Government Decree No. 487 / 2000 Coll.
Government regulation setting the value of the point and the amount of the health care payments paid from public health insurance for the first half of 2001
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Regulation
Effective from 01.01.2001
Text versions:
01.01.2001
29.12.2000
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487
GOVERNMENT REGULATION
of 18 December 2000
determining the value of the point and the amount of the public health insurance contributions for the first half of 2001
The Government orders pursuant to § 17 (5) 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. 2 / 1998 Coll., hereinafter referred to as "the Act":
This Regulation sets the values of the point and the amount of the health care payments paid by public health insurance in the first half of 2001 for health care in health care institutions, including professional medical institutions, treated by long-term sick and health care establishments reporting under the Decree issuing a list of health performance with points, 1) (hereinafter referred to as the "Decree '), treatment day 00005 and the amount of the reimbursement when providing urgent health care in non-contractual health institutions.
(1) Health care provided in health care institutions of the Czech Republic, with the exception of health care in professional medical institutions, long-term sick hospitals and in health care establishments reporting on treatment day No 00005 (hereinafter referred to as "bed facilities") is paid in the first half of 2001 under the contractual agreement between the health insurance company and the bed establishment
(a) a flat rate;
(b) according to the list of health performance referred to in the Decree; or
(c) on the proposal of a sleeper device, combined payment with a diagnosis payment.
(2) A bed establishment and a health insurance undertaking may agree on a method of payment other than those referred to in paragraph 1 if the total amount of the payment is higher than the payment provided for in paragraph 1 (a) or (b).
(3) The procedure for calculating the flat rate, the value of the point and the conditions for reimbursement referred to in paragraph 1 (a) and (b) are set out in Annex 1 to this Regulation.
(4) The amount of the remuneration referred to in point (c) of paragraph 1 shall be agreed in a contract between the health insurance undertaking and the bed establishment, the amount of the payment for the provision of emergency bed care being fixed at a flat rate and the other health care paid.
(5) If the bed establishment and the health insurance undertaking agree an amendment to the contract or agree a new contract containing new medical performance provided by the bed establishment or agree a new structure of the healthcare provided, the health insurance undertaking shall include these elements in the total amount of the payments for the first half of 2001.
(6) If, in the first half of 2001, income from the collection of insurance premiums per insured person is higher than that provided for in the approved health insurance scheme for the year 2001, the health insurance undertaking shall increase the value of the point set out in Annex 1 to this Regulation by as much as the annual collection of premiums per insured person has increased by as much as the amount specified in the health insurance plan. This increase shall be paid by the sickness insurance company to the hospital until 30 November 2001.
(7) In addition to the flat rate referred to in paragraph 1 (a), the health insurance undertaking will pay a remuneration in the first half of 2001
(a) for cardioverters and also for pacemakers, including electrodes, provided in the case of reimplantation (performances No 55217 and 55219 referred to in the Decree), which were provided in the first half of 2001;
(b) for neuromodulation stimulators that were provided in the first half of 2001 for the treatment of epilepsy and Parkinson's disease;
(c) for neuromodulatory stimulators and intrathecal pumps provided for the treatment of chronic pain conditions in the first half of 2001 in the bed facilities listed in Annex 3 to this Regulation (peripheral nerve stimulation (PNS), spinal cord stimulation or back root stimulation (SCS), deep cerebral and cortical stimulation, for the forequarters of spinal cord (SARS) in transverse spinal lesions); the sleeper establishments listed in Annex 3 to this Regulation may, in aggregate, apply a maximum of 30 programmable prostheses to health insurance companies in the Czech Republic,
(d) for in vitro fertilisation treatment provided in the first half of 2001 by sleeper establishments performing standard sterilisation treatment using an out-of-body fertilisation method;
(e) for the medical performance of haemodialysis No 18051, 18052, 18510, 18513, 18521, 18522, 18530, 18550, 18560, 18570, 18580 and 18590 according to the list of health performance listed in the Decree, which was provided in the first half of 2001, at CZK 1 per point, and for the health performance No 18521, 18522, 18530, 18550, 18560, 18570, 18580 and 18590, respectively, the overhead costs of 4 points per minute shall be determined;
(f) for the specifically charged medicinal products intended for the treatment of haemophilia listed in Annex 4 to this Regulation, provided in bed facilities in the first half of 2001;
(g) for specifically charged HIV / AIDS medicinal products (antiretroviral medicinal products and medicinal products for the treatment of opportunistic infections), provided in the bed facilities listed in Annex 5 to this Regulation in the first half of 2001,
h) for the specifically charged Cerezyme medicinal product, for the treatment of Morbus Gaucher disease, provided only by the General Faculty Hospital Prague in the first half of 2001,
(i) for intensive care medical performance No 00651, 00652, 00653, 00656, 00657, 00658, 00661, 00665, 00668, according to the list of health performance listed in the Ordinance, provided for in the treatment of extensive burns in the first half of 2001, at CZK 1 per point in the bedding facilities listed in Annex 6 to this Regulation, as follows:
1. in adults
1.1 with burns of over 40% of the body's surface,
1.2 in burns above 10% of the body's surface in simultaneous inhaled burn trauma,
1.3 in electric burns,
2. in children
2.1 from 2 to 5 years of age for burns over 10% of body surface area, for children from 6 to 10 years of age for burns over 15% of body surface area and for children from 11 years of age for burns over 40% of body surface area,
2.2 in inhalation trauma or electrocution,
(j) for medicinal products specifically charged for the treatment of cystic fibrosis in bed establishments listed in Annex 7 to this Regulation in the first half of 2001; the list of medicinal products specifically charged is set out in Annex 8 to this Regulation,
(k) for the specifically charged medicinal products provided in the first half of 2001 for selected groups of cancer patients treated at the pedigree oncology centres listed in Annex 9 to this Regulation; the list of medicinal products specifically charged is set out in Annex 10 to this Regulation.
(1) Health care provided in professional medical institutions is paid in the first half of 2001 according to the contractual agreement between the health insurance company and the professional medical institution
(a) a flat rate; or
(b) in a combined manner.
(2) The procedure for calculating the flat rate and the remuneration in a combined manner, the amount of the remuneration, the amount of the point and the conditions for payment referred to in paragraph 1 (a) and (b) are set out in Annex 2 to this Regulation.
(3) If the medical professional institution and the health insurance undertaking agree an amendment to the contract or agree a new contract containing new medical performance provided by the medical professional institution, or agree a new structure of healthcare provided, the health insurance undertaking shall include this in the total amount of the payments for the first half of 2001.
(1) Health care provided in long-term hospitals is paid in the first half of 2001 according to the contractual agreement between the health insurance company and the healthcare establishment according to the list of health performance listed in the decree.
(2) For the payment referred to in paragraph 1, the value of the point of CZK 1 shall be determined.
(3) The value of the direction laid down in the Decree, attached to the point value of the treatment day No 00024 as set out in the Order, is increased by 60 points compared to the first half of 2000.
(4) The flat-rate amount to be paid for medicinal products under Section 17 (6) of the Act is increased by CZK 10 compared to the first half of 2000.
(1) Health care provided in health care establishments reporting on treatment day 00005, as referred to in the Decree, shall be paid in the first half of 2001 under the contractual arrangement between the health insurance undertaking and the health care establishment according to the list of health performance listed in the Decree.
(2) For the payment referred to in paragraph 1, the value of the point of CZK 1 shall be determined.
(3) The value of the direction laid down in the Decree, attached to the point value of the treatment day No 00005 referred to in the Order, is increased by 60 points compared to the first half of 2000.
(4) The flat-rate amount to be paid for medicinal products under Section 17 (6) of the Act is increased by CZK 10 compared to the first half of 2000.
The reimbursement of urgent health care, unless a contract is concluded between a healthcare establishment and a health insurance company, shall be made in the first half of 2001 for the medical performance provided as follows:
(a) dental outpatient care shall be paid at the rates applicable to medical care provided by dental practitioners in the first half of 2001.2)
b) Other health care is paid according to the list of health performance mentioned in the decree and the value of the point is set at CZK 0.82; the health insurance company can apply regulatory mechanisms under the Act (3) as for contractual health institutions.
In cases where the number of points declared on the basis of the list of health performance referred to in the Decree is used for reimbursement, valid until 30 June 2000, and at the same time the score of these health performance is different from that of the list of health performance valid from 1 July 2000, the score of health performance from 1 half 2000 shall be converted into a value according to the list of health performance valid from 1 July 2000.
This Regulation shall enter into force on 1 January 2001.
Prime Minister:
Ing. Zeman v. r.
Minister for Health:
Prof. MUDr. Fisher, CSc.
Příloha č. 1
Annex No. 1 to Government Decree No. 487 / 2000 Coll.
Procedure for calculating the remuneration, flat rate, value of the point and conditions of reimbursement pursuant to § 2 (1) (a) and (b)
(A) Procedure for determining the flat rate payment:
1. The reimbursement of health care provided by bed facilities shall include:
(a) the payment of emergency bed care recorded in hospitalisation accounts, including the relevant performance of the complement (hereinafter referred to as "hospitalisation payment");
(b) the payment of outpatient care recorded in outpatient accounts, including the relevant performance of the complement ("outpatient payment");
(c) reimbursement of the performance of health transport (hereinafter referred to as "transport payment"),
(d) the reimbursement of other health care performance, where provided by the bed establishment, of complements for other healthcare establishments or, where appropriate, other contracted performances ("other remuneration").
If one of these types of healthcare does not provide bed facilities, it is not part of the remuneration.
2. Procedure for establishing the flat rate for the first half of 2001:
The flat rate shall be calculated for the different types of healthcare referred to in points 1 (a) to (d) of the performance volume for the first half of 2000 which have been declared by the sleeper and recognised by the health insurance undertaking from 1 January 2000 to 30 November 2000, as follows:
The total volume of performance (points and separately charged medicinal products and separately charged material) is divided by the number of unique treated insured persons who have received health care in a bed establishment. A single insured person shall mean a single insured person, regardless of how many times a bed establishment has shown health care on that insured person within a specified period of time. The performance and unique treatment of the insured person shall be calculated separately for each type of remuneration referred to in points 1 (a) to (d).
The flat rate shall include:
(a) the number of points per special insured person,
b) flat rate for separately charged medicinal products and separately charged material, on 1 special treated insured person, in CZK.
2.1. Flat rate hospitalisation
PHB
where:
PHB = number of points per unique treated insured person for the first half of 2000
BH = number of points for all hospitalisation, including points per patient category, for the first half of 2000 of a given bed establishment, which have been declared by the bed establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000, except for points:
(a) for health benefits paid in excess of the flat rate of hospitalisation or included in another flat rate, the declared and recognised medical performance provided in the course of hospitalisation in experts no longer contracted for the first half of 2001;
(b) for recognised and recognised health performance provided in the course of hospitalisation in experts no longer contracted for the first half of 2001.
PHZ = flat rate for separately charged medicinal products and separately charged material provided in the first half of 2000 to hospitalised insured persons, except for the specifically charged medicinal products and separately charged material which are paid in excess of the flat rate of hospitalisation or included in another flat rate which has been declared by the hospital and recognised by the health insurance company from 1 January 2000 to 30 November 2000 for 1 unique treated insured person.
ZH = reimbursement for the medicinal products specifically charged and the material specifically charged provided in the first half of 2000 to hospitalised insured persons, except for the medicinal products specifically charged and the material specifically charged, which are paid in excess of the flat rate of hospitalisation or included in another flat rate declared by the hospital and recognised by the health insurance company from 1 January 2000 to 30 November 2000.
UH = number of unique treated insured persons who were hospitalised in the first half of 2000 and the medical performance provided to them was declared by the bed establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000.
2.2. Outpatient flat rate
PAB
where:
PAB = number of points per unique treated insured person for the first half of 2000.
BA = number of points for all medical performance provided in ambulances, for the first half of 2000 which have been declared by the bed establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000, except for points:
(a) for medical performance in excess of or included in the flat rate;
(b) for recognised and recognised health performance provided in ambulances in specialised areas no longer contracted for the first half of 2001.
PAZ = flat rate for separately charged medicinal products and separately charged material provided in ambulances treated to insured persons in the first half of 2000, except for the specifically charged medicinal products and separately charged material which are paid in excess of the flat rate of the outpatient or included in another flat rate declared by the hospital and recognised by the health insurance company from 1 January 2000 to 30 November 2000 on 1 unique treated insured person.
ZA = reimbursement for the medicinal products specifically charged and the material specifically charged, provided in the first half of 2000 in ambulances treated to insured persons, except for the medicinal products specifically charged and the material specifically charged, which are paid in excess of the flat-rate outpatient rate in the first half of 2001 or included in another flat-rate which has been declared by the hospital and recognised by the health insurance company from 1 January 2000 to 30 November 2000.
UA = number of unique treated insured persons who were treated in ambulances in the first half of 2000 and the medical performance provided to them by the sleeper establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000.
2.3. Flat rate for health transport
PDB = INDIVIDUD PDZ = INDIVIDUAL
where:
PDB = number of points per unique treated insured person for the first half of 2000
BD = the number of points for all medical performance provided for health transport in the first half of 2000 of the bed establishment in question, which were declared by the bed establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000, except for points:
(a) for medical performances paid in excess of the flat rate for health transport or included in another flat rate;
(b) for recognised and recognised health performance provided in the course of health transport in expertise no longer contracted for the first half of 2001.
PDZ = flat rate for separately charged medicinal products and separately charged material provided in the first half of 2000 for medical transport to insured persons, except for the specifically charged medicinal products and the separately charged material, which are paid in excess of the flat rate for health transport in the first half of 2001 or included in another flat rate declared by the hospital and recognised by the health insurance company from 1 January 2000 to 30 November 2000 for 1 unique treated insured person.
ZD = reimbursement for the medicinal products specifically charged and the material specifically charged provided in the first half of 2000 for medical transport to insured persons, except for the medicinal products specifically charged and the material specifically charged, which are paid in excess of the flat rate for health transport in the first half of 2001 or included in another flat rate declared by the hospital and recognised by the health insurance company from 1 January 2000 to 30 November 2000.
UD = number of unique treated insured persons who were transported in health transport during the first half of 2000 and, where appropriate, treated and the medical performance provided to them by the bed establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000.
2.4. Flat rate for other health performance
PJB
where:
PJB = number of points per unique treated insured person for the first half of 2000
BJ = number of points for all other medical performance provided in the first half of 2000 of the bed establishment in question, which have been declared by the bed establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000, except for points:
(a) for medical performance in excess of the flat rate for other medical performance or included in another flat rate;
(b) for recognised and recognised other medical performance provided by experts no longer contracted for the first half of 2001.
PJZ = flat rate for separately charged medicinal products and separately charged material provided in the first half of 2000 at other health benefits to insured persons, except for separately charged medicinal products and separately charged material which are paid in excess of the flat rate for other health activities in the first half of 2001 or included in another flat rate which was declared by the bed establishment and the health insurance company recognised from 1 January 2000 to 30 November 2000 at 1 unique treated insured person.
ZJ = reimbursement for the medicinal products specifically charged and the material specifically charged provided in the first half of 2000 at other health benefits to insured persons, except for the medicinal products specifically charged and the material specifically charged, which are paid in excess of the flat rate for other health activities in the first half of 2001 or included in another flat rate declared by the bed establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000.
UJ = number of unique insured persons who received other medical benefits in the first half of 2000, which were declared by the bed establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000.
(3) Determination of flat-rate remuneration per point
For the first half of 2001, the flat-rate remuneration per 1 point for a particular bed establishment shall be fixed. It is based on the individual amount of the remuneration for 1 point in the first half of 2000, which is adjusted by the differentiated increase in the remuneration in 3 bands (according to point 3.2).
3.1 The individual amount of remuneration for 1 point (IVCB) for 1 half of 2000 represents the proportion of the total remuneration, excluding the medicinal products specifically charged and the material separately charged, to 1 point. It shall be determined according to the following formula:
IVCB1.pol.2000 = Z1.pol.2000
where:
HRADA1.pol.2000 = remuneration for all medical performance provided, including the patient's category, provided by the bed establishment in question in the first half of 2000, which was declared and recognised from 1 January 2000 to 30 November 2000, shall not be included in this remuneration for medical performance which is paid in excess of the flat rate in the first half of 2001.
Z1.pol.2000 = remuneration for the medicinal products separately charged and the material separately charged, excluding the medicinal products separately charged and the material separately charged, paid in excess of the flat rate provided in the first half of 2000, which were declared by the bed establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000.
BODY1.pol.2000 = number of points for health performance, transport performance and patient category provided by the bed establishment in question in the first half of 2000, which were declared by the bed establishment and recognised by the health insurance company from 1 January 2000 to 30 November 2000.
3.2 The flat-rate remuneration for 1 point for the first half of 2001 (VCB) consists of the individual amount of remuneration for 1 point recorded for the first half of 2000. The following shall be determined:
a) if the calculated IVCB is less than CZK 0.89, then the VCB is CZK 0.89 for the first half of 2001,
b) if the calculated IVCB is CZK 0.89 or less or CZK 0.99, add CZK 0.01 to this price (VCB = IVCB + 0,01),
(c) if the calculated IVCB is equal to or greater than CZK 1, the calculated price (VCB = IVCB) shall be used.
The flat-rate remuneration per point must be increased in the cases referred to in Paragraph 2 (6) of this Regulation by the Government.
4. Calculation of total remuneration for healthcare provided
4.1 The flat-rate payment for the different types of healthcare referred to in points (1) (a) to (d) per single treated insured person shall be made by multiplying the number of points per unique treated insured person by a flat-rate payment per point plus the amount of the flat-rate charge for the medicinal products separately charged and the materials separately charged to one unique treated insured person.
The calculation of the flat-rate remuneration per single insured person for the different types of healthcare referred to in points 1 (a) to 1 (d) for the first half of 2001 shall be as follows:
PHC = (PHB * VCB) + PHZ
PAC = (PAB * VCB) + PAZ
PDC = (PDB * VCB) + PDZ
PJC = (PJD * VCB) + PJZ
where:
PHC = flat-rate hospitalisation payment for 1 special insured person
PAC = flat-rate outpatient payment for 1 special insured person
PDC = flat-rate transport payment per special insured person
PJC = flat-rate other remuneration per special insured person
4.2. The remuneration for the different types of healthcare referred to in points 1 (a) to (d) shall be calculated by multiplying the flat-rate payment per single treated insured person by the number of individuals treated in the reporting period as follows:
HU = PHC * UHV
AU = PAC * UAV
DU = PDC * UDV
JU = PJC * UJV
where:
HU = hospitalisation remuneration
AU = outpatient remuneration
DU = transport payment
JU = other remuneration
UHV = number of hospitalised unique treated insured persons to whom health care has been provided reported in the first half of 2001 and recognised by the health insurance company
UAV = number of unique insured persons who received outpatient health care reported in the first half of 2001 and recognised by the health insurance company
UDV = number of unique insured persons to whom health transport has been provided reported in the first half of 2001 and recognised by the health insurance company
UJV = number of unique insured persons to whom other performance has been provided reported in the first half of 2001 and recognised by the health insurance company
4.3 The total remuneration (CU) is the sum of each type of remuneration:
CU = HU + AU + DU + JU
The total remuneration is also part of the remuneration of the performance according to § 2 (5) of this regulation by the Government.
5. Calculation of reimbursement in regulation of the prescription of medicinal products and medical devices:
In addition, regulatory mechanisms based on a comparison of the average remuneration for prescribed medicinal products and medical devices to one insured person between the first half of 2000 and the first half of 2001 shall apply when calculating the total remuneration of healthcare provided under point 4.3. Medicinal products and medical devices authorised by a revision physician are excluded from the comparison.
5.1 Where the average remuneration for prescribed medicinal products and medical devices for 1 treated insured person in the first and 2nd quarters of 2001, excluding medicinal products and medical devices authorised by a revision doctor, exceeds 102% of the average reference remuneration, which is made up of the payment for prescribed medicinal products and medical devices for 1 treated insured person in the first half of 2000, a reduction of 60% of the total excess, calculated as the product of the treated number of insured persons during that period, and the amount of the excess of the costs of the medicinal products and medical devices per treated insured person shall be set at 102% of the average reference remuneration for medicinal products and medical devices per insured person.
5.2. If the average payment for the prescribed medicinal products, medical devices for 1 treated insured person in the first half of 2001 does not reach 102% of the average reference remuneration, which consists of payment for the prescribed medicinal products and medical devices for 1 treated insured person in the first half of 2000, except for medicinal products and medical devices approved by the medical examiner, the remuneration for the first half of 2001 will be increased by 40% of the savings achieved. This saving shall be calculated as the product of the treated number of insured persons during the period and the amount of the underutilisation of the costs of medicinal products and medical devices per insured person, compared to 102% of the average reference remuneration for medicinal products and medical devices per insured person.
6. A monthly advance shall be granted by the sickness insurance company to a bed establishment of 106% of one sixth of the amount of remuneration paid to that bed establishment in the first half of 2000.
B) When determining the reimbursement according to the list of health performance mentioned in the Order
1. The value of the point is set at CZK 0.89.
2. The method of reimbursement referred to in Article 2 (1) (b) may be applied only to sleeper establishments where there is a significantly fluctuating amount of public health care, where it is not possible to set a flat rate for the reference period due to the small number of insured persons of the health insurance company concerned and where on average the sleeper establishments do not charge a single health insurance company more than CZK 300,000 per calendar quarter.
3. If the Contracting Parties agree, this option may also be chosen in case of higher billing volumes, but the condition of fluctuating health care provided must be fulfilled.
Příloha č. 2
Annex No. 2 to Government Decree No. 487 / 2000 Coll.
The procedure for calculating the flat rate and the remuneration in a combined manner, the amount of remuneration, the amount of the point and the conditions for reimbursement referred to in Article 3 (1) (a) and (b)
A) Procedure for determining the flat rate reimbursement for healthcare
The remuneration is 110% of the comparison amount. The comparative amount of remuneration shall be equal to the remuneration for healthcare provided in the corresponding 1 half of 2000, declared and recognised from 1 January 2000 to 30 November 2000, and shall not include the remuneration for healthcare provided in the comparative period in cases where such treatment is no longer provided in the medical professional institution or is otherwise paid.
1. The condition for reimbursement of health care provided is that the number of treatment days declared in the first half of 2001 must be at least 95% of the number of treatment days declared in the first half of 2000. In the case where the professional treatment institution accounts for less than 95% of the treatment days thus determined, the fixed flat rate for the first half of 2001 for bed care shall be reduced by a percentage by which no fixed limit on the number of treatment days has been met.
2. Calculation of reimbursement in regulation of the prescription of medicinal products and medical devices:
2.1 Where the average remuneration for prescribed medicinal products and medical devices for 1 treated insured person in the first and 2nd quarters of 2001, excluding medicinal products and medical devices authorised by a revision doctor, exceeds 102% of the average reference remuneration, which is made up of the payment for prescribed medicinal products and medical devices for 1 treated insured person in the first half of 2000, a reduction of 60% of the total excess, calculated as the product of the treated number of insured persons during that period, and the amount of the excess of the costs of the medicinal products and medical devices per treated insured person shall be set at 102% of the average reference remuneration for medicinal products and medical devices per insured person.
2.2 If the average payment for the prescribed medicinal products, medical devices for 1 treated insured person in the first half of 2001 does not reach 102% of the average reference remuneration, which consists of payment for the prescribed medicinal products and medical devices for 1 treated insured person in the first half of 2000, except for medicinal products and medical devices approved by the medical examiner, the remuneration for the first half of 2001 will be increased by 40% of the savings achieved. This saving shall be calculated as the product of the treated number of insured persons during the period and the amount of the underutilisation of the costs of medicinal products and medical devices per insured person, compared to 102% of the average reference remuneration for medicinal products and medical devices per insured person.
(B) When determining the remuneration in a combined manner:
1. Bed care will be paid for by payment for the treatment day and for the performance to be reported as income and discharge tests according to the list of health performance listed in the decree. The value of the point is CZK 1. This method of payment shall be used only for professional medical institutions which are contracted only by medical performance - day of treatment.
2. Outpatient care and health transport will be paid at a flat rate. The flat rate shall be calculated on the basis of the output volume for the first half of 2000 declared by the medical institution and recognised by the health insurance undertaking from 1 January 2000 to 30 November 2000 as follows:
The total volume of health performance (points and separately charged medicinal products and separately charged material) shall be divided by the number of unique treated insured persons who have received health care at the medical institution. A single insured person shall mean a single insured person, regardless of the number of times the professional medical institution has declared that insured person within a specified period of time. The benefits and unique treatment of insured persons are calculated separately for outpatient care and health transport.
The flat rate shall include:
(a) the number of points per special insured person,
b) a flat rate for separately charged medicines and separately charged material per special treated insured person in CZK.
2.1. Outpatient flat rate
PAB
where:
PAB = number of points per unique treated insured person for the first half of 2000
BA = number of points for all provided medical performance in ambulances in the first half of 2000 of the professional medical institute, which were declared and recognised from 1 January 2000 to 30 November 2000, except for:
(a) for medical performance in excess of or included in the flat rate;
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Regulation Information
| Citation | Government Regulation No. 487 / 2000 Coll., setting the value of the point and the amount of the health care payments paid from public health insurance for the first half of 2001 |
|---|---|
| Regulation Type | Regulation |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 29.12.2000 |
|---|---|
| Effective from | 01.01.2001 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
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