20 March 2020 17:48

Mandatory health insurance rules have been approved 

Four mandatory health insurance rules have been approved by the relevant orders of the Cabinet of Ministers of the Azerbaijan Republic:

1. “Rule for the step-by-step payment of the insurance fee in 2020 at the expense of the state budget for mandatory health insurance"
2. "Rules for assigning the insured to the state medical facility on primary health care"
3. "Rules for carrying out medical and economic examinations"
4. "Rules for carrying out medical services quality examinations"

The first rule establishes a step-by-step payment plan for mandatory health insurance fees for citizens of our country at the expense of the state budget. This also includes foreigners who have received refugee status in our country and are under the protection of the UN High Commissioner for Refugees in the country, as well as people without a citizenship, in accordance with the sequence of application of mandatory health insurance on the administrative territorial divisions of the country this year. The mandatory health insurance fee per capita is 90 manat for administrative territorial divisions where mandatory health insurance was applied in January-March, 67.5 manat for administrative territorial divisions where it was applied in April-June, 45 manat for administrative territorial divisions where it was applied in July-September, and 22.5 manat for the administrative territorial divisions where it was applied in October-December. 

According to the second rule, the assignment of a citizen to a medical facility and their choice of a family doctor (field doctor-therapist, field doctor-pediatrician) is carried out by submitting an application either in paper or the electronic format to the medical facility operating in their area of residence. Along with the application, a citizen must submit an identity document and a document certifying his/her registration at the place of residence to the medical facility.

The third rule establishes the procedures for controlling the scope, duration, quality, and conditions of medical services provided by a medical facility through medical and economic examination. Medical and economic examination is carried out in order to establish whether the period and scope of medical services provided, as well as the amount of insurance payments calculated by the medical facility, is in compliance with the provisions of the contract for medical services, the primary medical documents, and the reporting documents of the medical facility.

The fourth rule establishes control over the scope, duration, quality, and conditions of medical services provided by a medical facility through a medical services quality examination. Medical services quality examinations are carried out to identify whether medical services are provided in a timely manner, including whether the correct prevention, diagnosis, treatment, and rehabilitation methods are chosen, as well as to identify violations in the provision of medical services.