Decree No. 618 / 2006 Coll.
Order issuing framework contracts
Valid
Effective from 01.01.2007
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618
DECLARATION
of 20 December 2006
on the issue of framework contracts
According to Article 17 (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. 2 / 1998 Coll., Act No. 117 / 2006 Coll. and Act No. 245 / 2006 Coll., ("the Act '):
Framework contracts for health insurance (1) (hereinafter referred to as "insurance undertakings') and healthcare establishments (2) providing
1. health care for practitioners and practitioners for children and adolescents,
2. outpatient specialised care, with the exception of medical institutions providing physiotherapy (expertise 902 and 9183) and ergotherapy, and for medical institutions providing care for female doctors (expertise 603 and 6043) and clinical loopedia,
3. outpatient dental care,
4. health care in hospitals, professional medical institutions, professional children's and health and long-term care,
5. outpatient diagnostic care (expertise 222, 801, 802, 804, 805, 807, 809, 812 to 819, 822 and 8233),
6. domestic health care, physiotherapy (expertise 902 and 9183), ergotherapy, birth aid, orthoptics and pleoptic care,
7. medical emergency services and transport,
8. medical care,
9th spa care
are listed in Annexes 1 to 9 to this Decree.
Decree No. 290 / 2006 Coll., which issues a decision of the Ministry of Health on framework contracts pursuant to § 17 (3) of Act No. 48 / 1997 Coll., on Public Health Insurance and amending and supplementing certain related laws, is hereby repealed.
Contracts concluded under existing legislation shall be brought into line with this decree by 31 December 2007.
This Decree shall take effect on 1 January 2007.
Minister:
Dr. Julinek v. r.
Příloha č. 1
Annex No 1 to Decree No 618 / 2006 Coll.
Framework contract for health care institutions providing medical care for practitioners and practitioners for children and adolescents and health insurance companies
General provisions
Contractual relations
(1) The framework agreement lays down the conditions under which contracts are concluded between medical institutions providing medical care for practitioners and practitioners for children and adolescents and insurance companies, in order to ensure that health care covered by public health insurance (hereinafter referred to as "covered health care") is carried out in kind. 1
(2) The legal relationships provided for in the contract for the provision and reimbursement of covered healthcare (hereinafter referred to as "the contract"), concluded between insurance companies (2) and health institutions, must not derogate from the provisions of the framework contract provided for in this decree, except for those provisions for which such an option is expressly provided for by this framework agreement.
Contracts
Conclusion of contracts
(1) The legal relationship between the insurance undertaking and the health establishment shall be governed by a written contract concluded under this framework agreement, by the legislation governing public health insurance and the provision of health care, even if the insurance undertaking plays the role of auxiliary institution in implementing European Union3) or by international social security agreements concluded by the Czech Republic (4). In cases not covered by this legislation and by the contract, it shall be governed by the Commercial Code.
(2) The basic condition for the conclusion of a contract is the authorisation of a health care establishment in the relevant field.
(3) The Treaty contains:
(a) the rights and obligations of the Contracting Parties;
(b) the conditions for the quality and effectiveness of the provision of health care, in particular the type, category and extent of healthcare provided, specified by the list of points of performance according to the types of care which the healthcare establishment is authorised to provide, including material and technical equipment and personnel security;
(c) the value of point (5), the amount of reimbursement of the health care paid and the regulatory limitation of the volume of the healthcare provided in accordance with the Decree issued pursuant to Article 17 (6) of the Act;
(d) the way in which the reimbursement of healthcare provided is carried out;
(e) the conditions necessary to check the performance of the contract, including the accuracy and legitimacy of the amounts charged;
(f) the extent and manner of communication of the data necessary to check the performance of the contract;
(g) provisions on the settlement of disputes in the conciliation negotiations or, where appropriate, provisions on the application of arbitration;
(h) the period of validity of the contract, the manner and reasons for its termination;
(i) the provisions on acceptance and compliance with the agreed procedure for the acquisition, transmission and evaluation of documents in accordance with the Methodology for the acquisition and transmission of documents (hereinafter referred to as "the methodology"), the rules for the evaluation of documents (hereinafter referred to as "the rules") and the uniform data interfaces established by the General Health Insurance Company of the Czech Republic in cooperation with representatives of insurance companies and professional associations of health care providers and issued by the General Health Insurance Company of the Czech Republic, in force at the time of the conclusion of the contract,
(j) provisions on how a healthcare establishment is to be informed of any changes to the methodology and rules, including how such changes are to be transmitted.
(4) The Treaty may include other arrangements necessary for its implementation and control, provided that they comply with this Framework Treaty and legislation.
Rights and obligations of the Contracting Parties
1) Contracting Parties:
(a) comply with the agreed methodology, rules and data interface when reporting and paying for the healthcare covered; the contract shall state the version number valid at the time of conclusion of the contract,
(b) undertake its employees, with a view to protecting the rights of insured persons, to maintain the confidentiality of personal data (6) and the facts of which they have become aware in the performance of their duties or employment or in the processing of data from the information system under contract or in connection with them, where appropriate (2).
2) Medical facilities:
(a) provide paid health care in accordance with the legislation in the fields of expertise and scope agreed and defined in the contract for which it is physically and technically provided and staffed, by its operator - natural person or staff;
(b) provide paid health care to insured persons from EU Member States, the EEA and Switzerland, in accordance with the relevant provisions of the European Union 3) and to insured persons of other countries with whom the Czech Republic has concluded social security treaties (4) (hereinafter referred to as EU insured persons), under the same conditions as insurance insurers, to the extent provided by them, so as not to discriminate against them or to favour them, even if the insured person from the EU pays medical care in cash,
(c) be responsible for ensuring that its staff (7) who will provide the insured with covered healthcare in a contract meet the requirements laid down by the legislation for the performance of this activity (8);
(d) be responsible for the fulfilment of the substantive and technical conditions laid down for the healthcare provided by him under the special legislation9);
(e) provide paid health care without overcost, but always taking into account that the necessary diagnostic or therapeutic effect is achieved with regard to the individual health status of the insured person;
(f) be responsible for the effectiveness of the indication when sending the insured person to complementary and consul examinations and, on the basis of their results, regulates the diagnosis or treatment;
(g) shall, for the assessment of the legitimacy of the health care to be charged in a conclusive form, keep the medical documentation on the treatment of insured persons in which the performance of the health care, requested healthcare, prescribed medicinal products and medical devices will be recorded and the results of the examinations and treatments requested and delivered in accordance with the specific legislation10);
(h) ensure that, in the absence of a performance provider authorised to provide health care under the contract and fulfilling the conditions for the performance of that activity (operator - natural person or employee of a healthcare establishment), the presence of another qualified performance provider is not present and, in contractually agreed cases, notifies the insured and the insurance undertaking,
(i) provide, in accordance with the legislation, health care establishments to which the insured person is to be brought into or chosen by the insured person with the information necessary to ensure the continuity of health care and to avoid duplication of diagnostic and therapeutic performance and when taking custody of the insured person he will require such information from the relevant establishments;
(j) does not refuse to receive custody of the insured person except for the reasons set out in Paragraph 11 (1) (b) of the Act;
(k) does not make the insured person's right to free choice of doctor, health care institution or to provide paid health care subject to any registration fees or sponsorship gifts and no financial compensation shall be levied on the insured person for the provided health care provided by the insurance undertaking, unless it results from legislation;
(l) does not make the insured person's right to receive paid health care subject to a change in the insurance undertaking or otherwise;
(m) it does not favour the insured persons of one or more insurance undertakings to the detriment of the insured persons of the insurance undertakings of the others and it will make the availability of health care paid by the insurance undertaking more favourable by providing care otherwise;
(n) notify the insurance undertaking, in accordance with Section 55 of the Act, of accidents or other damage to the health of persons to whom it has provided paid medical care, if it has reasonable grounds to suspect that they have been caused by acts of a legal or natural person;
(o) be responsible for the correct and complete completion of the recipe form under the special legislature11; is also responsible for the correct and complete completion of the voucher for medical devices or for the examination / treatment or health transport order. If the prescription restriction resulting from the legislation has not been respected during the prescription and the insurance company has paid this medicinal product to the pharmacy, the insurance undertaking shall have the right to require the medical establishment to pay the amount paid,
(p) when concluding a contract with an insurance undertaking, it shall attest proof of liability for damage caused to citizens in connection with the provision of health care and shall be insured throughout the duration of the contractual relationship with the insurance undertaking.
3) Insurance:
(a) pay to the healthcare institution paid for health care, documented and justified to its insured persons as well as EU insured persons who have chosen the insurance undertaking as an assistance institution in the implementation of European Union law (3) in accordance with the law and the Treaty;
(b) establish, at the request of the medical institution, the insurer's jurisdiction to the insurance undertaking without undue delay in cases where the insurer's ID is not available and his personal data are available;
(c) does not require the benefit of its insured persons at the expense of the insured persons of other insurance undertakings;
(d) be entitled to carry out checks on the performance of contractually agreed material and technical conditions and on the staff provision of covered health care provided by health care establishments under the contract;
(e) provide health care institutions with an agreed methodology, rules, data interface and the relevant code lists issued by the General Health Insurance Company to report and calculate the reimbursement of the paid health care;
(f) inform the health care institution of the agreed changes to the methodology, rules and code list changes for at least one month and the change to the data interface at least two months before the date of their validity. In the event of a change in legislation which does not allow that period to be met, that period may be reduced accordingly.
Reimbursement of paid health care
(1) The values of point (5) for healthcare covered by the list of benefits, the amount of payments of paid health care and the regulatory limitation of the volume of healthcare provided under Article 17 (6) of the Act shall be indicated in the Appendix to the contract.
(2) The methods of payment shall be:
(a) payment for health performance according to the list of health performance with points;
(b) a combined remuneration for registered insured persons and for health performance according to the list of health performance with points (combined capital charge); or
(c) another agreed method of reimbursement.
(3) A change in the structure, scope and volume of the covered healthcare provided must always be agreed between the Contracting Parties, in particular because of the change in capacity, the structure of the healthcare facility, the modification or renewal of the instrumentation specified in the contract.
(4) The medical establishment for the application of claims for reimbursement of paid health care shall transmit to the insurance undertaking once a month the bill of discharge of the care provided by means of an invoice with annexes, unless the parties agree to forward the bill for a longer period. The invoice shall contain the particulars of the accounting document12). The elements of the Annex are contained in the methodology or shall be specified in the contract in accordance with the methodology. Where the invoice does not contain the particulars of the accounting document and the annex does not contain the particulars of the agreed methodology or contract, the insurance undertaking shall have the right to refuse it and return it to the medical establishment without undue delay for replenishment or repair, where appropriate; in such a case, the repayment period shall run only from the date of its readmission by the insurance undertaking.
(5) The medical establishment is responsible for the completeness, formal and factual accuracy of the documents and for their transmission in a manner agreed in the methodology and data interface. The documents for the medical care paid to insurance and EU insured persons who have chosen the insurance undertaking as an assistance institution in the implementation of European Union law (3) shall be transmitted by the healthcare establishment to the insurance undertaking together with the bill by the deadline and in a manner agreed in the contract (electronic medium or in electronic form or paper documents).
(6) If the insurance undertaking ascertains in the bill before the payment is made incorrectly or incorrectly accounted for, it shall not pay this part of the account by the due date. The insurance undertaking shall, in a verifiable manner, notify the medical institution without undue delay of the extent and reason of the care charged but not paid. In doing so, the insurance company will call on the health care establishment to correct the incorrectly accounted care or to provide evidence of the provision of paid health care. The insurance undertaking shall pay the due and settled care within the next payment deadline.
(7) The insurance company will pay for its insured persons and EU insured persons who have chosen the insurance undertaking as an auxiliary institution in the implementation of European Union law (3), the reimbursement of paid health care, charged in accordance with legislation and contract. If the check reveals errors in the documents, it shall follow the methodology and rules. The refusal of the payment or part of the payment of the insurance undertaking shall be justified in writing without undue delay to the healthcare establishment. The granting of the remuneration shall be without prejudice to the insurance undertaking's right to carry out a follow-up check on the bill paid to the extent and under the conditions laid down in the legislation and the contract.
(8) If the insurance undertaking finds that the misstatement transmitted to the health care establishment is incorrect retrospectively, i.e. after payment and the health care establishment within 10 working days of receipt of the written request by the insurance undertaking does not pay the amount itself or does not justify the validity of the contested amount to be charged or any other payment deadline agreed between the parties, the insurance undertaking shall, by unilaterally setting off the claim, reduce the corresponding amount of payment for the medical establishment for the payment of the medical care submitted in the following settlement period.
(9) Reimbursement of the covered health care provided, subject to the conditions agreed in the contract, will be made at the time of transmission of the bill to the insurance undertaking on an electronic medium or in electronic form within 30 calendar days and at the time of transmission of the bill to the insurance undertaking on paper documents within 50 calendar days of the date of receipt of the invoice to the insurance undertaking, unless otherwise assessed by the Contracting Party. The due date shall be respected if payment is credited to the health care establishment on the last day of the period.
(10) In the event of a malfunctioning of the calculation system, which makes it impossible to carry out the bill or reimbursement of the paid health care in good time, the insurance undertaking shall, within the agreed payment deadline, provide an advance of the average monthly amount of the reported health care, calculated from the last two closed calendar quarters, unless otherwise agreed by the parties in the case in question.
Control
(1) The insurance undertaking shall, in accordance with Article 42 of the Act and the contract, carry out checks on the use and provision of covered health care in its volume and quality, including compliance with prices, through its information system, review doctors and other health professionals, eligible for review activities (hereinafter referred to as "experts").
(2) In the context of their professional competence, the review practitioners and the professional staff authorised to check whether the chosen method of healthcare paid has been indicated with regard to the health status of the insured person, is in line with current available medical science knowledge and has not been unnecessarily economically demanding.
(3) In cases provided for by legislation, the review physician shall also assess the justification of the treating physician proposed or, where appropriate, the treatment process and shall approve whether the insurance undertaking will pay for the procedure used.
(4) The health care establishment shall provide the insurance undertaking with the necessary synergies in the performance of the check, in particular providing the required documents, communicating the data and providing explanations. It will allow the supervisory practitioners and experts of the insurance company to enter their premises, to consult the health documentation of the insured person in accordance with the special legislation13) and other documents directly related to the checks carried out on the health performance, pharmaceuticals and medical devices, including the medicaments and the material specifically charged. The revised physician (a revision expert) is obliged to proceed in such a way that the control does not interfere with the therapeutic performance performed.
(5) In the case of an inspection (investigation) in a health care facility, an alert shall be prepared on the spot, indicating the most important findings and opinions of the healthcare establishment. This record shall not replace the report referred to in paragraph 6.
(6) The report, containing the conclusions of the check, shall be prepared and transmitted to the healthcare establishment within 15 calendar days of the completion of the check; where it is not possible for objective reasons to meet this deadline, the insurance undertaking shall notify the health care establishment accordingly. The check shall, as a general rule, be terminated within 30 calendar days of its initiation.
(7) The medical establishment shall be entitled to submit reasoned objections to the insurance undertaking in writing within 15 calendar days of receipt of the conclusion of the check. The insurance undertaking shall give its opinion on the objections within 30 calendar days of their receipt. If, for objective reasons, these time limits cannot be complied with, they may be extended up to twice as long at the request of the relevant Contracting Party. Within the prescribed period, the insurance undertaking shall inform the health care institution whether it confirms or changes the findings of the check. The submission of objections shall not have suspensory effect in respect of the insurance undertaking's financial claims towards the medical establishment. This is without prejudice to the right of the healthcare establishment to exercise its opposition to the decision of the insurance undertaking in another proceedings.
(8) If the check shows that the health care paid has been incorrectly or incorrectly paid for or provided for, the insurance company shall not pay such care under Article 42 (3) of the Act and shall be entitled to comply with the penalties provided for in the contract. In the event that the findings of the check prove unjustified, the insurance undertaking shall reimburse the medical establishment for the amount by which the check reduced the reimbursement of the covered healthcare. The medical establishment shall be entitled to comply with the penalties provided for in the contract.
Penalties
(1) The Contracting Parties may negotiate a contractual fine and its amount for failure to fulfil their contractual obligations and for other reasons agreed in the contract in accordance with paragraph 2.
(2) Where:
(a) Contracting Party
1. disclose false, incomplete or distortive information at the time of conclusion of the contract or at the time of performance;
2. Failure to comply with the provisions of the contract, with the result that the public health insurance funds are clearly inefficient,
3. does not provide the information agreed in the contract;
(b) medical facilities
1. Incorrectly or multiple charges for health care;
2. does not provide compulsory reporting under public health insurance legislation;
3. Unjustifiably late in showing paid health care;
4. has repeatedly infringed the obligation to report to the insurance undertaking in accordance with Section 55 of the Act accidents or other damage to the health of the insured person caused by the conduct of a legal or natural person;
(c) insurance undertaking
1. Unjustifiably reduce or reject the payment of paid healthcare;
2. to make payment of the healthcare provided with delay which is legally charged, except where it is not liable for late payment.
(3) The application of the penalty shall be without prejudice to the right of the Contracting Parties to refund for wrongfully or wrongly charged and paid medical care.
Duration, method and reasons for termination
The contract shall be concluded for a period of 8 years, unless otherwise agreed by the Contracting Parties.
The contract or part thereof shall cease:
(a) the date on which the decision on the revocation or amendment of the registration pursuant to Act No. 160 / 1992 Coll., on health care in non-state health institutions, as amended, or the withdrawal or amendment of the instrument of incorporation, issued to the health establishment, took place;
(b) the date of death of the medical establishment or insurance undertaking or the date of death of the natural person who was the operator of the medical establishment;
(c) on the date indicated in the written notification to the insurance undertaking if, for serious medical or operational reasons, the health care institution cannot continue to provide health care;
(d) on the date on which the physical, technical or personnel conditions for the provision of healthcare in the agreed scope, laid down by law or contract, within the meaning of Article 3 (2) (a), have ceased to exist, provided that the medical establishment has not remedied the deficiencies beyond an appropriate period of time; the contract or part thereof shall be terminated only in the part defining the extent of the contracted medical care in which the medical establishment does not comply with the legislation or contract provided for, unless there are such serious circumstances as cannot be expected to continue to perform the contract in its entirety.
The contract may be terminated by written notice of five months, beginning on the first day of the month following the date of service of the contract to the other Contracting Party, if, as a result of serious circumstances, no further performance of the contract can reasonably be expected, provided that:
(a) Contracting Party
1. mislead the other Contracting Party, either at the time of conclusion of the contract or at the time of performance of the contract, in a matter essential to the performance of the contract,
2. in contractual relations it has in a gross manner infringed a serious obligation imposed on it by the relevant legislation governing public health insurance or the provision of healthcare, or by contract;
3. repeatedly infringes the obligation under Paragraph 41 of the Act;
4. enter into liquidation or on her property, the court declares bankruptcy,
(b) medical facilities
1. without prior agreement with the insurance undertaking, it does not provide health care of the agreed extent and quality without justification;
2. in spite of a written notice without prior agreement with the insurance undertaking, it shall re-charge healthcare provided beyond the agreed type, expertise and scope of activity;
3. in spite of the written notice, unjustifiably limits the period of service agreed in the contract for insured persons,
4. provide health care without adequate material and technical equipment and staffing;
5. it is shown that it does not provide health care to insured persons in good quality and that it has repeatedly refused to provide health care for reasons other than those laid down by law;
6. Requires, contrary to legislation, financial compensation from insured persons for the health care paid by the insurance undertaking or for the admission to the care of the insured person;
7. in spite of a written notice, it has been shown to charge healthcare unduly repeatedly,
8. does not provide the necessary synergies to carry out the control activities carried out by the insurance undertaking in accordance with the law;
(c) insurance undertaking
1. in spite of a written notice, it shall repeatedly not unduly cover the healthcare provided to the healthcare establishment,
2. despite the written notice, it repeatedly fails to comply with the payment deadlines agreed in the contract;
3. despite the written notice, it repeatedly exceeds the scope of the control activity laid down by law,
4. Provides third parties with data on health establishments in excess of legislation or contract.
The contract may be terminated before the end of the agreed period:
(a) where the law so provides,
(b) by written agreement of the Contracting Parties, under the conditions and within the time limit specified therein.
Communication of data and transmission of documents necessary to check the performance of the contract
(1) Contracting Parties:
(a) use the establishment identification number (IČZ), workplace identification number (IČP) for unambiguous identification of the health care establishment, in accordance with the methodology, organisation identification number (IČ);
(b) communicate the information necessary to check the performance of the contract;
(c) ensure continuous and clear information on the existence of the contractual relationship and the rights deriving therefrom for the insured;
(d) they may transmit the data necessary to evaluate the quality and effectiveness of the healthcare provided to the extent and under the conditions agreed in the contract.
(2) Medical facilities:
(a) provide evidence to the insurance undertaking, on reasonable grounds of suspicion of non-compliance with the procedure, that medical devices have been used in the provision of covered healthcare in accordance with specific legislation14;
(b) notify the other Contracting Party without delay, and within 30 calendar days at the latest, of the facts which could significantly affect the performance of the contract, such as changes in the information contained in the contract, if any
1. to cancel the workplace or part thereof without compensation or to close it for more than 30 calendar days;
2. to leave the staff member named in the contract,
3. the failure of the apparatus necessary for performance without compensation for more than 30 calendar days.
Failure to fulfil the obligations referred to in points (a) or (b), or to fulfil the obligations referred to in point (b), shall be considered a serious breach of the contractual obligation.
(3) Insurance undertaking
(a) may provide health care facilities in a generalized form with the information necessary for their economic activities or for their scientific and research activities and for the quality control of the healthcare provided, to the extent and under the conditions agreed in the contract;
(b) may publish on its website, within the framework of the list of contractual medical establishments, the trade name or business and the address of the medical establishment, its expertise and telephone and, where appropriate, e-mail links or other information mutually agreed.
Dispute settlement
(1) The Contracting Parties shall address any disputes concerning the performance of the contract, in particular by mutual action of the representatives of the Contracting Parties, as a rule within 14 calendar days of the request of one of the Contracting Parties. If there is no agreement between them, they may discuss the issues at issue in conciliation. This shall be without prejudice to the right of the Contracting Parties to exercise their right to settle a dispute in a court or arbitration procedure under a special legislative provision (15) if the Contracting Parties agree to settle disputes in an arbitration procedure in a contract.
(2) Conciliation is proposed by one of the Contracting Parties. The proposal shall contain a precise and sufficiently detailed definition of the dispute. A party to the conciliation proceedings shall be a party to the dispute, the party to the dispute to which the dispute is addressed, the representatives of the relevant group contractual health institutions represented by their interest associations (16), pursuant to Article 17 (3) of the Act and the representatives of the insurance undertaking. Each Party may invite a maximum of two expert advisers to discuss the dispute. The conciliation negotiations shall be terminated by a record containing a settlement or the conclusion that the contradiction has not been removed, indicating the views of both parties.
Příloha č. 2
Annex No 2 to Decree No 618 / 2006 Coll.
Framework contract for medical institutions providing outpatient specialised care, with the exception of health institutions providing physiotherapy (expertise 902 and 918) 1) and ergotherapy, and for women's healthcare institutions (expertise 603 and 604) 1) and clinical loopedia and health insurance companies
General provisions
Contractual relations
(1) The framework agreement lays down the conditions under which contracts are concluded between outpatient specialised care establishments, with the exception of physical therapy (expertise 902 and 918) (1) and ergotherapy, and for women's healthcare establishments (expertise 603 and 604) (1), and clinical loopedia, and insurance companies, in order to ensure the provision and reimbursement of paid health care.
(2) The legal relationships provided for in the contract concluded between insurance undertakings (2) and health institutions must not derogate from the provisions of the framework contract under this decree, except those for which such an option is expressly stated in the framework agreement.
Contracts
Conclusion of contracts
(1) The legal relationship between the insurance undertaking and the health establishment shall be governed by a written contract concluded under this framework agreement, by the legislation governing public health insurance and the provision of health care, even if the insurance undertaking plays the role of auxiliary institution in implementing European Union3) or by international social security agreements concluded by the Czech Republic (4). In cases not covered by this legislation and by the contract, it shall be governed by the Commercial Code.
(2) The basic condition for the conclusion of a contract is the authorisation of a health care establishment in the relevant field.
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Regulation Information
| Citation | Decree No. 618 / 2006 Coll., which issues framework contracts |
|---|---|
| Regulation Type | - |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 30.12.2006 |
|---|---|
| Effective from | 01.01.2007 |
| Effective until | - |
| Status | Valid |
The regulation text is for informational purposes only.
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