months old.
(5) The function of Director of an occupational insurance undertaking cannot be exercised by a person who, because of a conflict of interest,
(a) is a member of a statutory body, supervisory board, a member of a legal entity which is a supplier of goods or services to an occupational insurance undertaking or is an employee or in a similar legal relationship to that legal entity;
(b) as a natural person who supplies goods or services to an occupational insurance undertaking; or
(c) be in the position of a person close to the persons referred to in points (a) and (b).
(6) The duties of Director of the Employee Insurance Corporation are terminated
(a) the expiry of the term of office;
(b) by appeal,
(c) the date on which the written declaration of resignation of the Management Board is received;
(d) the date on which he became legally competent in a judgment which deprived him of legal capacity or restricted him to legal capacity;
(e) the date on which the judgment which sentenced him to the offence referred to in paragraph 4 became final; or
(f) death.
(7) If the post of Director of the Employee Insurance Corporation is vacant before the end of his term of office, the Management Board shall appoint a new Director of the Employee Insurance Company within 60 calendar days at the latest. Until the appointment of the new Director of the Employee Insurance Corporation, this function shall be exercised by the Head of Staff of the Health Insurance Corporation, who shall be entrusted by the Management Board. '.
4.
(1) The institutions of the occupational insurance undertaking are the Director of the occupational insurance undertaking, the Management Board and the Supervisory Board.
(2) The Management Board of the occupational insurance undertaking shall decide:
(a) approval of the insurance plan, accounts and annual reports;
(b) approval of the principles of contract policy;
(c) applications for credit from an occupational insurance undertaking;
(d) purchase of real estate;
e) purchase of tangible capital goods at a cost exceeding CZK 1 000 000,
(f) taking over the guarantee obligation;
(g) the use of reserve funds;
(h) other important matters relating to the activities of the occupational insurance undertaking which they reserve for decision-making.
(3) The Management Board of the Employee Insurance Corporation consists of 5 members appointed by the Government and 10 members elected by employers and insured persons of the Employee Insurance Corporation, in the way that 5 members are elected from candidates submitted by representative employers' organisations and 5 members are elected from candidates submitted by representative trade unions. The method of choice and the electoral order shall be laid down by the Ministry of Health by decree.
(4) The Management Board of the occupational insurance undertaking shall decide by voting. The decision of the Management Board shall require the consent of an absolute majority of all members of the Management Board of the Employee Insurance Corporation.
(5) The Board of Supervisors of the Employee Insurance Corporation is composed of:
(a) three members appointed and withdrawn by the Government on a proposal from the Minister of Finance, the Minister for Labour and Social Affairs and the Minister for Health;
(b) 6 members elected by employers and insured persons of an occupational insurance undertaking, in the way that 3 members are elected from candidates submitted by representative employers' organisations and 3 members are elected from candidates submitted by representative trade unions. The method of choice and the electoral order shall be laid down by the Ministry of Health by decree.
(6) The Supervisory Board shall decide by vote. The decision of the Supervisory Board shall require the consent of an absolute majority of all members of the Supervisory Board.
(7) A member of the Management Board cannot be a member of the Supervisory Board at the same time and vice versa. A member of the Management Board may not be a member of the Supervisory Board even in the four-year term following the end of his or her membership of the Management Board; This also applies to a member of the Supervisory Board in the event of his membership of the Management Board.
(8) The term of office of a member of the institution of the occupational insurance undertaking is 4 years. Members of the institution may be removed from office before their term of office expires.
(9) A member of an occupational insurance institution may re-perform the same function in no more than two consecutive functional periods.
(10) A member of the Management Board and the Supervisory Board does not perform his duties in employment relations with an occupational insurance undertaking; he / she is entitled to reimbursement of the expenses associated with the performance of his / her duties and may be remunerated at the rate specified in the health insurance plan.
(11) The rules of procedure and the decision-making arrangements of the institutions of the occupational insurance undertaking shall lay down the rules of the occupational insurance undertaking.
(12) The function of a member of the institution of an occupational insurance undertaking may not be held by a person who:
(a) is a member of a statutory body, supervisory board, a member of a legal entity which is a supplier of goods or services to an occupational insurance undertaking or is an employee or in a similar legal relationship to that legal entity;
(b) as a natural person who supplies goods or services to an occupational insurance undertaking;
(c) be in the position of a person close to the persons referred to in points (a) and (b).
(13) Only an upstanding citizen of the Czech Republic with a permanent residence in its territory who has reached the age of at least 25 may be a member of the institution of the employee insurance company or its alternate. The member of the institution of the occupational insurance undertaking and the head of the head office or, where appropriate, the head of the lower organisational unit or their representative shall not be a citizen who is in an employment or similar relationship with the entity with which the occupational insurance undertaking has concluded a health care contract. ';
5.
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Regulation Information
| Citation | Act No. 117 / 2006 Coll., amending certain laws in the field of public health insurance |
|---|---|
| Regulation Type | - |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 31.03.2006 |
|---|---|
| Effective from | 01.04.2006 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
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