List of institutions providing high-tech medical care. On approval of the procedure for organizing the provision of high-tech medical care using a specialized information system. What documents are needed to obtain a quota?

Registration No. 35499

In accordance with Part 8 of Article 34 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” (Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724; 2013, N 48, Art. 6165) and subclause 5.2.29 of the Regulations on the Ministry of Health of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 19, 2012 N 608 (Collected Legislation of the Russian Federation, 2012, N 26, Art. 3526; 2014, N 37, Art. 4969), I order:

1. Approve the attached Procedure for organizing the provision of high-tech medical care using a specialized information system.

2. Recognize as invalid the order of the Ministry of Health and Social Development of the Russian Federation of December 28, 2011 N 1689n “On approval of the procedure for sending citizens of the Russian Federation to provide high-tech medical care at the expense of budgetary allocations provided for in the federal budget to the Ministry of Health and Social Development of the Russian Federation , using a specialized information system" (registered by the Ministry of Justice of the Russian Federation on February 8, 2012, registration N 23164).

Minister V. Skvortsova

The procedure for organizing the provision of high-tech medical care using a specialized information system

I. Organization of high-tech medical care

1. This Procedure establishes the rules for organizing the provision of high-tech medical care using a specialized information system in medical organizations providing high-tech medical care.

2. High-tech medical care, which is part of specialized medical care, includes the use of new complex and (or) unique treatment methods, as well as resource-intensive treatment methods with scientifically proven effectiveness, including cellular technologies, robotic technology, information technologies and genetic methods engineering, developed on the basis of the achievements of medical science and related branches of science and technology 1.

3. High-tech medical care is provided in accordance with the procedures for providing medical care and based on the standards of medical care.

4. High-tech medical care is provided in the following conditions:

4.1. In a day hospital (in conditions that provide medical supervision and treatment during the day, but do not require round-the-clock medical supervision and treatment);

4.2. Inpatient (in conditions that provide round-the-clock medical supervision and treatment).

5. High-tech medical care is provided in accordance with the list of types of high-tech medical care established by the program of state guarantees of free medical care to citizens 2, which includes:

5.1. A list of types of high-tech medical care included in the basic compulsory health insurance program, financial support, which is provided through subventions from the budget of the Federal Compulsory Health Insurance Fund to the budgets of territorial compulsory health insurance funds;

5.2. List of types of high-tech medical care not included in the basic compulsory health insurance program, the financial support of which is carried out from funds provided to the federal budget from the budget of the Federal Compulsory Health Insurance Fund in the form of other interbudgetary transfers in accordance with the federal law on the budget of the Federal Compulsory Health Insurance Fund for the next financial year and for the planning period.

6. High-tech medical care according to the list of types included in the basic compulsory health insurance program is provided by medical organizations included in the register of medical organizations operating in the field of compulsory health insurance.

7. High-tech medical care according to the list of types not included in the basic compulsory health insurance program is provided:

7.1. Federal government institutions, the list of which is approved by the Ministry of Health of the Russian Federation in accordance with Part 6 of Article 34 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”;

7.2. Medical organizations, the list of which is approved by the authorized executive body of the constituent entity of the Russian Federation (hereinafter referred to as the list of medical organizations) in accordance with Part 7 of Article 34 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation”.

8. The authorized executive body of the constituent entity of the Russian Federation submits a list of medical organizations to the Ministry of Health of the Russian Federation by December 20 of the year preceding the reporting year.

9. The Federal Compulsory Medical Insurance Fund, based on information from territorial compulsory medical insurance funds, submits to the Ministry of Health of the Russian Federation a list of medical organizations included in the register of medical organizations operating in the field of compulsory medical insurance and providing high-tech medical care according to the list of types of high-tech medical care, included in the basic compulsory health insurance program until December 10 of the year preceding the reporting year.

10. The Ministry of Health of the Russian Federation forms in a specialized information system a list of medical organizations providing high-tech medical care in accordance with paragraphs 4-6 of this Procedure by December 30 of the year preceding the reporting year.

II. Direction to provide high-tech medical care

11. Medical indications for the provision of high-tech medical care are determined by the attending physician of the medical organization in which the patient undergoes diagnosis and treatment as part of the provision of primary specialized health care and (or) specialized medical care, taking into account the right to choose a medical organization 3.

12. Medical indications for referral to high-tech medical care are the presence of a patient with a disease and (or) condition that requires the use of high-tech medical care in accordance with the list of types of high-tech medical care.

13. If there are medical indications for the provision of high-tech medical care, the attending physician of the medical organization in which the patient is undergoing diagnosis and treatment as part of the provision of primary specialized health care and (or) specialized medical care (hereinafter referred to as the referring medical organization) issues a referral for hospitalization for the provision of high-tech medical care on the letterhead of the referring medical organization, which must be legibly written by hand or in printed form, certified by the personal signature of the attending physician, the personal signature of the head of the medical organization (authorized person), the seal of the attending physician, the seal of the sending medical organization and contain the following intelligence:

13.1. Last name, first name, patronymic (if any) of the patient, date of birth, address of registration at the place of residence (stay);

13.2. Compulsory health insurance policy number and name of the medical insurance organization (if any);

13.3. Insurance certificate of compulsory pension insurance (if available);

13.4. Diagnosis code for the underlying disease according to ICD-10 4;

13.5. Profile, name of the type of high-tech medical care in accordance with the list of types of high-tech medical care shown to the patient;

13.6. Name of the medical organization to which the patient is sent to provide high-tech medical care;

13.7. Last name, first name, patronymic (if available) and position of the attending physician, contact phone number (if available), email address (if available).

14. The following patient documents are attached to the referral for hospitalization to provide high-tech medical care:

14.1. An extract from the medical documentation, certified by the personal signature of the attending physician, the personal signature of the head (authorized person) of the referring medical organization, containing the diagnosis of the disease (condition), diagnosis code according to ICD-10, information about the patient’s health status, results of laboratory, instrumental and other types of studies , confirming the established diagnosis and the need for high-tech medical care.

14.2. Copies of the following patient documents:

a) a document certifying the patient’s identity (the main document certifying the identity of a citizen of the Russian Federation on the territory of the Russian Federation is a passport 5);

a document certifying the identity of a person employed or working in any capacity on board a sea vessel (except for a warship), a sea vessel of the fishing fleet, as well as a mixed (river - sea) vessel used for the purposes of merchant shipping, is seaman's identity card 6;

the identity document of a military personnel of the Russian Federation is the identity card of a military personnel of the Russian Federation 7;

documents certifying the identity of a foreign citizen in the Russian Federation are a passport of a foreign citizen or another document established by federal law or recognized in accordance with an international treaty of the Russian Federation as a document certifying the identity of a foreign citizen;

The identity document of a person applying for refugee recognition is a certificate of consideration of the application for refugee recognition on the merits, and the identity document of a person recognized as a refugee is a refugee certificate 8.

Documents identifying a stateless person in the Russian Federation are:

a document issued by a foreign state and recognized in accordance with an international treaty of the Russian Federation as an identification document of a stateless person;

temporary residence permit;

resident card;

other documents provided for by federal law or recognized in accordance with an international treaty of the Russian Federation as documents identifying the identity of a stateless person 9);

b) the patient’s birth certificate (for children under 14 years of age);

c) the patient’s compulsory medical insurance policy (if available);

d) insurance certificate of compulsory pension insurance (if available);

14.3. Consent to the processing of personal data of the patient and (or) his legal representative.

15. The referring medical organization submits a set of documents provided for in paragraphs 13 and 14 of this Procedure within three working days, including through a specialized information system, postal and (or) electronic communication:

15.1. To a medical organization included in the register of medical organizations operating in the field of compulsory health insurance, in the case of providing high-tech medical care included in the basic compulsory health insurance program (hereinafter referred to as the receiving medical organization);

15.2. To the executive authority of a constituent entity of the Russian Federation in the field of healthcare (hereinafter referred to as the OHC) in the case of the provision of high-tech medical care that is not included in the basic compulsory health insurance program.

16. The patient (his legal representative) has the right to independently submit a completed set of documents to the health care institution (in the case of the provision of high-tech medical care not included in the basic compulsory health insurance program), or to the receiving medical organization (in the case of the provision of high-tech medical care included in the basic compulsory health insurance program).

17. When referring a patient to the receiving medical organization, the receiving medical organization provides the patient with a coupon for the provision of high-tech medical care (hereinafter referred to as the Voucher for the provision of high-tech medical care) using a specialized information system, attaching a set of documents provided for in paragraphs 13 and 14 of this Procedure.

18. When referring a patient for the provision of high-tech medical care that is not included in the basic program of compulsory medical insurance, the issuance of a Voucher for the provision of high-tech medical care using a specialized information system is provided by OOU with the attachment of a set of documents provided for in 13 and 14 of this Procedure and the conclusion of the Commission of the executive authority of the subject Russian Federation in the field of healthcare on the selection of patients for the provision of high-tech medical care (hereinafter referred to as the OHC Commission).

18.1. The period for preparing the decision of the OHC Commission on confirming the presence (absence) of medical indications for referring a patient to the receiving medical organization for the provision of high-tech medical care should not exceed ten working days from the date of receipt by the OHC of the set of documents provided for in paragraphs 13 and 14 of this Procedure.

18.2. The decision of the OHA Commission is documented in a protocol containing the following information:

18.2.1. Grounds for the creation of the OUZ Commission (details of the normative legal act);

18.2.2. Composition of the OHA Commission;

18.2.3. Patient data in accordance with the identity document (last name, first name, patronymic, date of birth, data on place of residence (stay));

18.2.4. Diagnosis of the disease (condition);

18.2.5. Conclusion of the OHA Commission containing the following information:

a) on confirmation of the presence of medical indications for referring the patient to a medical organization for the provision of high-tech medical care, diagnosis of the disease (condition), diagnosis code according to ICD-10, code for the type of high-tech medical care in accordance with the list of types of high-tech medical care, name of the medical organization , to which the patient is sent to provide high-tech medical care;

b) about the absence of medical indications for referring the patient to a medical organization for the provision of high-tech medical care and recommendations for further medical observation and (or) treatment of the patient according to the profile of his disease;

c) the need for additional examination (indicating the required scope of additional examination), diagnosis of the disease (condition), diagnosis code according to ICD-10, name of the medical organization to which it is recommended to refer the patient for additional examination.

18.3. The protocol of the decision of the OUZ Commission is drawn up in two copies, one copy must be stored for 10 years in the OUZ.

18.4. An extract from the protocol of the decision of the OHC Commission is sent to the sending medical organization, including via postal and (or) electronic communication, and is also handed over to the patient (his legal representative) upon written application or sent to the patient (his legal representative) via postal and ( or) electronic communications.

19. The basis for hospitalization of a patient in the receiving medical organization and medical organizations provided for in paragraph 5 of this Procedure (hereinafter referred to as medical organizations providing high-tech medical care) is the decision of the medical commission of the medical organization to which the patient is sent to select patients for the provision of high-tech medical care , (hereinafter referred to as the Commission of a medical organization providing high-tech medical care).

19.1. The commission of a medical organization providing high-tech medical care is formed by the head of the medical organization providing high-tech medical care 10.

19.1.1. The Chairman of the Commission of a medical organization providing high-tech medical care is the head of the medical organization providing high-tech medical care or one of his deputies.

19.1.2. The regulations on the Commission of a medical organization providing high-tech medical care, its composition and work procedure are approved by order of the head of the medical organization providing high-tech medical care.

19.2. The commission of a medical organization providing high-tech medical care makes a decision on the presence (absence) of medical indications for hospitalization of the patient, taking into account the types of high-tech medical care provided by the medical organization, within a period not exceeding seven working days from the date of registration of a Voucher for the patient for the provision of high-tech medical care (for with the exception of cases of emergency care, including emergency specialized medical care).

19.3. The decision of the Commission of a medical organization providing high-tech medical care is documented in a protocol containing the following information:

1) the basis for the creation of the Commission of a medical organization providing high-tech medical care (details of the order of the head of the medical organization providing high-tech medical care);

2) the composition of the Commission of a medical organization providing high-tech medical care;

3) patient data in accordance with the identity document (last name, first name, patronymic, date of birth, data on place of residence (stay));

4) diagnosis of the disease (condition);

5) conclusion of the Commission of a medical organization providing high-tech medical care, containing the following information:

a) on the presence of medical indications and the planned date of hospitalization of the patient in a medical organization providing high-tech medical care, diagnosis of the disease (condition), diagnosis code according to ICD-10, code of the type of high-tech medical care in accordance with the list of types of high-tech medical care;

6) about the absence of medical indications for hospitalization of the patient in a medical organization providing high-tech medical care with recommendations for further medical observation and (or) treatment of the patient according to the profile of his disease;

c) the need for additional examination (indicating the required scope of additional examination), diagnosis of the disease (condition), diagnosis code according to ICD-10, indicating the medical organization to which it is recommended to refer the patient for additional examination;

d) on the presence of medical indications for referring the patient to a medical organization for the provision of specialized medical care, indicating the diagnosis of the disease (condition), diagnosis code according to ICD-10, and the medical organization to which it is recommended to refer the patient.

20. An extract from the protocol of the Commission of a medical organization providing high-tech medical care, within five working days (no later than the date of the planned hospitalization) is sent via a specialized information system to the referring medical organization and (or) the health care facility that issued the Voucher for the provision of high-tech medical care, as well as issued to the patient (his legal representative) upon written application or sent to the patient (his legal representative) via postal and (or) electronic communication.

21. Based on the results of providing high-tech medical care, medical organizations provide recommendations for further observation and (or) treatment and medical rehabilitation with the preparation of appropriate entries in the patient’s medical records.

22. Referral of patients from among the citizens of the Russian Federation, whose health care, in accordance with the legislation of the Russian Federation, falls under the jurisdiction of the Federal Medical and Biological Agency (hereinafter - FMBA of Russia), to federal medical organizations subordinate to the FMBA of Russia for the provision of high-tech medical care is carried out by FMBA Russia.

23. The referral of patients from among military personnel and persons equivalent to military personnel in terms of medical support to medical organizations providing high-tech medical care is carried out in accordance with Article 25 of the Federal Law of November 21, 2011 N323-F3 “On the fundamentals of protecting the health of citizens In Russian federation".

1 Part 3 of Article 34 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” (Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724; 2013, N 48, Art. 6165 ).

2 Part 5 of Article 80 of the Federal Law of November 21, 2011 N 323-FZ “On the fundamentals of protecting the health of citizens in the Russian Federation” (Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724; 2013, N 48, Art. 6165 ), Decree of the Government of the Russian Federation of November 28, 2014 N 1273 “On the Program of State Guarantees for the provision of free medical care to citizens for 2015 and for the planning period of 2016 and 2017” (Collected Legislation of the Russian Federation, 2014, N49, Art. 6975) .

3 Order of the Ministry of Health and Social Development of the Russian Federation dated April 26, 2012 N 406 “On approval of the Procedure for a citizen to choose a medical organization when providing him with medical care within the framework of the program of state guarantees of free provision of medical care to citizens” (registered by the Ministry of Justice of the Russian Federation on May 21, 2012 g., registration N 24278), order of the Ministry of Health of the Russian Federation dated December 21, 2012 N 1342n “On approval of the Procedure for a citizen to choose a medical organization (except for cases of emergency medical care) outside the territory of the subject of the Russian Federation in which the citizen lives, when providing him with medical care within the framework of the program of state guarantees of free provision of medical care to citizens" (registered by the Ministry of Justice of the Russian Federation on March 12, 2013, registration No. 27617).

4 International statistical classification of diseases and related health problems (10th revision).

5 Decree of the President of the Russian Federation of March 13, 1997 N 232 “On the main document identifying the citizen of the Russian Federation on the territory of the Russian Federation” (Collected Legislation of the Russian Federation, 1997, N 11, Art. 1301).

6 Decree of the Government of the Russian Federation of August 18, 2008 N 628 “On the Regulations on the seaman’s identity card, the Regulations on the nautical book, the sample and description of the form of the nautical book” (Collected Legislation of the Russian Federation, 2008, N 34, Art. 3937).

7 Decree of the Government of the Russian Federation of February 12, 2003 No. 91 “On the identity card of a military serviceman of the Russian Federation” (Collected Legislation of the Russian Federation, 2003, No. 7, Art. 654).

8 Federal Law of February 19, 1993 No. 4528-1 “On Refugees” (Gazette of the Congress of People's Deputies and the Supreme Soviet of the Russian Federation, 1993, No. 12, Art. 425; Collection of Legislation of the Russian Federation, 1997, No. 26, Art. 2956 ; 1998, N 30, Art. 3613; 2000, N 33, Art. 3348; N 46, Art. 4537; 2003, N 27, Art. 2700; 2004, N 27, Art. 2711; N 35, Art. 3607 ; 2006, N 31, article 3420; 2007, N 1, article 29; 2008, N 30, article 3616; 2011, N1, article 29).

9 Article 10 of the Federal Law of July 25, 2002 N 115-FZ “On the legal status of foreign citizens in the Russian Federation” (Collected Legislation of the Russian Federation, 2002, N 30, Art. 3032).

10 Order of the Ministry of Health and Social Development of the Russian Federation dated May 5, 2012 N 502n “On approval of the procedure for the creation and activities of a medical commission of a medical organization” (registered by the Ministry of Justice of the Russian Federation on June 9, 2012 N 24516).

High-tech medical care (hereinafter referred to as HTMC) is part of specialized medical care and includes the use of new complex and (or) unique treatment methods, as well as resource-intensive treatment methods with scientifically proven effectiveness, including cellular technologies, robotic technology, information technology and genetic engineering methods developed on the basis of the achievements of medical science and related branches of science and technology.

The organization and procedure for providing high-tech medical care to residents of Moscow are determined by order of the Ministry of Health and Social Development of the Russian Federation dated December 28, 2011 No. 1689n “On approval of the procedure for sending citizens of the Russian Federation to provide high-tech medical care at the expense of budgetary allocations provided for in the federal budget to the Ministry of Health and Social Development of the Russian Federation , using a specialized information system.”

The list of profiles and types of high-tech medical care is determined by the order of the Ministry of Health and Social Development of the Russian Federation dated December 29, 2012 No. 1629n “On approval of the list of types of high-tech medical care” (until December 31, 2013). On January 1, 2014, Order No. 565n of the Ministry of Health of the Russian Federation dated August 12, 2013 “On approval of the list of types of high-tech medical care” comes into force.

Residents of Moscow can receive VMP from medical organizations of the Moscow state health care system, as well as from federal medical organizations subordinate to the Ministry of Health of the Russian Federation, the Russian Academy of Medical Sciences and the Federal Medical and Biological Agency.

To obtain high medical care in medical organizations of the state healthcare system of Moscow or in federal medical organizations, in accordance with Order of the Ministry of Health and Social Development of Russia No. 1689n dated December 28, 2011 “On approval of the procedure for sending citizens of the Russian Federation to provide high-tech medical care at the expense of budgetary allocations provided for in federal budget to the Ministry of Health and Social Development of the Russian Federation, using a specialized information system", which can be found on the website of the Ministry of Health of Russia at: http://www.rosminzdrav.ru/docs/mzsr/high-tech-med/37" , to issue a “Voucher for the provision of medical treatment”, the patient (or his legal representative) must submit the following documents:

written application from the patient (his legal representative, authorized representative), consent to the processing of personal data of the citizen (patient);
an extract from the protocol of the decision of the medical commission of the medical institution at the place of observation and treatment with a recommendation on the need to provide VMP (original);
an extract from the medical documentation signed by the head of the medical organization at the place of treatment and observation of the patient, containing
information about the diagnosis of the disease, information about the state of health, examination and treatment performed;
results of laboratory, instrumental and other types of medical research on the profile of the disease;
a copy of the passport of a citizen of the Russian Federation (pages 2, 3 and 5);
a copy of the compulsory health insurance policy;
a copy of the certificate of compulsory pension insurance (if available);
a copy of the disability document (if available).

The specified documents should be submitted to the Reception Office of the Moscow Department of Health at the address: Moscow, 2nd Shchemilovsky lane, 4A, building 4 daily, except weekends and holidays, from 9 a.m. until 13 o'clock 30 min. and from 2 p.m. 30 min. until 18:00, telephone for inquiries: 8-499-973-08-61.

List of medical organizations of the city’s public health systemMoscow, where high-tech medical care is provided

	Profile of high-tech medical care	Name of medical organizations of the Moscow state healthcare system
	Abdominal surgery	GBUZ "Research Institute for SP named after. N.V. Sklifosovsky DZM", GBUZ "Moscow Clinical Scientific and Practical Center DZM", GBUZ "GKB named after. S.P. Botkin DZM", State Budgetary Institution "City Clinical Hospital No. 1 named after. N.I. Pirogova DZM", GBUZ "City Clinical Hospital No. 7 DZM", GBUZ "City Clinical Hospital No. 12 DZM", GBUZ "City Clinical Hospital No. 24 DZM", GBUZ "City Clinical Hospital No. 31 DZM", GBUZ "City Clinical Hospital No. 50 DZM", GBUZ "GKB No. 64 DZM", GBUZ "City Clinical Hospital No. 67 DZM", GBUZ "City Clinical Hospital No. 79 DZM", GBUZ "GVV No. 3 DZM", GBUZ "DGKB No. 13 named after. N.F. Filatova DZM"
	obstetrics and gynecology	GBUZ "Center for Family Planning and Reproduction DZM", GBUZ "GKB named after. S.G1. Botkin DZM", State Budgetary Institution "City Clinical Hospital No. 1 named after. N.I. Pirogova DZM", GBUZ "City Clinical Hospital No. 12 DZM", GBUZ "City Clinical Hospital No. 31 DZM", GBUZ "City Clinical Hospital No. 50 DZM"*, GBUZ "City Clinical Hospital No. 64 DZM", GBUZ "City Clinical Hospital No. 79 DZM", GBUZ "RD No. 17 DZM"
	Gastroenterology	GBUZ "Moscow Clinical Scientific and Practical Center of DZM", GBUZ "GKB named after. S.P. Botkin DZM", State Budgetary Healthcare Institution "City Clinical Hospital No. 24"
	Hematology	GBUZ "GKB im. S.P. Botkin DZM", GBUZ "City Clinical Hospital No. 40 DZM", GBUZ "City Clinical Hospital No. 52 DZM", GBUZ "Morozovskaya DGKB DZM"
	Dermatovenereology	State Budgetary Institution "Scientific and Practical Center of Dermatovenereology and Cosmetology, Department of Health"
	Combustiology	GBUZ "Research Institute for SP named after. N.V. Sklifosovsky DZM", GBUZ "City Clinical Hospital No. 36 DZM", GBUZ "DGKB No. 9 named after. G.N. Speransky DZM"
	Neurosurgery	GBUZ "Research Institute for SP named after. N.V. Sklifosovsky DZM", State Budgetary Institution "GKB named after. S.P. Botkin DZM", State Budgetary Institution "City Clinical Hospital No. 15 named after. O.M. Filatova DZM", GBUZ "City Clinical Hospital No. 67 DZM", GBUZ "Research Institute of Emergency Pediatric Surgery and Traumatology DZM", GBUZ "Scientific Center of Medical Care for Children with Deformations of the Craniofacial Region and Congenital Diseases of the Nervous System DZM", GBUZ "Morozovskaya Children's City Clinical Hospital DZM" , GBUZ "DGKB No. 9 named after. G.N. Speransky DZM"
	Neonatology	GBUZ "Center for Family Planning and Reproduction of the Department of Health", GBUZ "City Clinical Hospital No. 13 of the Department of Health", GBUZ "City Clinical Hospital No. 8 of the Department of Health", GBUZ "Children's Clinical Hospital No. 13 named after. N.F. Filatova DZM", GBUZ "DIKB No. 6 DZM"
	Oncology	GBUZ "Moscow City Oncology Hospital No. 62 DZM", GBUZ "Oncological Clinical Dispensary No. 1 DZM", GBUZ "City Clinical Hospital No. 24 DZM", GBUZ "City Clinical Hospital No. 40 DZM", GBUZ "City Clinical Hospital No. 57 DZM", GBUZ "Morozovskaya DGKB DZM" »
	Otorhinolaryngology	GBUZ "MNPC of Otorhinolaryngology of the Department of Health", GBUZ "City Clinical Hospital No. 1 named after. N.I. Pirogov DZM", GBUZ "City Clinical Hospital No. 67 DZM", GBUZ "Morozovskaya DGKB DZM", GBUZ "DGKB St. Vladimir DZM", GBUZ "DGKB No. 9 named after. G.N. Speransky DZM"
	Ophthalmology	GBUZ "OKB DZM", GBUZ "City Clinical Hospital No. 1 named after. N.I. Pirogov DZM", GBUZ "City Clinical Hospital No. 12 DZM", GBUZ "City Clinical Hospital No. 15 named after. O.M. Filatova DZM", GBUZ "City Clinical Hospital No. 36 DZM", GBUZ "City Clinical Hospital No. 67 DZM", GBUZ "Morozovskaya DGKB DZM"
	Pediatrics	State Budgetary Healthcare Institution "Morozov Children's City Clinical Hospital No. 9 named after. G.N. Speransky DZM", State Budgetary Healthcare Institution "District Clinical Hospital No. 6 DZM"
	Rheumatology	GBUZ "City Clinical Hospital No. 1 named after. N.I. Pirogov DZM", GBUZ "City Clinical Hospital No. 4 DZM", GBUZ "City Clinical Hospital No. 52 DZM"
	Cardiovascular surgery	GBUZ "Research Institute for SP named after. N.V. Sklifosovsky DZM", State Budgetary Institution "Scientific Center for Interventional Cardioangiology, Department of Health of the Department of Health", State Budgetary Institution "City Clinical Hospital named after. S.P. Botkin DZM", State Budgetary Institution "City Clinical Hospital No. 1 named after. N.I. Pirogov DZM"*, GBUZ "City Clinical Hospital No. 4 DZM", GBUZ "City Clinical Hospital No. 7 DZM", GBUZ "City Clinical Hospital No. 12 DZM", GBUZ "City Clinical Hospital No. 15 named after. O.M. Filatov DZM", GBUZ "City Clinical Hospital No. 23 DZM", GBUZ "City Clinical Hospital No. 64 DZM", GBUZ "City Clinical Hospital No. 81 DZM", GBUZ "DGKB No. 13 named after. N.F. Filatova DZM"
	Thoracic surgery	GBUZ "Research Institute for SP named after. N.V. Sklifosovsky DZM", GBUZ "City Clinical Hospital No. 36 DZM", GBUZ "DGKB No. 13 named after. N.F. Filatova DZM"
	Traumatology and orthopedics (including endoprosthetics of large joints)	GBUZ "Research Institute for SP named after. N.V. Sklifosovsky DZM", GBUZ "MNPC of Medical Rehabilitation, Rehabilitation and Sports Medicine DZM", GBUZ "Research Institute of Emergency Pediatric Surgery and Traumatology DZM", GBUZ "GKB named after. S.P. Botkin DZM", State Budgetary Institution "City Clinical Hospital No. 1 named after. N.I. Pirogov DZM", GBUZ "City Clinical Hospital No. 7 DZM", GBUZ "City Clinical Hospital No. 12 DZM", GBUZ "City Clinical Hospital No. 13 DZM", GBUZ "City Clinical Hospital No. 15 named after. O.M. Filatova DZM", GBUZ "City Clinical Hospital No. 31 DZM", GBUZ "City Clinical Hospital No. 59 DZM", GBUZ "City Clinical Hospital No. 64 DZM", GBUZ "City Clinical Hospital No. 67 DZM", GBUZ "City Clinical Hospital No. 81 DZM", GBUZ "GVV No. 2 DZM" ", GBUZ "GVV No. 3 DZM", GBUZ "Morozovskaya DGKB DZM", GBUZ "DGKB No. 13 named after. N.F. Filatova DZM"
	Transplantation	GBUZ "Research Institute for SP named after. N.V. Sklifosovsky DZM", State Budgetary Healthcare Institution "City Clinical Hospital No. 7 DZM"
	Urology	GBUZ "City Clinical Hospital No. 1 named after. N.I. Pirogova DZM", GBUZ "City Clinical Hospital No. 12 DZM", GBUZ "City Clinical Hospital No. 31 DZM", GBUZ "City Clinical Hospital No. 50 DZM"*, GBUZ "City Clinical Hospital No. 57 DZM", GBUZ "Morozovskaya Children's City Clinical Hospital No. 13 im. N.F. Filatova DZM"
	Maxillofacial Surgery	GBUZ "Moscow Clinical Scientific and Practical Center of the Department of Health" *, GBUZ "City Clinical Hospital No. 1 named after. N.I. Pirogov DZM", State Budgetary Healthcare Institution "City Clinical Hospital No. 36 DZM"
	Endocrinology	GBUZ "City Clinical Hospital No. 67 DZM", GBUZ "City Clinical Hospital No. 81 DZM", GBUZ "GVV No. 3 DZM", GBUZ "Morozovskaya DGKB DZM"

Find out on the basis of what documents a VMP coupon is issued, which organizations have the right to provide services and how to connect to the program. The information will allow you to navigate issues of high-tech assistance and avoid problems when working with documents.

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What is VMP

VMP is high-tech medical care that is provided to treat patients with complex and severe diseases. Services involve the use of expensive equipment, the latest developments and innovative technologies.

List of types of high-tech medical care

Diseases subject to treatment using coupons, VMP codes for 2019 are reflected in the Decree of the Government of the Russian Federation of December 19, 2016 No. 1403 “On the Program of State Guarantees for the provision of free medical care to citizens for 2017 and for the planning period of 2018 and 2019.”

The Decree lists 1,435 types of HFMP, which include:

microsurgery;
video thoracoscopic operations;
radiological interventions;
laser, intensive therapy;
transplantation of organs and tissues, etc.

Reference:Most often, patients need therapeutic, surgical and combined treatment.

Not all types of high-tech medical care are provided within the compulsory medical insurance system. The second section of the Resolution reflects a list of diseases financed from the federal budget from the Compulsory Medical Insurance Fund and other interbudgetary transfers. To start treatment outside compulsory medical insurance, the patient also receives a VMP coupon. The patient must be prepared for a long wait in line, as the number of places is sharply limited.

How can a patient obtain a voucher for VMP services?

The decision on the need for treatment is made at the outpatient hospital to which the patient belongs at the place of registration. You need to prove the presence of a serious illness, collect a package of documents and undergo additional examination. The final decision on whether to issue a VMP coupon or not is made at the regional level within 10 days.

If the outcome is positive, the papers are sent to an institution where high-tech medical care will be provided. The clinic commission has the right to review documents for another 10 days for electronic applications or 3 days for personal consultations.

Important! To receive a voucher for high-tech care that is not included in the basic program, contact the health department or the local branch of the Ministry of Health, and not the clinic at the place of registration.

List of documents for issuing a VMP coupon

List of documents for the provision of high-tech medical care for all persons:

conclusion of the chief freelance specialist of the Ministry of Health on the profile of the disease, which indicates that the person needs to receive medical treatment. In the conclusion, they write the type of assistance, the name of the federal center where the person will receive treatment;
an extract from the patient's outpatient card in printed form describing the examination results;
referral indicating the diagnosis code according to ICD-10;
pictures and disks with examination results - they are sent by the medical organization to the Ministry of Health by e-mail.

All adult patients (over 18 years of age) will need:

passport of a citizen of the Russian Federation;
compulsory medical insurance policy;
SNILS;
if there is a disability - certificates of medical and social examination;
consent to the processing of personal data.

Children under 18 will need:

birth certificate, from 14 years old - passport;
compulsory medical insurance policy;
SNILS;
medical and social examination certificates;
consent to the processing of personal data from parents and guardians;
passport of the parent or guardian.

As soon as the package of documents is collected, the person responsible for the provision of medical treatment in the clinic transfers it to the Ministry of Health of the region. The patient cannot do this on his own. After which the patient will find out the necessary information in the hospital to which he is attached, and if he has a coupon - on the open portal of high-tech medical care. In addition, on the website you can track the quota for VMP.

Important! If a person needs immediate help, but there is no time to prepare documents, he receives treatment and then collects the papers. But in this case, VMP is provided only for one area, for example, a vital operation is performed, and the associated problems are eliminated later.

In general, several months pass from the moment of submitting documents to the start of treatment. Most often, emergency hospitalization is not possible due to the fact that there is a long queue for VMP. Many patients do not wait for help at all, since their disease is considered insufficiently serious or incurable.

If assistance is refused, the patient has the right to contact Rosminzdrav. A VMP coupon can be issued after consideration of the complaint if a positive decision is made. In cases where a patient is not eligible for high-tech care for a number of reasons, he is offered alternative treatment methods.

Which clinics provide assistance with VMP coupons?

High-tech medical care, included in the basic compulsory health insurance program, is provided by organizations included in the register.
Assistance not included in the basic compulsory medical insurance program is provided by:

Federal State Institution of the Ministry of Health of the Russian Federation in accordance with the List (part 6 of article 34 of Law No. 323-FZ; clause 1 of the Order of the Ministry of Health of Russia dated December 28, 2015 No. 1014n);
medical organizations, the list of which is approved by the authorized executive body of the constituent entity of the Russian Federation (health care management body, OHC) (Part 7, Article 34 of Law No. 323-FZ; clauses 7, 8 of the Procedure).

The medical organization to which the patient is sent must be connected to the voucher assistance program, have a license and meet a number of criteria. In this case, each year you are required to submit an application for participation within a strictly allotted time.

How to become a participant in the basic compulsory medical insurance program

Organizations wishing to provide high-tech assistance next year are required to send a notification to the territorial fund before September 1 of the current year. A document is considered if it is drawn up in accordance with all the rules. What information to provide and in what form to prepare the paper is specified in the Compulsory Medical Insurance Rules.

The territorial fund checks documents and medical organizations for compliance with the criteria. A representative of the clinic has the right to be present during the inspection. If everything is in order, the fund assigns a registration number to the institution and sends a corresponding notification by email within 2 working days.

How to become a participant in the provision of assistance outside of compulsory medical insurance

The Ministry of Health compiles a list of organizations specializing in the provision of services outside the compulsory medical insurance program annually. If a clinic applies for inclusion in the register, it must submit documents before June 1 of the current year.

Reference: a complete list of documents and selection criteria are presented in the Rules for compiling the list (Government Decree No. 1160 dated November 12, 2016).

Members of the expert council, which includes specialists from the Ministry of Health, FAS, Roszdravnadzor, FFOMS, FMBA, FANO and institutions, analyze the papers and make a verdict. The council will inform the clinic of its decision within five working days. If it is negative, the representative of the institution can appeal it.

Reference: if you want to check whether an organization is included in the register or not, visit the VMP portal. The site provides a search for medical organizations by type of high-tech care.

How much funds are allocated for treatment using VMP coupons?

The Prime Minister annually reviews and approves the list of diseases and abnormalities, types and methods of treatment. The Resolution specifies the standards of financial costs per unit of volume (the cost of the procedure performed), as well as the number of allocations. Most types of high-tech assistance are priced between 50-200 thousand rubles.

The budget for 2019 allocated 100.8 billion rubles for the provision of high medical care outside compulsory medical insurance:

94.6 billion rubles. - for federal medical institutions;
6.4 billion rubles. - subsidies for regions.

To treat many diseases, patients do not have enough allocated funds, so they can only count on receiving a quota, and not covering all expenses. If the cost of a service exceeds the permissible limit, the patient bears part of the material costs or refuses assistance.

How are clinics financed?

For high-tech assistance under compulsory medical insurance, funds are allocated to territorial funds in the form of subventions, and for high-tech medical care not under the state program, they are awarded directly from federal institutions. The regional budget participates in financing in rare cases.

The regional commission distributes the volume of assistance between clinics. Members of the commission take into account standards for medical care, the volume of medical care consumed in the institution, the number of insured persons assigned to the hospital, etc. An amount is allocated for the treatment of patients, which is required by law and reflected in the Resolution (from 50 to 200 thousand rubles in 2019).

Important! Private clinics, which can also provide primary care since February 13, 2019, receive subsidies only if they are licensed and included in the register. The procedure for providing subsidies is approved in Government Decree No. 56 dated January 29, 2019.

What can organizations spend funds on?

Basic compulsory medical insurance program

The medical organization receives an amount that can be spent on the purchase of software, databases, communications, fire safety measures, security, checking devices, etc. That is, a medical organization has the right to spend funds accrued for providing assistance using VMP coupons for general business needs.

Providing assistance with VMP coupons outside compulsory medical insurance

The cost standard includes not only general economic needs, but also funds for providing assistance, including salaries for doctors, medicines, purchase of movable property, etc.

Regardless of the basis on which a medical organization provides high-tech care, it is obliged to report on treatment and expenditure of funds. If shortcomings are discovered, the institution is deprived of its license, and subsequently its management cannot apply for participation in the program.

If you plan to provide high-tech care, engage in the development of medical personnel so that the qualifications of doctors meet the requirements. Enroll them in advanced training courses at the Qualification and Training Assessment Center No. 1. , their duration and training time.

More materials

In the magazine, we examined the issues of financial support for the provision of high-tech medical care in 2015. Today we will analyze issues related to organizing the provision of such assistance. Starting from 01/01/2015, the procedure for providing high-tech medical care was established by Order of the Ministry of Health of the Russian Federation dated December 29, 2014 N 930n “On approval of the Procedure for organizing the provision of high-tech medical care using a specialized information system” (hereinafter referred to as Order N 930n).

In a day hospital (in conditions that provide medical supervision and treatment during the day, but do not require round-the-clock medical supervision and treatment);

High-tech medical care is provided in accordance with the list of types of high-tech medical care established by the State Guarantees Program. This list includes:

A list of types of high-tech medical care included in the basic compulsory medical insurance program, the financial support of which is provided through subventions from the FFOMS budget to the TFOMS budgets. Let us recall that this list is given in Sect. 1 appendix to the State Guarantee Program;

A list of types of high-tech medical care not included in the basic compulsory medical insurance program, the financial support of which is carried out from funds provided to the federal budget from the MHIF budget in the form of other interbudgetary transfers in accordance with the federal law on the MHIF budget for the next financial year and planning period. It is given in Sect. 2 annexes to the State Guarantee Program.

Note. High-tech medical care according to the specified lists is provided by medical organizations included in the register of medical organizations operating in the field of compulsory medical insurance.

By virtue of clause 9 of Order No. 930n, the FFOMS, on the basis of information from the TFOMS, submits to the Ministry of Health a list of medical organizations included in the register of medical organizations operating in the field of compulsory medical insurance and providing high-tech medical care according to the list of types of high-tech medical care included in the basic compulsory medical insurance program, in until December 10 of the year preceding the reporting year.

Medical organizations, the list of which is approved by the authorized executive body of the constituent entity of the Russian Federation in accordance with Federal Law N 323-FZ. This list must be submitted by the authorized executive body of the constituent entity of the Russian Federation to the Ministry of Health before December 20 of the year preceding the reporting year.

The Ministry of Health creates a list of medical organizations providing high-tech medical care in a specialized information system by December 30 of the year preceding the reporting year.

In accordance with clause 13 of Order N 930n, if there are medical indications for the provision of high-tech medical care, the attending physician of the medical organization in which the patient is undergoing diagnosis and treatment as part of the provision of primary specialized health care and (or) specialized medical care, issues a referral to hospitalization for the provision of high-tech medical care. It should be noted that a medical indication for the provision of high-tech medical care is the presence of a disease and (or) condition in the patient that requires the use of high-tech medical care in accordance with the list of types of such care.

A referral for hospitalization must be made on the letterhead of the referring medical organization. It must be legibly handwritten or submitted in printed form, certified by the personal signature of the attending physician, the personal signature of the head of the medical organization (the person authorized by him), the seal of the attending physician, the seal of the referring medical organization. The following patient documents must be attached to the referral for hospitalization:

1) an extract from the medical documentation, certified by the personal signature of the attending physician, the personal signature of the head (his authorized person) of the referring medical organization, containing the diagnosis of the disease (condition), diagnosis code according to ICD-10, information about the patient’s health status, results of laboratory, instrumental and other types of studies confirming the established diagnosis and the need for high-tech medical care;

The above set of documents must be sent within three working days, including through a specialized information system, postal and (or) electronic communication:

To a medical organization included in the register of medical organizations operating in the field of compulsory medical insurance, in the case of providing high-tech medical care included in the basic compulsory medical insurance program;

To the executive authority of a constituent entity of the Russian Federation in the field of healthcare (hereinafter referred to as the OHC) in the case of the provision of high-tech medical care that is not included in the basic compulsory medical insurance program.

In addition, it should be noted that the referral of patients from among the citizens of the Russian Federation, whose health care in accordance with the legislation of the Russian Federation falls under the jurisdiction of the FMBA, to federal medical organizations for the provision of high-tech medical care is carried out by the FMBA. In turn, patients from among military personnel and persons equal in medical support to military personnel are sent to medical organizations that provide high-tech medical care in accordance with Federal Law N 323-FZ.

OOUZ Commission. According to clause 18 of Order No. 930n, when referring a patient to provide him with high-tech medical care that is not included in the basic compulsory medical insurance program, the commission of the executive body of the constituent entity of the Russian Federation in the field of healthcare for selecting patients for the provision of high-tech medical care (hereinafter referred to as the OHC commission) issues a coupon for provision of high-tech medical care. The coupon is issued by the OHC using a specialized information system, attaching a set of documents submitted by the patient or the referring medical organization.

The period for preparing the decision of the OHC commission on confirming the presence (absence) of medical indications for referring the patient to the receiving medical organization to provide him with high-tech medical care should not exceed 10 working days from the date of receipt of the set of documents by the OHC.

An extract from the protocol of the decision of the OHC commission is sent to the sending medical organization, including via postal and (or) electronic communication, and is also handed over to the patient (his legal representative) upon written application or sent to the patient (his legal representative) via postal and ( or) electronic communications.

Note. The decision of the OOUZ commission is documented in a protocol, which is drawn up in two copies, one of which is subject to storage in the OOUZ for 10 years.

A medical organization providing high-tech medical care. The basis for hospitalization of a patient in a medical organization providing high-tech medical care is the decision of the medical commission of the medical organization to which the patient is referred to select patients for the provision of high-tech medical care (hereinafter referred to as the commission of the medical organization providing high-tech medical care). This commission is formed by the head of a medical organization providing high-tech medical care.