Act No. 200 / 2015 Coll.
Act amending Act No. 48 / 1997 Coll., on Public Health Insurance, and amending and supplementing certain related laws, as amended, 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, and Act No. 592 / 1992 Coll., on Insurance against Public Health Insurance, as amended
Valid
Law
Effective from 01.09.2015
Zobrazeno prvních 200 z celkem 490 ustanovení tohoto předpisu.
Zobrazit celý předpis →
Pro stažení celého znění použijte tlačítko Stáhnout výše.
200
THE LAW
of 23 July 2015
amending Act No. 48 / 1997 Coll., on Public Health Insurance and amending and supplementing certain related laws, as amended, 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, and Act No. 592 / 1992 Coll., on Insurance against Public Health Insurance, as amended
Parliament has decided on this law of the Czech Republic:
Amendment to the Public Health Insurance Act
Act No. 1 / 2006, Act No. 1 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 1 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 5 / 2006, Act No. 6 / 2006, Act No. 5 / 2006, Act No. 5, Act No. 5 / 2006, Act No. 5, Act No. 5, Act No. 2006, Act No. 2006, Act No. 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No 2006, No
1. in Article 3 (2) (a), the word "death" shall be replaced by "death."
2. In Article 8 (4), the fifth sentence is replaced by the following: "If the insured person does not submit to the competent health insurance undertaking a proof of the insured health insurance abroad and its length, he shall be obliged to pay back the insurance premiums as if the cancellation had not taken place; the periodic penalty payment is not enforced in such a case. If the insured person submits a proof of insured health insurance abroad which does not cover the entire period when he was not obliged to pay the premiums in the Czech Republic according to the first sentence, he shall be obliged to pay back the premium for each calendar month in which the health insurance abroad did not last for the whole calendar month; the periodic penalty payment is not enforced in such a case. Further statements under the first sentence may be submitted to the health insurance undertaking not earlier than 2 full calendar months following the date of re-entry. ';
3. In Article 8, paragraph 6 is added:
"(6) Penalties shall not be enforced in the case of a long-term foreign insured person who has not made a written declaration in accordance with paragraph 4, has not paid premiums and has not benefited from paid services throughout his stay abroad. In such a case, the insured person shall be required to submit a proof of the insured health insurance abroad and its length covering the whole long-term stay abroad. In such cases, the duration of the long-term stay abroad shall be calculated from the date indicated as the beginning of the insurance in the proof of the closure of health insurance abroad. ';
4. In Article 10 (5), the words "minors or persons not competent to act 'are replaced by the words" with limited competence' and the words ", guardian or guardian 'are added at the end of the text of the paragraph.
5. In Article 10 (6), the words "the guardian or guardian 'shall be inserted after the words" the mother of the child is not insured under this law, and the words "the mother of the child shall be inserted after the words" the guardian or guardian of the child' and the words "on the day of his birth 'shall be inserted after the words" the father of the child is not insured under this law'; if the mother of the child is not insured under this law, the legal representative, guardian or guardian of the child's birth shall be notified to the health insurance undertaking with which the father of the child is insured on the day of his birth '.
6. In Paragraph 10 (7), "Death 'is replaced by" Death'.
7. in Article 11 (1) (a):
"(a) the choice of health insurance undertakings, unless otherwise provided for in this law,"
8. in Paragraph 11 (1) (f), including footnote 19a:
"(f) for the provision of health care paid to the extent and under the conditions laid down by this Act relating to diseases with very low incidence in the population within the meaning of the directly applicable European Union19a legislation (hereinafter referred to as" rare diseases "), including orphan medicinal products covered by this Act.
(19a) Article 3 of Regulation (EC) No 141 / 2000 of the European Parliament and of the Council of 16 December 1999 on orphan medicinal products. "
9. The following Section 11a is inserted after Section 11:
(1) The health insurance undertaking may be changed once every 12 months only on the first day of the calendar semester. The application shall be signed by the insured person, his legal representative, guardian or guardian, and shall be submitted to the selected health insurance undertaking during the calendar half-year immediately preceding the change of the health insurance undertaking, no later than 3 months before the required change date. An application for a change to a health insurance undertaking may be submitted only one calendar year; any further applications shall no longer be taken into account, even if submitted within the time limit set.
(2) The insured person shall be entitled to change the health insurance undertaking even within a period shorter than that referred to in paragraph 1 if:
(a) the health insurance undertaking with which it is insured has entered into liquidation;
(b) forced administration has been introduced over the health insurance undertaking with which it is insured; or
(c) there has been a merger of health insurance companies, which also covers the health insurance company with which he is insured;
on the first day of each calendar month following the month in which the event listed in points (a) to (c) occurred.
(3) The change of health insurance companies is carried out by their legal representative, guardian or guardian for persons with limited professional capacity.
(4) When the child is born, the right to choose a health insurance undertaking shall not apply. On the day of birth, the child becomes insured by a health insurance company with which the child's mother is insured on the day of birth. If the mother of the born child is not insured under this law, the child becomes insured on the day of birth by a health insurance company with which the father of the child is insured on the day of birth.
(5) The change of the child's health insurance undertaking may be made by its legal representative, guardian or guardian only after the birth number has been assigned to the child on the date specified in paragraph 1 or 2. ';
10. in Article 12 (j) (3), the word "abroad" is replaced by the words "abroad according to Article 8 (4)."
11. in Paragraph 15 (3):
"(3) From health insurance, health services provided on the basis of recommendations from the registrar in the field of gyno and obstetrics in connection with artificial insemination, if it is a form of extracurricular fertilisation (in vitro fertilisation), shall be reimbursed:
(a) women with double-sided obstruction of fallopian tubes between the ages of 18 and the date of the thirty-ninth year of age;
(b) other women aged 22 to the date of the thirty-ninth year of age;
not more than three times in life, or if in the first two cases it has been transferred to the female sex organs of not more than 1 human embryo resulting from fertilisation of an egg of sperm outside the female body, four times in life. ';
12. In Paragraph 17 (1), the first sentence is replaced by the following: "In accordance with the first sentence, including their amendments and amendments relating to the method of payment, the amount of remuneration and the regulatory limits on remuneration, the determination of the period for which the method of payment, the amount of remuneration and the regulatory limitation on remuneration agreed in such a contract are to apply. If an agreement is reached between the provider and the health insurance undertaking on the method and level of payment of the services paid and the regulatory restrictions only during the calendar year to be agreed on, the provider and the health insurance undertaking may agree that this agreement shall apply to the determination of the method and amount of payment of the services paid and the regulatory restrictions for the whole or part of that calendar year. ';
13. in Paragraph 17 (1), the sentence "Part of the contract for the provision and reimbursement of the services paid in accordance with the first sentence, including its amendments and additions relating to the scope of the services covered by the contract, shall be inserted after the fourth sentence, and the list of health performance from the list of health performance issued by the decree referred to in paragraph 4, which this contract covers."
14. In Paragraph 17 (2), the sentence "The conciliation procedure may be initiated by either party or by the Ministry of Health 'is inserted after the first sentence.
15. Paragraph 17 (4) reads:
"(4) Providers and other bodies providing paid services in the reporting of health performance use a list of health performance with points and with rules for reporting them and the health insurance undertaking accepts this method of reporting unless another means of reporting is assessed with the health insurance company. The Ministry of Health shall establish by decree a list of health performance with points and rules for reporting them. ';
16. In Article 17 (5), the fifth sentence is replaced by the sentence "If, in the conciliation procedure to the agreement, by 30 June of the relevant calendar year or if the Ministry of Health finds that the agreement is not in conformity with legislation or public interest, the value of the item, the amount of the payment of the services paid, the amount of the advances for payment of the services paid and the regulatory limit for the following calendar year by the Ministry of Health shall be determined by the decree of 31 October of the calendar year. '.
17. Paragraph 17 (8), including footnotes 60 and 61, reads:
"(8) If the transfer of all property rights relating to the provision of health services from a provider who has requested the withdrawal of the health service authorisation under the Health Service Act (60), to another person who has subsequently been granted a health service authorisation, or if another person provides health services on the basis of a certificate of compliance with the conditions for the continued provision of health services by a deceased provider under the Health Service Act (61), or subsequently granted a health service authorisation to him, the health insurance undertaking shall, at his request, conclude a contract on the provision and payment of services to the same extent as the original provider, within 180 days of the date of receipt of the application to the health insurance undertaking; the contract is not required by the health insurance undertaking in the event that it has terminated the contract to the original provider. The application may be lodged by the person referred to in the first sentence no later than 30 days from the date of the authorisation to provide health services, if the person to whom the property rights relating to the provision of health services have been transferred or within 30 days from the date of the granting of the certificate of compliance with the conditions for continuing the provision of health services is the person who continues to provide health services after the deceased provider. Until the conclusion of the contract for the provision and payment of the services paid, the person referred to in the sentence shall have the first right to reimbursement of the services provided to the extent resulting from the contract for the provision and payment of the services provided between the original provider and the health insurance undertaking, but for a maximum period of 210 days from the date of transfer of the property rights relating to the provision of health services or from the date on which the provision of health services under the authorisation of the deceased provider continues.
60) Paragraph 23 (3) of the Health Services Act.
61) Article 27 of the Health Services Act. '
18. In Article 17, the following paragraph 9 is added:
"(9) The health insurance undertaking shall publish the contract referred to in paragraph 1 and paragraph 7 (d) in a manner that allows remote access not later than 60 days from the date of conclusion of such a contract. In the same way and within the same period, the health insurance undertaking shall publish any amendment or amendment to the contract referred to in paragraph 1 and paragraph 7 (d) resulting in the amount of remuneration of the health insurance undertaking to the provider for the services rendered or the scope of the services provided (hereinafter referred to as" the Appendix '). The contract referred to in paragraph 1 and paragraph 7 (d) or the Appendix shall take effect on the date of publication in accordance with the first sentence. Where the health insurance undertaking and the provider agree on a method or amount of remuneration other than those laid down in the decree referred to in paragraph 5 for a given calendar year, they shall publish this fact when the contract is published in accordance with the first sentence. The health insurance company shall not disclose information and data which are subject to protection under other legislation. In addition, the health insurance company shall not publish a contract, information and data relating to the provider which is also the reporting service.';
19. The following Article 17b is inserted after Article 17a:
(1) The inclusion, modification or exclusion of the health performance from the list of health performance is proposed by the Ministry of Health, Health Insurance or the relevant professional company, associated with the Czech Medical Society, Jana Evangelist Purkyně, a professional organisation or a professional company which brings together natural persons with professional or specialised competence in the medical profession (hereinafter referred to as the "competent professional company").
(2) The proposal referred to in paragraph 1 shall include a draft registration sheet containing at least the name of the health performance, the justification for the design, the description of the health performance and its implementation, the rules for its reporting and the supporting documents for calculating its point value. When proposing the inclusion of a new health performance, an assessment of the effectiveness of the health performance and a comparison with the proven therapeutic benefit of existing procedures in the same or similar indication shall also be included in the registration sheet if such comparison is possible. The model of the draft registration sheet, the instructions for filling it in and the calculation formula for calculating the point value of the health performance shall be published by the Ministry of Health on its website. Furthermore, the Ministry of Health shall publish its own proposals and proposals on its website for at least 30 days.
(3) In order to evaluate the proposal from a technical point of view, the Minister for Health, as his advisory body, establishes a working group on the list of health performance. The Working Party on the list of health performance issues gives opinions on individual proposals.
(4) The members of the working group on the list of health performance include 1 representative of the General Health Insurance Company, 1 representative of the Association of Medical Insurance Institutions, 1 representative of the Czech Medical Society Jan Evangelist Purkyně, 1 representative of the Czech Pharmaceutical Society Jan Evangelist Purkyně, 1 representative of the Association of Outpatient Specialists of the Czech Republic, 1 representative of the Association of Medical Services of the Czech Republic, 1 representative of the Czech Association of Sisters and 3 representatives of the Ministry of Health. A representative of the relevant professional company that submitted the proposal shall always be invited to the meetings of the Health Performance Working Group. The working group's activities on the list of health performance are governed by the Rules of Procedure published by the Ministry of Health in the Ministry of Health Bulletin.
(5) The Ministry of Health shall continuously review the health performance contained in the list of health performance to ensure that health performance is consistent with developments in the provision of health services and cost developments. If the Ministry of Health finds, in accordance with the procedure laid down in the first sentence, that health performance does not correspond to developments in the provision of health services and in the development of costs, it shall proceed in accordance with paragraphs 1 and 2.
(6) The health performance registers included in the list of health performance and the dates of all revisions made to the individual health performance referred to in paragraph 5 are published by the Ministry of Health on its website. "
20. In Paragraph 30 (2) (b), the words "at the end of the text of point 4 shall be added; in the case of insured persons over 65 years of age, vaccination against pneumococcal infections according to an approved vaccination scheme" shall be added.
21. in Article 30 (2) (b) (6), the words "three doses of vaccine" shall be deleted;
22. in Paragraph 36 (2), "medical transport" is replaced by "paid."
23. In Paragraph 39, the words "to the nearest contractor who is able to carry out a specified type of autopsy under the instrument of inspection of the deceased 'shall be inserted after the words" to death' and the words "to death 'shall be replaced by the words" to death'.
24. in Paragraph 39l (1), "3 years" is replaced by "5 years."
25. in Paragraph 39q (2) (a), "(b) or (c)" is replaced by "(a) to (c)."
26. In Paragraph 40 (8), the words "underage insured or deprived of legal capacity 'are replaced by the words" persons with limited professional capacity' and the words ", guardian or guardian 'are inserted after the words" legal representative'.
27.
(1) For the purposes of the procedure provided for in Article 53 of the basic population register, the health insurance company uses data to the extent that:
(a) surname;
(b) the name and, where appropriate, the names,
(c) the address of the place of stay,
(d) date, place and district of birth; the date, place and state of birth of the data subject born abroad;
(e) the date, place and district of death; if the death of the data subject is outside the territory of the Czech Republic, the date of death, the place and the State in whose territory the death occurred; if the court's decision on the declaration of death is given, the date indicated in the decision as the date of death or the date on which the data subject declared to be dead did not survive and the date on which the decision was acquired;
(f) citizenship and, where appropriate, multiple citizenship.
(2) For the purposes of the procedure provided for in Section 53, the health insurance company uses data from the population information system to the extent that:
(a) the name (s), names (s), surnames (s) and, where applicable, their change, surnames (s),
(b) the date of birth;
(c) place and district of birth; a citizen born abroad, the place and state where he was born,
(d) the birth number and its changes;
(e) citizenship and, where appropriate, multiple citizenship;
(f) the address of the place of permanent residence, including previous addresses of the place of permanent residence;
(g) the beginning of the permanent residence or, where applicable, the date of cancellation of the permanent residence or the date of termination of the permanent residence in the Czech Republic;
(h) the date on which the decision of the court to approve the contract of assistance or representation of a member of the household, including the date on which the court which approved the contract or representation, of the date on which the decision of the court to restrict incapacity is taken, the name and, where applicable, the name, surname and birth number of the guardian; If the guardian has not been assigned a birth number, the date, place and district of his birth and the guardian who was born abroad, the place and state where he was born, if the guardian is a legal person, the name and address of the registered office,
(i) the name and, where applicable, the name, surname and birth number of the father, mother or other legal representative; where one of the parents or other legal representative or guardian does not have a birth number, his name and, where applicable, his name, surname and date of birth; where another legal representative of the child is a legal person, the name and address of the registered office;
(j) the family status and the date of its amendment;
(k) the spouse's birth number; if the spouse is a natural person who is not assigned a birth number, his name and, where applicable, his name, surname and date of birth;
(l) the birth number of the child,
(m) the date, place and district of death; if the death of a citizen is outside the territory of the Czech Republic, the date, place and state on whose territory the death occurred,
(n) the date given in the court's decision on the death declaration as the day of death or, where appropriate, as the day which he did not survive;
(o) the date indicated in the decision of the court on the declaration of the missing person as the date on which the publication of the missing person's declaration took effect and the date on which the decision of the court on the missing person's declaration was acquired.
(3) For the purposes of the procedure provided for in Section 53 of the Aliens Information System, the health insurance company uses data to the extent
(a) the name and, where appropriate, the names, the surnames, their change, the surname of the family;
(b) the date of birth;
(c) the place and state of birth;
(d) the birth number and its changes;
(e) citizenship or nationality, where appropriate;
(f) the type and address of the place of stay;
(g) the number and validity of the residence permit;
(h) the beginning of the stay or, where appropriate, the date of termination of the stay;
(i) limitation of inefficiency;
(j) administrative or judicial expulsion and the period during which entry into the Czech Republic is not allowed;
(k) the family status, the date and place of his change, the name and, where applicable, the names, the surname of the husband and his birth number; where the birth number has not been assigned, the date of birth;
(l) the name and, where appropriate, the name, surname and birth number of the child; where the birth number has not been assigned, the date of birth;
(m) the name and, where applicable, the name of the father, the mother or any other legal representative or guardian and their birth number; where one of the parents or other legal representative or guardian does not have a birth number, his name or, where applicable, his name, surname and date of birth;
(n) date, place and district of death; if there is a death outside the territory of the Czech Republic, the State in whose territory the death occurred or the date of death,
(o) the date given in the court's decision on the death declaration as the day of death or the day on which the alien declared dead did not survive;
(p) the date indicated in the decision of the court on the declaration of the missing person as the date on which the publication of the missing person's declaration took effect and the date on which the decision of the court on the missing person's declaration was acquired;
(q) name and surname, where applicable
1. an elderly child of a stranger,
2. a minor alien who has been entrusted by decision of the competent authority with a decision of the competent authority with regard to alternative family care or who has been engaged by a stranger or his spouse or whose guardian or spouse is a stranger;
3. a lonely stranger aged 65 years or regardless of the age of a stranger who cannot take care of himself for health reasons if he goes to merge a family with a parent or child who is a stranger,
4. a stranger who is an unfurnished direct relative in the ascending or descending line or such a relative of a citizen of the European Union,
5. the parent of a minor stranger and his birth number; if there are foreigners who are not assigned a birth number, the name and, where applicable, the names, surnames and date of birth.
(4) For the purposes of the procedure referred to in Article 53, the health insurance undertaking shall use data from the register of natural persons assigned a birth number but not kept in the information systems referred to in paragraph 2 or 3 to the extent that:
(a) the name and / or surname, surname and / or surname,
(b) the birth number and its amendments;
(c) date of birth;
(d) place and district of birth, for a natural person born abroad, place and state of birth.
(5) Data which are referred to as reference data in the population base register shall be used from the population registration information system or from the alien information system only if they are in the form preceding the current situation.
(6) Only such data as are necessary to fulfil the task may be used from the data provided in a particular case. ';
28. The following Section 41a is inserted after Section 41, including the title:
Classification of acute bed care and reference network of providers
(1) For the purpose of rationalising the functioning of the public health insurance system in the field of emergency bed care, the Institute of Health Information and Statistics of the Czech Republic (hereinafter referred to as the "Institute of Health Information ') establishes and updates annually the list of groups of hospital care groups in acute bed care related to diagnosis (hereinafter referred to as" groups'), their relative cost, the rules for the inclusion of hospitalization into groups and the methodologies related to the reporting of paid services in acute bed care. The current data and methodology according to the first sentence shall be transmitted by the Institute of Health Information to the Ministry of Health within 90 days of the end of the calendar year. The rules for the inclusion of hospitalization into groups are maintained by the Institute of Health Information in a computer program provided by the Ministry of Health at the same time as the data provided in the second sentence.
(2) The Ministry of Health shall publish the data and methodologies referred to in the second sentence of paragraph 1 on its website and shall, on request, provide, in particular, for the purpose of reporting the paid emergency bed care services to health insurance companies, providers and other entities, the computer programme referred to in paragraph 1, third sentence.
(3) For the purposes of the transmission of information to the National Register of Paid Services under the Health Services Act, the health insurance company shall process the information on the provider of the Paid Acute Bed Care Services declared in the computer program referred to in paragraph 1, third sentence.
(4) In order to ensure the development of a system for the inclusion of hospitalisation in groups in acute bed care, the Institute of Health Information may conclude a contract with the provider of information on the cost of hospitalisation. The Ministry of Health shall publish a list of providers with which the contract was concluded according to the first sentence in the Ministry of Health Bulletin. '
29. In the last sentence of Paragraph 43 (2), the words "or 'shall be replaced by a comma and the words', guardian or guardian 'shall be inserted after the words' legal representative '.
30. § 45a reads:
(1) A health insurance undertaking commits an administrative offence by:
(a) not publish a contract for the provision and payment of the services paid pursuant to Paragraph 17 (9) or its amendment or amendment;
(b) it does not keep or publish a list of contractual providers under Paragraph 40 (10) (a);
(c) does not provide an overview of healthcare professionals providing paid services to individual providers under Paragraph 40 (10) (b);
(d) does not provide their insured persons with the provision of paid services, including their local and timely availability, in accordance with Paragraph 46 (1); or
(e) in breach of Paragraph 52 (2), it shall conclude a contract for the provision and reimbursement of the services paid with the tenderer without recommending the conclusion of such a contract in the selection procedure.
(2) A fine shall be imposed for the administrative offence:
(a) 100 000 CZK if it is an administrative offence referred to in paragraph 1 (b) or (c);
(b) 1 000 000 CZK if it is an administrative offence referred to in paragraph 1 (e);
(c) 10 000 000 CZK if it is an administrative offence under paragraph 1 (a) or (d).
(3) The health insurance company is not responsible for an administrative offence if it proves that it has made every effort to prevent an infringement of the legal obligation.
(4) In determining the amount of the fine to the health insurance undertaking, account shall be taken of the seriousness of the administrative offence, in particular the manner in which it was committed and the consequences thereof and the circumstances in which it was committed.
(5) The liability of the health insurance undertaking for the administrative offence shall cease if the administrative authority has not initiated proceedings for it within 1 year of the date on which it became aware of it, but no later than 3 years from the date on which it was committed.
(6) The administrative offences referred to in paragraph 1 are discussed by the Ministry of Health.
(7) The fines shall be collected and enforced by the authority which imposed them.
(8) The income from fines is the income of the state budget. '
31. In Paragraph 46, at the end of paragraph 2, the dot is replaced by "or 'and the following point (f) is added:
"(f) when concluding a contract for the provision and payment of the services paid under Paragraph 17 (8)."
32. In Paragraph 46 (4), the words "or tenderer 'are replaced by the words" candidate or municipality'.
33. in Article 47 (2) (a), the words "specifically defined" shall be inserted after the words "services and";
34. in Paragraph 48 (1) (b):
"(b) a representative of the relevant chamber established by the Act on the Czech Medical Chamber, the Czech Dental Chamber and the Czech Pharmacy Chamber or a representative of a professional organisation where no Chamber is competent,"
35. in Paragraph 48 (1) (d):
"(d) the health service expert to be provided by the tenderer; where a professional company operates in the field of such health services, a representative of that professional company shall be a member of the selection board. ';
36. In the fourth sentence of Paragraph 49 (2), the words "Commission proceedings' shall be inserted after the word" O 'and the words "The President of the Commission shall forward the minutes to the declarant without delay after the end of the proceedings of the commission. That concludes the commission."
37.Paragraph 49 (3) is deleted.
Paragraph 4 shall become paragraph 3.
38. In Paragraph 51 (1), the words "to the network of a health insurance undertaking in the field and territory concerned 'shall be inserted after the words" in particular'.
39. In Paragraph 52, paragraphs 3 and 4 are added:
"(3) If the conclusion of the contract with the tenderer in the selection procedure has not been recommended, the tenderer may not submit a proposal for a new selection procedure in the same field and territory until three months after the date of publication of the outcome of the selection procedure.
(4) Where a contract with a tenderer has been recommended in the selection procedure, that tenderer may reapply for a call for tender or submit an application for an already announced tender for the field, territory and health insurance undertaking for which the contract for the provision and reimbursement of the services paid was recommended after three months from the date of publication of the outcome of such a tender. ';
40. In the third sentence of Article 53 (1), the words "and the likely amount of premiums' shall be deleted and in the last sentence, the words" in respect of premiums due 'shall be inserted after the words "notice'.
41. In Paragraph 55, paragraphs 6 to 8 are added:
"(6) The health insurance undertaking may waive recovery of part or all of the costs referred to in paragraph 1,
(a) where the recovery of such compensation is linked to specific or disproportionate difficulties; or
(b) if the recovery costs are likely to exceed its yield.
There shall be no legal entitlement to waive the recovery of part or all of the costs referred to in paragraph 1.
(7) When determining the amount of the reimbursement of the costs which the health insurance undertaking shall waive pursuant to paragraph 6, the health insurance undertaking shall take into account in particular how the damage occurred and the personal and property ratios of the person causing the damage.
(8) For the purposes of claiming the right to reimbursement of the costs referred to in paragraph 1, the staff of a health insurance undertaking shall not be obliged to maintain the confidentiality provided for by a special law, namely the facts relevant to the exercise of the right and against the persons to whom or through whom it claims. ';
42. The following point 42 is inserted after point 41 of Annex No 1:
| „42. | 403 | Protonová radioterapie | Z | Výkon bude hrazen jen, pokud byl proveden na základě indikace poskytovatele, který má statut centra vysoce specializované zdravotní péče v oboru onkologie udělený podle zákona o zdravotních službách.“. |
Points 42 to 57 shall become points 43 to 58.
43. in Annex 1, point 72 is deleted;
44. In Annex 3, Section C, the words "and after approval by the revision physician 'under heading 68 are deleted.
45. In Annex 3, Section C, under item 91, the amount "CZK 5,800 'is replaced by" CZK 11 600'.
46. In Annex 3, Section C, under headings 103 and 104, the word "over 'is inserted after the word" defect'.
47. In Annex 3, Section C, the word "ORP 'is inserted in entry 149.
Transitional provisions
Sign in for notes, favorites and notifications
Regulation Information
| Citation | Act No. 200 / 2015 Coll., amending Act No. 48 / 1997 Coll., on Public Health Insurance, and amending and supplementing certain related laws, as amended, 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, and Act No. 592 / 1992 Coll., on Insurance against Public Health Insurance, as amended |
|---|---|
| Regulation Type | Law |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 17.08.2015 |
|---|---|
| Effective from | 01.09.2015 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
Comments 0