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- The cost increase will be included in the estimate: new rules for the provision of paid medical services from September 1
The cost increase will be included in the estimate: new rules for the provision of paid medical services from September 1
From September 1, clinics providing paid medical services will begin operating according to the updated rules — Decree of the Government of the Russian Federation No. 659 comes into force. The regulations will be in effect until September 1, 2031. Read more about the innovations in the Izvestia article.
Protection of rights to free assistance
The new rules strictly prevent attempts to push patients to pay for services. Since September 1, clinics have no right to reduce the volume or increase the waiting time for free compulsory medical insurance due to a person's refusal of paid options. In addition, doctors are required to inform the patient about the possibility of receiving the necessary care for free under the state guarantee program.
Yuri Zhulev, co-chairman of the All-Russian Union of Patients, noted that the situation when a patient had to choose between a long wait for free care and a paid service was very common.: This is one of the most frequent complaints received by patient organizations. At the same time, it was often not about a direct refusal of free assistance, but about an unspoken choice: either to wait for the service under the state guarantee program, or to receive it faster, but on a paid basis.
According to Yuri Zhulev, that is why one of the key innovations was an outright ban on reducing the amount of free assistance or increasing the waiting time due to the refusal of paid services.
"Free assistance should be provided in full and on time, regardless of whether a person has used paid services or not," the expert emphasized.
Such a rule, he noted, is designed to eliminate the problem when people were actually forced to choose "to pay or to wait a long time."
If the patient is given to understand, directly or indirectly, that "it will only work faster for a fee," it is important to record the circumstances of the violation. It is recommended to save an appointment, correspondence, promotional messages, or a written refusal or offer to switch to a paid service, as well as record the date, time, and last name of the employee. If possible, you should contact the head of the medical organization with a written request and request an official response.
— They write a statement addressed to the chief physician, which indicates the actual circumstances. Then a copy is sent to the Department of Health, which has a website. In Moscow, it is enough to send a statement to this website, and, as a rule, measures are taken quickly enough," Irina Gritsenko, a medical lawyer, explained to Izvestia the algorithm for further actions.
Registration of paid medical services remotely
Starting from September 1, it will be possible to conclude a contract for paid examination and treatment remotely through the clinic's website, mobile application, or even the Maks messenger. ESIA (the system used by Gosuslugi) is suitable for identification, so an electronic signature is optional.
Yuri Zhulev explained that such opportunities are especially important for people with limited mobility and residents of remote areas. At the same time, the service will also be useful to a wider range of patients, for example, working people who find it difficult to personally come for paperwork, as well as those who undergo repeated treatment or follow-up.
Irina Gritsenko, a medical lawyer, noted that it is important to check the medical organization's website before applying.
— When you visit the website to receive a remote service, there should be all the information about the medical organization, including the list of services from the registry of licenses, — she explained.
The list of services must comply with the data from the Unified Register of Licenses of Roszdravnadzor. The contract will be considered concluded after acceptance, for example, payment is made. The patient's electronic signature is not required.
"The payment confirmation is a receipt: information about it is received by the tax service, and the payment is usually carried out by card," the expert added.
The patient's identity can be confirmed in various ways — via ESIA, phone number, email, or a one-time code. At the same time, Yuri Zhulev pointed out, the patient should be attentive to the paperwork.
— Even if the interaction takes place remotely, the patient must understand that the contract has actually been concluded, and not just exchange messages. We recommend that you keep a copy of the contract or an electronic document, confirmation of its conclusion, payment documents and correspondence with the medical organization. In addition, before applying, it is necessary to make sure that the clinic has a valid license for medical activities — this information is available in open state registers," he recalled.
Rough estimate — a new approach to the cost of services
One of the key innovations is the introduction of the concept of "rough estimate" along with the usual "firm" one. This is important for complex cases where the amount of medical intervention depends on the diagnostic results and it is impossible to calculate all the manipulations in advance. The clinic will be able to initially indicate a likely increase in the cost of services (for example, by 10-20%), but if the estimate has to be expanded, the patient must be notified immediately.
As Irina Gritsenko explained, this removes unnecessary bureaucracy.
— Previously, when the amount of treatment changed and it increased, as a rule, it was necessary to sign a new estimate. Currently, the clinic can immediately write that the cost can be increased by 10-20%. This removes the need to sign the estimate several times," she said.
For clinics, an approximate estimate becomes an important legal confirmation: it records that the patient has been notified in advance of a possible price increase.
— But the estimate is also needed so that if the patient subsequently refuses to pay, the clinic can go to court and file a confirmation that they notified the patient of the cost. If this estimate is not available, then the court would definitely refuse to satisfy such requirements. At the same time, the estimate is the responsibility of the clinic to provide it in case of a patient's request," the expert emphasized.
Updates on anonymous medical services, tax deductions, and information procedures
For those who apply for anonymous medical services, the registration requirements will be noticeably relaxed from September 1: now you will not need to specify passport data in the contract. At the same time, clear deadlines for providing care remain an important control tool for the patient. They are necessarily prescribed in the contract and allow you to monitor whether the clinic is complying with its obligations.
The process of applying for a social tax deduction will also be simplified. Starting from September 1, the clinic is required to provide a prescription with a doctor's seal and signature or an extract from a medical card upon request. This set of documents is sufficient to apply to the tax service.
The approach to informing the patient will also change. Now detailed information about treatment methods, risks and expected results is not provided automatically, but only at the request of a person — and in a form understandable to him. At the same time, the obligation to transfer treatment data to the Unified State Health Information System (USISZ) remains in cases stipulated by law.
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