48/1997 Coll.
LAW
of 7 November. March 1997
on public health insurance and amending and supplementing certain
related laws
Change: 242/1997.
Modified: 2/1998 Coll.
Change: 127/1998 Coll.
Change: 225/1999 Coll.
Change: 363/1999 Coll.
Modified: 18/2000 Sb.
Change: 459/2000 Sb.
Change: 132/2000 Coll., 155/2000 Coll., 220/2000 Coll. 258/2000 Coll.
Change: 176/2002 Coll. (part)
Change: 176/2002 Sb.
Change: 285/2002 Sb.
Change: 198/2002 Coll., 320/2002 Coll.
Change: 274/2003 Coll.
Change: 424/2003 Coll. (part)
Change: 222/2003 Coll., 424/2003 Coll., 425/2003 Coll., 455/2003 Coll.
Change: 176/2002 Coll. (part), 85/2004 Sb.
Change: 359/2004 Sb.
Change: 438/2004 Sb.
Change: 422/2004 Sb.
Change: 436/2004 Sb.
Change: 123/2005 Sb.
Change: 168/2005 Sb.
Change: 253/2005 Sb.
Change: 361/2005 Coll.
Change: 350/2005 Sb.
Change: 47/2006 Sb.
Change: 117/2006 Sb.
Change: 245/2006 Sb.
Change: 340/2006 Sb.
Change: 214/2006 Sb.
Change: 165/2006 Sb.
Change: 362/2003 Coll., 109/2006 Coll., 112/2006 Coll. 264/2006 Sb.
Change: 181/2007 Sb.
Change: 57/2007 Coll. 261/2007 Coll. 296/2007 Sb.
Change: 137/2008 Sb.
Change: 270/2008 Sb.
Change: 189/2006 Coll., 129/2008 Coll., 274/2008 Sb.
Change: 59/2009 Sb.
Change: 306/2008 Coll., 362/2009 Sb.
Change: 227/2009 Sb.
Change: 281/2009 Sb.
Change: 298/2007 Sb.
Change: 298/2007 Coll. (part), 365/2011 Sb.
Change: 1/2012 Sb.
Change: 369/2011 Coll., 458/2011 Sb.
Change: 275/2009 Sb.
Change: 401/2012 Coll. 401/Sb.
Change: 44/Sb.
Change: 238/Sb.
Change: 238/2013 Coll. (part)
Change: 60/2014 Sb.
Change: 109/2014 Sb.
Change: 458/2007 Coll., 60/2014 Coll. (part), 250/2014 Coll. 256/2014 Sb.
267/2014 Sb.
Change: 1/2015 Sb.
Change: 200/2015 Sb.
Parliament has passed the following Act of the United States:
PART THE FIRST
BASIC PROVISIONS
§ 1
(1) this Act incorporates the relevant provisions of the European Union ^ 1b),
at the same time follows the directly applicable European Union regulations ^ 51) and
modifies the
and) public health insurance (hereinafter referred to as "medical insurance"),
(b)) the extent and conditions under which are based on this Act of
health insurance covered medical services (the "paid for by
services "),
(c)) the way pricing and reimbursement of medicinal products and food for
Special medical purposes covered by health insurance.
(2) this law shall apply, unless otherwise provided in the applicable rules directly
The European Union governing the coordination of social security systems
(hereinafter referred to as "coordination regulation") otherwise ^ 49).
Participation in the health insurance
§ 2
Personal health insurance range
(1) pursuant to this Act are insured:
and) persons having permanent residence in the territory of the Czech Republic,
(b)) persons on the territory of the Czech Republic do not have permanent residence, if the
they are employees of an employer, having its registered office in the territory of the United
Republic,
(b)) persons on the territory of the Czech Republic do not have permanent residence, if the
are employees of the employer, which has its registered office or permanent residence on the
the territory of the Czech Republic,
(hereinafter referred to as the "insured persons").
(2) for the purposes of the employer health insurance means a legal
or a natural person who is the payer of income from employment and
emoluments under special legislation ^ 1a), employs
employees and has its registered office or permanent residence on the territory of the Czech Republic,
as well as the organisational unit of the State. ^ 1 c)
(3) for the purposes of employment, health insurance means the activity
employees [section 5 (a))], from which it flows from the employer income
from employment and functional benefits taxed under a special
^ law 1a).
(4) for the purposes of employer Based health insurance means for
the seat of the legal person, as well as the seat of its organisational units,
which is registered in the commercial register or in another law
the specified index or is conducted within the established registration with the competent
authority in the Czech Republic, and in the case of a natural person instead of a permanent
of stay, where appropriate, in the case of a foreign physical person, the place of
business.
(5) the health insurance Of persons who are excluded in the Czech
States carry out illegal work under section 5 (b). e) point 3 of the law on
employment, and persons who do not reside in the territory of the United
States and actions are in the Czech Republic for employers who
enjoy diplomatic advantages and immunities, or for employers who
do not have a registered office in the territory of the United Kingdom, and people over the long term
staying in a foreign country and do not pay the premiums (section 8, paragraph 4).
§ 3
Commencement and termination of health insurance
(1) the health insurance begins on the day:
and) of birth, if it is a person with permanent residence in the territory of the Czech Republic,
b) where the person without permanent residence in the territory of the Czech Republic has become a
an employee of the [section 5 (a))],
(c)) to obtain permanent residence in the territory of the Czech Republic.
(2) health insurance expires on the date:
the death of the insured person) or his declaration of death,
(b)) when the person without permanent residence in the territory of the United States has ceased to be
an employee of the [section 5 (a))],
(c)) their permanent residence in the territory of the Czech Republic.
PART TWO
INSURANCE
Premiums health insurance payers
§ 4
the title of the paid
Payers of health insurance premiums (hereinafter referred to as the "payer insurance")
they are:
and insured persons referred to in §) 5,
(b)), employers,
c) State.
Categories of insured persons
§ 5
The insured person pays insurance premiums where the
and is an employee); an employee for the purposes of health insurance
a natural person shall be considered, that arise or should flow income from
employment under special legislation ^ 1a), with the exception of
1. a person who only has income from dependent activities which are not
subject to tax or exempt,
2. the pupil or student who only has income from employment for
the work of practical training,
3. persons employed on the basis of the agreement on the implementation of work, or more
agreements for work for one employer, if the sum of income from
such agreements in a calendar month fell short of the amount of the income, which
It is a condition for the participation of such a person to sickness insurance according to the
the law governing sickness insurance (hereinafter referred to as "creditable
income "); per zúčtovaný income by the employer until the end of
the agreement on the implementation of the work shall be considered as income to zúčtovaný
the calendar month in which this agreement has ended,
4. a member of a cooperative that is not in the employment relationship to the cooperative, but
exercises for team work, for which he is rewarded, and that in the
calendar month has not reached the prescribed reckonable income
5. persons employed on the basis of contracts for work, or more
agreements for work for one employer, if the sum of income from
such agreements in a calendar month has not reached the prescribed reckonable income;
per zúčtovaný income by the employer until the end of the agreement on the
working activities shall be considered as income zúčtovaný to the calendar
the month in which the agreement has ended,
6. voluntary worker nursing services, in a calendar
the month has not reached the prescribed reckonable income
7. a member of the District Election Commission at the elections to the European Parliament, the
The Senate and the Councils of territorial self-governing units and a member of the Anne Arundel
the Electoral Commission and special district election Commission at the elections to the
The Chamber of Deputies and in the choice of the President,
(b)) is a self-employed person. For self-employed persons
persons shall be deemed, for the purposes of health insurance:
1. the persons doing business in agriculture; ^ 1 d)
2. persons engaged in Business; ^ 2)
3. the persons carrying on business in accordance with special legislation; ^ 3)
4. persons engaged in artistic or other creative activities based on
Copyright relations, ^ 4) with the exception of the activity from which the revenues are
under special legislation with a separate basis for income tax
natural persons for the taxation of the special tax rate ^ 4a);
5. shareholders public companies and partners
limited liability partnerships; ^ 5)
6. persons performing an independent profession, that is not a trade or
business under the specific legislation. ^ 6)
7. persons performing activities on the basis of a mandate agreement by the agent
concluded under the commercial code, ^ 6a) If this activity is not
considered the employment referred to in subparagraph (a)), and the contract has not been
concluded in the framework of other self-employment,
8. cooperating persons self-employed persons, pursuant to the
the law on income tax, you can distribute the income accruing to them performance
cooperation and the expenditure incurred in their reach, ensuring and maintaining,
(c)) has a permanent residence in the Czech Republic, but is not listed under the
previous letters and not the premium payer State for him, if
above still occur throughout the calendar month.
§ 6
The employer pays part of the premiums for their employees, with the exception
employees who are advancing according to § 8 para. 4. the employer is
the payer of the income portion of premiums from employment and functional
benefits under special legislation cleared former ^ 3)
employees after the end of employment.
§ 7
(1) the State is liable for insurance through the State budget, in
the insured person:
and dependent children); nezaopatřenost of a child are to be judged according to the law on
State social support; ^ 7)
(b)) of those receiving pensions pension insurance has been granted
pension before 1. before 1 January 1993 in accordance with the laws of the Czech and Slovak Federal
Republic and after 31 December 2006. December 1992 in accordance with the laws of the United States. For
a pensioner for the purposes of this Act, the person shall be deemed to
the previous sentence even in months when it according to the regulations on pension
insurance payout annuity does not belong;
(c) the recipient parent's allowance;) ^ 7)
d) women on maternity and parental leave and persons receiving
maternity benefit according to the regulations on sickness insurance ^ 8);
(e)) job seekers, including job seekers, who have accepted the
short-term employment; ^ 9)
f) persons receiving benefit assistance in material need and those with them together
^ 10) under consideration, provided that they are not based on the Bill-confirmation
assistance in material need benefits on work or similar relationship or
do not exercise a self-employed person are not in registration
and it's not about those receiving old-age pensions, invalidity
pension for disability of the third degree, the widow's or widower's
retirement, or those receiving parental allowance or dependent
the child,
g) persons that are dependent on the care of another person in stage II (medium
heavy dependency) or level III (severe dependence) or stage IV
(total dependence) ^ 11), and persons taking care of these people, and those working
persons under the age of 10 years, which are dependent on the care of another person in the degree of
I (light addiction)
h) occupants of service in the armed forces, with the exception of
occupations, and persons called to military exercises,
(I) persons in the performance of security) detention or custody or the person in
imprisonment;
(j)) a person referred to in section 5 (b). (c)), that are beneficiaries of sickness
insurance; ^ 14)
k) persons who are disabled in the third degree, or who have reached the age of
required for entitlement to a retirement pension, but do not comply with other conditions
for the award of disability pension for disability of the third degree, or
old-age pension and have income from employment, from a separate
gainful employment and who do not enjoy no pension from abroad, or this
the pension does not exceed the amount equal to the monthly minimum wage; ^ 15)
l) people all day personally and properly looking after at least one child to
seven years of age, or at least two children under 15 years of age, unless the person
referred to in point (c)), or (d)). The condition is considered to be full-day care
to be fulfilled, even if it is a child of preschool age placed in the Manger
(nursery school), or a similar device at the time that
does not exceed four hours per day, and in the case of a child performing compulsory school
attendance, for visits to schools, with the exception of the location on the device with the
weekly or year-round residents. For such a person is considered to be only
one person, either the father or mother of the child, or the person who
took over the child to the permanent care replacing parental care, ^ 16) if they do not have
income from employment or from self-employment,
m) juvenile placed in school facilities for institutional upbringing
and protective care,
n) persons carrying out a long-term volunteer service on the basis of
the contract with the broadcasting organization which has been granted accreditation
The Ministry of the Interior, which go beyond the average of at least 20
hours per calendar week, if there is a volunteer insurance payer
under section 5, or it is not the premium payer State under the previous
letters and) to m)
o) spouses or registered partners of State employees under the Act
the civil service or other employees in the organizational components of the State,
If you follow to their place of posting to work abroad
or for the performance of foreign service with the consent of the organizational folder
State, and are not employees or self-employed persons
According to § 5 or are persons carrying out similar activities under
the law of the foreign State to which their spouses or registered
partners sent to work abroad or to the performance of foreign
services,
p) foreigners who have been granted permission to stay in the territory of the United
States to provide temporary protection by a special
^ law 16a) if they do not have income from employment or from
self-employment,
q) applicants for international protection and the child born on
the territory of the alien who has been granted a visa to stay over 90 days for the purpose of
leave to stay, and the child born on the territory of ^ 16b), if they don't have receipts
from the employment or from self-employment,
r) recipients of old-age pension for specified period of time, a lifetime pension or pensions
the specific time period with a fixed amount of income exactly according to the law
governing supplementary pension savings to reach the age required for
entitlement to old-age pension pursuant to section 32 of the Act on pension
insurance, provided that the conditions laid down in § 22 para. 4 or §
23 para. 6 Act No 427/2007 Coll. on supplementary pension savings; When
the determination of this age for women shall be treated as men of the same
the date of birth.
(2) the Government insured are persons referred to in paragraph 1 (b). a) to i)
and r) even if they have income from employment or from a separate
gainful employment.
§ 8
The obligation to pay the insurance
(1) the health insurance premium shall be paid, for which the insured person is
insured, (hereinafter referred to as "the relevant health insurance"). The obligation to pay
insurance the insured person arises on the day:
and employee to employment) (§ 2 (3));
b) self-employment [section 5 (b))];
(c)) when he became insured under section 5 (b). (c));
(d)) to which it will return to the United States after the insured person has logged in
in accordance with paragraph 4 for the health insurance companies;
(e)) return to the United States after continuous residence in a foreign country, that
started before 1. in January 1993, if the day falls on a return period
After 30. April 1995; above, the insured person is obliged to the competent
health insurance company to prove;
(f)) return to the United States after continuous residence in a foreign country, that
commenced between the 1. before 1 January 1993 and 1. July 1993, if the day of return
falls on the period after 30 June. April 1995, if the insured person
1. overseas of affiliation,
2. during this period paid for by the service has been provided to him,
3. has applied retroactively relevant health insurer about the procedure under
of paragraph 4.
This does not affect the obligation to pay the premiums for the period preceding stay
in a foreign country.
(2) the obligation of the employer to pay part of the premiums for their employees
created the day of onset of an employee to a job (§ 2 (3)) and
the date of employment, with the exceptions set out in section 6. Per day boarding
employee to employment is considered to be
a) for employment including employment contracted by foreign
the legislation of the day on which the employee joined the work, and
the day of termination of employment shall be the date of termination of employment,
(b)) in the service of the day on which the employee joined the performance
the service, if it is a State employee, and the date of commencement of the service per day
termination of employment shall be the date of termination of service,
(c)) for team members in cooperatives, where the condition of membership is their
the working relationship with the team, if outside the employment relationship
exercising for team work, for which they are rewarded by day
the start of work for the team, and their employment is considered to be
the day of the termination of membership in the cooperative,
d) for employees working on the basis of contracts for work day
which for the first time after the conclusion of the work the employee started
to carry out the agreed work and termination of employment shall be deemed to
day, by which time has elapsed, at which the agreement was negotiated, in
employees operating on the basis of the agreement on the implementation of the work is progressing
Similarly,
(e)) at the date of commencement of the judge judges into the function, and the date of the end of employment
shall be the date the end of the performance of the duties of a judge,
(f)) for members of the Councils of territorial self-governing units and councils
boroughs or municipalities disaggregated territorial statutory
the towns and the city of Prague, who are for the long term
released or who before electing a member of the Municipal Council were not
in employment, but acting in the same range as
the long-term release of members of the Municipal Council of the date from which member belongs to
the reward for the performance of the paid members of the Councils of local
local authorities and councils of districts or city
circuit broken down territorial statutory towns and the city of Prague, who
are for the long term performance of relaxation or who before election to the
Member of the Municipal Council were in employment, but they perform
function in the same range as the long-term release of members
the Municipal Council, and in the day of termination of employment shall be the date on which the
This reward does not belong. Where the former mayor or mayor of tasks after
the expiry of the term until the date of the constituent meeting of the newly
the elected Municipal Council and he receives remuneration referred to in the sentence
First, it is considered an employee for a period of time that it
This remuneration; This applies to the County Governor and the Mayor of the
the city of Prague,
g) for members of the Chamber of Deputies and Senators of the Senate of the Czech
the Republic and the members of the European Parliament elected in the territory of the United
the Republic day of the election, and for the day of termination of employment shall be the date
the expiry of the term, where applicable, date of termination of the mandate,
h) for members of the Government, the President, Vice-President and members of the Supreme
Audit Office, members of the Council for radio and television broadcasting,
the members of the Council of the Czech Telecommunications Office, the financial arbiter,
the representative of the financial arbiter, Ombudsman and a representative of the
The Ombudsman function, the date of commencement and the date of the end
employment is considered to be the day of the end of the performance,
I) for individuals not referred to in points (e) to (h)))
were appointed or elected to functions and their appointment did not arise
work or service, the date of taking up their duties, and the date of the end
employment is considered to be the day of the end of the performance,
j) for voluntary workers day care service, in which he began to
voluntary worker to provide care, and the date of the end
employment is considered to be the day ceased to be a willing worker
care services,
to a person) takes care of the child and the person who is registered in the register of persons
that can perform foster care on a temporary basis, if these
persons paid the foster parent allowance under the Act on social and legal protection
children ^ 16 c), the date from which this reward belongs to, and the date of the end
employment shall be the date from which that remuneration is not part of the other
than temporary incapacity,
l) for inmates in the performance of the protective measures and security detention
a sentence included in the classification of the work day to work, and for
the day of termination of employment shall be the date of the appeal of the work,
m) for persons in employment, the employment relationship that has the content, but
the employment relationship did not arise, since the conditions laid down have not been met
labour law for its origin, for starting the work, and
for the day of termination of employment shall be the date of termination of the work,
n) for employees other than those listed in subparagraphs) to n) day, when he began
the employee to perform the work, on the basis of the revenue shall come from him
dependent work and emoluments, and the date of the end of employment
shall be the date of termination of the work.
(3) the obligation of the State pay a premium for insured person begins on the day when the
State pursuant to § 7 becomes liable for insurance premiums. This obligation shall cease on the date on
which the State ceased to be under section 7 of the premium payer.
(4) an insured person is not required to pay a premium for, which is a long-
in a foreign country, if it is in a foreign country of affiliation and made about this
the fact of the appropriate health insurance a written declaration.
The obligation to pay the premiums, however, shall cease on the date on which an insured person in
the statement said, according to the first sentence, but not earlier than on the day following
the date on which this statement was delivered to the respective health
the insurance company. From the same date to the date when the insured person for the
health insurance companies once again signed up, does not have an insured person entitled to
the provision of paid services. At the same time with then logging back on for
the health insurance policy holder is obliged to this insurance company
Additionally to provide proof of health insurance abroad, closed and
its length. If the insured person does not submit the relevant health insurance company
proof of health insurance abroad, closed, and its length is
required to retroactively premiums as if to avoid;
the penalty payment, in this case to enforce. If the insured person shall submit to the
proof of the closed health insurance abroad, which does not cover the entire
the time when he was not required to pay in the Czech Republic by the phrase
First, it is required to retroactively premiums for each calendar month,
in which health insurance abroad did not take all such
calendar month; the penalty payment, in this case to enforce. For more
the statement in the first sentence can be lodged after the first health insurance company
2 full calendar months following the date of re-
login. For a long-term stay abroad is considered to be a continuous stay
longer period of six months.
(5) if the payer to pay the insurance premiums in the specified amount and on time
It is competent health insurance company required to enforce on the debtor's
payment including penalties.
(6) the periodic penalty payment to enforce during the long stay of the insured person in a foreign country, before the
which has not made a written declaration in accordance with paragraph 4, paying insurance premiums
and for the entire stay abroad paid for by the nečerpal service. In such a
If the policy holder is obliged to submit proof of the closed medical
insurance in foreign countries and its length, which covers all the time fixed
the stay in a foreign country. Time for a long-term stay abroad, in this case
starting on the date referred to as insurance in the proof of origin
the closure of health insurance abroad.
§ 9
The amount and method of payment of premiums and penalties
(1) the amount of the premiums, penalties and the method of payment provides for specific
^ 17) Act.
(2) insurance premiums paid by the employees of one third of the staff of the two
thirds of the employer.
PART THREE
THE RIGHTS AND OBLIGATIONS OF INSURANCE PAYERS
§ 10
Notification obligation of insurance payers
(1) the employer shall, not later than eight days from the occurrence
the fact that announces the health to do so for
insurance companies notice of:
and employee to employment) (§ 2 (3)) and its termination;
in the case of insured persons according to § 2 (2). 1 (b). (b)), to announce whether or not this
the fact
(b)) change in employee health insurance, if this fact
said; notification shall be made from the payment of premiums by opting out at the original
health insurance companies and logging on to the premium payments for health
insurance companies, which the employee has chosen,
(c) the facts decisive for the obligation) of the State to pay for employee
insurance, even in those cases where the obligation of the State was at the time,
When an employee has provided the time off work without compensation income, if
These facts are known.
About the reported facts, the employer is obliged to keep a register and
the documentation. In the performance of the notification obligation mijnbouwregeling employer
name, surname, residence and social security number of the employee or other
the number of the insured person.
(2) the employee is required to notify the competent health insurance company
the fact under the preceding paragraph shall, without delay, if it finds that its
the employer has not complied with this obligation, or if the information referred to under
(b)), and (c)) your employer has not communicated.
(3) an insured person who is self-employed, is obliged to
notify the competent health insurance company separate start and end
employment no later than eight days from the date of this activity
began or ended. The insured person, doing business on the basis of the trade
permissions, fulfills this obligation even if the make a notification to the competent
the Trade Office ^ 17b).
(4) the insured shall, within eight days from the date when the insured person became
pursuant to section 5 (b). (c)), notify the competent sickness
the insurance company.
(5) the insured person is obliged to notify the competent health insurance company
at the latest within eight days, the operative events for the creation or termination of
the obligations of the State to pay the premium for it under section 7. For persons employed
they have this obligation to the employer, if he is the fact
known. For a person with limited legal capacity shall fulfil this obligation the
guardian, custodian or guardian.
(6) the Birth of the insured person is his legal guardian, legal guardian or
the trustee shall be obliged to report within eight days from the date of birth health
the insurance company, which is insured by the child's mother on the day of his birth;
If it is not the child's mother are medically insured under this Act, it shall notify
guardian, guardian or guardian of the child's birth
health insurance, for which the insured is the child's father on the day of its
the birth of. The competent municipal authority entrusted with the direction of the Registrar shall notify the
the birth of the insured person to a central register of insured persons ^ 18) immediately
After the social security number allocations.
(7) the Death of the insured person or his or her declaration of death is required to notify
A central register of insured persons ^ 18) within eight days of the entry into the register
the competent municipal authority entrusted with the direction of the Registrar.
section 10a
Business offices
(1) the trade authorities that have adopted a notice under section 10, paragraph 1. 3 sentences
Second, shall transmit this information in due time ^ 18a) health insurance,
which the insured person has stated in its notification (hereinafter "the appropriate
insurance company ").
(2) Business offices shall be communicated not later than 5 working days, the competent
the insurance company first, or the demise of the last permission to operate
and suspension of trades, with an indication of the date on which
These facts have occurred.
(3) the authorities shall, at the request of business health insurance company a copy of the
the documents, which the insured person is joined to its notification referred to in paragraph 1.
(4) the business offices and health insurance companies in the limits of their
the scope of each other shall transmit the data required for the implementation of the public
health insurance of self-employed persons, which
operating on the basis of trade licence.
PART FOUR
THE RIGHTS AND OBLIGATIONS OF THE INSURED
§ 11
(1) an insured person has the right to
and) the selection of health insurance company, unless otherwise provided by this Act,
(b)) on the selection of providers of health services in the territory of the Czech Republic
(hereinafter referred to as "provider"), which is under contract to the competent
health insurance company, and in the selection of medical equipment of this
the provider; in the case of a registered provider can this right
apply once per 3 months,
(c)) on time, and the local availability of paid services provided
by the appropriate health insurance providers,
(d)) to provide covered services to the extent and under the conditions laid down
This Act, while the provider shall not for such paid services
accept no remuneration from the insured person,
e) on medicines and foods for special medical purposes without
direct remuneration, in the case of medicines and foods for special
medical purposes paid from health insurance and prescribed in accordance
with this Act; This is true even in cases where the provider of Pharmacy
care insurance of the insured person does not yet have a contract,
(f)) to provide health care paid to the extent and under the conditions
laid down in this Act related with diseases with very low
incidence in the population in the sense of directly applicable legislation
The European Union ^ 19a) (hereinafter referred to as "orphan"), including
orphan medicinal products covered under this Act,
(g) to obtain information from) health insurance companies about him provided by the
paid services
h) contribute to the scrutiny provided by the health care paid for by the health
insurance,
I) on the issue of the payment of the regulatory charge under section 16a,
(j)) on the issue of the payment of the balance due for release in part
paid by the medicinal product or foods for special medical purposes
Pharmacy,
to the payment of amounts exceeding) the limit for payments for prescribed
partly paid for by medicines or foods for special medical
purposes under section 16b health insurance within the time limit under section 16b, para. 2,
l) the costs, incurred to emergency care
pumped abroad, and only up to the amount provided for the reimbursement of such care,
If it has been granted on the territory of the Czech Republic,
m) the costs, incurred to the health services, pumped in
another Member State of the European Union, with regard to health services, which
It would have been when the provision on the territory of the Czech Republic covered by health
insurance (hereinafter referred to as "paid for by cross-border services"), and only in the amount of
laid down for the payment of such services should have been provided in the territory of
The United States,
n) to information about options to draw health services in other
the Member States of the European Union.
(2) If an insured person for that, he paid for the services are not provided in the
accordance with this Act, may file a complaint under the Act on health
services.
(3) Soldiers in active service with the exception of soldiers, reservists called up to
military exercises and military schools, students who are preparing to
the service of a soldier by profession and there are soldiers in active service, they are insured
for Military health insurance. The soldiers and the students of military schools are
Military health insurance policyholders to the last day of the calendar
the month in which a study on the military school. From the first day
the next calendar month are insured with health
insurance companies, which were insured prior to going into the military
health insurance companies. For this purpose, is a military health insurance
required to communicate once a month the central insurance company General
health insurance company ^ 18) name, surname, permanent residence and social security numbers
insured persons who have started or completed studies at the military school. For
change of health insurance by the insured person under the preceding paragraph to the
the time limit of 12 months shall not be counted in the Military health insurance
the insurance company. For soldiers in active service, ^ 22a) with the exception of soldiers in ambush
called up for military exercises, and for students of military schools, ^ 22b) who
preparing for the service of a soldier by profession and there are soldiers in Active
the service will pay the Ministry of defence through military health
insurance companies
and the difference between the amount of the remuneration) covered services provided by your
laid down by special legislation governing the service of the
troops from the occupation, which are partly covered by public health
insurance pursuant to this Act, and the amount of remuneration provided by the Military
health insurance company; This does not apply for reimbursement of dental products
b) preventive care provided beyond the covered services according to § 29 in
the scope of the Decree of the Ministry of Defense.
(4) in the case of a merger by acquisition, the military health insurance with another
health insurance company under special legislation ^ 28) at which
Military health insurance expires, rights and obligations
established by this Act of military health insurance company, as well as
obligations laid down in the Ministry of defence and others to the military
health insurance company, to the acquiring health insurance. The information about the
the merger of merger of Military health insurance with another health
the insurance company, in which the Military health insurance lapse, publish
The Ministry of health in a way allowing remote access.
(5) in the case of persons to whom services are provided in the area of employment ^ 22 c)
and for the people, which is to be carried out to determine the examination by a doctor,
whether it can be placed in a police cell or should be released from it, and
people in the performance of the security of the detention or custody or imprisonment
imprisonment is the selection of the provider of medical equipment and
medical transport services limited under the specific legislation.
§ 11a
(1) a health insurance company can be changed once every 12 months, and it always just
to 1. day of the calendar half-year. An application form bearing the signature of the
the insured person, his legal representative, a guardian or trustee shall be obliged to
submit the selected health insurance company in the course of the calendar half-year
immediately preceding that in which the change of health
insurance company occur not later than 3 months before the requested date changes.
Application to change the health insurance companies can submit only one in
calendar year; any other applications will no longer be disregarded,
even then, if they are submitted within the prescribed time limit.
(2) an insured person is entitled to change the health insurance company i within the time limit
shorter than that referred to in paragraph 1, if the
and health insurance), for which it is insured, gone into liquidation
(b)) was over health insurance that is insured, introduced compulsory
Administration, or
(c)) saw the merging of health insurance companies, which also applies to health
insurance company that is insured, always on the first day 3 calendar
months following the month in which occurred the events listed
in points (a) to (c)).)
(3) the health insurance fund carried out a person with limited legal capacity
their legal guardian, custodian or guardian.
(4) when the child is born with the right to choose health insurance
does not apply. The date of birth of the child is insured health
insurance company that is insured by the child's mother on the day of his birth.
If the mother of the child who was born disabled insured under this
the law, the date of birth of the child becomes the insured person's health insurance company
that affiliation is the child's father on the day of his birth.
(5) the health insurance of the child may Change its legal representative,
guardian or trustee may be made only after the allocation of the child, the social security number
and that, on the date laid down in paragraph 1 or 2.
§ 12
The insured person is obliged to:
and) perform the notification obligation under section 10,
(b)) at date of commencement of employment for which the employer
health insurance is insured. The same obligation even if the
If the insured person other health insurance companies at the time duration
employment; This obligation will meet within eight days from the date of the changes to the health
the insurance company. Receipt of the communication referred to in the previous sentences, the employer is
the insured person must confirm in writing. The employer has the right to request
to employees or former employees of the payment of the penalty paid by the
connection with any health changes or late notification
insurance by the insured person,
(c) pay the relevant health insurance) premiums, if this law
provides otherwise, the
(d)) to assist in the provision of health services and control of
the course of individual treatment and to comply with provider
medical regime,
e) undergo preventive examinations on request, if so determined by the
This Act or generally binding legal regulations,
(f)) to comply with measures to prevent diseases
g) avoid negotiations whose objective is the conscious damage to your
health,
h) demonstrate the provision of health services, with the exception of
the provision of medicinal products, foods for special medical purposes and
medical devices, a valid proof of the policy holder or replacement
a document issued by the relevant health insurance,
I) report within eight days of the loss or the competent health insurance company
damage to the insured person's card,
(j)) return within eight days of the relevant health insurance company insurance card
When
1. the demise of health insurance pursuant to § 3 (2). 2 (a). (b)), and (c));
2. change the health insurance companies;
3. a long-term stay abroad according to § 8 para. 4,
to the competent health insurance company) to notify changes of name, surname,
permanent residence, or social security number, and within 30 days of the date when the
change occurred; If the insured person in the place of permanent residence, it is
obliged to notify the competent health insurance company also the address of the place of stay
on the territory of the Czech Republic, where it mostly resides (hereinafter referred to as
"residence"),
l) when you change health insurance companies to submit the newly selected health
insurance proof of the amount of the advances on the premiums calculated based
the base, in the case of a self-employed person,
m) pay regulatory fees to the provider pursuant to section 16a.
PART FIVE
CONDITIONS FOR THE PROVISION OF PAID SERVICES
Health care currently paid from health insurance
section 13 of the
Paid services
(1) the health insurance covers medical services provided
insured persons in order to improve or maintain his health or
to relieve his suffering, if
and the insured's State of health) and the purpose of which is to be their
the provision has been reached, and for insured persons are reasonably safe,
(b)) are in accordance with the current available knowledge of medical science,
(c)) there is evidence of their effectiveness in view of the purpose of their
the provision.
(2) the Paid services are within the scope and under the conditions laid down in this
by law
and preventive health care,), dispensary, diagnostic, therapeutic,
the pharmacy, klinickofarmaceutická, sanatorium rehabilitation, Spa
hospital rehabilitation, assessment, nursing, palliative and
the health care of donor blood, tissues and cells, or organs related to the
their collection, and in all forms of the provision under the law on
health services,
(b)) the provision of medicinal products, foods for special medical
purposes, medical devices and dental products
(c) the transport of the insured and refund) travel costs
(d)) and the collection of blood samples of tissues, cells and organs intended for transplantation and
the necessary handling (storage, storage, processing and
examination),
(e) the transport of living donor to) place of collection and from this place to the place of
the provision of health care associated with the collection and from this place and
reimbursement of travel costs,
f) transport a deceased donor to the sampling point and from this place,
g) carriage of removed tissues, cells and organs,
(h) the deceased insured person and tour) autopsy, including transport,
and the insured's Wizard) in the clinic bed care,
j) health care related to pregnancy and childbirth child whose
the mother asked for confidentiality in connection with childbirth; This care
are paid by the health insurance company, which is based on the identification of the data
the insured person shall ask the appropriate provider for reimbursement.
§ 14
(1) the health insurance covers medical services provided on
the territory of the Czech Republic.
(2) from health insurance to insured persons on the basis of its application
will provide a reimbursement of costs incurred for emergency care,
the need arose during his stay abroad, and only up to the amount
laid down for the payment of such services should have been provided in the territory of
Of the Czech Republic.
(3) the health insurance Of the insured person on the basis of its application
will provide a refund of the cost of cross-border services, and paid for by
It's only up to the limits laid down for the payment of such paid services, if
would have been granted on the territory of the Czech Republic. If the refund is
the cost of cross-border services subject to the granting of paid by the previous
consent under section 14b, to pay costs only if the
If prior consent has been granted.
(4) in the case when the provision covered by the cross-border services a necessary
care paid for by the coordination regulation and the costs associated with its
drawing on the coordination regulation are covered only partly,
It shall apply to compensation for the costs incurred by the insured person and company
According to the coordination regulation, the first sentence of paragraph 3. In this case,
the insured shall provide the refund of the costs incurred by it in the amount of
calculated as the difference between the total amount of the remuneration of such health
the service, which would provide in the territory of the Czech Republic was covered
from health insurance, and the total amount of the amount for such
health service paid for by the coordinating regulation. If the calculated
amount is greater than the amount which the insured person has made, he shall provide the
refund only the amount spent.
(5) If this Act or decision of the State Institute for the control of
of medicinal products (hereinafter referred to as "the Institute") issued pursuant to the conditions
for payment of covered services, the following conditions must be met for
compensation paid to cross-border services; for such a condition is
does not consider the conclusion of a contract for the provision and payment of covered services.
§ 14a
The amount of reimbursement of costs pursuant to § 14 para. 2 to 4 shall be determined on the basis of the
This law, Decree issued pursuant to § 17 para. 4, price regulation,
measures of a general nature referred to in article 15, paragraph 2. 5 and the decision of the Institute according to
effective on the date of the copy of the accounting document on which
the basis of the refund is carried out; This applies mutatis mutandis to the reimbursement of costs,
that the insured person has incurred in connection with drawing on health services in the
another Member State of the European Union, European economic area
or the Swiss Confederation, which has been allocated an authorisation under
coordination of regulation to ensure the payment of health services
(hereinafter referred to as "the authorisation according to the coordination regulation").
section 14b
Prior consent of the
(1) the Government may by regulation define paid for by cross-border services for which
is to provide reimbursement of costs pursuant to § 14 para. 3 subject to the granting of an
prior consent. As paid for by cross-border services, which is
refund of costs subject to prior approval, may be defined
only
and the planned paid services), for which the regulation of the local government and
availability of health services stated time
availability and which at the same time require hospitalization or highly
specialized instrumentation or medical equipment, or
(b)) paid services, which include a treatment that constitutes a specific
the risk for the patient or the population.
(2) the Ministry of health shall notify the European Commission, which
covered services is subject to prior approval of the reimbursement of costs.
(3) on the granting of prior consent shall be decided by the appropriate health
the insurance company, at the request of the insured person. The request must be submitted before the
the start of pumping paid cross-border services.
(4) the health insurance fund may refuse to grant prior approval only,
If
and the insured person) would be due to their health condition during pumping
financed by the cross-border service is exposed to the risk that cannot be attributed
to be acceptable, taking into account the potential contribution of drawing these paid
cross-border services,
(b)) is a reasonable concern that the drawdown would be covered by the cross-border services
could result in substantial danger to public health,
(c)) about who is paid to provide cross-border services,
There is justified concern regarding compliance with the standards and guidelines
regarding the quality of health services provided and on the safe
the insured person, or
(d)) can be required to provide medical services to the insured person on the territory of the United
Republic within the period of time laid down by regulation of the Government of the availability
local and temporal availability of health services.
(5) the health insurance of the insured person when examining an application for the grant of
prior consent must also consider whether in the present case are not
the conditions for the issue of permits under the coordination regulation.
If these conditions are met, the health insurance fund shall issue to the insured
authorisation in accordance with the coordination regulation; This does not apply if the insured person in
the request stated that asks only about the granting of prior informed consent and its
grant requests, even after he was informed of the health insurance company
the advantages of that bringing the issue of permits under the coordination of regulation
as opposed to the granting of prior consent.
§ 14 c
(1) information concerning the drawing of health services in the Member
States of the European Union provides a national contact point, which is
the body, which was intended for a range of health insurance as a liaison
in accordance with the coordination regulation (hereinafter referred to as the "focal point").
The Department of health says the name and contact details of the contact
the place of the European Commission and published on the official Board and is in the
The Ministry of health. The name and contact information of the focal point
published on their website and the health insurance companies.
(2) point of contact provides, in particular, information about
and drawing options) of health services in the Member States of the European
of the Union,
(b)), providers
(c)) the contact details of national focal points in other
the Member States of the European Union,
(d)), the United Kingdom legislation governing standards and guidelines
on the quality and safety of delivery of health services, including
provisions on the supervision and evaluation of providers, and providers, the
that these standards and guidelines apply,
e) patients ' rights, procedures for the submission of complaints and mechanics
to rectify the situation and how to resolve disputes in the Czech Republic,
f) terms, to be under the laws of the United
States listed on the prescriptions that are displayed on the
the request of the patient who is going to use in another Member State of the European
Union.
(3) at the request of contact point provides information about
and provide a specific provider) health care services or
about any limitations of its permissions,
(b) the accessibility of specific medical devices) in the Czech Republic
for persons with disabilities,
(c) draw health services) options under the coordination of regulation,
(d) the insured person's rights) in connection with the drawing of health services in the
other Member States of the European Union, and in particular on the rules and
conditions of reimbursement of costs and procedures for their application,
(e)) the rights of the patient from another European Union Member State on the territory of the
The United States in connection with the drawing of health services, in particular on
How to appeal and the remedy, if the patient has considered that was damaged on
their rights, including in cases where the injury occurs as a result of the pumping
health services.
(4) to provide information relating to the disbursement of health services
in another Member State of the European Union contact point shall communicate which rights
result of the coordination regulation and resulting from this Act.
The information referred to in paragraph 2 of point of contact exposes on their
website. The information referred to in paragraphs 2 and 3 shall, at the request
shall provide, in a form which allows them to be with the following information in
extent necessary to ascertain and persons with disabilities.
(5) the contact point works in order to exchange the necessary information
and examples of good practice with the national contact points of the other
Member States of the European Union, European Commission, health
insurance companies and associations operating in the field of protection of patients rights
These people.
(6) providers, the authorities competent to issue permissions to provide
health services and health insurance companies are obliged to call
a place to provide information on his application, in accordance with paragraphs 2 and 3
without delay and free of charge, if you have this information available.
§ 15
(1) health insurance is, or is to be paid only in certain
conditions, medical procedures referred to in Appendix No. 1 to this Act.
(2) health insurance won't cover a further performances of acupuncture.
(3) the health insurance Of health services provided on the basis of
recommendation of a registered provider in the field of obstetrics and
obstetrics in connection with artificial insemination, if it is a form of
discontinued and fertilisation (in vitro fertilization) shall be borne by
and women with a double-sided obstruction) of the fallopian tubes in the age from 18 years to
delivery reaching thirty-ninth year of age,
(b)) other women aged between 22 years to the day of the thirty-ninth achievement
year of age,
most three times in your life, or if it was in the first two cases
transferred to the genitals of a woman no more than 1 human embryo resulting from
fertilization of the eggs of sperm outside the body of a woman four times in a lifetime.
(4) health insurance fully paid in at least
economically challenging medicinal products containing these active substances:
and serum stafylokokovým infections),
b) serum against diphtheria,
c) serum snake venom
d) serum botulism,
e) gas gangrene, serum
f) rabies serum
g) immunoglobulin against tetanus,
h) immunoglobulin hepatitis B,
I) tetanus toxoid,
j) stafylokokovým infections, vaccine
the vaccine against rabies),
l) antidotes (used in the treatment of poisoning organophosphates, heavy metals and
hydrogen cyanide).
(5) health insurance is to be covered in the provision of out-patient
health care medicines and foods for special medical
purposes, unless the Department decided on the amount to be paid (section 39 h). In each
a group of active substances referred to in annex No. 2 of the health
insurance always fully paid at least one medicinal product or foodstuff
for special medical purposes. Additionally, from health insurance shall be borne by
individually prepared medicinal products, radiopharmaceuticals, blood transfusion
preparations for advanced therapy medicinal products, and tissue and cells of
fixed the Institute measures of a general nature. From health insurance to
in the provision of fully paid bed care medicines and foods
for special medical purposes, individually prepared medicines
medicinal products, radiopharmaceuticals, blood products, medical devices,
advanced therapy medicinal products, and tissue and cells, in the implementation of
at least economically challenging, depending on the extent and severity of the
disease of the insured person and their remuneration is not taking part.
(6) health insurance is not reimbursable medicinal products and food
for special medical purposes referred to in the first sentence of paragraph 5, if the
The Institute admitted by a decision of the reimbursement. The Institute will not admit to a remuneration, in the case of
medicines and foods for special medical purposes
and supporting and complementary)
(b)) the use of inappropriate is from the professional point of view,
(c)) do not have sufficient evidence of the therapeutic efficacy,
d) fulfil the conditions effective therapeutic intervention, or
(e)) which are the similar treatment under section 39b of paragraph 1. 4 in the
the reference group, which was according to the law on medicinal products registered as
biological medicinal product or a generic medicine, and the marketing authorisation holder shall
in writing, together with the application for determination of the amount and terms of payment of the committed
deliver medicine or food for special medical purposes
the Czech market for a period of 12 months from the effective date set forth above and the terms and conditions
the remuneration,
(f)) which can be issued without a prescription with the exception of
foods for special medical purposes and such medicinal products, the
where in the course of proceedings for the determination of the amount and conditions of payment with a confession
the remuneration shall be expressed on the basis of public interest under § 17 para. 2 the consent
all health insurance companies.
(7) the Therapeutic effect is the ability to induce desirable
the effect of using the medicinal product or foods for special
medical purposes in normal clinical practice. Efficient
therapeutic intervention means the medical services provided to the
prevention or treatment of diseases in order to achieve the most effective and
the safest treatment while maintaining cost effectiveness.
(8) Cost effectiveness means the determination of the ratio between the cost and the
the benefits associated with the use of the medicinal product or food for
Special medical purposes, compared with the use of another of the medicinal
medicine, foods for special medical purposes or treatment
the procedure; cost effectiveness is evaluated in comparison with such
therapeutic procedure borne out of the health insurance funds,
that is generally accepted as usual. Cost effective are such
medical treatment at comparable costs bring the same
or a higher therapeutic effect of life extension,
improve the quality of life or to improve a substantial and measurable
the criteria of the relevant diseases, or at least comparable
therapeutic effect of mean lower total cost for the system
health insurance, or at higher costs and higher
therapeutic effect of this ratio is comparable with other therapeutic
the procedures covered by the health insurance funds. Reviews
cost effectiveness is required for medicinal products or food for
Special medical purposes that are not included in the reference group
pursuant to section 39 c of paragraph 1. 1, or for which it is proposed for prescription or
indicator limit in principle contrary to therapeutically interchangeable
medicinal products or foods for special medical purposes, or
required the determination of the next higher remuneration under section 39b of paragraph 1.
11, or for which it is required an increase in the remuneration of the medicinal product
or food for special medical purposes, as opposed to basic pay.
(9) the Institute shall decide on the
and determination, alteration and) cancellation of the level of remuneration of medicinal products and food
for special medical purposes,
(b) the making of payments) of medicines and foods for special medical
purposes referred to in subparagraph (a)) in a way, Bill preskripčními and
indicating constraints or use in providing health care to the
specialised workplaces (hereinafter referred to as the "terms of payment"),
(c) the refusal of payment) medicines and foods for special
medical purposes,
(d)), and the cancellation of the determination of the change in the maximum price under the legislation on
regulate prices announced in the journal of the Department of health (hereinafter referred to
"price regulation") ^ 23 c),
(e)) on the classification of the medicinal product, the reference group.
(f) basic pay) reference group.
(10) the medicinal product whose remuneration from health insurance is
by decision of the Constitution subject to the use of a specialized workplace,
health insurance company pays only providers with which to
the efficient use of such medicinal products has entered into a special
the contract. Part of such a contract must be a medicinal product and
workplace medical equipment provider.
(11) the medical devices referred to in section B of annex 3 of this
the law of health insurance. Medical devices
listed in section C of annex 3 of this Act from the health
insurance paid in the amount and under the conditions laid down in this annex.
(12) medical devices not listed in paragraph 11, the health
insurance pays 75% of the cost of the medical device design
at least economically challenging, depending on the extent and severity of the
disability; the price of the least economically demanding the implementation of
medical device detects the health insurance market.
From health insurance under this paragraph shall be borne by the medical
the funds prescribed for the purpose of
and) continue in the treatment process,
(b) to support the stabilisation of health) of the insured person or the significantly
improve or eliminate its deterioration, or
(c)) to compensate or mitigate the consequences of health defects including compensation or
modification of the Anatomy or of a physiological process.
(13) from the health insurance covers dental products in the range
and under the conditions specified in annex 4 of this Act.
(14) health insurance is no cost examination, inspection, medicinal
products, foods for special medical purposes and medical
resources and other performances made in the personal interest of and at the request of
natural persons, or in the interest of and at the request of legal persons, with the aim of
It is not to maintain or improve the State of health of the insured person. Paid services
also do not include examinations, examinations, medicines, food for
Special medical purposes and medical devices and other health
performances carried out at the request of the Court, the public prosecutor's Office, the institutions
the State administration and the authorities of the police of the Czech Republic. The reimbursement of medical
services under the preceding sentence shall provide the authority for the medical facility
that health services are carried out, in the amount set by the list
medical procedures with spot values ^ 25) in accordance with decision
The Ministry of health; in the case of remuneration at the request of the police authorities
The United States, the provider will send an expense report to the Interior Ministry, and
within 15. day of the calendar month following the
the calendar month in which the medical services provided.
(15) a health service provided in children's homes for children up to 3 years
the age of health care professionals who are employees of the provider
health services in this facility, shall be paid from the budget of the
of the founder. From the budget of the founder to be paid whether or not medical rescue
the service, with the exception of medical procedures in accordance with section 28.
section 16 of the
(1) the health insurance fund pays in exceptional cases
health care services health insurance otherwise unpaid, if the
provision of such health services is the only option in terms of
the State of health of the insured person.
(2) except in cases where there is a risk of late payment, the provision of
health services under the preceding paragraph shall be bound to the previous
medical consent.
section 16a
Regulatory fees
(1) the insured person or his legal representative for him, is obliged to pay the
provider of regulatory fee of 90 € for the use of medical
emergency services or emergency services in the branch of dental medicine
(hereinafter referred to as "the emergency").
(2) the regulatory fee referred to in paragraph 1 shall not apply,
a) in the case of an insured person placed in children's homes for children up to 3 years
^ age 53), in school facilities for institutional upbringing or
protective care ^ 54) or for the performance of institutional care in nursing homes
for persons with disabilities ^ 55) or in the case of the insured person
located on the basis of the decision of the Court in facilities for children in need
immediate help ^ 56) or the insured person assigned by the Court to the
foster care, guardian care or custody under other
^ Law 57),
(b)) in the case of insured persons, which is shown by the decision, notification or
certificate issued by the authority on assistance in material need a dose that is him
provided by other legislation ^ 10), not the older 30 days,
c) in the case of insured persons who are under another law ^ 58)
provided social services in the residential homes for persons with
disabilities, homes for the elderly, nursing homes with special regime or in the
bed care establishments, if this insured person after
remuneration for Board and lodging shall be determined by the balance of at least 15
% of his income ^ 59) less than $ 800, or if he has no income; This
the fact proves the insured person confirms no earlier than 30 days, which
at his request, is obliged to issue a social service provider, or
d) if within the emergency services attending physician found that the status of the
the insured person requires hospitalization.
(3) the regulatory fee is the income provider that regulatory
fee. The provider is obliged to apply the selected regulatory
fees to cover the costs associated with the operation and modernization
the health care facility in which the contingency service
paragraph 1 is granted.
(4) the provider is obliged to expose the insured person or his legal
representatives at his request, proof of payment of the regulatory charge, with
the number of insured persons, the stamp and the signature of provider
a person who has adopted a regulatory fee. The provider is obliged to
communicating to health insurance in the Bill provided by the
covered services for the applicable calendar month, or for the
calendar quarter, information about regulatory fees selected
referred to in paragraph 1, indicating the number of the insured person, to which the regulatory
fee binds, and the date on which the regulatory fee.
(5) the provider is obliged to control the charge referred to in paragraph 1 from
the insured person or his legal representative to choose, unless it is an exception from the
payment of regulatory charge referred to in paragraph 2.
section 16b
Limits of arrears on medicines or foods for special medical purposes
(1) if the total amount paid by the insured person or his legal
Representative for additional payment for prescribed health insurance partially
paid for medicines and foods for special medical purposes,
issued on the territory of the Czech Republic, in a calendar year exceeds the limit
the amount of 5 000 CZK, children under the age of 18 years, including the calendar year in
which have reached 18. year of age, and for insured persons older 65 years, including
the calendar year in which the aged 65. year of age, in the amount of 2 500 CZK
is the health insurance company have to pay to the insured person or his legal
representatives of the amount by which this limit is exceeded. To the limit by
the first sentence shall be included in part paid for by the medicinal supplements on
products or foods for special medical purposes, containing the same
the active substances and the same route of administration only in the amount calculated in accordance with
the balance of a medicinal product or a foodstuff for special medical
the purposes for which a supplement to the volume of this active substance is
the lowest and which has not been found to interrupt or discontinue the delivery.
This does not apply, if the prescriber on the recipe marked that
prescribed medicinal product cannot be replaced (§ 32 para. 2); in such a
the case is within the limit of the balance to be counted in full. To the limit
do not count towards partially paid supplements on medicinal products or
foods for special medical purposes containing active substances intended for
additional support or treatment; This does not apply in the case of medicinal products and
foods for special medical purposes prescribed on a prescription insurance policy holders
the older 65 years, including delivery, which reached 65. a year age. For a list of
active substances intended for supporting or complementary treatment lays down
The Ministry of Health decree.
(2) the health insurance fund is required to pay to the insured person or his or her
legal representative the amount by which it exceeds the sum of arrears
pensionable service to the limit, notified the providers of care
health insurance company referred to in paragraph 4, the limit referred to in paragraph 1, the
60 calendar days after the end of the calendar quarter in which the
limit exceeded. In calendar quarters following the
calendar quarter in which the limit referred to in paragraph 1 no longer
exceeded, the health insurance fund is required to pay to the insured person or his or her
legal representative a sum equal to the sum of the fees eligible for the
the limit for the relevant calendar quarter, notified to the provider
care health insurance company pursuant to section 16a para. 6 and 7, to the
60 calendar days after the expiry of each such calendar
quarter. The amount referred to in the first or second sentence that in a calendar
quarter does not exceed $ 50, will pay the health insurance company within 60
calendar days after the expiry of the last calendar quarter in
calendar year.
(3) when changing the health insurance fund during the calendar year is
health insurance, for which the insured person insured required to notify
new health insurance company insured the grounds for calculating
the amounts referred to in paragraph 2. The amount pursuant to paragraph 2 shall be reimbursed by the insured person or
the legal representatives of the health insurance fund, for which the insured person is
insured up to the last day of the calendar year in which the limit was
has been exceeded. Health insurance company referred to in the second sentence shall notify the health
insurance companies, for which the insured person is insured in the calendar year,
the total amount by which the limit was exceeded, and the insured person
a proportional amount, calculated in accordance with the periods of insurance attributable to the
the insurance company, which is the amount announced. Health insurance companies are
the amount attributable to them are required to pay a health insurance company listed
in the sentence the second within 30 days from the date of receipt of notice of the amount.
(4) the pharmacy shall be obliged to communicate to the health
at the same time with billing insurance companies for the period information about
drug benefits, which will be included in the limit referred to in paragraph 1, with the
the number of the insured person, to which it attaches, the amount of the surcharge
paid the balance due and the date of issue partially borne by the medicinal product
or foods for special medical purposes.
(5) the pharmacy shall be obliged to issue to the insured person or
his legal representative at his request, proof of payment of the balance due for the
partially paid medicine or food for special medical
purposes, which will count towards the limit referred to in paragraph 1. In the document
Pharmacy shall indicate the name of the part paid by the pharmaceutical
medicine or food for special medical purposes, to which the
the balance of the balance, attaches, social security number and proof of imprint
his stamp and signature of the person that the supplement has adopted.
§ 17
(1) for the purpose of providing benefits in kind in the provision of paid services
the insured shall conclude in general health insurance company of the United States and
other health insurance companies, established pursuant to other legal
prescription ^ 28), contracts with providers about provision and reimbursement for covered
services. Contract for the provision and payment of covered services can be closed
only for health services that the service provider is authorised to provide.
Part of the contract for the provision and payment of covered services by the phrase
the first, including its amendments and additions relating to the scope covered by the
services covered by the contract is concluded, it is always an enumeration of health
list of medical procedures by a decree issued pursuant to paragraph 4, which
This contract includes. The contract is not required in the provision of
and emergency care to the insured person),
(b)) to the insured health services in custody or serving a sentence
deprivation of liberty or security of the detention designated provider performance
The prison service
(c) health services to insured persons), which is in the performance of the protective treatment
ordered by the Court, in the case of health services provided in the context of the
with a disease for which the insured person is obliged to submit to treatment.
(2) the contract referred to in paragraph 1 concluded between the health insurance company and
the provider shall be governed by the framework agreement, which is the result of
the conciliation procedure between the representatives of associations of health insurance companies and
representatives of the Group of the represented providers
their interest associations. Conciliation may invoke any of the
his party or the Ministry of health. Each of the framework contract
are submitted to the Ministry of health, which shall examine them from the
for compliance with the law and the public interest in ensuring
quality and availability of paid services, the functioning of the health system
and its stability within the financial possibilities of the system of public
health insurance (hereinafter referred to as "public interest"), and then issues as
a decree. If conciliation does not occur between the parties to the agreement on
content of the framework agreement within six months, or if the presented framework
the contract is contrary to the legislation or to the public interest, is entitled to
make the decision to the Ministry of health. The framework agreement contains
always the provision, which refers to the efficacy, methods and time because of the
termination of the contract pursuant to paragraph 1, that it is possible to terminate the contract
always to 1. January of the following year, with the period of notice must be
at least six months. This notice does not apply in cases where, in
as a result of serious circumstances cannot reasonably be expected for more performance
of the Treaty. Furthermore, the framework agreement shall include arrangements for the implementation of the remuneration
provided covered services, the rights and obligations of the parties to the Treaty
referred to in paragraph 1, if they are not determined by law, the General conditions
the quality and effectiveness of the provision of paid services, the conditions necessary for
performance of the contract referred to in paragraph 1, the control mechanism of quality
paid services provided and the accuracy of the posted amounts, as well as
the obligation of mutual communication of the information necessary to check the performance of the contract
on the granting and reimbursement for covered services, the way and the reasons for their
the contract referred to in paragraph 1, the provisions on arbitration.
(3) providers, and other entities providing paid services are
the Bills health insurers are required to indicate the number of insured persons,
who paid for the services provided.
(4) providers, and other entities providing paid services when
reporting of medical procedures use a list of medical procedures with
point values and with the rules for their reporting and health
the insurance company accepts this method of reporting, unless you
health insurance company a different way of reporting. The Ministry of
Health shall decree a list of medical procedures with spot
values and with the rules for their reporting.
(5) unless otherwise provided by this Act, the point values, the amount of the reimbursement paid by the
services and regulatory restrictions in respect of the following calendar year
in conciliation the parties agree that the representatives of the general health insurance company
The United States and other health insurance companies, and the respective
professional associations as representatives of the providers
providers. Svolavatelem of conciliation is the Ministry of
the health sector. If there is agreement, the Ministry will assess its contents
health care in terms of compliance with the law and the public interest.
If the agreement is in accordance with the law and the public interest, it shall issue
The Ministry of health as a decree. In the absence of the conciliation
management of the agreement until 30 June. 6. the calendar year or, if the Court finds
The Ministry of health that this agreement is not in conformity with the laws and
legislation or public interest, determines the value of a point, the amount of remittances
covered services, the amount of the advances to the payment of covered services and regulatory
restrictions for the following calendar year of the Ministry of health
the decree by the deadline of 31 December 2006. October of the calendar year. The decree by the phrase
the fourth and fifth shall apply, if the provider and health insurance company
in compliance with the health insurance plan health insurance
agree on the method of payment, amount of payment and regulatory limitations otherwise.
(6) the health insurance fund shall be borne by the providers, with the exception of
providers of pharmaceutical care, medicines in a lump sum, the
above shall negotiate in the Treaty under paragraph 1. Beyond the agreed lump-sum
the amount of the relevant health insurance company will pay, in the amount set by the
The Institute, providing outpatient health care providers, medical
preparations which decides to Institute such a method of payment. In the contract
can health insurance company to arrange another method of reimbursement of medicinal products
in the provision of institutional care, which has negotiated amount and conditions for reimbursement
with the holder of the registration or with the manufacturer.
(7) the health insurance fund shall pay always on the basis of:
and) a prescription issued by a contractual provider, physician
providing emergency care to the insured person, the doctor providing the
paid services in the social welfare facilities and contract physician providing
paid services together, my husband, my parents, grandparents, children, grandchildren
and siblings, if his expertise guarantees the Czech Medical Chamber
or the Czech dental Chamber and if a doctor concludes
a special contract with a health insurance company
1. providers of pharmaceutical care medicines and health
resources, and even if it does not have a pharmacy
Yet an agreement referred to in paragraph 1,
2. providers of pharmaceutical care and other Contracting bodies the glasses and
AIDS eye optics, hair replacements, orthopaedic prosthetic devices
standard and individually manufactured, AIDS for the disabled, including the
trucks and jacks for immobile people and AIDS for the hearing impaired
disabled, blind and partially sighted,
3. patient care providers and other bodies of the instruments used
to therapy
(b)) submitted by the contractors account
1. dental prosthetic replacements and therapeutic rehabilitation AIDS
2. orthodontic devices,
c) submitted by the contractors account or other contractual
operators of the service provided by medical interventions,
(d)) of the Treaty to persons that have permission to distribute medicinal products
According to the law on pharmaceuticals, medicinal products containing vaccines for
regular vaccination according to the composition of vaccines antigenního
established by the Ministry of health according to the law on the protection of
public health,
e) submitted by the account in accordance with the implementing regulation and price
Regulation of persons authorized to transport human remains under the law
about the funeral industry, the transport of the deceased insured person to autopsy the body and from the autopsy.
(8) if the transfer of all property rights relating to the
provision of health services from the provider, who asked for the withdrawal of
permissions to the delivery of health services under the health
^ 60), services to another person that was granted in response to
permissions to the provision of health services, or provides other
a person medical services on the basis of a certificate of compliance with the conditions for
the continuation of the provision of health services after the death of the provider
According to the law on health services ^ 61) or subsequently granted her
permissions to the provision of health services, the health insurance fund shall conclude a
with that person, on request and payment of the contract paid by the
services to the same extent as the original provider, within 180
days from the date of receipt of the request, your health insurance company; the contract is not
obliged to take out health insurance in the event that the original
provider contract. The request of the person referred to in the sentence
the first to submit no later than 30 days from the date of granting permission to
provision of health services, in the case of a person, which has been converted
property rights relating to the provision of health services, or to
30 days from the date of the grant of the certificate of compliance with the conditions for the continuation of the
provision of health services, in the case of a person who continues
provision of health services after the death of the provider. By the time of
the conclusion of the contract and payment of covered services to the person
referred to in the first sentence the right to reimbursement of the paid services provided in
the range represented by the contract for the provision and payment of covered services
concluded between the provider and the health insurance company, for a maximum
However, after a period of 210 days from the date of transfer of the economic rights relating to the
provision of health services, or from the date from which continues
provision of health services based on the permissions of the deceased
of the provider.
(9) the health insurance fund shall publish the contract referred to in paragraph 1 and paragraph 7
(a). (d)) in a way allowing remote access no later than 60 days from the
the date of conclusion of such an agreement. In the same way and at the same time
health insurance company shall publish each supplement or amendment to the contract under
paragraph 1 and paragraph 7 (b). (d)), which shows the amount of the reimbursement of medical
the insurance company paid for the provided service providers or range
provided covered services (the "amendment"). The Treaty according to the
paragraph 1 and paragraph 7 (b). (d)) or Appendix shall become effective on the date
publication referred to in the first sentence. If the health insurance company and
the parties agree to another method of the provider or the amount of payment, than it is for
the calendar year specified in a decree in accordance with paragraph 5, it shall publish this
the fact of the contract pursuant to the first sentence. Health
the insurance company shall not disclose information and data which are the subject of protection
under other legislation. Health insurance company also will not disclose
the contract, information and data relating to the provider that is
at the Intelligence Agency.
§ 17a
To ensure that contributions in kind in the provision of nursing care
insurance policy holders located in the facilities of the social services providing
residential social services concluded in general health insurance company of the United
States and other health insurance companies set up under the Special
the law ^ 28) specific contracts with providers of social services.
Appropriate health insurance special contract, if
social service provider so requests and at the same time proves that the
nursing care will be provided by healthcare professionals
provider of social services, who are eligible for the performance
the medical profession under special legislation ^ 28a).
section 17b
paid
section 18
Conditions for the provision of paid services
(1) unless otherwise provided by this Act, provide paid services, others
healthcare professionals than doctors, with the exception of clinical psychologists and
pharmacists, only on the basis of the indications of the treating physician of the insured person
(hereinafter referred to as "doctor").
(2) the treating physician for the purposes of health insurance means
and a registered provider, physician)
(b) specialized providers) the doctor out-patient care,
(c) the day care provider) the doctor, or
(d) the doctor with specialised competences) provider of inpatient care.
§ 19
cancelled
section 20
cancelled
section 21
cancelled
section 22
Special outpatient care
Paid services is also the special outpatient care provided
insurance policy holders with acute or chronic disease, the insured people,
sensory or mentally disabled and dependent on foreign aid and
palliative care, provided to the insureds in the Terminal State in their
their own social environment; This care is provided as
and home health care), if it is provided on the basis of the recommendation of the
a registered provider of outpatient care in General
practical medicine or in the field of practical medicine for children and adolescents
or the treating physician during hospitalization or on the basis of a recommendation
the attending physician, if it is a palliative care client in
end-stage condition,
(b)) health care in social welfare institutions, if it is provided on the basis of
the recommendation of the attending physician,
c) healthcare provided by inpatient care in medical facilities
persons who are placed in them for other than medical reasons, ^ 30)
d) health care in social service facilities,
e) nursing care provided on the basis of practice prescribing
a physician to the insured that are located in residential social services establishments
the competent employees of these facilities, unless
providers of residential social services have concluded a specific agreement with the
appropriate health insurance under section 17a.
§ 22a
Special inpatient care
Paid for services is the treatment palliative and symptomatic persons in
end-stage condition provided in special inpatient facilities
the hospice type.
the title launched
Article 23 of the
cancelled
section 24
cancelled
§ 25
Stay guide client in inpatient care
(1) If during hospitalization of the insured person in the clinic
bed care needed all day because of the presence of the wizard
and the insured's medical condition), or
(b)) to the insured person's guide training in the care and treatment
rehabilitation of the insured person, accompanied by an
is the insured person's Guide to the age of the stay of the sixth year of age
accompanied by the insured, including the contribution to be paid by the service; stay Guide
the insured person of an older 6 years it is paid by the service only with the consent
the review of the doctor.
(2) a guide shall be borne by health insurance company, for which it is insured
accompanied by the insured person.
section 26
Equipment of the insured person after their hospitalization
(1) paid for services is insured and medicinal products,
foods for special medical purposes and medical devices after
their hospitalization for 3 days or in duly substantiated cases, on the
Next, absolutely necessary.
(2) if the insured person is discharged to home on a pass,
the provider is not for the duration of the passes are entitled to charge the health
the insurance company charges for in-patient care, with the exception of medicinal products and
medical devices, which the insured person for the duration of the passes
equip.
section 27 of the
cancelled
section 28
Medical rescue service and emergency services
(1) Paid services include medical procedures carried out in the framework of the
emergency medical services.
(2) Paid services include medical procedures carried out in the framework of the
the emergency services, and even if it were urgent medical
performances carried out by a doctor outside his expertise.
Preventive care
section 29
(1) Paid services are also preventive examinations, which are
be carried out
and in the first year of life) nine times a year, of which at least six times in the
the first half year of life and of which at least three times in the first three
months of life if they are not provided dispensary care,
(b)) at 18 months of age,
(c)) in three years and then every two years, however, the first 18
months after making the last preventive examinations.
(2) in the field of dental medicine preventive inspection:
a) for children and adolescents under the age of 18 years, twice a year
(b)) twice in pregnant women during pregnancy,
(c)) in adults once a year.
(3) in the field of gynaecology and obstetrics, preventive inspection of the
at the completion of compulsory schooling and, starting with the 15th year
age once a year.
section 30
(1) the services are paid for by the tests and examinations carried out in the framework of the
measures against infectious diseases. ^ 34) tours of the insured
carrying out activities carried out in the context of severe epidemiological
with the issuance of a medical certificate to the covered services not included.
(2) the following are services paid for by the
vaccination and payment) of medicinal products containing vaccines for
regular vaccination according to the composition of vaccines antigenního
established by the Ministry of health according to the law on the protection of
public health,
b) vaccination and reimbursement of medicinal products containing vaccine in the
at least economically challenging
1. rabies
2. tetanus when injuries and healing wounds,
3. against tuberculosis for insured persons who meet indications for vaccination
provided for by the law governing the vaccination against infectious
diseases, including tuberkulinového of the test carried out in cases where it is
need to vaccinate a child older than 6 weeks; vaccination is in this case
be carried out only if the tuberculin test is negative,
4. the insured persons against influenza over the age of 65, the insured after
Splenectomy or stem cell transplant, for insured persons,
suffering from serious chronic heart disease, and to resist the pharmacologically
and blood vessels, or respiratory tract, or kidney, or diabetes, and for insured persons
located in health-care facilities long-term provider
inpatient care or homes for the elderly, or in homes for persons with
a disabled person or in homes with special regime; paid for by the
following is the service for insured persons over 65 years of age vaccinated against
pneumococcal infections according to the approved schedule,
5. against pneumococcal infections, if 3 doses of the vaccine have been
applied to the seventh month of age of the insured person; paid service is also
a booster made to the 15th month of age of the insured person; paid for by the
the service is further vaccination made after expiry of the time limits laid down in
This provision, if there is a postponement of the application of one or more benefits
vaccines because of the State of health of the insured person,
6. against the human papilloma virus, and that for girls, where vaccinations started
from the completion of the 13th year of age up to the age of the fourteenth.
(c) carried out in materials) of medical devices
health care provider on the microbiological, immunological and
parasite examination for clinical purposes and in connection with the occurrence of
diseases,
d) examination of the materials referred to in (c)) laboratories of the
providers,
(e) HIV diagnostics, anti), HCV and HBsAG in donors of blood, tissues, organs, and
the gametes and the HIV diagnosis carried out in health facilities
providers, preventive care in cases of preventative
procedures and in cases where it's suspected the insured person has requested it, with
the exception:
1. anonymous examination,
2. examination of private and business trips abroad.
(3) the services are not paid for by the
and) the provision of vaccines with the exception referred to in paragraph 2 (a).
(b)),
b) subscriptions of materials and their examination carried out for the purposes of the State
health surveillance National Health Institute and the health institutes,
(c) HIV diagnostics including investigations) carried out in the national health
the Institute and the health institutions at the request of the insured person including anonymous
examination.
section 31
Dispensary care
(1) in the framework of the covered services, dispensary care provides to the insured
healthy and the sick, endangered in these groups:
and children up to one year),
(b)) to children from selected one year of age, the chronically ill and vulnerable
health disorders, and as a result of the unfavourable family
or another social environment,
c) selected to minors,
d) pregnant women from the date of detection of pregnancy,
e) women who used hormonal and intrauterine contraception
(f)) affiliated persons at risk or suffering from serious diseases.
(2) an insured person to a dispensary care classified according to technical criteria
the doctor of the registering a provider that is responsible for the effectiveness and
coordination of dispensary care. The insured person can be dispenzarizován for
one diagnosis with only one doctor.
§ 32
Provision of medicinal products and medical devices
(1) the dispensing of medicinal products and medical devices by governing
special legislation. ^ 36)
(2) if so requested by the insured person for the issue of another medicinal product with the same
the active ingredient, the same route of administration and the same pharmaceutical form,
replaces it with the pharmacy in accordance with a special law ^ 37) other
medicinal product with a lower payment, if the prescriber to
the recipe has not indicated that the prescribed medicinal product cannot be replaced.
(3) the health insurance fund may lend some medical
resources; lease medical devices keeps records. Release
medical devices or their lease will record the prescribing
the doctor in the medical records.
(4) the provider of a legitimate supply medicinal products shall not in respect of
dispensing of the medicinal product bound to prescription, person
public health insurance, provide, offer or promise
monetary or non-monetary transactions, benefits or gifts of property or non-material
nature, even through third parties; This does not affect the possibility
discount or reduction of the final price not the maximum
margin at the time of such medicinal product.
(5) the provider authorized to supply medicinal products is committed
the administrative offense, if you commit a breach of the prohibition referred to in paragraph 4. For administrative
the offence is a fine of up to Czk 1 0000 0000 stores. Administrative offence dealt with and
a fine Department stores. The fine enforced by the Customs Office. Income from fines is
State budget revenue. A fine may be imposed within 1 year from the date on which
The Institute has detected a violation of the prohibition, but within 3 years from the date on which the
There has been a violation of the prohibition.
§ 33
Hospital rehabilitation care
(1) Paid by them on hospital rehabilitation care, provided by the
as a necessary part of the process, the provision of recommended
the attending physician and confirmed by the auditing physician. A proposal on hospital
rehabilitation care serves on the health insurance company doctor
the registering of the provider or the treating physician during hospitalization;
in the case of the provision of a spa hospital rehabilitation care, the proposal contains
also specify the degree of urgency.
(2) the Spa sanatorium rehabilitation care is provided solely as a
subsequent inpatient care in health facilities, which are located
at the site of the occurrence of the natural medicinal resources or territory with the climate
conditions favourable for healing, and in the provision of care are the following
of natural medicinal resources or climatic conditions favourable for healing
used.
(3) the Spa sanatorium rehabilitation care is provided and paid for by as
comprehensive Spa sanatorium rehabilitation care or Government-funded Spa
hospital rehabilitation care.
(4) comprehensive Spa sanatorium rehabilitation care builds on the bed
care or specialized out-patient health care and is focused on
rehabilitation, prevention of disability and the lack or
minimize the extent of the disability. For participants in the sickness insurance scheme is
provides at the time of their temporary inability to work. Of the insured person
summons to a spa hospital rehabilitation care facilities of Spa care.
The insured person in the first order of urgency is to get the Spa hospital
rehabilitation care summoned not later than one month from the date of
exposure draft, or with the agreement of the attending, the review and
Spa doctor is translated into medical equipment provider
Spa sanatorium rehabilitation care directly from the health care facility
provider of inpatient care. In the second order of the urgency of the patient's
summoned not later than within three months, children and adolescents within six months from the
the date of the proposal. Comprehensive Spa sanatorium rehabilitation care is
fully covered by health insurance.
(5) the Contribution of the Spa sanatorium rehabilitation care is provided
insurance policy holders with chronic diseases especially in cases when they are not
compliance with the conditions referred to in paragraph 4. Paid services are only
examination and treatment of the insured person. This care may be given once in a
for two years, unless otherwise decided by the auditing physician otherwise.
(6) Children and adolescents under 18 years of age, the Spa sanatorium rehabilitation care
provides pursuant to paragraph 4, if not at the request of the parents is provided
in accordance with paragraph 5. Transfer of an insured person under 18 years of
medical equipment providers in the medical bed care
the device provider Spa sanatorium rehabilitation care review
the doctor does not qualify.
(7) in the case of occupational disease and other damage to health from work
the Spa hospital provides rehabilitation care referred to in paragraph 4,
If it is recommended or endorsed the expert for indication
occupational disease.
(8) the Spa sanatorium rehabilitation care in accordance with paragraphs 4 and 5, granted to the
the insured person for the first time indication is referred to as the basic treatment
the stay. For more curative stay corresponding indication, based on which it was
made a basic therapeutic stay, is referred to as a recurring therapeutic
stay, if not in annex 5 to this Act provides otherwise.
(9) of the disease, which can be a spa hospital rehabilitation care
provide ways of providing the Spa sanatorium rehabilitation care for
indications, the length of the basic treatment and repeated
treatment for each indication, the frequency of the recurring therapeutic
stay, the time limit for the stay at the onset of treatment indications, where is this period
reasonably provide in terms of therapeutic effect, the possibility of extending
treatment by individual indications and ways of providing
Spa sanatorium rehabilitation care and other professional criteria related
to each of the indications set out in annex 5 to this
law (indication list of Spa care for hospital rehabilitation).
(10) the extension of the length of the basic treatment or
repeated treatment provided as a comprehensive Spa
hospital rehabilitation care, may propose to the competent doctor
medical equipment provider of the Spa rehabilitation clinic
care, if this option is in the appropriate indications indicated in annex No. 5
to this Act. The proposal to extend the treatment is administered
review the health insurance companies, the doctors that the extension and
its length.
(11) the extension of repeated treatment provided as
contributory Spa sanatorium rehabilitation care to 21 days in cases
When was such a stay on the basis of the indications of the resolution proposing the doctor approved
the review by a doctor the competent health insurance company only 14 days in length
(hereinafter referred to as "indicated the case"), your doctor may suggest a competent
medical equipment provider of the Spa rehabilitation clinic
care. The proposal to extend the treatment is administered review doctors
competent health insurance company that the extension and the length of the
hereby approved.
(12) the Ministry of health shall for each indication
display the elements of the draft decree on the Spa hospital
rehabilitation care for adults, children and adolescents, indicating the assumptions
contra-indications, the technical criteria for the granting of Spa Clinic
rehabilitation care including necessary examination, field of specialization
a doctor who recommends such care, requirements on availability
health workers in the clinic provider
Spa sanatorium rehabilitation care and Spa focus indicator
places in which is a natural source or climate
conditions suitable for the treatment of diseases.
§ 34
Care in professional children's hospitals and Sanatorium schools
(1) health care as an essential part of the treatment
process, on the recommendation of the attending physician in children and adolescents under 18 years of age
in the children's specialized hospital and Sanatorium schools shall be borne by the health
the insurance company. Proposal on health care of children's hospitals and in specialized
Sanatorium schools served on the health insurance companies registering
general practitioner, general practitioner for children and adolescents, or attending
physician during hospitalization. Proposal for revision of the relevant doctor confirms
health insurance companies; the review does not consider the transfer of the insured's physician
hospitalization to specialist children's Hospital.
(2) Disease in which children and adolescents under 18 years of age provides health
care in specialist children's hospitals, and the focus of these indicator
hospitals (indication list for health care in specialist children's
hospitals) the Ministry of health shall lay down by Decree. In cases
When the indication to treat in children's specialist hospitals overlap with
indications for the treatment of Spa provider in healthcare facilities
hospital rehabilitation care, decides on the suitability of treatment in
the medical equipment of the provider of the Spa rehabilitation clinic
care or children's specialized hospital care, physician recommended.
The length of treatment in specialist children's hospitals are governed by the
health of the sick, and decides on her head doctor institutes.
(3) for children from three to 15 years due to adverse health weakened
environment, children with health problems associated with
improper lifestyle and children in recovery, whose health
the State does not require specialist treatment in a medical facility
Spa sanatorium rehabilitation care or in a children's specialized hospital,
provides the committed revision draft of the attending doctor doctor
health insurance care in ozdravovně. Length of stay in ozdravovně
does not normally exceed 21 days; extended stay is only possible with the consent of
the review of the doctor.
§ 35
cancelled
section 35a
The transplantation of tissues and organs
Collection of tissues, cells and organs from living or deceased donors, testing
potential donors necessary to assess the fitness for a particular
the recipient, the necessary waste taken from tissues, cells and organs, and
transport of a living donor or to pay his travel expenses and transportation
deceased donor shall be borne by the recipient's health insurance company.
Transport and reimbursement of the travel costs
section 36
(1) the service is paid for by the insured person's transport to the territory of the Czech Republic to the
contract providers, from contract to permanent provider
or to the place of residence or residential social
services between the provider and the provider, as part of the contractual
in the event that the insured person's State of health does not permit the carriage of ordinary
way without the use of medical transport services. If the disease
of the insured occurred in the place of residence, to the place of permanent
the stay, which is more than the place of residence, covered only
If it's according to the attending physician necessitates
the State of health of the insured person. Carriage is performed, the contracting vehicles
medical transport services. If the attending physician indicated
the escort shall be borne by the insured person's sickness insurance fund, which shall be borne by the transport
the insured person, as well as the transport of accompanying persons, and to the same extent
as the transport of the insured person.
(2) the carriage referred to in paragraph 1 shall be borne by health insurance company in the amount of
corresponding to the distance of the nearest provider of contract which is
able to provide the required by the service.
(3) in exceptional cases, or in cases where the
and it's more economical), are paid by the health insurance fund on the basis of
indication of the treating physician and the medical approval and the necessary
air transport,
(b) there is a risk of default), are paid by the health insurance costs and
another provider of health services; for such carriage shall be decided by
the attending physician,
(c)), the person moving mostly in a wheelchair for the disabled and
is indicated by the transport of medical transport for medical reasons
the service is paid by the health insurance company and other carriers, transport if
This transport is provided by means of specially adapted for
transporting people in a wheelchair for the disabled; for such carriage
shall be decided by the attending physician.
(4) if required by the State of health of the insured person absolutely and, if
immediately threatened his life, paid by the health insurance fund in the territory
The United States transport blood products, special healing
products, tissues, cells and organs for transplantation, as well as the transport of
a doctor or other healthcare professional to specialised and
the necessary performance.
§ 37
(1) the health insurance shall be paid to transport doctors and indicated
other health care workers for the insured person.
(2) if the insured person, who is entitled to carriage under section 36,
decides on transport by private car controlled by another person and if the
the attending physician approves such a transport, an insured person has the right to
reimbursement of travel expenses in the amount corresponding to the distance of the nearest
contract provider that is capable of the required health services
provide.
§ 38
Advisory work
The service is paid for and the assessment of temporary incapacity and
temporary inability to study the treating physician and the assessment of
the fact that, pursuant to section 191 of the labour code important personal
obstacles at work, and similar feats for pupils and students.
§ 39
Tour of the deceased insured person and autopsy
The service is paid for by the tour of the deceased insured person, autopsy, transport to
the autopsy to the nearest contract providers, able to specified
type of inspection according to the autopsy of the deceased, and the transport of
the autopsy into the place where the death occurred, or to the place of burial, if
This space the same distance or closer than the place where the person died.
The service is not paid for by the dissections and judicial autopsy and transport to
such execution and from them.
PART SIX
PRICE CONTROLS AND REIMBURSEMENT OF MEDICINAL PRODUCTS AND FOODS FOR PARTICULAR
MEDICAL PURPOSES
§ 39a
The fixing of maximum prices for medicines and foods for special
medical purposes
(1) the maximum prices of proprietary medicinal products and the
foods for special medical purposes, which is based on the price
prescription ^ 23 c) determined by this method of price control, decisions of the Institute.
(2) the Institute shall determine the maximum price of the manufacturer, with the exception of the procedures referred to in
paragraphs 4 to 6, at the rate of
and the average of the prices of the manufacturer) of the medicinal product under consideration, or food
for special medical purposes of the 3 Member States of the European Union, with the
the exception of Bulgaria, the Czech Republic, Estonia, Germany, Luxembourg,
Austria, Romania, Cyprus and Malta (hereinafter referred to as "the land of the reference basket"),
that have the lowest price of the medicinal product under consideration, or food
for special medical purposes, when the medicinal product under consideration, or
food for special medical purposes on the market in at least 3 countries
the reference basket,
(b) the manufacturer of a medicinal product prices), or foods for special medical
the purposes contained in the written agreement closed in the public interest pursuant to section
Article 17(1). 2 health insurance with the holder of the marketing authorisation
of the medicinal product, the importer or domestic manufacturer of food for
Special medical purposes, by the importer or by the promoter of the specific
the treatment program, if the arrangement is concluded for a period of at least 1 year with
at least 3 months ' notice for all supplies of medicinal
medicine or food for special medical purposes on the Czech market
Republic, and if you cannot do this under (a)),
(c)) the producer price of the nearest therapeutically correspond to those of the medicinal
medicine or food for special medical purposes identified in countries
the reference basket or in the Czech Republic, if you can not follow the
letters and) and (b)). If the nearest therapeutically comparable pharmaceutical
product or foodstuff for special medical purposes available in Czech
Republic, then applies its lowest cost manufacturer established in the United
Republic; If in such therapeutically correspond to those of the medicinal
medicine or food for special medical purposes, the holder of the
the decision on the registration of identical to that of the medicinal product under consideration
or foods for special medical purposes, this price shall apply,
If it was established pursuant to subparagraph (a)). If you cannot do this
in a way, it is the lowest price the manufacturer identified in countries
the reference basket. When selecting the nearest therapeutically correspond
medicinal product or foods for special medical purposes
the criteria taken into account in the following order: the active substance,
pharmaceutical form, strength of the medicinal product, the size of the package.
(3) the Ministry of health shall lay down the implementing regulation
and rules for the selection) the vesting period for the conversion of foreign prices from
foreign currency,
(b)) the vesting period and the rules for price and manufacturer for
the assessment of the availability of the medicinal product or foods for special
medical purposes,
(c) maximum above) how the price of a similar product by
paragraphs 4 to 6,
d) rules to exclude foreign producer price levels identified pursuant to
paragraph 2 of the application for the fixing of maximum prices
e) tolerance in the size of the Pack in search of foreign prices
the manufacturer referred to in paragraph 2,
(f) increase the maximum) the prices in the public interest pursuant to section 17
paragraph. 2,
(g) the method of determining the maximum prices) for highly innovative medicinal
products for which the application is made on the fixing of maximum prices in the
the same amount for all strengths of the medicinal product, regardless of the content of the
the active substances,
h) rules relating to notification of the highest price at which the holder intends to
the marketing authorisation for the medicinal product, the importer or the domestic
manufacturer of foods for special medical purposes or an unauthorised
the medicinal product is used in the context of a specific treatment program
indicate a medicine or food for special medical purposes
the market for medicinal products or foods for special medical purposes,
not subject to the control of the producer price fixing maximum prices.
(4) the Institute shall determine the maximum price of a similar product as the maximum
the price of the medicinal product, which is the medicinal product under consideration
similar to, in the case that
and the determination is not required) maximum price in excess of the maximum prices
a medicinal product which is similar to that of the medicinal product under consideration
accordance with the application under section 39f of paragraph 1. 8,
(b) the applicant in the request for) the fixing of maximum prices for similar product
ask for the maximum price in the proceedings under section 39 g of paragraph 1. 9, and
(c) the remuneration does not prevent conditions) pursuant to § 15 para. 6 (a). e) or section
39 g of paragraph 1. 10.
(5) the Institute shall calculate the maximum price of a similar product in the first
the reference group referred to in paragraph 4 and that price will be reduced by
and) 15% in the case that it is a product that was under the law on
Pharmaceuticals registered as a biological medicinal product, in a situation where
the system of payments from health insurance (hereinafter referred to as "the system of payments")
only one similar to a product which has been registered as a biological medicinal product
medicine,
(b) in the case of 32%), that it is a product that was under the law on
Pharmaceuticals registered as a generic medicine in a situation where the system of payments
only one similar to a product which has not been registered as a generic medicine,
c) 15% in the case that it is a product that was not in accordance with the law on
Pharmaceuticals registered as a generic medicine, in a situation where the system of payments
only one similar to a product which has not been registered as a generic medicine.
(6) the Institute shall calculate the maximum price of a similar product in the first
the reference group, for which the conditions are not fulfilled in accordance with paragraph 4,
procedure laid down in paragraphs 2 and 5 and the maximum price shall be fixed at a level which
According to this calculation, the lowest.
(7) the maximum price of the medicinal product as provided for in accordance with paragraphs 5 and 6
You cannot increase the execution of the first following an in-depth revision pursuant to §
39 l.
(8) the maximum price of the medicinal product or foods for special
medical purposes, containing the active substance, which can be used to treat
the disease, which has not yet been influenced by another medicinal product
or food for special medical purposes or represents a major
improvement of the treatment (hereinafter referred to as "highly innovative product"), that is
I know plenty of data on the cost effectiveness or results of your treatment
use in clinical practice, and which is subject to a maximum price regulation
price according to price prescription ^ 23 c), shall be determined in accordance with paragraph 2 (a).
and cannot be determined). If the maximum price referred to in paragraph 2 (a). and)
the maximum price shall be fixed at the average manufacturer prices found in the 2
countries of the reference basket; in cases where you cannot use this procedure,
proceed as indicated in paragraph 2 (a). (b)), or (c)).
The determination of the policy, or changes in the amount and conditions of payment of medicinal products and
foods for special medical purposes
section 39b
(1) the amount and conditions for reimbursement of medicinal products and food for
Special medical purposes shall be decided by the Department. Such a decision may Institute
issue in the case, that the medicinal product has been authorised, or was
approved the use of an unauthorised medicinal product in the context of the
a specific treatment program under a special legal
^ Regulation 42b). In the case of a medicinal product or a foodstuff for special
medical purposes subject to price regulation the maximum price ^ 23 c), Institute of
issues a decision, if this price was fixed or
determination of the maximum price is at the same time with the management about the determination of the amount and
the terms of payment.
(2) in determining the amount and terms of payment in the medicinal product, or
foods for special medical purposes shall be considered
and) its therapeutic efficacy and safety,
(b) the severity of the disease) to which the treatment is intended,
c) submitted by the party to evaluate the cost-effectiveness of and impact of
on the financial resources of health insurance caused by use of
medicinal product or foods for special medical purposes,
by expressing the cost of 1 and the estimated number of patients treated with
for the year, and that in those cases the setting or change of the terms and conditions of payment
or deep or shortened revision for medicinal products or food
for special medical purposes, for which the extension is requested, the conditions
payments to increase the number of patients treated, the increase of the remuneration
compared to the basic payment or other remuneration 1 increased compared to the current
State or over other medicines or food for
Special medical purposes in the reference group,
(d)) in the public interest (section 17 (2)),
e) appropriateness of the route of administration, dosage form, strength and package size,
(f)) to the normal dosage,
(g) the necessary duration of treatment),
h) the level of synergies between the person to whom it is given,
I) its substitutability another medicine or food for
Special medical purposes, paid from health insurance and compare
their prices and remittance with the price set by the medicinal product under consideration
or foods for special medical purposes,
(j) the estimated impact of the remuneration) the financial resources of the health
insurance,
k) best practices professional institutions and experts, and it's always from the
the perspective of cost effectiveness and taking into account the impact on the financial
health insurance resources.
(3) the Institute may provide remuneration for an unauthorised medicinal product,
If its use is sufficiently justified by current scientific
knowledge and treatment is the only option, or if its use of cost
efficient compared to available therapy, and for the period of the approved
a specific treatment program ^ 42b). The Department may provide for the payment by the
authorised medicinal product for the indication in the summary of
product not listed, if the use of the medicinal product is sufficiently
justified by current scientific knowledge and if the use of the
of the only treatment options, or if it is cost effective in
comparison with existing treatment.
(4) a similar product for the purposes of this Act, a medicinal
a product that has the same active substance or active substances and the same
or similar pharmaceutical form of the medicinal product with borne, which is
in principle, therapeutically interchangeable. Additionally, similar with means
a biological medicinal product which is similar to a biological substance or
biological substances and the same pharmaceutical form or similar with borne
medicinal product, which is in principle, therapeutically interchangeable.
The first similar product means a similar product for
that is the request for the fixing of the maximum price or amount and conditions
payment of the first in the sequence.
(5) the Institute shall determine the amount of payment under consideration of a similar product by
the amount and conditions of payment of the medicinal product, which is a medicinal product under consideration
the preparation is similar to, in the case that
and is not required to determine the amount) and the conditions of payment beyond the amount and
the terms of payment of the medicinal product, which is a medicinal product under consideration
the preparation is similar to that in accordance with section 39f of paragraph 1. 8,
(b) the applicant in the request for) fixing the amount and conditions of payment of a similar
the product requests a determination of the amount and terms of payment in the proceedings under section
39 g of paragraph 1. 9,
(c) the remuneration does not prevent conditions) pursuant to § 15 para. 6 (a). e) or section
39 g of paragraph 1. 10 and
(d) whether or not the request is made) on the fixing of maximum prices pursuant to § 39a para. 4
or 5, if the medicinal product or foodstuff for special medical
purposes shall be subject to price regulation.
(6) the Institute calculates the amount to be paid for a similar product in the first reference
the group referred to in paragraph 5 and this payment will decrease in the manner prescribed in
§ 39a para. 5.
(7) in the event that the first similar product in the reference group
does not meet the conditions referred to in paragraph 5, the Institute calculates the amount of payment
pursuant to section 39 c of paragraph 1. 8 and this further reduces the remuneration referred to in paragraph 6.
(8) the Department with legal force of the decision determining the amount and terms and conditions
the remuneration referred to in paragraph 6 or 7 shall forthwith initiate the procedure pursuant to § 39 c
paragraph. 9.
(9) to change the decision on the registration or transfer of registration of medicinal product
the medicine has no effect on a fixed maximum price or amount and conditions
payment of an authorised medicinal product if the change registration
or transfer the registration not to change, which can have a direct impact
the maximum price or the amount of, or conditions for reimbursement.
(10) a medicinal product or a food for special medical purposes can be
even without the proposal to lay down the conditions for reimbursement
and) if so required by the professional point of view or the point of view of safety associated with the
treatment with this medicine or food for special medical
purposes,
(b)) if the knowledge achieved in the framework of the research or the use of the
medicine or food for special medical purposes results in practice,
that medicine or food for special medical purposes has
a significant therapeutic value for certain groups of patients,
certain indications or clinical practice under certain conditions,
(c)) if it is necessary to ensure the effective and efficient
the use of the medicinal product or foods for special medical
purposes,
(d)) with respect to highly costly, the cost for the year are
at least one-tenth of the gross domestic product for 1
the person in the Czech Republic for the previous calendar year,
(e)) in cases where the limit exists and is applied in the
countries of the reference basket, or in other Member States
Of the European Union.
(11) the Institute provides for a medicinal product or a foodstuff for special
medical purposes in addition to the above terms and conditions of payment of the corresponding base
payment reference group and one other remuneration increased, where
This increased remuneration was appropriate on the basis of the evaluation of the active substances, medicinal
medicine or food for special medical purposes or dosage forms
for a selected indication or for a particular group of patients. For the determination of
the increased remuneration, the provisions for determining the reimbursement of medicinal products
medicines and foods for special medical purposes, by analogy.
(12) the amount of the reimbursement of medicinal products consisting of two or more medicinal
substances for which there is more than 1 active substance separately remunerated,
provides for the
and the sum of the payments for the usual) daily therapeutic dose of relevant
separately payable by active substances laid down pursuant to § 39 c of paragraph 1. 7,
(b)) of the highest producer price contained in the written agreement referred to in section
39A para. 2 (a). (b)), if the latter price is lower than the remuneration is calculated
According to subparagraph (a)),
(c) the amount of payment) contained in the written agreement under section 39 c of paragraph 1. 2
(a). (d)), if the payment is lower than the remuneration, calculated in accordance with subparagraphs
and) and (b)),
(d)) at the rate of the producer price recorded in any country of the European Union for the
each individual medicinal product with the same combination of active substances and
their content, if this price is lower than the remuneration calculated in accordance with
letters and), b) and (c))
(13) the amount of the reimbursement of medicinal products consisting of two or more medicinal
substances for which there is only 1 active substance separately paid, shall be adopted
and the price the manufacturer) found in any country of the European Union for the
each individual medicinal product with the same combination of active substances and
their content,
(b)) of the highest producer price contained in the written agreement referred to in section
39A para. 2 (a). (b)), if the latter price is lower than the remuneration is calculated
According to subparagraph (a)),
(c) the amount of payment) contained in the written agreement under section 39 c of paragraph 1. 2
(a). (d)), if the payment is lower than the remuneration, calculated in accordance with subparagraphs
a) and (b)).
(14) the Ministry of health shall lay down the implementing regulation
and) the rules and limits for increase or decrease of the remuneration referred to in paragraph 2
compared to the set basic remuneration having regard to the characteristics of the period
medicinal product or foods for special medical purposes in
compared to the other, in principle, therapeutically interchangeable medicinal
products or foodstuffs for special medical purposes,
(b)) the level of remuneration of a similar method of conversion of the product in accordance with paragraphs 5 to
7,
(c)) use of the procedures under section 39b to 39i for setting or changing the amount and
conditions of reimbursement of medicinal products consisting of two or more medicinal
substances,
d) procedure for the determination or changing the amount and conditions of payment of medical
medicines and foods for special medical purposes, in the form of liquid
non-split pharmaceutical forms,
(e) the method of determining the remuneration) of the medicinal products for which a
a request for a determination of the payment of the same amount for all the forces, regardless of the
the content of active substances,
(f) determining the conditions) rules for payment in the form of preskripčních and
restrictions and payment methods,
g) procedure for determining reimbursement of medicinal products including high
innovative products.
§ 39 c
(1) the Institute marshals the medicinal product in the context of proceedings under section 39 g to
reference group, where, in the course of the procedure proves that the given
reference group does not belong. The remuneration of the medicinal product shall be at the
the basis of the basic remuneration of the reference group to which the
preparation is classified. The basic remuneration is the payment for the usual daily
therapeutic dose of medicinal substances contained in medicinal products and
is the same as for the whole of the reference group. Reference groups are
the groups of medicinal products, in principle, therapeutically interchangeable with
similar or close to efficiency and safety and similar clinical
using the. The list of reference groups, provides for the Ministry of health
an implementing regulation.
(2) the basic remuneration in reference groups shall be
the lowest price of the manufacturer) attributable to the daily therapeutic dose
medicinal product or foods for special medical purposes
included in the reference group, found in any country of the European
the Union for medicine or food for special medical purposes
available in the Czech Republic; a medicine or food for
Special medical purposes is available on the market in the Czech Republic means
medicine or food for special medical purposes, which
share of the total sales volume, in principle, therapeutically interchangeable
medicinal products or foods for special medical purposes,
containing the same active substance, in the period amounted to at least 3%,
If this is not the first to third a similar medicine in the healing substance in order
by the time of application for the fixing of the amount and conditions of payment, or
the medicinal product in respect of which the manufacturer or pay the highest price was
concluded a written agreement; such medicinal products shall always be deemed
available on the market in the Czech Republic,
b) daily cost other therapy reduced the margin and
applied to value added tax, if a comparably efficient and cost-
effective compared with taking the medicinal product or food for
Special medical purposes under subparagraph (a)), and these facts are the Institute of
When the basic remuneration, taking into account the necessary
length of therapy medicinal product or a foodstuff for special medical
purposes and the necessary period of comparable treatment,
(c)) the highest producer price contained in the written agreement pursuant to § 39a para.
2 (a). (b)), if the latter price is lower than the remuneration, calculated in accordance with subparagraphs
a) and b), if the holder of the marketing authorisation of the medicinal product,
the importer or domestic manufacturer of foods for special medical purposes,
the importer or the submitter of a specific treatment program did not make in the
the last 2 years the administrative offense under § 39q para. 1 (b). (b)),
(d)) the remuneration included in the written agreement closed in the public interest
all health insurance companies with the holder of the marketing authorisation
of the medicinal product, the importer or domestic manufacturer of food for
Special medical purposes, if not committed in the last 2 years
the administrative offense under § 39q para. 1 (b). (c)), if the payment of the
lower than the remuneration, calculated in accordance with subparagraphs), b) and (c)), if the arrangement
closed for at least 1 year with at least 3 months ' notice for
all supplies of medicinal products or foods for special medical
the purpose of the market of the Czech Republic, and if its part of the commitment that the medicinal
product or foodstuff for special medical purposes for
the validity of this agreement available on the market in the United States, and the price for
the final consumer of such medicine or food for
Special medical purposes does not exceed the maximum possible reimbursement for the final
of the consumer.
(3) the basic remuneration in the reference in principle interchangeable groups
medicinal products whose therapeutic efficacy is low, do not use
the causal treatment of diseases, or are used to treat non-serious
disease is less than 60% of the remuneration referred to in paragraph 2.
(4) the provisions on reference groups on the medicinal product, or
food for special medical purposes, which cannot be classified in
reference group, or group of medicinal products or food for
Special medical purposes, in principle, therapeutically interchangeable, that
cannot be assigned to any reference groups, apply mutatis mutandis.
(5) in the event that, in the determination of remuneration under section 39b-39e was not in
some of the groups of active substances referred to in annex 2 of this Act,
regardless of the therapeutic interchangeability of at least 1 medicine
fully paid, the Department shall adjust the remittance decision so that the least expensive
medicinal product from a group of medicinal products has been fully assessed
paid.
(6) the Ministry of health may determine an implementing regulation
reference group, in which the health insurance fund may amount to be paid
medicinal products or foods for special medical purposes to enhance and
modify the conditions for reimbursement for the benefit of the patient above the level set
By the Institute. Health insurance fund is required to access when you deviate
modify the above terms and conditions of payment to all other medicinal products or
foods for special medical purposes listed in the reference group
as well.
(7) the basic remuneration reference groups will be established in the framework of the deep
or abbreviated revision of payments and is valid until the following revision changes
remittances. Similarly in the determination of the next higher remuneration pursuant to §
39B para. 11.
(8) unless otherwise provided by this Act, in proceedings for the setting or change of
the amount and conditions of payment to the payment made to the changes to the base
following the revision of the system used for the establishment or modification of the level of remuneration
all, in principle, therapeutically interchangeable medicinal products and food
for special medical purposes, the amount of the basic remuneration reference group
determined in accordance with paragraph 7; This does not apply if the applicant referred to in section
39f para. 2 (a). and) or (b)) was designed, the amount and conditions for reimbursement
more cost effective.
(9) in the case that was in accordance with section 39b para. 6 or 7 set
the first payment of a similar product in the reference group, which
and according to the law) was on pharmaceuticals registered as a generic medicine,
the basic payment established pursuant to paragraph 7 of 32%,
(b)) was not according to the law on medicinal products registered as a generic medicine,
the basic payment established pursuant to paragraph 7 of 15%,
(c)) was according to the law on medicinal products registered as a biological medicinal product
the product reduces the basic remuneration referred to in paragraph 7 by 15%.
(10) the reduction of the basic remuneration referred to in paragraph 9 shall be carried out according to the procedure
laid down in § 39p.
(11) the Ministry of health shall lay down the implementing regulation
and the required properties of the medicinal product) for the procedure under paragraph 2
(a). and)
(b) the determination of the basic details of the remuneration),
(c) the vesting period for the assessment of) the availability and price of the manufacturer
under section 39b and 39 c,
(d) the rules for the assessment of the presence) of the medicinal product, or
foods for special medical purposes on the market,
e) rules for the increase and decrease of the basic remuneration in the public interest,
f) assessment criteria of medicinal products or foods for particular
medical purposes, whose therapeutic efficacy is low, they are not
giving rise to the treatment of diseases, or are used to treat non-serious
disease,
g) the method of determining the typical daily therapeutic dose
(h) the procedure for determining the base) of the remuneration referred to in paragraph 5, including
the required properties, the least expensive of the medicinal product.
§ 39d
The principles for remuneration to the highly innovative products
(1) if it is in the public interest (section 17 (2)), the Institute shall decide on the amount and
conditions of temporary payment of highly innovative product that is
I know plenty of data on the cost effectiveness or results of your treatment
use in clinical practice, and that's only if warranted by the available
in the absence of enough information benefit highly innovative product for
treatment and if it satisfies the highly innovative product the other conditions for
the determination of remuneration and, if paid from public funds at least 2
countries of the reference basket. When the basic remuneration, the Institute shall proceed
pursuant to § 39 c apply mutatis mutandis.
(2) the amount and conditions of the temporary payment is fixed at 24 months and can be
fix it again, up to a further 12 months. For such other
determination of temporary payment, you must submit the results of reviews
laid down in paragraph 3, the application must be made no later than 6
months before the expiry of the period for which was the first temporary settlement
established. The second interim payment shall be determined pursuant to § 39 c of paragraph 1. 2 to 5,
the provisions of § 39 c of paragraph 1. 8 does not apply. Between the terms of payment of the highly
the innovative product is always filing for specialized work.
(3) The requirements for an application for a temporary payment shall apply section 39f of paragraph 1. 1,
5 to 11. The applicant is also required to demonstrate how the
shall ensure
and the interim evaluation of the therapy under consideration) highly innovative
with,
(b) impact, offers temporary payment) on the financial resources of the health
insurance,
(c) evaluate the cost-effectiveness of),
(d)) to cover costs on the rehabilitation of a patient with highly innovative
After the expiry of the period for which temporary settlement was established, until the
transferring a patient to another therapy.
(4) in proceedings for the determination of temporary payment and in proceedings relating to the determination of the amount and
conditions of payment after the expiry of the temporary payment, section 39 c of paragraph 1. 8 does not apply, and
The Institute provides for reimbursement under section 39 c of paragraph 1. 2 to 5.
(5) in the event of a breach of the undertaking referred to in paragraph 3, the Institute will not admit
considered highly innovative product second temporary cover.
(6) the Ministry of health shall lay down the implementing regulation
the elements of the undertaking referred to in paragraph 3, the conditions under which
specialised workplaces can be a highly innovative product, and
support criteria and procedures for the assessment, whether the medicinal product is
highly innovative, with the highly innovative product should always be
designed for the treatment of highly serious illnesses.
(7) a specialized institution, which may bring a highly innovative
the product on the basis of a special contract under § 15 para. 10, is required to
to provide, at the request of transmission of data related to assessing the effectiveness and
the position of the highly innovative product in clinical practice, health
the insurance company, and in promotional marketing authorisation holder
This medicinal product. The range of the data transmitted to health
the insurance company and the marketing authorisation holder of highly innovative
of the Ministry of health shall lay down the implementing
provision.
section 39e
Úhradová contest
(1) in order to ensure a fully covered by medicinal products and savings
resources health insurance Institute may enlist in a contest for the lowest
reimbursement of medicinal product (hereinafter referred to as "úhradová"), if its
the notice will ask the health insurance company. Úhradovou competition can be listed in the
the active substances and formulations, in which occur the healing
products from at least 3 marketing authorisation holders. In the reimbursement
the contest participants offer the lowest payment attributable to the usual
daily therapeutic dose and undertake to place on the market medicinal products
the corresponding request reimbursement of the competition so that their price for
the final consumer does not exceed the maximum possible reimbursement for
the final consumer.
(2) the Úhradová contest is carried out by means of the electronic auction. Electronic
the auction means the process of evaluation of the tenders, in which
the participant uses the electronic tools for the presentation of new
reduced tender values. A participant in the price competition is the holder of the
of the marketing authorisation that has fulfilled the conditions of qualification. Qualifications
shall mean verification of eligibility for fulfilment of the obligation of reimbursement of the competition.
(3) the request for invitation to tender the competition must always include
and affirmative representations of the Ministry of health) with an application on
invitation to tender competition,
(b)) the designation of the active substances and formulations, in the framework of which a notice of
reimbursement of the competition asks.
(4) Furthermore, the request typically contains
and the content of the active substance) in medicinal products, whose full
payment must be ensured, or úhradovou competitions required dose,
to be achieved by the unit of the pharmaceutical form of medicinal products
preparations or their division or times use (hereinafter referred to as
"the content"),
(b)) the minimum number of usual daily therapeutic dose in the package
medicinal products whose full remuneration must be úhradovou competitions
assured.
(5) the Institute shall notify the initiation of reimbursement of the contest within 30 days from the date of submission of the
the application in your Journal, and in a way allowing remote access.
The notification shall contain
and labelling of the active substance) and formulations, in the framework of which úhradová
competition prints,
(b) the number of the usual daily) of therapeutic doses of this active substance, and
pharmaceutical forms distributed on the Czech market for 18 months
prior to the initiation of reimbursement of the competition,
(c)) the conditions of qualification
(d)) the deadline by which it is possible to qualify to participate in the tender competition,
that is at least 15 days from the date of publication of the notice in the Gazette,
e) instruction on the course of the reimbursement of the competition,
(f) additional requirements arising from) the request referred to in paragraph 4.
(6) can qualify only the marketing authorisation holder of the medicinal
product available under section 39 c of paragraph 1. 2 (a). and) and containing the
the active substance in the dosage form in the application referred to in paragraph 3, which
for the last three years did not make the administrative offense under § 39q para. 1
(a). (d)). the condition of qualification for participation in the tender competition is further
specifications for medicinal products) the content that will be
placed on the Czech market in the case of winnings in the competition with the payment of the reimbursement
the corresponding decision in competition and a maximum reimbursement for the price for
the final consumer, not exceeding the maximum possible reimbursement for
the final consumer,
(b)) a written declaration of commitment to supply in the event of winning in the reimbursement
competition on the Czech market medicinal products referred to in point (a)) for the price for
the final consumer, not exceeding the maximum possible reimbursement for
the final consumer, and evenly over a period of 18 months from the date of
the enforcement of such a decision, and to the extent of at least half of the
the usual daily consumption of therapeutic doses in the medicinal substance, and
pharmaceutical form, distributed on the Czech market for 18 months
prior to the initiation of reimbursement of the competition.
(7) Department of the resolution decides that a person who or when prompted to
compensate for the lack of Administration did not fulfil the conditions of qualification, is not
participant. Against that order can be appealed.
(8) If a reimbursement is not participating in the competition at least 2 participants, Institute of
úhradovou contest by order of stops.
(9) the Institute participants reimbursement at least 7 days in advance of the competition shall notify the date
and the exact time of the implementation of the electronic auction. Notice under this
paragraph shall be delivered only a public decree in a manner allowing
remote access, and shall be deemed received on the tenth day after
off-hook. The notification also contains
and information on the number of participants) reimbursement of the competition,
b) opening auction value that corresponds to a valid basic pay
active substance and formulations for the usual daily therapeutic dose,
c) instruction on the course of the electronic auction,
(d)) information related to the used electronic means and other
technical information necessary for electronic communications in the context of the
electronic auctions,
(e) determining the minimum difference) for individual administration of decreasing auction
value, which corresponds to approximately 1% of the base payment for the usual daily
therapeutic dose of the drug substance and dosage form.
(10) electronic auction in the reimbursement of the contest takes place the day and time
provided by the Institute and notified the participants referred to in paragraph 9 and has only 1
bike. The Institute to issue a decision not to disclose the identity of the participants
reimbursement of the competition.
(11) electronic auction takes at least 30 minutes. Each administration, reducing
the auction value of 29. minute, extended the duration of the electronic auction
about another minute from this administration. Throughout the electronic auction is
The Institute is obliged to disclose information about the participants is currently the lowest
auction value.
(12) if the lowest auction value reached in electronic
the auction is at least 2% lower, than the opening value of the auction, the Department of
úhradovou contest by order of stops.
(13) the stopping of the reimbursement of the competition referred to in paragraphs 8 and 12, the Institute shall notify the
participants and make communication about it in their Journal and the way
allowing remote access. Against the resolution terminating the reimbursement
competition cannot be appealed.
(14) if the úhradová contest is not stopped, the Institute shall issue, within 7 days after
their electronic auction in reimbursement decisions, which
receives the lowest auction value (hereinafter referred to as "taken by the auction value").
The decision is delivered to the participants of the competition, and can be a "settlement against him
appeal. In the operative part of the decision, the Institute shall indicate the
and the list of participants) reimbursement of the competition,
(b) the designation of the party) offered the lowest auction value (hereinafter referred to as
the "winner"),
(c)) adopted the auction value
(d)) the designation of medicinal products requested content that will be put
on the Czech market with payment of the corresponding auction value received (hereinafter referred to as
"products"),
(e) the determination of the obligations of the winner) to supply medicinal products to the desired
the content, for which it was adopted the auction value at the price on the Czech market for
the final consumer, not exceeding the maximum possible reimbursement for
the final consumer, and evenly over a period of 18 months from the date of
enforceability of a judgment in the amount corresponding to at least half of the
the usual daily consumption of therapeutic doses in the medicinal substance, and
formulation of distributed on the Czech market for 18 months
prior to the initiation of reimbursement of the competition (hereinafter referred to as "the obligation of reimbursement
the competition ").
(15) in the preamble to the decision of the Institute shall, in particular,
and) list of people who meet the conditions for qualification in the reimbursement
the competition, on the grounds
(b) a summary of the course of the reimbursement) competition.
(16) following the entry into force of the decision on the reimbursement shall contest the
the result of the reimbursement of the competition notice, which shall be published within five days in a way
allowing remote access and in your Journal, and which contains the
information from the grounds of the decision in the tender competition.
(17) following the entry into force of the decision on the reimbursement Department of competition to 10
the days of initiating the procedure on changing the amount of remuneration and the conditions of medicinal products
that contain the same active ingredient and the same pharmaceutical form as the
received products. In this procedure, the Institute changed the amount of payment received
products according to accepted auction values and other medicinal products
changes the amount of payment according to 75% of the value of the auction, and received it on time
the validity of the tender competition, the violation of this obligation, or
to fulfill this commitment, the waiver. Conditions for reimbursement in this
control does not change. The parties are persons referred to in section 39f of paragraph 1. 2.
The first act in this control is the issue of the decision. The appeal against the
This decision does not have suspensory effect. The decision is enforceable on the day
enforceability of a judgment in the price competition.
(18) decision on the reimbursement shall be enforceable on the first day competition of the fifth
calendar month following the acquisition of its legal power.
(19) for the duration of the obligation of reimbursement of medicinal products, the competition
containing the active substance and the pharmaceutical form in which it was issued
the decision on reimbursement, paid in the amount provided for in paragraph 17;
enforceability of the terms and conditions of payment set out above to these medicinal products
in proceedings pursuant to § 39 g is hereby suspended.
(20) the provisions of paragraph 7 shall not prevent the initiation and conduct of the proceedings and issue
the decision to establish or change the amount and conditions of payment of medical
the products referred to in this paragraph, as well as perform an in-depth or
short review reference group, to which it belongs, including the
These medicinal products. Such a decision is enforceable on the expiry of
the period of validity of the reimbursement of the contest, is a violation of this commitment,
the obligation to observe this obligation to release, or under paragraph 25.
(21) from the date of enforcement of the decision on the reimbursement is the winner of the competition
obliged to fulfill the obligation of reimbursement of the competition. The Institute may winner
by a decision of exemption from the obligation to fulfil the obligation of reimbursement if
winner proves that there has been such and not caused by him in advance
unpredictable material change in the conditions under which you can no longer
reasonably required to fulfil the obligation of reimbursement of the competition. Such
the decision is enforceable in the first day of the calendar month following
After a month in which came into legal force. On the day of the enforcement of this
the provisions of paragraph 19 of the decision does not apply and the obligation of reimbursement
the competition is valid.
(22) in the case of an infringement of the obligation of reimbursement under section competition
39q first day of the next calendar month, with the provisions of the
paragraph 7 shall not apply and the commitment of the reimbursement of the competition will be cancelled.
(23) the next úhradovou competition can be in the same active ingredients and pharmaceutical
forms of launch soon after 10 months from the date of enforcement
the previous decision on the reimbursement. The inaugural auction value
auction value is received from the previous decision on the reimbursement.
(24) in the next contest for reimbursement listed medicines of the same
active substances and pharmaceutical forms is not the lowest auction value reached in
electronic auction of at least 2% lower than the opening auction value has
the former winner of the ability to deliver the Institute's proposal to extend the existing
the auction received value and its obligation of reimbursement for the period
the next 18 months. The proposal must be delivered to the winner's 30 calendar days after the
stop reimbursement of the competition, or at least 30 calendar days before
the expiry date of the reimbursement of the contest in the event that additional
úhradová competition has not been announced. For the submission of the proposal the provisions of the
paragraph 6 similarly. In this case the Department of his proposal without delay
will meet.
(25) in the case that after the period of validity of the tender competition the Institute of
Decides in deep or shortened revision amending the above terms and conditions
the remuneration received by the preparations so that the level of remuneration is less than the amount
the remuneration provided for in paragraph 5, the provisions of paragraphs 19 and 23,
does not apply and the commitment of the reimbursement of the competition will be cancelled. Such
the decision shall be enforceable pursuant to section 39 h of paragraph 1. 3.
section 39f
The request for the fixing of maximum prices and the request for the fixing of terms and conditions
payment of the
(1) an application for the determination of the maximum price or request for determination of the amount and
the terms of payment shall be submitted individually for each pharmaceutical form of the medicinal
product or foods for special medical purposes.
(2) an application for the determination of the amount and terms of payment may be made by
and) the marketing authorisation holder of the medicinal product, if the medicinal product
authorised ^ 42b), and the importer or domestic manufacturer of food
for special medical purposes,
(b)) or importer or domestic manufacturer of the medicinal product, if it imported
or produced medicinal product used in the territory of the Czech Republic in
under the specific treatment program or another promoter
a specific treatment program ^ 42b),
(c)) the health insurance fund.
(3) the request for the fixing of maximum prices may be made by persons referred to in
paragraph 2 (a) and (b)).) The persons referred to in paragraph 2 (a). (c)) can
application may be made only if the medicinal product or foodstuff for
Special medical purposes shall be subject to the regulation of the maximum price and its
the maximum price is higher than price calculated pursuant to § 39a para.
2, or the maximum price has not been determined.
(4) the Institute shall initiate the procedure for the fixing of maximum prices or determining the
the amount and conditions of payment, even ex officio, if the determination of the maximum
the price or the determination of the amount and terms of payment of the public interest.
(5) an application for reimbursement must contain
a) name or business name, identification number of the person if
granted, the address of the applicant,
(b) the name of the medicinal product) code assigned by the Institute, is a medicinal
product is authorised,
(c)), pharmaceutical form, package sizes, the method and route of administration,
d) for unregistered medicinal products or foods for particular
medical purposes, an indication of its composition, with an indication of the active substance
international non-proprietary name recommended by the World Health
Organization, where such name exists, the
e) therapeutic indications, for which the remuneration is being suggested,
f) quantifiable and genotypic expected results and the reasons
Pharmacotherapy, to be achieved by the inclusion of a medicinal product or
foods for special medical purposes into the system of payments of health
insurance for all indications, for which the remuneration is being suggested, laid down
on the basis of objective and verifiable criteria,
g) dosage, defined daily dose recommended by the world
the World Health Organisation and the usual therapeutic dose for
therapeutic indications, for which payment is required, the number of daily benefits in
packaging,
(h) the amount of payment) the proposed in Czech Crowns per therapeutic
the daily dose, the proposed additional conditions for reimbursement,
I) proposed the maximum price of the medicinal product or food for
Special medical purposes in Czech Crowns, if the medicinal product is subject to
price regulation the maximum price and the price has not been established,
price calculation in the event that the price of the medicinal product or food for
Special medical purposes is guided under the price regulations, where applicable,
the proposed market price, if the medicinal product or foodstuff for
Special medical purposes is not affordable.
(6) the applicant shall attach to the request
and the results of the clinical trials available), indicating the benefits with which
were carried out, farmakoekonomických study evaluation, in particular the analysis of
cost effectiveness and impact analysis on financial resources
health insurance (hereinafter referred to as "impact analysis"),
(b)) the differences in the summaries of product characteristics, if a product is in the Member
States of the European Union authorised the national registrations and individual
summaries are substantively different,
(c) a list of the States of the European Union), in which the medicinal product is
or food for special medical purposes, present, indicating the
the relevant trade name, manufacturer, price, amount and conditions of payment
out of public funds and an affidavit of the applicant, that is a
product or foodstuff for special medical purposes as referred to
conditions in individual countries, traded,
d) basic data on the costs of existing treatment options, or
Pharmacotherapy with an estimate of the impact of the medicinal product under consideration, or
foods for special medical purposes on the health resources
insurance; the estimated consumption and estimated the number of patients treated with
the medicine or food for special medical
purposes,
e) proposal to set higher remuneration under section 39b of paragraph 1. 11 the definition,
for that group of patients, or the indication is to be determined and its
in the preamble,
(f) the interim arrangement), health insurance companies, if they relate to the volume of
supply, prices or payments to the circumstances of the medicinal product, or
foods for special medical purposes, done in the public interest (section 17
paragraph. 2) with the holder of the authorisation, if it is to such an agreement by the manufacturer
empowered by, or with the manufacturer or importer of a medicinal product or
foods for special medical purposes,
(g) a copy of the decision on the specific) treatment program ^ 42b), unless
medicinal product is authorised.
(7) the structure of the data and the requirements of the documentation referred to in paragraphs 5 and 6
the Ministry of health shall lay down the implementing legislation.
(8) the applicant for a determination of the amount and conditions of payment is not obliged to submit
the supporting documents referred to in paragraph 5 (b). (f)) and paragraph 6 (a). a), b), (d))
and (e)), if the medicinal product or foodstuff under consideration for special
medical purposes is similar with the medicinal product, or
food for special medical purposes, which has already been in the Czech Republic
fixed remuneration, and, in principle, therapeutically interchangeable, and
the applicant does not request an increase in the basic remuneration or payment in different
indications. If the proposed use of the medicinal product or a foodstuff
for special medical purposes different from use in principle, therapeutically
assimilated to a medicinal product or foods for special medical
the purpose to which the applicant refers, or to be a medicinal product, or
food for special medical purposes being used with different objectives
Pharmacotherapy, in different doses or different therapeutic indications,
the provisions of the first sentence shall not apply.
(9) an application for the determination of the maximum price shall contain the details and attachments
in accordance with paragraph 5 (b). a) to (c)) and i) and pursuant to paragraph 6 (b). (c)), and (f)).
If the applicant at the same time asking for a determination of the amount of the remuneration,
a separate application to establish maximum prices only to requests for
remuneration shall be asking at the same time fixing the maximum prices.
(10) an applicant referred to in paragraph 2 (a). (c)) shall be attached to the request only
the supporting documents referred to in paragraph 6 (b). d) to (f)).
(11) the applicant who submitted the request for the fixing of maximum prices, or about
determining the amount and terms of payment, is entitled to mark some of the
the information contained in the request or in the annexes to the application in the subject
trade secret ^ 42d). For the subject of a trade secret pursuant to
This Act cannot be marked
and the trade name of the medicinal product), and the code allocated to the Institute when
medicinal product is authorised, or trade name of food for
Special medical purposes,
(b) identification of the applicant)
c) quantifiable and genotypic expected results and the reasons
Pharmacotherapy, to be achieved by the inclusion of a medicinal product or
foods for special medical purposes into the system of payments of health
insurance,
d) for unregistered medicinal products the indication of the composition
the active substance of the preparation, with mention of the international non-proprietary name
recommended by the World Health Organization, where such name
There are,
e) dosage, defined daily dose recommended by the world
the World Health Organisation and the usual therapeutic dose for
therapeutic indications, for which payment is required, the number of daily benefits in
the packaging referred to in paragraph 5,
f) results of available clinical trials, indicating the benefits with which
were carried out, farmakoekonomických study evaluation, in particular the analysis of
cost effectiveness and impact analysis referred to in paragraph 6,
g) trade names, price, amount and conditions for reimbursement from public funds
the method of payment or its limitations in the countries of the European Union, where there is a
the product traded in accordance with paragraph 6,
h) the comparison of the information contained in the summaries of product characteristics in accordance with
paragraph 6,
I) substantial part of the arrangements for the prices of the medicinal product or a foodstuff
for special medical purposes and their validity, contained in the
agreements with health insurance companies in accordance with paragraph 6,
j) basic data on the costs of existing treatment options, or
drug therapy, with an estimate of the impact on health insurance resources
the estimated consumption and estimated the number of patients treated with the
a medicine or food for special medical purposes.
(12) for the subject of a trade secret can be highly innovative
preparations to mark the selected part of the contractual arrangements entered into between the
the persons referred to in paragraph 2, that govern the impact of remuneration on offers
the financial resources of health insurance or that may have an impact on the
cost efficiency, including the data referred to in paragraph 11 (a). (c)),
(f)) and i).
§ 39 g
The procedure for the fixing of maximum prices and the procedure for determining the amount and terms and conditions
payment of the
(1) a party to the proceedings on the fixing of maximum prices and the procedure for the determination of the
the amount and conditions of payment are persons who have submitted an application, health
insurance companies, if they are not persons that made the request, the marketing authorisation holder,
in the case of an authorised medicinal product, importer or domestic manufacturer,
in the case of an unregistered medicine used in the approved
a specific treatment program, or a food for special medical
purposes.
(2) the Institute shall decide on the maximum price and the amount and terms of payment
no later than 75 days from the date on which the proceedings were initiated; in the case of
the common procedure for the setting of maximum prices and the determination of the amount and
the terms of payment shall be the period of 165 days.
(3) the Institute of the request of the person referred to in § 39f para. 2 (a). and) or (b))
granted when the proposed maximum price is less than the maximum price
the calculated pursuant to § 39a para. 2 to 6 or less is the proposed level of remuneration
than the amount of remuneration calculated according to § 39 c and adjusted in accordance with section 39b.
(4) in deciding on the amount and conditions of payment of the Institute of medicine
or food for special medical purposes provides for payment pursuant to § 39 c.
In determining the amount and terms of payment of the medicinal product, or
foods for special medical purposes, the payment of increases or decreases in
the basis of the assessment of the conditions laid down in section 39b para. 2 way
laid down in the implementing regulation.
(5) the parties to the proceedings are entitled to propose evidence and do other
15 days of the initiation of proceedings; This time limit may, by resolution of the Institute of
extended. Parties to the proceedings have the right to comment on the background for
decision within 10 days from the date of notification of the communication of their
discovery of documents for decision; This time limit may, by resolution of the Institute of
extended.
(6) if in the course of the procedure for the determination of the maximum price or the procedure for
determining the amount and terms of payment to changes in the data submitted, and
documentation, the applicant is obliged to immediately notify the Institute these changes.
(7) in proceedings relating to the fixing of maximum prices, in proceedings relating to the determination of the amount and
conditions of payment, as well as in proceedings on the amendment or revocation as set out
the maximum price or terms and conditions of payment set out above shall apply
the provisions on the management of a large number of participants in accordance with the administrative
order ^ 42e).
(8) the Institute collected price reference medicinal products and food
for special medical purposes and details of their availability and the presence of
shall be deemed correct if the party to the proceedings is not to the contrary.
(9) if the conditions of section 39b para. 5 and 6 and article 39f of paragraph 1. 8 and
If he fails, according to paragraph 10, the Institute shall decide within a period of 30 days from the
the initiation of proceedings. Will not issue a decision within the time limit under the first sentence, the
consider that sets the amount of and conditions for reimbursement in accordance with section 39b para. 5 and 6
or the maximum price in accordance with § 39a para. 4 and 5. Decision referred to in
the second sentence is enforceable in accordance with section 39 h of paragraph 1. 3. in proceedings under
the first sentence of the provisions of paragraphs 2, 4 and 5 shall not apply and the participants
control is given the opportunity to comment on the background to the decision referred to in
paragraph 10.
(10) the Institute proceedings pursuant to paragraph 9, where it stops within 10 days of its
begin the request for determining the amount and terms of payment does not meet the
the elements listed in section 39f of paragraph 1. 8, and at least one of the parties with
Thus, within 5 days of receipt of notice of termination detection
supporting documents for the issuance of the decision concerned give their consent. On the day following
the legal force of a resolution in the first sentence, the Institute shall initiate proceedings on the application for
determining the amount and terms of payment with the procedure laid down in paragraphs 1 to 8.
(11) the Agreement closed in the public interest under section 39 c of paragraph 1. 2 (a). (c))
or (d)), it is possible to negotiate a suspensory effect not later than the date of application
the decision establishing or changing the basic remuneration.
(12) the appeal authority is not bound by the reasons of the appeal in the case that the contested
decision cancelled because of its non-compliance with the legislation. In such a
case, the appellate body further by the opposition parties.
section 39 h
The decision on the fixing of maximum prices and the determination of the amount and the conditions of
payment of the
(1) the Institute shall establish the maximum price or decision shall lay down the amount and
conditions of payment, conditions are met for their determination as
of this Act. Medicine is paid in the amount specified by the sum of the
provided for remuneration, the maximum trade margins and taxes of the value added
values (hereinafter referred to as "the highest possible remuneration for the final consumer"),
However to the maximum of the above actually raised prices for the end
of the consumer. Set out the amount and conditions of payment shall not apply, if
health insurance shall proceed in accordance with § 39 c of paragraph 1. 6.
(2) if the decision is not issued within the time limits laid down in this Act,
can the person who filed the request for the fixing of maximum prices, pharmaceutical
medicine or food for special medical purposes on the market at a price
proposed in the application, and the enforceability of a judgment on the determination
the maximum prices.
(3) If the decision in the deep or shortened revision, the decision to
determination of the maximum price or the decision on the determination of the amount and the conditions of
the remuneration, as well as their modification or cancellation of the decision on appeal
resource, or the decision on examination procedure has the power to
15. day of the calendar month, including enforceable release of the nearest
the following list under § 39n para. 1. If it has power
15. day of the calendar month, shall be enforceable by issuing the second nearest
list referred to in paragraph 1(b). paragraph 39n 1.
(4) an appeal against a decision in deep or shortened revision,
the decision on the fixing of maximum prices or decisions fixing the amount of
and conditions of remuneration, as well as their modification or cancellation, and against
the decision in the review does not have suspensory effect. If such
the decision challenged by the appeal, or decomposition, is provisionally enforceable
in accordance with paragraph 3.
(5) the effects of a decision repealing the decision referred to in paragraph 4,
occur under paragraph 3 apply mutatis mutandis.
section 39i
Changes the maximum price and the amount and terms of payment
(1) the Institute shall decide on changing the specified maximum price or above, and
conditions of payment at the request of the person referred to in
and section 39f) para. 2 (a). a) to (c)), as regards the maximum price; persons
referred to in section 39f of paragraph 1. 2 (a). (c)) may submit an application only if that
the maximum price of the medicinal product or foods for special
medical purposes is higher than the price calculated pursuant to § 39a para. 2,
(b)) § 39f para. 2 (a). a) to (c)), as regards the determination of the amount and the conditions of
the remuneration.
(2) the Institute shall without delay initiate proceedings ex officio on the change set out above
and the conditions of payment of the medicinal product or foods for special
medical purposes, which does not correspond to the basic payment established pursuant to § 39 c
paragraph. 7, or the conditions for reimbursement of unsatisfactory conditions has the remuneration
laid down in deep or shortened revision. The first sentence shall not apply to
medicines and foods for special medical purposes for which the
payment in accordance with section 39 c of paragraph 1. 8 the second sentence. The Institute will initiate proceedings ex officio
official about changing the maximum prices if after the evaluation laid down by
maximum prices according to § 39 l finds that the maximum price is
higher than the maximum price that you would Institute established under section 39a, or
If it is clear that the maximum price of a similar product determined in accordance with
§ 39a para. 4 or 5 is higher than the maximum price that you would Institute
established pursuant to § 39a para. 2.
(3) the Institute shall decide on the reduction, or to modify the conditions of payment,
If this reduction is part of the measures approved by the Government in order to ensure
the financial stability of the health insurance system) 42f ^ ^. Reimbursement of medicinal products
products or foodstuffs for special medical purposes Institute adjusted in
extent necessary, gradually, from the groups covered by the general reference,
After the reference group, life-saving medicines.
(4) the Institute shall decide on the request of the person referred to in section 39f of paragraph 1. 2 (a). and)
or (b)) on the reduction of the maximum prices according to § 39 g of paragraph 1. 9.
(5) in proceedings about changing the process according to § 39 g of paragraph 1. 1 to 8 and section 39 h
by analogy. The requirements for an application for amendment of the maximum price or changes in the amount of
and the conditions of payment shall apply section 39f of paragraph 1. 1, 5 and 11. The applicant,
seeking a reduction in payment or tightening conditions of payment, may
ask the Institute about the abandonment of the submission of the particulars referred to in section 39f
paragraph. 6. the Institute a request, unless the particulars necessary to
the assessment of interest on the availability of effective and safe medical care.
An applicant who applies for a reduction in the maximum price, it may request the Institute of
the abandonment of the submission of the particulars referred to in section 39f of paragraph 1. 6 (a). (c)).
§ 39j
Cancellation and termination of the maximum price and the amount and terms of payment
(1) If a medicine or food for special medical
the purposes are not made available on the Czech market for more than 12 months, the Institute can
to revoke a specified maximum price or amount and conditions
reimbursement at the request of the person referred to in section 39f of paragraph 1. 2 (a). and) or (b)), or from the
ex officio, and the maximum price or the cancellation of the above terms or conditions
remuneration is not contrary to the interest of the security of the availability of effective and
safe health care.
(2) the Institute may decide to revoke the above terms and conditions of payment
at the request of the person) and referred to in section 39f of paragraph 1. 2 (a). and) or (b)),
(b) at the request of the person) referred to in section 39f of paragraph 1. 2 (a). (c)), if provided for in
the amount and conditions of payment are not in accordance with this Act and the
compliance cannot be achieved by changing the maximum price or amount and conditions
payment, or
c) ex officio, if it is not a medicine or food for
Special medical purposes, suitable for use in clinical practice, and the holder of the
registration of the medicinal product or the importer or the domestic
manufacturer of foods for special medical purposes, evidence to the contrary.
(3) the Institute may decide to revoke the above terms and conditions of payment can
the official, provided this is not contrary to the public interest, if the person on whose
the request was granted by a decision of the administrative offense under § 39q
paragraph. 1, will not ensure the fulfilment of the obligations under paragraph 39d paragraph. 3 or fails to comply with
the obligation provided for in § 39 para. 1 (b). and) or (b)) or in § 39 para.
2. the decision to cancel the payment to that person may Institute for up to 3 years
Disable submission for determination of the amount and terms of payment of the medicinal
medicine or food for special medical purposes, in connection with the
This person committed an administrative offense.
(4) the Institute shall decide on cancellation of the specified maximum price or above, and
the conditions of remuneration referred to in paragraphs 1 to 3 within 75 days from the
the date on which proceedings were initiated. In proceedings for annulment provided for maximum
prices and conditions of payment, the amount shall be treated according to section 39 g of paragraph 1. 1 to 8
and section 39 h. The requirements for an application for revocation of the maximum price or
the cancellation of the above terms and conditions of payment shall apply section 39f of paragraph 1. 1 and section 39f of paragraph 1. 5
(a). a) to (c)), and (e)) apply mutatis mutandis.
(5) the maximum prices of proprietary medicinal products and food
for special medical purposes, for which the price is according to the decision of the
issued under the price regulation ^ 23 c) decided to cancel a regulation
the maximum price, the effective date of this decision.
The maximum price of the medicinal product or foods for special medical
the purpose of the enforceability of the decision expires on the date of the cancellation of the above terms and conditions
the remittance of this medicine or foods for special medical
purposes.
(6) the maximum price and the amount and terms of payment of the authorised
products expire on the date when the registration has been cancelled or allowed to lapse
the medicinal product or the marketing authorisation for the medicinal product
lost its validity, if it was not yet decided on the progressive download
medicinal product out of circulation; If it was possible to its gradual withdrawal from the
circulation, the amount and conditions of payment and the maximum price shall cease the expiry of
the deadline for the implementation of this download. For unregistered medicinal
the maximum price and the amount of products and conditions for reimbursement shall cease on the date of
a specific treatment program has been terminated; This does not apply, if it was with the
implementation of a specific treatment program for an identical pharmaceutical
product is reissued in a period of 6 months from the date of their
the validity of the prior agreement.
§ 39 k
Extraordinary extension of time
In the case of an extremely large number of requests for an increase in the maximum prices may
Institute of the period referred to in section 39 g of paragraph 1. 2 extend the resolution of 60 days, and
It only once. The applicant and the persons referred to in section 39f of paragraph 1. 2 (a). a) and
(b)), unless the applicant notifies the Department of extension of time prior to its
the end of the.
§ 39 l
A thorough revision of maximum prices or payments
(1) the Institute shall regularly evaluate at least once in 5 years, if specified
maximum prices do not exceed the limits laid down by law, the amount of
the basic remuneration, the amount of remittance compliance for all in principle, therapeutically
substitute medicinal products or foodstuffs for special medical
the purpose of the basic remuneration, consistency and effectiveness of the conditions laid down
reimbursement and compliance set out above and the terms of reimbursement of medicinal products and
foods for special medical purposes with this Act, and in particular
meet the expected results and the reasons, the effectiveness of the pharmacotherapy
determination of reference groups, the amount of the basic remuneration, conditions of payment,
evaluation of the clinical and cost effectiveness and comparison with the original objectives
pharmacotherapy.
(2) the Institute shall regularly evaluate the data obtained from its own activities and from the
third parties and observed situation maximum prices or reimbursement.
(3) on the basis of the information collected under paragraphs 1 and 2 of the Institute handles
the audit report, including the proposal on the adjustment of the reference groups and proceed
under paragraph 4 of the setting, modification or deletion of the maximum price or
the amount and conditions of payment of medicines and foods for special
medical purposes.
(4) a thorough revision of maximum prices or payments (hereinafter referred to as
"thorough revision") is done in the common procedure for the whole reference
a group within the period specified under section 39 g of paragraph 1. 2. In-depth review can be
self initiate and lead and to those medicinal products or
foods for special medical purposes for which it is proceeding on the
establishing, changing or cancelling the maximum price or amount and conditions
payment, or a shortened revision.
§ 39 m
The provision of information
(1) following the entry into legal force of the decision on the fixing of maximum prices, or
the decision on the determination of the amount and conditions of payment is the person on whose application
the decision was made (hereinafter referred to as "the holder") shall
without delay
and the Institute of information) to provide eligible affect the conditions for
a fixed maximum price or the amount and conditions of payment under section 39b of paragraph 1.
2 (a). a), c) and (f)) to (i)),
(b)) meet the Institute addressed letters rogatory relating to information referred to in point (a)
and)
(c) to inform the Department about the change) information necessary for interoperability
Of the Institute with the holder (for example, phone, fax, address
electronic mail).
(2) the person on whose application the decision on determination of the maximum
price or the decision on the determination of the amount and conditions of payment, which came into
legal force before 31 December 2006. in January 2010, the Institute is required to submit the data in
extent provided in § 39f para. 5 and 6 to 31. by 1 January 2013 and every
5 years. The person on whose application the decision on determining the
the maximum price or the decision on the determination of the amount and conditions of payment,
which came into force after 31 December 2006. January 2010, is required to submit to the Institute
data to the extent provided in section 39f of paragraph 1. 5 and 6 to 31. January 2018 and then
every 5 years.
(3) the obligation of notification under paragraphs 1 and 2 apply to health
insurance companies likewise.
§ 39n
Publication of information
(1) the Institute publishes on the first day of the calendar month a list that
exposes the electronic notice board. The list contains
and) for medicinal products and foods for special medical purposes
covered by the general health insurance scheme, for which the Institute shall decide on the amount and
conditions of payment, their full list along with the amount of the advertised price
the manufacturer, or the maximum set prices on the grounds, as the maximum
prices were established, with the amount and the terms of payment on the grounds, as above
and conditions for reimbursement laid down, with the highest possible remuneration for the final
consumers on the grounds, as it was calculated, and with the amount of the balance due
in the limit of pensionable service under section 16b, para. 1,
(b)) the basic payment reference groups on the grounds, as the base
the remuneration laid down, together with a full listing of medicinal products and food
for special medical purposes listed in reference groups,
(c)) the maximum prices of medicines and foods for special medical
the purposes for which the Institute shall act only on the maximum price together with a full
listing of medicines and foods for special medical purposes and with the
the rationale, as the maximum prices were established.
(2) the Institute shall regularly publish in the electronic notice board to 20. the date of
calendar month the draft list referred to in paragraph 1. In the penultimate
day of the calendar month, you can draft the list. Institute of
evaluates the expression and performs the repair. On the evaluation of the proposal for repair
list of Institute who filed a proposal, not inform.
(3) in the case of detection of defects in the amount of the maximum price or the highest possible
payment for the final consumers of the medicinal product in the list referred to in
paragraph 1 or update it promptly removes defects Institute.
(4) the Institute once a year, inform the Commission of the European Union
and) list of medicinal products and food for special medical purposes,
the maximum prize was established in the period under review, indicating the
the amount of the
(b)) the list of medicinal products, and foods for special medical purposes
of which the maximum price increased in the period considered, under
the amount of the
(c)) the updated list of medicines and foods for special
medical purposes covered by health insurance; the list contains
a full list of them along with the amount and the terms of payment on the grounds, as
the amount and conditions of payment has been established.
(5) the Institute will allow, at the request of the legal entity or natural person to inspect
the documentation submitted with the request for the fixing of the maximum
prices and fixing the amount of remuneration and the terms and conditions which it was taken during the
the procedure for the fixing of maximum prices or determining the amount and terms and conditions
the remuneration. When submitting the application data marked as the subject of the business
the secret of the Institute does not provide or otherwise disclose.
(6) if the applicant subsequently publish some information that
described under section 39f of paragraph 1. 11 for the subject of business secrets, cannot be
This information will continue to be considered for the subject of a trade secret; about
the applicant is obliged to inform the Institute.
(7) the information considered to be the subject of a trade secret pursuant to this
the law may Institute to provide on-demand administrative authorities for the
needs assessment of price controls, the fixing of maximum prices and the amount and
the terms of payment of, or in connection with their administrative, control or
sanctioning activities, as well as courts and law enforcement authorities. On
demand also provides this information to the Commission of the European Union.
§ 39o
Service in proceedings under part six
In a proceeding for the establishment, amendment or repeal of the maximum price or above, and
the terms of payment in the deep or shortened revision, in proceedings on appeal
resource or in review, all of the document served
only a public decree in a way allowing remote access.
The document shall be deemed to have been delivered on the fifth day after posting.
§ 39p
Abridged revision of maximum prices or payments
(1) the Institute conducts the proceedings ex officio or at the request of the person referred to
in section 39f of paragraph 1. 2 (a). (c) the revision of the maximum reduced) prices or
payments (hereinafter referred to as "shortened revision") in the event that the projected savings
health insurance resources in the reference group is greater than 30
0000 0000 CZK per year, or 5 0000 0000 CZK in the case of high level of remuneration
an innovative product.
(2) if the Department finds that in some of the groups of medicinal substances
referred to in annex 2 of this Act is not even 1 medicine fully
paid, shall forthwith initiate ex officio the abridged revision of all
reference groups containing active substances referred to in the relevant
the Group of annex 2 of this Act and a decision modifies the remuneration so that
in accordance with section 39 c of paragraph 1. 5 was the least expensive medicine
belonging to this group are fully paid.
(3) the Institute shall without delay initiate the shortened revision on the basis of the written
agreement under section 39 c of paragraph 1. 2 (a). c) or (d)) in the case that
the estimated savings in health insurance funds in the reference
the group is at least 20 0000 0000 CZK per year.
(4) the Institute shall without delay initiate the shortened review in the case that there has been a
and) violation of written agreement under section 39 c of paragraph 1. 2 (a). (c))
the basic payment reference group was established in the amount of such
the written agreement, or
(b)) violation of written agreement under section 39 c of paragraph 1. 2 (a). (d))
the basic payment reference group was established by such
the written agreement.
(5) the decision in the proceedings referred to in paragraphs 1 to 4 and § 39 c of paragraph 1. 9 Department of
to 50 calendar days from the date of initiation of the proceeding. Parties to the proceedings
they are entitled to propose evidence and make other suggestions 10 calendar days
from the date of initiation of the proceeding, and this period may Institute by resolution
extended. In the management of the revision of the maximum prices or
tender, the provisions of section 39 g of paragraph 1. 5 does not apply. A shortened revision under
paragraphs 1 to 4 and pursuant to section 39 c of paragraph 1. 9 it is possible to take place only at
in principle, therapeutically interchangeable group of medicinal products and
foods for special medical purposes, in which took place the first revision
the system of payments; otherwise, the Institute shall proceed pursuant to section 39 l short
revision pursuant to § 39 c of paragraph 1. 9 shall be carried out from the base of the remuneration conversion
set out under section 39 c of paragraph 1. 7 and the conditions of payment are maintained.
(6) a shortened revision is done in the common procedure for the whole reference
the Group of. A shortened revision can be separately to initiate and lead and to those
medicinal products or foods for special medical purposes,
which is proceeding for the establishment, amendment or repeal of maximum prices
or the amount of the remuneration, terms and conditions, or depth of the revision.
§ 39q
Administrative offences
(1) legal or natural person has committed the administrative business
offense, if the breach
and submitted pursuant to section). 6 (a). (e)),
(b) a written agreement) pursuant to § 39 c of paragraph 1. 2 (a). (c)), which was
fixed basic remuneration reference groups,
(c) a written agreement under paragraph) 39 c of paragraph 1. 2 (a). (d)), which was
fixed basic remuneration or reference groups
(d) the obligation of reimbursement) the competition under section 39e.
(2) for the administrative offence referred to in paragraph 1 shall be fined
and the $ 10 0000 0000), in the case of an administrative offence referred to in paragraph 1 (b). and)
(c)),
(b)) for a third of annual turnover in the context of the active substances and
the dosage form in the Czech Republic, up to 100 0000 0000 Czk in the case
on administrative offence pursuant to paragraph 1. (d)).
(3) a legal or natural person-entrepreneur for the administrative offence
does not match, if it proves that made every effort, which was
may be required to prevent a breach of duty.
(4) in determining the amount of the fine to take account of the seriousness of the administrative
offense, in particular, the way a criminal offence and its consequences, and
circumstances in which it was committed, and if it is a repeated
violation of this law.
(5) the responsibility for the administrative offence shall cease, if the administrative authority about him
has commenced proceedings in 2 years, when aware of it, but not later than 5
years from the date on which it was committed.
(6) administrative offences referred to in paragraph 1 dealt with the Institute. The fine exacted
the Customs Office. Income from fines is the State budget revenue.
PART SEVEN
section 40
Health insurance companies
(1) the health insurance these health insurance companies:
and general health insurance company), United States, ^ 43)
b) departmental, sectoral, enterprise or any other insurance company. ^ 44)
(2) the health insurance companies are required to pay the providers, or
other entities referred to in § 17 paragraph 2. 7, who, in accordance with this
by law are written by paid to the insured services, such services provided in
time limits negotiated in the contract pursuant to § 17 para. 1. If it is not between
the health insurance company and provider of contract negotiated, and if they are
health insurance pursuant to this Act are required to provided by health
service pay, be paid in the same time limits as the providers,
which health insurance company concluded a contract pursuant to § 17 para. 1.
(3) the health insurance fund shall provide health providers under contract
services a remuneration of $ 100 for each day on which it was in the period from
1 January to 31 December 2004. December 2014, provided its inpatient care
the insured person, the insured person, for each such day, being in
which the insured person was adopted to provide inpatient care and day on
which has been providing bed care ended, counts as one day
(hereinafter referred to as ' the compensation '). Health insurance compensation calculated from
data on inpatient care provided to the provider of the reported 31. March
2015 and the recognized sickness insurance fund.
(4) the Compensation referred to in paragraph 3 shall be granted in the form of monthly advances with
subsequent billing. The basis of the advance shall be calculated as one-twelfth of the
the total regulatory charges for in-patient care, that the provider was
obliged in 2013 for this care select and choosing this regulatory
fee health insurance company has reported. In the month of July 2014 will pay
health insurance provider, seven times higher than the base backup,
not later than 31 December 2006. July 2014. The monthly advance in August to
December 2014, the health insurance fund shall pay to the provider of the base
backup not later than on the last day of each such calendar
of the month. Expense report monthly prepayments and calculated the compensation of health
the insurance company performs up to 30. from 1 June 2015.
(5) the health insurance fund shall decide on applications of its insured persons about
the issue of permits under the coordination regulation. The request must be
shows what health services insured person intends to draw instead of their
drawing and estimated time of their usage. Health insurance company
authorisation in accordance with the coordination regulation shall only be granted if they are for
his release conditions stipulated coordination ^ 52) regulations.
If there is reason to fear that the required health service cannot be
the insured person due to his State of health and the probable course of the
the disease is granted on the territory of the United States in a timely manner and there is no danger of
delay, the health insurance company to issue a permit under the coordination
regulation without delay.
(6) the health insurance fund shall provide to the insured at his request a refund
costs pursuant to § 14 para. 2 to 5 not later than the last day of the month
following the acquisition of the decision pursuant to § 53 para. 1.
(7) the health insurance companies are obliged to ensure their insurance policy holders
and the local availability of paid services). The local availability of means
reasonable distance of the place of provision of paid services due to the
place of residence or the place of residence of the insured person. Local
availability is expressed by the coastdown time. Local availability
emergency medical services provided by law, governing health
emergency service. The coastdown time shall, for the purposes of this Act, the
time in whole minutes, which corresponds to the effective availability of places
means of transport which is proportional to the speed of land
communication and is in accordance with the law governing the operation of the road
roads. Driving time determined by the Government, by regulation,
(b) the availability of paid services) time. The time availability of the means
ensuring the provision of urgent and acute covered services within
corresponding to their urgency. The deadline for expressing time availability
the planned paid services provides for government regulation.
(8) the health insurance companies are required to issue free of charge to its insureds
insurance card or replacement document. Pass or replacement document
a person with limited legal capacity shall issue the relevant health insurance
guardian, guardian or guardian. Insurance card
or replacement document contains name, last name, or title,
force and the number of the insured person, which is, in the case of citizens of the United States
your social security number. Health insurance lead in information systems data
of their insured individuals needed to implement the public health
insurance under the number of the insured person.
(9) insurance card or replacement document can contain in addition to the data
to identify a policyholder in written form also similar information in
electronic form. For the issue of a replacement document capable to bear the
information in electronic form has health insurance are entitled to the reimbursement of
the cost of its acquisition. On the card of the insured or on the replacement
the document can be stored even more data on insured persons, if so determined by the
the law. Additional data can be stored on the ID card of the insured person or
the replacement document, if the insured person agrees with the appropriate
health insurance company.
(10) health insurance lead
and a list of providers); This list, which does not contain data
referred to in point (b)), is required to disclose any health insurance company
manner allowing remote access,
(b) an overview of the medical workers) paid service
each of the providers in the breakdown of doctor, dentist,
pharmacist and healthcare worker engaged in allied health
occupation according to the law on the paramedical professions, who
show your health insurance company made to medical procedures according to the list
medical procedures with point values (hereinafter referred to as the "recipient"); for
to this end, they are required to disclose health insurance providers
for the past quarter, and at the latest within 30 days, a list of individual
holders of performances on the last day of the quarter, giving the name,
last name, title, social security number and category of the wearer power according to the
list of medical procedures with point values; This provider
the obligation to fulfil even if health insurance shall notify only those
the changes that have occurred since the previous report.
(11) health insurance companies give the initiative to cancel the Trade Office
trade licence entrepreneurs because of non-compliance
entrepreneurs pay a premium on health insurance premiums.
(12) the health insurance fund is a user-maintained in reference data
basic population register about subjects who are its
the insured person, to the extent
and) surname,
(b) the name or names),
(c) the address of the place of stay)
(d)) of the date, place and County of birth; for the data subject, who was born in
abroad, the date, place and the State where he was born,
(e)) of the date, place and County of death; in the case of the death of the data subject outside the territory
The United States, date of death, place and the State on whose territory the death
has occurred.
(13) the health insurance fund is a user of the data kept in the registry
social security numbers of natural persons who are its beneficiaries in
the range of
and) the name or names, first and last name,
(b) the social security number),
(c)) in the event of the original social security number, personal identification number,
(d)) the day, month and year of birth.
(14) the data needed by health insurance under paragraphs 12
and 13, may use, only if they are necessary for the performance of its responsibilities.
Use of data from the population register and the register of birth
numbers for health insurance is free.
(15) the health insurance fund shall collect data relating to the administrative
proceedings in matters relating to compensation of the costs for health services pumped
insured persons in other Member States of the European Union, in particular, the
and) proceedings initiated on the reimbursement of costs pursuant to § 14 para. 2 to 4, of the
their number, place of their drawing and about how it was in the individual
proceedings decided
(b)) proceedings initiated for the granting of prior consent, about the number of
and, as was decided in the respective proceedings,
(c)) the amounts that were in accordance with § 14 para. 2 to 4 are replaced by the insured.
(16) the data collected in accordance with paragraph 3 shall be communicated to health insurance
in anonymised form at the request of the Ministry of health.
The Ministry of health provides this information to the European Commission in the
her deadlines.
§ 41
the title launched
(1) the health insurance fund used for the purposes of proceedings under section 53 of the
the basic data of the population register to the extent
and) surname,
(b) the name or names),
(c) the address of the place of stay)
(d)) of the date, place and County of birth; for the data subject, who was born in
abroad, the date, place and the State where he was born,
(e)) of the date, place and County of death; in the case of the death of the data subject outside the territory
The United States, date of death, place and the State on whose territory the death
has occurred; If it is issued the Court's decision on the Declaration of death, day,
that is the decision, listed as the day of death or the date on which the entity
data declared dead have survived, and the date of acquisition of legal power of this
the decision,
f) nationality, or more of State citizenship.
(2) the health insurance fund used for the purposes of proceedings under section 53 of the
the information system of the population register data in the range
and) the name or name, last name, or changing them, native
last name,
(b)) date of birth,
(c)) place and County of birth; for the citizen, who was born in a foreign country, location and
State where he was born,
(d) the social security number) and its amendments,
e) nationality, or more of State citizenship,
(f) the address of the place of residence), including previous address space
permanent residence,
(g)) the beginning of permanent residence or cancellation date data on the place of
permanent residence or the date of their permanent residence in the territory of the United
Republic,
h) date of final court decision on the approval of the Treaty on
agent or representative office of a member of the household including the Court that
contract or agency has approved, the date of the decision
Court on the restriction of incapacitation, the name or names, surname and maiden
the number of the guardian; If no guardian identity number allocated,
the date, place and County of birth, and the guardian, who was born in
abroad, the place and the State where he was born, is the guardian of the legal
the person, the name and address of the registered office,
I) name or name, last name and social security number of the father, mother,
or other legal representative; in the event that one of the parents or
another legal representative or guardian does not have a social security number, his name,
where appropriate, the name, surname and date of birth; If other regulatory
the representative of the child's legal person, the name and address of the registered office,
j) family status and due date changes
spouse's social security number); If the husband is a natural person who does not have
assigned a social security number, his name or names, the surname of the husband and
the date of his birth,
l) social security number of the child,
m) date, place and County of death; in the case of the death of a citizen outside the United
Republic, the date, place and the State on whose territory the death occurred,
n) day, who was in the Court decision on the Declaration of death listed
as the day of death, or as a day that did not survive,
o) day, who was in the Court decision about declared missing listed
as the day when the effects of the Declaration of the nezvěstnosti occurred, and the date of acquisition
the decision of the Court about the declared missing.
(3) the health insurance fund used for the purposes of proceedings under section 53 of the
the information system of the foreigners to the extent information
and) the name or names, surnames, their change, maiden name,
(b)) date of birth,
(c)) the place and State of birth,
(d) the social security number) and its amendments,
e) country of citizenship or nationality,
(f)) the type and address of the place of stay,
g) number and valid permission to stay,
(h) the beginning of the stay, if applicable) date of the termination of the stay,
I) limitation of incapacitation,
j) administrative or judicial expulsion and the period for which it is not allowed to enter
on the territory of the Czech Republic,
k) marital status, date and place of its changes, the name or names,
the surname of the husband and his social security number; in the case that the social security number was not
allocated, date of birth,
l) the name or names, the family name of the child and his social security number; in
If the social security number was not assigned, date of birth,
m) the name or names, the surname of the father, mother or any other
legal representative or guardian and their social security number; in the case that
one of the parents or other legal representative or guardian does not have native
the number of his name, where applicable, the name, surname and date of birth,
n) date, place and County of death; in the case of deaths outside the United
the Republic, the State on whose territory the death occurred, or the date of death,
o) day, who was in the Court decision on the Declaration of death listed
as the day of death or the date on which the stranger declared dead survivors
p) day, who was in the Court decision about declared missing listed
as the day when the effects of the Declaration of the nezvěstnosti occurred, and the date of acquisition
the decision of the Court about the declared missing,
q) the name or names, and last names
1. an adult dependent child of a foreigner,
2. minor aliens who had been strangers, or his or her spouse
by decision of the competent authority entrusted into foster care, or
that was a stranger, or his spouse acquired or whose guardian
or the husband of his guardian is a foreigner,
3. the lone stranger 65 years or older, regardless of age of the alien,
that you cannot take care of himself for health reasons, in the case of
family reunification with a parent or child who are aliens,
4. an alien who is a dependent direct relatives in the ascending or
descending line or such relatives of the husband of a citizen of the European Union,
5. the parents of a minor alien and his or her social security number; in the case of foreigners,
who do not have assigned a social security number, name, or name, surname and
date of birth.
(4) the health insurance fund used for the purposes of proceedings under section 53 of the registry
social security numbers of individuals who have been granted social security number,
However, they are kept in information systems referred to in paragraph 2
or 3, the data in the range
and) the name or name, surname, maiden name, if applicable
(b) the social security number) and its amendments,
(c)) date of birth,
d) place and County of birth, for physical persons born abroad of a place and
State of birth.
(5) the data which are kept as reference data in the principal registry
of the population, shall be used from the information system of the population register or
information system for foreigners only if they are in the shape of the previous
the current state.
(6) of the provided data that can be used in a particular case only
such data, which are necessary for the performance of the task.
section 41a
Classification of acute care and a reference network providers
(1) for the purposes of rationalization of the functioning of the system of public health
insurance in the area of acute care Institute of health information
and statistics of the Czech Republic (hereinafter referred to as the "Institute of health
information ") creates and annually updates the list of groups
in acute care hospitalizations related to diagnosis (hereinafter referred to as
"the group"), their relative cost, marshaling rules
hospitalizations into groups and methodologies related to reporting
paid services provided in acute care. The current data and
methodology in the first sentence it passes the Institute of health information
The Ministry of health always within 90 days before the end of the calendar
of the year. Rules for the classification of hospitalizations into groups leading the Institute
health information in a computer program, which the Ministry of
health care provides at the same time with the data referred to in the second sentence.
(2) the Ministry of health data and methodologies referred to in paragraph 1 sentence
the second published on its website and, upon request, free of charge
It provides in particular for the purposes of the reporting of covered services acute
care health insurers, providers and other entities
a computer program referred to in paragraph 1, the sentence of a third.
(3) for the purposes of the transmission of information to the national registry of covered services
According to the law on health services health insurance information
the provider reported acute care services covered by the
processes in the computer program referred to in paragraph 1, third sentence.
(4) to ensure the development of the Marshal hospitalizations in acute
inpatient care to groups may Institute of health information to conclude
the contract with the provider of the transmission of information on costs
hospital admissions. The Department of health will publish a list
providers with whom the contract has been concluded, according to the first sentence in the
Journal of the Department of health.
Review
§ 42
(1) the health insurance fund shall control the use and provision of paid
services and the health insurance bill, in terms of volume
and quality, including compliance with the prices with providers and policy holders.
(2) control activities are carried out through information data in the
the scope of the law and the activities of the inspection of doctors. Other control
the activities carried out by healthcare professionals who are eligible for health care
audit activities (hereinafter referred to as "qualified persons"). Health insurance companies
the implementation of control activities through access to
A central repository of electronic prescriptions under the Special
the law ^ 44a).
(3) the revision shall be considered substantiation of the therapeutic process doctors with a special
regard to its progress, and the prescription of medicinal products, food
for special medical purposes and medical devices, and on the
the assessment of the needs of the Spa sanatorium rehabilitation care as part of the
therapeutic care. Review by doctors and other professionals on
check whether
and paid services) provided correspond to the borne vyúčtovaným services
health insurance,
(b)) have been accounted for only those performances, medicines and food for
Special medical purposes and medical devices which is a health
the insurance company have to pay,
(c)) and the type of covered services range corresponds to a State of health
of the insured person.
If the check shows the unlawfulness or incorrectness of the statement
covered services, health insurance does not pay for such services. If
check shows that the insured person has been prescribed for the medicinal product in
contrary to the conditions laid down in the decision of the Institute about the amount and
conditions of payment and health insurance this medicine
care providers pay, has the appropriate health
the insurance company the right to reimbursement of the amount paid for such a medicinal product
provider, where he was a medicine prescribed to you.
(4) to fulfil the tasks referred to in the preceding paragraphs are revision
doctors and healthcare professionals who are authorized to enter into health care
device. The performance of the activities of the medical and professional staff must not
disrupt the treatment carried out performance. The provider provides health
insurance company necessary assistance in the exercise of control, in particular presents
required documents, communicates information, and provides an explanation. Access to the
medical documentation allows only physicians to review or
specialists; These workers have access to health care
the documentation only to the extent the corresponding control.
(5) Review the doctors carrying out control activities in the field, in particular
where the acquired specialization.
(6) Review the doctors carrying out control activities in employment
relation to the health insurance company, which is contracted on the basis of
the selection procedure.
(7) the review doctors undertake monitoring activities with your provider,
of which are employees, owners, co-owners, operators, members of the
statutory authority, or where by reference to their relationship to the
the controlled persons or to the subject of checks are reasonable doubt
about their impartiality. Revision doctors are obliged to immediately after
what becomes aware of facts indicating their bias,
tell your health insurance company, for which they perform the inspection
activity.
§ 43
(1) the health insurance fund shall be subject to the control of the State authorities of the Czech
of the Republic.
(2) health insurance leads a personal account of the insured person as overview
expenditure on paid services provided to that insured person and paid
regulatory charges under section 16a and supplements for partially paid for by the active
medicines and foods for special medical purposes that are
count towards the limit under section 16b, para. 1. Upon request of the insured person is
health insurance shall in writing without undue delay and free of charge
provide once a year in the form of statement of personal account data on
covered services paid for the insured person during the period of the past
12 months including regulatory charges paid pursuant to section 16a and
supplements for partly paid for medicines and foods for special
medical purposes during this period, the following information, if applicable, for the number of months
that the insured person during the last 12 months for this health
insurance companies insured. Health insurance is required on request
of the insured person to provide remote access to his personal account. If you can to
the insured person, his legal representative, a guardian or guardian a written
consent may be made available to this personal account as well as doctor
of the insured person.
PART EIGHT
FINES AND SURCHARGES TO THE FUSE
§ 44
(1) for failure to comply with the notification obligation referred to in article 10, the competent
health insurance save policyholders a fine up to $ 10,000 and
employers of up to 200 000. Failure to comply with the notification
the obligation by the employer to impose a fine only to the employer.
(2)
cancelled
(3) upon repeated failure to comply with the notification obligation may be imposed
a fine of up to twice the amount of the fine imposed.
(4) when the failure to fulfil obligations to be subject to preventive
inspection under section 12 (a). (e)) or in breach of its obligations under section 12
(a). I) to), or if the insured is prematurely released from inpatient
care for the continuing gross violations of internal regulations of the provider
inpatient care, the relevant health insurance save policyholders
a fine up to $ 500. Health insurance company may impose a fine on
up to $ 5000 to the insured that the provision covered by the
the services proved her identity card of the insured person, although at that time it
the insured person was not. A fine may be imposed within one year from the date of
appropriate health insurance company has found a violation of or failure to perform
obligations, but within three years from the date on which the acts of infringement or
failure to fulfil obligations has occurred.
(5)
cancelled
(6) the financial penalty is receiving health insurance, which it imposed.
§ 45
(1) the health insurance fund may charge a premium to the fuse
employers, which has occurred in the past calendar year to
a recurrence of accidents at work or occupational diseases in the same
causes ^ 45) and, consequently, to increase the cost of health services,
with the exception of those accidents at work or occupational diseases, the
the cause is detected or occurring threat to animals or
natural elements or due to infringement of third parties.
(2) the health insurance fund shall be levied to the employer referred to in paragraph
1 Premium contributions up to 5% of the market share, driven by
insurance for all employees.
(3) payment of premiums, premium assessment for the calendar year can be
post by 30. June of the calendar year following the
the year in which the facts referred to in paragraph 1. Premium on
premiums shall be paid in one lump sum on behalf of the health insurance companies.
(4) employers are required to send the competent health insurance company
^ 46) copy records on accidents at work, and at the same time for the past
calendar month, not later than the fifth day is always the following month.
Failure to comply with this obligation, the competent health insurance company
Save the employer a fine up to 100 000 CZK.
(5) providers, who are entitled to the recognition of occupational diseases,
are required to send a copy of the report, the competent health insurance company
occupational diseases.
(6) as regards maturity increases to premiums, the method of payment,
its recovery, forfeiture and return of overpaid on the costs of premiums,
proceed as with the premium.
§ 45a
(1) the health insurance fund is committing an administrative offense, by
and) shall not disclose contract and payment of covered services pursuant to §
Article 17(1). 9 or its amendment or modification,
(b) does not result in a list of the providers) pursuant to § 40 paragraph 2. 10 (a). and)
or such a list will not disclose,
(c) an overview of the health of workers does not keep) providing paid
for each service providers pursuant to § 40 paragraph 2. 10 (a). (b)),
(d) does not provide their insureds the provision) covered services, including
their local and temporal availability pursuant to § 46 para. 1, or
e) in violation of § 52 para. 2 enters into a contract for the provision and payment of
paid services to the applicant without the recommendation of the conclusion of such an agreement in
the selection procedure.
(2) an administrative offense shall be fined in the
and 100 000 CZK), in the case of an administrative offence referred to in paragraph 1 (b). (b)) or
(c)),
(b)) 1 0000 0000 CZK in the case of an administrative offence referred to in paragraph 1 (b). (e)),
(c) Eur 10 0000 0000), in the case of an administrative offence referred to in paragraph 1 (b). and)
or (d)).
(3) the health insurance fund for the administrative offence does not match, if the
demonstrates that he made every effort, that it was possible to require that
breach of legal obligations.
(4) in determining the amount of the fine to take account of health insurance
the severity of the administrative offense, in particular, to the manner of its perpetration, and his
consequences and the circumstances under which it was committed.
(5) the liability of the insurer for the administrative offence shall cease, if the
administrative authority about him has not initiated proceedings within 1 year from the date on which it
learned, but not later than within 3 years from the date on which it was committed.
(6) administrative offences referred to in paragraph 1 dealt with the Ministry of
the health sector.
(7) the Fines collected and enforced by the authority that is saved.
(8) income from fines is the State budget revenue.
section 45b
cancelled
PART NINE
NETWORK OF PROVIDERS OF HEALTH CARE SERVICES
§ 46
(1) the health insurance fund is required to ensure the provision of paid
services to its affiliated persons, including their regional and time availability.
This obligation through providers with which it has concluded
contract for the provision and payment of covered services. These providers
form a network of providers, health insurance companies (hereinafter referred to as
the "network").
(2) before entering into a contract for the provision and payment of covered services,
the selection procedure takes place. Selection procedure does not take place
and care providers),
(b) if the provider) is paid by the prison service, services
(c)) in cases of extension of medical provider network Contracting
emergency services,
(d)) in the conclusion of a new contract for the provision and payment of covered services,
If this is a contractual relationship with the same body and at the same time
There is no extension of the scope of the provided covered services,
e) in the case of highly specialized care provided, provider
which was to provide such medical care is granted under the law on
health services the health status of the Centre of highly specialized
care, or
f) when concluding the contract and payment of covered services according to
§ 17 para. 8.
(3) in the event of a change of legal form provider that has an
contract for the provision and payment of covered services, and in the case where the
the founder of the limited liability company is a natural person, that has
a contract for the provision and payment of covered services, whose
permissions to the provision of health services as natural person ceases to exist
When you grant permission to provide these health services as
limited liability company, the selection process takes place only when the
When the extension of the scope of the provided covered services.
(4) the venue of the selection procedure may suggest a health insurance company,
applicant, or a municipality. Applicant means the provider of authorised
provide health care in the field, or the natural or
legal person who intends to provide health services and is able to
the time limit set in the notice of the selection procedure to meet the requirements for
provision of health services in the field of health care.
§ 47
(1) the tender announced by the way in the place of the usual regional office in
the capital city of Prague, Prague City Hall (hereinafter referred to as "regional
the Office "). The local jurisdiction of the regional office shall be the place of the provision of
health services. Tender for the provision of beds and Spa
hospital rehabilitation care announced by the Ministry of health.
(2) the tender must include:
and paid services and range) specifically defined area for which they have
be provided, and the health insurance companies, if the health
the undertaking by the applicant selection process
(b)) the time within which to submit a tender; This time limit shall not be shorter than
30 working days,
(c) the place for filing of the application),
(d)), from which the time limit is necessary to ensure the provision of health services,
which are the subject of the tender.
§ 48
(1) the Principal shall for each tender to the Commission. Members of the Commission
they are:
and a representative of the regional authority), in the case of a tender, organized
the regional authority, or a representative of the Ministry of health, in the case of
the tender launched by that Ministry,
(b) a representative of the relevant Chamber) established by law of the Czech Medical Chamber,
The Czech dental Chamber and the Czech Chamber of pharmacists or representatives
professional organization in the case where there is no appropriate Chamber,
(c) a representative of the competent sickness insurance fund),
(d)) the expert for health services to be provided by the applicant;
When it operates in the field of health services support company, is
a member of the selection board, the representative of the company.
(2) the members of the Commission could not be persons for whom taking into account their relationship
the candidates are doubts about their impartiality, and relatives
those persons.
(3) the membership of the Commission is indispensable. The members of the Commission are covered by
obligation of professional secrecy on all the facts which are
learn in the context of the selection process. Provide information on the
the fact that the person participated in the selection process, the members of the Commission
not considered a breach of the confidentiality obligations under
a special law.
§ 49
(1) the activities of the Commission, chaired by its President, who is the representative of the regional
the Office, in the case of a tender, the promoter's Regional Office,
or a representative of the Ministry of health, in the case of a selection procedure,
the promoter is the Ministry of health.
(2) the Commission is quorate if the majority
all members of the Commission. The decision is taken, if voted for him
an absolute majority of present members of the Commission. In the event of a tie
a representative of the casting vote, the competent health insurance company. About hearing
the Commission, the progress and outcome of the selection procedure, the Commission shall,
which shall be signed by the Chairman and the members of the Commission by all present. The entry shall
contain the names of the members of the Commission and the determination of the application, stating the order
the number of obtained votes. The President of the Commission shall transmit the registration vyhlašovateli
immediately after the end of the meeting of the Commission. The activity of the Commission ends.
(3) the costs associated with the announcement of the selection procedure and activities of the Commission
paid by the announcer. The costs associated with participation in the tender shall be borne by
the tenderer.
§ 50
(1) tenders shall be notified within the time limit set by the vyhlašovateli pursuant to § 47
paragraph. 2 (a). (b)). The candidate is required to demonstrate that it meets, or is in the
the period laid down in the tender, able to meet the prerequisites for
the provision of paid services in the field of health care, which
is the subject of the tender.
(2) the applicant shall be invited to meetings of the announcer of the selection board (hereinafter referred to as
"the Commission"). Applicants whose application has formal defects that
the candidate does not remove the time limit set by the organising body, returns
announcer application, stating the reasons.
§ 51
(1) when assessing applications for members of the Commission shall take into account, in particular, to the network
health insurance companies in the field and to the reputation of the applicant, to
experience in the relevant field, to disciplinary measures imposed by
under the Act on the Czech Medical Chamber, the Czech dental Chamber and
The Czech Chamber of pharmacists, to ethical approach to patients to complain
on the provision of health services. The members of the Commission also considered the intent of the
the applicant to the provision of paid services in the field of health care, which
is the subject of the tender, and its ability to meet the prerequisites for
provide covered services within the period specified in the notice of the selection
control.
(2) after examination of applications the Commission shall determine the order of candidates.
§ 52
(1) the Principal is obliged to publish the outcome of the selection procedure including the
the number of votes referred to in § 49 paragraph 1. 2.
(2) the health insurance fund shall take into account the results of the selection procedure when
the conclusion of contracts for the provision of and payment of covered services. The result of the
the selection procedure shall not confer the right to contract with health
the insurance company. Health insurance company is authorized to enter into a contract with
the applicant only where the conclusion of such a contract in the selection
recommended control.
(3) the conclusion of the contract with the tenderer in the tender
recommended that this candidate may submit an application for a declaration of a new
the selection procedure in the same scope and territory again after 3
months from the date of publication of the result of such a tendering procedure.
(4) if the conclusion of the contract with the tenderer in the tender
recommended, can this candidate again to request the publication
competition or to apply to the already renowned for the selection
tender for the scope, territory and a health insurance company, for which it was
the conclusion of the contract and payment of covered services recommended to
After the expiration of 3 months from the date of publication of the result of such a selection
control.
PART TEN
THE PROVISIONS OF THE COMMON
§ 53
Decision making
(1) on the decision-making of health insurance companies in matters relating to
granting of prior informed consent under section 14b, authorisation by the
the co-ordination regulation, the reimbursement of costs pursuant to § 14 para. 2 to 4,
the price increases to premiums, fines, and the likely amount of the premium and the
disputed cases in matters of premium payments, penalties, refunds
the excess on the insurance and reduce the prepaid insurance premiums are subject to the General
regulations on administrative proceedings, ^ 47) unless otherwise provided by this Act. In
administrative application proceedings shall be decided whether or not in the insured person's
disputed cases about payment of amounts under section 16b; to the design of the insured person
shall be accompanied by proof of payment of regulatory charges that are counted
in the limit under section 16b and evidence of payment of the fees for part
paid for medicines and foods for special medical purposes,
that will be included in the limit under section 16b, from which it follows that
limit under section 16b has been exceeded. Health insurance companies make decisions on
matters increases to premiums, fines and in contentious cases
premium payments and penalties payment acreage. The appeal against the
the payment of the insurance premium assessment in matters does not have suspensory effect.
(2) the outstanding premiums and penalties may prescribe to the health insurance company
a statement of the arrears payment also. Statement of arrears must contain
the premium payer), which show arrears,
(b) the amount of the arrears by status) the payer's account of premiums on a specific day
based on the data reported by the payer or of the checks
carried out by the health insurance premiums of likely,
If it was fixed, and the finance charge calculated on that date,
(c)), the date on which the amount of the arrears was detected,
(d)), the competent health insurance account numbers, on which must be
arrears paid
e) instruction on the enforceability,
f) instruction on the objections,
(g)) the health insurance companies, which issued a statement of arrears, and
the date of issue. Statement of arrears shall be provided with an official stamp and
signed with the name, surname and the functions of an authorized person.
(3) a statement of arrears shall be enforceable on the day of its delivery. A statement of the
arrears shall be served on the same way as credit assessment.
(4) Against the statement of arrears can be health insurance company, which the statement
arrears has released, filed within 8 days from receipt of written comments, if
the payer does not agree with the existence of debt premiums on the insurance and finance charge memos
or its amount. The reason for the opposition is the payer of insurance shall in
objections noted.
(5) the health insurance fund on the basis of the objections within 30 days of their
delivery issues a decision, which the statement of arrears either confirm, if the
the amount of the arrears is fixed correctly, or cancelled. If health
the insurance company decides about the objections within the time limit referred to above, shall cease to be a statement of the
arrears of force.
(6) the health insurance fund may cancel the arrears on its own statement
initiative.
(7) The procedure for issuing the statement of arrears are not subject to the General provisions
on the administrative proceedings.
(8) the Enforceable decision on the matters referred to in paragraph 1 and
enforceable statements of arrears are heading for court ^ 47a) or
^ 47) administrative enforcement.
(9) the administrative execution of the decision on the matters referred to in paragraph 1 shall be
health insurance credit assessment issued at first instance
the proceedings; This applies to statements of arrears.
(10) on the appeal against the decision of the health insurance fund referred to in paragraph 1
shall be decided by the arbitration authority of the health insurance companies. The arbitration body shall be composed
one representative of the health insurance companies, one representative of the Ministry of
the health sector, one representative of the Ministry of labour and Social Affairs,
one representative of the Ministry of finance, which shall designate three representatives from
its members, the Board of health insurance, and three representatives of that
shall designate from among its members, the Supervisory Board of health insurance company. The arbitration body
It is able to pass resolutions if more than two thirds of the present members. To
the validity of the decision should be by an absolute majority of the members present. To
the first meeting shall convene the members of the arbitration body Director of health
the insurance company. At this first meeting, members of the arbitration body shall elect
from among their number a President who continues to convene and conduct
the arbitration body.
(11) in the performance of the functions of a member of the arbitration body may be granted
the reward, which is decided by the Board of health insurance companies.
(12) decide if arbitration body in the first instance shall apply mutatis mutandis
the provisions of the code of administrative procedure of decompilation.
(13) the Final decision of the health insurance companies referred to in paragraph 1 are
subject to review by the Court in accordance with the specific legislation.
§ 53a
(1) the health insurance fund may remove the hardness of which would
occurred when prescribing penalties, the amount of which does not exceed 20 000 CZK to date
delivery hardness removal requests.
(2) the arbitration body may remove the hardness that would arise in the
the imposition of fines, assessment surcharges to premiums or prescription of penalties,
the amount of which exceeds the 20 000 CZK.
(3) the removal of hardness in accordance with paragraph 1 or 2, you cannot decide
If
and insurance premiums) the payer not pay health insurance contributions payable
to the date of issue of the decision on immunity, increases to the premiums or
finance charge memo
(b)) to the payer of insurance was filed insolvency ^ 47b)
(c)) the payer of insurance entered into liquidation.
(4) for a waiver of premiums, fines, surcharges or penalties shall be decided
at the written request of the payer of the insurance or other authorized persons
(hereinafter referred to as "the applicant"). An application may be made to the acquisition of legal power
the decision, which was fine, levied a surcharge to premiums
or the prescribed penalty; If new facts have emerged that
through no fault of the applicant could not apply to the time of the acquisition of the legal
the power of this decision may be lodged within three years of legal
the power of this decision.
(5) The procedure for the remission of fines, surcharges, premiums or periodic penalty payments
not covered by the General rules of administrative procedure. ^ 47)
removal of hardness is the decision final.
§ 53b
The delivery of a public decree
(1) the health insurance fund shall apply in proceedings pursuant to § 53 para. 1 delivery
a public decree in the case where it is not known residence or registered office of the
party to the proceedings, or in the event that the party does not stay on
the place of his residence, registered office or the address for service of that insurance company
He said.
(2) service of a public decree makes health insurance so that
be posted at the headquarters for a period of fifteen days in place of the usual way
notification of location of documents with its precise indication; notification
also be posted at the headquarters of the locally applicable organizational unit
health insurance companies that document served. The last day of the period
in the first sentence shall be considered the date of delivery.
§ 53 c
In carrying out the obligations arising from this Act, and the Special
law, ^ 17) are compulsory subjects entitled social security numbers of the persons
Alternatively, a different number of the insured person.
§ 54
cancelled
section 55
Reimbursement of costs of paid services incurred as a result of an unlawful
behaviour towards the insured person
(1) the health insurance fund has against a third party the right to claim
the cost of paid services that incurred as a result of culpable
infringement of the third party against the insured person. Replacement according to
the first sentence is receiving health insurance funds.
(2) for the purposes of reimbursement of paid services referred to in paragraph 1 are
providers are required to notify the relevant accident and health insurance
other damage to the health of the people, which are written by paid services if they have
reasonable grounds for believing that an injury or other damage to health caused by
conduct legal or natural persons. The obligation of notification have
the authorities of the police of the Czech Republic, the Prosecutor's Office and the courts.
The obligation of notification under this paragraph shall be implemented within 1 month from the date of
When the one who announces the fact he learned about it.
(3) for the purposes of reimbursement of paid services referred to in paragraph 1 are
public health authorities are required to provide on request
competent health insurance company reports on the results of epidemiological and
other investigations which are carried out by these authorities shall be obliged to
the specific legislation.
(4) for the purposes of reimbursement of paid services referred to in paragraph 1 are
labour inspection authority and the authorities of the State mining authority required to provide
upon request, the competent health insurance company the results of the investigations into the causes
deadly, heavy and bulk of work accidents and occupational diseases.
(5) for the purposes of reimbursement of paid services referred to in paragraph 1 shall
information referred to in the preceding paragraphs, provided free of charge.
(6) the health insurance fund may waive recovery of all or part of the above
reimbursement of the costs referred to in paragraph 1,
and) if enforcement of the recovery of the costs associated with special or
nepoměrnými, or
(b)) if it is likely that the costs of enforcement outweigh the proceeds.
The waiving of recovery of part or all of the amount of reimbursement of costs pursuant to
paragraph 1 is not a legal right.
(7) in determining the amount of the refund of the costs from its enforcement of the health
the undertaking referred to in paragraph 6 shall refrain, shall take into account health insurance
in particular, how the damage occurred, and to the personal circumstances and property
the person who caused the injury.
(8) for the purposes of a claim for reimbursement of the costs referred to in paragraph 1
not employees of health insurance company secrecy
established by a special law, and it's about the facts decisive for
claims and against persons in respect of which, or through which the
the claim alleges.
section 55a
Relationship to international treaties
Provisions of this Act shall not apply where an international treaty to which the
Parliament gave its assent, which the Czech Republic is bound and which was
published, provides otherwise.
section 55b
For the regional authority or municipality of the village with
extended jurisdiction under this Act are transferred
the scope of the.
PART ELEVEN
TRANSITIONAL AND FINAL PROVISIONS
§ 56
(1) for dependent children, pursuant to § 7 para. 1 (b). and until 31 December 2008).
December 1998, and university students older than 26 years old. This provision
does not apply after the date of interruption of studies to students who study at the
the high school had been interrupted.
(2) For those receiving pensions from pension insurance pursuant to § 7 para. 1
(a). (b)) shall be treated as beneficiaries of pensions granted also after 31 December 2006. December
1992 according to the regulations of the Czech Republic or the Slovak Republic, if they
a pension was calculated taking into account the period of employment before 1. January
1993 the employer established in the territory of the Czechoslovak Socialist
Republic or the Czech and Slovak Federal Republic.
(3) where regulations uses the term "general health
insurance "means" public health insurance ".
§ 57
Shall be deleted:
1. the law of the Czech National Council No. 550/1991 Coll., on general health
insurance, as amended by Act of the Czech National Council No. 592/1992 Coll., Act
The Czech National Council No. 10/1993 Coll., Act of the Czech National Council No. 15/1993
Coll., Act No. 166/1993 Coll., Act No. 333/1993 Coll., Act No. 241/1994
Coll., Act No. 58/1995 Coll., Act No. 160/1995 Coll., Act No. 145/1996
Coll. and Constitutional Court of the Czech Republic No. 206/1996 Coll.,
2. The Ministry of finance Decree No. 273/1993 Coll., laying down the
method of making and using departmental funds, industry, corporate, and
other health insurance companies,
3. The Ministry of finance Decree No. 269/1993 Coll., laying down the
more detailed conditions for the creation and use of the Reserve Fund of the general health
the insurance company.
PART TWELVE
CHANGE AND THE ADDITION OF RELATED LAWS
§ 58
The Czech National Council Act No. 553/1991 Coll. on general health
the insurance company of the Czech Republic, as amended by the Act of the Czech National Council.
593/1992 Coll., Act of the Czech National Council No. 10/1993 Coll., Act No.
60/1995 Coll. and Act No. 149/1996 Coll., shall be amended and supplemented as follows:
1. In article 7 (2). 1 (b). and at the end of a comma) be replaced by a semicolon and
connect with these words: "the basic Fund covers the costs of further
the activities of the insurance company pursuant to section 5 (b). d),".
2. In article 7 (2). 1 (b). (c)) at the end of attached these words: ";" Special-purpose
You cannot create pools of basic resource or reserve fund ".
§ 59
The Czech National Council Act No. 280/1992 Coll., on departmental, disciplinary,
corporate and other health insurance companies, as amended by the law of the Czech
the National Council No. 10/1993 Coll., Act of the Czech National Council No. 15/1993 Coll.
Act No. 60/1995 Coll. and Act No. 149/1996 Coll., amending and supplementing
as follows:
1. in article 13, paragraph 2 is deleted.
2. In article 16(1). 2 at the end of this sentence connects:
"The special funds of the basic resource cannot be created or reserve
Fund. ".
3. in article 16, paragraph 4 shall be deleted.
4. § 17 para. 1 reads as follows:
"(1) the health insurance fund is used to pay for health care
paid for by the general health insurance scheme and is made up of payments
insurance premiums. From the Fund the costs of further activity
employee insurance companies according to § 13 para. 1 (b). d).".
5. in paragraph 22 of part five shall be inserted, which including the title reads as follows:
"PART FIVE
HEDGE FUND
§ 22a
(1) this Act establishes a hedge fund (the "Fund"), which
is a legal entity. The Fund is recorded in the commercial register. Fund
He is not a fund within the meaning of such a law.
(2) the Fund is used to pay for the health care provided by healthcare professionals.
devices to the insured employee insurance destroyed by 6
paragraph. 6 (a). and), in cases where they were not on the date of completion of the liquidation, the
employee insurance companies met all due accounts receivable
health care facilities, and in cases where an employee and the insurance company has
several lenders and is not able to for a long period to meet its debts,
or if it is předlužena.
(3) Any employee of an insurance undertaking shall be obliged to contribute to the Fund.
The annual contribution of employee insurance companies in the Fund is 0.5% of the average
the annual expenditure of the basic Fund employee insurance. The contribution to the
The Fund is an employee and the insurance company is obliged to pay for the previous
calendar year not later than 31 December 2006. January of the current year. The Fund may
to invest funds in government securities, securities
securities guaranteed by the State or in vouchers the Czech National Bank.
(4) the Fund is managed by a Board of Directors. Members of the Management Board shall be appointed by
the Minister of health. Members of the Board are appointed for a period
five years, and it repeatedly. As a member of the Management Board does not belong
the reward.
(5) the details of the activities of the Fund adjusts the Fund rules, issued by the
The Ministry of health.
section 22b
(1) the Fund shall provide reimbursement of medical devices based on its
request, the conditions are fulfilled according to § 22a para. 2. the Fund shall have the right
to review the lawfulness of the provision of health care, which has to pay;
the provisions of this law and other laws regarding
staff employee of the insurance undertaking shall not apply.
(2) the remuneration shall be as follows:
and) with regard to claims arising in respect of the provision of health care
general practitioner and general practitioner for children and adolescents, in the amount of 80%
the amount owed, but not more than 200 Czk per person
(b)) in respect of claims arising from the title of the provision of out-patient
health care specialists, in the amount of 80% of the outstanding amount, no more than
However, 900 Eur per insured person,
(c)) in respect of claims arising from the title of the provision of hospital
care, amounting to 80% of the outstanding amount, but not more than 1200 Czk per
the insured person,
(d)) with respect to claims arising from the title on the basis of dispensing
a prescription, in the amount of 80% of the outstanding amount, but not more than 700 CZK
one of the insured person.
(3) the right of medical equipment on the reimbursement from the Fund shall become statute-barred
the expiry of five years from the date laid down in paragraph 1.
(4) in the event that the resources of the Fund are not sufficient to pay the law
provided for payments, will provide the remaining part of the necessary cash
resources to Fund the State in the form of returnable financial assistance. In such a
the case increases the employee's contribution to the Fund from the insurance
the year following the granting of a loan to double the percentage of the
referred to in § 22a para. 3. in the year following the repayment of repayable
financial assistance to post reduced to the percentage referred to in §
22A paragraph 2. 3.
section 22 c
Fund becomes a creditor of health insurance rights
medical equipment from the Fund. ".
section 60
The Czech National Council Act No. 592/1992 Coll., on premiums for General
health insurance, as amended by Act of the Czech National Council No. 10/1993 Coll.
the Czech National Council Act No. 15/1993 Coll., Act No. 166/1993 Coll.,
Act No. 333/1993 Coll., Act No. 42/1994 Coll., Act No. 241/1994 Coll.
Act No. 58/1995 Coll. and Act No. 149/1996 Coll., amending and supplementing
as follows:
1. in article 15, paragraph 2. 1 at the end of this sentence connects:
"Arrears of premiums, the amount in the aggregate does not exceed one
complied and one insurance company of $ 50, you cannot recover them. ".
2. section 18, the following paragraph 4 is added:
"(4) if not prescribed penalty does not exceed in the aggregate $ 100 for one
calendar year. ".
3. section 28b, the following paragraph 4 is added:
"(4) in accordance with the provisions of § 15 para. 1 and § 18 para. 4 insurance proceeds
even in the case of periodic penalty payments, which should be assessed by the insurance company or enforce the day
the effectiveness of these provisions, however, until the date of their effectiveness so
failed to do so. ".
PART THIRTEEN
§ 61
The effectiveness of the
This Act shall take effect on 1 January 2000. April 1997, with the exception of article 15, paragraph 2.
10 the first sentence, and article 59 paragraph 5 which enter into force on 1 January 2000. January
1998.
Zeman in r.
Havel, v. r.
Klaus r.
Annex 1
LIST OF MEDICAL PROCEDURES FROM A HEALTH INSURANCE COMPANY OR
COVERED ONLY UNDER CERTAIN CONDITIONS
List of abbreviations and symbols
---------- ------------------------------------------------------------------------------
Mark, Explanation
symbol
---------- ------------------------------------------------------------------------------
ODB expertise
CAT health category performance in terms of payment of health insurance
-symbols N, Z, W-see below
The performance marked in column n KAT symbol "N"-health performance significantly
nehrazený of health insurance, the exception may be the previous
to enable the audit trail for the insured's doctor, due to its
serious medical condition (or special health need)
W marked in column performance KAT symbol "W"-health performance fully
paid from health insurance only when certain conditions or
maximum reimbursable limit frequencies, you do not need the approval of the revision
doctor
Of performance in the column marked "Z" symbol KAT-health performance fully
paid health insurance only under certain conditions and after approval by
the review by a doctor
DG. diagnosis
sequence. No serial number power
---------- ------------------------------------------------------------------------------
---------- ----------------------------------------------------------------------------
ODB Name
---------- ----------------------------------------------------------------------------
001 General practical medicine
002 practical medicine for children and adolescents
014 Dentistry General-General dentist-dentist
015 Orthodontics
201 rehabilitation and physical medicine
401 occupational medicine
404 Dermatovenereology
504 vascular surgery
601 plastic surgery
603 of gynaecology and obstetrics
605 Oral and maxillo-facial surgery
606 Orthopedics
701 Otorhinolaryngology
705 Ophthalmology
706 Urology
808 forensic medicine
809 diagnostic radiology
903 clinical speech therapy
911 General nurse
999 Universal care-without binding on the expertise
----------- ---------------------------------------------------------------------------
List of medical procedures from public health insurance company
or covered only under certain conditions
-------------- ------------------------------------------------------ -------------------------------------
Sequence. ODB Name Health Condition of payment performance KAT
No.
-------------- ------------------------------------------------------ -------------------------------------
1.001 Health educational činnostN
2.002 Disabled educational activity N
3.014 Sealing fissures-tooth N
4.014 Koferdam-one jaw N
5.014 alveolár bone Trephination N
6.014 Augmentation, guided tissue regeneration and implant a N
in dentistry
7.014 Makeshift bridge made in N
8. Fix the fixed compensation in 014 surgery N
9.015 Professional consultations at the request of orthodontic patient N
10. Reconstruction and 504. iliaca int. and other feats of N
for vascular impotence
11.603 Rekanalizace the fallopian tube after previous sterilization N
12.701 Indirect laryngoscopy with instillation of drug to the larynx N
13. The implantation of penile prostheses 706 N
14.706 cock-kavernosometrie N
15.706 Kavernosografie N
16. the types of preventive examinations-903 detect N
in the field
17. The investigation carried out at the workplace 001 racing doctor W performance will be paid if the
jenezbytný to determine the
the epidemiological situation in the workplace
18.014 Injectable anesthesia W performance will be paid except
intraligamentární anesthesia
19.014 Comprehensive examination by a doctor of the provider in the field of Watts power will be paid only when the
the takeover of the insured person to the dentist care
upon registration of the insured person
20.014 Review oral hygiene-prophylaxis W Paid twice a year
21.014-prophylactic removal of tartar W Paid once a year
22.014 Local fluoridation with drying W Paid when the product
with aminofluoridem without carrier
23.014 Fill permanent teeth (regardless of the number of Watts Paid only when you use
faces, including the reconstruction of the nedózovaného amalgam)
in the scope of the entire set of teeth, when you
use samopolymerujícího
composite only to the extent
the canine teeth, including
24.014 Composite fill the permanent tooth (without Watts Paid for children up to the age
regardless of the number of faces, including 18 years in the range of the canines, including
reconstruction of the muzzle and the completion of the plastic)
25.014 endodontic treatment W Paid when you use
the registered material
method of the central pin
26.014 Transitional splint without preparation-per tooth W Paid when you use
self-polymerizing
composite resin
27.014 Temporary splint with the preparací-per tooth W Paid when you use
self-polymerizing
composite resin
28. Determination of the long-term rehabilitation 201 W Paid once during treatment
plan on the basis of past rehabilitation Conference
29. The investigation in the workplace of the insured person 401 W Performance will be paid only
in terms of risks of professional examination for indication
damage to threatened, suspicious or
This ongoing professional disability
30.601 Reshaping and tightening odstálého ears W Full payment to 10 years of age
a child over 10 years of health
the insurance company will not refund the
31.701 agravaci tests and simulation of W in the case of proven simulation
nehrazen
32.705 Applications contact lenses W performance will be paid after the operation
cataracts
33.808 Consultation findings the Court doctor W performance will be paid, if it is
nažádost doctor
necessary to explain the award
for the particular case
34. A comprehensive assessment of health 911 W Performance will be paid only on
the status of an insured person in his environment, the recommendation of a medical practitioner
upon receipt of the insured person to
doctor indicated the temporary or
long-term nursing care
in the home
35. check of the insured person in the 911 Targeted home environment W performance will be paid after the previous
indication of general practitioner,
that can be a one-off or
expressing a specific frequency
visits to a specific period
36.911 Nursing intervention is simple in a home environment W performance will be paid after the previous
indication of general practitioner,
that can be a one-off or
expressing a specific frequency
visits to a specific period
37.911 Comprehensive care ošetřovatelsky W Performance-intensive will be paid after the previous
or non-moving the insured person in a domestic environment the indication of a medical practitioner,
that can be a one-off or
expressing a specific frequency
visits to a specific period
38.999 Psychotherapy support-performed by doctor nepsychiatrem W performance will be paid only on one
the insured person once a year
in a single scope after detailed
registration in the medical
documentation
39.999 to interview the doctor with the family will be paid on the Watts power one
insured persons under the age of 15 years
no more than twice per year,
in adults once a year after
detailed registration in the medical
documentation
40.999 Educational interview doctor with a sick or family W Paid only when health
the indication of a reasoned in writing
vezdravotnické documentation
and legitimized by the signature of the edukovaného
or his legal representative
41.999 Consultation doctor Watts power provider paid only if it is on
specialized outpatient care practitioner's request
42.403 Proton radiotherapy of performance will be paid only if it was done
on the basis of the indications of a provider that
mástatut Center of highly specialized
health care in the field of Oncology awarded
According to the law on health services.
43.404 Epilation á 30 minutes of performance will be paid only
for dg. E00-E07 (disorders of the thyroid
gland, hormonal disorders),
E10-E14 (diabetes mellitus),
E20-E35 (diencefalohypofyzární
disorders)
42.601 correction of congenital anomalies of the auricle of the small
and the surrounding area (bone growths)
45.601 Xanthelasma of
46.601 Operation ptózy face-upper, dolníZ
47.601 Operation ptózy face-total (smas of
lifting)
48.601 Operations hard and soft nose for the function of the
malfunction
49. Rinoplastika-601 soft nose of
50.601-Rinoplastika sedlovitý nose (L-graft, including collection)
51. Rinofyma of 601
52. gigantomastie Operation of 601
53.601 Ablation with preserving the areola of the breast
54. The reconstruction of the areomamilárního complex of 601
55.601 Capsulotomy implant from housing
56.601 breast implant removal with kapsulektomií from
57. The implantation of tissue Expander and 601 of
58.605 chin augmentation bone, cartilage or prosthesis of
60.605 Subperiosteal implant-one jaw of the
61. the Chin Correction of 605
62.606 Osteotomy of the hip
63.606, shortening of the long bones Extending from the
64.701 of Septoplasty
65. Laser iridotomy 705 of the Performance is paid when you perform
1 St 3 times, when most
another implementation is to be paid
require the consent of the review a doctor
66.705 Dermatoplastika one eyelid, or from
blepharochalasis-exize from one eyelid
+ fat removal and fold
67.705 Laser coagulation of the retina of the Performance is paid when you perform
1 St 5 times, when most
another implementation is to be paid
require the consent of the review a doctor
68.705 plastic surgery of the skin of the eyelid of the Rotary
the caudate lobe or offset
69. thermotherapy Transurethral prostate of 706
70.706 cock-intrakavernózní injection of vasoactive substances from
71. the vas deferens-706 Ligature vazektomie from
-------------- ------------------------------------------------------ -------------------------------------
Annex 2
LIST OF GROUPS OF ACTIVE SUBSTANCES
--------- --------------------------------------------------------------------------------------
The number of the name of a group of substances
Group
--------- --------------------------------------------------------------------------------------
1 protivředová of the drug from a group of Proton pump inhibitors, oral administration
2 agents, oral administration
3 from the Group setronů antiemetics
4 anti-inflammatory drugs with inflammatory intestinal inflammation, oral administration
5 anti-inflammatory drugs for inflammation in the bowel, rectal application
6 micronized multienzymové pancreatic preparations
7 insuliny short-acting
8 insuliny intermediate acting
9 insuliny long-acting
10 oral antidiabetics of biguanides group
11 oral agents from a group of sulphonylurea
12 vitamin D and its analogues, oral administration
13 vitamin D and its analogues, parenteral administration
14, oral administration of calcium salts
15 salt potassium oral
16 antithrombotika of vitamin K antagonist
17 antithrombotika of a group of heparin
18 antithrombotika acting through the anti-Xa (low molecular weight
heparins and similar drugs)
19-in addition to aspirin anti-platelet agents
20 antifibrinolytics, oral administration
21 antifibrinolytics, parenteral application
22 antihemorrhagics (vitamin K), oral administration
23 coagulation factor VIII
24 coagulation factor IX
25 iron salts, oral administration
26 iron salts in combination with folic acid, oral administration
27 iron salts, parenteral application
28 erythropoietin and other drugs with a similar mechanism of action
29 substituents plasma and plasma proteins (albumin)
30 substituents plasma and plasma proteins (other)
31 total parenteral nutrition (components for the systems all in one)
32 by solutions has the solution
33 intravenous glucose solutions
34 solutions for peritoneal dialysis
35 solutions for haemodialysis
36 cardiac glycosides, oral administration
37 class I and III antiarrhythmics, oral administration
38 adrenaline
39 nitrates and molsidomin for chronic oral administration of
40 nitrates for emergency treatment
41 antiadrenergic agents, antihypertensives-oral
42 drug for pulmonary hypertension
43 diuretics lower the effect of oral administration of diuretickým,
44 diuretics with high effect, oral administration
45 diuretics with high effect, parenteral application
potassium-sparing diuretics, 46 oral administration
47 selective beta blockers, oral administration
48 vápníkového channel blockers from the Group dihydropyridinů Active 24 hours, more than 3 months
oral administration of
49 other calcium channel blockers, oral administration, acting
less than 24 hours
50 other groups of calcium channel blockers, oral administration, acting
more than 24 hours
51 ACE-inhibitors acting for more than 24 hours
52 drugs affecting the renin-angiotensin system, with the exception of the ACE-inibitorů
Statin lipid lowering medicines from a group of 53
lipid lowering medicines from a group of 54 Fibrates
55 antifungals for topical use
56 antipsoriatics for topical use
57 antibiotics for topical use
58 corticosteroids used for topical therapy-the weak and moderate
1. and 2. generation
59 corticosteroids used for topical therapy-the weak and moderate
3. and 4. generation
60 corticosteroids used for topical therapy-a strong and very strong
1. and 2. generation
61 corticosteroids used for topical therapy-a strong and very strong
3. and 4. generation
62 active substances against acne for topical use
63 gynecological antifungals, antibiotics and chemotherapeutics for topical
the use of the
64 of the drug rising tone of the uterus
65 drugs reducing the tone of the uterus
66 prolactin inhibitors
67 male sex hormones
68 female sex hormones of estrogen, oral administration group
69 female sex hormones of estrogen, parenteral application group
70 female hormones from a group of progestins
71 gonadotropins and other ovulation stimulants
72 other sex hormones, androgens and modulators
73 urinary antispasmodics
74 drugs used in benign prostatic hyperplasii
75 front lobe of the pituitary hormones and their analogues
the rear lobe of the pituitary gland 76 hormones and their analogues
77 the hypothalamus hormones and their analogues
78 total use of corticosteroids, oral administration
79 total use of corticosteroids, parenteral application
80 thyroid hormones
81 of antithyroid drugs
82 glucagon
83 homeostatika calcium
84 tetracycline antibiotics, oral administration
85 Penicillins with wide range and combination of Penicillins, including inhibitors
betalactamases, oral administration
sensitive to Penicillins, betalaktamáze 86, oral administration
87 different lactam antibiotics, oral administration
88 sulfonamides and trimethoprim, oral administration
89 macrolide antibiotics, oral administration
90 linkosamidová antibiotics, oral administration
91 aminoglycoside antibiotics
92 quinolone chemotherapy, oral administration
93 imidazolová and nitrofuranová chemotherapy, oral administration
94 antimycotics for systemic use, oral administration
95 antimycobacterials
System 96 antivirals for treatment of herpes, cytomegalovirových infections
and some other viral infections, oral administration
97 antiretroviral therapy
98 immunoglobulins, normal human
99 human tetanus immunoglobulin
100 human immunoglobulins against the hepatitis
101 other human specific immunoglobulins
from a group of alkylating antineoplastic 102 substances, oral administration
from a group of alkylating antineoplastic 103 substances, parenteral application
104-folic acid analogues antimetabolites, oral administration
105-folic acid analogues antimetabolites, parenteral application
106 antimetabolites-purine and pyrimidine analogs, oral administration
107 antimetabolites-purine analogues, parenteral application
108 antimetabolites-pyrimidine analogues, the other the application paths
109 of vinca alkaloids and analogues
110 podofylotoxinu derivatives, oral administration
111 podofylotoxinu derivatives, the other the application paths
112 taxanes
113 anthracyclines and their derivatives
114 cytotoxic antibiotics
115 Platinum antineoplastic agents
116-tyrosine kinase inhibitors, antineoplastic agents, oral administration
117 antineoplastic agents-monoclonal antibodies
118 a cytostatic effect of hormonal medicines, parenteral administration
119 antagonists of hormones-anti-estrogens, oral administration
120 antagonists of hormones-antiandrogens, oral administration
121 aromatáz inhibitors
122 interferons used in Oncology
123 the interferons and glatiramer acetate are used in neurology
124 interferons used in Hepatology
125 immunosuppressive drugs-m-TOR, oral administration
126 immunosuppressive drugs-calcineurin inhibitors, oral administration
127 of immunosuppressive drugs, TNF-alpha inhibitors
128 nonsteroidal anti-inflammatory drugs, oral administration
129 nonsteroidal anti-inflammatory drugs, rectal
130 Central muscle relaxants, oral administration
131 anti-gout agents, oral administration
132 Drugs acting on bone mineralisation-bisphosphonates, oral administration
133 local anesthetics of the amide hydrolysis group
134-strong opioid analgesic oral
135-strong opioid analgesics, transdermal application
136 analgesics-morphine, parenteral administration
137 analgesics-weak opioids, oral administration
138-strong opioid analgesics for the treatment of breakthrough pain
139 analgesics-antipyretics, oral administration
140 antimigraine preparations
141 antiepileptics from a group of barbiturates
142 antiepileptics, oxazolidinů of the Group of hydantoinátů and sukcinimidů
143 antiepileptics from a group of benzodiazepines and karboxamidů
144 antiepileptics from the Group derivatives of fatty acids
145 anticholinergic antiparkinsonian
146 dopaminergic antiparkinsonian levodopa from the Group and their derivatives
147 of the dopamine agonist antiparkinsonian group
148 antiparkinsonian acting on MAO or COMT
149-classical antipsychotic Neuroleptics, class I, oral administration
150-classical antipsychotic Neuroleptics, II. class, oral administration
151 low potential antipsychotic drugs seizures, oral administration
Antipsychotics-152 and dopamine receptors of serotonin antagonists
153 Antipsychotics-multireceptoroví antagonists
154 lithium
155 antipsychotic drugs, Neuroleptics parenteral applications-depot preparations
156 anxiolytics, oral administration
157 anxiolytics, rectal
158 antidepressants non-selectively inhibits the reuptake of Monoamines,
oral administration of
159 antidepressants-selective serotonin acting on one transmiterový
system, the oral administration of
160 antidepressants-selective serotonin acting on two transmiterové
systems, oral administration
161-the oral administration of Central stimulants
162 drugs for the treatment of Alzheimer's disease (cholinesterase inhibitors)
163 parasympatomimetika, oral administration
164 of the drug used in the treatment of dizziness, oral administration
165 antimalarial drugs
166 anthelmintic
167 nasal corticosteroids including hypoallergenic
168 inhaled sympathomimetics
169 inhaled corticosteroids
170 inhaled anticholinergics
171 antileukotrieny, oral administration
172 non-sedating antihistamines
173 ophthalmologicals-antibiotics
174 ophthalmologicals-chemotherapy
our 175-antivirals
176 ophthalmologicals-corticosteroids
177 ophthalmologicals-nonsteroidal anti-inflammatory drugs
178 antiglaukomatika of a group of sympathomimetics and parasympatomimetik
179 antiglaukomatika from the Group of beta blockers
180 antiglaukomatika of a group of prostaglandins and prostanoidů
181 mydriatika and cykloplegika
our 182-antialergika
183 therapeutic extracts standardized allergens, neinjekční administration
184 therapeutic extracts standardized allergen injection
185 basic antidotes
186 antidotes used in the treatment of chemotherapy, oral administration
187 antidotes used in the treatment of chemotherapy, parenteral administration
188 defined mixture of amino acids without phenylalanine
189 defined mixture of amino acids amino acids (except without the selected
phenylalanine) for other metabolic disorders
190 individually prepared radiopharmaceutical for diagnosis
191 individually prepared radiopharmaceutical therapy
192 of packed products
193 trombocytární preparations
194 products from plasma
195 leukocyte preparations
--------- --------------------------------------------------------------------------------------
Annex 3
THE LIST OF MEDICAL DEVICES
SECTION AND
List of abbreviations and symbols
In the list of medical devices which are not fully from the resources
health insurance and in the list of medical devices covered by
health insurance funds in the provision of out-patient
health services have used abbreviations and symbols the following meaning:
and) group
1 bandages, plasters
2 AIDS for incontinence
3 Ostomy AIDS
4 orthopaedic prosthetic devices mass produced
5 orthopaedic prosthetic devices individually made
6 compression stockings and girdles
7 disability including trolleys accessories
8 hearing aid accessories
9 glasses and optical AIDS
10 AIDS respiratory and inhalation
11 tools for diabetics
12 compensatory aids for the disabled
13 on unspecified equipment
14 compensatory aids for the visually impaired
15 compensatory aids for the hearing impaired
16 orthopedic shoes
17 tools for laryngektomované
(b)) the abbreviation
DB decibel
DPT diopters
K. t. compression class
PVC (polyvinyl chloride)
SRT verbal threshold of clarity
(c) specialisation and marking abbreviations) special focus sites
ALG Allergology and Clinical Immunology
CHR surgery
DIA Endocrinology and diabetology
DRV dermatovenereology
FON foniatrie
GER Geriatrics
J16 surgeries with the activity of angiologickou and lymfologickou
NEU Neurology, Child Neurology
OHM Oncology and Hematology
OPH ophthalmology
ORP prosthetics
ORT orthopedics
OTO Otorhinolaryngology
PED paediatrics, practical medicine for children and adolescents
PRL general practical medicine
REH, rehabilitation and physical medicine
S3 owning Company ENT doctor certificate entitling to
to regulation and the issue of hearing aids financed by public funds
health insurance
S4 ophthalmic surgeries for the dispensing of special optical AIDS
S5 special health insurance scheme for the approval of the review a doctor
TRA Traumatology
TRN Pneumology and phthisiology
TVL sports medicine
URN in urology and Nephrology
SECTION B
The list of medical devices which are not fully public health
insurance in the provision of out-patient health services
----------------- ----------------------------------------------------------------------------------
Item Group name of the species (kind of) medical device Note
----------------- ----------------------------------------------------------------------------------
1 1 patches with the exception of hypoalergických
patches
2 1 patch for corns
plena 3 2 PVC
4 2 pads PVC
5 4 shoe tennis
6 4 brace sports
stroller accessories-7 7 worktop
8 7 of the pram accessories-storage basket
9 7 the stroller accessories-raincoat
10 7 accessories to the cart-job board
11 7 accessories to the trolley-raincoat
12 7 electric trolleys accessories-control for escorts
diagnostic strips on 13 11 determination of cholesterol
14 12 chodítkům accessories that are beyond the scope of their functions
15 13 eye dropper
16 13 Rod eye
17 13 breast pump
18 13 finger technical rubber
19 13 bed health
20 13 intrauterine device
21 13 pillow including coating
22 16 neortopedické insoles
23 repair medical devices in addition to wheelchairs and strollers and individually manufactured
Orthopedic and prosthetic products and repair jacks and positioning beds
----------------- ----------------------------------------------------------------------------------
SECTION C
The list of medical devices covered by public health
insurance in the provision of out-patient health services
----------------- ------------------------------------------ -------------------------------------------------------------------------------
Item Group name of the species (kind of) the restriction of the limitations of the above remuneration
medical
resource
----------------- ------------------------------------------ -------------------------------------------------------------------------------
1 1 resources for classic healing max. size 10 x 10 cm 100%; Max. 4 Eur per 1 piece; And
2 1 non-wovens max. size 10 x 10 cm. 100%; Max. 50 € per 100 pieces; And
Max. 100 PCs per month;
3 1 resources for moist wound healing max. dimension 12x12cm; 100%; Max. 160 CZK per 1 piece; And
After prescription of the CHR, DIA, DRV,
GER, INT, JI6; the prescription
possible to delegate to the PRL; When
treatment of longer than 3 months after the
the approval of the review a doctor
Hypo-allergenic patch 4 1 to 18 years of age, only for stomiky and 100%; Max. 30 € per pack; And
diabetics
elastic bandage 5 1 max. size 14 cmx 5 m 100%; Max. 50 Eur per 1 piece; And
6 1 bandage sterile hydrophilic max. size 12 cmx 5 m 100%; Max. 15 CZK per 1 piece; And
flexible hose wrap 7 1 100%; Max. 30 Eur per 1 piece; And
8 1 tampons coil max. 1 000 pieces per year; After 100%; Max. 70 CZK per 1 000 PCs; And
prescription of DIA
9 1 cotton cellulose max. 500 g 100%; Max. $ 50 per 500 g; And
10 2 absorption means for max. 150 PCs per month 100%; Max. 450 CZK per 150 PCs; And
incontinent-inserts
for light incontinence
11 2 absorption means for max. 150 PCs per month 100%; Max. 900 CZK/150 SC; And
medium incontinence
-shaped diapers
12 2 absorption means for max. 150 PCs per month 100%; Max. 1 700 CZK/150 SC; And
severe incontinence-
diaper
13 2 absorbent fixation devices max. 24 PCs per year 100%; Max. 190 CZK per 24 PCs; And
for a fee the diapers
14 2 condoms urine max. 30 PCs per month 100%; Max. 700 CZK for 30 DC; And
urine collection bags, 15 2 max. 10 PCs per month 100%; Max. 500 CZK per 10 PCs; And
colostomy pads 16 3 max. 10 PCs per month 100%; Max. 3 000 CZK for 10 PCs; (B)
Ileostomy pads 17 3 max. 15 PCs per month 100%; Max. 4 500 € for the 15 DC; (B)
18 3 washers urostomy max. 15 PCs per month 100%; Max. 4 500 € for the 15 DC; (B)
19 3 caps Ostomy max. 30 PCs per month; 100%; Max. 3 100 CZK for 30 DC; (B)
After the approval of the review a doctor
20 3 Stoppers Ostomy max. 30 PCs per month; 100%; Max. 3 100 CZK for 30 DC; And
After the approval of the review a doctor
21 3 systems colostomy max. 60 PCs per month 100%; Max. 4 000 CZK for 60 PCs; (B)
two piece closed-bags
22 3 systems colostomy max. 60 PCs per month 100%; Max. 7 500 CZK for 60 PCs; (B)
one-piece closed-bags
(including support)
Ileostomy systems 23 3 max. 30 PCs per month 100%; Max. 9 000 CZK for 30 DC; (B)
one-piece drain-bags
Ileostomy systems 24 3 max. 30 PCs per month 100%; Max. 8 500 CZK for 30 DC; (B)
one-piece drain-bags
(including support)
urostomy two-piece systems 25 3 max. 30 PCs per month 100%; Max. 5 500 CZK for 30 DC; (B)
-bags
urostomy systems 26 3 max. 30 PCs per month 100%; Max. 9 000 CZK for 30 DC; (B)
one-piece-bags
(including support)
27 3 retaining straps and a max. 2 PCs per year; after the approval of 100%; Max. 600 CZK per 2 PCs; And
resources for stomiky review a doctor
Ostomy irrigation systems 28 3-max. 2 sets including accessories 100%; Max. 2 800 CZK per 2 sets; And
sets and accessories per year; After the approval of the review
doctor
Ostomy-29 3 systems to the max. 1 system (10pcs pads 100%; Max. 13 000 CZK per 1 system; And
a temporary stoma kontinenci 60 PCs sealed bags and 15 PCs
device for temporary kontinenci
Stoma) per month; after approval
the review by a doctor
Ostomy-drain washers 30 3 max. 10 PCs per month; 100%; Max. 3 000 CZK for 10 PCs; (B)
After the approval of the review a doctor
Ostomy-drainage systems 31 3 max. 30 PCs per month; 100%; Max. 8 500 CZK for 30 DC; (B)
one-piece-bags after the approval of the review a doctor
(including support)
Ostomy-drainage systems 32 3 max. 30 PCs per month; 100%; Max. 7 000 CZK for 30 DC; (B)
two-piece-bags after the approval of the review a doctor
Ostomy-resources 33 3 100%; And
filling out and buffer
Ostomy-resources thickening 34 3 max. 30 PCs per month; 100%; Max. 360 CZK for 30 DC; And
for ileostomiky
Ostomy resources 35 3-cleaning 100%; Max. 350 Czk per month; And
36 3 Remover pads 100% Ostomy; Max. 300 € per month; And
Ostomy-resources trade 37 3 100%; Max. 1 000 CZK per month; And
38 3 resources-Ostomy deodorant after the approval of a revision doctor 100%; Max. 350 Czk per month; And
series-produced orthosis 39 4 max. 1 piece per year; after prescription of 100%; And
ORT, ORP, REH, CHR, NEU, TRA, TVL
40 4 sleeve one max. 8 PCs per year 100%; And
41 4 Jockstrap max. 2 PCs 100% per year; Max. 130 CZK per 2 PCs; And
Breast epitéza 42 4 max. 1 PC for 2 years; 100%; Max. 1 800 CZK per 1 piece; And
After prescription of the CHR, OHM, PRL
43 4 self-adhesive breast epitéza max. 1 PC for 2 years; at 100%; Max. 3 000 CZK per 1 piece; And
the lymphatic swelling; After the prescription
Ohm, J16
epitéza postoperative breast 44 4 max. 1 DC in rámci1 operations; 100%; Max. 500 CZK per 1 piece; And
After prescription of the CHR, OHM
45 4 compression bra max. 1 piece per year; at 100%; Max. 1 300 CZK per 1 piece; And
the lymphatic swelling;
After prescription of the CHR, OHM
46 5 brace individually made after prescription of ORP, ORT, REH, 100%; And
CHR, NEU, and after approval by the review
doctor
epitéza 47 5 individually made max. 1 PC for 2 years; 100%; And
After prescription of the CHR, ORP, ORT
and after the approval of the review a doctor
upper and lower dentures 48 5 max. 1 PC for 2 years; 100%; And
limbs-basic design after prescription of ORP, REH, ORT
49 5 modular prosthesis for upper and a max. 1 PC for 2 years; 100%; And
the lower limbs that are after prescription of ORP, REH, ORT
constructed of modular and, after approval by the review a doctor
preparations and reports, including
tensile prostheses for upper limbs
50 5 prostheses myoelektrické, max. 1 DC in 5 years (in the case of 100%; And
the loss of both upper limbs, disability of both limbs 1 pair per
or unilateral amputation with 5 years); After prescription of ORP, REH,
functional disabilities second ORT and after approval by the review
upper limb doctor S5
51 6 compression elastic max. 2 pairs per year; After 100%; Max. 820 CZK per 2 pairs; And
stockings leg II. Prescribing PRL to T, CHR, INT, DRV,
J16
52 6 compression elastic max. 2 pairs per year; After 100%; Max. 900 CZK per 2 pairs; And
stockings leg III. K. T prescription CHR, INT, DRV, J16
53 6 compression elastic max. 2 pairs per year; After 100%; Max. 2 000 CZK per 2 pairs; And
stockings leg IV. K. T prescription CHR, INT, DRV, J16
54 6 compression elastic max. 2 pairs per year; After 100%; Max. 1 050 CZK per 2 pairs; And
stockings polostehenní II. Prescribing PRL to T, CHR, INT, DRV,
J16
55 6 compression elastic max. 2 pairs per year; After 100%; Max. 1 200 CZK per 2 pairs; And
stockings polostehenní III. K. T prescription CHR, INT, DRV, J16
56 6 compression elastic max. 2 pairs per year; After 100%; Max. 2 600 CZK per 2 pairs; And
stockings polostehenní IV. K. T prescription CHR, INT, DRV, J16
57 6 compression elastic max. 2 pairs per year; After 100%; Max. 1 200 CZK per 2 pairs; And
stockings thigh II. Prescribing PRL to T, CHR, INT, DRV,
J16
58 6 compression elastic max. 2 pairs per year; After 100%; Max. 1 200 CZK per 2 pairs; And
stockings thigh III. K. T prescription CHR, INT, DRV, J16
59 6 compression elastic max. 2 pairs per year; After 100%; Max. 3 000 CZK for 2 pairs; And
stockings thigh IV. K. T prescription CHR, INT, DRV, J16
60 6 compression elastic max. 2 PCs per year; after prescription of 100%; Max. 700 CZK per 2 PCs; And
stockings thigh with PRL, CHR, INT, DRV, J16
at the waist (II). K. T
61 6 compression elastic max. 2 PCs per year; after prescription of 100%; Max. 750 CZK per 2 PCs; And
stockings thigh with the CHR, INT, DRV, J16
at the waist (III). K. T
62 6 compression elastic max. 2 PCs per year; after prescription of 100%; Max. 800 CZK per 2 PCs; And
stockings thigh with the CHR, INT, DRV, J16
at the waist (IV). K. T
63 6 compression elastic max. 2 PCs per year; after prescription of 100%; Max. 1 900 CZK/2 DC; And
tights Womens PRL, CHR, INT, DRV, J16 and after
II. A. T. the approval of the review a doctor
64 6 compression elastic max. 2 PCs per year; after prescription of 100%; Max. 2 000 CZK per 2 PCs; And
tights Womens CHR, INT, DRV, J16 and after
III. A. T. the approval of the review a doctor
65 6 compression elastic max. 2 PCs per year; after prescription of 100%; Max. 2 000 CZK per 2 PCs; And
tights Womens CHR, INT, DRV, J16 and after
IV. A. T. the approval of the review a doctor
66 6 compression elastic max. 1 piece per year; after prescription of 100%; Max. 950 CZK per 1 piece; And
pantyhose CHR, INT, DRV, J16 and after
maternity (II). K. T. the approval of the review a doctor
67 6 compression elastic max. 1 piece per year; after prescription of 100%; Max. 1 300 CZK per 1 piece; And
pantyhose CHR, INT, DRV, J16 and after
maternity III. and (IV). K. T. the approval of the review a doctor
68 6 arm shoe assy II. K.T. Max. 2 PCs per year; after prescription of 100%; Max. 1 000 CZK per 2 PCs; And
CHR, INT, DRV, J16, OHM
69 6 arm shoe assy (III). Max. 2 PCs per year; after prescription of 100%; Max. 1 000 CZK per 2 PCs; And
and (IV). K. T. CHR, INT, DRV, J16, OHM
70 6 compression elastic max. 2 PCs per year; after prescription of 100%; Max. 4 000 CZK per 2 PCs; And
stockings and girdles II., III. CHR, INT, DRV, J16 and after
and (IV). K. t.-individually approve the review a doctor
made up of technology
circular knitting
71 6 compression elastic max. 2 PCs per year; after prescription of 100%; Max. 15 000 CZK per 2 PCs; And
stockings and girdles II., III. J16, and after approval by the review
and (IV). K. t.-individually doctor S5
made up of flat knitting technology
ankle and knee 72 6 piece piece max. 2 PCs per year; after prescription of 100%; Max. $ 260 for 2 PCs; And
II. and III. K. T. CHR, ORT, REH, PRL, DRV, J16
73 6 aid for donning max. 1 piece per year; after prescription of 100%; Max. 300 CZK per 1 piece; And
compressive elastic, CHR, INT PRL, DRV, J16
stockings II., III. and (IV). K. T.
74 7 stroller health max. 1 SC in 3 years; After 100%; Max. 21 000 CZK
prescription REH, ORT, NEU and 1 SC; And
the approval of the review a doctor
75 7 health-stroller accessories max. 1 SC in 3 years; After 100%; Max. 5 000 CZK per 1 piece; And
prescription REH, ORT, NEU and after
the approval of the review a doctor
76 7-core trolley mechanical max. 1 DC in 5 years; After 100%; Max. 9 EUR per 1 piece; And
prescription REH, ORT, NEU, INT
and after the approval of the review a doctor
mechanical-lightweight trolley 77 7 max. 1 DC in 5 years; After 100%; Max. 19 EUR per 1 piece; And
prescription REH, ORT, NEU, INT
and after the approval of the review a doctor
78 7 truck mechanical-active max. 1 DC in 5 years; After 100%; Max. 21 000 Eur per 1 piece; And
prescription REH, ORT, NEU, INT
and after the approval of the review a doctor
a mechanical trolley 79 7-baby max. 1 DC in 5 years; After 100%; Max. 21 000 Eur per 1 piece; And
prescription REH, ORT, NEU and after
the approval of the review a doctor
80 7 truck mechanical-special max. 1 DC in 5 years; After 100%; Max. 55 EUR per 1 piece; And
having regard to the degree and severity of prescription REH, ORT, NEU and after
the approval of the review of disability by a doctor
81 7 truck mechanical accessories max. 1 DC in 5 years; After 100%; And
prescription REH, ORT, NEU, INT
and after the approval of the review a doctor
82 7 leather gloves for wheelchair users max. 2 pairs per year 100%; Max. 300 CZK per 2 pairs; And
(mechanical)
83 7 trolley electric cars max. 1 DC in 7 years; After 100%; Max. 136 EUR per 1 piece; And
-for operation usually prescription REH, ORT, NEU, INT
in the exterior, and after the approval of the review a doctor
84 7 trolley electric cars max. 1 DC in 7 years; After 100%; Max. 115 EUR per 1 piece; And
-the standard for light traffic prescription REH, ORT, NEU, INT and
usually in the Interior, after approval by the review doctor S5
85 7 cart electric-accessories max. 1 DC in 7 years; After 100%; And
prescription REH, ORT, NEU, INT
and after the approval of the review a doctor
86 7 repair truck mechanical, after the approval of a revision doctor 90%
the power and the health of the stroller
87 8 hearing aid for aerial lines max. 2 DC in 5 years; from 0 to 100%; Max. 10 600 CZK per 2 PCs; And
-for moderate 7 years; After prescription of the FON
hearing loss from 30 dB to
59 dB SRT
88 8 hearing aid for aerial lines max. 2 DC in 5 years; from 0 to 100%; Max. 11 600 CZK per 2 PCs; And
-for heavy and very heavy for 7 years; After prescription of the FON
hearing loss from above 60 dB
SRT above, remnants of the hearing, deafness
89 8 hearing aid on bone conduction-max. 2 DC in 5 years; from 0 to 100%; Max. 22 000 CZK per 2 PCs; And
hearing loss in the double-sided 7 years; After prescription of the FON
abnormality of the ear canal and, after approval by the review a doctor
and middle ear with severe conversion
hearing loss, chronic
discharge of mucus membranes,
kofochirugických operations
intractable allergies to
fitting, bad effect
hearing aids on air management
90 8 hearing aid for aerial lines max. 2 DC in 5 years; from 7 to 100%; Max. 10 600 CZK per 2 PCs; And
-for moderate, 18 years of age; After prescription of FON, OTO
hearing loss from 30 dB to S3
59 dB SRT
91 8 a hearing aid for aerial lines max. 2 DC in 5 years; from 7 to 100%; Max. 11 600 CZK per 2 PCs; And
-for heavy and very heavy for 18 years; After prescription of FON, OTO
60 dB hearing loss from SRT, S3
the remains of the hearing loss, deafness
92 8 hearing aid on bone conduction-max. 2 DC in 5 years; from 7 to 100%; Max. 6 800 CZK per 2 PCs; And
hearing loss in the double-sided 18 years; After prescription of the FON
abnormality of the ear canal and the review and approval by a physician
the middle ear with severe conversion
hearing loss, chronic
effluent from the middle ear, the States
After kofochirugických
operations, intractable
allergies on the fitting,
the bad effect of hearing aids on the
air management
hearing aid for air max 93 8. 1 DC in 5 years; from 18 years of age; 100%; Max. 2 700 CZK per 1 piece; And
leadership-for moderate after prescription of FON, OTO S3
hearing loss from 40 dB to 59 dB SRT
hearing aid for air max 94 8. 1 DC in 5 years; from 18 years of age; 100%; Max. 3 900 CZK per 1 piece; And
leadership-for severe after prescription of FON, OTO S3
hearing loss from 60 dB to
79 dB SRT
hearing aid for the air max 95 8. 1 DC in 5 years; from 18 years of age; 100%; Max. 5 100 CZK per 1 piece; And
leadership-for very severe after prescription of FON, OTO S3
conductive hearing loss, loss of
80 dB SRT, remnants of the hearing, deafness
the bone conduction hearing aid 96 8-max. 1 DC in 5 years; from 18 years of age; 100%; Max. 6 800 CZK per 1 piece; And
hearing loss in the double-sided after prescription of FON, OTO S3 and after
anomaly of the ear canal and the approval of the review a doctor
the middle ear with severe conversion
hearing loss, chronic
effluent from the middle ear, the States
After kofochirugických
operations, intractable
allergies on the fitting,
the bad effect of hearing aids
97 8 batteries to the SoundBridge converts max. 4 PCs in 5 years; After 100%; Max. 80 EUR for 4 PCs; And
prescription of FON, OTO S3
98 8 optician adapter to the suspension max. 1 DC in 5 years; After 100%; Max. 90 Eur per 1 piece; And
the SoundBridge converts the prescription of FON, OTO S3
99 8 ear fitting-individually made max. 2 PCs in 1 year; from 18 years of age; 100%; Max. 700 CZK per 2 PCs; And
After prescription of FON, OTO S3
100 8 ear fitting-individually made max. 1 DC in 5 years; from 18 years of age; 100%; Max. 350 CZK per 1 piece; And
Max. 2 DC in 5 years-only for
Deafblind; After the prescription after
Fon, OTO S3
101 8 ear fitting protective-max. 1 PC for 2 years; from 18 years of age; 100%; Max. 250 CZK per 1 piece; And
individually made States with otevřenýmstředouším; After
prescription of OTO, and after approval by
the review by a doctor
102 8 ear fitting-series-produced max. 1 DC in 5 years; After 100%; Max. 20 Eur per 1 piece; And
prescription of FON, OTO S3
103 9 eye glasses max. 3 pieces per year-up to 6 years; 100%; Max. 300 Eur per 1 piece
Max. 1 piece per year-from 6 to 15
years of age; two glasses during refractive
a defect of the nad +-3 DPTdo distance; After
prescription OPH
104 9 eye glasses max. 1 SC in 3 years-15 years; 100%, max. 150 CZK per 1 piece; And
two-glasses when the refractive defect
NAD +-3 DPT into the distance; After
prescription OPH
105 9 lens eyewear spherical, a toric max. 3 times per year-up to 6 years; 100%; And
Max. Once a year-from 6 to 15 years of age;
Max. once every 3 years-15 years;
without changing the correction; epileptikům,
jednookým-always hardened;
After the prescription OPH
106 9 lens eyewear lenticular max. 3 times per year-up to 6 years; 100%; And
Max. Once a year-from 6 to 15 years of age;
Max. once every 3 years-15 years;
without changing the correction; NAD +-10
DPT; up to 3 years for afakie; After
prescription OPH
107 9 lens eyewear vysokoindexová max. 3 times per year-up to 6 years; 100%; And
Max. Once a year-from 6 to 15 years of age;
Max. once every 3 years-15 years;
without changing the correction; myopia over
-10 DPT; Central
the field of view; After the prescription OPH
and after the approval of the review a doctor
108 9 lens bifocal glasses, max. 2 x per year-up to 6 years; 100%; And
Franklin, zatavovaná, max. Once a year-from 6 to 18 years of age;
vybrušovaná, silicate, plastic without changing the correction; strabismus;
afakie; After the prescription OPH; from
18 years old nehrazeno
109 9 lens eyewear prismatická max. 3 times per year-up to 6 years; 100%; And
Max. Once a year-from 6 to 15 years of age;
Max. once every 3 years-15 years;
without changing the correction; diplopia;
strabismus; After the prescription OPH
prismatické 110 9 foil-soft, hard max. 3 times per year-up to 6 years; 100%; And
Max. Once a year-from 6 to 15 years of age;
Max. once every 3 years-15 years;
without changing the correction; diplopia;
strabismus; After the prescription OPH
111 9 lens glasses plastic-spherical, a toric max. 2 x per year-up to 6 years; 100%; And
Max. Once a year-from 6 to 15 years of age;
Max. once every 3 years-15 years;
without changing the correction; from 15 years old
+-10 DPT; up to 15 years over +-3
DPT; After the prescription OPH
112 9 absorption layer on the lens max. 3 times per year-up to 6 years; 100%; And
Max. Once a year-from 6 to 15 years of age;
Max. once every 3 years-15 years;
without changing the correction; afakie,
pseudoafakie, diseases and defects
coherent světloplachostí; After
prescription OPH
113 9 lens eyewear hyperokulární max. 2 x per year-up to 18 years of age; 100%; And
Max. once every 3 years-from 18 years of age;
without changing the correction; After the prescription
And after the approval of the PBC review
doctor
soft contact lens 114 9 max. 2 x per year-up to 15 years; 100%; And
Max. Once a year-15 years;
without changing the correction; refraction; above the
+-10 DPT; afakiealespoň
astigmatism in one eye,
anisometropie irregularis, 3 DPT
and more; After the prescription OPH
115 9 lens hard contact max. 2 x per year-up to 15 years; 100%; And
Max. 1 x every 2 years-15 years;
without changing the correction; Keratoconus
astigmatism irregularis, within 15
years for afakie; After the prescription OPH
and after the approval of the review a doctor
hard contact lens-116 9 max. 2 x per year-up to 15 years; 100%; And
individually made max. 1 x every 2 years-15 years;
without changing the correction; Keratoconus
astigmatism irregularis; up to 15
years for afakie; After the prescription OPH
and after the approval of the review a doctor
117 9 lens contact max. 2 x per year-up to 15 years; 100%; And
stenopeutická, color, therapeutic max. Once a year-15 years;
without changing the correction; only serious
disease of the cornea, the iris or
combination; After the prescription OPH
and after the approval of the review a doctor
118 9 Occluder gel, náplasťový, plastic, after 100% prescription OPH; And
119 9 dalekohledový system at a distance of max. 1 DC in 7 years; After 100%; Max. 8 EUR per 1 piece; And
even at the close, with accessories for the prescription OPH S4a after approval
the review by a doctor
120 9 Magnifier magnifying asferická 4 x + max. 1 DC in 5 years; After 100%; Max. 1 500 CZK per 1 piece; And
prescription OPH S4a after approval
the review by a doctor
Magnifier magnifying sphere to 121 9 4 x max. 1 DC in 5 years; After 100%; Max. 100 CZK per 1 piece; And
prescription OPH
122 9 prosthesis eye glass max. 2 PCs per year; after prescription of 100%; Max. 800 CZK per 1 piece; And
OPH
Acrylic prosthesis eye 123 9-max. 2 SC in 3 years; After 100%; Max. 2 000 CZK per 1 piece; And
individually made prescription OPH and after approval
the review by a doctor
124 10 applicators aerosol preparations by prescribing a THORN, ALG, OTO, 100%; Max. 500 CZK per 1 piece; And
PED; from 18 years after the
the review by a doctor
125 10 inhaler compressor max. 1 DC in 5 years; After 100%; Max. 4 500 CZK per 1 piece; And
prescription of THORN, ALG, OTO and after
the approval of the review a doctor
126 10 inhaler ultrasound max. 1 DC in 10 years; After 100%; Max. 4 500 CZK per 1 piece; And
prescription of THORN, ALG, OTO and after
the approval of the review a doctor
127 10 oxygen concentrator after the prescription after the approval of the 100% of TRNa; And
the review by a doctor
128 10 resources for the application of max. 1 PCs. for 2 years; After 100%; Max. 300 CZK per 1 piece; And
powder inhaled forms of pharmaceuticals prescription according to of the prescriber
restrictions on pharmaceuticals
CPAP device after 129 10 prescription THORN, NEU and after 100%; Max. 40 EUR per 1 piece; And
approval of a revision doctor S5
130 10 appliance BPAP after prescription of THORN, NEU and after 100%; Max. 60 EUR per 1 piece; And
approval of a revision doctor S5
131 10 spirometer personal after prescription of THORN, ALG and after 100%; Max. 300 CZK per 1 piece; And
the approval of the review a doctor
132 10 nebulizer to inhaler (attachment) max. 1 PC for 2 years; After 100%; Max. 600 CZK per 1 piece; And
prescription of THORN, ALG, OTO and after
the approval of the review a doctor
133 11 insulin insulin Pen applicator-max. 1 SC in 3 years; Max. 2 PCs 100%; Max. 1 500 CZK per 1 piece; And
for 3 years when the concurrent application
two types of insulin; After
prescription of DIA
134 11 applicator insulin to application max. 1 SC in 3 years; After 100%; Max. 1 200 CZK per 1 piece; And
syringe prescription DIA
135 11 applicator blood sampling using the lancet max. 1 DC in 5 years; After 100%; Max. 250 CZK per 1 piece; And
prescription of DIA
-blood glucose meter for diabetics 136 11 max. 1 DC in 10 years; After 100%; Max. 1 000 CZK za1 SC; And
treated with intenzifikovaným prescription of DIA and after approval
the insulin regimen (3 doses of the review a doctor
daily or insulin pump),
for unstable diabetics with
2 doses of insulin per day
137 11 needles to injection syringes after prescription of the DIA 100%; Max. 120 € per 100 pieces; And
the application of insulin
138 11 insulin Pen needle to the max. 200 PCs per year; After 100%; Max. 530 CZK per 200 PCs; And
prescription of DIA
139 11 needles for pens neinzulínovým max. 100 PCs per year; After 100%; Max. 270 € per 100 pieces; And
prescription of DIA
140 11 set to application syringe after prescription of DIA (100%; Max. € 370 100 PCs; And
with a fixed needle)
141 11 lancets for blood sampling max. 100 PCs per year; After 100%; Max. 300 CZK per 100 PCs; And
prescription of DIA
142 11 strips diagnostic glucose on the determination of max. 400 pieces per year; After 100%; Max. 3 200 CZK per 400 PCs; And
prescription of DIA
Max. 1 000 pieces per year; for 100%; Max. 8,000 CZK per 1 000 PCs; And
patients treated with intenzifikovaným
the insulin regimen or
insulin pump; After
prescription of DIA and after approval
the review by a doctor
Max. 1 800 PCs per year-up to 18 years of age 100%; Max. 14 400 CZK per 1 800 SC; And
and for pregnant diabetics; After
prescription of DIA and after approval
the review by a doctor
143 11 insulin pump max. 1 piece or set of 2 for 4 100%; Max. 100 EUR per 1 piece or 1 set; And
years; After prescription of the DIA and after
approval of a revision doctor S5
144 11 sets of metal infusní to the insulin pump after prescription of the DIA 100%; Max. 160 CZK per 1 set; And
145 11 sets infusní nonstick after prescription after approval of 100% DIAa; Max. 300 CZK per 1 set; And
the insulin pump review by a doctor
injection syringe to 146 11 application of insulin after prescription of the DIA 100%; Max. 230 € per 100 pieces; And
147 12 crutches max. 1 pair every 2 years 100%; Max. 400 CZK per 1 pair; And
crutch forearm 148 12 max. 1 pair or 1 piece in 2 years 100%; Max. 300 CZK per 1 piece; And
149 12 Walker max. 1 DC in 5 years; After 100%; Max. 7 000 CZK per 1 piece; And
prescription REH, NEU, ORP, ORT
and after the approval of the review a doctor
150 12 stick max. 1 DC for 3 years 100%; Max. 130 CZK per 1 piece; And
151 12 bed positioning with the possibility of the power max. 1 DC in 10 years; After 100%; Max. 30 EUR per 1 piece; And
setting the prescription REH, ORT, NEU and after
approval of a revision doctor S5
Chair of the 152 12 max. 1 DC in 5 years; After 100%; Max. 4 000 CZK per 1 piece; And
prescription REH, ORT, NEU, PRL, GER
153 12 TOILET attachment max. 1 SC in 3 years; After 100%; Max. 1 200 CZK per 1 piece; And
prescription REH, ORT, NEU, PRL, GER
154 12 seat in the tub and the shower max. 1 DC in 5 years; After 100%; Max. 2 000 CZK per 1 piece; And
prescription REH, ORT, NEU, PRL, GER
the pointing device 155 12 max. 1 DC in 10 years; After 100%; Max. 60 EUR per 1 piece; And
prescription REH, ORT, NEU and after
the approval of the review a doctor
156 12 accessories for your pointing device max. 1 DC in 10 years; After 100%; Max. 10 EUR per 1 piece; And
prescription REH, ORT, NEU and after
the approval of the review a doctor
157 12 lifter mechanical, electric, max. 1 DC in 10 years; After 100%; Max. 30 EUR per 1 piece; And
hydraulic prescription REH, ORT, NEU and after
the approval of the review a doctor
158 12 bed positioning with the option max. 1 DC in 10 years; After 100%; Max. 15 000 CZK per 1 piece; And
the mechanical setting of the prescription REH, ORT, NEU and after
the approval of the review a doctor
159 13 wig max. 1 piece per year; after prescription of 100%; Max. 1 EUR per 1 piece
OHM, DRV, INT
160 13 pad Anti-decubitus max. 1 SC in 3 years; After 100%; And
prescription REH, ORT, NEU and after
the approval of the review a doctor
161 13 helmet protection max. 1 PC for 2 years; After 100%; Max. 2 500 CZK per 1 piece; And
prescription REH, NEU, dogs and after
the approval of the review a doctor
catheter for intermittent catheterisation 162 13 max. 150 PCs per month; After 100%; Max. 7 500 CZK per 150 PCs; And
-covered prescription URL and after approval by
the review by a doctor
163 13 catheter for intermittent catheterization max. 150 PCs per month; After 100%; Max. 2 300 CZK per 150 PCs
-non-prescription URL and after approval by
the review by a doctor
164 14 stick white Braille max. 3 PCs per year; after 100%; And
prescribing PRL OPH,
165 14 compensatory aids for the blind max. 1 DC in 7 years; After 100%; Max. 2 000 CZK per 1 piece; And
prescribing PRL OPH, and after
the approval of the review a doctor
166 15 induction set Amps max. 1 DC in 7 years, after 100%; Max. 1 000 CZK per 1 piece; And
prescription of FON, OTO S3
167 15 compensatory aids for hearing max. 1 DC in 7 years; After 100%; Max. 2 000 CZK per 1 piece; And
the affected prescription of FON, OTO S3 and after
the approval of the review a doctor
168 16 orthopedic shoes for kids-max individually. 3 pairs per year; After 100%; Max. $ 60 for 3 pairs
made prescription REH, ORT, ORP and after
the approval of the review a doctor
169 16 orthopedic shoes for Kids-series-max. 3 pairs per year; After 100%; Max. 3 000 CZK for 3 pairs
manufactured prescription REH, ORT, ORP and after
the approval of the review a doctor
170 16 orthopedic shoes-max. 1 pair every 2 years; After 50%
individually made-simple prescription REH, ORT, ORP
Orthopedic shoes-171 16 max. 1 pair every 2 years; After 90% of
individually made-prescription REH, ORT, ORP
more complex and very complex
172 16 shoes for diabetics max. 1 pair every 2 years; After 100%; Max. 1 000 CZK per 1 pair
prescription of DIA and after approval
the review by a doctor
173 16 insert orthopedic-max. 1 pair every 2 years; After 100%; Max. 100 € for 1 pair
individually made prescription REH, ORT, ORP
174 16 insert orthopedic-max. 2 pairs per year; After 100%; Max. 600 CZK for 2 pairs
individually made-the children's prescription of REH, ORT, ORP
175 16 insert orthopedic-special max. 2 pairs per year; after 80%
prescription REH, ORT, ORP
176 17-a noble metal cannula of max. 3 PCs per year; and 18 years; After 100%; Max. 10 500 EUR for 3 PCs; And
prescription of OTO, FON and after
the approval of the review a doctor
177 17-a noble metal cannula of max. 2 DC in 5 years; from 18 years of age; 100%; Max. 4 000 CZK per 2 PCs; And
After the prescription of OTO, FON
178 17-a cannula of max. 3 PCs per year; and 18 years; After 100%; Max. 10 500 EUR for 3 PCs; And
Silicone paediatric prescription of OTO, FON and after
the approval of the review a doctor
179 17-a cannula silicone max. 2 PCs per year; from 18 years of age; After 100%; Max. 4 000 CZK per 2 PCs; And
prescription of OTO, FON and after
the approval of the review a doctor
180 17 electric breast pump, mechanical max. 1 DC in 5 years; After 100%; Max. 4 000 CZK per 1 piece; And
prescription of OTO, and after
the approval of the review a doctor
181 17 breast pump accessories-max. 150 PCs per year; After 100%; Max. 1 000 CZK per 150 PCs; And
suction catheters for the prescription of OTO, and after
the approval of the review a doctor
182 17 accessories for tube tracheostomické max. 1 x per year; After the prescription 100%; Max. 2 000 CZK per
Oto, FON 1 Pack complete accessories; And
183 17 voice prosthetics accessories max. 1 x per year; After the prescription 100% max. 12 500 CZK per 1 Pack complete
Oto, FON and approval review accessories; And
doctor
elektrolaryng 184 17 max. 1 DC in 10 years; After 100%; Max. 15 500 Eur per 1 piece; And
prescription of FON, and after approval by
the review by a doctor
185 17 battery to elektrolaryngu max. 1 PC for 2 years; 100%; Max. 700 CZK per 1 piece; And
After the prescription FONa after approval
the review by a doctor
----------------- ------------------------------------------ -------------------------------------------------------------------------------
Symbols of reimbursement limits
And-remuneration of the prices for the final consumer healthcare
resource in the implementation of the least economically challenging depending on the degree of
and severity of disability (hereinafter referred to as "economically at least
challenging variant of "); the price of the least economically challenging variants
medical device detects the health insurance market.
(B) remuneration of prices-economically at least challenging variations of the entire
the system of medical devices Group No. 3 of this
section.
Annex 4
LIST OF DENTAL PRODUCTS
List of abbreviations and explanatory notes
List of dental products contains the individually carved
dental prosthetic and orthodontic apparatus of compensation, rehabilitation
and medical equipment.
Payment of health insurance is established for dental products
by way of derogation for persons:
and) to 18 years (codename dental products begins with a digit
7)
(b) over 18 years of age) (codename dental products begins
the numeral 8)
For each dental products to their lists:
1. identification code
2. the name of the
3. dental alloy, using a numeric symbol alloy designed for
the making of the dental product in the basic version
4. the category of orthodontic products, using symbols to indicate
the category of the product and the amount of the remuneration of the orthodontic health
the insurance company
5. preskribční restrictions, if treatments and fabrication of dental
the product may only be carried out by a doctor specialist, the symbol P
6. payment of health insurance
a) in its entirety, the symbol and
(b)) of the amount indicated in Eur
------------------------------------------------------------------
Dental alloys for dental products
in the basic version
------------------------------------------------------------------
Dental Symbol
alloy
------------------------------------------------------------------
1 chrome-nickel alloy
for ceramic and resin
facets
------------------------------------------------------------------
2 stříbrocínová, stříbroměděná
replacement alloy
------------------------------------------------------------------
3 chromkobaltová,
chromkobaltmolybdenová
alloy for skeletons
------------------------------------------------------------------
The price for the cam Orthotics used dental alloys included in price
delivery of the product. For a fixed price for the used Orthotics
Dental alloy added to the price of the dental product.
Health insurance shall be borne by the making of cast to partial reinforcement
a removable compensation with simple retention elements (products with codes
82001, 82002, 72001, 72002). Price cast reinforcement will be added to the price
delivery of the product. In the article "repair or adjustment of the scanning
apparatus with the imprint "(code 86081 and 76081) is not included in the price
orthodontic screw. In the case of the use of the screw with its price
added to the price of the dental product.
Health insurance dental precious metal alloys used in the
cases:
1. reconstruction of the clinical crowns of teeth in children under 15 years of age,
2. reconstruction of the clinical crowns of teeth for congenital or hereditary disorders
the formation of hard dental tissues,
3. fabrication of fixed compensation for missing teeth at birth or
hereditary disorders of tooth development and eruption,
4. fabrication of fixed refunds when the total reconstruction of the mandibular skusů
anomalies, which can no longer improve orthodontic treatment,
but where prosthetic by modifying the dentition can be achieved by improving the function of
the lingual apparatus,
in the amount of at least 400 CZK per 1 gram of gold in the pure metal.
The life of dental products
Health insurance covers:
-once every two years in resin jacket Crown made of plastic and
composite plastic,
-every five years other fixed prosthetic replacements,
-every three years, removable partial and total compensation,
If the auditing physician health insurance company decides otherwise.
The exception are:
-the Crown of the mantle made of plastic (codes 71111, 71112)
-the Crown of the mantle of composite plastic material (71113, 71114 codes),
-Crown protective sheath cast (code 71103)
-protective jacket crowns minted (code 71104)
-removable partial refunds (72001-72152 codes),
-removable total refunds (codes 72201-75445)
which health insurance shall be borne by persons under 18 years of age without restriction.
Health insurance shall stipulate that:
-lost or negligent treatment of a destroyed stomatologicko-prosthetic
compensation, medical and rehabilitation equipment, orthodontic devices,
-removal of defects, which are covered by the legal warranty
----------------------------------------------------------------------------------------------------
Categorization for reimbursement of orthodontic products
health insurance company
Mark
the distinguishing criteria categories Above
payment of the
----------------------------------------------------------------------------------------------------
and) clefts lip, jaw and palate, congenital defects, and overall system
orthodontic disease manifestations, without depending on the age of full payment
----------------------------------------------------------------------------------------------------
(b)) 1. hypodontia of four or more permanent teeth in one jaw out of teeth
wisdom
2. reverse bite incisors and individual
3. a protrusion defect with incizálním step seven or more millimeters
4. the open bite in the range of all permanent incisors, two and more
millimeters
5. retention, palatal position and agenze of the standing of the Studio. In children under
18 years of the lack of space for permanent canine tooth, five millimetres and more
6. the retention of the standing of the upper lateral incisor
7. deep bite with traumatisation of gingiva
8. cross bite with forced the leadership of the lower jaw
9. nonokluze at least two pairs of antagonists, including wisdom teeth
in one lateral segment
without depending on age except as specified in point 5. 80% of the
calculated prices
standard. product
----------------------------------------------------------------------------------------------------
(c)) the other anomalies of the teeth and bite in children under 18 years of age 50%
calculated prices
standard. product
----------------------------------------------------------------------------------------------------
(d)) other anomalies of the teeth and bite for persons over 18 years of age shall stipulate
----------------------------------------------------------------------------------------------------
Decisive for the inclusion of the patient to the appropriate category under the
the gravity anomaly is the diagnosis in the patient file at the beginning of
orthodontic treatment. This classification is valid until the end of the treatment, including
the retention phase. Improvement of the anomalies in the course of treatment with categorization
does not change.
Model and x-ray the patient file must be stored in the
the clinic for three years after the end of treatment.
Lifetime orthodontic appliances is given in therapeutic effectiveness
These apparatuses according to treatment plans.
Orthodontic products are paid by the health insurance company only to those Contracting
medical facilities, where these products exhibits:
-dentist with a license for the field of orthodontics,
-dentist licensed general dentist and with the certificate, SHALL BE for the
the scope of orthodontics.
Dental products-persons under 18 years of age
+-----+---+------------------------------+--------+-----+-----+-----------+
| Code | STRANG | The name of the dental product | Dental | Kat | OME | Payment |
| | | | alloy | | | insurance company |
+-----+---+------------------------------+--------+-----+-----+-----------+
Separate the production phase
70001 | | Study model with imprint | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
70002 | | Analysis of models in okludoru | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
70004 | | Diagnostic remodeling | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
70011 | | A functional fingerprint of the upper jaw | | | | (I)
| | in individual spoon | | | |
------+---+------------------------------+--------+-----+-----+------------
70012 | | A functional fingerprint of the lower jaw | | | | (I)
| | in individual spoon | | | |
------+---+------------------------------+--------+-----+-----+------------
70013 | | The imprint of the jaw Anatomy | | | | (I)
| | in individual spoon | | | |
------+---+------------------------------+--------+-----+-----+------------
70021 | | Registration of the face Tanner | | | | (I)
| | ARC | | | |
------+---+------------------------------+--------+-----+-----+------------
70031 | | Reconstruction of mezičelistních | | | | (I)
| | skusovými relations templates | | | |
------+---+------------------------------+--------+-----+-----+------------
70041 | | Registration of functional positions | | | | (I)
| | mandible | | | |
------+---+------------------------------+--------+-----+-----+------------
70051 | | Modelling of black-pillar | | | | (I)
| | | | | |
------+---+------------------------------+--------+-----+-----+------------
70061 | | Milling-pillar | | | | (I)
| the bridge construction or ' | ' | | | |
Reconstruction of the Crown
71041 | | The inlay of the root, one channel | 2 | | | (I)
| direct, aluminium | | | | |
------+---+------------------------------+--------+-----+-----+------------
71042 | | The inlay of the root, one channel | 2 | | | (I)
| indirect, aluminium | | | | |
------+---+------------------------------+--------+-----+-----+------------
71051 | | The inlay of the root, two canals | 2 | | | (I)
| direct, aluminium | | | | |
------+---+------------------------------+--------+-----+-----+------------
71052 | | The inlay of the root, two canals | 2 | | | (I)
| indirect, aluminium | | | | |
------+---+------------------------------+--------+-----+-----+------------
71061 | | Root inlay, three and more | 2 | | | (I)
| ducts, direct, | aluminium | | | |
------+---+------------------------------+--------+-----+-----+------------
71062 | | Root inlay, three and more | 2 | | | (I)
| |, indirect, aluminium ducts | | | |
------+---+------------------------------+--------+-----+-----+------------
71071 ' | | Aesthetic plastic bezel | | | | (I)
Crown of the refund
71101 | | Crown steel, sheath | 1 | | | (I)
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
71102 | | Crown steel, sheath | 1 | | | (I)
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
71103 | | Crown protective sheath | | | | (I)
| | aluminium | | | |
------+---+------------------------------+--------+-----+-----+------------
71104 | | Crown protective sheath | | | | (I)
| | embossed | | | |
------+---+------------------------------+--------+-----+-----+------------
71111 | | Crown sheath of plastic | | | | (I)
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
71112 | | Crown sheath of plastic | | | | (I)
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
71113 | | Crown sheath | | | | 693.0-
| from composite plastic, | | | | |
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
71114 | | Crown sheath | | | | 745.0-
| from composite plastic, | | | | |
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
71121 | | Crown bevelled-plastic, | 1 | | | (I)
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
71122 | | Crown bevelled-plastic, | 1 | | | (I)
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
71123 | | Crown bevelled-| | | | 1014.0-
| preparation of composite plastic, | | | | |
| | in | | | |
------+---+------------------------------+--------+-----+-----+------------
71124 | | Crown bevelled-| | | | 1066.0-
| preparation of composite plastic, | | | | |
| | schůdková | | | |
------+---+------------------------------+--------+-----+-----+------------
71131 | | Crown skeleton, armovaná | | | | (I)
| |-plastic | | | |
------+---+------------------------------+--------+-----+-----+------------
71132 | | Crown bevelled-| | | | 1014.0-
| | metal-ceramics | | | |
Fixed bridges abutment design of bridges
71201 | | Crown steel, sheath | 1 | | | (I)
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
71202 | | Crown steel, sheath | 1 | | | (I)
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
71211 | | Crown bevelled-plastic, | 1 | | | (I)
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
71212 | | Crown bevelled-plastic, | 1 | | | (I)
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
71221 | | Crown bevelled-| | | | 942.0-
| preparation of composite plastic, | | | | |
| | in | | | |
------+---+------------------------------+--------+-----+-----+------------
71222 | | Crown bevelled-| | | | 994.0-
| preparation of composite plastic, | | | | |
| | schůdková | | | |
------+---+------------------------------+--------+-----+-----+------------
71231 | | Crown bevelled-| | | | 942.0-
| | metal-ceramics | | | |
------+---+------------------------------+--------+-----+-----+------------
71251 | | The root CAP, one | | | | 597.0-
| | Canal | | | |
------+---+------------------------------+--------+-----+-----+------------
71252 | | The root CAP, two ducts | | | | 662.0-
------+---+------------------------------+--------+-----+-----+------------
71253 | | The root CAP, three and more | | | | 753.0-
| | Canal | | | |
Connection pilířových construction
71301 | The bridge-| | 1 | | | (I)
------+---+------------------------------+--------+-----+-----+------------
71302 | The bridge, a faceted-| | 1 | | | (I)
| |: plastic | | | |
------+---+------------------------------+--------+-----+-----+------------
71303 | The bridge, a faceted-| | | | | 598.0-
| composite plastic | | | | |
------+---+------------------------------+--------+-----+-----+------------
71312 | The bridge, a faceted-| | | | | 598.0-
| | metal-ceramics | | | |
------+---+------------------------------+--------+-----+-----+------------
71321 | | Support the caliper individually | | | | (I)
| |-crafted | | | |
------+---+------------------------------+--------+-----+-----+------------
71322 | | Support the caliper prefebrikovaný | | | | (I)
Adhesive refunds
71501 | | Adhesive bridge, one | | | | (I)
| | mezičlen-plastic | | | |
------+---+------------------------------+--------+-----+-----+------------
71502 | | Adhesive bridge, more | | | | (I)
| | mezičlen-plastic | | | |
------+---+------------------------------+--------+-----+-----+------------
71531 | | Adhesive aluminium splint-| | | | (I)
| | to 6 teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
71532 | | Adhesive aluminium splint-| | | | (I)
| and more teeth | 7 | | | |
Temporary fixed refunds, repairs of fixed refunds
71601 | | A makeshift protective Crown | | | | (I)
| | | | | |
------+---+------------------------------+--------+-----+-----+------------
71611 | | A makeshift protective bridge | | | | (I)
| |-up to 6 plastic teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
71612 | | A makeshift protective bridge | | | | (I)
| |-plastic 7 + teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
71621 | | Fix fixed refunds | | | | (I)
| |-new bearing bezel | | | |
------+---+------------------------------+--------+-----+-----+------------
71631 | | Fix fixed refunds | | | | (I)
| |-bearing joining | | | |
Partial dentures dental defect
72001 | Partial removable replacement | | | | | (I)
| with simple retention | | | | |
| |-to elements 6 teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
72002 | Partial removable replacement | | | | | (I)
| with simple retention | | | | |
| |-7 elements and more teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
72011 | Partial removable replacement | | 3 | | | 2010.0-
| with cast anchor elements |-| | | |
| | to 6 teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
72014 | Partial removable replacement | | 3 | | | 2146.0-
| with cast anchor elements |-| | | |
| and more teeth | 7 | | | |
------+---+------------------------------+--------+-----+-----+------------
72021 | Partial removable replacement | | 3 | | | 2490.0-
| |-stabilises the bottom with cast | | | |
| |-7 connection bracket and more | | | |
| | teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
72022 | Partial removable replacement | | 3 | | | 2502.0-
| upper bunk with cast | | | | |
| |-7 plate and more teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
72041 | | Baby cam replacement | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
72104 | | The top skeleton replacement-| 3 | | | (I)
| | 2 anchor elements | | | |
------+---+------------------------------+--------+-----+-----+------------
72105 | | The top skeleton replacement-| 3 | | | (I)
| | 3 or more anchor elements | | | |
------+---+------------------------------+--------+-----+-----+------------
72106 | | The top skeleton replacement-| 3 | | | (I)
| | nesponové anchor elements | | | |
------+---+------------------------------+--------+-----+-----+------------
72114 | | The lower compensation-skeleton | 3 | | | (I)
| | 2 anchor elements | | | |
------+---+------------------------------+--------+-----+-----+------------
72115 | | The lower compensation-skeleton | 3 | | | (I)
| | 3 or more anchor elements | | | |
------+---+------------------------------+--------+-----+-----+------------
72116 | | The lower compensation-skeleton | 3 | | | (I)
| | nesponové anchor elements | | | |
------+---+------------------------------+--------+-----+-----+------------
72141 | | Aluminium splint pickup-| 3 | | | (I)
| | to 6 teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
72142 | | Aluminium splint pickup-| 3 | | | (I)
| and more teeth | 7 | | | |
------+---+------------------------------+--------+-----+-----+------------
72151 | | Aluminium splint fixed-up to 6 teeth | 3 | | | (I)
------+---+------------------------------+--------+-----+-----+------------
72152 | | Aluminium fixed splint-| 3 | | | (I)
| and more teeth | 7 | | | |
The total dentures
72201 | | The total remuneration of the top | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
72203 | | The total remuneration of the top with cast | 3 | | | 3125.0-
| | top bunk | | | |
------+---+------------------------------+--------+-----+-----+------------
72204 | | The total remuneration of the top hybrid | | | | 2707.0-
------+---+------------------------------+--------+-----+-----+------------
72211 | | The total replacement of the bottom | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
72212 | | The total replacement of the bottom with cast | 3 | | | 3177.0-
| | Base | | | |
------+---+------------------------------+--------+-----+-----+------------
72213 | | The total compensation of the lower hybrid | | | | 2759.0-
Repairs and adjustments to the casting, rebaze
72301 | | Fix-tooth vypadlého | | | | (I)
| from refunds | | | | |
------+---+------------------------------+--------+-----+-----+------------
72311 | | Fix on the model-cracked | | | | (I)
| broken replacement | | | | |
------+---+------------------------------+--------+-----+-----+------------
72320 | | Fix or edit the retention | | | | (I)
| compensation elements, | | | | |
------+---+------------------------------+--------+-----+-----+------------
72331 | | Edit-extension of the base | | | | 537.0-
| |-up to 4 teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
72332 | | Edit-extension of the base | | | | 600.0-
| |-5 or more teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
72341 | | Fix wireframe-| | | | (I)
| joining, scoring | | | | |
------+---+------------------------------+--------+-----+-----+------------
72351 | | Edit-rebaze partial | | | | 353.0-
| dentures unhashed | | | | |
------+---+------------------------------+--------+-----+-----+------------
72352 | | Edit-rebaze partial | | | | 940.0-
| | dentures bearing | | | |
------+---+------------------------------+--------+-----+-----+------------
72353 | | Edit-rebaze total | | | | 405.0-
| without the fingerprint | | | | |
------+---+------------------------------+--------+-----+-----+------------
72354 | | Edit-rebaze total | | | | 1122.0-
| refund with fingerprint | function | | | |
| | framing | | | |
Reconstruction of the refund
73001 | | Obturátor floor with partial | | | | (I)
| resin replacement | | | | |
------+---+------------------------------+--------+-----+-----+------------
73002 | | Obturátor floor with partial | 3 | | | (I)
| skeleton replacement | | | | |
------+---+------------------------------+--------+-----+-----+------------
73003 | | Obturátor floor with a total || | | | (I)
| replacement teeth | | | | |
------+---+------------------------------+--------+-----+-----+------------
73011 | Partial refund | poresekční | | | | (I)
| | top JAWS | | | |
------+---+------------------------------+--------+-----+-----+------------
73012 | Partial refund | poresekční | | | | (I)
| the upper jaw with the Chamber, | | | | |
------+---+------------------------------+--------+-----+-----+------------
73021 | Partial refund | poresekční | | | | (I)
| | lower jaw | | | |
------+---+------------------------------+--------+-----+-----+------------
73032 | | Total poresekční recovery | | | | (I)
| | lower jaw | | | |
Rehabilitation and therapeutic AIDS
74001 | | Fusing resin | | | | (I)
| the occlusal splint | | | | |
------+---+------------------------------+--------+-----+-----+------------
74011 | | Fixed resin nákusná | | | | (I)
| |-splint | | | |
------+---+------------------------------+--------+-----+-----+------------
74012 | | Fixed skeletovaná nákusná | 3 | | | (I)
| |-splint | | | |
------+---+------------------------------+--------+-----+-----+------------
74021 | | Sensing resinous nákusná | | | | (I)
| |-splint | | | |
------+---+------------------------------+--------+-----+-----+------------
74022 | | Nákusná cam skeletovaná | 3 | | | (I)
| |-splint | | | |
------+---+------------------------------+--------+-----+-----+------------
74031 | | Cover of postoperative plate | | | | (I)
| | Kiliánova Board | | | |
------+---+------------------------------+--------+-----+-----+------------
74032 | | Carrier transplant | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
74033 | | Cover plate for newborns | | | | (I)
| with cleft palate | | | | |
------+---+------------------------------+--------+-----+-----+------------
74034 | | Oklusní surgical splint-| | | | (I)
| | bimaxilární plate | | | |
------+---+------------------------------+--------+-----+-----+------------
74035 | | N t brace | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
74036 | | Strut plate to support | | | | (I)
| orbital trash | | | | |
------+---+------------------------------+--------+-----+-----+------------
74041 | | Rozvolňovač the oral closure | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
74042 | | Spring gag | | | | (I)
Orthodontic products
76001 | | Orthodontic diagnostic | | | P | (I)
| documentation models | | | | |
------+---+------------------------------+--------+-----+-----+------------
76010 | | Simple functional sensing | | and | P | (I)
| | device (monoblocks, propulsor) | | | |
------+---+------------------------------+--------+-----+-----+------------
76011 | | Simple functional sensing | | (b) | P | 1289.0-
| | device (monoblocks, propulsor) | | | |
------+---+------------------------------+--------+-----+-----+------------
76012 | | Simple functional sensing | | (c) | P | 806.0-
| | device (monoblocks, propulsor) | | | |
------+---+------------------------------+--------+-----+-----+------------
76013 | | Moderately complex functional devices | | and | P | (I)
| | (klammt, balters) | | | |
------+---+------------------------------+--------+-----+-----+------------
76014 | | Moderately complex functional devices | | (b) | P | 1770.0-
| | (klammt, balters) | | | |
------+---+------------------------------+--------+-----+-----+------------
76015 | | Moderately complex functional devices | | (c) | P | 1106.0-
| | (klammt, balters) | | | |
------+---+------------------------------+--------+-----+-----+------------
76016 | | Complex functional removable appliance | | and | P | (I)
| | (fránkel, bimler, lehnam, | | | |
| | hansa-platte) | | | |
------+---+------------------------------+--------+-----+-----+------------
76017 | | Complex functional removable appliance | | (b) | P | 2450.0-
| | (fránkel, bimler, lehnam, | | | |
| | hansa-platte) | | | |
------+---+------------------------------+--------+-----+-----+------------
76018 | | Complex functional removable appliance | | (c) | P | 1532.0-
| | (fránkel, bimler, lehnam, | | | |
| | hansa-platte) | | | |
------+---+------------------------------+--------+-----+-----+------------
76020 | | Positioner | | and | P | (I)
------+---+------------------------------+--------+-----+-----+------------
76021 | | Positioner | | (b) | P | 3258.0-
------+---+------------------------------+--------+-----+-----+------------
76022 | | Positioner | | (c) | P | 2036.0-
------+---+------------------------------+--------+-----+-----+------------
76030 | | Simple plate cam | | and | P | (I)
| |-up to 4 devices elements (wire., | | | |
| | 1 screw) | | | |
------+---+------------------------------+--------+-----+-----+------------
76031 | | Simple plate cam | | (b) | P | 1043.0-
| |-up to 4 devices elements (wire., | | | |
| | 1 screw) | | | |
------+---+------------------------------+--------+-----+-----+------------
76032 | | Simple plate cam | | (c) | P | 652.0-
| |-up to 4 devices elements (wire., | | | |
| | 1 screw) | | | |
------+---+------------------------------+--------+-----+-----+------------
76033 | | A complex plate removable appliance | | and | P | (I)
------+---+------------------------------+--------+-----+-----+------------
76034 | | A complex plate removable appliance | | (b) | P | 1323.0-
------+---+------------------------------+--------+-----+-----+------------
76035 | | A complex plate removable appliance | | (c) | P | 827.0-
------+---+------------------------------+--------+-----+-----+------------
76036 | | Obtain canopy sunshades | | and | P | (I)
------+---+------------------------------+--------+-----+-----+------------
76037 | | Obtain canopy sunshades | | (b) | P | 965.0-
------+---+------------------------------+--------+-----+-----+------------
76038 | | Obtain canopy sunshades | | (c) | P | 603.0-
------+---+------------------------------+--------+-----+-----+------------
76040 | | Fixed device to extend | | and | P | (I)
------+---+------------------------------+--------+-----+-----+------------
76041 | | Fixed device to extend | | (b) | P | 1933.0-
| | midpalatal suture | | | |
------+---+------------------------------+--------+-----+-----+------------
76042 | | Fixed device to extend | | (c) | P | 1208.0-
| | midpalatal suture | | | |
------+---+------------------------------+--------+-----+-----+------------
76050 | | Laboratory-made nábradek | | and | P | (I)
------+---+------------------------------+--------+-----+-----+------------
76051 ' | | Laboratory-made nábradek | | (b) | P | 709.0-
------+---+------------------------------+--------+-----+-----+------------
76052 | | Laboratory-made nábradek | | (c) | P | 443.0-
------+---+------------------------------+--------+-----+-----+------------
76070 | | Laboratory prepared | | and | P | (I)
| intraoral | arc | | | |
------+---+------------------------------+--------+-----+-----+------------
76071 | | Laboratory prepared | | (b) | P | 542.0-
| intraoral | arc | | | |
------+---+------------------------------+--------+-----+-----+------------
76072 | | Laboratory prepared | | (c) | P | 339.0-
| intraoral | arc | | | |
------+---+------------------------------+--------+-----+-----+------------
76080 | | Repair or adjustment of the scanning | | | | (I)
| a simple apparatus (lom |, | | | |
| wire Element | 1) | | | |
------+---+------------------------------+--------+-----+-----+------------
76081 | | Repair or adjustment of the scanning | | | P | (I)
| apparatus bearing the ' | ' | | | |
Dental products-persons older than 18 years of age
+-----+---+------------------------------+--------+-----+-----+-----------+
| Code | STRANG | The name of the dental product | Dental | Kat | OME | Payment |
| | | | alloy | | | insurance company |
+-----+---+------------------------------+--------+-----+-----+-----------+
Separate the production phase
80001 | | Study model with imprint | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
80002 | | Analysis of models in okludoru | | | | 132.0-
------+---+------------------------------+--------+-----+-----+------------
80004 | | Diagnostic remodeling | | | | 156.0-
------+---+------------------------------+--------+-----+-----+------------
80011 | | A functional fingerprint of the upper jaw | | | | (I)
| | in individual spoon | | | |
------+---+------------------------------+--------+-----+-----+------------
80012 | | A functional fingerprint of the lower jaw | | | | (I)
| | in individual spoon | | | |
------+---+------------------------------+--------+-----+-----+------------
80013 | | The imprint of the jaw Anatomy | | | | (I)
| | in individual spoon | | | |
------+---+------------------------------+--------+-----+-----+------------
80021 | | Registration of the face Tanner | | | | 156.0-
| | ARC | | | |
------+---+------------------------------+--------+-----+-----+------------
80031 | | Reconstruction of mezičelistních | | | | 190.0-
| | skusovými relations templates | | | |
------+---+------------------------------+--------+-----+-----+------------
80041 | | Registration of functional positions | | | | 300.0-
| | mandible | | | |
------+---+------------------------------+--------+-----+-----+------------
80051 | | Modelling of black-pillar | | | | 84.0-
| | | | | |
------+---+------------------------------+--------+-----+-----+------------
80061 | | Milling-pillar | | | | 105.0-
| the bridge construction or ' | ' | | | |
Reconstruction of the Crown
81041 | | The inlay of the root, one channel | 2 | | | 350.0-
| | direct | | | |
Reconstruction of the Crown
81042 | | The inlay of the root, one channel | 2 | | | 596.0-
| indirect, aluminium | | | | |
------+---+------------------------------+--------+-----+-----+------------
81051 | | The inlay of the root, two canals | 2 | | | 369.0-
| direct, aluminium | | | | |
------+---+------------------------------+--------+-----+-----+------------
81052 | | The inlay of the root, two canals | 2 | | | 666.0-
| indirect, aluminium | | | | |
------+---+------------------------------+--------+-----+-----+------------
81061 | | Root inlay, three and more | 2 | | | 429.0-
| ducts, direct, | aluminium | | | |
------+---+------------------------------+--------+-----+-----+------------
81062 | | Root inlay, three and more | 2 | | | 770.0-
| |, indirect, aluminium ducts | | | |
Crown of the refund
81101 | | Crown steel, sheath | 1 | | | (I)
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
81102 | | Crown steel, sheath | 1 | | | (I)
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
81111 | | Crown sheath of plastic | | | | (I)
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
81112 | | Crown sheath of plastic | | | | (I)
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
81113 | | Crown sheath | | | | 693.0-
| from composite plastic, | | | | |
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
81114 | | Crown sheath | | | | 745.0-
| from composite plastic, | | | | |
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
81115 | | Crown sheath ceramic, | | | | 745.0-
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
81121 | | Crown bevelled-plastic, | 1 | | | 561.0-
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
81122 | | Crown bevelled-plastic, | 1 | | | 592.0-
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
81123 | | Crown bevelled-| | | | 561.0-
| preparation of composite plastic, | | | | |
| | in | | | |
------+---+------------------------------+--------+-----+-----+------------
81124 | | Crown bevelled-| | | | 592.0-
| preparation of composite plastic, | | | | |
| | schůdková | | | |
------+---+------------------------------+--------+-----+-----+------------
81132 | | Crown bevelled-| | | | 561.0-
| | metal-ceramics | | | |
Fixed bridges abutment design of bridges
81201 | | Crown steel, sheath | 1 | | | 815.0-
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
81202 | | Crown steel, sheath | 1 | | | 867.0-
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
81203 | | Crown sheath ceramic, | | | | 550.0-
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
81211 | | Crown bevelled-plastic, | 1 | | | 519.0-
| preparation to the lost | | | | |
------+---+------------------------------+--------+-----+-----+------------
81212 | | Crown bevelled-plastic, | 1 | | | 550.0-
| | schůdková perm | | | |
------+---+------------------------------+--------+-----+-----+------------
81221 | | Crown bevelled-| | | | 519.0-
| preparation of composite plastic, | | | | |
| | in | | | |
------+---+------------------------------+--------+-----+-----+------------
81222 | | Crown bevelled-| | | | 550.0-
| preparation of composite plastic, | | | | |
| | schůdková | | | |
------+---+------------------------------+--------+-----+-----+------------
81231 | | Crown bevelled-| | | | 519.0-
| | metal-ceramics | | | |
------+---+------------------------------+--------+-----+-----+------------
81251 | | The root CAP, one | | | | 597.0-
| | Canal | | | |
------+---+------------------------------+--------+-----+-----+------------
81252 | | The root CAP, two ducts | | | | 662.0-
------+---+------------------------------+--------+-----+-----+------------
81253 | | The root CAP, three and more | | | | 753.0-
| | Canal | | | |
Connection pilířových construction
81301 | The bridge-| | 1 | | | 470.0-
Connection pilířových construction
81302 | The bridge, a faceted-| | 1 | | | 321.0-
| |: plastic | | | |
------+---+------------------------------+--------+-----+-----+------------
81303 | The bridge, a faceted-| | | | | 321.0-
| composite plastic | | | | |
------+---+------------------------------+--------+-----+-----+------------
81311 | The ceramic bridge | | | | | 321.0-
------+---+------------------------------+--------+-----+-----+------------
81312 | The bridge, a faceted-| | | | | 321.0-
| | metal-ceramics | | | |
Adhesive refunds
81531 | | Adhesive aluminium splint-| | | | 1230.0-
| | to 6 teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
81532 | | Adhesive aluminium splint-| | | | 1716.0-
| and more teeth | 7 | | | |
Temporary fixed refunds, repairs of fixed refunds
81601 | | A makeshift protective Crown | | | | 282.0-
| | | | | |
------+---+------------------------------+--------+-----+-----+------------
81611 | | A makeshift protective bridge | | | | 679.0-
| |-up to 6 plastic teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
81612 | | A makeshift protective bridge | | | | 929.0-
| |-plastic 7 + teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
81621 | | Fix fixed refunds | | | | 208.0-
| |-new bearing bezel | | | |
------+---+------------------------------+--------+-----+-----+------------
81631 | | Fix fixed refunds | | | | 508.0-
| |-bearing joining | | | |
Partial dentures dental defect
82001 | Partial removable replacement | | | | | (I)
| with simple retention | | | | |
| |-to elements 6 teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
82002 | Partial removable replacement | | | | | (I)
| with simple retention | | | | |
| |-7 elements and more teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
82011 | Partial removable replacement | | 3 | | | 2010.0-
| with cast anchor elements |-| | | |
| | to 6 teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
82014 | Partial removable replacement | | 3 | | | 2146.0-
| with cast anchor elements |-| | | |
| and more teeth | 7 | | | |
------+---+------------------------------+--------+-----+-----+------------
82021 | Partial removable replacement | | 3 | | | 2490.0-
| |-stabilises the bottom with cast | | | |
| |-7 connection bracket and more | | | |
| | teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
82022 | Partial removable replacement | | 3 | | | 2502.0-
| upper bunk with cast | | | | |
| |-7 plate and more teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
82104 | | The top skeleton replacement-| 3 | | | 1260.0-
| | 2 anchor elements | | | |
------+---+------------------------------+--------+-----+-----+------------
82105 | | The top skeleton replacement-| 3 | | | 1395.0-
| | 3 or more anchor elements | | | |
------+---+------------------------------+--------+-----+-----+------------
82114 | | The lower compensation-skeleton | 3 | | | 1246.0-
| | 2 anchor elements | | | |
------+---+------------------------------+--------+-----+-----+------------
82115 | | The lower compensation-skeleton | 3 | | | 1345.0-
| | 3 or more anchor elements | | | |
------+---+------------------------------+--------+-----+-----+------------
82141 | | Aluminium splint pickup-| | | | 1374.0-
| | to 6 teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
82142 | | Aluminium splint pickup-| | | | 2008.0-
| and more teeth | 7 | | | |
------+---+------------------------------+--------+-----+-----+------------
82151 | | Aluminium splint fixed-up to 6 teeth | | | | 1712.0-
------+---+------------------------------+--------+-----+-----+------------
82152 | | Aluminium fixed splint-| | | | 2321.0-
| and more teeth | 7 | | | |
The total dentures
82201 | | The total remuneration of the top | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
82203 | | The total remuneration of the top with cast | 3 | | | 1531.0-
| | top bunk | | | |
------+---+------------------------------+--------+-----+-----+------------
82204 | | The total remuneration of the top hybrid | | | | 1326.0-
------+---+------------------------------+--------+-----+-----+------------
82211 | | The total replacement of the bottom | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
82212 | | The total replacement of the bottom with cast | 3 | | | 1555.0-
| | Base | | | |
------+---+------------------------------+--------+-----+-----+------------
82213 | | The total compensation of the lower hybrid | | | | 1351.0-
Repair of casting, rebaze
82301 | | Fix-tooth vypadlého | | | | 164.0-
| from refunds | | | | |
------+---+------------------------------+--------+-----+-----+------------
82311 | | Fix on the model-cracked | | | | 225.0-
| broken replacement | | | | |
------+---+------------------------------+--------+-----+-----+------------
82320 | | Fix or edit the retention | | | | 363.0-
| compensation elements, | | | | |
------+---+------------------------------+--------+-----+-----+------------
82331 | | Edit-extension of the base | | | | 587.0-
| |-up to 4 teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
82332 | | Edit-extension of the base | | | | 600.0-
| |-5 or more teeth | | | |
------+---+------------------------------+--------+-----+-----+------------
82341 | | Fix wireframe-| | | | 876.0-
| joining, scoring | | | | |
------+---+------------------------------+--------+-----+-----+------------
82351 | | Edit-rebaze partial | | | | 353.0-
| dentures unhashed | | | | |
------+---+------------------------------+--------+-----+-----+------------
82352 | | Edit-rebaze partial | | | | 940.0-
| | dentures bearing | | | |
------+---+------------------------------+--------+-----+-----+------------
82353 | | Edit-rebaze total | | | | 405.0-
| without the fingerprint | | | | |
------+---+------------------------------+--------+-----+-----+------------
82354 | | Edit-rebaze total | | | | 1122.0-
| refund with fingerprint | function | | | |
| | framing | | | |
Reconstruction of the refund
83001 | | Obturátor floor with partial | | | | (I)
| resin replacement | | | | |
------+---+------------------------------+--------+-----+-----+------------
83002 | | Obturátor floor with partial | 3 | | | (I)
| skeleton replacement | | | | |
------+---+------------------------------+--------+-----+-----+------------
83003 | | Obturátor floor with a total || | | | (I)
| replacement teeth | | | | |
------+---+------------------------------+--------+-----+-----+------------
83011 | Partial refund | poresekční | | | | (I)
| | top JAWS | | | |
------+---+------------------------------+--------+-----+-----+------------
83012 | Partial refund | poresekční | | | | (I)
| the upper jaw with the Chamber, | | | | |
------+---+------------------------------+--------+-----+-----+------------
83021 | Partial refund | poresekční | | | | (I)
| | lower jaw | | | |
------+---+------------------------------+--------+-----+-----+------------
83031 | | Total poresekční recovery | | | | (I)
| | top JAWS | | | |
------+---+------------------------------+--------+-----+-----+------------
83032 | | Total poresekční recovery | | | | (I)
| | lower jaw | | | |
Rehabilitation and therapeutic AIDS
84001 | | Fusing resin | | | | (I)
| the occlusal splint | | | | |
------+---+------------------------------+--------+-----+-----+------------
84011 | | Fixed resin nákusná | | | | (I)
| |-splint | | | |
------+---+------------------------------+--------+-----+-----+------------
84012 | | Fixed skeletovaná nákusná | 3 | | | (I)
| |-splint | | | |
------+---+------------------------------+--------+-----+-----+------------
84021 | | Sensing resinous nákusná | | | | (I)
| |-splint | | | |
------+---+------------------------------+--------+-----+-----+------------
84022 | | Nákusná cam skeletovaná | 3 | | | (I)
| |-splint | | | |
------+---+------------------------------+--------+-----+-----+------------
84031 | | Cover of postoperative plate | | | | (I)
| | Kiliánova Board | | | |
------+---+------------------------------+--------+-----+-----+------------
84032 | | Carrier transplant | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
84034 | | Oklusní surgical splint-| | | | (I)
| | bimaxilární plate | | | |
------+---+------------------------------+--------+-----+-----+------------
84035 | | N t brace | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
84036 | | Strut plate to support | | | | (I)
| orbital trash | | | | |
------+---+------------------------------+--------+-----+-----+------------
84041 | | Rozvolňovač the oral closure | | | | (I)
------+---+------------------------------+--------+-----+-----+------------
84042 | | Spring gag | | | | (I)
Orthodontic products
86001 | | Orthodontic diagnostic | | | P | (I)
| documentation models | | | | |
------+---+------------------------------+--------+-----+-----+------------
86010 | | Simple functional sensing | | and | P | (I)
| | device (monoblocks, propulsor) | | | |
------+---+------------------------------+--------+-----+-----+------------
86011 | | Simple functional sensing | | (b) | P | 1289.0-
| | device (monoblocks, propulsor) | | | |
------+---+------------------------------+--------+-----+-----+------------
86013 | | Moderately complex functional | | and | P | (I)
| | removable appliance | | | |
| | (klammt, balters) | | | |
------+---+------------------------------+--------+-----+-----+------------
86014 | | Moderately complex functional | | (b) | P | 1770.0-
| | removable appliance | | | |
| | (klammt, balters) | | | |
------+---+------------------------------+--------+-----+-----+------------
86016 | | Complex functional removable appliance | | and | P | (I)
| | (fránkel, bimler, lehman, | | | |
| | hansa-platte) | | | |
------+---+------------------------------+--------+-----+-----+------------
86017 | | Complex functional removable appliance | | (b) | P | 2450.0-
| | (fránkel, bimler, lehman, | | | |
| | hansa-platte) | | | |
------+---+------------------------------+--------+-----+-----+------------
86020 | | Positioner | | and | P | (I)
------+---+------------------------------+--------+-----+-----+------------
86021 | | Positioner | | (b) | P | 3258.0-
------+---+------------------------------+--------+-----+-----+------------
86030 | | Simple plate cam | | and | P | (I)
| |-up to 4 devices elements (wire., | | | |
| | 1 screw) | | | |
------+---+------------------------------+--------+-----+-----+------------
86031 | | Simple plate cam | | (b) | P | 1043.0-
| |-up to 4 devices elements (wire., | | | |
| | 1 screw) | | | |
------+---+------------------------------+--------+-----+-----+------------
86033 | | A complex plate removable appliance | | and | P | (I)
------+---+------------------------------+--------+-----+-----+------------
86034 | | A complex plate removable appliance | | (b) | P | 1323.0-
------+---+------------------------------+--------+-----+-----+------------
86036 | | Obtain canopy sunshades | | and | P | (I)
------+---+------------------------------+--------+-----+-----+------------
86037 | | Obtain canopy sunshades | | (b) | P | 965.0-
------+---+------------------------------+--------+-----+-----+------------
86040 | | Fixed device to extend | | and | P | (I)
| | midpalatal suture | | | |
------+---+------------------------------+--------+-----+-----+------------
86041 | | Fixed device to extend | | (b) | P | 1933.0-
| | midpalatal suture | | | |
------+---+------------------------------+--------+-----+-----+------------
86050 | | Laboratory-made nábradek | | and | P | (I)
------+---+------------------------------+--------+-----+-----+------------
86051 | | Laboratory-made nábradek | | (b) | P | 709.0-
------+---+------------------------------+--------+-----+-----+------------
86070 | | Laboratory prepared | | and | P | (I)
| intraoral | arc | | | |
------+---+------------------------------+--------+-----+-----+------------
86071 | | Laboratory prepared | | (b) | P | 542.0-
| intraoral | arc | | | |
------+---+------------------------------+--------+-----+-----+------------
86080 | | Repair or adjustment of the scanning | | | | (I)
| a simple apparatus (lom |. | | | |
| | 1 wire. Element) | | | |
------+---+------------------------------+--------+-----+-----+------------
86081 | | Repair or adjustment of the scanning | | | P | (I)
| apparatus bearing the ' | ' | | | |
------+---+------------------------------+--------+-----+-----+------------
Annex 5
Indication list of Spa care for hospital rehabilitation
SECTION AND
A. list of indicator groups for adults
Even Diseases Oncology
(II) circulatory system diseases
(III) diseases of the digestive system
(IV) Disease of metabolic disorders and endocrine glands
In Diseases of the respiratory system
VI nerve diseases
VII Diseases of the musculoskeletal system
(VIII) Diseases of the urinary system
(IX) mental disorders
X Skin Diseases
XI Disease Gynecologic
B. indication list for spa hospital rehabilitation care for adults
------------------------------------------------------------------------------------------------------------------------------------
The Number Of Indications BASIC RECURRING
the indication for therapy treatment vacation
------------------------------------------------------------------------------------------------------------------------------------
-method of providing spa treatment-method of providing a spa hospital
rehabilitative care: rehabilitation care:
The (complex) or P (contribution) to the (complex) or P (contribution)
-other criteria related-other criteria related
to each individual indications indications
-the length of the treatment-the length of the treatment
-the deadline for the onset of treatment stay-the deadline for the onset of treatment stay
-the possibility of an extension-extension
------------------------------------------------------------------------------------------------------------------------------------
EVEN DISEASES ONCOLOGY
------------------------------------------------------------------------------------------------------------------------------------
I/1-malignant tumors. To 21 days to 21 days
Within 12 months after their comprehensive Hodgkin's disease
treatments (with the exception of up to 36 months from the beginning of the base.
long-term hormone therapy).
The possibility of an extension. P 21 days in the indicated cases, P 14 days
Hodgkin's disease after 36 months from the beginning of
Basic stay.
P 21 days in the indicated cases, P 14 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
(II) CIRCULATORY SYSTEM DISEASES
------------------------------------------------------------------------------------------------------------------------------------
II/1-Symptomatic ischemic P P 21 days 21 days, in indicated cases, P 14 days
heart disease.
------------------------------------------------------------------------------------------------------------------------------------
II/2-State after myocardial infarction. To 28 days
Within 12 months after the occurrence of myocardial infarction.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
(II)/3-Hypertensive disease to 28 days P 21 days in the indicated cases, P 14 days
II.-III. grade evaluation of Hypertension (III). the degree of hypertensive disease complicated refractory.
hypertensive disease. coronary artery disease,
congestive heart failure,
stroke, transient
Ischemic atakou or chronic
renal insufficiency on the basis
Vascular nefrosklerosy.
The possibility of an extension.
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
II/4-a disease of the arteries of the legs on to the 21 days to 21 days
the basis of aterosklerotickém (II) (b). Disease of the arteries of the legs on the basis of a disease of the arteries of the legs on the basis
or inflammatory. aterosklerotickém II (b). aterosklerotickém
P 21 days (II) (b). within 18 months from the beginning of the basic
The other. stay, if invasive treatment is not possible.
P 21 days in the indicated cases, P 14 days
The other.
If invasive treatment is not possible.
------------------------------------------------------------------------------------------------------------------------------------
II/5-functional disorders of the peripheral to the 21 days P 21 days in indicated cases, P 14 days
vessels and States after thrombosis.
-Chronic lymphatic oedema. Functional disorders of the peripheral vessels
as an occupational disease, according to another
the legislation, which provides for the
the list of occupational diseases,
at the earliest 3 months after
the acute stage.
P 21 days
The other.
Functional disorders of the peripheral vessels and
conditions after thrombosis at the earliest
3 months after the acute stage.
------------------------------------------------------------------------------------------------------------------------------------
II/6-conditions after the 28 days after cardiac P 21 days in the indicated cases, P 14 days
performances of the type:
replacement valve bioprotézou Direct transfer of health care within 12 months from the beginning of the base.
or metallic prosthesis, bed care provider facility
Reconstructive procedures or
valves, Atrial Septal defects within 3 months after the operation.
or chambers,
Surgical Revascularization Option extension.
myocardium – coronary artery
bypass surgery (CABG),
operation of congenital heart P 21 days
defects in adults, other
left ventricular aneurysm operation,
heart tumors, surgery operation
the pericardium,
thoracic aortic aneurysm operation.
------------------------------------------------------------------------------------------------------------------------------------
(II)/7-stages after percutaneous P 21 days
transluminal coronary within 3 months after percutaneous transluminal
angioplasty (PTCA). coronary angioplasty (PTCA).
------------------------------------------------------------------------------------------------------------------------------------
II/8-States after reconstruction and to 21 days
revaskularizačních conditions after operations, reconstruction and
on the outside of the heart and the vascular system revaskularizačních on Vascular Surgery
thoracic aortic aneurysm. the system outside of the heart to the 4 months after
-Conditions after percutaneous surgery.
transluminal angioplasty.
P 21 days
In the range of 4 to 12 months after percutaneous
transluminal angioplasty.
------------------------------------------------------------------------------------------------------------------------------------
II/9-after a heart transplant. To 28 days to 28 days
Direct transfer of health care within 12 months from the beginning of the base.
bed care provider facility
or within 12 months after the operation. The possibility of an extension.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
(III) DISEASES OF THE DIGESTIVE SYSTEM
------------------------------------------------------------------------------------------------------------------------------------
III/1-chronic and recurrent P P 21 days 21 days, in indicated cases, P 14 days
diseases of the stomach and intestines
with maldigestivními symptoms
even when the standard
pharmacotherapy.
-Conditions after heavy intestinal
infections, parazitózách, and
fungal diseases.
------------------------------------------------------------------------------------------------------------------------------------
III/2-States after stomach surgery, to 21 days 21 days, P in indicated cases, P 14 days
the duodenum, esophagus and intestines within 6 months after the operation. In the range of 12 to 18 months after the operation, or
with the postresekční symptomatologií their complex treatment lasting
endoscopically proven. The possibility of an extension. of 138.39 days;.
P 21 days
In the range of 6 to 12 months after surgery.
------------------------------------------------------------------------------------------------------------------------------------
III/3-Crohn's disease. To 21 days to 21 days
-Ulceroza Colitis. A severe form of the disease. Recurring exacerbations of the disease: 1 during the
calendar year to stabilize the State.
The possibility of an extension.
P 21 days in the indicated cases, P 14 days
P 21 days of rest.
The other.
------------------------------------------------------------------------------------------------------------------------------------
III/4-chronic gallbladder disease P P 21 days 21 days, in indicated cases, P 14 days
and gall tract with lithiazou, to maintain remission.
If the operation is contra-indicated.
-Sclerosing cholangoitis.
-Functional disorders of the gall tract.
------------------------------------------------------------------------------------------------------------------------------------
III/5-States after complicated operations to 21 days P 21 days in indicated cases, P 14 days
gallbladder and bile tract, after
surgery for stenosis and lithiazu within 6 months after the complicated operations Continued dysfunction of the biliary tract.
biliary tract post-surgery gallbladder and gallstone-tract.
pankreatitidocholangoitis,
Icterus, instrumentation for stenosis After biliary surgery and lithiázu
paths, endoscopic retrograde biliary tract.
Cholangiopancreatography (ERCP).
-Conditions after dissoluci stones and the possibility of extension.
extracorporeal lithotripsy.
P 21 days
Within 6 months after the dissoluci stones
and extracorporeal lithotripsy.
------------------------------------------------------------------------------------------------------------------------------------
III/6-conditions after acute hepatitis for 21 days to 21 days
any toxic etiology and within 6 months of the determination of disease of liver damage when the persistent
liver damage (medicines even when conservative therapy. signs of things to process as a disease
the influence of the work). of the profession under other legislation,
-Chronic hepatitis with the possibility of extension. which sets out the list of occupational diseases.
persistence of positives markers.
-Associated autoimmune hepatitis. P 21 days in the indicated cases, P 14 days
-Primary biliary cirrhosis.
Other when the persistent biochemical
or histological signs of liver disease.
------------------------------------------------------------------------------------------------------------------------------------
III/7-States after resection procedures to 21 days P 21 days in indicated cases, P 14 days
and transplantation of the liver after resection or speed up to 6
and transplantation operations months after the operation.
pancreatic cancer. Conditions after transplantation into 12
months after the operation.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
III/8-conditions after acute pancreatitis to 21 days P 21 days in indicated cases, P 14 days
or after an exacerbation of chronic within 6 months from the initiation of treatment of acute
pancreatitis. pancreatitis or after Lengthy maldigesce and exacerbation of malabsorption in the
-Proven chronic chronic pancreatitis, the proven failure of nutritional status, if
pancreatitis. is the cause of the dysfunction of the pancreas.
When complications within 12 months from the
the initiation of treatment of acute pancreatitis or
After the exacerbation of chronic pancreatitis.
The possibility of an extension.
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
(IV) DISEASES OF METABOLIC DISORDERS AND ENDOCRINE GLANDS
------------------------------------------------------------------------------------------------------------------------------------
IV/1-Diabetes mellitus. P to 21 days 21 days in the indicated cases, P 14 days
States with complications (microangiopathy statuses with complications (microangiopathy
and makroangiopatie, neuropathy). and makroangiopatie, neuropathy).
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
IV/2-conditions after total thyreoidektomii. P to 21 days 21 days in the indicated cases, P 14 days
-Hypothyroidism in difficult-to-
ongoing drug substitution. Up to 6 months after surgery. Difficult to ongoing substitution or
in the development of secondary symptoms
P 21 days (in particular, arthropathy and benign myopathy).
Within 6 months of the determination of the disease
hypotyreozy.
------------------------------------------------------------------------------------------------------------------------------------
IV/3-States after operations of hyperfunkčního to 21 days
a benign adenoma of the pituitary gland
and the adrenal gland in the presence of up to 6 months after surgery.
secondary symptoms
(in particular, arthropathy and myopathy). The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
IN NON-TUBERCULOSIS DISEASES OF THE RESPIRATORY SYSTEM
------------------------------------------------------------------------------------------------------------------------------------
V/1-States after surgery of the upper respiratory to 28 days
and lower respiratory tract infections
tract; does not concern the conditions after the States of lower respiratory tract after operation
the operations of the tonsil, adenoidních within 6 months after the operation.
vegetation and nasal septum.
-Conditions after lung transplantation. The possibility of an extension.
To 28 days
Conditions after lung transplant to 12 months
After the transplant.
The possibility of an extension.
To 21 days
Conditions after operation of upper respiratory tract
within 6 months after the operation.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
V/2-damage to the larynx and vocal cords to 21 days P 21 days in indicated cases, P 14 days
as a result of voice overload.
-Conditions after fonochirurgické treatment. When through the use of all possibilities when through the use of all possibilities
conservative or surgical treatment, conservative or surgical treatment
It does not modify the features of the voice. It does not modify the features of the voice.
------------------------------------------------------------------------------------------------------------------------------------
V/3-conditions after the complicated inflammation to 21 days
surfaces In the four months after their hospitalisation.
------------------------------------------------------------------------------------------------------------------------------------
In/4-Bronchiektazie to 21 days to 21 days
-Recurrent inflammation of the lower
chronic inflammation of the respiratory tract and the possibility of extension. 1 during a calendar year.
as a disease of the respiratory system
According to another legal profession
the regulation, which lays down a list of
occupational diseases.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
In/5-bronchial asthma. To 28 days to 28 days
-Chronic obstructive pulmonary
the disease. Proven ventilation disorder-the decline in Proven ventilation failure-fall
the value of a volume of air vydechnutého the value of a volume of air vydechnutého
in the first second at maximum effort in the first few seconds at maximum effort
(FEV) 1 sec repeatedly below 60% of the proper (FEV) 1 sec repeatedly below the 60% of the relevant
the value or necessity of long-term (multiple values or the need for long-term (more
than 6 months in a year) system than 6 months in the year) system
kortikoterapie for the disease. kortikoterapie for the disease.
The possibility of an extension. 1 during a calendar year.
P 21 days extension.
The other.
P 21 days in the indicated cases, P 14 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
V/6-Interstitial Pulmonary Fibrosis to 28 days to 21 days
any etiology in systematic occupational disease pursuant to other legal occupational disease pursuant to other legal
healing. the regulation, which lays down the list of diseases Act, which sets out the list of diseases
of the profession. of the profession.
The possibility of an extension. 1 during a calendar year.
The possibility of extending to 28 days.
When proven ventilation failure-fall
the value of the vital capacity (VC) repeatedly to 21 days
below 80% of predicted.
When proven ventilation failure-fall
The possibility of an extension. the value of the vital capacity (VC) repeatedly
below 80% of predicted.
P 21 days
The other. 1 during a calendar year.
The possibility of an extension.
P 21 days in the indicated cases, P 14 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
V/7-the consequences of toxic gases to 28 days to 21 days
fumes, vapor and corrosive irritant
money on upper respiratory and occupational disease by other means, within 12 months from the beginning of the base.
lower respiratory tract. the regulation, which lays down the list of diseases
of the profession.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
VI NERVE DISEASES
------------------------------------------------------------------------------------------------------------------------------------
Vi/1-facial palsy. To 28 days to 28 days
-Postpoliomyelitický syndrome.
-Weak palsy, outside of post-traumatic, facial palsy in the acute phase, Postpoliomyelitický syndrome.
including the poinfekční if it is not continuous ambulatory
polyradikuloneuritis or inpatient rehabilitation care once during the calendar year.
following up on their acute effective.
phase. The possibility of an extension.
Postpoliomyelitický syndrome.
Other diseases for the duration of the feeble P 21 days in the indicated cases, P 14 days
peripheral paralysis with accompanied by:
elektromyografií (EMG) and after other periods for the duration of a poor peripheral
gradual adjustment functions. polio with accompanied by elektromyografií
(EMG) and for gradual adjustment functions.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
Vi/2-Polyneuropathy with paretickými to 28 days to 28 days
speeches.
Weak palsy with disabilities 0. up to 3. Weak palsy with disabilities 0. up to 3.
the degree of muscle test and demonstrable degree test and proven
disabilities by electromyography (EMG). disabilities by electromyography (EMG).
The possibility of an extension. 1 x in the course of 24 months.
P 21 days extension.
The other.
P 21 days in the indicated cases, P 14 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
(VI)/3-Root syndromes with P to 21 days 21 days in the indicated cases, P 14 days
iritačně-zánikovým syndrome.
In direct follow-up to hospitalization
the neurological or rehabilitation
Department inpatient care (within 3 months after
their hospitalization), or in cases
nejevících signs of improvement after 6 weeks of
continuous outpatient rehabilitation
care, which has been excluded of the indication
to neurochirurgickému or
spondylochirurgickému surgery.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
Vi/4-inflammatory disease of the central to 28 days to 28 days
nerves:
condition after meningoencephalitis and, for persistent palsy with The 36 months from the beginning of the basic residence,
encephalitis, documented elektromyografickým if you still experience heavy to medium's palsy
myelitis and encephalomyelitis that, testing (EMG) tests and after, and is a prerequisite for the improvement of health
After a period of gradual encefalomyelopolyradi-editing functions. State.
kuloneuritis, no later than 6 months after their
hospitalization if they are present. The possibility of an extension.
spastickoparetické signs.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
VI/5-Hemiparézy, and paraparézy to 28 days to 28 days
Vascular origin with signs
restorative function. In direct follow-up to hospitalization, To 36 months from the beginning of the basic
not later than 6 months after the end of the stay, if you still experience heavy
hospitalization. to medium's palsy and is the assumption
In the aftermath of the acute stage of the disease. for the improvement of health.
The possibility of an extension. The possibility of an extension.
P 21 days in the indicated cases, P 14 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
Vi/6-conditions after injuries and 28 days to 28 days
the operations of the brain, the spinal cord paresis with gradual To Persistent 36 months from the beginning of the basic residence,
and peripheral nerves with the editing functions, not later than 6 months if there is persistent heavy to medium paresis
disorders of motility after surgery or injury. and is a prerequisite to improve health.
signs of restorative function.
The possibility of an extension. The possibility of an extension.
P 21 days in the indicated cases, P 14 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
Vi/7-multiple sclerosis and the other for 28 days to 28 days
demyelinating disease
in remission. The possibility of an extension. 1 in the course of 24 months.
P 21 days in the indicated cases, P 14 days
------------------------------------------------------------------------------------------------------------------------------------
Vi/8-a neuromuscular disease to 28 days to 28 days
primary, secondary and
degenerative. The possibility of an extension. 1 during a calendar year.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
Vi/9-Syringomyelie with paretickými to 21 days to 21 days
speeches.
1 in the course of 24 months.
P 21 days in the indicated cases, P 14 days
------------------------------------------------------------------------------------------------------------------------------------
VI/10-cerebral palsy in to 28 days to 28 days
a separate mobility options
and without significant psychological changes, to the age of 21.
assuming the maintenance work
skills or full independence for 28 days
and self-sufficiency.
Over 21 years of age.
1 in the course of 24 months.
P 21 days in the indicated cases, P 14 days
------------------------------------------------------------------------------------------------------------------------------------
VI/11-Parkinson's disease. To 21 days to 21 days
(Not applicable to Parkinsonského
syndrome and secondary if the premise of improving the
movement of the syndrome of health and maintain self-sufficiency.
in the treatment of psychofarmaky.)
1 in the course of 24 months.
------------------------------------------------------------------------------------------------------------------------------------
VII DISEASES OF THE MUSCULOSKELETAL SYSTEM
------------------------------------------------------------------------------------------------------------------------------------
VII/1-Rheumatoid arthritis I to IV. To 28 days to 28 days
stages of evaluation of rheumatoid
arthritis, including juvenile Treatment from II. stages of disease with functional Treatment from II. stages of disease with functional
arthritis, consistently treated disabilities class (b). disabilities class (b).
in the context of out-patient care.
The possibility of an extension. 1 during a calendar year.
P 21 days extension.
The disease without a previous exacerbation of P 21 days in the indicated cases, P 14 days
and treatment in case of lower stages
disease than II. the stage with a functional Disease without exacerbation
disabilities class (b). and treatment in case of lower stages
disease than II. with a functional stage
disabilities class (b).
------------------------------------------------------------------------------------------------------------------------------------
VII/2-Ankylosing spondylitis to 28 days to 28 days
(Bechterew's disease), consistently
treated in the outpatient care. From The II. stages of disease with functional From II. stages of disease with functional
disabilities, disabilities class b class b.,
in the continuing care of a rheumatologist or continuous care or rheumatologist
a rehabilitation physician. a rehabilitation physician.
The possibility of an extension. The possibility of an extension.
P P 21 days 21 days in the indicated cases, P 14 days
The other. The other.
------------------------------------------------------------------------------------------------------------------------------------
VII/3-other seronegative for 28 days to 28 days
spondartritis has consistently treated
in the context of out-patient care, Reiter's Involvement of the spine (II). and higher stages of spinal Disability II. and a higher stage
syndrome, enteropatická arthritis, according to the classification for ankylosing according to the classification for ankylosing
reactive-parainfectious), spondylitis. Spondylitis.
-Secondary artitis, consistently
treated in the outpatient care. Chronic arthritis, peripheral joints Chronic Arthritis, peripheral joints
from a functional disability class II. b. from a functional disability class II. b.
stage classification for the classification stage for rheumatoid arthritis, rheumatoid arthritis,
artritis. artritis.
The possibility of an extension. First 12 months from the beginning of the basic
stay and once during a calendar year.
P 21 days
The other. The possibility of an extension.
P 21 days in the indicated cases, P 14 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
VII/4-extra articular rheumatism, to 28 days to 28 days
consistently treated in the framework of the
out-patient care. In remission. In remission.
-Diffuse disease binders
consistently treated within the extension. 1 in the course of 24 months.
ambulatory care (System
Lupus erythematodus, exacerbation of an underlying disease
Scleroderma, after their last comprehensive treatment
polymyositis, dermatomyositis, acute phase and before the expiry of the 24 months.
Sjogren's syndrome and other
pop-up syndromes). The possibility of an extension.
P 21 days in the indicated cases, P 14 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
VII/5-Osteoporosis with complications, to 21 days to 21 days
If continuous ambulatory
rehabilitation care longer than Bone changes that are the result of Bone changes that are the result of
3 months is not effective or work in compressed air work in compressed air as
following the hospitalization occupational disease pursuant to other legal occupational disease pursuant to other legal
for the complication of osteoporosis. the regulation, which lays down the list of diseases Act, which sets out the list of diseases
-Bone changes that are out of the profession. of the profession.
as a result of work in compressed
the air as occupational disease, pathological fractures of the spine pathological fractures of the spine in the wake
under other legislation, in the immediate wake of the removal of the corset.
which sets out the list of diseases of their immobilization in bed
of the profession. or removal of the corset. Within 24 months from the start of the base.
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
VII/6-painful syndromes of tendon, to 21 days to 21 days
tendinous sheaths, bursae, ligaments, an occupational disease pursuant to other legal occupational disease pursuant to other legal
muscle, skeletal muscle or regulation, which lays down the list of diseases Act, which sets out the list of diseases
joints (including occupational disease. by profession, within 12 months from the beginning of the
due to the effect of the vibration of the base.
and long-term, excessive, P 21 days
unilateral overload as 21 days in the indicated cases, P 14 days
occupational diseases in another Other.
the law, which lays down the other.
the list of occupational diseases).
------------------------------------------------------------------------------------------------------------------------------------
VII/7-Koxartroza, gonartroza to 21 days to 21 days
in continuous ambulatory care
Orthopedic and rehabilitation From III. degree reviews by disease III. ratings under
doctor. Kellgrena. Kellgrena.
II. the degree of functional impairment (b), since the degree of functional disability II (b),
If this is about a painful form of with if this is about a painful form of with
frequent exacerbations and frequent exacerbations and quick fast
progression or repeated inflammatory disease progression or repeated inflammatory
irritation. irritation and it is expected to improve
momentum and maintain self-sufficiency.
The possibility of an extension.
1 in the course of 24 months.
P 21 days
The other, States to operation contraindicated
If it is not continuous ambulatory
rehabilitation care efficient. 1 during a calendar year.
P 21 days in the indicated cases, P 14 days
I. to II. the degree of illness, if it is not
ongoing outpatient care effective,
assuming a reduction in long term
Pharmacotherapy or out on the operating
treatment.
The States prohibited the operation,
If there is no ongoing outpatient care
effective.
------------------------------------------------------------------------------------------------------------------------------------
VII/8-Arthritis in the other for 21 days to 21 days
localizations.
-Arthropathy. Painful form with frequent exacerbations. If this is about a painful form of frequent
exacerbations and rapid progression or
in the case of repeated inflammatory irritation;
always assuming the improvement in momentum and
maintain self-sufficiency.
1 in the course of 24 months.
P 21 days in the indicated cases, P 14 days
Others, if not continuous ambulatory
care effective, provided the reduction
long-term pharmacotherapy.
------------------------------------------------------------------------------------------------------------------------------------
VII/9-Chronic vertebral P to 21 days 21 days in the indicated cases, P 14 days
algický syndrome of functional
origin in continuous outpatient Chronic vertebral algický
rehabilitation care. syndrome of functional origin in direct
following the hospitalization (up to 3
months after their hospitalization)
or cases showing signs of improvement
After 6 weeks of continuous ambulatory
rehabilitation care.
The possibility of an extension.
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
VII/10-States after orthopedic to 28 days
operations with the use of joint
the refund. Immediately, as soon as possible
load the therapeutic rehabilitation, not later than
within 3 months after injury or surgery;
in the case of postoperative komplikacído
6 months after surgery.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
VII/11-musculoskeletal conditions after injuries to 28 days to 28 days
and after orthopedic
operations including conditions after Immediately, as soon as possible the load within 24 months after surgery
the operations of the rehabilitation, treatment of intervertebral nejpozdějivšak intervertebral discs, spinal stenosis
discs and stenosis of the channel within 6 months after an injury or surgery; channel or accident when persistent
the backbone, if it is not systematic in the case of post-operative complications serious momentum and limitations
outpatient or inpatient, within 12 months after the operation. It is the assumption of self-sufficiency and improve the
rehabilitation care efficient. the State of health.
The possibility of an extension.
P 21 days in the indicated cases, P 14 days
Other syndrome surgical treatment failure
(FBS).
------------------------------------------------------------------------------------------------------------------------------------
VII/12-lower to amputacích after 21 days
limbs, degree of activity 1 to
4, when the policy holder is equipped with a 12 months after surgery.
the prosthetic.
------------------------------------------------------------------------------------------------------------------------------------
(VIII) DISEASES OF THE URINARY SYSTEM
------------------------------------------------------------------------------------------------------------------------------------
VIII/1-Recurrent and chronic P to 21 days 21 days in the indicated cases, P 14 days
non-tuberculous infections of the kidney and
urinary tract infection-resistant Chronic pyelonefritis in solitary
treatment with antibiotics (ATB) and another kidney.
pharmacological treatment, in a systematic
the care of a urologist for at least 12 months. Cystic kidney disease. The level of
-Cystic kidney disease. serum creatinine permanently exceeds the
150 μmol/1.
The possibility of an extension.
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
VIII/2-Nephrolithiasis without congestion to 21 days P 21 days in indicated cases, P 14 days
in the urinary tract.
-Ectopic calcification. Nephrolithiasis in solitary kidney In prokázáném clinical effect of previous
bilateral nephrolithiasis, or if a spa hospital rehabilitation care.
the States are not indicated to the operating
treat or lithotripsy.
Cystinová nephrolithiasis.
Bilateral ectopic calcification.
The possibility of an extension.
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
VIII/3-States after operations of the kidneys and to 21 days
urinary tract including the operations
endovezikálních and conditions after within 6 months after the surgery, kidney and
complicated Prostatectomy and urinary tract, including operations
nefrolitotrypsii, rehabilitation after endovezikálních and after
lithotripsy extrakorporálními Prostatectomy and nefrolitotrypsii.
shock waves (LERV).
P 21 days
Other
up to 6 months.
------------------------------------------------------------------------------------------------------------------------------------
VIII/4-Chronic prostatitis or P P 21 days 21 days, in indicated cases, P 14 days
chronic prostatovesikulitis
resistant to pharmacological
treatment and treatment with antibiotics (ATB)
in the continuing care of a urologist
a minimum of 12 months.
------------------------------------------------------------------------------------------------------------------------------------
VIII/5-after a kidney transplant to 21 days P 21 days in indicated cases, P 14 days
when stabilized graft function
(kidney transplant). Within 6 months after the transplant, when the States after kidney transplant
-The donor graft (kidneys). complications within 12 months (not applicable to the donor graft).
After the transplant.
The possibility of extending in the case of
transplants.
------------------------------------------------------------------------------------------------------------------------------------
(IX) MENTAL DISORDERS
------------------------------------------------------------------------------------------------------------------------------------
IX/1-Psychosis in remission. To 28 days to 28 days
In direct follow-up to hospitalization within 24 months from the start of a basic stay
in inpatient psychiatric ward in a proven effect of previous residence.
or when continuous ambulatory care
as an alternative to the subsequent bed extension.
psychiatric care after every exacerbation.
P 21 days in the indicated cases, P 14 days
The possibility of an extension.
The other.
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
IX/2-severe neurotic disorders to 21 days to 21 days
and other nepsychotické disorders.
In direct follow-up to hospitalization for up to 12 months from the beginning of the basic residence
inpatient psychiatric ward or a proven effect of previous residence.
When continuous ambulatory care as
alternative bed extension subsequent.
psychiatric care after every exacerbation.
P 21 days in the indicated cases, P 14 days
The possibility of an extension.
The other.
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
X SKIN DISEASES
------------------------------------------------------------------------------------------------------------------------------------
X/1-atopic eczema. To 21 days to 21 days
To 25 years of age, the elderly in direct as an alternative to inpatient care in the field of
following a hospitalization for treatment of hyperhidrosis.
inpatient Department of dermatovenereology
or as an alternative to this care. 1 in the course of 24 months.
The possibility of an extension. The possibility of an extension.
P P 21 days 21 days in the indicated cases, P 14 days
The other. The other.
------------------------------------------------------------------------------------------------------------------------------------
X/2-generalized and artropatická to 28 days to 28 days
Psoriasis vulgaris.
In direct follow-up to hospitalization as an alternative to inpatient care in the field of
the inpatient Department of dermatovenereology of hyperhidrosis.
or as an alternative to this care.
1 during a calendar year.
The possibility of an extension. The possibility of an extension.
P P 21 days 21 days in the indicated cases, P 14 days
The other. The other.
------------------------------------------------------------------------------------------------------------------------------------
X/3-Toxic contact dermatitis, 28 days to 21 days
-Eczema as occupational disease
in the continuing care of occupational diseases in another occupational disease pursuant to other legal
dermatovenerologa. the legislation, which sets out a list of rules, which sets out the list of diseases
occupational diseases. of the profession.
The possibility of an extension. 1 during a calendar year.
P 21 days extension.
The other.
P 21 days in the indicated cases, P 14 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
X/4-chronic dermatoses hung for 28 days P 21 days in the indicated cases, P 14 days
the outpatient treatment.
The treatment shall be granted exceptionally, in direct
following the hospitalization
inpatient Department of dermatovenereology
or as an alternative to this care.
The possibility of an extension.
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
X/5-States after burns and after 28 days to 21 days
Reconstructive procedures, where
significant CONTRACTURE. Within 3 months of their care within 24 months from the start of the base.
relevant specialists.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XI DISEASE GYNECOLOGIC
------------------------------------------------------------------------------------------------------------------------------------
XI/1-sterility and infertility to 21 days to 21 days
primary (3 and more spontaneous
abortion) women in 40 years. Women under 40 years of age.
-Secondary sterility on
the basis of inflammatory and functional. The sterility of women over 35 years after the sterility of women over 35 years after the
-Abortus habitualis. negative testing partner women. negative testing partner women.
Infertility (3 and more spontaneous Infertility (3 and more spontaneous
abortion) following a negative genetic abortion) following a negative genetic
examination of both partners. examination of both partners.
The possibility of an extension. Within 24 months from the start of the base.
P 21 days in the indicated cases, P 14 days
Women under 40 years of age.
------------------------------------------------------------------------------------------------------------------------------------
XI/2-repeating inflammatory to 21 days P 21 days in indicated cases, P 14 days
internal diseases of the genitals and
their consequences (adnexitis within 3 months after resolution of acute women 40 years of age.
chronica, metritis chronica, exacerbation of pelvic inflammatory disease
adhesiones pelvis minoris, in women under 40 years of age.
occlusio tubarum, kolpitis
chronica). The possibility of an extension.
P 21 days
The other.
------------------------------------------------------------------------------------------------------------------------------------
XI/3-States after complicated to 28 days
gynecological operations.
-Conditions after complicated operations
in the small pelvis.
Within 3 months after the operation.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
SECTION B
Indication list of Spa rehabilitation clinic for care of children and
Puppy
A. list of indicator groups for children and adolescents
XXI Disease cancer
XXII of the circulatory organs
XXIII of the Diseases of the digestive system
XXIV of metabolic disorders and endocrine glands and obesity
XXV respiratory diseases
XXVI nerve diseases
XXVII Diseases of the musculoskeletal system
ARTICLE XXVIII of the Diseases of the urinary system
XXIX mental disorders
XXX Skin Diseases
XXXI gynecological Diseases
B. indication list of Spa rehabilitation clinic for care of children and
Puppy
Number indication
------------------------------------------------------------------------------------------------------------------------------------
The Number Of Indications BASIC RECURRING
the indication for therapy treatment vacation
------------------------------------------------------------------------------------------------------------------------------------
-method of providing spa treatment-method of providing a spa hospital
rehabilitative care: rehabilitation care:
The (complex) to the (complex)
-other criteria related-other criteria related
to each individual indications indications
-the length of the treatment-the length of the treatment
-the deadline for the onset of treatment stay-the deadline for the onset of treatment stay
-the possibility of an extension-extension
------------------------------------------------------------------------------------------------------------------------------------
XXI DISEASE CANCER
------------------------------------------------------------------------------------------------------------------------------------
XXI/1-malignant tumors. To 28 days
Within 24 months after their comprehensive
anticancer treatment.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXII OF THE CIRCULATORY ORGANS
------------------------------------------------------------------------------------------------------------------------------------
XXII/1-congenital and acquired defects for 28 days to 28 days
the heart and major blood vessels after surgery.
-Conditions after a heart transplant. The possibility of an extension. Haemodynamic residual defects.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXII/2-systemic rheumatic and other to 28 days to 28 days
collagen disease with disabilities
the circulatory apparatus and joint form. The possibility of an extension. 1 in the course of 24 months,
When you relapse following the termination of the
acute phase before.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXII/3-juvenile hypertension. To 28 days to 28 days
The possibility of an extension. 1 during a calendar year.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXII/4-severe risk to resulted in 28 days
factors (Dyslipidemia or
the combination of other risk the possibility of an extension.
factors: arterial hypertension,
obesity, genetic load).
------------------------------------------------------------------------------------------------------------------------------------
XXIII OF THE DISEASES OF THE DIGESTIVE SYSTEM
------------------------------------------------------------------------------------------------------------------------------------
XXIII/1-chronic diseases of the stomach. To 28 days to 28 days
-Functional disorders of the stomach.
-Chronic gastritis and the possibility of extension. 1 during a calendar year.
duodenitis erosiva.
-Peptic ulcer disease of the stomach and up to 48 months from the beginning of the basic
the duodenum. stay in a proven effect
-States after operations of the esophagus, the previous stay.
the stomach and duodenum.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXIII/2-chronic bowel disease. To 28 days to 28 days
-Functional disorders of the small and
the large intestine. The possibility of an extension. Chronic enterocolitis and Crohn's disease.
-Chronic enterocolitis, including
Crohn's disease and other primary once during the calendar year.
Malabsorption Syndromes.
-Dermatogenní malabsorption syndromes. The possibility of an extension.
-Coeliakie.
Intestini-Polyposis. Other:
-Megacolon congenital and acquired.
-States after operations on thin even once during the calendar year.
the colon. To 48 months from the beginning of the base.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXIII/3-diseases of the liver. To 28 days to 28 days
-States after infectious hepatitis.
-Chronic hepatitis. The possibility of an extension. 1 during a calendar year.
-Cirrhosis in State compensation.
-Toxic damage to the liver. Conditions after transplantation in 12 months to 36 months from the beginning of the base.
-States after Infectious Mononucleosis after the operation.
with a liver disorder. The possibility of an extension.
-Conditions after injuries, operations and
transplantation of the liver.
-Other hepatopatie.
------------------------------------------------------------------------------------------------------------------------------------
XXIII/4-chronic gallbladder disease to 28 days to 28 days
and bile ducts.
-Congenital bile formation and the possibility of extension. 1 during a calendar year.
Biliary excretion.
-Chronic cholecystitis. In the 36 months since the beginning of the basic
-Biliary dyspepsia. stay in a proven effect prior
-States after operations of the gallbladder and stay.
the bile ducts.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
(XXIII)/5-chronic diseases of the pancreas. To 28 days to 28 days
-Conditions after acute pancreatitis.
-Chronic pancreatitis. The possibility of an extension. Chronic diseases of the pancreas
-Pancreatic achylie Congenital cystic fibrosis.
I obtained.
-Cystic fibrosis. 1 during a calendar year.
-Conditions after injuries, operations and
pancreas transplants. The possibility of an extension.
To 28 days
The other.
1 during a calendar year.
In the 36 months since the beginning of the base.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXIV, METABOLIC DISEASES AND DISORDERS AND ENDOCRINE GLANDS AND OBESITY
------------------------------------------------------------------------------------------------------------------------------------
XXIV/1-Diabetes mellitus. To 28 days to 28 days
The possibility of an extension. 1 during a calendar year.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXIV/2-obesity associated with other to 28 days to 28 days
risk factors.
The possibility of an extension. 1 during a calendar year.
In the 36 months since the beginning of the basic
stay in a proven effect prior
the stay.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXIV/3-Tyreopatie. To 28 days to 28 days
-States after operations of the thyroid gland.
-States after operations of benign Option extension. Tyreopatie.
tumors of the adrenal gland and pituitary gland.
1 during a calendar year.
In the 36 months since the beginning of the base.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXV NON-TUBERCULOSIS DISEASES OF THE RESPIRATORY SYSTEM
------------------------------------------------------------------------------------------------------------------------------------
XXV/1-Recurrent complicated to 28 days to 28 days
otitis after operating solutions.
The possibility of an extension. The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXV/2-chronic bronchitis/to 28 days to 28 days
recurrent bronchitis.
The possibility of an extension. 1 during a calendar year.
To 48 months from the beginning of the base.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXV/3-Status after repeated inflammation to 28 days
the lungs over the last 2 years.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXV/4-Bronchiektasie. To 28 days to 28 days
The possibility of an extension. The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXV/5-Asthma bronchiale. To 28 days to 28 days
The possibility of an extension. The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXV/6-States after operations, and to 28 days to 28 days
traumas upper and lower
respiratory tract and lungs with the exception of the possibility of an extension. The possibility of an extension.
conditions after tonsilektomii and
operation adenoidních vegetation.
-States after operations of malformations
chest with reduced lung function.
------------------------------------------------------------------------------------------------------------------------------------
XXV/7-cystic fibrosis. To 28 days to 28 days
-Interstitial Pulmonary fibrosis. The possibility of an extension. The possibility of an extension.
-Sarcoidosis the lung.
------------------------------------------------------------------------------------------------------------------------------------
XXVI NERVE DISEASES
------------------------------------------------------------------------------------------------------------------------------------
XXVI/1-Syndrome peripheral to 28 days to 28 days
any motor neuron
the etiology. The possibility of an extension. The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXVI/2-muscular dystrophy and to 28 days to 28 days
other muscle disease.
The possibility of an extension. The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXVI/3-cerebral palsy. To 28 days to 28 days
-Cerebellar syndromes. The possibility of an extension. The possibility of an extension.
-Driving fault within the small cerebral involvement.
------------------------------------------------------------------------------------------------------------------------------------
XXVI/4-other drivers fault to 28 days to 28 days
a central origin:
-driving fault after inflammation of the possibility of an extension. The possibility of an extension.
brain and spinal cord, autoimmune,
degenerative and heredofamiliární
disease control
rehabilitation care.
-driving disorders after stroke
the incidents of brain.
-driving disorders after injuries of the brain.
-driving disorders after surgery
tumors of the central nervous system.
------------------------------------------------------------------------------------------------------------------------------------
XXVI/5-Root syndromes to 28 days to 28 days
the Czech origin.
The possibility of an extension. During a relapse of the disease.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXVII DISEASES OF THE MUSCULOSKELETAL SYSTEM
------------------------------------------------------------------------------------------------------------------------------------
XXVII/1-juvenile chronic arthritis. To 28 days to 28 days
-Other chronic rheumatic Option extension. The possibility of an extension.
diseases of joints and spine.
------------------------------------------------------------------------------------------------------------------------------------
XXVII/2-inherited or acquired for 28 days to 28 days
orthopaedic defects.
The possibility of an extension. The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXVII/3-conditions after injuries and 28 days to 28 days
Orthopedic operations
in the event of motor functions. The possibility of an extension. To 36 months after surgery or injury.
------------------------------------------------------------------------------------------------------------------------------------
XXVII/4-Scoliosis that requires corset to 28 days to 28 days
from the Ib by Cobb, in the continuous
rehabilitation care. The possibility of an extension. The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXVII/5-Osteochondrosis in the stage to 28 days
reparačním.
Morbus Perthes disease in the stage of extension.
reparačním.
-Primary and secondary
Osteoporosis children and
adolescent age.
------------------------------------------------------------------------------------------------------------------------------------
XXVII/6-Morbus Scheuermann. To 28 days
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXVII/7-Vii algický to 28 days to 28 days
syndrome.
The possibility of an extension. When you relapse.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
ARTICLE XXVIII OF THE DISEASES OF THE URINARY SYSTEM
------------------------------------------------------------------------------------------------------------------------------------
XXVIII/1-Recurrent or lingering for 28 days to 28 days
inflammation of the kidneys and urinary tract
paths on the basis of anatomical possibility of extension. In case of confirmed activity process of the disease.
or functional.
------------------------------------------------------------------------------------------------------------------------------------
XXVIII/2-Urolithiasis in situ, to 28 days to 28 days
After the spontaneous departure
konkrementu, eliminating the possibility of an extension. When you relapse.
surgical or endoscopic
along the way, or litotrypsií extension.
extrakorporálními shock
the waves (LERV).
------------------------------------------------------------------------------------------------------------------------------------
XXVIII/3-States after operations to 28 days
the urinary system
outside the urolitiázu. Within 3 months after the operation; When a postoperative
complications within 6 months after the operation.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXVIII/4-chronic diffuse to 28 days to 28 days
Glomerulonephritis.
-Lipoic nephrosis. The possibility of an extension. In the 36 months since the beginning of the base.
-Hereditary nephropathy
at the stage of remission. The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXVIII/5-after a kidney transplant. To 28 days to 28 days
The possibility of an extension. To 36 months post-transplant.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXVIII/6-functional disorders of urination to 28 days to 28 days
(even without the inflammatory causes)
in cases, if there is no possibility of extension. Within 12 months from the beginning of the base.
ongoing outpatient care
effective. The possibility of an extension.
-Children having reached the age of 9
the age of the
the existing regime and
medical measures.
------------------------------------------------------------------------------------------------------------------------------------
XXIX MENTAL DISORDERS
------------------------------------------------------------------------------------------------------------------------------------
XXIX/1-Psychosis in remission. To 28 days to 28 days
In direct follow-up to hospitalization within 24 months from the start of the base.
in inpatient psychiatric ward
or when continuous outpatient care the possibility of extension.
as an alternative to the subsequent bed
psychiatric care after every exacerbation.
The possibility of an extension.
------------------------------------------------------------------------------------------------------------------------------------
XXIX/2-neurotic disorders and another to 28 days to 28 days
nepsychotické disorders.
In direct follow-up to hospitalization within 24 months from the start of the base.
in inpatient psychiatric ward
or when continuous outpatient care the possibility of extension.
as an alternative to the subsequent bed
psychiatric care after every exacerbation.
The possibility of an extension.
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XXX SKIN DISEASES
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XXX/1-Psoriasis vulgaris-chronic for 28 days to 28 days
and recurrent forms.
The possibility of an extension. When the activity of the disease process.
The possibility of an extension.
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XXX/2-chronic and relapsing to 28 days to 28 days
including atopic eczema.
The possibility of an extension. When the activity of the disease process.
-Chronic prurigo.
The possibility of an extension.
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XXX/3-Indurativní and konglobující to 28 days to 28 days
forms of acne.
The possibility of an extension. When the activity of the disease process.
The possibility of an extension.
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XXX/4-Scleroderma. To 28 days to 28 days
The possibility of an extension.
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XXX/5-Ichthyosis. To 28 days to 28 days
The possibility of an extension. The possibility of an extension.
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XXX/6-chronic dermatoses. To 28 days to 28 days
The possibility of an extension. When the activity of the disease process.
The possibility of an extension.
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XXX/7-States after burns and to 28 days to 28 days
After reconstructive surgery
where there is shrinkage of scar tissue. The possibility of an extension. To 36 months after the burn or
The possibility of an extension.
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XXXI GYNECOLOGICAL DISEASES
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XXXI/1-Recurrent inflammatory to 28 days to 28 days
diseases of the external and internal
of the genitals. The possibility of an extension. In the 36 months since the beginning of the base.
-A post-inflammatory change in a small saucepan.
The possibility of an extension.
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XXXI/2-primary and secondary: to 28 days to 28 days
amenorrhea,
oligomenorrhea and dysmenorrhea, the possibility of extension. In the 36 months since the beginning of the base.
If there is no out-patient care
effective. The possibility of an extension.
-Menstrual Irregularities
cycle when a contraindication
hormonal treatment.
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XXXI/3 States with postoperative to 28 days to 28 days
complications after operations
(within 3 months after the operation): the possibility of an extension. Within 12 months from the beginning of the base.
-in a small saucepan.
-after other abdominal operations, the possibility of extension.
with the relationship to the landscape of the small pelvis.
-After appendectomii.
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XXXI/4-hormonal dysfunction after 28 days to 28 days
their pharmacological
ovarian cancer protection when the possibility of an extension. Within 12 months from the beginning of the base.
treatment for genital and
extragenitální tumour extension.
the disease.
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Selected provisions of the novel
Article II of Act No. 458/2000 Coll.
Transitional provision
Point values and the amount of the reimbursement paid by health care, including the regulatory
the restrictions provided for under the existing legislation, shall apply to the
1. half of the year 2001; If there is no after entry into force of this Act, to the agreement
price according to § 17 para. 5 of Act No. 48/1997 Coll., on public
health insurance and amending and supplementing certain related
laws, as amended by this Act, shall remain in force the prices fixed
for the 1. half of 2001.
Article II of Act No. 176/2002 Sb.
Transitional provision
Request insurance payers about immunity, increases to the premiums
or finance charge, filed an arbitration authority before the entry into force of this
law and arbitration authority pending the entry into force of this Act
the undecided are assessed under this Act.
Article. VII of Act No. 422/2003 Coll.
Transitional provision
For the self-employed person does not consider the person exercising the
the activities of the agent on the basis of mandate contracts concluded under the business
code, if this contract has been concluded before 1 January 2002. January 2004.
Article. XIII of law No. 359/2004 Sb.
TRANSITIONAL PROVISION
1. The provisions concerning the incompatibility of the function of the members of the European Parliament
According to § 53 para. 2 (a). (c)), and (d)) of Act No. 62/2003 Coll., on elections to the
The European Parliament and amending certain acts, will for the first time
members of the European Parliament elected in the first elections to the European
Parliament in 2004.
2. The provisions of sections of the second to eleventh will for the first time on the MEP
The European Parliament elected in the first elections to the European
Parliament in 2004.
Article. VIII of Act No. 435/2004 Coll.
In the list of medicinal products, and foods for special medical purposes
under § 15 para. 5 the first sentence Act No. 48/1997 Coll., on public
health insurance and amending and supplementing certain related
laws, as amended by article. VII, point 1 to this Act, the date of application
the effectiveness of this law written to medicines and food for
Special medical purposes contained to this day in the General
health insurance companies in the Czech Republic. List of medicinal products and
foods for special medical purposes under the first sentence, the Ministry of
Health shall publish the effective date of this Act on its
page on the Internet.
Article II of Act No. 123/2005 Sb.
Transitional provision
Application for inclusion in the list of medicinal products and food for special
medical purposes covered by health insurance, filed to the Ministry of
health services before the date of entry into force of this Act and the Ministry of
health to the entry into force of this Act are undecided
be assessed under this Act.
Article. LXV Act No. 261/2007 Coll.
Transitional provisions
1. the maximum prices established according to current price regulations for
medicines and foods for special medical purposes, that the
the basis of the price regulation issued under this Act shall be subject to the prices
the regulation of the maximum price is valid until the date on which the decision
The Institute on the fixing of maximum prices under this Act. Maximum price
provided for under the previous price laws for medicinal products and
foods for special medical purposes, on the basis of the price
the regulation issued under this Act are not subject to price regulation
the maximum price is valid until the issue of price regulation pursuant to this
the law.
2. the marketing authorisation holder, the manufacturer or importer of a medicinal product, or
foods for special medical purposes shall be obliged to submit an application for
determination of the maximum prices within 90 days of the effective date of this Act,
If the medicines and foods for special medical purposes, by
price regulation issued under this Act shall be subject to the regulation of
the maximum price and the maximum price has not been determined in accordance with the existing
price laws. Remuneration provided for this product or
food for special medical purposes shall cease on the day following the expiry of the 90
days of the effective date of this Act, if not filed within this time limit
the request for the fixing of the maximum price and the amount and conditions of payment.
3. the amount and conditions for reimbursement of medicines and foods for special
the medical purposes set out before the date of entry into force of this Act
According to the existing legislation, the effective date of this Act,
consider the amount and conditions for reimbursement under this Act until the application
the decision of the Institute on the determination of the amount and conditions of payment.
4. the procedure for the fixing of maximum prices for the executor on the date of a final
the effectiveness of this law shall be completed in accordance with existing regulations.
5. the Institute to 180 days from the entry into force of this Act shall initiate the procedure for the
reduction of the maximum prices on medicines and foods for special
medical purposes 31. December 2007 exceeded the limits referred
in § 39a para. 2.
Article. XXII of the Act No. 362/2009 Sb.
Transitional provisions
1. the basic payment reference group established under section 39 c of paragraph 1. 7
Act No. 48/1997 Coll., in the version in force from the date of entry into force of this
the law, to perform the first revision is considered the basic remuneration of the medicinal
medicine or food for special medical purposes, as provided for in
the last administrative action concerning the determination or changing the amount and conditions of payment
before the date of entry into force of this Act, in principle, any
therapeutically interchangeable water a medicinal product or a foodstuff for
Special medical purposes and has not been determined if the basic remuneration, shall be deemed to
for the basic remuneration remuneration determined in accordance with the previous legal
regulations. The basic remuneration under the first sentence in the first
revision, but not longer than for a period of 365 days from the date of entry into force of
This law, reduced by 7%.
2. On the date of entry into force of this Act shall set out the maximum prices and
the amount of the payment of all medicines and foods for special medical
the purpose of reducing the transposition of the first revision of their payments, but not longer than
for a period of 365 days from the date of entry into force of this law, by 7%. It
does not apply to the reimbursement of medicines and foods for special medical
the purpose of which has been established and the terms of payment under section 39b to 39 h
This law or for which a change was made to the above terms and conditions of payment
pursuant to section 39i of paragraph 1. 2 or § 39 l of Act No. 48/1997 Coll., as amended effective
before the date of entry into force of this Act. The request for an increase in the maximum
prices may be made in the period referred to in the first sentence.
3. On the date of entry into force of this Act shall be reported by the highest price
medicines and foods for special medical purposes covered by
public health insurance, which are not subject to price regulation price
the manufacturer, reduce to the implementation of the first revision of their payments, but not longer
than for a period of 365 days from the date of entry into force of this law, by 7%,
where holders of registration with authorised medicinal products and
domestic producers or importers of unregistered medicinal products or
foods for special medical purposes, these medicinal products or
foods for special medical purposes during this period, the placing on the market
not more than these reduced prices.
4. On the date of entry into force of this Act, the State Institute for the control of
medicinal products shall be published by the prices and level of remuneration adjusted in accordance with points 2 and 3 in the list of
medicines and foods for special medical purposes covered by the
health insurance.
5. In exceptional cases, the marketing authorisation holder
medicinal product may apply for exemption from the reduction of the prices referred to in point 2 or
3. the application must contain sufficient justification and in the proceedings on the application for
an exception to the price reduction of the State Institute for drug control procedure referred to in
the provisions of Act No. 48/1997 Coll., in the version in force from the date of acquisition
the effectiveness of this law, governing the fixing of maximum prices
that an exception granted only if the price of the medicinal product decreased by
section 2 or 3 is the lowest of the prices for such medicinal product detected
in the Member States of the European Union, pursuant to section 39 c of Act No. 48/1997 Coll., on
the version in force from the date of entry into force of this law, medicine
It is necessary to ensure the availability of effective and safe health care
paid for by public health insurance and cannot reasonably be
require that the medicinal product is made available on the Czech market at reduced
the price. Exemptions granted the State Institute for drug control will publish
without delay.
Article. (II) Act No. 298/2011 Sb.
Transitional provisions
1. The legal relations arising from the written agreement contained in
the public interest pursuant to 48/1997 Coll., in the version in force before the date of application
the effectiveness of this law, the health insurance company and holder of the
registration, the manufacturer or importer does not apply to section 39 c of paragraph 1. 2 (a). (c))
Act No. 48/1997 Coll., in the version in force from the date of entry into force of this
the law.
2. the amount of compensation provided for by the decision of the State of the medicinal product
Institute for drug control (hereinafter referred to as "the Institute") in accordance with Act No. 48/1997
Coll., in the version in force from the date of entry into force of this Act,
considers the level of remuneration of the medicinal product as laid down by law No.
48/1997 Coll., in the version in force until the date of entry into force of this Act,
reduced by the maximum amount of trade margins and on the applied tax
the added value. The amount of the basic remuneration reference group established
the Institute's decision pursuant to Act No. 48/1997 Coll., in the version in force from
the effective date of this Act, is deemed to be the amount of the basic remuneration
established by decision of the Institute by Act No. 48/1997 Coll., as amended by
effective from 1 January 2006. January 2008 to the date of entry into force of this Act,
reduced by the maximum amount of trade margins and on the applied tax
the added value. If the basic remuneration established according to the second sentence,
then the Institute lays down the procedure under section 39 c of paragraph 1. 2 to 5 of law No.
48/1997 Coll., in the version in force from the date of entry into force of this Act.
3. the Department within 60 days from the date of entry into force of this Act shall initiate procedures
to reject reimbursement for medicinal products and foods for particular
medical purposes that are written on the basis of Act No. 261/2007 Coll.
stabilization of public budgets, in the list referred to in paragraph 1(b). paragraph 39n 1 of the law
No. 48/1997 Coll., in the version in force until the date of entry into force of this Act,
and are marked with the symbol B, H, K, T, and U, in order to verify the conditions of the
laid down by section 15 para. 6 of Act No. 48/1997 Coll., in the version in force from the date of
entry into force of this Act. If the Department finds that the reasons for maintaining
the remuneration paid to the management stops and shall forthwith initiate the procedure for the change of the amount and
the terms of payment. In the case of refusal of payment remains the maximum price
medicinal product or foods for special medical purposes in
the validity of.
4. the Institute within 60 days from the date of entry into force of this Act shall initiate procedures
to reject reimbursement for medicinal products and foods for particular
medical purposes, incorporating medicinal substances within the scope of
the annex to Decree No 385/2007 Coll., on the establishment of the list of medicinal substances
for additional support or treatment, in the version in force until the date of
entry into force of this Act, for the purpose of verification of the conditions laid down in §
15 paragraph 1. 6 (a). and Act No. 48)/1997 Coll., in the version in force from the date of
entry into force of this Act. If the control has been demonstrated that the
This is not about medicines to support or additional treatment, Institute of
control stops.
5. the proceedings initiated pursuant to Act No. 48/1997 Coll., in the version in force until the date of
entry into force of this Act, the procedure shall be completed according to the existing
legislation; It does not apply to section 39 g of paragraph 1. 3 and 8, section 39 h of paragraph 1. 2 and 3,
§ 39n and 39o Act No. 48/1997 Coll., in the version in force from the date of acquisition
the effectiveness of this Act.
6. the Institute to 120 days from the date of entry into force of this Act, it shall initiate the
the procedure for the reduction of the maximum prices on medicines and food for
Special medical purposes on the date of entry into force of this Act
exceeded the limitations referred to in § 39a para. 2 of Act No. 48/1997 Coll., on
the version in force from the date of entry into force of this Act.
7. the proceedings initiated pursuant to section 39i and 39 l of Act No. 48/1997 Coll., as amended by
effective until the date of entry into force of this law, the Institute by resolution stops,
If
and assumptions are true) to begin the shortened revision under section 39p
Act No. 48/1997 Coll., in the version in force from the date of entry into force of this
of the Act, and
(b)) if within a period of 30 days from the date of entry into force of this Act
a decision in the case. The day following the legal force
the resolution in the first sentence, the Institute will initiate proceedings under § 39p of the law No.
48/1997 Coll., in the version in force from the date of entry into force of this Act.
8. If the proceedings referred to in point 8, stopped, set out above, remittance of medicinal
medicines and foods for special medical purposes shall be construed as
the highest possible remuneration for the final consumer in accordance with section 39 h of paragraph 1. 1
Act No. 48/1997 Coll., in the version in force from the date of entry into force of this
the law.
9. The appeal against the decision in deep or shortened revision,
the decision on the fixing of maximum prices or decisions fixing the amount of
and conditions of remuneration, as well as their modification or cancellation, and against
the decision in the review issued before the date of entry into force of
This Act have suspensory effect. This decision shall be enforceable
According to the existing legislation.
10. the procedure for price competition under section 39e of Act No. 48/1997 Coll., as amended by
effective until the date of entry into force of this Act, the date of acquisition of the executor
the effectiveness of this law, the Institute by order of stops. Liabilities from price
competition completed under section 39e of Act No. 48/1997 Coll., in the version in force in
the effective date of this Act, apply under Act No. 48/1997 Coll.,
in the version in force until the date of entry into force of this Act, if the
based on the result of this price competition set the basic remuneration
reference group.
11. the Institute to 15. January 2012 will launch proceedings on the cancellation of the payment of the medicinal
products and foods for special medical purposes, of which the price for
the final consumer is less than or equal to $ 50.
Article. (II) Act No. 369/2011 Sb.
Transitional provisions
1. Change to the health insurance company to 1. day of the calendar quarter can be
the effective date of this Act, only if, before the
the effective date of this Act, the request for a change
health insurance company to 1. day of the calendar quarter following the
date of submission of the application.
2. When providing health care under § 15 para. 3 of Act No. 48/1997
Coll., which began before the date of entry into force of this Act,
procedure referred to in article 15, paragraph 2. 3 of Act No. 48/1997 Coll., as amended effective
from the date of entry into force of this Act, if the conditions are met in the
It laid down.
3. the date of entry into force of this Act has not yet valid and effective payment of the
those medicinal products that may be issued without a
Regulation shall be abolished. Control to reject the payment to these medicinal products
not, and if it is kept, the effective date of this Act shall be
such proceedings be terminated.
4. the procedure for cancellation of the payment of the medicines and foods for special
medical purposes, of which the price for the final consumer is less than or
equal to 50 CZK, does not, and if it is kept, the effective date of this
the Act such proceedings be terminated.
Article. ARTICLE XXVIII of the Act No. 458/2011 Sb.
Transitional provisions
1. the amount and terms of payment of those medicinal products which can be
to be issued without a prescription, shall expire on 30 April 2005. June 2012 for
those medicinal products, for which the Institute into a 1. June 2012 does not receive
the request from all health insurance companies for reimbursement when you
the provision of outpatient health services in the public interest. The procedure for
determination, alteration, cancellation or refusal of payment of these medicinal
products, does not, and if conducted, on the date of termination of payment of such
proceedings terminated.
2. the procedure for cancellation of the payment of the medicines and foods for special
medical purposes, of which the price for the final consumer is less than or
equal to 50 CZK, does not, and if conducted, on the date of termination of payment of such
proceedings terminated.
Article. VI of Act No. 44/Sb.
Transitional provision
If it was before the date of entry into force of this Act, has embarked on one of the
processes or activities referred to in section 35 of Act No. 48/1997 Coll., as amended by
effective before the date of entry into force of this Act, it shall pay, as well as
all of the other provisions referred to in this activity and how to apply
This started a transplant even if they were initiated or completed
After the effective date of this Act, the health insurance fund referred to in section
35A of the Act No. 48/1997 Coll., in the version in force before the date of entry into force of
of this Act.
Article. (II) Act No. 256/2014 Sb.
Transitional provisions
1. the health insurance fund is required to pay to the insured person during the period prior to the
the effective date of this Act, the amount exceeding the limit for
regulatory fees and charges for prescribed medicines partially paid
medicines and foods for special medical purposes pursuant to section 16b, para.
2 of Act No. 48/1997 Coll., in the version in force before the date of entry into force of
of this Act.
2. the administrative procedure for recovering the amounts under section 16b of the Act No. 48/1997 Coll.,
in the version in force before the date of entry into force of this Act, initiated
the design of the insured person before the date of entry into force of this law shall be completed
According to § 53 para. 1 of Act No. 48/1997 Coll., in the version in force before the date of
entry into force of this Act.
3. in the proceedings for the payment of amounts in excess of the limit for regulatory fees
and supplements for prescribed medicines partially paid or
foods for special medical purposes under section 16b of the Act No. 48/1997
Coll., in the version in force before the date of entry into force of this law, for the
the period before the date of entry into force of this Act brought in disputed
cases on the proposal of the insured person after the date of entry into force of this Act,
proceed according to § 53 para. 1 of Act No. 48/1997 Coll., as amended effective
before the date of entry into force of this Act.
Article. (II) Act No. 1/2015 Sb.
Transitional provisions
1. Spa sanatorium rehabilitation care, in which the provision was
exposed to the proposal before the date of entry into force of this Act, shall be granted
pursuant to Decree No 267/2009 Coll., on the establishment of the indicator list for the
Spa sanatorium rehabilitation care for adults, children and adolescents, as amended by
effective 31 December 1998. December 2014.
2. Therapeutic stay made pursuant to Decree No 267/2012 Coll. as
the base is considered a basic therapeutic stay pursuant to Act No. 48/1997
Coll., in the version in force from the date of entry into force of this Act.
3. Therapeutic stay made pursuant to Decree No 267/2012 Coll. as
recurring is considered to be recurring therapeutic stay under Act No.
48/1997 Coll., in the version in force from the date of entry into force of this Act.
4. If the insured person has carried out the most curative stay in period 1. October
2009 to 30. September 2012, it will be considered a curative stay in basic
curative stay pursuant to Act No. 48/1997 Coll., in the version in force from the date of
entry into force of this Act.
5. The Spa sanatorium rehabilitation care, in which the provision was
exposed to the draft in the period from 1. January 2015 until the date of entry into force of this
the law, and that has been provided to the insured person for the first time, the indication
considered the basic therapeutic stay pursuant to Act No. 48/1997 Coll., on
the version in force from the date of entry into force of this Act.
6. Spa sanatorium rehabilitation care, in which the provision was
exposed to the draft in the period from 1. January 2015 until the date of entry into force of this
law and which corresponds to the indication on the basis of previously
curative stay took place, the insured person shall be deemed a recurring therapeutic
stay under Act No. 48/1997 Coll., in the version in force from the date of acquisition
the effectiveness of this Act.
Article. (II) Act No. 200/2015 Sb.
Transitional provisions
1. The contract pursuant to § 17 para. 1 and § 17 para. 7 (b). d) of Act No. 48/1997
Coll., in the version in force from the date of entry into force of this Act, including the
changes and additions, which shows the amount of the payment of health insurance companies
the providers of health services under the health services paid
public health insurance or the scope of these services, which are
effective on the date of entry into force of this law, shall be published by the health
the insurance company no later than 6 months from the date of entry into force of this
the law.
2. the contract referred to in § 17 paragraph 2. 1 and § 17 para. 7 (b). d) of Act No. 48/1997
Coll., in the version in force from the date of entry into force of this Act, including the
changes and additions, which shows the amount of the payment of health insurance companies
the providers of health services under the health services paid
public health insurance or the scope of these services, which have been
concluded before the date of entry into force of this Act and to
effective after the date of entry into force of this law, shall be published by the health
the insurance company no later than 6 months from the date of entry into force of this
the law; This agreement shall become effective on the date specified in them.
3. Health insurance companies are required to disclose whether or not the contract pursuant to § 17
paragraph. 1 and § 17 para. 7 (b). d) of Act No. 48/1997 Coll., as amended effective
from the date of entry into force of this Act, including any amendments and additions, from the
showing the amount of payment of health insurance providers
health services for the health care services covered by the public
health insurance or the scope of these services, which have been concluded in
2014 and 2015 and expired before the date of entry into force of this
of the Act, no later than 12 months from the date of entry into force of this Act.
4. the Institute of health information and statistics of the United Kingdom passes the
The Ministry of health for the first time, current data and methodologies in accordance with section 41a
paragraph. 1 of Act No. 48/1997 Coll., as amended by this Act, for the calendar
the year following the year in which this law came into effect.
5. Until such time as the Ministry of health for the first time will receive current information
and methodology pursuant to § 41 para. 1 of Act No. 48/1997 Coll., as amended by this
the law, the Ministry of Health publishes a list of groups
in acute care hospitalizations related to diagnosis, their
the relative cost, marshaling rules of admissions to these
groups and methodologies for reporting provided covered services in acute
inpatient care, which is available on its Web site.
6. the general health insurance company in the Czech Republic and departmental, sectoral,
corporate and other health insurance companies follow the section 41a of paragraph 1. 3
Act No. 48/1997 Coll., as amended by this Act, from the date of establishment of the
The national registry of covered services.
7. Contract and payment of covered services, including their changes
and additions concerning the extent of covered services, concluded prior to
the effective date of this Act, not later than 5 years from the date of
entry into force of this law shall be in accordance with section 17 para. 1 of the law
No. 48/1997 Coll., in the version in force from the date of entry into force of this
the law.
1) Council Directive 89/105/EEC of 21 December 1988 December 1988 relating to the transparency
the measures regulating the pricing of medicinal products and
their inclusion in the scope of national systems
health insurance.
Directive of the European Parliament and of the Council of 2011/24/EU of 9 June. March 2011
on the application of patients ' rights in cross-border healthcare.
The implementing Commission directive 2012/52/EU of 20. December 2012
down measures to facilitate the recognition of prescriptions
issued in another Member State.
1A) of section 6 of Act No. 586/1992 Coll., on income taxes, as amended
regulations.
1B) Directive No. 89/105/EEC relating to the transparency of measures regulating the formation of
prices for medicines for human use and their inclusion in the area
the scope of national health insurance systems.
1 c) section 3 of the Act No. 219/2000 Coll., on the Czech Republic and its assets
in legal relations.
1 d) Law No 249/1997 Coll., on agriculture, as amended.
2) Act No 455/1991 Coll., on trades (trade licensing
Act), as amended.
3) Eg. Act No. 85/1996 Coll., on the legal profession, law No. 359/1992
Coll., on notaries and their activities (notarial regulations), law No. 524/1992
Coll. on Auditors and Chamber of Auditors of the Czech Republic, Act No.
523/1992 Coll., on income tax advice and the Chamber of tax advisors of the Czech
Republic Act No. 36/1967 Coll. on experts and interpreters, law No.
237/1991 Coll., on patent agents, law No. 360/1992 Coll., on the
the profession of authorised architects and on the exercise of the profession of
Chartered Engineers and technicians active in construction, as amended by
amended.
4) Eg. Act No. 35/1965 Coll., on literary, scientific and
works (the Copyright Act), as amended.
4A) § 7 para. 8 and § 36 odst. 2 (a). e) of Act No. 586/1992 Coll., on
as amended.
5) section 76 et seq.. and § 93 et seq.. Act No. 513/1991 Coll., the commercial
code.
6) § 7 para. 2 (a). (b)) of Act No. 586/1992 Coll., on income taxes.
§ 6a) 566-575 of the commercial code.
7) Act No. 117/1995 Coll., on State social assistance, as amended by Act No.
137/1996 Coll.
8) § 32 and subs. Act No. 187/2006 Coll., on sickness insurance.
9) § 7 para. 1 and § 17 para. 7 of Act No. 1/1991 Coll., on employment, in the
as amended.
10) Law No 111/2006 Coll. on assistance in material need.
11) section 8 of Act No. 108/2006 Coll., on social services.
12 section 1 of the Decree of the Ministry) labour and Social Affairs No. 283/1995 Coll.
12A) § 80 (b). (b)), and (c)) Act No. 100/1988 Coll., on social
security, as amended by Act No. 133/1997.
14) § 4 of law No. 187/2006 Sb.
15) § 2 (2). 1 (b). (b)) Government Regulation No. 303/1995 Coll., on minimum
rates of pay.
16) § 31 para. 1 of law No 117/1995 Sb.
16A) Act No. 222/2003 Coll., on temporary protection of foreigners.
16B) Act No. 325/1999 Coll., on asylum and on the amendment of Act No. 283/1991 Coll., on the
Police of the Czech Republic, as amended, (asylum Act),
in the wording of later regulations.
16 c) § 47i Act No. 359/1999 Coll. on social and legal protection of children, in
as amended.
16 d) § 40a of the Act No. 117/1995.
17) Act No. 586/1992 Coll., on premiums for general health
insurance, as amended.
17B) § 2 (2). 1 (b). d) of Act No. 570/1991 Coll., of the commercial
offices, as amended by Act No 215/2006 Sb.
18) section 27 of Act No. 586/1992 Coll., as amended by Act No. 15/1993.
18A) § 45a para. 6 of Act No. 455/1991 Coll., on trades
(Trade Act), as amended by Act No 215/2006 Sb.
19) § 7 para. 1 of the law No. 280/1992 Coll., on departmental, disciplinary,
corporate and other health insurance companies, as amended by Act No.
149/1996 Coll.
19a) article 3 of the European Parliament and Council Regulation (EC) No 141/2000 of the
16 December 2002. December 1999 on orphan medicinal products.
20) Decree of the Minister of Foreign Affairs No. 143/1988 Coll., on the Convention on
Racing health services (No. 161).
Act No. 20/1966 Coll., on the health care of the people, as amended
regulations.
21) § 39 para. 2 of Act No. 20/1966 Coll., as amended by Act No. 548/1991
SB.
22A) § 16 para. 2 and 3 of Act No. 222/1999 Coll., on the scope of military
obligations and on military administrative offices (military law).
22B) section 166 of the Act No. 221/1999 Coll., on the soldiers of the occupation.
22 c) § 21 para. 2 of the Act No. 435/2004 Coll.
23A) Law No 289/2002 Coll., on donation and transplantation subscriptions
tissues and organs and on amendments to certain acts (the transplant law).
23B) Decree No. 23/2001 Coll., laying down the types of foods intended
for particular nutritional uses and how to use them.
23B) thatweshouldalsomentionatleastbriefly. 20 Act No. 20/1966 Coll., as amended by Act No. 422/2004
SB.
23 c) of section 10 of Act No. 526/1990 Coll., on prices, as amended by the Act No. 261/2007
SB.
24) Act No. 526/1990 Coll., on prices, as amended by Act No. 135/1994 Coll.
25) CZECH REPUBLIC Ministry of health Decree No. 256/1992 Coll., which
the list of medical procedures with point values, as
amended.
27) CZECH REPUBLIC Ministry of health Decree No. 434/1992 Coll., on the
emergency medical service, as amended.
27A) Decree No. 134/1998 Coll. issuing the list of health
performances with spot values, as amended.
27 c) § 1 and 2 of Act No. 245/2000 Coll., on public holidays, on the other
holidays, on significant days and days of rest, as amended by
amended.
27 d) in section 38 of Act No. 20/1966 Coll., on the health care of the people, as amended by
amended.
27 e) Act No. 109/2002 Coll. on the execution of institutional care or protective
education in school facilities and on preventive educational care in
school facilities and amending other laws, as amended
regulations.
27F) Act No. 258/2000 Coll., on the protection of public health and amending
some related laws, as amended.
27 g) Law No 111/2006 Coll. on assistance in material need, as amended by
amended.
27 h) of section 48 of Act No. 108/2006 Sb.
27i) section 42 of Act No. 359/1999 Coll. on social and legal protection of children, in
as amended.
27J) section 24 of Act No. 20/1966 Coll., as amended.
27 k) section 191a to 191g of the Act No. 99/1963 Coll., the code of civil procedure, in
as amended.
27l) Law No 289/2002 Coll., on donation and transplantation subscriptions
tissues and organs and on amendments to certain acts (the transplant)
as amended.
27 m) section 48 to 50 and 52 of Act No. 108/2006 Sb.
27n) § 71 para. 4 and § 73 para. 3 of Act No. 108/2006 Coll., as amended by
Act No. 261/2007 Coll.
28) Law No. 280/1992 Coll., as amended.
28A) Law No 96/2004 Coll., on conditions for the acquisition and recognition
competence for the exercise of paramedical professions and to the exercise
activities related to the provision of health care and amending
certain related laws (the law on the paramedical
occupations), as amended by Act No. 127/2005 Coll.
29) section 53 of Act No. 20/1966 Coll., as amended by Act No. 548/1991.
Decree of the Ministry of health no. 77/1981 Coll. on
health care workers and other professional workers in
the health sector.
30) section 73b of Act No. 100/1988 Coll. on social security, as amended by
Act No. 308/1993 Coll.
31) for example. Decree of the Ministry of health no. 91/1984 Coll., on
measures against communicable diseases, as amended by Decree No 204/1988 Coll.
32) § 23 para. 3 and 4 of Act No. 20/1966 Coll., as amended by Act No.
548/1991.
33) section 73b and 93a of the Act No. 100/1988 Coll. as amended by Act No. 308/1993 Coll.
Decree of the Ministry of labour and Social Affairs No. 310/1993 Coll. on the payment order
for the provision of social care in health facilities.
34) title III, part 1, Act No. 258/2000 Coll., on the protection of public health
and amending certain related laws.
36) Act No. 20/1966 Coll., as amended. Decree
The Ministry of health of the CZECH REPUBLIC No. 61/1990 Coll. on the management of medicines and
healthcare needs, as amended by Decree No 427/1992 Sb.
§ 8 paragraph 37). 7 of the Decree of the Ministry of health of the CZECH REPUBLIC No. 61/1990 Coll.
as amended by Decree No 427/1992 Sb.
38) § 12, 13 and 14 of the directives of the Ministry of health no. 49/1967, P. 1.
MZ on the assessment of medical fitness to work, as amended by directives no.
17/1970 p. MZ CZECHOSLOVAKIA, Reg. 2/1968 Coll. and the amount 20/1970 Sb.
39) section 11, 12, 13 and 14 of the directives of the Ministry of health no. 49/1967
MZ., as amended by directives No 17/1970 p. MZ CZECHOSLOVAKIA, Reg. 2/1968
Coll. and the amount 20/1970 Sb.
40) § 12 para. 8 directives of Ministry of health No 49/1967, P. 1.
MZ, as amended by directives No 17/1970 p. MZ CZECHOSLOVAKIA, Reg. 2/1968 Coll. and
the amount of the Sb 20/1970.
42A) Decree No. 288/2004 Coll., laying down the details of the
authorisation of medicinal products, changes, renewals, classification
medicinal products for the issue, transfer, registration, issuing permits for
parallel imports, presenting and designing specific treatment
programs with the use of unregistered medicinal products for
How to report and evaluate the adverse effects of the
of the product, including the requirements of the psur
security, and the type and scope of the notice of the use of an unauthorised
of the medicinal product (Registration Ordinance on medicinal products).
42B) Act No. 79/1997 Coll., as amended.
42 c) Act No. 137/2006 Coll., on public procurement, as amended
regulations.
42D) § 17 of the Act No. 513/1991 Coll., the commercial code, as amended
regulations.
42E) Act No. 500/2004 Coll., the administrative code, as amended by law no 413/2005
SB.
42f), for example, section 8 of Act No. 553/1991 Coll. on general health
the insurance company of the Czech Republic, as amended.
43) Act No. 553/1991 Coll., on the Czech General health insurance company
Republic, as amended.
44) Law No. 280/1992 Coll., as amended.
44a) Law No 378/2007 Coll., on pharmaceuticals and on changes of some
related laws (law on medicinal products), as amended.
45) Appendix III (1). 3 Decree of the Czech Office of work safety and
The Czech Mining Authority no 110/1975 Coll., on registration and registration
work-related accidents and reports of traffic accidents (accidents) and disorders
technical equipment, as amended by Decree No. 274/1990 Coll.
46) Appendix. (I) Decree of the Czech Office of work safety and the Czech
Mining Authority no 110/1975 Coll., as amended by Decree No. 274/1990 Coll.
46A) Law No 245/2006 Coll., on public nonprofit constitutional
medical devices and amending certain laws.
46A) Act No. 169/1999 Coll., on the imprisonment and amending
some related laws, as amended.
47) Act No. 71/1967 Coll., on administrative proceedings (administrative code).
47) Act No. 500/2004 Coll., the administrative code, as amended.
47A) Act No. 99/1963 Coll., the civil procedure code, as amended
regulations.
47B) Act No. 182/2006 Coll., on bankruptcy and the ways of its solution
(insolvency law), as amended.
49) § 2a para. 1 of law No 266/1991 Coll., on the scope of the authorities of the United
States in the field of prices, as amended.
for example, 49) European Parliament and Council Regulation (EC) No 883/2004 on the
coordination of social security systems, as amended by regulation of the European
Parliament and of the Council (EC) no 988/2009 and Commission Regulation (EU) No 1244/2010,
European Parliament and Council Regulation (EC) no 987/2009
down detailed rules for the application of Regulation (EC) No 883/2004 on the coordination
of social security systems, as amended by Commission Regulation (EU) No.
1244/2010, the European Parliament and of the Council Regulation (EU) no 1231/2010,
extending the provisions of Regulation (EC) No 883/2004 and Regulation (EC)
No 987/2009 to nationals of third countries, to which this
not already covered by regulation only because of their nationality and
European Parliament and Council Regulation (EU) No 492/2007 of 5 June. April
2011 on free movement of workers within the Union.
51) European Parliament and Council Regulation (EC) No 883/2004 of 29 April 2004.
April 2004 on the coordination of social security systems, as
the text of the.
European Parliament and Council Regulation (EC) no 987/2009 of 16 January 1996. September
2009 laying down detailed rules for the application of Regulation (EC) No 883/2004
on the coordination of social security systems, as amended.
The European Parliament and of the Council Regulation (EU) no 1231/2010 of 24.
November 2010, extending the provisions of Regulation (EC) No 883/2004
and Regulation (EC) no 987/2009 to nationals of third countries on the
which are not already covered by this regulation only by reason of their State
jurisdiction.
52) article 20 of the European Parliament and Council Regulation (EC) No 883/2004 of the
29 April 2004. April 2004 on the coordination of social security systems, in
as amended.
53) Law No. 372/2007 Coll., on health services and conditions of their
provision (law on health services), as amended
regulations.
54) Act No. 109/2002 Coll. on the execution of institutional care or protective
education in school facilities and on preventive educational care in
school facilities and amending other laws, as amended
regulations.
55) section 48 of Act No. 108/2006 Sb.
56) section 42 of Act No. 359/1999 Coll. on social and legal protection of children, in
as amended.
57) Law No 513/91 Coll., the civil code.
58) section 48 to 50 and § 52 of Act No. 108/2006 Sb.
59) § 71 para. 4 and § 73 para. 3 of Act No. 108/2006 Sb.
60) § 23 para. 3 of the law on health services.
61) section 27 of the Act on health services.