Advanced Search

Law On The Budget Of The National Health Insurance Fund For 2016.

Original Language Title: Закон за бюджета на Националната здравноосигурителна каса за 2016 г.

Subscribe to a Global-Regulation Premium Membership Today!

Key Benefits:

Subscribe Now for only USD$40 per month.
Name of the law, law on the budget of the national health insurance fund for 2016.




The name of the Bill a Bill to the budget of the national health insurance fund for 2016.





Acceptance date 01/12/2015 number/year 2015 Gazette Decree No 98/261

On the grounds of art. 98, paragraph 4 of the Constitution of the Republic of Bulgaria

I DECLARE:

To be published in the Official Gazette, the law on the budget of the national health insurance fund for 2016, adopted by HLÌÌI National Assembly on December 1, 2015.

Issued in Sofia on 9 December 2015.

The President of the Republic: Rosen Plevneliev

Stamped with the State seal.

Minister of Justice: Hristo Ivanov

LAW

for the budget of the national health insurance fund for 2016.

Art. 1. (1) adopt the budget of the national health insurance fund (NHIF) for 2016. in revenues and transfers – all in total 3 204 749 Hill. EUR, as follows:





по

ред





Indicators





Amount

(in thousand EUR)









1





2





3









I.





REVENUE AND TRANSFERS – ALL





3 204 749









1.





Health insurance revenues





3 166 199









1.1.





Health insurance contributions





2 121 0000









1.2.





Transfers for health insurance





1 045 199









2.





Non-tax revenue





14 550









3.





Received transfers from the Department of health to fund the cost of medicinal products, vaccines and their application to health activities under art. 82, para. 2, item 3, of the Act on health (HH); for hospital activities, including: persons Bill (outpatient) may delay monitoring in patients with skin-venereal and psychiatric disorders; intensive care; activities under art. 82, para. 1 2 HH and for amounts under art. 37, para. 6 of the law on health insurance, proving (HIA)





24 000











(2) adopt the budget of the national health insurance fund for 2016 in expenses and transfers – all in total 3 204 749 Hill. EUR, as follows:





по

ред





Indicators





Amount

(in thousand EUR)









1





2





3









II.





COSTS AND TRANSFERS – ALL





3 204 749









1.





Costs





3 201 065









1.1.





Current expenditure





2 877 445









1.1.1.





Staff costs





32 509









1.1.2.





Cost of administrative activities





11 688









1.1.3.





Health insurance payments





2 809 248









1.1.3.1.





health insurance payments for primary outpatient medical care





180 017









1.1.3.2.





health insurance payments for specialized out-patient medical care (including integrated may (outpatient) observation)





201 542









1.1.3.3.





health insurance payments for dental help





123 000









1.1.3.4.





health insurance payments for medical diagnostic business





70 441









1.1.3.5.





health insurance payments for medicinal products, medical devices, and dietary foods for special medical purposes for home treatment within the territory of the country and, in the case of medicinal products for the treatment of malignant diseases in terms of hospital medical assistance HEALTH INSURANCE paid off the cost of medical services provided 750 926









1.1.3.5.1.





including, in the case of medicinal products for the treatment of malignant diseases in terms of hospital medical assistance HEALTH INSURANCE paid off the cost of our medical services





210 000









1.1.3.6.





health insurance payments for medical devices used in the inpatient medical care





80 000









1.1.3.7.





health insurance payments for hospital medical assistance





1 343 322









1.1.3.8.





other health insurance payments 60 000









1.1.3.8.1.





including for medical care provided in accordance with the rules on the coordination of social security systems





60 000









1.1.4.






Payments from the transfers from the Department of health under para. 1, line 3 to:





24 000









1.1.4.1.





medicinal products, vaccines and their application under art. 82, para. 2, item 3 HH





2 712









1.1.4.2.





activities for zdravnoneosigureni persons, including: Bill may delay (outpatient) monitoring in patients with skin-venereal and psychiatric disorders; intensive treatment





1 288









1.1.4.3.





activities for zdravnoneosigureni women upon art. 82, para. 1, т. 2 ЗЗ





5 000









1.1.4.4.





amounts under art. 37, para. 6 HIA





15 000









1.2.





Acquisition of non-financial assets





7 000









1.3.





Reserve, including for unforeseen and urgent expenses





316 620









2.





Submitted transfers of the National Revenue Agency under art. 24, t. 6 HIA and to budgetary organizations, concluded contracts for the operation of medical services with the national health insurance fund 3 684











(3) adopt the budget of the national health insurance fund for 2016 with balanced budget balance.

Art. 2. the amount of the compulsory health insurance contribution for 2016 is 8 percent.

Art. 3. (1) within the framework of the values referred to in art. 1, al. 2, order and order 1.1.3.2 1.1.3.4 shall establish the national health insurance fund for each of the regional health insurance fund (NHIF) and for each quarter to contracts with providers of outpatient primary care and medical assistance:

1. the number of specialized medical activities in accordance with art. 1, al. 2, 1.1.3.2 line;

2. the value of the medical-diagnostic activities in accordance with art. 1, al. 2 row 1.1.3.4.

(2) the Supervisory Board of the FUND shall adopt rules on the conditions and procedure for applying the Al. 1.

(3) the conditions and procedures for monitoring, analysis and control of the implementation of the volumes under art. 55 (a) of the law on health insurance and the values are determined in the national framework contract for medical activities for 2016, and if it is not adopted such a decision – under art. 54, para. 9 of the law on health insurance.

Art. 4. (1) within the framework of the values referred to in art. 1, al. 2, 1.1.3.5.1 line, red line and 1.1.3.7 1.1.3.6 for application of art. 55 (a) of the law on health insurance and the national framework contract for medical activities for 2016:

1. the Supervisory Board of the NATIONAL HEALTH INSURANCE FUND:

(a) for each District Council) approve health insurance fund annual total cost for health insurance payments, which are broken down by months;

(b) distribute the agreed annual volumes) under art. 55, para. 2, item 3 (a) of the law on health insurance of the types of medical assistance at the district health insurance coverage;

analyze and adjust the allocated) volumes on the letter "b" depending on their implementation reports to the size of the agreed national framework contract annual volume medical activities;

2. the directors of the REGIONAL HEALTH INSURANCE FUND:

(a) allocate the annual volumes) established under item 1 (b) and in paragraph 1 (a) by month for the ECONOMIST;

(b)) purchased by the contractors of the hospital medical assistance health activities of the package under art. 2, al. 1 of the law on health insurance within the volumes and values referred to in (a).

(2) the implementation of paragraphs 1 and 2. 1, item 2 is controlled by the Supervisory Board of the NATIONAL HEALTH INSURANCE FUND.

(3) the Supervisory Board of the FUND shall adopt rules on the conditions and procedure for applying the Al. 1 and 2.

(4) the conditions and procedures for monitoring, analysis and control of the implementation of the volumes under art. 55 (a) of the law on health insurance and the Al. 1, item 2 of the contractors of the hospital medical assistance shall be laid down in the national framework contract for medical activities for 2016, and if it is not adopted such a decision – under art. 54, para. 9 of the law on health insurance.

Transitional and final provisions

§ 1. Over income from health insurance contributions and non-tax revenue can be used as a source of additional health insurance payments over the eligible costs and submitted the budget of the FUND transfers by decision of the Supervisory Board of the NATIONAL HEALTH INSURANCE FUND.

§ 2. (1) the Ministry of health on a monthly basis until the end of the month following the reference, on the basis of the received request from NHF provides transfer to the budget of the NATIONAL HEALTH INSURANCE FUND under art. 1, al. 1, row 3 for financing the cost of medicinal products, vaccines and their application under art. 82, para. 2, item 3 of the law on health; activities for zdravnoneosigureni persons, including: Bill may delay (outpatient) TI lûdenie in patients with skin-venereal and psychiatric disorders; intensive care; activities under art. 82, para. 1, item 2 of the law on health and for the amounts under art. 37, para. 6 of the law on health insurance. The funds are reported under art. 1, al. 2 budget line of the NHIF 1.1.4.

(2) the transfer under paragraph 1. 1 is the amount of the FUND during months of commitment to medical institutions for their activities, according to the holders of marketing authorisations of medicinal products for wholesale quantities delivered and attached the vaccines.

(3) the Shuttle over the amount of art. 1, al. 1, row 3 is determined and provided by the Department of health under conditions and by an order determined by the Minister of health and by the Manager of the FUND, without prejudice to the balance of the budget of the NATIONAL HEALTH INSURANCE FUND.


(4) in the cases referred to in para. 3 the Manager of the FUND on a monthly basis after reporting a payments effected during the preceding month approve compensated changes on indicators under art. 1, al. 1 line 3 and para. 2 row 1.1.4 without disrupting the balance of the budget of the NATIONAL HEALTH INSURANCE FUND.

§ 3. From the State budget through the budget of the Ministry of health can be obtained on the budget of the NATIONAL HEALTH INSURANCE FUND targeted subsidies under art. 23, para. 1, item 9 of the law on health insurance than those in art. 1, al. 1 for performance of the obligations arising from the application of the rules on coordination of social security systems and for benefits in kind, outside medical assistance under art. 45 of the law on health insurance. With the underlying costs of these benefits are increased amounts under art. 1, al. 2 lines, 1, 1.1.3.8.1, and 1.1.3 1.1.3.8.

§ 4. (1) health insurance payments by means of art. 1, al. 2 line 1.1.3 and payments from the transfers from the Department of health under art. 1, al. 2 row 1.1.4 under contracts concluded pursuant to art. 59, para. 1 of the law on health insurance between the authorising departments budget and FUND are recorded as transfers under art. 1, al. 2, row 2.

(2) in the cases referred to in para. 1 the Manager of the FUND on a monthly basis, after accounting for payments effected during the preceding month, approve compensated changes between the indicators under art. 1, al. 2 line 1.1.3, 1.1.4 and line art. 1, al. 2, row 2.

§ 5. Discounts for medicinal products agreed upon pursuant to art. 45, para. 10 and 19 of the law on health insurance, which are reimbursed directly to the NATIONAL HEALTH INSURANCE FUND by the holder of the marketing authorisation/his representative, taking into account the reduction in the costs incurred by the NATIONAL HEALTH INSURANCE FUND of funds under art. 1, al. 2, lines 1, 1.1.3 and 1.1.3.5.

§ 6. Reliance on the amounts due in accordance with the requirement of art. 24, s. 6 of the Act on health insurance from the budget of the NATIONAL HEALTH INSURANCE FUND to the budget of the National Revenue Agency takes place at the end of each calendar month in size 0.2 per cent on the previous month raised health insurance contributions. The funds are recorded as transfers between budgetary accounts under art. 1, al. 2, row 2.

§ 7. (1) the Supervisory Board of the FUND may decide that proceeds from the sale of tangible assets to be used for the acquisition of such assets over the established values in art. 1, al. 2 row 1.2.

(2) the provisions of para. 1 shall apply when the total amount of over-§ 1 revenue reduced by the additional health insurance payments in the same paragraph, shall not exceed the income under para. 1.

§ 8. (1) in 2016. the means of medicinal products under art. 4, item 1 of the law on war veterans and in art. 15, para. 1 and 2 of the law on military and voennopostradalite, as well as targeted means of diagnosis and treatment in hospitals for hospital care of persons who have no income and/or personal property, which provides them with personal involvement in a zdravnoosiguritelniâ process in accordance with Decree No 17 of the Council of Ministers since 2007, laying down the procedures for the acquittal of the target funds for the diagnosis and treatment in hospitals for hospital care of persons who have no income and/or personal property, which provides them with personal involvement in the zdravnoosiguritelniâ process (official SG 13 of 2007; Amended 16/2008 13/2009 of 29/2011 and 2/2014), are at the expense of the State budget and paid by the Agency for social assistance through the NATIONAL HEALTH INSURANCE FUND.

(2) the Agency for social assistance translates the NATIONAL HEALTH INSURANCE FUND the necessary funds for the payment of the amounts claimed by pharmacies under contract with the national health insurance fund, for medicinal products granted to veterans of wars, voennoinvalidi and voennopostradali.

(3) the Agency for social assistance translates the NHIF assigned funds for the diagnosis and treatment in hospitals for hospital assistance to eligible persons in accordance with Decree No 17 of the Council of Ministers since 2007, laying down the procedures for the acquittal of the target funds for the diagnosis and treatment in hospitals for hospital care of persons who have no income and/or personal property that provides them with personal involvement in a health insurance process.

§ 9. (1) pending the adoption of a national framework contract for medical activities for 2016. in the context of the values of art. 1, al. 2, 1.1.3.5.1 line, red line and 1.1.3.7 1.1.3.6:

1. The national health insurance fund determined for each regional health insurance fund annual total cost for health insurance payments, which are broken down by months;

2. the district health insurance coverage set the value for the activities under this paragraph to the contracts with the contractors of the hospital medical assistance allocated by month.

(2) the values under para. 1, item 2 and its amendment pursuant to para. 3 shall be approved by the Supervisory Board of the NATIONAL HEALTH INSURANCE FUND.

(3) the implementation of the activities referred to in para. 1 is controlled by month and adjust the quarter within the eligible costs for the budget of the NATIONAL HEALTH INSURANCE FUND.

(4) the Supervisory Board of the FUND shall adopt rules on the conditions and procedures for determining and modifying the values under para. 1, item 1 and 2 and for the control and adjustment in al. 3.

§ 10. (1) pending the adoption of a national framework contract for medical activities for 2016. in the context of the values of art. 1, al. 2, order and order: 1.1.3.2 1.1.3.4

1. establishes the national health insurance fund for each regional health insurance fund and for each quarter to contracts with providers of outpatient primary care and medical assistance:

a) number of the specialized medical activities in accordance with art. 1, al. 2, 1.1.3.2 line;


(b)) the value of the medical-diagnostic activities in accordance with art. 1, al. 2 row 1.1.3.4.

(2) the number under para. 1, item 1 (a) and the values under para. 1, item 1 (b) and their modification in accordance with para. 3 shall be approved by the Supervisory Board of the NATIONAL HEALTH INSURANCE FUND.

(3) the Supervisory Board of the FUND shall adopt rules on the conditions and procedure for applying the Al. 1 and to carry out the controls and options under para. korek 1 and 2.

§ 11. The Supervisory Board of the HEALTH INSURANCE FUND shall take decisions on the allocation of funds under art. 1, al. 2 line 1.3 ", including Reserve for unforeseen and urgent expenses" for health insurance payments following the adoption of the National framework contract for medical activities for 2016 and a national framework agreement for eventual actions to 2016 or the judgment under art. 54, para. 9 of 3akona health care insurance, the first decision to allocate part of the funds under art. 1, al. 2 line 1.3 shall be taken not earlier than 31 March 2016.

§ 12. In the law on health insurance (official SG. 70 of 1998; amend., SG. 93 and 153 of 1998, no. 62, 65, 67, 69, 110 and 113 in 1999, issue 1 and 64 in 2000, 41/2001, no. 1, 54, 74, 107, 112, 119 and 120 of 2002, no. 8, 50, 107 and 114 from 2003. , PC. 28, 38, 49, 70, 85 and 111 in 2004, PCs. 39, 45, 76, 99, 102, 103 and 105 of 2005, St. 17, 18, 30, 33, 34, 59, 80, 95 and 105, 2006, issue. 11 of 2007; Decision of the Constitutional Court No. 3 of 2007 – PCs. 26 of 2007; amend., SG. 31, 46, 53, 59, 97, 100 and 113 of 2007, PC. 37, 110 and 71 of 2008, PCs. 35, 41, 42, 93, 99 and 101 of 2009, PCs. 19, 26, 43, 49, 58, 59, 62, 96, 97, 98 and 100 by 2010, PC. 9, 60, 99 and 100 by 2011, issue. 38, 60, 94, 101 and 102 of the 2012 issue. 4, 15, 20, 23 and 106 by 2013, PCs. 1, 18, 35, 53, and 54 107 by 2014 and PCs. 12, 48, 54, 61, 72 and 79 by 2015.) make the following changes and additions:

1. In art. 2 create al. 3:

"(3) the national health insurance fund purchased from the executors of medical assistance health activities under para. 1 set in type, volume, price and complying with the criteria of quality and accessibility, and in accordance with this law. "

2. In art. 15, para. 1 creating item 5 (a):

' 5a. allocate the volumes under art. 55, para. 2, item 3 (a) of the types of medical assistance at the REGIONAL HEALTH INSURANCE FUND; ".

3. In art. 19, para. 1 creating the second sentence: "upon expiry of the mandate of the FUND Manager continues to carry out its functions until the election of a new Governor."

4. In art. 20, para. 1 create item 5 and 6:

5. enter into, amend and terminate contracts for medicinal products under art. 262, para. 6, item 1 of the law on medicinal products for human use, for medical devices and for dietary foods for special medical purposes for home treatment within the territory of the country with the holders of marketing authorisations of medicinal products in the retail pharmacy in accordance with the terms and conditions under art. 45, para. 15;

6. purchases from providers of medical assistance health activities under art. 2, al. 1 within the volume set out in art. 15, para. 1, item 5 (a) of the relevant AGREEMENTS. "

5. In art. 29, para. 3:

a) in item 5 Finally a comma and add "as well as medicinal products for the treatment of malignancies in terms of hospital medical assistance HEALTH INSURANCE paid off the cost of our medical activities";

(b)) (a) point 6 is repealed.

6. In art. the words "32 hospitals for hospital" are replaced by "the executors of hospital medical".

7. In art. 39 Al is created. 6:

(6) Zdravnoosiguritelniât status, necessary for the exercise of health insurance rights of persons under art. 33, is formed on the basis of data from health insurance claims and declarations under this law, entries in the official public records, written evidence submitted by individuals, and imported or health insurance contributions payable. "

8. In art. 40, para. 3, item 1 last comma and added "but not later than the age of 21 years of age".

9. in art. 45, para. 1:

a) point 7 shall be repealed;

b) point 15 is replaced by the following:

"15. the medical activities and medicinal products outside the scope of the statutory health insurance, financed by transfer from the Ministry of health in accordance with the law on the budget of the national health insurance fund for the year concerned;".

10. In art. 51 after the abbreviation "R & D" a comma and add "as well as the costs of clinical trials on medicinal products and medical devices".

11. in art. 54:

a) paragraph 6 shall be replaced by the following:

(6) national framework contracts shall be adopted not later than the last day of the month of February, shall enter into force on 1 April of the year concerned and should comply with the budget of the national health insurance fund for that year. ";

(b)) in the Al. 9, the words "in the law on the budget of the national health insurance fund for next year provides for the funding of new medical activities, therefore dental activities, medicinal products and medical devices, for which in the present R & D does not contain requirements" shall be replaced by ' changes in the legislation in force require amendment of the requirements contained in the R & D ";

in paragraph 10) shall be repealed;

(d)) in the Al. 11 ' and 10 ' shall be deleted.

12. in art. 55:

(a)) in the Al. 1 the words "January 1" shall be replaced by ' 1 April ';

(b)) in the Al. 3 p 5 is repealed.

13. in art. 55 and finally adds "and in accordance with the parameters of the cost in the budget of the FUND set out in the law on the budget of the NATIONAL HEALTH INSURANCE FUND for the year.

14. In art. 59:

(a)) in the Al. 1, the words ' or 10 ' shall be deleted;

(b)) in the Al. 3 the words "and 10" shall be deleted;

in) in the Al. 11 item 1 and 2 are amended:

 1. taking into account the activity which was not carried out, as well as in the conduct and reporting of medical activities, for which there is no relevant indications established by the order of art. 72, para. 2:

 artist s) of outpatient medical care in a certain package – partially in respect of the doctor/Doctor of dental medicine, which has not carried out this activity;

 (b)) by artist of the hospital medical assistance – partly for the medical activities of the package, which has reported neizv″ršenata activity;


 2. repeated infringement referred to in paragraph 1 shall terminate the contract with the contractor in full; "

 (d)) paragraph 13 shall be replaced by the following:

 (13) the Manager of the NATIONAL HEALTH INSURANCE FUND, according to the Director of the REGIONAL HEALTH INSURANCE FUND fully or partially terminate contracts with providers of medical and/or dental aid in the cases referred to in para. 11, paragraphs 1 and 2 and, in the cases referred to in para. 11, item 3 and 4 impose a financial penalty under the NFA. The order for termination of the contract or the imposition of a financial penalty shall be subject to challenge pursuant to the administrative code.

15. in art. 59A, al. 4, the words ' and 10 ' shall be deleted.

16. In art. 59 (b):

 (a)) in the Al. 6 the word "decisions" shall be replaced by "decision", and the words "and 10" shall be deleted;

 (b)) is hereby set up al. 7:

 (7) paragraphs 4 and 5 shall not apply where, on the basis of the assessment of needs and established under the national health card failure, there is a need for medical assistance. "

17. In art. the words "their last 67 ' shall be replaced by" relevant ".

18. in art. 72:

a) paragraph 2 is amended as follows:

"(2) in the performance of the contracts with the national health insurance fund for the provision of medical and/or dental aid is done through checks carried out by officials – employees of the NATIONAL HEALTH INSURANCE FUND, established by order of the President of the NATIONAL HEALTH INSURANCE FUND or from authorised by him, and officer of the officials of the REGIONAL HEALTH INSURANCE FUND – controllers. The Manager of the NATIONAL HEALTH INSURANCE FUND or an official authorised by him may, with a warrant to order the inspection by surveyors from the REGIONAL HEALTH INSURANCE FUND with the participation of the employees of the NATIONAL HEALTH INSURANCE FUND. ';

(b)) created new al. 3, 4 and 5: "(3) the employees of the NATIONAL HEALTH INSURANCE FUND under para. 2 may carry out inspections on the territory of the country by order of the President of the NATIONAL HEALTH INSURANCE FUND or an official authorised by him. The staff of the REGIONAL HEALTH INSURANCE FUND – controllers, may carry out inspections on the territory of the REGIONAL HEALTH INSURANCE FUND by order of the Director or on the territory of another REGIONAL HEALTH INSURANCE FUND by order of the President of the NATIONAL HEALTH INSURANCE FUND or an official authorised by him. For the issuance of the order of the President of the NATIONAL HEALTH INSURANCE FUND of inspection on the territory of another MEDIA controllers be nominated upon the proposal of the Director of the REGIONAL HEALTH INSURANCE FUND, the officials said.

(4) in carrying out the checks referred to in paragraph 1. 3 experts may attend professional organizations of physicians and dental practitioners who are not in a contractual relationship with the artist of the medical assistance. Experts provide written opinions, which are an integral part of a protocol under art. 74, para. 3.

(5) the officers of the NATIONAL HEALTH INSURANCE FUND under para. 2 and suddenly controllers carried out control on execution of contracts with providers of medical and/or dental assistance, control before payment of medical and/or dental help and follow-up. ';

in the past) Al. 3 it al. 6 and in her words "Immediate control in al. 2 is a recurring and to perform "are replaced by" control under para. 2 may be carried out through ";

d) past al. 4 it al. 7 and the figure ' 3 ' is replaced by ' 6 ";

(e)) the current al. 5 it al. 8 and the figure ' 3 ' is replaced by ' 6 ";

is) paragraph 6 shall be repealed;

(g)) the current al. 7 it al. 9;

h) past al. 8 it al. 10 and in her words "and 7 ' shall be replaced by" 7, 8 and 9.

19. in art. 73:

(a)) in the Al. 1:

AA) in the text before item 1 the words "Financial inspectors" shall be replaced by ' inspection authorities under art. 72, para. 2 ";

a new BB) item 1: ' 1. to audit payments from the NATIONAL HEALTH INSURANCE FUND of the executors of medical and/or dental help and related documents; "

BB) in item 4, finally a comma and add "made by the executors of medical and/or dental assistance under their contracts with the national health insurance fund";

yy) established that 5-10:

"5. to verify the existence of payments from mandatory aggravated the performers, their size and reason, in cases where it is granted medical and/or dental assistance under a contract with the national health insurance fund;

6. to examine contracts of executors of medical and/or dental assistance concluded with other medical institutions to implement part of the activity under contract with the national health insurance fund in the cases provided for in R & D;

7. to check the conformity of the activities of the contractors with the criteria of accessibility and quality of medical care provided for in R & D in accordance with art. 59 in;

8. check the type and volume of medical and/or dental assistance under a contract with the national health insurance fund;

9. check the type and quantities of purchased from the executors of hospital medical assistance and input in the performance of the contract with the NHIF medical devices applied in terms of hospital medical care paid by NATIONAL HEALTH INSURANCE FUND in whole or in part;

10. to verify the consistency between assistance provided medical and/or dental aid and amounts paid for it by the NHIF; "

(b)) in the Al. 2 the words "financial inspectors" shall be replaced by ' inspection authorities under art. 72, para. 2 ";

in) in the Al. the words "Financial inspectors" shall be replaced by ' inspection authorities under art. 72, para. 2 ";

d) paragraphs 4, 5 and 6 are repealed.

20. in art. 74:

a) paragraph 1 shall be repealed;

b) paragraph 2 is amended as follows:

"(2) the supervisory authorities under art. 72, para. 2 operate through planning and sweeps and on occasion complaints. ";

in) paragraph 3 shall be amended as follows:

"(3) when establishing a violation under art. 73, para. 1 the official under art. 72, para. 2 shall draw up and sign the Protocol, which describes the findings. A copy of the minutes shall be made available to the person – the object of the inspection, against a signature, and copies thereof shall be forwarded to the Manager of the NATIONAL HEALTH INSURANCE FUND, according to the Director of the REGIONAL HEALTH INSURANCE FUND and the District Council of the professional organization of doctors or dental practitioners ";


(d)) in the Al. 4, after the words "an opinion" be added before "the Manager of the NATIONAL HEALTH INSURANCE FUND, according to the" and the words "physician-controlled or doctor of dental medicine-controller" shall be replaced by the words "official under para. 3 ";

(e)) in the Al. 5, the words "physician-controlled or doctor of dental medicine-controller" shall be replaced by the words "official under para. 3 "and after the word" findings "is added" the Manager of the FUND, respectively.

21. In art. 75:

(a)) in the Al. 1:

AA) the words "physician-controlled or doctor of dental medicine-controller" shall be replaced by ' the relevant officer under art. 72, para. 2, the Manager of the NATIONAL HEALTH INSURANCE FUND, respectively ";

BB) the second sentence shall be inserted: "When the findings are disputed to the Manager of the NATIONAL HEALTH INSURANCE FUND, the dispute shall be decided by the Arbitration Board of the REGIONAL HEALTH INSURANCE FUND, the Director-General contractor of medical or dental help – the subject of the investigation, has concluded a contract.";

(b)) in the Al. 3 the words "physician-controlled or doctor of dental medicine-controller" shall be replaced by ' the relevant officer under art. 72, para. 2. "

22. in art. 76:

(a)) in the Al. 1 the words "physician-controlled or doctor of dental medicine-controller" shall be replaced by the words "official under art. 72, para. 2 ";

b) paragraph 2 is amended as follows:

"(2) the penalties imposed by order of the President of the NATIONAL HEALTH INSURANCE FUND, according to the Director of the REGIONAL HEALTH INSURANCE FUND, which shall be issued within one month of the notification of the Arbitration Commission of the Manager of the NATIONAL HEALTH INSURANCE FUND, according to the Director of the REGIONAL HEALTH INSURANCE FUND that confirmed the findings of an official under art. 72, para. 2, and shall be communicated to the person – the subject of the inspection. When the infringement is established by officials-controllers of the REGIONAL HEALTH INSURANCE FUND, the proposal to the Manager of the national health insurance fund for issue is made by the Director of the REGIONAL HEALTH INSURANCE FUND. "

23. In art. 76A:

(a)) in the Al. 2, after the words "objection" is inserted in front of "the Manager of the NATIONAL HEALTH INSURANCE FUND, according to the";

(b)) in the Al. 3 after the figure "2" is added "the Manager of the FUND, respectively.

24. In art. 76 (b):

(a)) in the Al. 1, after the words "under this Act or the R% AMP% D" is added "the Manager of the NATIONAL HEALTH INSURANCE FUND, respectively";

(b)) in the Al. 2, after the words "under para. 1 "insert" the Manager of the FUND, respectively.

25. in art. 105 h, para. 2, after the words "issue of" insert "the Manager of the FUND, respectively.

26. New art. 106:

"Art. 106. (1) the Director of the REGIONAL FUND, which purchased and/or pay health activities in violation of the values for the REGIONAL HEALTH INSURANCE FUND determined in accordance with the law on the budget of the national health insurance fund for the year in question, is punishable by a fine of 600 to 1000 BGN, and for repeat offenders, from 1000 to 2000 BGN.

(2) the offences referred to in paragraph 1. 1 establish themselves with acts of officials of the NATIONAL HEALTH INSURANCE FUND, established by order of the President of the NATIONAL HEALTH INSURANCE FUND, and the penal provisions shall be issued by the Manager of the NATIONAL HEALTH INSURANCE FUND. "

27. In § 1 of the additional provisions create t. 25 – 27:

"25." Suddenly "control is the control associated with the cost of medical/dental assistance in performance of a contract with the national health insurance fund, as well as the conformity of the activities of providers of medical and dental aid with the criteria of accessibility and quality of medical care provided for in R & D, which is done at the time of the provision of medical assistance to the person zdravnoosigureno.

26. "Control before payment of medical/dental assistance" is checked in the hospital or in the documents reported in the MEDIA activity before payment.

27. "follow-up" is checked in the hospital or in the documents reported in the MEDIA business after the pay. "

§ 13. The national framework contract for medical activities for 2015 (SG. 6 by 2015) and the national framework contract for eventual activities for 2015 (SG. 6 by 2015) shall continue to have effect until 31 March 2016, except in the cases under art. 54, para. 8 of the law on health insurance, under which continue to have effect pending the adoption of new national framework contracts.

§ 14. The hospitals, which after 31 December 2015 for the first time received permission for activities under art. 48, para. 1 of the law on medical institutions, and medical institutions, whose activities included permission for new activities after 31 December 2015, may not conclude in 2016 contracts or additional agreements with the national health insurance fund for the relevant activities.

§ 15. The implementation of the law is assigned to the management authorities of the national health insurance fund.

§ 16. The law shall enter into force from 1 January 2016.

The law was passed by the National Assembly-43 on December 1, 2015, and is stamped with the official seal of the National Assembly.

President of the National Assembly Tsetska Tsacheva:

7920