Law Of Services Of The Overall Health Of The Plurinational State Of Bolivia

Original Language Title: LEY DE PRESTACIONES DE SERVICIOS DE SALUD INTEGRAL DEL ESTADO PLURINACIONAL DE BOLIVIA

Read the untranslated law here: http://www.gacetaoficialdebolivia.gob.bo/index.php/normas/verGratis_gob2/150435

Law No. 475 law of 30 of December of 2013 EVO MORALES AYMA President constitutional of the PLURINATIONAL State of BOLIVIA, by how much, the plurinational Legislative Assembly, has sanctioned the following law: the Assembly Legislative PLURINATIONAL, D E C R E T A: law of performance of services of INTEGRAL health of State PLURINACIONAL DE BOLIVIA chapter I provisions general article 1. (OBJECT). This Act aims to: establish and regulate the comprehensive care and financial protection in health of the beneficiary population described in this law, which are not covered by compulsory Social insurance of short term.

Establish the basis for the universalization of the comprehensive care in health.
ARTICLE 2. (PRINCIPLES). The principles governing this law are as follows: integrity. It articulates the processes for the promotion of health, prevention, care and rehabilitation of illness, quality, warmth, relevance, opportunity, continuity and fitness, to the person, family and community.

Intraculturalidad. Recover, strengthens and native indigenous revitalises the cultural identity of peoples and Nations peasants and afrobolivianos, in the process health - illness of the person, family and community.

Interculturality. It recognizes, accepts and native indigenous respects the feelings, knowledge, expertise and practices of the peoples and Nations peasants and afrobolivianos, through actions and services that assume each other the cultural logics in health, with the articulation of academic and traditional medicines.

Quality of health focused on the person and the community. Responsible and committed to the organizations and health institutions to apply the knowledge and technologies available, ensuring good treatment and the problem-solving capacity appropriate to the needs and expectations of the users.

Opportunity. Health services are provided at the moment and circumstances the person, family and community need them, obtaining the maximum benefit without delays that could cause damage, complications or damage.
ARTICLE 3. (DEFINITIONS). The scope of this law, the expression: financial protection in health. It is the guarantee that grants the plurinational State of Bolivia to the beneficiaries established in the present law that access to health services of first level, who are referred to the second and third level, and those deemed as urgent and emergency cases so that they receive for free health benefits defined by the Ministry of health and sports reducing the expenditure of families pocket and the possibility of that they suffer a catastrophic health expenditure.

Pocket expenditure on health. They are all types of medical expenses incurred by families at the moment in which one of its members benefits of healthcare such as medical fees, purchase of drugs, payment of hospital services and others.

Catastrophic health expenditure. It is all that expense which requires a family to spend more than thirty per cent (30%) of their ability to pay, to the financing of the health of its members, suddenly diminishing its capacity to cover other basic needs such as food, education or housing.

Comprehensive health care. They are actions for the promotion of health, prevention, treatment and rehabilitation of diseases with health technology existing in the country and according to problem-solving capacity of health facilities.

Health-care technology. It is the set of drugs, devices and medical or surgical procedures used in health care, as well as organizational systems and support, within which such care is provided.

Mobile health unit. It is a multidisciplinary team of professionals and technicians of health doing care in remote places or in those who are not covered by the staff of health facilities.

Sexual and reproductive health care. They are all actions aimed at the prevention and treatment of premalignant lesions of cervical cancer, as well as guidance and provision of contraceptive methods voluntarily and freely consent, treatment of sexually transmitted infections and those prioritized by the Ministry of health and sports, which are closely related to safe motherhood.
ARTICLE 4. (SCOPE OF APPLICATION). This law aims to scope the central level of the State, the autonomous territorial entities and the sub-sectors of public health, social security's short-term and private under agreement and other entities recognized by the national health system.
CHAPTER II BENEFICIARIES AND BENEFICIARIES, BENEFITS AND ACCESS TO COMPREHENSIVE HEALTH CARE ARTICLE 5. (BENEFICIARIES AND BENEFICIARIES). They are beneficiaries and beneficiaries of the comprehensive care and financial protection of health, all the inhabitants and shelves in the country that do not have any health insurance and that are included in the following population groups: pregnant women, from the beginning of pregnancy until six (6) months after delivery.

Girls and boys under the age of five (5) years of age.

Women and men from the sixty (60) years.

Women in fertile age with respect to sexual and reproductive health care.

People with disabilities who are qualified according to the computer program system of single national registry of people with disabilities? SIPRUNPCD.

Others to be determined by resolution of the Council of sectoral coordination of health, endorsed and approved by Supreme Decree, in accordance with article 12 of this law.
ARTICLE 6. (HEALTH BENEFITS).

I. the comprehensive health care includes the following prestacion:accion of promotion, prevention, comprehensive outpatient, inpatient, complementary services for the diagnosis and medical, dental, and surgical treatment, and the provision of essential medicines, medical supplies and traditional natural products.
II. the Ministry of health and sports, will regulate through specific benefits to be granted, costs, exclusions, manner of payment and the extension of benefits, beneficiaries and beneficiaries within the framework of the comprehensive care and protection to financial health.
ARTICLE 7. (ACCESS TO COMPREHENSIVE HEALTH CARE).
I. the beneficiaries and beneficiaries access to health services of comprehensive care and financial protection of health, mandatory through health facilities on the first level of the public subsectors, short-term and private Convention under social security, and mobile health teams in the framework of the SAFCI policy.
II. access to the second level, will be exclusively by reference of the first level.
III. access to the third level, will be only the second or first level reference.
IV. is excepted from the provisions of this article, the cases of emergency and urgency which will be regulated by the Ministry of health and sports, that must be addressed immediately at any level of the national system of health care.
CHAPTER III COMPREHENSIVE HEALTH CARE FINANCING ARTICLE 8. (FINANCING). Financial protection in health will be funded with the following sources: funds of the General Treasury of the State.

Resources of the special account of the 2000 dialog.

Municipal tax sharing resources.

The direct tax on hydrocarbons resources.
ARTICLE 9. (THE STATE GENERAL TREASURY FUNDS). The General State Treasury to finance human resources in health in the public subsector and the functioning of national health programs.
ARTICLE 10. (MUNICIPAL ACCOUNTS OF HEALTH).
Will i. the autonomous municipal governments have to charge a tax account specific, called? Do Municipal Health account?, management: fifteen and a half per cent (15.5%) of resources in Municipal tax partnership or the equivalent of the resources from the municipal HDI.

The resources are transferred to them by the national compensatory Health Fund.
II. the Municipal Health account will go to finance benefits that are defendants in the first, second and third level establishments existing in the municipal jurisdiction, by all beneficiary and beneficiary arising from any municipality.
III. in case of accumulated annual balances of resources in municipal health accounts, they will be reassigned to the same for the following management or may be used for the recruitment of human resources, strengthening of infrastructure and equipment for health facilities, or special programs of health.
ARTICLE 11. (NATIONAL COMPENSATORY FUND OF HEALTH).
I. to create the national compensatory Health Fund? COMSALUD, which will be administered by the Ministry of health and sports, will be designed to complement effectively and timely resources in municipal health accounts when autonomous municipal Governments demonstrate that the resources of these accounts are insufficient for the attention of the beneficiaries and beneficiaries.
II. the compensatory Fondo Nacional de Salud - COMSALUD will allow to manage: ten percent (10%) of the resources of the special account of the 2000 dialogue until its closure.


From the closure of the special account of the 2000 dialogue, the General Treasury of the State will assign a similar amount to the average awarded to the national solidarity fund of the SUMI in the 2009-2012 period.
III. at the end of each management, if any balances in the national compensatory Health Fund? COMSALUD, resources will be reallocated to the same for the following management or may be used according to regulations of the Ministry of health and sports, and prioritization: extension of benefits.
Extension of beneficiaries and beneficiaries.
Extension or creation of special health programmes.
CHAPTER IV BASIS FOR THE UNIVERSALIZATION OF THE COMPREHENSIVE HEALTH CARE ARTICLE 12. (EXPANSION OR INCLUSION OF SOURCES OF FINANCING, BENEFICIARIES, BENEFICIARIES AND BENEFITS).
I. the Ministry of health and sports, and the autonomous territorial entities, through the health sector coordination Council, may agree to increase the percentages of funding sources allocated to municipal health accounts and the national compensatory Health Fund? COMSALUD, or the inclusion of additional earmarked for the expansion of benefits, beneficiaries and beneficiaries according to prioritization of the sector and funding availability.
II. the organ Executive from the central level of the State, according to the resolution of the Council of sectoral coordination of health, will endorse and approve through Supreme Decree the enlargements that are concerted.
ARTICLE 13. (CREATION OF ADDITIONAL ITEMS FOR HEALTH PERSONNEL). Departmental autonomous governments and municipal autonomous governments, can allocate resources from direct tax hydrocarbons which are assigned to them, to the creation of additional items for health personnel of the health facilities of its territorial scope, in coordination with the Ministry of health and sports, according to current regulations.
ARTICLE 14. (FINANCING OF EXTRAORDINARY PERFORMANCE OF HEALTH). The autonomous territorial entities, within the framework of its powers and regional powers in health, may assign additional resources from taxes, royalties or from its own resources, other than those listed in articles 10 and 11 of this law, for the financing of extraordinary performance or programmes for the most vulnerable populations, according to current regulations , within its territorial scope, that are not set out in the framework of this law, prior coordination with the Ministry of health and sports.
SOLE ADDITIONAL PROVISION. Short-term Social security agencies managers, condonarán payment of accessories surcharges applied to premiums of quotes that are pending payment from the entry into force of the law No. 3323 on January 16, 2006 and the implementation of health insurance for the elderly - SSPAM, on behalf of the autonomous municipalities.

TRANSITIONAL PROVISIONS FIRST.

I. is there the technical closure of the maternal child Universal insurance? SUMI created by law No. 2426 of 21 November 2002, and health insurance for the elderly? SSPAM created by law No. 3323 of January 16, 2006, in the run up to ninety (90) days working, computable from the publication of this law.
II. benefits and insurance agreements subject to closure in the previous paragraph, shall remain in force until the publication of the regulatory Supreme Decree.
THE SECOND. This law will be regulated by Supreme Decree in a maximum period of sixty (60) days working, computable from the publication of this law.
THIRD. The balances relating to municipal health accounts? SUMI, December 31 of the current year, once all debts are cancelled by care of the SUMI, within the framework of the management of the national system of health, will be arranged by the autonomous municipal governments, for the improvement of infrastructure and equipment of health in its municipality.
SOLE ABROGATION AND REPEAL PROVISION.
I will appeal the following provisions: Law No. 2426 of 21 November 2002, Universal maternal infant insurance.

Law No. 3250 on December 6, 2005, enlargement of the SUMI, law No. 3323 on January 16, 2006, health insurance for the elderly.

Decree Supreme No. 26874 on December 21, 2002, regulation of benefits and management of SUMI.

Decree Supreme # 26875 of 21 December 2002, model management and tell them.

Decree Supreme # 28968 of 13 December 2006, regulation of benefits and management of the SSPAM.
II. appeal and repealed all regulatory provisions contrary to this law.
Refer to the Executive Branch, for constitutional purposes.
It is given in the room of sessions the Assembly Legislative plurinational, on the twentieth day of the month of December of two thousand thirteen years.
FDO. Lilly Gabriela MONTAÑO Viana, Betty Asunta Tejada Soruco, Andres Agustin Villca Daza, Claudia Jimena Torres Chávez, Marcelo Elio Chavez, Angel David Cortés Villegas.
I therefore enacted it is and meets as a law of the plurinational State of Bolivia.
Government Palace of the city of La Paz, on the thirtieth day of the month of December of the year two thousand thirteen.
FDO. EVO MORALES AYMA, Juan Ramón Quintana Taborga, Luis Alberto Arce Catacora, Juan José Hernando Sosa Soruco, Juan Carlos Calvimontes Camargo, Claudia clear Stacy Pena, Amanda Davila Torres.