law no 475
LAW OF DECEMBER 30, 2013
EVO MORALES AYMA
CONSTITUTIONAL PRESIDENT OF THE PLURINATIONAL STATE OF BOLIVIA
For the Plurinational Legislative Assembly, it has The following Law:
THE PLURINATIONAL LEGISLATIVE ASSEMBLY,
D E C R E T A:
LAW ON HEALTH SERVICES BENEFITS
INTEGRAL TO THE PLURINATIONAL STATE OF BOLIVIA
ARTICLE 1. (OBJECT). This Law is intended to:
Establish and regulate comprehensive care and financial protection in the health of the beneficiary population described in this Law, which is not covered by the Mandatory Social Security
Set the foundation for the universalization of comprehensive health care.
ARTICLE 2. (PRINCIPLES). The principles that govern this Law are as follows:
Integrality. It articulates the processes of health promotion, prevention, care and rehabilitation of the disease, with quality, warmth, relevance, opportunity, continuity and suitability, to the person, family and community.
Intraculturality. Retrieves, strengthens, and revitalizes the cultural identity of indigenous peoples and nations originating peasants and Afro-olivians, in the health-disease process of the person, family, and community.
Interculturality. Recognizes, accepts, and respects the " sentres, knowledge, knowledge and practices of indigenous peoples and nations originating peasants and Afro-olivianos, through actions and services that reciprocally assume cultural logics in health, with the articulation of medicines traditional and academic.
Quality in Health centered on the person and community. Responsible and commits health organizations and institutions to apply the available knowledge and technologies, ensuring good treatment and adequate resolutive capacity for the needs and expectations of and users.
Opportunity. Health services are provided at the time and circumstances that the person, family, and community need, obtaining the maximum benefit without delay may cause damage, complications or damages.
ARTICLE 3. (DEFINITIONS). Within the scope of this Law, it is understood by:
Financial Protection in Health. It is the guarantee granted by the Plurinational State of Bolivia to the beneficiaries established in this Law that access the first level health services, which are referred to the second and third level, and to those considered as emergency and emergency cases so that they receive free of charge the health benefits defined by the Ministry of Health and Sports, reducing the out-of-pocket costs of the families and the possibility that they will suffer a catastrophic expense in health.
Health Bolsillo Spending. These are all types of healthcare costs incurred by families at the time one of their members benefits from a health service such as being medical fees, purchasing from
medicines, hospital service payments, and others.
Catastrophic health spending. It's all that spending that forces a family to allocate more than thirty percent (30%) of their ability to pay, to financing The health of its members, which suddenly deserved its capacity to cover other basic needs such as food, education or housing.
Comprehensive Health Care. It is the actions of health promotion, prevention, treatment and rehabilitation of diseases with existing health technology in the country and according to the resolutive capacity of the health establishments.
Technology Health. It is the set of drugs, medical devices and procedures used in healthcare, as well as the organizational and support systems, within which such care is provided.
Health Mobile. It is a multidisciplinary team of health professionals and technicians who care in places far away or in those who are not covered by health facilities.
Health care Sexual and Reproductive. They are all actions aimed at prevention and treatment of premalignant cervical cancer lesions, as well as the orientation and provision of voluntary and freely consented contraception, the treatment of sexually transmitted infections and those prioritized by the Ministry of Health and Sports, who keep close relationship with safe motherhood.
ARTICLE 4. (SCOPE OF APPLICATION). This Law has as its scope the central level
of the State, the autonomous territorial entities and the subsectors of public health, of the social security of short-term and private under convention and other entities recognized by the National Health System.
AND BENEFICIARIES, CAPABILITIES, AND
ACCESS TO COMPREHENSIVE HEALTH CARE
ARTICLE 5. (BENEFICIARIES AND BENEFICIARIES). They are beneficiaries and beneficiaries of comprehensive health care and financial protection, all the inhabitants and shelves of the national territory that do not have some health insurance and that are included in the following groups population:
Pregnant women, from the beginning of gestation to six (6) months after delivery.
Girls and children under five (5) years of age.
Women and men from Sixty (60) years.
Women of childbearing age with respect to sexual health care and reproductive.
Persons with disabilities who are qualified according to the Computer System of the National Single Registry Program of Persons with Disabilities? SIPRUNPCD.
Other to be determined by the Resolution of the Health Sectoral Coordination Council, endorsed and approved by Supreme Decree, in accordance with the provisions of Article 12 of this Law.
ARTICLE 6. (HEALTH BENEFITS).
I. The comprehensive health care includes the following benefits: promotion, prevention, comprehensive outpatient consultation, hospitalization, complementary diagnostic and medical, dental and surgical services, and the provision of essential medicines, medical supplies and traditional natural products.
II. The Ministry of Health and Sports, will regulate by means of norm specifies the benefits to be granted, the
costs, the exclusions, the modality of payment and the extension of the benefits, beneficiaries and beneficiaries in the framework of comprehensive health care and financial protection.
ARTICLE 7. (ACCESS TO COMPREHENSIVE HEALTH CARE).
I. The beneficiaries and beneficiaries will access the health services of comprehensive health care and financial protection,
obligatorily through the health facilities of the first level of the subsectors public, short-term and private social security under agreement, and mobile health teams in the framework of the SAFCI Policy.
II. Access to the second level will be exclusively by reference to the first level.
III. Access to the third level will be exclusively by reference to the second or first level.
IV. of the provisions of this Article, the cases of emergency and urgency that will be regulated by the
Ministry of Health and Sports, which must be attended immediately in any level of attention of the National Health System.
FINANCING COMPREHENSIVE HEALTH CARE
ARTICLE 8. (financial). Financial health protection will be funded by the following
State Treasury Funds.
Special Account Resources for Dialogue 2000.
Municipal Tax Co-Participation Resources.
Hydrocarbon Direct Tax Resources.
ARTICLE 9. (FUNDS FROM THE STATE TREASURY). The State Treasury
will fund human resources in the health of the public subsector and the functioning of the National Health Programs.
ARTICLE 10. (MUNICIPAL HEALTH ACCOUNTS).
I. The Municipal Autonomous Governments will have a specific tax account, called? Municipal Account
of Health?, for the administration of:
The fifteen and half percent (15.5%) of the resources of the Municipal Tax Coparticipation or the equivalent of the resources coming from the municipal IDH.
resources transferred to them by the National Health Compensation Fund.
II. The Municipal Health Account shall be intended to finance the benefits that are required in establishments
of the first, second and third existing level in the municipal jurisdiction, for all beneficiaries and beneficiary from any municipality.
III. In case of cumulative annual balances of resources in the Municipal Health Accounts, they will be reallocated to
the same for the next management or they can be used for the hiring of human resources, strengthening of infrastructure and equipment of health facilities, or in special health programs.
ARTICLE 11. (NATIONAL HEALTH COMPENSATION FUND).
I. The National Health Compensation Fund is created? COMHEALTH, which will be administered by the Ministry of Health and
Sports, will be designed to complement timely and effectively the resources of the Municipal Health Accounts when the Municipal Autonomous Governments demonstrate that the resources
II.The National Health Compensatory Fund-COMHEALTH will allow you to manage:
The ten percent (10%) of the resources of the Special account for the 2000 Dialogue until it closes.
From Closing the Special Account of the 2000 Dialogue, the State Treasury will allocate a similar amount to the average granted to the SUMI National Solidarity Fund in the period 2009-2012.
III. At the end of each management, if there are balances in the National Health Compensation Fund? COMHEALTH, the
resources will be reassigned to the same for the next management or they can be used according to prioritization and regulations of the Ministry of Health and Sports, for:
Extension of Prstations.
Beneficiaries and Beneficiaries.
Extending or creating special health programs.
BASES FOR UNIVERSALIZATION OF
COMPREHENSIVE HEALTH CARE
ARTICLE 12. (EXTENSION OR INCLUSION OF FUNDING SOURCES, BENEFICIARIES, BENEFICIARIES AND BENEFITS).
I. The Ministry of Health and Sports, and the autonomous territorial entities, through the Health Coordination Council
, will be able to agree to increase the percentages of the sources of funding allocated to the accounts. Municipal Health and the National Health Compensation Fund? COMHEALTH, or the inclusion of additional ones aimed at extending benefits, beneficiaries and beneficiaries according to sector prioritization and financial availability.
II. The Executive Body of the central level of the State, according to the Resolution of the Sectoral Coordination Council of
Health, will endorse and approve through the Supreme Decree the extensions that are concerted.
ARTICLE 13. (CREATION OF ADDITIONAL ITEMS FOR HEALTH PERSONNEL). The Governments
Autonomous Department and the Municipal Autonomous Governments, may allocate resources from the Direct Tax to the Hydrocarbons that 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 HEALTH BENEFITS). The
autonomous territorial entities, within the framework of their powers and autonomy in health, will be able to allocate additional resources from taxes, royalties or their own resources, different from those mentioned in the Articles 10 and 11 of this Law, for the financing of extraordinary benefits or special programs for the most vulnerable populations, according to current regulations, within their territorial scope, that are not established in the framework of this Law, after coordination with the Ministry of Health and Sports.
ONLY. The Short Term Social Security Managers, will grant the payment of the ancillary surcharges
applied to the premiums of contributions that are pending payment as of the validity of Law No 3323 of 16 January 2006 and the implementation of the Health Insurance for the Older Adult-SSPAM, in favor of the Municipal Autonomous Governments.
I. Is the Technical Closure of Universal Child Maternal Insurance available? SUMI created by Law No. 2426 of November 21, 2002, and Health Insurance for Older Adult? SSPAM established by Law No 3323 of 16 January 2006, within the period of up to ninety (90) working days, which can be computed from the publication of this Law.
II. The benefits and conventions of the Insurance to be closed in the Previous paragraph, will remain valid until the
publication of the Supreme Regulatory Decree.
SECOND. This Law will be regulated by Supreme Decree within a maximum of sixty
(60) business days, computable from the publication of this Law.
THIRD. The balances corresponding to the Municipal Health Accounts? SUMI, at December 31 of the year
in progress, once all debts for the attention of the SUMI are cancelled, in the framework of the Management of the National Health System, they will be arranged by the Municipal Autonomous Governments, for the improvement of health infrastructure and equipment in its municipality.
OPENING AND ABROGATORY PROVISION
I. The following provisions are opened:
Law No. 2426 of November 21, 2002, Universal Child Maternal Insurance.
Law No. 3250 of December 6, 2005, Extending the SUMI,
Law No. 3323 of 16 January 2006, Health Insurance for the Elderly.
Supreme Decree No. 26874 of 21 December 2002, Regulation of Benefits and Management of SUMI.
Supreme Decree No. 26875 of 21 December 2002, Model of Management and DILOS.
Supreme Decree No 28968 of 13 December 2006, Regulation of Benefits and Management of SSPAM.
II. All provisions contrary to this Law shall be abrogated and repealed.
Remit to the Executive Body, for constitutional purposes.
It is given in the Session Room of the Legislative Assembly. Plurinational, at twenty days of the month of December
two thousand thirteen years.
Fdo. Lilly Gabriela Montano Viana, Betty Asunta Tejada Soruco, Andres Agustín Villca Daza, Claudia Jimena Torres Chavez, Marcelo Elio Chavez, Angel David Cortes Villegas.
Therefore, it has been enacted to comply with the law of the State. Plurinational of Bolivia.
Palace of Government of the city of La Paz, at the thirty days of the month of December of the year two thousand thirteen.
FDO. EVO MORALES AYMA, Juan Ramon Quintana Taborga, Luis Alberto Arce Catacora, Juan Jose Hernando Sosa Soruco, Juan Carlos Calvimontes Camargo, Claudia Stacy Peña Claros, Amanda Davila Torres.