Decree No. 98 / 2022 Coll.
Ordinance on the method of measuring the cost of health services for the purpose of redistribution of public health insurance premiums
Valid
Order
Effective from 30.04.2022
Text versions:
30.04.2022
29.04.2022
98
DECLARATION
of 26 April 2022
on how the cost of health services is to be measured for the purpose of the redistribution of public health insurance premiums
According to § 21f (d) of Act No. 592 / 1992 Coll., on Insurance for Public Health Insurance, as amended by Act No. 145 / 2017 Coll.:
Subject matter
This Decree regulates, for the purpose of redistribution, the method of valuation of the costs of health services declared in 2021.
Method of pricing the cost of health services
(1) Health insurance undertakings shall, for the purpose of redistribution, evaluate the costs of health services declared in 2021 in accordance with other public health insurance legislation pursuant to paragraphs 2 to 7.
(2) The costs of acute bed care are evaluated by the product of the value of the point of CZK 1,44 and the number of points of health performance laid down by Decree No. 134 / 1998 Coll., which issues a list of health performance with points, as amended, (hereinafter referred to as "the list of performances") for the relevant health performance in the year in which the health services were provided. In addition to the valuation according to the first sentence, for hospitalized patients with a diagnosis of U07.1 according to the international classification of diseases (1), an amount of CZK 59 064 for each treatment day No 00051 to 00078 is added according to the list of performance at which output No 55227 according to the list of performance lists or one of the DRG markers No 90901 to 90907 according to the communication from the Czech Statistical Office No. 385 / 2020 Coll., on the update of the classification of hospitalized patients of CZ- DRG, provided within 20 days of the first provision of output No 82301 to 90907 according to the list of performance reports or performance testing tests by COVID- 19 using the PCR method with a positive result or performance on the SARSARSARS-CoV-2 certificate with a positive result, if it was not provided by the performance list of output No 8301 or 82302 according to any of performance by any provider during the last 180 calendar days. To the valuation according to the first sentence, for hospitalised patients with a diagnosis of U07.1 according to the international classification of diseases for which the conditions under the second sentence are not met, an amount of CZK 39 967 for each treatment day No 00051 to 00078, provided within 20 days of the first provision of performance No 82301 according to the list of performance or the performance of COVID-19 screening testing using the PCR method with a positive result or performance on the SARS-CoV-2 antigen with a positive result if no performance No 823301 or 82302 according to the list of performance by any provider during the last 180 calendar days.
(3) The costs of health services provided by special bed care providers and subsequent and long-term bed care providers, with the exception of the costs of health services of follow-up intensive care, follow-up ventilation care, follow-up comprehensive intensive rehabilitation and long-term intensive nursing care, are to be valued in accordance with the Annex to this Decree.
(4) The cost of health services included in the capitalisation payment for providers in the field of general medical practice and providers in the field of practical medicine for children and young persons shall be valued at the amount of the basic capitalisation rate for the converted number of insured persons according to Annex 2, Part A, point 1 of Decree No. 242 / 2021 Coll., on determining the method of including compensation in the amount of compensation for the services paid in 2021, as amended, at CZK 48 per insured person and month.
(5) The costs of health services, the compensation of which is laid down in Decree No. 242 / 2021 Coll. in Czech crowns and the valuation of which does not apply paragraphs 2 to 4, are valued at the amount set out in Decree No. 242 / 2021 Coll.
(6) The cost of health services for which paragraphs 2 to 5 are not applied shall be measured by the product of the value of the point referred to in Article 3 and the number of points of performance determined in accordance with the list of performance effective in the year in which the health services were provided. In addition to the valuation according to the first sentence, for treatment days No 00017 according to the list of performance provided to patients with a diagnosis of U07.1 according to the international classification of diseases, the amount of CZK 39 967 shall be added to the assessment of treatment days provided within 20 days of the first provision of power No 82301 according to the list of performance or screening testing COVID-19 using the PCR method with a positive result or performance on the SARS-CoV-2 antigen with a positive result if no performance No 82301 or 82302 according to the list of performance by any provider during the last 180 calendar days.
(7) The cost of health services for which paragraphs 2 to 6 are not applied shall be valued at the amount of remuneration applied for the services provided.
The valuation in accordance with Paragraph 2 (6) shall apply to:
a) outpatient care declared in expertise 603 and 604 according to the performance list value of point of CZK 1.07,
b) haemodialysis care value of a point of CZK 0.82,
(c) health services declared by the health care service provider or patient transport providers of urgent care value of a point of CZK 1.17,
d) health services declared in the medical emergency service value of a point of CZK 1,
e) special outpatient care value of a point of CZK 1.16,
(f) health services declared by providers in the field of practical medicine and practical medicine for children and adolescents, including the performance of transport of health workers declared by these professionals, value of a point of CZK 1.16,
g) outpatient care in expertise 809 and 810 according to the list of performances including magnetic resonance, computer tomography and denzitometry value of point of 0.94 CZK,
h) outpatient care in expertise 222, 403, 801, 802, 807, 812 to 819 and 823 according to the performance list, except for cervical screening performance, the value of a point of CZK 0,74,
i) outpatient care in professionals 911, 914, 916, 921, 925 and 926 according to the list of performance and performance of transport of health workers declared by these professionals value of a point of CZK 1.06,
j) outpatient care in expertise 902 and 917 according to the list of performance and performance of transport of health workers declared by these professionals value of point of CZK 0.81,
k) health services declared by the health transport service provider value point of CZK 1.23,
l) health services of follow-up intensive care, follow-up ventilation care, follow-up complex intensive rehabilitation and long-term intensive nursing care declared by the providers of post and long-term bed care value point of CZK 1.27,
m) outpatient care not mentioned in points (a) to (l) value of the point of CZK 1.05.
Repeal
Decree No 175 / 2021 Coll., on the method of measuring the cost of health services for redistribution purposes, is hereby repealed.
Efficacy
This Decree shall take effect on the day following that of its publication.
Minister for Health:
Prof. MUDr. Válek, CSc., MBA, EBIR, v. r.
Minister of Finance:
Ing. Stanjura v. r.
Annex to Decree No 98 / 2022 Coll.
Valuation of the cost of health services declared by special bed care providers and subsequent and long-term bed care, except for the cost of health services of follow-up intensive care, follow-up ventilation care, follow-up comprehensive rehabilitation treatment and long-term intensive nursing care
The cost of health services declared by special bed care providers and subsequent and long-term bed care, with the exception of the cost of health services of follow-up intensive care, follow-up ventilation care, follow-up comprehensive rehabilitation care and long-term intensive nursing care, shall be evaluated according to the type of day and patient category according to the performance list as follows:
| Ošetřovací den | Pro kategorii pacienta 1 podle seznamu výkonů | Pro kategorii pacienta 2 podle seznamu výkonů | Pro kategorii pacienta 3 podle seznamu výkonů | Pro kategorii pacienta 4 podle seznamu výkonů | Pro kategorii pacienta 5 podle seznamu výkonů |
|---|---|---|---|---|---|
| 00005 | 1 867,87 | 2 020,55 | 2 256,51 | 2 440,10 | 2 728,06 |
| 00021 | 2 583,16 | 2 782,86 | 3 037,51 | 3 243,41 | 3 356,89 |
| 00022 | 2 142,91 | 2 303,41 | 3 134,38 | 3 369,23 | 3 585,20 |
| 00023 | 2 008,15 | 2 358,62 | 2 590,85 | 2 785,32 | 3 171,82 |
| 00024 | 2 201,94 | 2 385,55 | 2 618,48 | 2 796,13 | 2 971,22 |
| 00025 | 5 385,80 | 5 682,06 | 6 068,14 | 6 203,82 | 6 349,95 |
| 00026 | 2 864,33 | 3 201,63 | 3 477,13 | 3 669,98 | 4 134,77 |
| 00027 | 2 142,89 | 2 386,64 | 3 053,68 | 3 284,22 | 3 378,69 |
| 00028 | 3 969,45 | 4 157,25 | 4 533,99 | 5 017,85 | 5 364,43 |
| 00029 | 2 602,59 | 2 777,79 | 3 009,00 | 3 291,09 | 3 556,52 |
| 00030 | 2 032,60 | 2 135,06 | 2 295,63 | 2 400,98 | 2 506,33 |
| 00031 | 569,358 | ||||
| 00032 | 569,358 |
1) Communication from the Czech Statistical Office No. 576 / 2020 Coll., on updating the International Statistical Classification of Diseases and Associated Health Problems (MKN-10).
Sign in for notes, favorites and notifications
Regulation Information
| Citation | Decree No. 98 / 2022 Coll., on the method of measuring the cost of health services for the purpose of redistribution of public health insurance premiums |
|---|---|
| Regulation Type | Order |
| Author | - |
| Collection | Code of Laws |
| Date of Promulgation | 29.04.2022 |
|---|---|
| Effective from | 30.04.2022 |
| Effective until | - |
| Status | Valid |
Legal Areas:
Civil law
Civil law substantive
The regulation text is for informational purposes only.
Comments 0