Decree of the Ministry of Finance No. 41 / 2000 Coll.
Decree laying down detailed conditions for the creation and use of funds intended for medical insurance against medical care paid beyond public health insurance under the State Budget of the Ministry of Defence
Valid
Effective from 10.03.2000
41
DECLARATION
Ministry of Finance
of 24 February 2000
laying down detailed conditions for the creation and use of funds intended for medical insurance against medical care paid in excess of public health insurance by State Budget funds of the Ministry of Defence chapter
The Ministry of Finance, after consulting the Ministry of Health and the Ministry of Defence, provides, pursuant to § 16 paragraph 6 of Act No. 280 / 1992 Coll., on departmental, branch, corporate and other health insurance companies, as amended by Act No. 225 / 1999 Coll.:
Health care brokerage fund
(1) The source of the health care brokers1) is the State Budget Funds of the Ministry of Defence (Ministry). These funds are made available in advance by the Ministry to a separate bank account of designated health insurance companies (hereinafter referred to as "the insurance company '). The resources of the Fund shall include interest received by the insurance undertaking in connection with the management of such funds.
(2) The sickness insurance fund shall be used to cover the difference between the amount of medical care provided or prescribed by a doctor or health care institution, 3) which is partly covered by public health insurance, 4) and the amount of remuneration granted by an insurance undertaking for a defined number of insured persons. 4) The Ministry may provide for the maximum reimbursement of medical care prescribed by the medical institutions referred to in § 3 (1) paid by the insurance company in cases where there are several price variations for medicines and medical devices.
(3) The insurance undertaking accounts for the expenditure of the Fund for the provision of medical care and separate management (5)
(a) account management fees and fees for postal services relating to the sickness insurance fund;
(b) other operational and investment expenditure related to the separate management and management of the sickness insurance fund. 6)
(4) As a basis for verifying the eligibility of the fund's funds, the Ministry shall submit to the insurance undertaking data on professional soldiers and pupils of military schools, indicating the birth number, name and surname, date of establishment and termination of the membership of the category4)
(a) by the 20th day of each month for the preceding calendar month; or
(b) at intervals agreed in excess of the periodic reports referred to in (a).
The arrangements for the transmission of data shall be negotiated in writing by the Ministry with the insurance undertaking.
(5) The accounts for the purposes referred to in paragraph 2 shall be settled by the insurance undertaking within 30 working days of the end of each quarter. On the basis of an assessment of the drawing-up of the previous advance, the Ministry shall indicate a normal advance for the following quarter no later than 30 working days after the presentation of the account concerned. In determining the amount of this advance, account shall be taken of the financial balance of the previous advance, the expected trend in health performance prices and the price of medicines and medical devices in the following financial year. In the event of a justified increase in the fund's expected use, the Ministry shall, at the request of the insurance undertaking in writing, release additional funds in excess of the normal advance. The financial balances of the previous period shall be left in the insurance undertaking's bank account referred to in paragraph 1 and transferred to the following period. Their amount is adjusted by the Ministry for the next period.
(6) Advances shall also be made in the bank account referred to in paragraph 1 for the expenditure referred to in paragraph 3 (a) and (b), the amount of which shall be calculated as one quarter of the budget of the year concerned, which shall form part of the health insurance plan of that year. Actual expenditure shall be accounted for in the context of the annual accounts. The surplus or arrears shall be settled financially at the latest with the advance immediately following the closure of the accounts.
(7) The expenditure of the Fund in the current year shall include any corrections to the accounts of the previous financial year. The final settlement of the use of the Fund in the previous year shall be carried out within the framework of the insurance undertaking's annual accounts. For the purposes of clearing relations with the state budget, the insurance company shall submit to the Ministry a report on the accounts of the revenue and expenditure of the Fund for the previous financial year.
Preventive care fund
(1) The resources of the Fund for Preventive Care (7) are the funds of the State Budget chapter of the Ministry. These funds are made available in advance by the Ministry to the separate bank account of the insurance undertaking. The resources of the Fund shall include interest received by the insurance undertaking in connection with the management of such funds.
(2) The Fund for Preventive Care is used to cover preventive care (8) provided in addition to the preventive care covered by public health insurance (9) for a defined range of insured persons (4).
(3) For the brokerage of payments from the Preventive Care Fund and separate management of the Fund (4), the insurance undertaking accounts for the expenditure of the Fund.
(a) account management fees and postal charges relating to the preventive care fund;
(b) other operational and investment expenditure related to the separate management and management of the preventive care fund. 6)
(4) The departments referred to in Article 1 (4) shall be the basis for verifying the eligibility of the fund's funds, including the identification data of insured persons entitled to draw on specific preventive schemes.
(5) Paragraph 1 (5), (6) and (7) shall apply mutatis mutandis to the evaluation of the use of the preventive care fund and the method for determining the amount of advances.
Common provisions
(1) The issue of a prescription for medicines, a reference to a medical device or a bill of health performance, the payment of which, in addition to the public health insurance payment, is made by the funds referred to in Sections 1 and 2, is made only by the medical contract and other insurance contract facilities. 3) The recipes, vouchers and statements of the health performance related to this payment must be identified in a manner that allows for a clear identification of the fund for the provision of medical care or the preventive care fund. The method of marking is part of the health care compensation contract between the insurance undertaking and the medical contract or other contractual facilities. 3)
(2) The insurance undertaking shall reimburse only the medical care provided or prescribed for the defined group of insured persons by means of the Ministry, provided that such medical care is justified by the health needs of the insured person, by way of advance payment to the special accounts of the funds referred to in Sections 1 and 2. Health care, medicines and medical devices shall not be paid, which shall be requested by the insured person for the contract medical or other contract establishment.
(3) The Ministry shall carry out checks on the creation and use of the Funds pursuant to Sections 1 and 2 and compliance with the procedures laid down in paragraphs 1 and 2. For checks, the insurance undertaking shall provide the Ministry with more detailed information, the content of which and the deadline for submission of which are the subject of a written contract between the insurance undertaking and the Ministry.
Transitional provisions
(1) The amount of advances for the first and second quarters of 2000 will be proposed by the insurance undertaking, taking into account the expected amount of public health insurance payments and the expected amount of additional payments for such health care for each category of insured persons under the Fund under Section 1 (2) and the expected extent of the preventive programmes implemented under the Fund under Section 2 (2). The proposal also includes the planned amount of insurance expenditure under Sections 1 (3) and 2 (3). Proposals for the amount of these advances shall be submitted by the insurance company to the Ministry within 5 working days of the effective date of the decree. The proposal for the amount of such advances shall also include the accounting of funds which have been proven and effectively spent in connection with the implementation of the separate management of the two Funds, as well as the actual expenditure referred to in Sections 1 (2) and 2 (2) paid from the date of application of the specific legislation. 10)
(2) The bank account numbers of the funds referred to in Sections 1 and 2 shall be communicated by the insurance company to the Ministry no later than 3 working days after the effective date of the decree. These bank accounts shall be referred to by the Ministry as advance payments of the amount referred to in paragraph 1 no later than 10 working days after the effective date of the decree.
This decree shall take effect on the day of its publication.
Minister:
Doc.
1) Article 16 (2) of Act No. 280 / 1992 Coll., on departmental, branch, corporate and other health insurance companies, as amended by Act No. 225 / 1999 Coll.
3) Article 11 (3) of Act No. 48 / 1997 Coll., on Public Health Insurance and on the amendment and addition of certain related laws, as amended by Act No. 225 / 1999 Coll. Decree No. 285 / 1999 Coll., on the provision of health care in military medical institutions.
4) Paragraph 11 (3) of Act No. 48 / 1997 Coll., as amended by Act No. 225 / 1999 Coll.
5) Sections 8 (3) and 16 (2) of Act No. 280 / 1992 Coll., as amended by Act No. 225 / 1999 Coll.
6) Articles 3 (6) and 6 (2) (e) of Decree No 227 / 1998 Coll., which provides for a more detailed definition of the heading and amount of the income and expenditure of the public health insurance funds of health insurance companies, the conditions for their creation, use, admissibility of transfers of funds and their management, the limit of the cost of the activities of health insurance companies covered by the resources of the basic fund, including the calculation procedure, as amended by Decree No 235 / 1999 Coll. and Decree No 42 / 2000 Coll.
7) Article 16 (3) of Act No. 280 / 1992 Coll., as amended by Act No. 225 / 1999 Coll.
8) For example, Decree No. 256 / 1999 Coll., on the assessment of medical fitness for military active service, Decree No. 281 / 1999 Coll., which provides for a harmful or particularly difficult service and a range of service facilities for the provision of preventive rehabilitation, and Decree No. 282 / 1999 Coll., on the assessment of medical fitness of military personnel.
9) Sections 29 and 35 of Act No. 48 / 1997 Coll., as amended.
10) Act No. 225 / 1999 Coll., amending certain laws in connection with the adoption of the Law on Occupational Soldiers.
Sign in for notes, favorites and notifications
Regulation Information
| Citation | Decree No. 41 / 2000 Coll., laying down the detailed conditions for the creation and use of funds of the Military Health Insurance Agency of the Czech Republic for the reimbursement of medical care paid in excess of the public health insurance from the state budget of the Ministry of Defence chapter |
|---|---|
| Regulation Type | - |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 10.03.2000 |
|---|---|
| Effective from | 10.03.2000 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
Comments 0