618/2006 Sb.



The DECREE



of 20 December. in December 2006,



the issue of the framework contract



The Ministry of health shall determine in accordance with section 17 paragraph. 3 of Act No. 48/1997

Coll., on public health insurance and amending and supplementing certain

related laws, as amended by Act No. 2/1998 Coll., Act No. 117/2006

Coll. and Act No. 245/2006 Coll. (hereinafter the "Act"):



§ 1



Framework contract for health insurance "^ 1") (hereinafter referred to as "insurance") and

medical equipment ^ 2) providing



1. health care practitioners and general practitioners for children and

adolescents,



2. outpatient specialist care, with the exception of medical devices

providing physiotherapy (expertise and 918 902 ^ 3)), and occupational therapy, and

for health care facilities providing care for female doctors (expertise

603 and 604 ^ 3)) and clinical logopedii,



3. outpatient care, dental practitioners,



4. health care in hospitals, specialised therapeutic institutes,

specialized children's hospitals and ozdravovnách and long term hospitals

of the sick,



5. out-patient diagnostic care expertise, 801 (222, 802, 804, 805,

807, 809, 812 to 819, 822 and 823 ^ 3)),



6. home health care, physiotherapy (expertise and 918 902 ^ 3)),

occupational therapy, midwifery, ortoptikou and pleoptickou care,



7. medical emergency service and transport,



8. pharmacy care,



9. Spa care



are listed in the annexes 1 to 9 of this Ordinance.



§ 2



Decree No. 290/2006 Coll., issuing the decision of the Ministry of

health care on the framework contracts referred to in § 17 paragraph. 3 of Act No.

48/1997 Coll., on public health insurance and amending and supplementing

some of the related laws, is hereby repealed.



§ 3



Contracts concluded in accordance with the existing legislation shall be to

accordance with the provisions of this Decree to the 31. December 2007.



§ 4



This Decree shall take effect on 1 January 2005. January 1, 2007.



Minister:



Mudr. Julínek in r.



Annex 1



Framework contract for health care facilities providing health care

General practitioners and general practitioners for children and adolescents and health

the insurance company



THE FIRST PART OF THE ANNEX



General provisions



Article 1



Contractual relations



(1) a framework agreement lays down the conditions under which the contract is concluded

between the health establishments providing health care practical

doctors and general practitioners for children and adolescents, and insurance companies, and under the

order to ensure the contribution in the provision of health care and reimbursement

paid from public health insurance (hereinafter referred to as "paid by the health

care ") ^ 1).



(2) the legal relationships in the Treaty on the provision and payment of paid

health care (hereinafter referred to as "the agreement"), concluded between the

insurance ^ 2), and medical devices shall not deviate from the

the provisions of the framework contract in accordance with this Ordinance, with the exception of those

provisions, for which such a possibility this framework contract expressly

lists.



PART TWO OF THE ANNEX TO



Of the Treaty



Article 2



Conclusion of contracts



(1) the legal relationship between the insurance company and medical facilities is governed by the

a written contract concluded under this framework contract, legal

the rules governing the public health insurance and the provision of

health care, and even in the case where the undertaking fulfils the role of a temporary

institutions in the implementation of the rights of the European Union ^ 3) or on the basis of the

international agreements on social security concluded by the Czech

Republic ^ 4). In matters not regulated by these laws and regulations and

the contract shall be governed by the commercial code.



(2) the basic condition for the conclusion of a contract is the permission of the medical

the equipment for the provision of health care in the field.



(3) the contract includes:



and) the rights and obligations of the parties



(b) the quality and effectiveness of the) conditions of the provision of health care, in particular

the kind, scope, and extent of health care provided by the specified list of

performance with point values according to the types of care, which is a medical

the device shall be entitled to provide, including substantive and technical equipment and

staffing,



(c) point values) ^ 5), the amount of the reimbursement paid by health care and regulatory

limitation of the volume of paid health care provided in accordance with the Decree

issued under section 17, paragraph. 6 of the Act,



(d) the implementation of the remuneration provided by) the way of health care,



(e)) the conditions required to check the performance of the contract, including the accuracy and

the legitimacy of the posted amounts



f) range and method of mutual communication of the information necessary to check the

performance of the contract,



(g)) the provisions on the resolution of conflicts in the course of the negotiations, where appropriate, the provisions of

about the use of arbitration,



(h) the period of application of the Treaty), the way and the reasons for her termination,



I) provisions on the acceptance of and compliance with the agreed procedure for

acquisition, transmission and evaluation of documents in accordance with the methodology for the

acquisition and transmission of documents (hereinafter referred to as the "methodology"), the rules for

the evaluation documents (hereinafter referred to as "the rules") and the single data

the interface generated by the general health insurance company in the Czech Republic

in cooperation with the representatives of insurance companies and representatives of professional associations

health care providers and issued general health

the insurance company of the Czech Republic, in force at the time of conclusion of the contract,



j) provisions on how to get started with any medical facility

changes to the methodology and rules, including the method of transmission of these changes.



(4) the contract may also contain other arrangements necessary for the implementation and

check if they are in accordance with this agreement and the legal framework

provisions.



Article 3 of the



The rights and obligations of the parties



1) the Contracting Parties:



and when reporting and shall comply with), payment of paid health care agreed

the methodology, rules and data interface; the contract shall specify the version number

at the time of conclusion of the contract,



(b) undertake their employees) with regard to the protection of the rights of insured persons, to the

maintaining the confidentiality of the personal data required ^ 6) and facts

which to learn in the performance of their duties or employment or in

processing of data from the information system on the basis of the Treaty, or of the

connection with a ^ 2).



2) medical device:



and provides paid health care) in accordance with the legislation in

proficiency and the extent of the agreed and defined in the Treaty, for which the

It is factually and technically equipped and staffed to ensure, and that its

operator – a natural person or an employee,



(b)) provides health care paid for by the insured from the EU Member States,

The EEA and Switzerland, according to the relevant regulations of the European Union ^ 3) and

the insured of other States with which the Czech Republic has closed

Social Security Treaty ě4 (hereinafter referred to as the insured from the EU),

the same conditions as the insured the insurance company, in the range from them

the documents submitted so as to avoid discrimination or

preference, and even in the event that the beneficiary from the EU pay the

health care in cash,



(c)) is responsible for the fact that his staff ^ 7), who will be insured

provide in the contract negotiated paid health care, meet the

the requirements laid down by law for the performance of this activity ^ 8),



(d)) is responsible for the implementation of the substantive and technical conditions laid down for the

It provided health care under a special legal regulation, ^ 9),



e) provides health care paid for by the "lege artis" without excess

the cost, however, with a view to making the necessary diagnostic

or therapeutic effect was achieved with regard to individual health

the status of the insured person,



(f)) is responsible for the effectiveness of the indication when sending the insured person to

complementary and konziliárním examination and, on the basis of their results

modifies the diagnosis or therapeutic procedure,



(g)) will lead to eligibility made health care in

conclusive form of health documentation on the treatment of policyholders, in which

the performances will be recorded made health, requested medical

care, prescription medicines and medical devices and

kept in the Inbox the results requested and carried out examination and

treatment, in accordance with a special law ^ 10),



(h)) to ensure, in the case where it is not present, the performance of the authorized holder

provide health care according to the Treaty and complying with the conditions for the exercise of

This activity (operator – a natural person or an employee of

medical device), a crowd of other qualified holder of power

and in the cases agreed in the contract shall notify the insured and

the insurance undertaking,



I) to provide, in accordance with the legislation of the medical establishment,

which the insured person passes into the care or that the beneficiary's choice

the information needed to ensure continuity of health care and to avoid

duplicate the implementation of diagnostic and treatment procedures and acceptance

insured persons in the care of such information from the relevant device

require,



(j) adoption of the insured person to refuse) your care except for the reasons set out

in section 11, paragraph 1 (b)) of the Act,



to the right of the insured person making the) freedom of choice of doctor, medical

equipment or the provision of health care paid for by any of the

registration fees or with various donations and granted
health care paid for by the insurance company will not be from the insured person, if it

did not result from legislation, to collect any financial remuneration,



(l) the right of the policyholder to making) the granting of paid health care

changing the insurance undertaking or in any other way,



It will not discriminate between insured m) of one or more insurance undertakings in

detriment of policyholders of insurance companies and worsen the availability

health care paid for by the insurance company a priority the provision of care

paid for by other means,



n) shall notify the insurance undertaking in accordance with section 55 of the Act injuries or other damage

the health of the persons who provided paid health care, if you have reason to

suspecting that they were caused by acts legal or natural person,



about) by the special legal regulation ^ 11) for the correct and complete

fill in the form of a recipe; also responsible for the correct and complete filling

voucher for medical devices or voucher to the examination/treatment

or to the medical transport. When prescribing was not

respected prescribing restrictions arising from legislation and the

undertaking this medicinal product equipment pharmaceutical treatments, has

the insurance company the right to demand remuneration paid by medical device

of the amount,



p) showing when concluding a contract with an insurance company proof of insurance

liability for damage caused to citizens in connection with the provision

health care and will be insured for the entire duration of the contractual relationship with the

the insurance company.



3) Insurance:



and will pay the medical facility) made paid health care,

clearly documented and reasonably provided to the insured and the

insurance policy holders in the EU, who have the insurance company selected as the institution of manner

in the implementation of the rights of the European Union ^ 3) in accordance with the law and

the Treaty,



(b)), on request, sees therapeutic equipment without undue delay

the jurisdiction of the insured person to the insurance undertaking in cases where it is not available

insurance card and his personal data are available,



(c)) will not require preferential treatment of their policyholders at the expense of policyholders

other insurance companies,



(d)) is authorised to control compliance with the contractually agreed payment in kind and

technical conditions and staffing financed by health care

provided by the medical establishment, under the Treaty,



e) provides medical equipment to ensure uniform conditions

the agreed methodology, rules, data interface and the appropriate dials

issued by the general health insurance company for reporting and calculation of the remuneration

paid for by the health care



(f) medical device with familiar) the agreed changes to the methodology,

rules and with the changes at least one month and the dials with the change

the data interface at least two months before the date of their

the validity of. In the case of changes to the legislation, which does not allow this period

keep, can be referred to commensurately reduced.



Article 4 of the



Remuneration provided paid health care



(1) the value of the point ^ 5) for health care paid for by the performance,

the amount of the reimbursement paid by health care and regulatory restrictions on the volume of provided

paid health care under section 17, paragraph. 6 of the Act is given in the appendix to the

the Treaty.



(2) methods of payment shall be considered as:



and health) payment for performances by the health interventions with

point values



(b)) combined payment for insured and registered for health performance

According to the list of medical procedures with point values (the combined

kapitačně performance payment), or



(c) any other agreed method of payment).



(3) Between the parties must always be agreed the change

the structure, scope and volume of provided paid health care, in particular

due to the capacity changes, the structure of the medical device amendments, or

recovery of instrumentation as specified in the contract.



(4) medical equipment for the filing of claims for reimbursement provided

paid for by the health care bill passes the insurance company once a month

care provided an invoice with attachments, if the Contracting Parties

agree on passing the Bill over a longer period. The invoice contains

Essentials of accounting document ^ 12). The essentials of the annex are contained in the

the methodology or in accordance with the methodology shall specify in the contract. In the case of

that the invoice does not contain particulars of the accounting document and annex does not contain

requirements of the agreed methodology or a contract, an insurance undertaking has the right to

reject it and return without undue delay the medical device to

complement, where appropriate, to correct; in this case, the running period of maturity

to date her repossess the insurance company.



(5) the Medical device is responsible for the completeness, formal and factual

the accuracy of the documents and their transfer in the manner agreed in the methodology

and data interface. Documents for paid care provided

the insured the insurance companies and the insured from the EU, who have chosen the insurance company's

as the institution of manner in the implementation of the rights of the European Union ^ 3), passes

medical devices, together with a breakdown of the insurance undertaking in the term and

in the manner agreed in the contract (or on an electronic medium in

electronic form or on paper).



(6) where the insurance company billing before payment incorrectly

or vyúčtovanou care, reimbursement of that part of the increase in care

the term to maturity. The insurance company provable way shall notify the

medical devices range without undue delay and the reason

made, but outstanding care. The insurance company will invite medical

a device to repair improperly accounted for care or to support the provision of

paid health care. Duly granted and vyúčtovanou care insurance company

will pay in the next term.



(7) the insurance company performs for its clients and policyholders, who the EU

the insurance company selected as the institution of manner in the implementation of the rights of

The European Union ^ 3), the reimbursement of paid health care, accounted in accordance with the

the law and the contract. If on verification finds errors in the

documents, in accordance with the methodology and rules. Denial of payment or

part of the payment the insurance company without undue delay, medical devices

justify in writing. By providing a payment shall not prejudice the right of an insurance undertaking to

the implementation of subsequent checks paid the Bill to the extent and for the

the conditions laid down by the legislation and the contract.



(8) where the insurance company misconduct in the Bill submitted to the medical

Additionally, i.e. the device. After payment and medical equipment to 10

working days from the receipt of the written call the insurance company the amount

itself does not settle, or they can demonstrate the legitimacy of the disputed amount charged or

not unless otherwise agreed between the Contracting Parties, dates of payment, insurance company

unilateral offsetting claims will reduce the medical facility of the

the amount of the remuneration for the employers of health care bill

presented in the following billing period.



(9) the remuneration margin provided by the paid health care, in compliance with the

the conditions stipulated in the contract, shall be made upon delivery of the Bill

the insurance company or on an electronic medium in electronic form within 30

calendar days and when you pass the Bill the insurance company on paper

documents within 50 calendar days from the date of receipt of the invoice to the insurance undertaking,

unless the contracting parties otherwise. Payment deadline is not respected,

If a payment on the last day of the period is credited to the account of the medical

the device.



(10) In the case of computing system, preventing the timely

the implementation of the Bill or of the remuneration paid by health care, provide

insurance medical facility within the agreed time of payment advance

in the amount of average monthly volume reported by the health care

calculated from the last calendar quarter of two closed, if

the Contracting Parties agree otherwise in a given case.



Article 5



Check



(1) the insurance undertaking in accordance with section 42 of the Act and the Treaty control

the use and provision of paid health care in its volume and

quality, including compliance with the prices, through its information

system, audit practitioners and other professional workers in

health, eligible for the review activities (hereinafter referred to as "professional

workers ").



(2) in the framework of their competence review doctors and specialist

staff permissions to control whether the method shall be considered paid

health care was indicated with regard to the State of health of the insured person, the

in accordance with the current available knowledge of medical science and has not been

unnecessarily economically challenging.



(3) in the cases provided for by the legislation of the auditing physician assesses and

the rationale for treating physician proposed or carried out by the

a treatment procedure and approved, whether the procedure used the insurance company will pay.



(4) a medical facility shall provide to the insurance undertaking in the performance of the checks

the necessary assistance, in particular submitted required documents, shall be communicated

data and provides explanations. The review will allow doctors and expert

workers insurance companies access to its object, the inspection

medical documentation in accordance with the particular legal
Regulation ^ 13) and other documents directly related to the

by checking the charged health, pharmaceuticals and

medical devices, including a particularly charged drug and especially

the posted material. Revision (revision specialist) is

obliged to do so, in order not to interrupt the check performed healing

performance.



(5) in the case of inspections (investigation) in the medical device will be on

the site handled a record indicating the most important findings and

the opinions of the medical device. This entry does not replace a message

referred to in paragraph 6).



(6) a report containing the conclusions of the inspection, the insurance company will process and transmit

medical device within 15 calendar days after the completion of the inspection;

If not possible, for objective reasons, this deadline, notify the

the insurance company this fact to the medical facility. A check will be

completed normally within 30 calendar days of its initiation.



(7) the Medical device is authorized within 15 calendar days from the

taking over the control of the insurance company, in writing, the conclusion may submit reasoned objections. To

the opposition of the insurance undertaking shall inform the opinion within 30 calendar days of their

delivery. If not possible, for objective reasons, these deadlines,

can be used at the request of the competent contracting party to extend to the double.

The insurance company shall inform in due time the medical device to determine whether

confirms or alters the conclusions of the inspection. The opposition has in terms of

financial claims against the insurance company's medical device suspensory

effect. This does not prejudice the right of the medical device to

disagreement with the decision of the insurance undertaking in other proceedings.



(8) if the check shows the unlawfulness or incorrectness of the statement

paid for by the health care or her unjustified provision, insurance company

According to § 42 paragraph 3 of the Act, such care does not pay and is entitled to

follow the penalty arrangements referred to in the Treaty. In the event that the

the conclusions of the inspection they prove unjustified, the insurance company

medical devices the amount on the basis of checks decreased

reimbursement provided paid health care. Medical equipment is

entitled to proceed under penalty arrangements referred to in the Treaty.



Article 6 of the



Penalty arrangements



(1) the Contracting Parties for non-compliance with contractual obligations and infringement of

the contracts referred to in paragraph 2), or from other reasons stipulated in the contract

can negotiate a contractual penalty and its amount.



(2) for breach of contract shall be the cases when



and) Contracting Party



1. the false, incomplete or misleading information in the conclusion

of the Treaty, or in its implementation,



2. fail to comply with the provisions of the Treaty, with the consequence of the proven neúčelného

expending the resources of public health insurance,



3. fails to provide the information in the contract negotiated,



(b)) medical equipment



1. unlawfully or multiple charges to health care,



2. fails to provide the required reports resulting from the legislation of the

governing the public health insurance,



3. unreasonably delay has provided paid health care,



4. repeatedly violated the obligation to report to the insurance undertaking in accordance with § 55

law, injuries or other damage to the health of the insured person caused by an act

legal or natural person,



(c) the insurance company)



1. the payment shall be reduced or refused unjustifiably provided paid health

care,



2. carries out the payment lawfully made provided paid health

care with the delay, except in cases where it is not responsible for the delay.



(3) the application of a sanction shall not affect the right of Contracting Parties to return

remuneration for improperly or incorrectly vyúčtovanou and paid paid

health care.



Article 7



The period of application, the method and the reasons for the termination of the contract



The contract is concluded for a period of eight years, unless the parties have agreed

otherwise.



Article 8 of the



The contract or its part shall lapse:



and the day) took the decision on the cancellation or change

registration under Act No. 160/1992 Coll., on health care in non-State

medical devices, as amended, or to

cancellation or change of the provisioning of the Charter, issued by the medical devices



(b) on the date of demise) of medical equipment or the insurance company or the date of death

natural persons, which was the operator of medical equipment,



(c)) of the date specified in the written notice to the insurance company, if the medical

devices from major health or operational reasons cannot health

continue to provide care,



d) date on which the medical facility lost its factual, technical or

personnel prerequisites for the provision of health care within the agreed

the extent provided for by law or the contract, within the meaning of article. 3

paragraph. 2 (a). and medical equipment), if the deficiencies did not

After subsequently set a reasonable time limit; the contract or its part

expires only in part defining the scope of the contracted health care in

which medical equipment does not comply with the law or the contract

set assumptions, unless it was so severe the circumstances for which

You cannot expect a further performance of the contract in its entirety.



Article 9



Before the expiry of the agreed period, you can terminate the agreement upon written notice to the

notice period of five months, which begins the first day of the month

following the delivery of the notification to the other Contracting Party, if in

as a result of serious circumstances cannot reasonably expect more performance

of the Treaty, and that, in the event that the



and) Contracting Party



1. the stated in the conclusion of the contract or the performance of other Contracting

in a mistake in the things essential to the performance of the contract,



2. in contractual relations, the rough way infringed the obligation to a major

saved it to the competent legislation on public health

insurance or health care, or the provision of the Treaty,



3. repeated breach of an obligation arising out of section 41 of the Act,



4. enter into liquidation or on its property, the Court will declare bankruptcy,



(b)) medical equipment



1. without prior agreement with the insurance company for no reason does not provide health

care within the agreed scope and quality,



2. through the written warning without previous agreement with the insurance company repeatedly

charges care provided in excess of the stipulated kind,

expertise and scope of activities,



3. through written notice to the insured person unreasonably limits the

insurance companies opening period agreed in the contract,



4. provides health care without adequate substantive and technical

equipment and staffing,



5. proven does not provide the insured health care quality and "lege

Artis ", or repeatedly refuses to provide health care from other,

than the statutory reasons,



6. calls, in conflict with the law from policy holders financial reimbursement

for health care paid for by the insurance company or the policyholder for the adoption of the

care,



7. a written warning over proven repeatedly wrongly charged

health care,



8. does not provide the necessary assistance for the performance of control activities

carried out by the insurance company in accordance with the law,



(c) the insurance company)



1. through the written warning repeatedly illegally fail to pay

the medical equipment provided paid health care,



2. through the written warning repeatedly fails to meet payment deadlines

agreed in the contract,



3. through the written warning repeatedly exceeds the range of the control

the activities provided for by law,



4. provide the third party data on medical devices above and beyond

the law or the contract.



Article 10



Before the expiry of the agreed period, you can terminate the contract:



and if so) lays down the law



(b)) a written agreement of the Contracting Parties under the conditions and within the time limit

referred to in this agreement.



Article 11



Mutual communication of information and transmission of documents necessary for the verification of compliance with

of the Treaty



(1) the Contracting Parties:



and) use to uniquely identify the medical equipment, in

accordance with the methodology, the organization identification number (IČ), identification

device number (IČZ), the identification number of the workplace (IČP)



(b) shall communicate the information required's) to check the performance of the contract,



(c)) shall ensure permanently accessible and clear information on the existence of a contractual

the relationship and the rights arising from it for the insured person,



d) may pass the information necessary to assess the quality and effectiveness of

provided paid health care, to the extent and under the conditions

stipulated in the contract.



(2) medical device:



and the insurance company shall, when) about suspected non-compliance procedure

"lege artis", that medical devices have been in the provision of paid

health care used in accordance with the special law of ^ 14)



(b)) shall immediately notify, not later than 30 calendar days, the other Contracting

side of the facts, which would substantially affect the implementation of the

the contract, for example. changes to the data referred to in the contract, if the



1. cancellation of the workplace or the part thereof without compensation, or

conclusion for more than 30 calendar days,



2. to leave the employee specifically referred to in the Treaty,



3. the failure of the instruments necessary for the implementation of performance without compensation on the

For more than 30 calendar days.
Failure to comply with the obligations referred to in points (a) or (b))), or late

compliance with the obligations referred to in point (a) (b)), it is considered a serious

breach of contractual obligations.



(3) the insurance company



and) can provide a medical facility in the generalized form of the information

needed to developing its activities or to his scientific and research

activities and to control the quality of health care provided by employers, and it

to the extent and under the conditions stipulated in the contract,



(b)) may publish on its website within the list of

medical device trade name or business name and address of the medical

his expertise and equipment, telephone, or e-mail links or

For more information of mutually agreed.



Article 12



Resolution of disputes



(1) the Contracting Parties shall resolve any disputes relating to the implementation of the

the Treaty primarily by negotiation representatives of the parties, and that

as a general rule within 14 calendar days from the challenges of one of the Contracting Parties.

If there is no agreement between them, the issues discussed in the

the conciliation negotiations. This does not affect the right of Contracting Parties to apply their

entitled to dispute in court or in arbitration proceedings under the Special

^ law 15), if the Contracting Parties on the settlement of disputes in

arbitration agree in the contract.



(2) the conciliation negotiations suggests one of the Contracting Parties. The proposal must

contain accurate and sufficiently detailed definition of the dispute. A participant in the

the conciliation negotiations is the Contracting Party that submitted the proposal for the consideration of the

the dispute, a Contracting Party that is a proposal for the consideration of the dispute addressed to,

the representative of the relevant group of medical facilities

represented their interest associations ^ 16) under section 17 (3)

the law and the representative of the insurance company. To discuss the dispute, each Contracting

Party may invite a maximum of two professional adviser. The conciliation negotiations with the

terminates the registration, containing a settlement or the conclusion that the conflict has not been removed

with an indication of the opinions of both parties.



1) Act No. 48/1997 Coll., on public health insurance, as amended by

amended.



Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Law No 160/1992 Coll., on health care in non-State medical

establishments, as amended.



2) Act No. 551/1991 Coll., on general health insurance company, in the text of the

amended.



Law No. 280/1992 Coll., on departmental, industry, corporate, and other

health insurance, as amended.



3) Council Regulation (EEC) No 1408/71 and 574/72.



4) Eg. Communication from the Ministry of Foreign Affairs No. 130/2002 SB., m.s.,

the negotiation of a Treaty between the Czech Republic and the Federal Republic of

Yugoslavia on social security,



Communication from the Ministry of Foreign Affairs No. 83/2000 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Croatia on the social

security, communication from the Ministry of Foreign Affairs No. 135/2004

Coll., on negotiation of the m.s. Treaty between the Czech Republic and the Turkish

Republic on social security.



5) section 10 of Act No. 526/1990 Coll., on prices, as amended.



6) Law No. 101/2000 Coll., on protection of personal data and on amendments to certain

laws, as amended.



7) Act No. 435/2004 Coll., on employment, as amended,

regulations.



8) Law No. 95/2004 Coll., on conditions for the acquisition and recognition of professional

competence and specialized competence to perform medical

the professions of doctor, dentist and pharmacist.



Law No 96/2004 Coll., on conditions for the acquisition and recognition of competence to

the exercise of paramedical professions and to pursue activities

related to the provision of health care and to change some of the

related laws.



9) Decree No. 49/1993 Coll., on technical and substantive requirements

equipment of medical devices, as amended.



10) Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Decree No 385/2006 Coll., on the medical documentation, as amended by the Decree of the

No 479/2006 Sb.



11) Decree No. 343/1997 Coll., laying down the method of prescribing

medicinal products, the particulars of medical regulations and the rules of their

of use, as amended.



12) Act No. 563/1991 Coll., on accounting, as amended.



13) § 67 b) of Act No. 20/1966 Coll., on the health care of the people, in the text of the

amended.



for example, law No 14) 123/2000 Coll., on medical devices and on

changes to some related laws, as amended.



15) Act No. 216/1994, Coll., on arbitration proceedings and enforcement of arbitral

the findings, in the wording of Act No. 245/2006.



16) Act No. 83/1990 Coll. on Association of citizens, as amended

regulations.



§ § 20f and subs. Act No. 40/1964 Coll., the civil code, as amended by

amended.



Annex 2



Framework contract for health care facilities providing out-patient

specialized care, with the exception of health care facilities providing

physiotherapy (expertise and 918 902) ^ 1) and occupational therapy, and for health

facilities providing care for female doctors (expertise of 603 and 604) ^ 1) and

Clinical logopedii and health insurance



THE FIRST PART OF THE ANNEX



General provisions



Article 1



Contractual relations



(1) a framework agreement lays down the conditions under which the contract is concluded

between the health establishments providing outpatient specialized

care, with the exception of health care facilities providing physiotherapy

(expertise and 918 902) ^ 1) and occupational therapy, and for health care facilities

providing care for female doctors (expertise of 603 and 604) ^ 1) and clinical

logopedii, and insurance companies, and to ensure that contributions in kind in the

the provision and payment of paid health care.



(2) the legal relationships in the contract concluded between the

insurance ^ 2), and medical devices shall not deviate from the

the provisions of the framework contract in accordance with this Ordinance, with the exception of those

provisions, for which such a possibility this framework contract expressly

lists.



PART TWO OF THE ANNEX TO



Of the Treaty



Article 2



Conclusion of contracts



(1) the legal relationship between the insurance company and medical facilities is governed by the

a written contract concluded under this framework contract, legal

the rules governing the public health insurance and the provision of

health care, and even in the case where the undertaking fulfils the role of a temporary

institutions in the implementation of the rights of the European Union ^ 3) or on the basis of the

international agreements on social security concluded by the Czech

Republic ^ 4). In matters not regulated by these laws and regulations and

the contract shall be governed by the commercial code.



(2) the basic condition for the conclusion of a contract is the permission of the medical

the equipment for the provision of health care in the field.



(3) the contract contains the



and) the rights and obligations of the Contracting Parties,



(b) the quality and effectiveness of the) conditions of the provision of health care, in particular

the kind, scope, and extent of health care provided by the specified list of

performance with point values according to the types of care, which is a medical

the device shall be entitled to provide, including substantive and technical equipment and

staffing,



(c) point values) ^ 5), the amount of the reimbursement paid by health care and regulatory

limitation of the volume of paid health care provided in accordance with the Decree

issued under section 17, paragraph. 6 of the Act,



(d) the implementation of the remuneration provided by) the way of health care,



(e)) the conditions required to check the performance of the contract, including the accuracy and

the legitimacy of the posted amounts



f) range and method of mutual communication of the information necessary to check the

performance of the contract,



(g)) the provisions on the resolution of conflicts in the course of the negotiations, where appropriate, the provisions of

about the use of arbitration,



(h) the period of application of the Treaty), the method and the reasons for her termination.



I) provisions on the acceptance of and compliance with the agreed procedure for

acquisition, transmission and evaluation of documents in accordance with the methodology,

rules and uniform data interface, produced by the universal

health insurance in the Czech Republic in cooperation with the representatives of

insurance companies and representatives of professional associations of health care providers

and issued a general health insurance company in the Czech Republic, the applicable

at the time of conclusion of the contract,



j) provisions on how to get started with any medical facility

changes to the methodology and rules, including the method of transmission of these changes.



(4) the contract may also contain other arrangements necessary for the implementation and

check if they are in accordance with this agreement and the legal framework

provisions.



Article 3 of the



The rights and obligations of the parties



(1) the Contracting Parties



and when reporting and shall comply with), payment of paid health care agreed

the methodology, rules and data interface; the contract shall specify the version number

at the time of conclusion of the contract,



(b) undertake their employees) with regard to the protection of the rights of insured persons, to the

maintaining the confidentiality of the personal data required ^ 6) and facts

which to learn in the performance of their duties or employment or in

processing of data from the information system on the basis of the Treaty, or of the

connection with a ^ 2).



2) medical equipment
and provides paid health care) in accordance with the legislation in

proficiency and the extent of the agreed and defined in the Treaty, for which the

It is factually and technically equipped and staffed to ensure



(b)) provides health care paid for by the insured from the EU under the same

conditions as to the insured the insurance company, in the range from applicants

documents, so as to avoid discrimination or preference

in particular, when taking on the medical interventions that are waiting, and even

If the beneficiary of EU health care paid for in cash,



(c)) is responsible for the fact that his staff ^ 7), who will be insured

provide in the contract negotiated paid health care, meet the

the requirements laid down by law for the performance of this activity ^ 8),



(d)) is responsible for the implementation of the substantive and technical conditions laid down for the

It provided health care under a special legal regulation, ^ 9),



e) provides health care paid for by the "lege artis" without excess

the cost, however, with a view to making the necessary diagnostic

or therapeutic effect was achieved with regard to individual health

the status of the insured person,



(f)) is responsible for the effectiveness of the indication when sending the insured person to

complementary and konziliárním examination and, on the basis of their results

modifies the diagnosis or therapeutic procedure,



(g)) will lead to eligibility made health care in

conclusive form of health documentation on the treatment of policyholders, in which

the performances will be recorded, on-demand made by the medical health care

including medical transportation, prescribed medicines and medical

resources and retained in her Inbox results requested and carried out

examination and treatment, in accordance with a special law ^ 10),



(h)) to ensure, in the case of the absence in the Treaty agreed the wearer

performance, the crowd another qualified holder performance and contract

agreed cases shall notify the insured and the insurance company,



I) to provide, in accordance with the legislation of the medical establishment,

which the insured person passes into the care or that the beneficiary's choice

the information needed to ensure continuity of health care and to avoid

duplicate the implementation of diagnostic and treatment procedures and acceptance

insured persons in the care of such information from the relevant device

require,



(j) adoption of the insured person to refuse) your care except for the reasons set out

in section 11, paragraph 1 (b)) of the Act,



to the right of the insured person making the) freedom of choice of doctor, medical

equipment or the provision of health care paid for by any of the

registration fees or with various donations and granted

health care paid for by the insurance company will not be from the insured person, if it

did not result from legislation, to collect any financial remuneration,



(l) the right of the policyholder to making) the granting of paid health care

changing the insurance undertaking or in any other way,



It will not discriminate between insured m) of one or more insurance undertakings in

detriment of policyholders of insurance companies and worsen the availability

health care paid for by the insurance company a priority the provision of care

paid for by other means,



n) shall notify the insurance undertaking in accordance with section 55 of the Act injuries or other damage

the health of the persons who provided paid health care, if you have reason to

suspecting that they were caused by acts legal or natural person,



about) by the special legal regulation ^ 11) for the correct and complete

fill in the form of a recipe; also responsible for the correct and complete filling

voucher for medical devices or voucher to the examination/treatment

or to the medical transport. When prescribing was not

respected prescribing restrictions arising from legislation and the

undertaking this medicinal product equipment pharmaceutical treatments, has

the insurance company the right to demand remuneration paid by medical device

hastky,



p) showing when concluding a contract with an insurance company proof of insurance

liability for damage caused to citizens in connection with the provision

health care and will be insured for the entire duration of the contractual relationship with the

the insurance company.



(3) the insurance company



and will pay the medical facility) made paid health care,

clearly documented and reasonably provided to the insured and the

insurance policy holders in the EU, who have the insurance company selected as the institution of manner

in the implementation of the rights of the European Union ^ 3) in accordance with the law and

the Treaty,



(b)), on request, sees therapeutic equipment without undue delay

the jurisdiction of the insured person to the insurance undertaking in cases where it is not available

insurance card and his personal data are available,



(c)) will not require preferential treatment of their policyholders at the expense of policyholders

other insurance companies,



(d)) is authorised to control compliance with the contractually agreed payment in kind and

technical conditions and staffing financed by health care

provided by the medical establishment, under the Treaty,



e) provides medical equipment to ensure uniform conditions

the agreed methodology, rules, data interface and the appropriate dials

issued by the general health insurance company for reporting and calculation of the remuneration

paid for by the health care



(f) medical device with familiar) the agreed changes to the methodology,

rules and with the changes at least one month and the dials with the change

the data interface at least two months before the date of their

the validity of. In the case of changes to the legislation, which does not allow this period

keep, can be referred to commensurately reduced.



Article 4 of the



Remuneration provided paid health care



(1) the value of the point ^ 5) for health care paid for by the performance,

the amount of the reimbursement paid by health care and regulatory restrictions on the volume of provided

paid health care under section 17, paragraph. 6 of the Act is given in the appendix to the

the contract, under a special legal regulation.



(2) methods of payment shall be considered as:



and health) payment for performances by the health interventions with

point values, or



(b)) other agreed method of payment.



(3) Between the parties must always be agreed in advance to increase or

the reduction of the volume of provided paid health care due to changes

capacity, the structure of the medical equipment, changes or reconstruction

Instrumentation as specified in the contract.



(4) medical equipment for the filing of claims for reimbursement provided

paid for by the health care bill passes the insurance company once a month

care provided an invoice with attachments, if the Contracting Parties

agree on passing the Bill over a longer period. The invoice contains

Essentials of accounting document ^ 12). The essentials of the annex are contained in the

the methodology or in accordance with the methodology shall specify in the contract. In the case of

that the invoice does not contain particulars of the accounting document and annex does not contain

requirements of the agreed methodology or a contract, an insurance undertaking has the right to

reject it and return without undue delay the medical device to

complement, where appropriate, to correct; in this case, the running period of maturity

to date her repossess the insurance company.



(5) the Medical device is responsible for the completeness, formal and factual

the accuracy of the documents and their transfer in the manner agreed in the methodology

and data interface. Documents for paid care provided

the insured the insurance companies and the insured from the EU, who have chosen the insurance company's

as the institution of manner in the implementation of the rights of the European Union ^ 3) passes

medical devices, together with a breakdown of the insurance undertaking in the term and

in the manner agreed in the contract (or on an electronic medium in

electronic form or on paper).



(6) where the insurance company billing before payment incorrectly

or vyúčtovanou care, reimbursement of that part of the increase in care

the term to maturity. The insurance company provable way shall notify the

medical devices range without undue delay and the reason

made, but outstanding care. The insurance company will invite medical

a device to repair improperly accounted for care or to support the provision of

paid health care. Duly granted and vyúčtovanou care insurance company

will pay in the next term.



(7) the insurance company performs for its clients and policyholders, who the EU

the insurance company selected as the institution of manner in the implementation of the rights of

The European Union ^ 3), the reimbursement of paid health care, accounted in accordance with the

the law and the contract. If on verification finds errors in the

documents, in accordance with the methodology and rules. Denial of payment or

part of the payment the insurance company without undue delay, medical devices

justify in writing. By providing a payment shall not prejudice the right of an insurance undertaking to

the implementation of subsequent checks paid the Bill to the extent and for the

the conditions laid down by the legislation and the contract.



(8) where the insurance company misconduct in the Bill submitted to the medical

Additionally, i.e. the device. After payment and medical equipment to 10

working days from the receipt of the written call the insurance company the amount
itself does not settle, or they can demonstrate the legitimacy of the disputed amount charged or

not unless otherwise agreed between the Contracting Parties, dates of payment, insurance company

unilateral offsetting claims will reduce the medical facility of the

the amount of the remuneration for the employers of health care bill

presented in the following billing period.



(9) the remuneration margin provided by the paid health care, in compliance with the

the conditions stipulated in the contract, shall be made upon delivery of the Bill

the insurance company or on an electronic medium in electronic form within 30

calendar days and when you pass the Bill the insurance company on paper

documents within 50 calendar days from the date of receipt of the invoice to the insurance undertaking,

unless the contracting parties otherwise. Payment deadline is not respected,

If a payment on the last day of the period is credited to the account of the medical

the device.



(10) In the case of computing system, preventing the timely

the implementation of the Bill or of the remuneration paid by health care, provide

insurance medical facility within the agreed time of payment advance

in the amount of average monthly volume reported by the health care

calculated from the last calendar quarter of two closed, if

the Contracting Parties agree otherwise in a given case.



Article 5



Check



(1) the insurance undertaking in accordance with section 42 of the Act and the Treaty control

the use and provision of paid health care in its volume and

quality, including compliance with the prices, through its information

system, audit practitioners and other professional workers in

health, eligible for the review activities (hereinafter referred to as "professional

workers ").



(2) in the framework of their competence review doctors and specialist

staff permissions to control whether the method shall be considered paid

health care was indicated with regard to the State of health of the insured person, the

in accordance with the current available knowledge of medical science and has not been

unnecessarily economically challenging.



(3) in the cases provided for by the legislation of the auditing physician (professional

assessing the rationale of the worker) and doctor (clinical

psychologist, clinical logopedem) proposed or carried out by the

a treatment procedure and approved, whether the procedure used the insurance company will pay.



(4) a medical facility shall provide to the insurance undertaking in the performance of the checks

the necessary assistance, in particular submitted required documents, shall be communicated

data and provides explanations. The review will allow doctors and expert

workers insurance companies access to its object, the inspection

medical documentation in accordance with the particular legal

Regulation ^ 13) and other documents directly related to the

by checking the charged health, pharmaceuticals and

medical devices, including a particularly charged drug and especially

the posted material. Revision (revision specialist) is

obliged to do so, in order not to interrupt the check performed healing

performance.



(5) in the case of inspections (investigation) in the medical device will be on

the site handled a record indicating the most important findings and

the opinions of the medical device. This entry does not replace a message

in accordance with paragraph 6.



(6) a report containing the conclusions of the inspection, the insurance company will process and transmit

medical device within 15 calendar days after the completion of the inspection;

If not possible, for objective reasons, this deadline, notify the

the insurance company this fact to the medical facility. A check will be

completed normally within 30 calendar days of its initiation.



(7) the Medical device is authorized within 15 calendar days from the

taking over the control of the insurance company, in writing, the conclusion may submit reasoned objections. To

the opposition of the insurance undertaking shall inform the opinion within 30 calendar days of their

delivery. If not possible, for objective reasons, these deadlines,

the relevant time limit shall be extended up to twice. Within the time limit

the insurance undertaking shall inform the medical device to determine whether it confirms or modifies

conclusions of the inspection. The opposition has in terms of financial claims

insurance against medical device have suspensive effect. This is not a

without prejudice to the right of the medical device to apply its disagreement with the

by the decision of the insurance undertaking in other proceedings.



(8) if the check shows the unlawfulness or incorrectness of the statement

paid for by the health care or her unjustified provision, insurance company

According to § 42 paragraph 3 of the Act, such care does not pay and is entitled to

follow the penalty arrangements referred to in the Treaty. In the event that the

the conclusions of the inspection they prove unjustified, the insurance company

medical devices the amount on the basis of checks decreased

reimbursement provided paid health care. Medical equipment is

entitled to proceed under penalty arrangements referred to in the Treaty.



Article 6 of the



Penalty arrangements



(1) the Contracting Parties for non-compliance with contractual obligations and infringement of

the contracts referred to in paragraph 2 or of other reasons stipulated in the contract

can negotiate a contractual penalty and its amount.



(2) for breach of contract shall be the cases when



and) Contracting Party



1. the false, incomplete or misleading information in the conclusion

of the Treaty, or when it fails to comply with the provisions of the treaty implementation, with the result

proven neúčelného expending funds for public health

insurance,



2. does the information stipulated in the contract,



(b)) medical equipment



1. unlawfully or multiple charges to health care,



2. fails to provide the required reports resulting from the legislation of the

governing the public health insurance,



3. unreasonably delay has provided paid health care,



4. repeatedly violated the obligation to report to the insurance undertaking in accordance with § 55

law, injuries or other damage to the health of the insured person caused by an act

legal or natural person,



(c) the insurance company)



1. the payment shall be reduced or refused unjustifiably provided paid health

care,



2. carries out the payment lawfully made provided paid health

care with the delay, except in cases where it is not responsible for the delay.



(3) the application of a sanction shall not affect the right of Contracting Parties to return

remuneration for improperly or incorrectly vyúčtovanou and paid paid

health care.



Article 7



The period of application, the method and the reasons for the termination of the contract



The contract is concluded for a period of eight years, unless the parties have agreed

otherwise.



Article 8 of the



The contract or its part shall lapse:



and the day) took the decision on the cancellation or change

registration under Act No. 160/1992 Coll., on health care in non-State

medical devices, as amended, or to

cancellation or change of the provisioning of the Charter, issued by the medical devices



(b) on the date of demise) of medical equipment or the insurance company or the date of death

natural persons, which was the operator of medical equipment,



(c)) of the date specified in the written notice to the insurance company, if the medical

devices from major health or operational reasons cannot health

continue to provide care,



d) date on which the medical facility lost its factual, technical or

personnel prerequisites for the provision of health care within the agreed

the extent provided for by law or the contract, within the meaning of article. 3

paragraph. 2 (a). and medical equipment), if the deficiencies did not

After subsequently set a reasonable time limit; the contract or its part

expires only in part defining the scope of the contracted health care in

which medical equipment does not comply with the law or the contract

set assumptions, unless it was so severe the circumstances for which

You cannot expect a further performance of the contract in its entirety.



Article 9



Before the expiry of the agreed period, you can terminate the agreement upon written notice to the

notice period of five months, which begins the first day of the month

following the delivery of the notification to the other Contracting Party, if in

as a result of serious circumstances cannot reasonably expect more performance

of the Treaty, and that, in the event that the



and) Contracting Party



1. the stated in the conclusion of the contract or the performance of other Contracting

in a mistake in the things essential to the performance of the contract,



2. in contractual relations, the rough way infringed the obligation to a major

saved it to the competent legislation on public health

insurance or health care, or the provision of the Treaty,



3. repeated breach of an obligation arising out of section 41 of the Act, 4. enters the

disposal or on its property, the Court will declare bankruptcy,



(b)) medical equipment



1. without prior agreement with the insurance company for no reason does not provide health

care within the agreed scope and quality,



2. through the written warning without previous agreement with the insurance company repeatedly

charges care provided in excess of the stipulated kind,

expertise and scope of activities,



3. through written notice to the insured person unreasonably limits the

insurance companies opening period agreed in the contract,



4. provides health care without adequate substantive and technical

equipment and staffing,
5. proven does not provide the insured health care quality and "lege

Artis ", or repeatedly refuses to provide health care from other,

than the statutory reasons,



6. calls, in conflict with the law from policy holders financial reimbursement

for health care paid for by the insurance company or the policyholder for the adoption of the

care,



7. a written warning over proven repeatedly wrongly charged

health care,



8. does not provide the necessary assistance for the performance of control activities

carried out by the insurance company in accordance with the law,



(c) the insurance company)



1. through the written warning repeatedly illegally fail to pay

the medical equipment provided paid health care,



2. through the written warning repeatedly fails to meet payment deadlines

agreed in the contract,



3. through the written warning repeatedly exceeds the range of the control

the activities provided for by law,



4. provide the third party data on medical devices above and beyond

the law or the contract.



Article 10



Before the expiry of the agreed period, you can terminate the contract



and if so) lays down the law



(b)) a written agreement of the Contracting Parties under the conditions and within the time limit

referred to in this agreement.



Article 11



Mutual communication of information and transmission of documents necessary for the verification of compliance with

of the Treaty



(1) the Contracting Parties



and) use to uniquely identify the medical equipment, in

accordance with the methodology, the organization identification number (IČ), identification

device number (IČZ), the identification number of the workplace (IČP)



(b) shall communicate the information required's) to check the performance of the contract,



(c)) shall ensure permanently accessible and clear information on the existence of a contractual

the relationship and the rights arising from it for the insured person,



d) may pass the information necessary to assess the quality and effectiveness of

provided paid health care, to the extent and under the conditions

stipulated in the contract.



(2) medical equipment



and the insurance company shall, when) about suspected non-compliance procedure

"lege artis", that medical devices have been in the provision of paid

health care used in accordance with the special law of ^ 14)



(b)) shall immediately notify, not later than 30 calendar days, the other Contracting

side of the facts, which would substantially affect the implementation of the

the contract, for example. the emergence of computer system faults, changes to the data referred to

in the contract, if the



1. cancellation of the workplace or the part thereof without compensation, or

conclusion for more than 30 calendar days,



2. to leave the employee specifically referred to in the Treaty,



3. the failure of the instruments necessary for the implementation of performance without compensation on the

For more than 30 calendar days.



Failure to comply with the obligations referred to in points (a) or (b))), or late

compliance with the obligations referred to in point (a) (b)), it is considered a serious

breach of contractual obligations.



(3) the insurance company



and) can provide a medical facility in the generalized form of the information

needed to developing its activities or to his scientific and research

activities and to control the quality of health care provided by employers, and it

to the extent and under the conditions stipulated in the contract,



(b)) may publish on its website within the list of

medical device trade name or business name and address of the medical

his expertise and equipment, telephone, or e-mail links or

For more information of mutually agreed,



Article 12



Resolution of disputes



(1) the Contracting Parties shall resolve any disputes relating to the implementation of the

the Treaty primarily by negotiation representatives of the parties, and that

as a general rule within 14 calendar days from the challenges of one of the Contracting Parties.

If there is no agreement between them, the issues discussed in the

the conciliation negotiations. This does not affect the right of Contracting Parties to apply their

entitled to dispute in court or in arbitration proceedings under the Special

^ law 15), if the Contracting Parties on the settlement of disputes in

arbitration agree in the contract.



(2) the conciliation negotiations suggests one of the Contracting Parties. The proposal must

contain accurate and sufficiently detailed definition of the dispute. A participant in the

the conciliation negotiations is the Contracting Party that submitted the proposal for the consideration of the

the dispute, a Contracting Party that is a proposal for the consideration of the dispute addressed to,

the representative of the relevant group of medical facilities

represented their interest associations ^ 16) under section 17 (3)

the law and the representative of the insurance company. To discuss the dispute, each Contracting

Party may invite a maximum of two professional adviser. The conciliation negotiations with the

terminates the registration, containing a settlement or the conclusion that the conflict has not been removed

with an indication of the opinions of both parties.



1) Decree No. 134/1998 Coll. issuing the list of health interventions

with point values, as amended.



2) Act No. 551/1991 Coll., on general health insurance company, in the text of the

amended.



Law No. 280/1992 Coll., on departmental, industry, corporate, and other

health insurance, as amended.



3) Council Regulation (EEC) No 1408/71 and 574/72.



4) Eg. Communication from the Ministry of Foreign Affairs No. 130/2002 SB., m.s.,

the negotiation of a Treaty between the Czech Republic and the Federal Republic of

Yugoslavia on social security,



Communication from the Ministry of Foreign Affairs No. 83/2000 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Croatia on the social

security, communication from the Ministry of Foreign Affairs No. 135/2004

Coll., on negotiation of the m.s. Treaty between the Czech Republic and the Turkish

Republic on social security.



5) section 10 of Act No. 526/1990 Coll., on prices, as amended.



6) Law No. 101/2000 Coll., on protection of personal data and on amendments to certain

laws, as amended.



7) Act No. 435/2004 Coll., on employment, as amended,

regulations.



8) Law No. 95/2004 Coll., on conditions for the acquisition and recognition of professional

competence and specialized competence to perform medical

the professions of doctor, dentist and pharmacist.



Law No 96/2004 Coll., on conditions for the acquisition and recognition of competence to

the exercise of paramedical professions and to pursue activities

related to the provision of health care and to change some of the

related laws.



9) Decree No. 49/1993 Coll., on technical and substantive requirements

equipment of medical devices, as amended.



10) Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Decree No 385/2006 Coll., on the medical documentation, as amended by the Decree of the

No 479/2006 Sb.



11) Decree No. 343/1997 Coll., laying down the method of prescribing

medicinal products, the particulars of medical regulations and the rules of their

of use, as amended.



12) Act No. 563/1991 Coll., on accounting, as amended.



13) § 67 b) of Act No. 20/1966 Coll., on the health care of the people, in the text of the

amended.



for example, law No 14) 123/2000 Coll., on medical devices and on

changes to some related laws, as amended.



15) Act No. 216/1994, Coll., on arbitration proceedings and enforcement of arbitral

the findings, in the wording of Act No. 245/2006.



Act No. 83/1990 Coll. on Association of citizens, as amended

regulations. § § 20f and subs. Act No. 40/1964 Coll., the civil code, in the

as amended.



Annex 3



Framework contract for health care facilities providing out-patient care

dentists and health insurance



THE FIRST PART OF THE ANNEX



General provisions



Article 1



Contractual relations



(1) a framework agreement lays down the conditions under which the contract is concluded

between the health establishments providing outpatient care, dental

doctors and insurance companies, and to ensure that contributions in kind in the

the provision and payment of paid health care ^ 1).



(2) the legal relationships in the contract concluded between the

insurance ^ 2), and medical devices shall not deviate from the

the provisions of the framework contract in accordance with this Ordinance, with the exception of those

provisions, for which such a possibility this framework contract expressly

lists. To ensure the creation of the uniform conditions for the same, or

comparable performance, in accordance with a special law, the

the elaboration of the text of the contract involved representatives of insurance companies and agents

health care providers, authorised to act in this matter.



PART TWO OF THE ANNEX TO



Of the Treaty



Article 2



Conclusion of contracts



(1) the legal relationship between the insurance company and medical facilities is governed by the

a written contract concluded under this framework contract, legal

the rules governing the public health insurance and the provision of

health care, and even in the case where the undertaking fulfils the role of a temporary

institutions in the implementation of the rights of the European Union ^ 3) or on the basis of the

international agreements on social security concluded by the Czech

Republic ^ 4). In matters not regulated by these laws and regulations and

the contract shall be governed by the commercial code.



(2) the basic condition for the conclusion of a contract is the permission of the medical

the equipment for the provision of health care in the field.
(3) the contract includes:



and) the rights and obligations of the Contracting Parties,



(b) the quality and effectiveness of the) conditions of the provision of health care, in particular

the kind, scope, and extent of health care provided by the specified list of

performance and a list of dental products according to the types of care, which is

medical devices shall be authorized to provide, and the obligation of medical

the device inform about the material and technical equipment, personnel

ensure to the extent agreed in the contract and the time of opening,



(c) point values) ^ 5), the amount of the reimbursement paid by health care and regulatory

limitation of the volume of paid health care provided in accordance with the Decree

issued under section 17, paragraph. 6 of the Act,



(d) the implementation of the remuneration provided by) the way of health care,



(e)) the conditions required to check the performance of the contract, including the accuracy and

the legitimacy of the posted amounts



f) range and method of mutual communication of the information necessary to check the

performance of the contract,



(g)) the provisions on the resolution of conflicts in the course of the negotiations, where appropriate, the provisions of

about the use of arbitration,



(h) the period of application of the Treaty), the way and the reasons for her termination



I) provisions on the acceptance of and compliance with the agreed procedure for

acquisition, transmission and evaluation of documents in accordance with the methodology,

rules and uniform data interface, produced by the universal

health insurance in the Czech Republic in cooperation with the representatives of

insurance companies and representatives of professional associations of health care providers

and issued a general health insurance company in the Czech Republic, the applicable

at the time of conclusion of the contract,



j) provisions on how to get started with any medical facility

changes to the methodology and rules, including the method of transmission of these changes.



(4) the contract may also contain other arrangements necessary for the implementation and

check if they are in accordance with this agreement and the legal framework

provisions.



Article 3 of the



The rights and obligations of the parties



(1) the Contracting Parties:



and when reporting and shall comply with), payment of paid health care agreed

the methodology, rules and data interface; the contract shall specify the version number

at the time of conclusion of the contract,



(b) undertake their employees) with regard to the protection of the rights of insured persons, to the

maintaining the confidentiality of the personal data required ^ 6) and facts

which to learn in the performance of their duties or employment or in

processing of data from the information system on the basis of the Treaty, or of the

connection with a ^ 2).



(2) medical device:



and provides paid health care) in accordance with the legislation in

proficiency and the extent of the agreed and defined in the Treaty, for which the

It is factually and technically equipped and staffed to ensure



(b)) provides health care paid for by the EU under the same insurance policy holders

conditions as to the insured the insurance company, in the range from applicants

documents, so as to avoid discrimination or preference,

and even in the event that the beneficiary from the EU, responsibility for health care in the

cash,



(c)) is responsible for the fact that his staff ^ 7), who will be insured

provide in the contract negotiated paid health care, meet the

the requirements laid down by law for the performance of this activity ^ 8),



(d)) is always required to offer insured persons by medical treatment

inform the insured about insurance and other options for treatment and

their remuneration,



(e)) is responsible for the implementation of the substantive and technical conditions laid down for the

It provided health care under a special legal regulation, ^ 9),



(f)) provides health care paid for by the "lege artis" without excess

the cost, however, with a view to making the necessary diagnostic

or therapeutic effect was achieved with regard to individual health

the status of the insured person,



(g)) is responsible for the effectiveness of the indication when sending the insured person to

complementary and konziliárním examination and, on the basis of their results

modifies the diagnosis or therapeutic procedure,



h) will lead to eligibility made health care in

conclusive form of health documentation on the treatment of policyholders, in which

the performances will be recorded, on-demand made by the medical health care

including medical transportation, prescribed medicines and medical

resources and retained in her Inbox results requested and carried out

examination and treatment, in accordance with a special law ^ 10),



I) make available, in the absence of an agreed in the contract holders

the performance of the insured health care facility information to them

provide acute and emergency health care practitioner, and in

contractually agreed cases shall notify the insurance undertaking,



j) shall provide in accordance with the law of medical facilities,

which the insured person passes into the care or that the beneficiary's choice

the information needed to ensure continuity of health care and to avoid

duplicate the implementation of diagnostic and treatment procedures and acceptance

insured persons in the care of such information from the relevant device

require,



to refuse receipt of the policyholder) to their care with the exception of the reasons given

in section 11, paragraph 1 (b)) of the Act,



(l) the right of the insured person making the) freedom of choice of doctor, medical

equipment or the provision of health care paid for by any of the

registration fees or with various donations and granted

health care paid for by the insurance company will not be from the insured person, if it

did not result from legislation, to collect any financial remuneration,



the right of the insured person making m) on the provision of paid health care

changing the insurance undertaking or in any other way,



n) will not discriminate between insured persons of one or more insurance undertakings in

against other insurance companies and policyholders get worse the availability of necessary

and emergency medical care paid for by the insurance company preferred

the provision of care to patients, care otherwise bunging



notify the insurance undertaking) in accordance with section 55 of the Act no accidents or other

damage to the health of the persons who provided paid health care, if

has reasonable grounds for believing that the conduct was caused by the legal or natural

of the person,



p) matches under special legislation ^ 11) for the correct and complete

fill in the form of a recipe; also responsible for the correct and complete filling

voucher for medical devices or voucher to the examination/treatment

or to the medical transport, set out the methodology. If, at the

prescribing has not been respected prescribing limits resulting from

legislation and undertaking this medicinal product or medical

means of care facilities, an insurance undertaking has the right

request from the medical device reimbursement of amounts paid,



q) showing when concluding a contract with an insurance company proof of insurance

liability for damage caused to citizens in connection with the provision

health care and will be insured for the entire duration of the contractual relationship with the

the insurance company.



(3) an insurance undertaking:



and will pay the medical facility) made paid health care,

clearly documented and reasonably provided to the insured and the

insurance policy holders in the EU, who have the insurance company selected as the institution of manner

in the implementation of the rights of the European Union ^ 3) in accordance with the law and

the Treaty,



(b)), on request, sees therapeutic equipment without undue delay

the jurisdiction of the insured person to the insurance undertaking in cases where it is not available

insurance card and his personal data are available,



(c)) will not require preferential treatment of their policyholders at the expense of policyholders

other insurance companies,



(d)) is authorised to control compliance with the contractually agreed payment in kind and

the technical conditions and the agreed staffing financed by

health care provided by the medical establishment in accordance with the Treaty,



e) provides medical equipment to ensure uniform conditions

the agreed methodology, rules, data interface and the appropriate dials

issued by the general health insurance company for reporting and calculation of the remuneration

paid for by the health care



(f) medical device with familiar) the agreed changes to the methodology,

rules and with the changes at least one month and the dials with the change

the data interface at least two months before the date of their

the validity of. In the case of changes to the legislation, which does not allow this period

keep, can be referred to commensurately reduced.



Article 4 of the



Remuneration provided paid health care



(1) the value of the point ^ 5) for health care paid for by the performance,

the amount of the reimbursement paid by health care and regulatory restrictions on the volume of provided

paid health care under section 17, paragraph. 6 of the Act is given in the appendix to the

the contract in accordance with a special law.



(2) methods of payment shall be considered as:



and health) payment for performances by the health interventions with

point values, or



(b)) other agreed method of payment.



(3) Between the parties must always be agreed in advance to increase or

the reduction in the agreed volume of employers provided health care because of

change or renewal of instrumentation as specified in the contract.



(4) medical equipment for the filing of claims for reimbursement provided
paid for by the health care bill passes the insurance company once a month

care provided an invoice with attachments, if the Contracting Parties

agree on passing the Bill over a longer period. The invoice contains

Essentials of accounting document ^ 12). The essentials of the annex are contained in the

the methodology or in accordance with the methodology shall specify in the contract. In the case of

that the invoice does not contain particulars of the accounting document and annex does not contain

requirements of the agreed methodology or a contract, an insurance undertaking has the right to

reject it and return without undue delay the medical device to

complement, where appropriate, to correct; in this case, the running period of maturity

to date her repossess the insurance company.



(5) the Medical device is responsible for the completeness, formal and factual

the accuracy of the documents and their transfer in the manner agreed in the methodology

and data interface. Documents documents under-funded health care

provided the insured the insurance companies and the insured from the EU who

the insurance company selected as the institution of manner in the implementation of the rights of

The European Union ^ 3), passes the medical device insurance company together with

bills on time and in the manner agreed by the contract (on

or an electronic medium in electronic form or on paper

documents).



(6) where the insurance company billing before payment incorrectly

or vyúčtovanou care, reimbursement of that part of the increase in care

the term to maturity. The insurance company provable way shall notify the

medical devices range without undue delay and the reason

made, but outstanding care. The insurance company will invite medical

a device to repair improperly accounted for care or to support the provision of

paid health care. Duly granted and vyúčtovanou care insurance company

will pay in the next term.



(7) the insurance company performs for its clients and policyholders, who the EU

the insurance company selected as the institution of manner in the implementation of the rights of

The European Union ^ 3), the reimbursement of paid health care, accounted in accordance with the

the law and the contract. If on verification finds errors in the

documents, in accordance with the methodology and rules. Denial of payment or

part of the payment the insurance company without undue delay, medical devices

justify in writing. By providing a payment shall not prejudice the right of an insurance undertaking to

the implementation of subsequent checks paid the Bill to the extent and for the

the conditions laid down by the legislation and the contract.



(8) where the insurance company misconduct in the Bill submitted to the medical

Additionally, i.e. the device. After payment and medical equipment to 10

working days from the receipt of the written call the insurance company the amount

itself does not settle, or they can demonstrate the legitimacy of the disputed amount charged or

not unless otherwise agreed between the Contracting Parties, dates of payment, insurance company

unilateral offsetting claims will reduce the medical facility of the

the amount of the remuneration for the employers of health care bill

presented in the following billing period.



(9) the remuneration margin provided by the paid health care, in compliance with the

the conditions stipulated in the contract, shall be made upon delivery of the Bill

the insurance company or on an electronic medium in electronic form within 30

calendar days and when you pass the Bill the insurance company on paper

documents within 50 calendar days from the date of receipt of the invoice to the insurance undertaking,

unless the contracting parties otherwise. Payment deadline is not respected,

If a payment on the last day of the period is credited to the account of the medical

the device.



(10) In the case of computing system, preventing the timely

the implementation of the Bill or of the remuneration paid by health care, provide

insurance medical facility within the agreed time of payment advance

in the amount of average monthly volume reported by the health care

calculated from the last calendar quarter of two closed, if

the Contracting Parties agree otherwise in a given case.



Article 5



Check



(1) the insurance undertaking in accordance with section 42 of the Act and the Treaty control

the use and provision of paid health care in its volume and

quality, including compliance with the prices charged by health insurance company, and it

through its information system, audit practitioners and other

professional health care workers, eligible for the review activities

(hereinafter referred to as "professionals").



(2) in the framework of their competence review doctors and specialist

staff permissions to control whether the method shall be considered paid

health care was indicated with regard to the State of health of the insured person, the

in accordance with the current available knowledge of medical science and has not been

unnecessarily economically challenging.



(3) in the cases provided for by the legislation of the auditing physician assesses and

the rationale for treating physician proposed or carried out by the

a treatment procedure and approved, whether the procedure used the insurance company will pay.

The decision to use treatment, including drug therapy, is in

the competence of the physician.



(4) a medical facility shall provide to the insurance undertaking in the performance of the checks

the necessary assistance, in particular submitted required documents, shall be communicated

data and provides explanations. The review will allow doctors and expert

workers insurance companies access to its object, the inspection

medical documentation in accordance with the particular legal

Regulation ^ 13) and other documents directly related to the

by checking the charged health, pharmaceuticals and

medical devices, including a particularly charged drug and especially

the posted material.



(5) in the case of inspections (investigation) in the medical device will be on

the site handled a record indicating the most important findings and

the opinions of the medical device. This entry does not replace a message

in accordance with paragraph 6.



(6) a report containing the conclusions of the inspection, the insurance company will process and transmit

medical device within 15 calendar days after the completion of the inspection;

If not possible, for objective reasons, this deadline, notify the

the insurance company this fact to the medical facility. A check will be

completed normally within 30 calendar days of its initiation.



(7) the Medical device is authorized within 15 calendar days from the

taking over the control of the insurance company, in writing, the conclusion may submit reasoned objections. To

the opposition of the insurance undertaking shall inform the opinion within 30 calendar days of their

delivery. If not possible, for objective reasons, these deadlines,

can be used at the request of the competent contracting party to extend to the double.

The insurance company shall inform in due time the medical device to determine whether

confirms or alters the conclusions of the inspection. The opposition has in terms of

financial claims against the insurance company's medical device suspensory

effect. This does not prejudice the right of the medical device to

disagreement with the decision of the insurance undertaking in other proceedings.



(8) if the check shows the unlawfulness or incorrectness of the statement

paid for by the health care or her unjustified provision, insurance company

According to § 42 paragraph 3 of the Act, such care does not pay and is entitled to

follow the penalty arrangements referred to in the Treaty. In the event that the

the conclusions of the inspection they prove unjustified, the insurance company

medical devices the amount on the basis of checks decreased

reimbursement provided paid health care. Medical equipment is

entitled to proceed under penalty arrangements referred to in the Treaty.



Article 6 of the



Penalty arrangements



(1) the Contracting Parties for non-compliance with contractual obligations and infringement of

the contracts referred to in paragraph 2 or of other reasons stipulated in the contract

can negotiate a contractual penalty and its amount.



(2) for breach of contract shall be the cases when



and) Contracting Party



1. the false, incomplete or misleading information in the conclusion

of the Treaty, or in its implementation,



2. fail to comply with the provisions of the Treaty, with the consequence of the proven neúčelného

expending the resources of public health insurance,



3. fails to provide the information in the contract negotiated,



(b)) medical equipment



1. unlawfully or multiple charges to health care,



2. fails to provide the required reports resulting from the legislation of the

governing the public health insurance,



3. unreasonably delay has provided paid health care,



4. repeatedly violated the obligation to report to the insurance undertaking in accordance with § 55

law, injuries or other damage to the health of the insured person caused by an act

legal or natural person,



(c) the insurance company)



1. the payment shall be reduced or refused unjustifiably provided paid health

care,



2. carries out the payment lawfully made provided paid health

care with the delay, except in cases where it is not responsible for the delay.



(3) the application of a sanction shall not affect the right of Contracting Parties to return

remuneration for improperly or incorrectly vyúčtovanou and paid paid

health care.



Article 7



The period of application, the method and the reasons for the termination of the contract



The contract is concluded for a period of 5 years, unless otherwise agreed by the Contracting Parties

otherwise.



Article 8 of the
The contract or its part shall lapse:



and the day) took the decision on the cancellation of registration under

Act No. 160/1992 Coll., on health care in non-State medical

establishments, as amended, or repealed or

change the formation of the Charter, issued by the medical devices



(b) on the date of demise) of medical equipment or the insurance company or the date of death

natural persons, which was the operator of medical equipment,



(c)) of the date specified in the written notice to the insurance company, if the medical

devices from major health or operational reasons cannot health

continue to provide care,



d) date on which the medical facility lost its factual, technical or

personnel prerequisites for the provision of health care within the agreed

the extent provided for by law or the contract, within the meaning of article. 3

paragraph. 2 (a). and medical equipment), if the deficiencies did not

After subsequently set a reasonable time limit; the contract or its part

expires only in part defining the scope of the contracted health care in

which medical equipment does not comply with the law or the contract

set assumptions, unless it was so severe the circumstances for which

You cannot expect a further performance of the contract in its entirety.



Article 9



Before the expiry of the agreed period, you can terminate the agreement upon written notice to the

notice period of five months, which begins the first day of the month

following the delivery of the notification to the other Contracting Party, in the event that the



and) Contracting Party



1. the stated in the conclusion of the contract or the performance of other Contracting

in a mistake in the things essential to the performance of the contract,



2. in contractual relations, the rough way infringed the obligation to a major

saved it to the competent legislation on public health

insurance or health care, or the provision of the Treaty,



3. repeated breach of an obligation arising out of section 41 of the Act,



4. enter into liquidation or on its property, the Court will declare bankruptcy,



(b)) medical equipment



1. without prior agreement with the insurance company for no reason does not provide health

care within the agreed scope and quality,



2. through the written warning without previous agreement with the insurance company repeatedly

charges care provided in excess of the stipulated kind,

expertise and scope of activities,



3. through written notice to the insured person unreasonably limits the

insurance companies opening period, about which medical equipment insurance

informed,



4. provides health care without adequate substantive and technical

equipment and staffing,



5. proven does not provide the insured health care quality and "lege

Artis ", or repeatedly refuses to provide health care from other,

than the statutory reasons,



6. calls, in conflict with the law from policy holders financial reimbursement

for health care paid for by the insurance company or the policyholder for the adoption of the

care,



7. a written warning over proven repeatedly wrongly charged

health care,



8. does not provide the necessary assistance for the performance of control activities

carried out by the insurance company in accordance with the law,



(c) the insurance company)



1. through the written warning repeatedly illegally fail to pay

the medical equipment provided paid health care,



2. through the written warning repeatedly fails to meet payment deadlines

agreed in the contract,



3. through the written warning repeatedly exceeds the range of the control

the activities provided for by law,



4. provide the third party data on medical devices above and beyond

the law or the contract.



Article 10



Before the expiry of the agreed period, you can terminate the contract:



and if so) lays down the law



(b)) a written agreement of the Contracting Parties under the conditions and within the time limit

referred to in this agreement.



Article 11



Mutual communication of information and transmission of documents necessary for the verification of compliance with

of the Treaty



(1) the Contracting Parties:



and) use to uniquely identify the medical equipment, in

accordance with the methodology, the organization identification number (IČ), identification

device number (IČZ), the identification number of the workplace (IČP)



(b) shall communicate the information required's) to check the performance of the contract,



(c)) shall ensure the availability of information on the existence of a contractual relationship,



d) may pass the information necessary to assess the quality and effectiveness of

provided paid health care, to the extent and under the conditions

stipulated in the contract.



(2) medical device:



and the insurance company shall, when) about suspected non-compliance procedure

"lege artis", that medical devices have been in the provision of paid

health care used in accordance with the special law of ^ 14)



(b)) shall immediately notify, not later than 30 calendar days, the other Contracting

side of the facts, which would substantially affect the implementation of the

the contract, for example. the emergence of computer system faults, changes to the data referred to

in the contract, if the



1. cancellation of the workplace or the part thereof without compensation, or

conclusion for more than 30 calendar days,



2. to leave the employee – the wearer power namely referred to in

the Treaty,



3. the failure of the instruments necessary for the implementation of performance without compensation on the

For more than 30 calendar days.



The late fulfilment of obligations deriving from paragraph 1(b). 2 (a). (b))

the article or their failure to comply shall be deemed a material breach of the contract

obligations.



(3) the insurance company



and) can provide a medical facility in the generalized form of the information

needed to developing its activities or to his scientific and research

activities and to control the quality of health care provided by employers, and it

to the extent and under the conditions stipulated in the contract,



(b)) may publish on its website within the list of

medical device trade name or business name and address of the medical

his expertise and equipment, telephone, or e-mail links or

For more information of mutually agreed,



Article 12



Resolution of disputes



(1) the Contracting Parties shall resolve any disputes relating to the implementation of the

the Treaty primarily by negotiation representatives of the parties, and that

as a general rule within 14 calendar days from the challenges of one of the Contracting Parties.

If there is no agreement between them, the issues discussed in the

the conciliation negotiations. This does not affect the right of Contracting Parties to apply their

entitled to dispute in court or in arbitration proceedings under the Special

^ law 15), if the Contracting Parties on the settlement of disputes in

arbitration agree in the contract.



(2) the conciliation negotiations suggests one of the Contracting Parties. The proposal must

contain accurate and sufficiently detailed definition of the dispute. A participant in the

the conciliation negotiations is the Contracting Party that submitted the proposal for the consideration of the

the dispute, a Contracting Party that is a proposal for the consideration of the dispute addressed to,

the representative of the relevant group of medical facilities

represented their interest associations ^ 16) under section 17 (3)

the law and the representative of the insurance company. To discuss the dispute, each Contracting

Party may invite a maximum of two professional adviser. The conciliation negotiations with the

terminates the registration, containing a settlement or the conclusion that the conflict has not been removed

with an indication of the opinions of both parties.



1) Act No. 48/1997 Coll., on public health insurance, as amended by

amended.



Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Law No 160/1992 Coll., on health care in non-State medical

establishments, as amended.



2) Act No. 551/1991 Coll., on general health insurance company, in the text of the

amended.



Law No. 280/1992 Coll., on departmental, industry, corporate, and other

health insurance, as amended.



3) Council Regulation (EEC) No 1408/71 and 574/72.



4) Eg. Communication from the Ministry of Foreign Affairs No. 130/2002 SB., m.s.,

the negotiation of a Treaty between the Czech Republic and the Federal Republic of

Yugoslavia on social security,



Communication from the Ministry of Foreign Affairs No. 83/2000 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Croatia on the social

security, communication from the Ministry of Foreign Affairs No. 135/2004

Coll., on negotiation of the m.s. Treaty between the Czech Republic and the Turkish

Republic on social security.



5) section 10 of Act No. 526/1990 Coll., on prices, as amended.



6) Law No. 101/2000 Coll., on protection of personal data and on amendments to certain

laws, as amended.



7) Act No. 435/2004 Coll., on employment, as amended,

regulations.



8) Law No. 95/2004 Coll., on conditions for the acquisition and recognition of professional

competence and specialized competence to perform medical

the professions of doctor, dentist and pharmacist.



Law No 96/2004 Coll., on conditions for the acquisition and recognition of competence to

the exercise of paramedical professions and to pursue activities

related to the provision of health care and to change some of the

related laws.



9) Decree No. 49/1993 Coll., on technical and substantive requirements

equipment of medical devices, as amended.



10) Act No. 20/1966 Coll. on health care of the people, as amended
regulations.



Decree No 385/2006 Coll., on the medical documentation, as amended by the Decree of the

No 479/2006 Sb.



11) Decree No. 343/1997 Coll., laying down the method of prescribing

medicinal products, the particulars of medical regulations and the rules of their

of use, as amended.



12) Act No. 563/1991 Coll., on accounting, as amended.



13) § 67 b) of Act No. 20/1966 Coll., on the health care of the people, in the text of the

amended.



for example, law No 14) 123/2000 Coll., on medical devices and on

changes to some related laws, as amended.



15) Act No. 216/1994, Coll., on arbitration proceedings and enforcement of arbitral

the findings, in the wording of Act No. 245/2006.



16) Act No. 83/1990 Coll. on Association of citizens, as amended

regulations.



§ § 20f and subs. Act No. 40/1964 Coll., the civil code, as amended by

amended.



Annex 4



Framework contract for health care facilities providing health care in

hospitals, specialised therapeutic institutes, specialized children's hospitals

and ozdravovnách and hospitals for long-term patients and health insurance companies



THE FIRST PART OF THE ANNEX



General provisions



Article 1



Contractual relations



(1) a framework agreement lays down the conditions under which the contract is concluded

between the health establishments providing health care in

hospitals, specialised therapeutic institutes, specialized children's hospitals

and ozdravovnách and hospitals for long-term patients and insurance companies, and under the

to ensure the provision of contributions in kind and cover when paid

health care ^ 1).



(2) the legal relationships in the contract concluded between the

insurance ^ 2), and medical devices shall not deviate from the

the provisions of the framework contract in accordance with this Ordinance, with the exception of those

provisions, for which such a possibility this framework contract expressly

lists.



PART TWO OF THE ANNEX TO



Of the Treaty



Article 2



Conclusion of contracts



(1) the legal relationship between the insurance company and medical facilities is governed by the

a written contract concluded under this framework contract, legal

the rules governing the public health insurance and the provision of

health care, and even in the case where the undertaking fulfils the role of a temporary

institutions in the implementation of the rights of the European Union ^ 3) or on the basis of the

international agreements on social security concluded by the Czech

Republic ^ 4). In matters not regulated by these laws and regulations and

the contract shall be governed by the commercial code.



(2) the basic condition for the conclusion of a contract is the permission of the medical

the equipment for the provision of health care in the field.



(3) the contract contains the



and) the rights and obligations of the Contracting Parties,



(b) the quality and effectiveness of the) conditions of the provision of health care, in particular

the kind, scope, and extent of health care provided by the specified list of

performance with point values according to the types of care, which is a medical

the device shall be entitled to provide, including substantive and technical equipment and

staffing, unless stated otherwise, legislation



c) catchment area (territory for which the medical device ensures

health care); by determining the gravity of the territory shall not affect the freedom of choice

medical devices under section 11 (a). (b)) of the Act,



(d) point values) ^ 5), the amount of the reimbursement paid by health care and regulatory

limitation of the volume of paid health care provided in accordance with the Decree

issued under section 17, paragraph. 6 of the Act,



(e) implementation of the remuneration provided by) the way of health care, including the establishment of

the terms of the statement,



(f)) the conditions required to check the performance of the contract, including the accuracy and

the legitimacy of the posted amounts



g) range and the way the mutual communication of the information necessary to check the

performance of the contract,



h) provisions on the resolution of conflicts in the course of the negotiations, where appropriate, the provisions of

about the use of arbitration,



I) provisions on the acceptance of and compliance with the agreed procedure for

acquisition, transmission and evaluation of documents in accordance with the methodology,

rules and uniform data interface, produced by the universal

health insurance in the Czech Republic in cooperation with the representatives of

insurance companies and representatives of professional associations of health care providers

and issued a general health insurance company in the Czech Republic, the applicable

at the time of conclusion of the contract,



j) provisions on how to get started with any medical facility

changes to the methodology and rules, including the method of transmission of these changes.



(4) the contract may also contain other arrangements necessary for the implementation and

check if they are in accordance with this agreement and the legal framework

provisions.



Article 3 of the



The rights and obligations of the parties



(1) the Contracting Parties



and when reporting and shall comply with), payment of paid health care agreed

the methodology, rules and data interface; the contract shall specify the version number

at the time of conclusion of the contract,



(b) undertake their employees) with regard to the protection of the rights of insured persons, to the

maintaining the confidentiality of the personal data required ^ 6) and facts

which to learn in the performance of their duties or employment or in

processing of data from the information system on the basis of the Treaty, or of the

connection with a ^ 2).



(2) medical equipment



and provides paid health care) in accordance with the legislation in

proficiency and the extent of the agreed and defined in the Treaty, for which the

It is factually and technically equipped and staffed to ensure



(b)) provides health care paid for by the insured from the EU under the same

conditions as to the insured the insurance company, in the range from applicants

documents, so as to avoid discrimination or preference

in particular, when taking on operations and other medical procedures, which are

waiting, even in the event that the beneficiary from the EU, responsibility for health care in the

cash. This care is, however, reported, and charge your paid

separately, separate from the health care provided to the insured

the insurance undertaking,



(c)) is responsible for the fact that his staff ^ 7), who will be insured

provide in the contract negotiated paid health care, meet the

the requirements laid down by law for the performance of this activity ^ 8),



(d)) is responsible for the implementation of the substantive and technical conditions laid down for the

It provided health care under a special legal regulation, ^ 9),



e) provides health care paid for by the "lege artis" without excess

the cost, however, with a view to making the necessary diagnostic

or therapeutic effect was achieved with regard to individual health

the status of the insured person,



(f) the insured's hospitalisation) accepts only if required by the health

the State, usually on the recommendation of the attending physician,



(g)) will lead to eligibility made health care in

conclusive form of health documentation on the treatment of policyholders, in which

the performances will be recorded, on-demand made by the medical health care

including medical transportation, prescribed medicines and medical

resources and retained in her Inbox results requested and carried out

examination and treatment, in accordance with a special law ^ 10),



(h)) to ensure, in the case of the absence in the Treaty agreed the wearer

performance, the crowd another qualified holder performance and contract

agreed cases in an appropriate manner shall notify this fact to the

the insured and the insurance company,



I) to provide, in accordance with the legislation of the medical establishment,

which the insured person passes into the care or that the beneficiary's choice

the information needed to ensure continuity of health care and to avoid

duplicate the implementation of diagnostic and treatment procedures and acceptance

insured persons in the care of such information from the relevant device

require,



(j) adoption of the insured person to refuse) your care,



to the right of the insured person making the) freedom of choice of doctor, medical

equipment or the provision of health care paid for by any of the

registration fees or with various donations and granted

health care paid for by the insurance company will not be from the insured person, if it

did not result from legislation, to collect any financial remuneration,



(l) the right of the policyholder to making) the granting of paid health care

changing the insurance undertaking or in any other way,



It will not discriminate between insured m) of one or more insurance undertakings in

detriment of policyholders of insurance companies and worsen the availability

health care paid for by the insurance company a priority the provision of care

paid for by other means,



n) shall notify the insurance undertaking in accordance with section 55 of the Act injuries or other damage

the health of the persons who provided paid health care, if you have reason to

suspecting that they were caused by acts legal or natural person,



about) by the special legal regulation ^ 11) for the correct and complete

fill in the form of a recipe; also responsible for the correct and complete filling

voucher for medical devices or voucher to the examination/treatment

or to the medical transport. When prescribing was not

respected prescribing restrictions arising from legislation and the

undertaking this medicinal product equipment pharmaceutical treatments, has
the insurance company the right to demand remuneration paid by medical device

of the amount,



p) showing when concluding a contract with an insurance company proof of insurance

liability for damage caused to citizens in connection with the provision

health care and will be insured for the entire duration of the contractual relationship with the

the insurance company.



(3) the insurance company



and will pay the medical facility) made paid health care,

clearly documented and reasonably provided to the insured and the

insurance policy holders in the EU, who have the insurance company selected as the institution of manner

in the implementation of the rights of the European Union ^ 3) in accordance with the law and

the Treaty,



(b)), on request, sees therapeutic equipment without undue delay

the jurisdiction of the insured person to the insurance undertaking in cases where it is not available

insurance card and his personal data are available,



(c)) will not require preferential treatment of their policyholders at the expense of policyholders

other insurance companies,



(d)) is authorised to control compliance with the contractually agreed payment in kind and

technical conditions and contractually agreed staffing

paid for by the health care provided by the medical facility under

of the Treaty,



e) provides medical equipment to ensure uniform conditions

the agreed methodology, rules, data interface and the appropriate dials

issued by the general health insurance company for reporting and calculation of the remuneration

paid for by the health care



(f) medical device with familiar) the agreed changes to the methodology,

rules and with the changes at least one month and the dials with the change

the data interface at least two months before the date of their

the validity of. In the case of changes to the legislation, which does not allow this period

keep, can be referred to commensurately reduced.



Article 4 of the



Remuneration provided paid health care



(1) the value of the point ^ 5) for health care paid for by the performance,

the amount of the reimbursement paid by health care and regulatory restrictions on the volume of provided

paid health care under section 17, paragraph. 6 of the Act is given in the appendix to the

the Treaty under special legislation. In the children's ozdravovnách

remuneration provided to paid care arranged Appendix to the Treaty in accordance

with a valid price Výměrem of the Ministry of finance for the relevant period.



(2) methods of payment shall be considered as:



and health) payment for performances by the health interventions with

point values



(b) the flat-rate payment for provided) health care,



(c)) the remuneration for the registered clients (combined kapitačně power

payment),



d) payment for diagnozu,



(e) the flat-rate payment for provided) care in the children's ozdravovnách, in

accordance with the Výměrem of the Ministry of finance, published in

The price of the journal of the Ministry of finance, or



(f) any other agreed method of payment).



(3) Between the parties must always be agreed in advance to increase or

the reduction of the volume of provided paid health care due to changes

capacities, or changes in the structure of the medical facility or rehabilitation

Instrumentation as specified in the contract.



(4) medical equipment for the filing of claims for reimbursement provided

paid for by the health care bill passes the insurance company once a month

care provided an invoice with attachments, if the Contracting Parties

agree on passing the Bill over a longer period. The invoice contains

Essentials of accounting document ^ 12). The essentials of the annex are contained in the

the methodology or in accordance with the methodology shall specify in the contract. In the case of

that the invoice does not contain particulars of the accounting document and annex does not contain

requirements of the agreed methodology or a contract, an insurance undertaking has the right to

reject it and return without undue delay the medical device to

complement, where appropriate, to correct; in this case, the running period of maturity

to date her repossess the insurance company.



(5) the Medical device is responsible for the completeness, formal and factual

the accuracy of the documents and their transfer in the manner agreed in the methodology

and data interface. Documents for paid care provided

the insured the insurance companies and the insured from the EU, who have chosen the insurance company's

as the institution of manner in the implementation of the rights of the European Union ^ 3), passes

medical devices, together with a breakdown of the insurance undertaking in the term and

in the manner agreed in the contract (or on an electronic medium in

electronic form or on paper).



(6) where the insurance company billing before payment incorrectly

or vyúčtovanou care, reimbursement of that part of the increase in care

the term to maturity. The insurance company provable way shall notify the

medical devices range without undue delay, the reason for and amount of the

made, but outstanding care. The insurance company will invite medical

a device to repair improperly accounted for care or to support the provision of

paid health care. Duly granted and vyúčtovanou care insurance company

will pay in the next term.



(7) the insurance company performs for its clients and policyholders, who the EU

the insurance company selected as the institution of manner in the implementation of the rights of

The European Union ^ 3), the reimbursement of paid health care, accounted in accordance with the

the law and the contract. If on verification finds errors in the

documents, in accordance with the methodology and rules. Denial of payment or

part of the payment the insurance company without undue delay, medical devices

justify in writing. By providing a payment shall not prejudice the right of an insurance undertaking to

the implementation of subsequent checks paid the Bill to the extent and for the

the conditions laid down by the legislation and the contract.



(8) where the insurance company misconduct in the Bill submitted to the medical

Additionally, i.e. the device. After payment and medical equipment to 10

working days from the receipt of the written call the insurance company the amount

itself does not settle, or they can demonstrate the legitimacy of the disputed amount charged or

not unless otherwise agreed between the Contracting Parties, dates of payment, insurance company

unilateral offsetting claims within the meaning of a specific legal

Regulation (§ § 580 and 581 of the Civil Code) will reduce the medical

the device of the appropriate amount of remuneration for the Bill paid by the health

care submitted the following billing period. as regards set-off

the claim against the State is permissible only on the basis of the agreement (section 42 (2)

from No 219/2000 Sb.)



(9) the remuneration margin provided by the paid health care, in compliance with the

the conditions stipulated in the contract, shall be made upon delivery of the Bill

the insurance company or on an electronic medium in electronic form within 30

calendar days and when you pass the Bill the insurance company on paper

documents within 50 calendar days from the date of receipt of the invoice to the insurance undertaking,

unless the contracting parties otherwise. Payment deadline is not respected,

If a payment on the last day of the period is credited to the account of the medical

the device.



(10) in the event of failure of the system, preventing the timely calculation

the implementation of the Bill or of the remuneration paid by health care, provide

insurance medical facility within the agreed time of payment advance

in the amount of average monthly volume reported by the health care

calculated from the last calendar quarter of two closed, if

the Contracting Parties agree otherwise in a given case.



Article 5



Check



(1) the insurance undertaking in accordance with section 42 of the Act and the Treaty control

the use and provision of paid health care in its volume and

quality, including compliance with the prices, through its information

system, audit practitioners and other professional workers in

health, eligible for the review activities (hereinafter referred to as "professional

workers ").



(2) in the framework of their competence review doctors and specialist

staff permissions to control whether the method shall be considered paid

health care was indicated with regard to the State of health of the insured person, the

in accordance with the current available knowledge of medical science and has not been

unnecessarily economically challenging.



(3) in the cases provided for by the legislation of the auditing physician assesses and

the rationale for treating physician proposed or carried out by the

a treatment procedure and approved, whether the procedure used the insurance company will pay.

The decision to use a treatment procedure, including Pharmacotherapy, is in

the competence of the physician.



(4) a medical facility shall provide to the insurance undertaking in the performance of the checks

the necessary assistance, in particular submitted required documents, shall be communicated

data and provides explanations. The review will allow doctors and expert

workers insurance companies access to its object, the inspection

medical documentation in accordance with the particular legal

Regulation ^ 13) and other documents directly related to the

by checking the charged health, pharmaceuticals and

medical devices, including a particularly charged drug and especially

the posted material.



(5) in the case of inspections (investigation) in the medical device will be on

the site handled a record indicating the most important findings and

the opinion of the worker's medical facilities present control.
This entry does not replace the report under paragraph 6.



(6) a report containing the conclusions of the inspection, the insurance company will process and transmit

medical device within 15 calendar days after the completion of the inspection;

If not possible, for objective reasons, this deadline, notify the

the insurance company this fact to the medical facility. A check will be

completed normally within 30 calendar days of its initiation.



(7) the Medical device is authorized within 15 calendar days from the

taking over the control of the insurance company, in writing, the conclusion may submit reasoned objections. To

the opposition of the insurance undertaking shall inform the opinion within 30 calendar days of their

delivery. If not possible, for objective reasons, these deadlines,

the relevant time limit shall be extended up to twice. Within the time limit

the insurance undertaking shall inform the medical device to determine whether it confirms or modifies

conclusions of the inspection. The opposition has in terms of financial claims

insurance against medical device have suspensive effect. This is not a

without prejudice to the right of the medical device to apply its disagreement with the

by the decision of the insurance undertaking in other proceedings.



(8) if the check shows the unlawfulness or incorrectness of the statement

paid for by the health care or her unjustified provision, insurance company

According to § 42 paragraph 3 of the Act, such care does not pay and is entitled to

follow the penalty arrangements referred to in the Treaty. In the event that the

the conclusions of the inspection they prove unjustified, the insurance company

medical devices the amount on the basis of checks decreased

reimbursement provided paid health care. Medical equipment is

entitled to proceed under penalty arrangements referred to in the Treaty.



Article 6 of the



Penalty arrangements



(1) the Contracting Parties for non-compliance with contractual obligations and infringement of

the contracts referred to in paragraph 2 or of other reasons stipulated in the contract

can negotiate a contractual penalty and its amount.



(2) for breach of contract shall be the cases when



and) Contracting Party



1. the false, incomplete or misleading information in the conclusion

of the Treaty, or in its implementation,



2. fail to comply with the provisions of the Treaty, with the consequence of the proven neúčelného

expending the resources of public health insurance,



3. fails to provide the information in the contract negotiated,



(b)) medical equipment



1. unlawfully or multiple charges to health care,



2. fails to provide the required reports resulting from the legislation of the

governing the public health insurance,



3. unreasonably delay has provided paid health care,



4. repeatedly violated the obligation to report to the insurance undertaking in accordance with § 55

law, injuries or other damage to the health of the insured person caused by an act

legal or natural person,



(c) the insurance company)



1. the payment shall be reduced or refused unjustifiably provided paid health

care,



2. carries out the payment lawfully made provided paid health

care with the delay, except in cases where it is not responsible for the delay.



(3) the application of a sanction shall not affect the right of Contracting Parties to return

remuneration for improperly or incorrectly vyúčtovanou and paid paid

health care.



Article 7



The period of application, the method and the reasons for the termination of the contract



The contract is concluded for a period of 5 years, unless otherwise agreed by the Contracting Parties

otherwise.



Article 8 of the



The contract or its part shall lapse:



and the day) took the decision on the cancellation or change

registration or part thereof pursuant to Act No. 160/1992 Coll., on health

care in non-State health establishments, as amended

regulations, or to cancel or change of activity referred to in

founding Charter, issued by the medical devices



(b) on the date of demise) of medical equipment or the insurance company or the date of death

natural persons, which was the operator of medical equipment,



(c)) of the date specified in the written notice to the insurance company, if the medical

equipment for operational reasons cannot continue to provide health care,



d) date on which the medical facility lost its factual, technical or

personnel prerequisites for the provision of health care within the agreed

the extent provided for by law or the contract, within the meaning of article. 3

paragraph. 2 (a). and medical equipment), if the deficiencies did not

After subsequently set a reasonable time limit; the contract or its part

expires only in part defining the scope of the contracted health care in

which medical equipment does not comply with the law or the contract

set assumptions, unless it was so severe the circumstances for which

You cannot expect a further performance of the contract in its entirety.



Article 9



Before the expiry of the agreed period, you can terminate the agreement upon written notice to the

notice period of five months, which begins the first day of the month

following the delivery of the notification to the other Contracting Party, if in

as a result of serious circumstances cannot reasonably expect more performance

of the Treaty, and that, in the event that the



and) Contracting Party



1. the stated in the conclusion of the contract or the performance of other Contracting

in a mistake in the things essential to the performance of the contract,



2. in contractual relations, the rough way infringed the obligation to a major

saved it to the competent legislation on public health

insurance or health care, or the provision of the Treaty,



3. repeated breach of an obligation arising out of section 41 of the Act,



4. enter into liquidation or on its property, the Court will declare bankruptcy,



(b)) medical equipment



1. without prior agreement with the insurance company for no reason does not provide health

care within the agreed scope and quality,



2. through the written warning without previous agreement with the insurance company repeatedly

charges care provided in excess of the stipulated kind,

expertise and scope of activities,



3. through written notice to the insured person unreasonably limits the

insurance companies opening period agreed in the contract,



4. provides health care without adequate substantive and technical

equipment and staffing,



5. proven does not provide the insured health care quality and "lege

Artis ", or repeatedly refuses to provide health care from other,

than the statutory reasons,



6. calls, in conflict with the law from policy holders financial reimbursement

for health care paid for by the insurance company or the policyholder for the adoption of the

care,



7. a written warning over proven repeatedly wrongly charged

health care,



8. does not provide the necessary assistance for the performance of control activities

carried out by the insurance company in accordance with the law,



(c) the insurance company)



1. through the written warning repeatedly illegally fail to pay

the medical equipment provided paid health care,



2. through the written warning repeatedly fails to meet payment deadlines

agreed in the contract,



3. through the written warning repeatedly exceeds the range of the control

the activities provided for by law,



4. provide the third party data on medical devices above and beyond

the law or the contract.



Article 10



Before the expiry of the agreed period, you can terminate the contract



and if so) lays down the law



(b)) a written agreement of the Contracting Parties under the conditions and within the time limit

referred to in this agreement.



Article 11



Mutual communication of information and transmission of documents necessary for the verification of compliance with

of the Treaty



(1) the Contracting Parties



and) use to uniquely identify the medical equipment, in

accordance with the methodology, the organization identification number (IČ), identification

device number (IČZ), the identification number of the workplace (IČP)



(b) shall communicate the information required's) to check the performance of the contract,



(c)) shall ensure permanently accessible and clear information on the existence of a contractual

the relationship and the rights arising from it for the insured person,



d) may pass the information necessary to assess the quality and effectiveness of

provided paid health care, to the extent and under the conditions

stipulated in the contract.



(2) medical equipment



and the insurance company shall, when) about suspected non-compliance procedure

"lege artis", that medical devices have been in the provision of paid

health care used in accordance with the special law of ^ 14)



(b)) shall immediately notify, not later than 30 calendar days, the other Contracting

side of the facts, which would substantially affect the implementation of the

the contract, for example. the emergence of computer system faults, changes to the data referred to

in the contract, if the



1. cancellation of the workplace or the part thereof without compensation, or

conclusion for more than 30 calendar days,



2. to leave the employee specifically referred to in the Treaty,



3. the failure of the instruments necessary for the implementation of performance without compensation on the

For more than 30 calendar days.



Failure to comply with the obligations referred to in points (a) or (b))), or late

compliance with the obligations referred to in point (a) (b)), it is considered a serious

breach of contractual obligations.



(3) the insurance company



and) can provide a medical facility in the generalized form of the information

needed to developing its activities or to his scientific and research

activities and to control the quality of health care provided by employers, and it

to the extent and under the conditions stipulated in the contract,



(b)) may publish on its website within the list of
medical device trade name or business name and address of the medical

his expertise and equipment, telephone, or e-mail links or

For more information of mutually agreed.



Article 12



Resolution of disputes



(1) the Contracting Parties shall resolve any disputes relating to the implementation of the

the Treaty primarily by negotiation representatives of the parties, and that

as a general rule within 14 calendar days from the challenges of one of the Contracting Parties.

If there is no agreement between them, the issues discussed in the

the conciliation negotiations. This does not affect the right of Contracting Parties to apply their

entitled to dispute in court or in arbitration proceedings under the Special

^ law 15), if the Contracting Parties on the settlement of disputes in

arbitration agree in the contract.



(2) the conciliation negotiations suggests one of the Contracting Parties. The proposal must

contain accurate and sufficiently detailed definition of the dispute. A participant in the

the conciliation negotiations is the Contracting Party that submitted the proposal for the consideration of the

the dispute, a Contracting Party that is a proposal for the consideration of the dispute addressed to,

the representative of the relevant group of medical facilities

represented their interest associations ^ 16) under section 17 (3)

the law and the representative of the insurance company. To discuss the dispute, each Contracting

Party may invite a maximum of two professional adviser. The conciliation negotiations with the

terminates the registration, containing a settlement or the conclusion that the conflict has not been removed

with an indication of the opinions of both parties.



1) Act No. 48/1997 Coll., on public health insurance, as amended by

amended.



Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Law No 160/1992 Coll., on health care in non-State medical

establishments, as amended.



2) Act No. 551/1991 Coll., on general health insurance company, in the text of the

amended.



Law No. 280/1992 Coll., on departmental, industry, corporate, and other

health insurance, as amended.



3) Council Regulation (EEC) No 1408/71 and 574/72.



4) Eg. Communication from the Ministry of Foreign Affairs No. 130/2002 SB., m.s.,

the negotiation of a Treaty between the Czech Republic and the Federal Republic of

Yugoslavia on social security,



Communication from the Ministry of Foreign Affairs No. 83/2000 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Croatia on the social

Security



Communication from the Ministry of Foreign Affairs No. 135/2004 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Turkey on the social

Security.



5) section 10 of Act No. 526/1990 Coll., on prices, as amended.



6) Law No. 101/2000 Coll., on protection of personal data and on amendments to certain

laws, as amended.



7) Act No. 435/2004 Coll., on employment, as amended,

regulations.



8) Law No. 95/2004 Coll., on conditions for the acquisition and recognition of professional

competence and specialized competence to perform medical

the professions of doctor, dentist and pharmacist.



Law No 96/2004 Coll., on conditions for the acquisition and recognition of competence to

the exercise of paramedical professions and to pursue activities

related to the provision of health care and to change some of the

related laws.



9) Decree No. 49/1993 Coll., on technical and substantive requirements

equipment of medical devices, as amended.



10) Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Decree No 385/2006 Coll., on the medical documentation, as amended by the Decree of the

No 479/2006 Sb.



11) Decree No. 343/1997 Coll., laying down the method of prescribing

medicinal products, the particulars of medical regulations and the rules of their

of use, as amended.



12) Act No. 563/1991 Coll., on accounting, as amended.



13) § 67 b) of Act No. 20/1966 Coll., on the health care of the people, in the text of the

amended.



for example, law No 14) 123/2000 Coll., on medical devices and on

changes to some related laws, as amended.



15) Act No. 216/1994, Coll., on arbitration proceedings and enforcement of arbitral

the findings, in the wording of Act No. 245/2006.



16) Act No. 83/1990 Coll. on Association of citizens, as amended

regulations.



§ § 20f and subs. Act No. 40/1964 Coll., the civil code, as amended by

amended.



Annex 5



Framework contract for outpatient health care facilities providing

the diagnostic skill, care (222 801, 802, 804, 805, 807, 809, 812

up to 819, 822 and 823) ^ 1) and health insurance companies



THE FIRST PART OF THE ANNEX



General provisions



Article 1



Contractual relations



(1) a framework agreement lays down the conditions under which the contract is concluded

between the health establishments providing outpatient diagnostic

care (222 skill, 801, 802, 804, 805, 807, 809 to 812, 822 and 819,

823) ^ 1) and insurance companies, and to ensure that contributions in kind in the

the provision and payment of paid health care.



(2) the legal relationships in the contract concluded between the

insurance ^ 2), and medical devices shall not deviate from the

the provisions of the framework contract in accordance with this Ordinance, with the exception of those

provisions, for which such a possibility this framework contract expressly

lists.



PART TWO OF THE ANNEX TO



Of the Treaty



Article 2



Conclusion of contracts



(1) the legal relationship between the insurance company and medical facilities is governed by the

a written contract concluded under this framework contract, legal

the rules governing the public health insurance and the provision of

health care, and even in the case where the undertaking fulfils the role of a temporary

institutions in the implementation of the rights of the European Union ^ 3) or on the basis of the

international agreements on social security concluded by the Czech

Republic ^ 4). In matters not regulated by these laws and regulations and

the contract shall be governed by the commercial code.



(2) the basic condition for the conclusion of a contract is the permission of the medical

the equipment for the provision of health care in the field.



(3) the contract includes:



and) the rights and obligations of the Contracting Parties,



(b) the quality and effectiveness of the) conditions of the provision of health care, in particular

the kind, scope, and extent of health care provided by the specified list of

performance with point values according to the types of care, which is a medical

the device shall be entitled to provide, including substantive and technical equipment and

staffing,



(c) point values) ^ 5), the amount of the reimbursement paid by health care and regulatory

limitation of the volume of paid health care provided in accordance with the Decree

issued under section 17, paragraph. 6 of the Act,



(d) the implementation of the remuneration provided by) the way of health care,



(e)) the conditions required to check the performance of the contract, including the accuracy and

the legitimacy of the posted amounts



f) range and method of mutual communication of the information necessary to check the

performance of the contract,



(g)) the provisions on the resolution of conflicts in the course of the negotiations, where appropriate, the provisions of

about the use of arbitration,



(h) the period of application of the Treaty), the way and the reasons for her termination,



I) provisions on the acceptance of and compliance with the agreed procedure for

acquisition, transmission and evaluation of documents in accordance with the methodology,

rules and uniform data interface, produced by the universal

health insurance in the Czech Republic in cooperation with the representatives of

insurance companies and representatives of professional associations of health care providers

and issued a general health insurance company in the Czech Republic, the applicable

at the time of conclusion of the contract,



j) provisions on how to get started with any medical facility

changes to the methodology and rules, including the method of transmission of these changes.



(4) the contract may also contain other arrangements necessary for the implementation and

check if they are in accordance with this agreement and the legal framework

provisions.



Article 3 of the



The rights and obligations of the parties



1) the Contracting Parties:



and when reporting and shall comply with), payment of paid health care agreed

the methodology, rules and data interface; the contract shall specify the version number

at the time of conclusion of the contract,



(b) undertake their employees) with regard to the protection of the rights of insured persons, to the

maintaining the confidentiality of the personal data required ^ 6) and facts

which to learn in the performance of their duties or employment or in

processing of data from the information system on the basis of the Treaty, or of the

connection with a ^ 2).



2) medical device:



and provides paid health care) in accordance with the legislation in

proficiency and the extent of the agreed and defined in the Treaty, for which the

It is factually and technically equipped and staffed to ensure



(b)) provides health care paid for by the insured from the EU under the same

conditions as to the insured the insurance company, in the range from applicants

documents, so as to avoid discrimination or preference,

and even in the event that the beneficiary from the EU, responsibility for health care in the

cash,



(c)) is responsible for the fact that his staff ^ 7), who will be insured

provide in the contract negotiated paid health care, meet the

the requirements laid down by law for the performance of this activity ^ 8),



(d)) is responsible for this, that health care workers are paid
health care on the basis of the physician's Office,



(e)) is responsible for the implementation of the substantive and technical conditions laid down for the

It provided health care under a special legal regulation, ^ 9),



(f)) provides health care paid for by the "lege artis" without excess

the cost, however, with a view to making the necessary diagnostic

or therapeutic effect was achieved with regard to individual health

the status of the insured person,



(g)) is responsible for the effectiveness of the indication when sending the insured person to

complementary and konziliárním examination and, on the basis of their results

modifies the diagnosis or therapeutic procedure,



h) will lead to eligibility made health care in

conclusive form of health documentation on the treatment of policyholders, in which

the performances will be recorded, on-demand made by the medical health care

including health services, and kept in her Inbox results

requested and carried out examination and treatment, in accordance with a special

the law ^ 10),



I) shall ensure that, in the absence of an agreed in the contract holders

performance, the crowd another qualified holder performance and contract

agreed cases shall notify the insured and the insurance company,



j) shall provide in accordance with the law of medical facilities,

which the insured person passes into the care or that the beneficiary's choice

the information needed to ensure continuity of health care and to avoid

duplicate the implementation of diagnostic and treatment procedures, to refuse)

the adoption of the insured person to his care with the exception of the reasons listed in section 11

paragraph 1 (b)) of the Act,



(l) the right of the insured person making the) freedom of choice of doctor, medical

equipment or the provision of health care paid for by any of the

registration fees or with various donations and granted

health care paid for by the insurance company will not be from the insured person, if it

did not result from legislation, to collect any financial remuneration,



the right of the insured person making m) on the provision of paid health care

changing the insurance undertaking or in any other way,



n) other insurance and the availability of health care paid for by

the insurance company paid for senior care provision in another way,



notify the insurance undertaking) in accordance with section 55 of the Act injuries or other damage

the health of the persons who provided paid health care, if you have reason to

suspecting that they were caused by acts legal or natural person,



p) showing when concluding a contract with an insurance company proof of insurance

liability for damage caused to citizens in connection with the provision

health care and will be insured for the entire duration of the contractual relationship with the

the insurance company.



3) Insurance:



and will pay the medical facility) made paid health care,

clearly documented and reasonably provided to the insured and the

insurance policy holders in the EU, who have the insurance company selected as the institution of manner

in the implementation of the rights of the European Union ^ 3) in accordance with the law and

the Treaty,



(b)), on request, sees therapeutic equipment without undue delay

the jurisdiction of the insured person to the insurance undertaking in cases where it is not available

insurance card and his personal data are available,



(c)) will not require preferential treatment of their policyholders at the expense of policyholders

other insurance companies,



(d)) is authorised to control compliance with the contractually agreed payment in kind and

technical conditions and staffing financed by health care

provided by the medical establishment, under the Treaty,



e) provides medical equipment to ensure uniform conditions

the agreed methodology, rules, data interface and the appropriate dials

issued by the general health insurance company for reporting and calculation of the remuneration

paid for by the health care



(f) medical device with familiar) the agreed changes to the methodology,

rules and with the changes at least one month and the dials with the change

the data interface at least two months before the date of their

the validity of. In the case of changes to the legislation, which does not allow this period

keep, can be referred to commensurately reduced.



Article 4 of the



Remuneration provided paid health care



(1) the value of the point ^ 5) for health care paid for by the performance,

the amount of the reimbursement paid by health care and regulatory restrictions on the volume of provided

paid health care under section 17, paragraph. 6 of the Act is given in the appendix to the

the Treaty under special legislation.



(2) methods of payment shall be considered as:



and health) payment for performances by the health interventions with

point values



(b) the flat-rate payment for provided) health care, or



(c) any other agreed method of payment).



(3) Between the parties must always be agreed in advance to increase or

the reduction of the volume of provided paid health care due to changes

capacity, the structure of the medical equipment, changes or reconstruction

Instrumentation as specified in the contract.



(4) medical equipment for the filing of claims for reimbursement provided

paid for by the health care bill passes the insurance company once a month

care provided an invoice with attachments, if the Contracting Parties

agree on passing the Bill over a longer period. The invoice contains

Essentials of accounting document ^ 11) Requirements of the annex are contained in the

the methodology or in accordance with the methodology shall specify in the contract. In the case of

that the invoice does not contain particulars of the accounting document and annex does not contain

requirements of the agreed methodology or a contract, an insurance undertaking has the right to

reject it and return without undue delay the medical device to

complement, where appropriate, to correct; in this case, the running period of maturity

to date her repossess the insurance company.



(5) the Medical device is responsible for the completeness, formal and factual

the accuracy of the documents and their transfer in the manner agreed in the methodology

and data interface. Documents for paid care provided

the insured the insurance companies and the insured from the EU, who have chosen the insurance company's

as the institution of manner in the implementation of the rights of the European Union ^ 3), passes

medical devices, together with a breakdown of the insurance undertaking in the term and

in the manner agreed in the contract (or on an electronic medium in

electronic form or on paper).



(6) where the insurance company billing before payment incorrectly

or vyúčtovanou care, reimbursement of that part of the increase in care

the term to maturity. The insurance company provable way shall notify the

medical devices range without undue delay and the reason

made, but outstanding care. The insurance company will invite medical

a device to repair improperly accounted for care or to support the provision of

paid health care. Duly granted and vyúčtovanou care insurance company

will pay in the next term.



(7) the insurance company performs for its clients and policyholders, who the EU

the insurance company selected as the institution of manner in the implementation of the rights of

The European Union ^ 3), the reimbursement of paid health care, accounted in accordance with the

the law and the contract. If on verification finds errors in the

documents, in accordance with the methodology and rules. Denial of payment or

part of the payment the insurance company without undue delay, medical devices

justify in writing. By providing a payment shall not prejudice the right of an insurance undertaking to

the implementation of subsequent checks paid the Bill to the extent and for the

the conditions laid down by the legislation and the contract.



(8) where the insurance company misconduct in the Bill submitted to the medical

Additionally, i.e. the device. After payment and medical equipment to 10

working days from the receipt of the written call the insurance company the amount

itself does not settle, or they can demonstrate the legitimacy of the disputed amount charged or

not unless otherwise agreed between the Contracting Parties, dates of payment, insurance company

unilateral offsetting claims will reduce the medical facility of the

the amount of the remuneration for the employers of health care bill

presented in the following billing period.



(9) the remuneration margin provided by the paid health care, in compliance with the

the conditions stipulated in the contract, shall be made upon delivery of the Bill

the insurance company or on an electronic medium in electronic form within 30

calendar days and when you pass the Bill the insurance company on paper

documents within 50 calendar days from the date of receipt of the invoice to the insurance undertaking,

unless the contracting parties otherwise. Payment deadline is not respected,

If a payment on the last day of the period is credited to the account of the medical

the device.



(10) In the case of computing system, preventing the timely

the implementation of the Bill or of the remuneration paid by health care, provide

insurance medical facility within the agreed time of payment advance

in the amount of average monthly volume reported by the health care

calculated from the last calendar quarter of two closed, if

the Contracting Parties agree otherwise in a given case.



Article 5



Check



(1) the insurance undertaking in accordance with section 42 of the Act and the Treaty control

the use and provision of paid health care in its volume and
quality, including compliance with the prices, through its information

system, audit practitioners and other professional workers in

health, eligible for the review activities (hereinafter referred to as "professional

workers ").



(2) in the framework of their competence review doctors and specialist

staff permissions to control whether the method shall be considered paid

health care was indicated with regard to the State of health of the insured person, the

in accordance with the current available knowledge of medical science and has not been

unnecessarily economically challenging.



(3) in the cases provided for by the legislation of the auditing physician assesses and

the rationale for treating physician proposed or carried out by the

a treatment procedure and approved, whether the procedure used the insurance company will pay.



(4) a medical facility shall provide to the insurance undertaking in the performance of the checks

the necessary assistance, in particular submitted required documents, shall be communicated

data and provides explanations. The review will allow doctors and expert

workers insurance companies access to its object, the inspection

medical documentation in accordance with the particular legal

regulation ^ 12) and other documents directly related to the

by checking the charged health, pharmaceuticals and

medical devices, including a particularly charged drug and especially

the posted material.



(5) in the case of inspections (investigation) in the medical device will be on

the site handled a record indicating the most important findings and

the opinions of the medical device. This entry does not replace a message

in accordance with paragraph 6. The report, containing the conclusions of the inspection, the insurance company

processes and forwards the medical facility within 15 calendar days after the

their control; If not possible, for objective reasons, this time limit

to comply with the undertaking shall notify this fact to the medical facility.

The check will be completed normally within 30 calendar days from the

initiation.



(6) a report containing the conclusions of the inspection, the insurance company will process and transmit

medical device within 15 calendar days after the completion of the inspection;

If not possible, for objective reasons, this deadline, notify the

the insurance company this fact to the medical facility. A check will be

completed normally within 30 calendar days of its initiation.



(7) the Medical device is authorized within 15 calendar days from the

taking over the control of the insurance company, in writing, the conclusion may submit reasoned objections. To

the opposition of the insurance undertaking shall inform the opinion within 30 calendar days of their

delivery. If not possible, for objective reasons, these deadlines,

the relevant time limit shall be extended up to twice. Within the time limit

the insurance undertaking shall inform the medical device to determine whether it confirms or modifies

conclusions of the inspection. The opposition has in terms of financial claims

insurance against medical device have suspensive effect. This is not a

without prejudice to the right of the medical device to apply its disagreement with the

by the decision of the insurance undertaking in other proceedings.



(8) if the check shows the unlawfulness or incorrectness of the statement

paid for by the health care or her unjustified provision, insurance company

According to § 42 paragraph 3 of the Act, such care does not pay and is entitled to

follow the penalty arrangements referred to in the Treaty. In the event that the

the conclusions of the inspection they prove unjustified, the insurance company

medical devices the amount on the basis of checks decreased

reimbursement provided paid health care. Medical equipment is

entitled to proceed under penalty arrangements referred to in the Treaty.



Article 6 of the



Penalty arrangements



(1) the Contracting Parties for non-compliance with contractual obligations and infringement of

the contracts referred to in paragraph 2 or of other reasons stipulated in the contract

can negotiate a contractual penalty and its amount.



(2) for breach of contract shall be the cases when



and) Contracting Party



1. the false, incomplete or misleading information in the conclusion

of the Treaty, or in its implementation,



2. fail to comply with the provisions of the Treaty, with the consequence of the proven neúčelného

expending the resources of public health insurance,



3. fails to provide the information in the contract negotiated,



(b)) medical equipment



1. unlawfully or multiple charges to health care,



2. fails to provide the required reports resulting from the legislation of the

governing the public health insurance,



3. unreasonably delay has provided paid health care,



4. repeatedly violated the obligation to report to the insurance undertaking in accordance with § 55

law, injuries or other damage to the health of the insured person caused by an act

legal or natural person,



(c) the insurance company)



1. the payment shall be reduced or refused unjustifiably provided paid health

care,



2. carries out the payment lawfully made provided paid health

care with the delay, except in cases where it is not responsible for the delay.



(3) the application of a sanction shall not affect the right of Contracting Parties to return

remuneration for improperly or incorrectly vyúčtovanou and paid paid

health care.



Article 7



The period of application, the method and the reasons for the termination of the contract



The contract is concluded for a period of eight years, unless the parties have agreed

otherwise.



Article 8 of the



The contract or its part shall lapse:



and the day) took the decision on the cancellation or change

registration under Act No. 160/1992 Coll., on health care in non-State

medical devices, as amended, or to

cancellation or change of the provisioning of the Charter, issued by the medical devices



(b) on the date of demise) of medical equipment or the insurance company or the date of death

natural persons, which was the operator of medical equipment,



(c)) of the date specified in the written notice to the insurance company, if the medical

devices from major health or operational reasons cannot health

continue to provide care,



d) date on which the medical facility lost its factual, technical or

personnel prerequisites for the provision of health care within the agreed

the extent provided for by law or the contract, within the meaning of article. 3

paragraph. 2 (a). and medical equipment), if the deficiencies did not

After subsequently set a reasonable time limit; the contract or its part

expires only in part defining the scope of the contracted health care in

which medical equipment does not comply with the law or the contract

set assumptions, unless it was so severe the circumstances for which

You cannot expect a further performance of the contract in its entirety.



Article 9



Before the expiry of the agreed period, you can terminate the agreement upon written notice to the

notice period of five months, which begins the first day of the month

following the delivery of the notification to the other Contracting Party, if in

as a result of serious circumstances cannot reasonably expect more performance

of the Treaty, and that, in the event that the



and) Contracting Party



1. the stated in the conclusion of the contract or the performance of other Contracting

in a mistake in the things essential to the performance of the contract,



2. in contractual relations, the rough way infringed the obligation to a major

saved it to the competent legislation on public health

insurance or health care, or the provision of the Treaty,



3. repeated breach of an obligation arising out of section 41 of the Act,



4. enter into liquidation or on its property, the Court will declare bankruptcy,



(b)) medical equipment



1. without prior agreement with the insurance company for no reason does not provide health

care within the agreed scope and quality,



2. through the written warning without previous agreement with the insurance company repeatedly

charges care provided in excess of the stipulated kind,

expertise and scope of activities,



3. through written notice to the insured person unreasonably limits the

insurance companies opening period agreed in the contract,



4. provides health care without adequate substantive and technical

equipment and staffing,



5. proven does not provide the insured health care quality and "lege

Artis ", or repeatedly refuses to provide health care from other,

than the statutory reasons,



6. calls, in conflict with the law from policy holders financial reimbursement

for health care paid for by the insurance company or the policyholder for the adoption of the

care,



7. a written warning over proven repeatedly wrongly charged

health care,



8. does not provide the necessary assistance for the performance of control activities

carried out by the insurance company in accordance with the law,



(c) the insurance company)



1. through the written warning repeatedly illegally fail to pay

the medical equipment provided paid health care,



2. fails to meet payment deadlines agreed in the contract,



3. through the written warning repeatedly exceeds the range of the control

the activities provided for by law,



4. provide the third party data on medical devices above and beyond

the law or the contract.



Article 10



Before the expiry of the agreed period, you can terminate the contract:



and if so) lays down the law



(b)) a written agreement of the Contracting Parties under the conditions and within the time limit

referred to in this agreement.



Article 11



Mutual communication of information and transmission of documents necessary for the verification of compliance with

of the Treaty



(1) the Contracting Parties:
and) use to uniquely identify the medical equipment, in

accordance with the methodology, the organization identification number (IČ), identification

device number (IČZ), the identification number of the workplace (IČP)



(b) shall communicate the information required's) to check the performance of the contract,



(c)) shall ensure permanently accessible and clear information on the existence of a contractual

the relationship and the rights arising from it for the insured person,



d) may pass the information necessary to assess the quality and effectiveness of

provided paid health care, to the extent and under the conditions

stipulated in the contract.



(2) medical device:



and the insurance company shall, when) about suspected non-compliance procedure

"lege artis", that medical devices have been in the provision of paid

health care used in accordance with the specific legislation of the ^ 13),



(b)) shall immediately notify, not later than 30 calendar days, the other Contracting

side of the facts, which would substantially affect the implementation of the

the contract, for example. the emergence of computer system faults, changes to the data referred to

in the contract, if the



1. cancellation of the workplace or the part thereof without compensation, or

conclusion for more than 30 calendar days,



2. to leave the employee specifically referred to in the Treaty,



3. the failure of the instruments necessary for the implementation of performance without compensation on the

For more than 30 calendar days.



Failure to comply with the obligations referred to in points (a) or (b))), or late

compliance with the obligations referred to in point (a) (b)), it is considered a serious

breach of contractual obligations.



(3) the insurance company



and) can provide a medical facility in the generalized form of the information

needed to developing its activities or to his scientific and research

activities and to control the quality of health care provided by employers, and it

to the extent and under the conditions stipulated in the contract,



(b)) may publish on its website within the list of

medical device trade name or business name and address of the medical

his expertise and equipment, telephone, or e-mail links or

For more information of mutually agreed.



Article 12



Resolution of disputes



(1) the Contracting Parties shall resolve any disputes relating to the implementation of the

the Treaty primarily by negotiation representatives of the parties, and that

as a general rule within 14 calendar days from the challenges of one of the Contracting Parties.

If there is no agreement between them, the issues discussed in the

the conciliation negotiations. This does not affect the right of Contracting Parties to apply their

entitled to dispute in court or in arbitration proceedings under the Special

the law ^ 14), unless the parties to the dispute settlement procedures in

arbitration agree in the contract.



(2) the conciliation negotiations suggests one of the Contracting Parties. The proposal must

contain accurate and sufficiently detailed definition of the dispute. A participant in the

the conciliation negotiations is the Contracting Party that submitted the proposal for the consideration of the

the dispute, a Contracting Party that is a proposal for the consideration of the dispute addressed to,

the representative of the relevant group of medical facilities

represented their interest associations ^ 15) under section 17 (3)

the law and the representative of the insurance company. To discuss the dispute, each Contracting

Party may invite a maximum of two professional adviser. The conciliation negotiations with the

terminates the registration, containing a settlement or the conclusion that the conflict has not been removed

with an indication of the opinions of both parties.



1) Decree No. 134/1998 Coll. issuing the list of health interventions

with point values, as amended.



2) Act No. 551/1991 Coll., on general health insurance company, in the text of the

amended.



Law No. 280/1992 Coll., on departmental, industry, corporate, and other

health insurance, as amended.



3) Council Regulation (EEC) No 1408/71 and 574/72.



4) Eg. Communication from the Ministry of Foreign Affairs No. 130/2002 SB., m.s.,

the negotiation of a Treaty between the Czech Republic and the Federal Republic of

Yugoslavia on social security,



Communication from the Ministry of Foreign Affairs No. 83/2000 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Croatia on the social

security,



Communication from the Ministry of Foreign Affairs No. 135/2004 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Turkey on the social

Security.



5) section 10 of Act No. 526/1990 Coll., on prices, as amended.



6) Law No. 101/2000 Coll., on protection of personal data and on amendments to certain

laws, as amended.



7) Act No. 435/2004 Coll., on employment, as amended,

regulations.



8) Law No. 95/2004 Coll., on conditions for the acquisition and recognition of professional

competence and specialized competence to perform medical

the professions of doctor, dentist and pharmacist.



Law No 96/2004 Coll., on conditions for the acquisition and recognition of competence to

the exercise of paramedical professions and to pursue activities

related to the provision of health care and to change some of the

related laws.



9) Decree No. 49/1993 Coll., on technical and substantive requirements

equipment of medical devices, as amended.



10) Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Decree No 385/2006 Coll., on the medical documentation, as amended by the Decree of the

No 479/2006 Sb.



11) Act No. 563/1991 Coll., on accounting, as amended.



12) § 67 b) of Act No. 20/1966 Coll., on the health care of the people, in the text of the

amended.



for example, law No 13) 123/2000 Coll., on medical devices and on

changes to some related laws, as amended.



14) Act No. 216/1994, Coll., on arbitration proceedings and enforcement of arbitral

the findings, in the wording of Act No. 245/2006.



15) Act No. 83/1990 Coll. on Association of citizens, as amended

regulations.



§ § 20f and subs. Act No. 40/1964 Coll., the civil code, as amended by

amended.



Annex 6



Framework contract for health care facilities that provide home health

care, physiotherapy (expertise and 918 902) ^ 1), occupational therapy, birth

assistance, ortoptickou, and pleoptickou care and health insurance



THE FIRST PART OF THE ANNEX



General provisions



Article 1



Contractual relations



(1) a framework agreement lays down the conditions under which the contract is concluded

between the health establishments providing home health care,

physiotherapy (expertise and 918 902) ^ 1), occupational therapy, midwifery,

ortoptickou and pleoptickou care and insurance undertakings (the "undertaking"),

and in order to ensure in the provision of benefits in kind and cover

paid health care.



(2) the legal relationships in the contract concluded between the

insurance ^ 2), and medical devices shall not deviate from the

the provisions of the framework contract in accordance with this Ordinance, with the exception of those

provisions, for which such a possibility this framework contract expressly

lists.



PART TWO OF THE ANNEX TO



Of the Treaty



Article 2



Conclusion of contracts



(1) the legal relationship between the insurance company and medical facilities is governed by the

a written contract concluded under this framework contract and legal

the rules governing the public health insurance and the provision of

health care, and even in the case where the undertaking fulfils the role of a temporary

institutions in the implementation of the rights of the European Union ^ 3) or on the basis of the

international agreements on social security concluded by the Czech

Republic ^ 4).



In matters not regulated by these laws and regulations and the contract shall be governed by

the commercial code.



(2) the basic condition for the conclusion of a contract is the permission of the medical

the equipment for the provision of health care in the field.



(3) the contract includes:



and) the rights and obligations of the Contracting Parties,



(b) the quality and effectiveness of the) conditions of the provision of health care, in particular

the kind, scope, and extent of health care provided by the specified list of

performance with point values according to the types of care, which is a medical

the device shall be entitled to provide, including substantive and technical equipment and

staffing,



(c) point values) ^ 5), the amount of the reimbursement paid by health care and regulatory

limitation of the volume of paid health care provided in accordance with the Decree

issued under section 17, paragraph. 6 of the Act,



(d) the implementation of the remuneration provided by) the way of health care,



(e)) the conditions required to check the performance of the contract, including the accuracy and

the legitimacy of the posted amounts



f) range and method of mutual communication of the information necessary to check the

performance of the contract,



(g)) the provisions on the resolution of conflicts in the course of the negotiations, where appropriate, the provisions of

about the use of arbitration,



(h) the period of application of the Treaty), the way and the reasons for her termination,



I) provisions on the acceptance of and compliance with the agreed procedure for

acquisition, transmission and evaluation of documents in accordance with the methodology,

rules and uniform data interface, produced by the universal

health insurance in the Czech Republic in cooperation with the representatives of

insurance companies and representatives of professional associations of health care providers

and issued a general health insurance company in the Czech Republic, the applicable

at the time of conclusion of the contract,



j) provisions on how to get started with any medical facility

changes to the methodology and rules, including the method of transmission of these changes.
(4) the contract may also contain other arrangements necessary for the implementation and

check if they are in accordance with this agreement and the legal framework

provisions.



Article 3 of the



The rights and obligations of the parties



(1) the Contracting Parties:



and when reporting and shall comply with), payment of paid health care agreed

the methodology, rules and data interface; the contract shall specify the version number

at the time of conclusion of the contract,



(b) undertake their employees) with regard to the protection of the rights of insured persons, to the

maintaining the confidentiality of the personal data required ^ 6) and facts

which to learn in the performance of their duties or employment or in

processing of data from the information system on the basis of the Treaty, or of the

connection with a ^ 2).



(2) medical device:



and provides paid health care) in accordance with the legislation in

proficiency and the extent of the agreed and defined in the Treaty, for which the

It is factually and technically equipped and staffed to ensure



(b)) provides health care paid for by the insured from the EU under the same

conditions as to the insured the insurance company, in the range from applicants

documents, so as to avoid discrimination or preference,

and even in the event that the beneficiary from the EU, responsibility for health care in the

cash,



(c)) is responsible for the fact that his staff ^ 7), who will be insured

provide in the contract negotiated paid health care, meet the

the requirements laid down by law for the performance of this activity ^ 8),



(d)) is responsible for this, that health care workers are paid

health care on the basis of the indications of the attending doctor,



(e)) is responsible for the implementation of the substantive and technical conditions laid down for the

It provided health care under a special legal regulation, ^ 9),



(f)) provides health care paid for by the "lege artis" without excess

the cost, however, with a view to making the necessary diagnostic

or therapeutic effect was achieved with regard to individual health

the status of the insured person,



(g)) will lead to eligibility made health care in

conclusive form of health documentation on the treatment of policyholders, in which

the performances will be recorded, on-demand made by the medical health care

including medical transportation, prescribed medicines and medical

resources and retained in her Inbox results requested and carried out

examination and treatment, in accordance with a special law ^ 10),



(h)) to ensure, in the case where it is not present, the performance of the authorized holder

provide health care according to the Treaty and complying with the conditions for the exercise of

This activity (either by the operator – a natural person or an employee of

medical device), a crowd of other qualified holder of power

and in the cases agreed in the contract shall notify the insured and

the insurance undertaking,



I) to provide, in accordance with the legislation of the medical establishment,

which the insured person passes into the care or that the beneficiary's choice

the information needed to ensure continuity of health care and to avoid

duplicate the implementation of diagnostic and treatment procedures and acceptance

insured persons in the care of such information from the relevant device

require,



(j) adoption of the insured person to refuse) your care except for the reasons set out

in section 11, paragraph 1 (b)) of the Act,



to the right of the insured person making the) freedom of choice of doctor, medical

equipment or the provision of health care paid for by any of the

registration fees or with various donations and granted

health care paid for by the insurance company will not be from the insured person, if it

did not result from legislation, to collect any financial remuneration,



(l) the right of the policyholder to making) the granting of paid health care

changing the insurance undertaking or in any other way,



It will not discriminate between insured m) of one or more insurance undertakings in

detriment of policyholders of insurance companies and worsen the availability

health care paid for by the insurance company a priority the provision of care

paid for by other means,



n) shall notify the insurance undertaking in accordance with section 55 of the Act injuries or other damage

the health of the persons who provided paid health care, if you have reason to

suspecting that they were caused by acts legal or natural person,



about) showing when concluding a contract with an insurance company proof of insurance

liability for damage caused to citizens in connection with the provision

health care and will be insured for the entire duration of the contractual relationship with the

the insurance company.



(3) an insurance undertaking:



and will pay the medical facility) made paid health care,

clearly documented and reasonably provided to the insured and the

insurance policy holders in the EU, who have the insurance company selected as the institution of manner

in the implementation of the rights of the European Union ^ 3) in accordance with the law and

the Treaty,



(b)), on request, sees therapeutic equipment without undue delay

the jurisdiction of the insured person to the insurance undertaking in cases where it is not available

insurance card and his personal data are available,



(c)) will not require preferential treatment of their policyholders at the expense of policyholders

other insurance companies,



(d)) is authorised to control compliance with the contractually agreed payment in kind and

technical conditions and staffing financed by health care

provided by the medical establishment, under the Treaty,



e) provides medical equipment to ensure uniform conditions

the agreed methodology, rules, data interface and the appropriate dials

issued by the general health insurance company for reporting and calculation of the remuneration

paid for by the health care



(f) medical device with familiar) the agreed changes to the methodology,

rules and with the changes at least one month and the dials with the change

the data interface at least two months before the date of their

the validity of. In the case of changes to the legislation, which does not allow this period

keep, can be referred to commensurately reduced.



Article 4 of the



Remuneration provided paid health care



(1) the value of the point ^ 5) for health care paid for by the performance,

the amount of the reimbursement paid by health care and regulatory restrictions on the volume of provided

paid health care under section 17, paragraph. 6 of the Act is given in the appendix to the

the Treaty under special legislation.



(2) methods of payment shall be considered as:



and health) payment for performances by the health interventions with

point values, or



(b)) other agreed method of payment.



(3) Between the parties must always be agreed in advance to increase or

the reduction of the volume of provided paid health care due to changes

capacity, the structure of the medical equipment, changes or reconstruction

Instrumentation as specified in the contract.



(4) medical equipment for the filing of claims for reimbursement provided

paid for by the health care bill passes the insurance company once a month

care provided an invoice with attachments, if the Contracting Parties

agree on passing the Bill over a longer period. The invoice contains

Essentials of accounting document ^ 11). The essentials of the annex are contained in the

the methodology or in accordance with the methodology shall specify in the contract. In the case of

that the invoice does not contain particulars of the accounting document and annex does not contain

requirements of the agreed methodology or a contract, an insurance undertaking has the right to

reject it and return without undue delay the medical device to

complement, where appropriate, to correct; in this case, the running period of maturity

to date her repossess the insurance company.



(5) the Medical device is responsible for the completeness, formal and factual

the accuracy of the documents and their transfer in the manner agreed in the methodology

and data interface. Documents for paid care provided

the insured the insurance companies and the insured from the EU, who have chosen the insurance company's

as the institution of manner in the implementation of the rights of the European Union ^ 3), passes

medical devices, together with a breakdown of the insurance undertaking in the term and

in the manner agreed in the contract (or on an electronic medium in

electronic form or on paper).



(6) where the insurance company billing before payment incorrectly

or vyúčtovanou care, reimbursement of that part of the increase in care

the term to maturity. The insurance company provable way shall notify the

medical devices range without undue delay and the reason

made, but outstanding care. The insurance company will invite medical

a device to repair improperly accounted for care or to support the provision of

paid health care. Duly granted and vyúčtovanou care insurance company

will pay in the next term.



(7) the insurance company performs for its clients and policyholders, who the EU

the insurance company selected as the institution of manner in the implementation of the rights of

The European Union ^ 3), the reimbursement of paid health care, accounted in accordance with the

the law and the contract. If on verification finds errors in the

documents, in accordance with the methodology and rules. Denial of payment or

part of the payment the insurance company without undue delay, medical devices

justify in writing. By providing a payment shall not prejudice the right of an insurance undertaking to

the implementation of subsequent checks paid the Bill to the extent and for the

the conditions laid down by the legislation and the contract.
(8) where the insurance company misconduct in the Bill submitted to the medical

Additionally, i.e. the device. After payment and medical equipment to 10

working days from the receipt of the written call the insurance company the amount

itself does not settle, or they can demonstrate the legitimacy of the disputed amount charged or

not unless otherwise agreed between the Contracting Parties, dates of payment, insurance company

unilateral offsetting claims will reduce the medical facility of the

the amount of the remuneration for the employers of health care bill

presented in the following billing period.



(9) the remuneration margin provided by the paid health care, in compliance with the

the conditions stipulated in the contract, shall be made upon delivery of the Bill

the insurance company or on an electronic medium in electronic form within 30

calendar days and when you pass the Bill the insurance company on paper

documents within 50 calendar days from the date of receipt of the invoice to the insurance undertaking,

unless the contracting parties otherwise. Payment deadline is not respected,

If a payment on the last day of the period is credited to the account of the medical

the device.



(10) In the case of computing system, preventing the timely

the implementation of the Bill or of the remuneration paid by health care, provide

insurance medical facility within the agreed time of payment advance

in the amount of average monthly volume reported by the health care

calculated from the last calendar quarter of two closed, if

the Contracting Parties agree otherwise in a given case.



Article 5



Check



(1) the insurance undertaking in accordance with section 42 of the Act and the Treaty control

the use and provision of paid health care in its volume and

quality, including compliance with the prices, through its information

system, audit practitioners and other professional workers in

health, eligible for the review activities (hereinafter referred to as "professional

workers ").



(2) in the framework of their competence review doctors and specialist

staff permissions to control whether the method shall be considered paid

health care was indicated with regard to the State of health of the insured person, the

in accordance with the current available knowledge of medical science and has not been

unnecessarily economically challenging.



(3) in the cases provided for by the legislation of the auditing physician assesses and

the rationale for treating physician proposed or carried out by the

a treatment procedure and approved, whether the procedure used the insurance company will pay.



(4) a medical facility shall provide to the insurance undertaking in the performance of the checks

the necessary assistance, in particular submitted required documents, shall be communicated

data and provides explanations. The review will allow doctors and expert

workers insurance companies access to its object, the inspection

medical documentation in accordance with the particular legal

regulation ^ 12) and other documents directly related to the

by checking the charged health, pharmaceuticals and

medical devices, including a particularly charged drug and especially

the posted material. Revision (revision specialist) is

obliged to do so, in order not to interrupt the check carried out by the health

performance.



(5) in the case of inspections (investigation) in the medical device will be on

the site handled a record indicating the most important findings and

the opinions of the medical device. This entry does not replace a message

in accordance with paragraph 6.



(6) a report containing the conclusions of the inspection, the insurance company will process and transmit

medical device within 15 calendar days after the completion of the inspection;

If not possible, for objective reasons, this deadline, notify the

the insurance company this fact to the medical facility. A check will be

completed normally within 30 calendar days of its initiation.



(7) the Medical device is authorized within 15 calendar days from the

taking over the control of the insurance company, in writing, the conclusion may submit reasoned objections. To

the opposition of the insurance undertaking shall inform the opinion within 30 calendar days of their

delivery. If not possible, for objective reasons, these deadlines,

can be used at the request of the competent contracting party to extend to the double.

The insurance company shall inform in due time the medical device to determine whether

confirms or alters the conclusions of the inspection. The opposition has in terms of

financial claims against the insurance company's medical device suspensory

effect. This does not prejudice the right of the medical device to

disagreement with the decision of the insurance undertaking in other proceedings.



(8) if the check shows the unlawfulness or incorrectness of the statement

paid for by the health care or her unjustified provision, insurance company

According to § 42 paragraph 3 of the Act, such care does not pay and is entitled to

follow the penalty arrangements referred to in the Treaty. In the event that the

the conclusions of the inspection they prove unjustified, the insurance company

medical devices the amount on the basis of checks decreased

reimbursement provided paid health care. Medical equipment is

entitled to proceed under penalty arrangements referred to in the Treaty.



Article 6 of the



Penalty arrangements



(1) the Contracting Parties for non-compliance with contractual obligations and infringement of

the contracts referred to in paragraph 2 or of other reasons stipulated in the contract

can negotiate a contractual penalty and its amount.



(2) for breach of contract shall be the cases when



and) Contracting Party



1. the false, incomplete or misleading information in the conclusion

of the Treaty, or in its implementation,



2. fail to comply with the provisions of the Treaty, with the consequence of the proven neúčelného

expending the resources of public health insurance,



3. fails to provide the information in the contract negotiated,



(b)) medical equipment



1. unlawfully or multiple charges to health care,



2. fails to provide the required reports resulting from the legislation of the

governing the public health insurance,



3. unreasonably delay has provided paid health care,



4. repeatedly violated the obligation to report to the insurance undertaking in accordance with § 55

law, injuries or other damage to the health of the insured person caused by an act

legal or natural person,



(c) the insurance company)



1. the payment shall be reduced or refused unjustifiably provided paid health

care,



2. carries out the payment lawfully made provided paid health

care with the delay, except in cases where it is not responsible for the delay.



(3) the application of a sanction shall not affect the right of Contracting Parties to return

remuneration for improperly or incorrectly vyúčtovanou and paid paid

health care.



Article 7



The period of application, the method and the reasons for the termination of the contract



The contract is concluded for a period of eight years, unless the parties have agreed

otherwise.



Article 8 of the



The contract or its part shall lapse:



and the day) took the decision on the cancellation or change

registration under Act No. 160/1992 Coll., on health care in non-State

medical devices, as amended, or to

cancellation or change of the provisioning of the Charter, issued by the medical devices



(b) on the date of demise) of medical equipment or the insurance company or the date of death

natural persons, which was the operator of medical equipment,



(c)) of the date specified in the written notice to the insurance company, if the medical

devices from major health or operational reasons cannot health

continue to provide care,



d) date on which the medical facility lost its factual, technical or

personnel prerequisites for the provision of health care within the agreed

the extent provided for by law or the contract, within the meaning of article. 3

paragraph. 2 (a). and medical equipment), if the deficiencies did not

After subsequently set a reasonable time limit; the contract or its part

expires only in part defining the scope of the contracted health care in

which medical equipment does not comply with the law or the contract

set assumptions, unless it was so severe the circumstances for which

You cannot expect a further performance of the contract in its entirety.



Article 9



Before the expiry of the agreed period, you can terminate the agreement upon written notice to the

notice period of five months, which begins the first day of the month

following the delivery of the notification to the other Contracting Party, if in

as a result of serious circumstances cannot reasonably expect more performance

of the Treaty, and that, in the event that the



and) Contracting Party



1. the stated in the conclusion of the contract or the performance of other Contracting

in a mistake in the things essential to the performance of the contract,



2. in contractual relations, the rough way infringed the obligation to a major

saved it to the competent legislation on public health

insurance or health care, or the provision of the Treaty,



3. repeated breach of an obligation arising out of section 41 of the Act,



4. enter into liquidation or on its property, the Court will declare bankruptcy,



(b)) medical equipment



1. without prior agreement with the insurance company for no reason does not provide health

care within the agreed scope and quality,



2. through the written warning without previous agreement with the insurance company repeatedly

charges care provided in excess of the stipulated kind,

expertise and scope of activities,



3. through written notice to the insured person unreasonably limits the
insurance companies opening period agreed in the contract,



4. provides health care without adequate substantive and technical

equipment and staffing,



5. proven does not provide the insured health care quality and "lege

Artis ", or repeatedly refuses to provide health care from other,

than the statutory reasons,



6. calls, in conflict with the law from policy holders financial reimbursement

for health care paid for by the insurance company or the policyholder for the adoption of the

care,



7. a written warning over proven repeatedly wrongly charged

health care,



8. does not provide the necessary assistance for the performance of control activities

carried out by the insurance company in accordance with the law,



(c) the insurance company)



1. through the written warning repeatedly illegally fail to pay

the medical equipment provided paid health care,



2. through the written warning repeatedly fails to meet payment deadlines

agreed in the contract,



3. through the written warning repeatedly exceeds the range of the control

the activities provided for by law,



4. provide the third party data on medical devices above and beyond

the law or the contract.



Article 10



Before the expiry of the agreed period, you can terminate the contract:



and if so) lays down the law



(b)) a written agreement of the Contracting Parties under the conditions and within the time limit

referred to in this agreement.



Article 11



Mutual communication of information and transmission of documents necessary for the verification of compliance with

of the Treaty



(1) the Contracting Parties:



and) use to uniquely identify the medical equipment, in

accordance with the methodology, the organization identification number (IČ), identification

device number (IČZ), the identification number of the workplace (IČP)



(b) shall communicate the information required's) to check the performance of the contract,



(c)) shall ensure permanently accessible and clear information on the existence of a contractual

the relationship and the rights arising from it for the insured person,



d) may pass the information necessary to assess the quality and effectiveness of

provided paid health care, to the extent and under the conditions

stipulated in the contract.



(2) medical device:



and the insurance company shall, when) about suspected non-compliance procedure

"lege artis", that medical devices have been in the provision of paid

health care used in accordance with the specific legislation of the ^ 13),



(b)) shall immediately notify, not later than 30 calendar days, the other Contracting

side of the facts, which would substantially affect the implementation of the

the contract, for example. the emergence of computer system faults, changes to the data referred to

in the contract, if the



1. cancellation of the workplace or the part thereof without compensation, or

conclusion for more than 30 calendar days,



2. to leave the employee specifically referred to in the Treaty,



3. the failure of the instruments necessary for the implementation of performance without compensation on the

For more than 30 calendar days.



Failure to comply with the obligations referred to in points (a) or (b))), or late

compliance with the obligations referred to in point (a) (b)), it is considered a serious

breach of contractual obligations.



(3) the insurance company



and) can provide a medical facility in the generalized form of the information

needed to developing its activities or to his scientific and research

activities and to control the quality of health care provided by employers, and it

to the extent and under the conditions stipulated in the contract,



(b)) may publish on its website within the list of

medical device trade name or business name and address of the medical

his expertise and equipment, telephone, or e-mail links or

For more information of mutually agreed.



Article 12



Resolution of disputes



(1) the Contracting Parties shall resolve any disputes relating to the implementation of the

the Treaty primarily by negotiation representatives of the parties, and that

as a general rule within 14 calendar days from the challenges of one of the Contracting Parties.

If there is no agreement between them, the issues discussed in the

the conciliation negotiations. This does not affect the right of Contracting Parties to apply their

entitled to dispute in court or in arbitration proceedings under the Special

the law ^ 14), unless the parties to the dispute settlement procedures in

arbitration agree in the contract.



(2) the conciliation negotiations suggests one of the Contracting Parties. The proposal must

contain accurate and sufficiently detailed definition of the dispute. A participant in the

the conciliation negotiations is the Contracting Party that submitted the proposal for the consideration of the

the dispute, a Contracting Party that is a proposal for the consideration of the dispute addressed to,

the representative of the relevant group of medical facilities

represented their interest associations ^ 15) under section 17 (3)

the law and the representative of the insurance company. To discuss the dispute, each Contracting

Party may invite a maximum of two professional adviser. The conciliation negotiations with the

terminates the registration, containing a settlement or the conclusion that the conflict has not been removed

with an indication of the opinions of both parties.



1) Decree No. 134/1998 Coll. issuing the list of health interventions

with point values, as amended.



2) Act No. 551/1991 Coll., on general health insurance company, in the text of the

amended.



Law No. 280/1992 Coll., on departmental, industry, corporate, and other

health insurance, as amended.



3) Council Regulation (EEC) No 1408/71 and 574/72.



4) Eg. Communication from the Ministry of Foreign Affairs No. 130/2002 SB., m.s.,

the negotiation of a Treaty between the Czech Republic and the Federal Republic of

Yugoslavia on social security,



Communication from the Ministry of Foreign Affairs No. 83/2000 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Croatia on the social

security,



Communication from the Ministry of Foreign Affairs No. 135/2004 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Turkey on the social

Security.



5) section 10 of Act No. 526/1990 Coll., on prices, as amended.



6) Law No. 101/2000 Coll., on protection of personal data and on amendments to certain

laws, as amended.



7) Act No. 435/2004 Coll., on employment, as amended,

regulations.



8) Law No. 95/2004 Coll., on conditions for the acquisition and recognition of professional

competence and specialized competence to perform medical

the professions of doctor, dentist and pharmacist.



Law No 96/2004 Coll., on conditions for the acquisition and recognition of competence to

the exercise of paramedical professions and to pursue activities

related to the provision of health care and to change some of the

related laws.



9) Decree No. 49/1993 Coll., on technical and substantive requirements

equipment of medical devices, as amended.



10) Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Decree No 385/2006 Coll., on the medical documentation, as amended by the Decree of the

No 479/2006 Sb.



11) Act No. 563/1991 Coll., on accounting, as amended.



12) § 67 b) of Act No. 20/1966 Coll., on the health care of the people, in the text of the

amended.



for example, law No 13) 123/2000 Coll., on medical devices and on

changes to some related laws, as amended.



14) Act No. 216/1994, Coll., on arbitration proceedings and enforcement of arbitral

the findings, in the wording of Act No. 245/2006.



15) Act No. 83/1990 Coll. on Association of citizens, as amended

regulations.



§ § 20f and subs. Act No. 40/1964 Coll., the civil code, as amended by

amended.



Annex 7



Framework contract for health care facilities providing health

rescue services and transportation, and health insurance



THE FIRST PART OF THE ANNEX



General provisions



Article 1



Contractual relations



(1) a framework agreement lays down the conditions under which the contract is concluded

between the health establishments providing medical rescue

service and transportation and insurance, and in order to ensure the factual

performance in the provision of and payment of paid health care ^ 1).



(2) the legal relationships in the contract concluded between the

insurance ^ 2), and medical devices shall not deviate from the

the provisions of the framework contract in accordance with this Ordinance, with the exception of those

provisions, for which such a possibility this framework contract expressly

lists.



PART TWO OF THE ANNEX TO



Of the Treaty



Article 2



Conclusion of contracts



(1) the legal relationship between the insurance company and medical facilities is governed by the

a written contract concluded under this framework contract, legal

the rules governing the public health insurance and the provision of

health care, and even in the case where the undertaking fulfils the role of a temporary

institutions in the implementation of the rights of the European Union ^ 3) or on the basis of the

international agreements on social security concluded by the Czech

Republic ^ 4). In matters not regulated by these laws and regulations and

the contract shall be governed by the commercial code.



(2) the basic condition for the conclusion of a contract is the permission of the medical

the equipment for the provision of health care in the field.



(3) the contract includes:



and) the rights and obligations of the Contracting Parties,



(b) the quality and effectiveness of the) conditions of the provision of health care, in particular

the kind, scope, and extent of health care provided by the specified list of

performance with point values according to the types of care, which is a medical
the device may be authorized to grant, 1. including the factual and technical equipment

and staffing,



(c) point values) ^ 5), the amount of the reimbursement paid by health care and regulatory

limitation of the volume of paid health care provided in accordance with the Decree

issued under section 17, paragraph. 6 of the Act,



(d) the implementation of the remuneration provided by) the way of health care,



(e)) the conditions required to check the performance of the contract, including the accuracy and

the legitimacy of the posted amounts



f) range and method of mutual communication of the information necessary to check the

performance of the contract,



(g)) the provisions on the resolution of conflicts in the course of the negotiations, where appropriate, the provisions of

about the use of arbitration,



(h) the period of application of the Treaty), the way and the reasons for her termination,



I) provisions on the acceptance of and compliance with the agreed procedure for

acquisition, transmission and evaluation of documents in accordance with the methodology,

rules and uniform data interface, produced by the universal

health insurance in the Czech Republic in cooperation with the representatives of

insurance companies and representatives of professional associations of health care providers

and issued a general health insurance company in the Czech Republic, the applicable

at the time of conclusion of the contract,



j) provisions on how to get started with any medical facility

changes to the methodology and rules, including the method of transmission of these changes.



(4) the contract may also contain other arrangements necessary for the implementation and

check if they are in accordance with this agreement and the legal framework

provisions.



Article 3 of the



The rights and obligations of the parties



(1) the Contracting Parties:



and when reporting and shall comply with), payment of paid health care agreed

the methodology, rules and data interface; the contract shall specify the version number

at the time of conclusion of the contract,



(b) undertake their employees) with regard to the protection of the rights of insured persons, to the

maintaining the confidentiality of the personal data required ^ 6) and facts

which to learn in the performance of their duties or employment or in

processing of data from the information system on the basis of the Treaty, or of the

connection with a ^ 2).



(2) the health care facility emergency services and transport:



and provides paid health care) in accordance with the legislation in

proficiency and the extent of the agreed and defined in the Treaty, for which the

It is factually and technically equipped and staffed to ensure



(b)) provides health care paid for by the insured from the EU under the same

conditions as to the insured the insurance company, in the range from applicants

documents, so as to avoid discrimination or preference,



(c)) is responsible for the fact that his staff ^ 7), who will be insured

provide in the contract negotiated paid health care, meet the

the requirements laid down by law for the performance of this activity ^ 8),



(d)) is responsible for the implementation of the substantive and technical conditions laid down for the

It provided health care under a special legal regulation, ^ 9),



(e) adoption of the insured person to refuse) your care with the exception of the reasons



(f) the right of the insured person making the) freedom of choice of doctor, medical

equipment or the provision of health care paid for by any of the

registration fees or with various donations and granted

health care paid for by the insurance company will not be from the insured person, if it

did not result from legislation, to collect any financial remuneration,



(g) the right of the policyholder to making) the granting of paid health care

changing the insurance undertaking or in any other way,



(h) encourage the insured) will be one or more insurance undertakings in

detriment of policyholders of insurance companies and worsen the availability

health care paid for by the insurance company a priority the provision of care

paid for by other means,



I) showing when concluding a contract with an insurance company proof of insurance

liability for damage caused to citizens in connection with the provision

health care and will be insured for the entire duration of the contractual relationship with the

the insurance company.



(3) medical devices medical emergency services:



and) will provide in continuous operation in the agreed geographical area

the performances of the pre-hospital urgent care, or within the agreed range of performances

transport, indicated by the medical devices insurance; in

the case of the urgent care and non-Contracting medical devices,



(b)) provides health care paid for by the "lege artis" without excess

the cost, however, with a view to making the necessary diagnostic

or therapeutic effect was achieved with regard to individual health

the status of the insured person,



(c)) for the assessment of eligibility of health care bill

conclusive form of health documentation on the treatment of policyholders, in which

records made by the health services used separately billed

material and made medicinal products in accordance with the particular legal

^ Regulation 10). Keeps audio recording of phone calls on the line after 155

for one year after its acquisition. On the traffic performance

leads the documentation in accordance with a special law ^ 11) and

the methodology,



(d)) shall provide in accordance with the law of medical facilities,

which the insured person passes into the care or that the beneficiary's choice

the information needed to ensure continuity of health care,



(e) notify the insurance undertaking) in accordance with section 55 of the Act for the purpose of compensation for damages

injuries or other damage to the health of the persons who provided paid

health care, if he has reasonable grounds for believing that they have been caused by the acts

legal or natural persons.



(4) medical equipment of transport:



and) will provide the agreed performance of transport indicated by the

medical devices insurance company in continuous operation, if the

the Contracting Parties agree otherwise,



(b) in the provision of paid) adapt health care insured method

the implementation of the transport performance of the insured's State of health according to the instructions

marked indicating the doctor in the medical transport,



(c)) will lead to eligibility made health care in

conclusive form in accordance with the methodology of the documentation, which will be

recorded made transport performance. Also keeps the documentation within the meaning of

special legal regulation ^ 11).



(5) an insurance undertaking:



and will pay the medical facility) made paid health care,

clearly documented and reasonably provided to the insured and the

insurance policy holders in the EU, who have the insurance company selected as the institution of manner

in the implementation of the rights of the European Union ^ 3) in accordance with the law and

the Treaty,



(b)), on request, sees therapeutic equipment without undue delay

the jurisdiction of the insured person to the insurance undertaking in cases where it is not available

insurance card and his personal data are available,



(c)) will not require preferential treatment of their policyholders at the expense of policyholders

other insurance companies,



(d)) is authorised to control compliance with the contractually agreed payment in kind and

technical conditions and staffing financed by health care

provided by the medical establishment, under the Treaty,



e) provides medical equipment to ensure uniform conditions

the agreed methodology, rules, data interface and the appropriate dials

issued by the general health insurance company for reporting and calculation of the remuneration

paid for by the health care



(f) medical device with familiar) the agreed changes to the methodology,

rules and with the changes at least one month and the dials with the change

the data interface at least two months before the date of their

the validity of. In the case of changes to the legislation, which does not allow this period

keep, can be referred to commensurately reduced.



Article 4 of the



Remuneration provided paid health care



(1) the value of the point ^ 5) for health care paid for by the performance,

the amount of the reimbursement paid by health care and regulatory restrictions on the volume of provided

paid health care under section 17, paragraph. 6 of the Act is given in the appendix to the

the Treaty under special legislation.



(2) methods of payment shall be considered as:



and health) payment for performances by the health interventions with

point values



(b) the flat-rate payment for provided) health care, or



(c) any other agreed method of payment).



(3) Between the parties must always be agreed in advance to increase or

the reduction of the volume of provided paid health care due to changes

capacity, the structure of the medical equipment, changes or reconstruction

Instrumentation as specified in the contract.



(4) medical equipment for the filing of claims for reimbursement provided

paid for by the health care bill passes the insurance company once a month

care provided an invoice with attachments, if the Contracting Parties

agree on passing the Bill over a longer period. The invoice contains

Essentials of accounting document ^ 12). The essentials of the annex are contained in the

the methodology or in accordance with the methodology shall specify in the contract. In the case of

that the invoice does not contain particulars of the accounting document and annex does not contain

requirements of the agreed methodology or a contract, an insurance undertaking has the right to

reject it and return without undue delay the medical device to

complement, where appropriate, to correct; in this case, the running period of maturity

to date her repossess the insurance company.
(5) the Medical device is responsible for the completeness, formal and factual

the accuracy of the documents and their transfer in the manner agreed in the methodology

and data interface. Documents for paid care provided

the insured the insurance companies and the insured from the EU, who have chosen the insurance company's

as the institution of manner in the implementation of the rights of the European Union ^ 3), passes

medical devices, together with a breakdown of the insurance undertaking in the term and

in the manner agreed in the contract (or on an electronic medium in

electronic form or on paper).



(6) where the insurance company billing before payment incorrectly

or vyúčtovanou care, reimbursement of that part of the increase in care

the term to maturity. The insurance company provable way shall notify the

medical devices range without undue delay and the reason

made, but outstanding care. The insurance company will invite medical

a device to repair improperly accounted for care or to support the provision of

paid health care. Duly granted and vyúčtovanou care insurance company

will pay in the next term.



(7) the insurance company performs for its clients and for insured persons of the EU who

the insurance company selected as the institution of manner in the implementation of the rights of

The European Union ^ 3), the reimbursement of paid health care, accounted in accordance with the

the law and the contract. If on verification finds errors in the

documents, in accordance with the methodology and rules. Denial of payment or

part of the payment the insurance company without undue delay, medical devices

justify in writing. By providing a payment shall not prejudice the right of an insurance undertaking to

the implementation of subsequent checks paid the Bill to the extent and for the

the conditions laid down by the legislation and the contract.



(8) where the insurance company misconduct in the Bill submitted to the medical

Additionally, i.e. the device. After payment and medical equipment to 10

working days from the receipt of the written call the insurance company the amount

itself does not settle, or they can demonstrate the legitimacy of the disputed amount charged or

not unless otherwise agreed between the Contracting Parties, dates of payment, insurance company

unilateral offsetting claims will reduce the medical facility of the

the amount of the remuneration for the employers of health care bill

presented in the following billing period.



(9) the remuneration margin provided by the paid health care, in compliance with the

the conditions stipulated in the contract, shall be made upon delivery of the Bill

the insurance company or on an electronic medium in electronic form within 30

calendar days and when you pass the Bill the insurance company on paper

documents within 50 calendar days from the date of receipt of the invoice to the insurance undertaking,

unless the contracting parties otherwise. Payment deadline is not respected,

If a payment on the last day of the period is credited to the account of the medical

the device.



(10) In the case of computing system, preventing the timely

the implementation of the Bill or of the remuneration paid by health care, provide

insurance medical facility within the agreed time of payment advance

in the amount of average monthly volume reported by the health care

calculated from the last calendar quarter of two closed, if

the Contracting Parties agree otherwise in a given case.



Article 5



Check



(1) the insurance undertaking in accordance with section 42 of the Act and the Treaty control

the use and provision of paid health care in its volume and

quality, including compliance with the prices, through its information

system, audit practitioners and other professional workers in

health, eligible for the review activities (hereinafter referred to as "professional

workers ").



(2) in the framework of their competence review doctors and specialist

staff permissions to control whether the method shall be considered paid

health care was indicated with regard to the State of health of the insured person, the

in accordance with the current available knowledge of medical science and has not been

unnecessarily economically challenging.



(3) in the cases provided for by the legislation of the auditing physician assesses and

the rationale for treating physician proposed or carried out by the

a treatment procedure and approved, whether the procedure used the insurance company will pay.



(4) a medical facility shall provide to the insurance undertaking in the performance of the checks

the necessary assistance, in particular submitted required documents, shall be communicated

data and provides explanations. The review will allow doctors and expert

workers insurance companies access to its object, the inspection

medical documentation in accordance with the particular legal

Regulation ^ 13) and other documents directly related to the

by checking the charged health, pharmaceuticals and

medical devices, including a particularly charged drug and especially

the posted material.



(5) in the case of inspections (investigation) in the medical device will be on

the site handled a record indicating the most important findings and

the opinions of the medical device. This entry does not replace a message

in accordance with paragraph 6.



(6) a report containing the conclusions of the inspection, the insurance company will process and transmit

medical device within 15 calendar days after the completion of the inspection;

If not possible, for objective reasons, this deadline, notify the

the insurance company this fact to the medical facility. A check will be

completed normally within 30 calendar days of its initiation.



(7) the Medical device is authorized within 15 calendar days from the

taking over the control of the insurance company, in writing, the conclusion may submit reasoned objections. To

the opposition of the insurance undertaking shall inform the opinion within 30 calendar days of their

delivery. If not possible, for objective reasons, these deadlines,

the relevant time limit shall be extended up to twice. Within the time limit

the insurance undertaking shall inform the medical device to determine whether it confirms or modifies

conclusions of the inspection. The opposition has in terms of financial claims

insurance against medical device have suspensive effect. This is not a

without prejudice to the right of the medical device to apply its disagreement with the

by the decision of the insurance undertaking in other proceedings.



(8) if the check shows the unlawfulness or incorrectness of the statement

paid for by the health care or her unjustified provision, insurance company

According to § 42 paragraph 3 of the Act, such care does not pay and is entitled to

follow the penalty arrangements referred to in the Treaty. In the event that the

the conclusions of the inspection they prove unjustified, the insurance company

medical devices the amount on the basis of checks decreased

reimbursement provided paid health care. Medical equipment is

entitled to proceed under penalty arrangements referred to in the Treaty.



Article 6 of the



Penalty arrangements



(1) the Contracting Parties for non-compliance with contractual obligations and infringement of

the contracts referred to in paragraph 2 or of other reasons stipulated in the contract

can negotiate a contractual penalty and its amount.



(2) for breach of contract shall be the cases when



and) Contracting Party



1. the false, incomplete or misleading information in the conclusion

of the Treaty, or in its implementation,



2. fail to comply with the provisions of the Treaty, with the consequence of the proven neúčelného

expending the resources of public health insurance,



3. fails to provide the information in the contract negotiated,



(b)) medical equipment



1. unlawfully or multiple charges to health care,



2. fails to provide the required reports resulting from the legislation of the

governing the public health insurance,



3. unreasonably delay has provided paid health care,



4. repeatedly violated the obligation to report to the insurance undertaking in accordance with § 55

law, injuries or other damage to the health of the insured person caused by an act

legal or natural person,



(c) the insurance company)



1. the payment shall be reduced or refused unjustifiably provided paid health

care,



2. carries out the payment lawfully made provided paid health

care with the delay, except in cases where it is not responsible for the delay.



(3) the application of a sanction shall not affect the right of Contracting Parties to return

remuneration for improperly or incorrectly vyúčtovanou and paid paid

health care.



Article 7



The period of application, the method and the reasons for the termination of the contract



The contract is concluded for a period of 5 years, unless otherwise agreed by the Contracting Parties

otherwise.



Article 8 of the



The contract or its part shall lapse:



and the day) took the decision on the cancellation or change

registration under Act No. 160/1992 Coll., on health care in non-State

medical devices, as amended, or to

cancellation or change of the provisioning of the Charter, issued by the medical devices



(b) on the date of demise) of medical equipment or the insurance company or the date of death

natural persons, which was the operator of medical equipment,



(c)) of the date specified in the written notice to the insurance company, if the medical

devices from major health or operational reasons cannot health

continue to provide care,



d) date on which the medical facility lost its factual, technical or

personnel prerequisites for the provision of health care within the agreed

the extent provided for by law or the contract, within the meaning of article. 3
paragraph. 2 (a). and medical equipment), if the deficiencies did not

After subsequently set a reasonable time limit; the contract or its part

expires only in part defining the scope of the contracted health care in

which medical equipment does not comply with the law or the contract

set assumptions, unless it was so severe the circumstances for which

You cannot expect a further performance of the contract in its entirety.



Article 9



Before the expiry of the agreed period, you can terminate the agreement upon written notice to the

notice period of five months, which begins the first day of the month

following the delivery of the notification to the other Contracting Party, if in

as a result of serious circumstances cannot reasonably expect more performance

of the Treaty, and that, in the event that the



and) Contracting Party



1. the stated in the conclusion of the contract or the performance of other Contracting

in a mistake in the things essential to the performance of the contract,



2. in contractual relations, the rough way infringed the obligation to a major

saved it to the competent legislation on public health

insurance or health care, or the provision of the Treaty,



3. repeated breach of an obligation arising out of section 41 of the Act,



4. enter into liquidation or on its property, the Court will declare bankruptcy,



(b)) medical equipment



1. without prior agreement with the insurance company for no reason does not provide health

care within the agreed scope and quality,



2. through the written warning without previous agreement with the insurance company repeatedly

charges care provided in excess of the stipulated kind,

expertise and scope of activities,



3. through written notice to the insured person unreasonably limits the

insurance companies opening period agreed in the contract,



4. provides health care without adequate substantive and technical

equipment and staffing,



5. proven does not provide the insured health care quality and "lege

Artis ", or repeatedly refuses to provide health care from other,

than the statutory reasons,



6. calls, in conflict with the law from policy holders financial reimbursement

for health care paid for by the insurance company or the policyholder for the adoption of the

care,



7. a written warning over proven repeatedly wrongly charged

health care,



8. does not provide the necessary assistance for the performance of control activities

carried out by the insurance company in accordance with the law,



(c) the insurance company)



1. through the written warning repeatedly illegally fail to pay

the medical equipment provided paid health care,



2. fails to meet payment deadlines agreed in the contract,



3. through the written warning repeatedly exceeds the range of the control

the activities provided for by law,



4. provide the third party data on medical devices above and beyond

the law or the contract.



Article 10



Before the expiry of the agreed period, you can terminate the contract:



and if so) lays down the law



(b)) a written agreement of the Contracting Parties under the conditions and within the time limit

referred to in this agreement.



Article 11



Mutual communication of information and transmission of documents necessary for the verification of compliance with

of the Treaty



(1) the Contracting Parties:



and) use to uniquely identify the medical equipment, in

accordance with the methodology, the organization identification number (IČ), identification

device number (IČZ), the identification number of the workplace (IČP)



(b) shall communicate the information required's) to check the performance of the contract,



(c)) shall ensure permanently accessible and clear information on the existence of a contractual

the relationship and the rights arising from it for the insured person,



d) may pass the information necessary to assess the quality and effectiveness of

provided paid health care, to the extent and under the conditions

stipulated in the contract.



(2) medical device:



and the insurance company shall, when) about suspected non-compliance procedure

"lege artis", that medical devices have been in the provision of paid

health care used in accordance with the special law of ^ 14)



(b)) shall immediately notify, not later than 30 calendar days, the other Contracting

side of the facts, which would substantially affect the implementation of the

the contract, for example. the emergence of computer system faults, changes to the data referred to

in the contract, if the



1. cancellation of the workplace or the part thereof without compensation, or

conclusion for more than 30 calendar days,



2. to leave the employee specifically referred to in the Treaty,



3. the failure of the instruments necessary for the implementation of performance without compensation on the

For more than 30 calendar days.



Failure to comply with the obligations referred to in points (a) or (b))), or late

compliance with the obligations referred to in point (a) (b)), it is considered a serious

violation of major contractual obligations.



(3) the insurance company



and) can provide a medical facility in the generalized form of the information

needed to developing its activities or to his scientific and research

activities and to control the quality of health care provided by employers, and it

to the extent and under the conditions stipulated in the contract,



(b)) may publish on its website within the list of

medical devices trade name or business name and address of the

medical equipment, his expertise, and dial-up. e-mail

connection, or other mutually agreed data.



Article 12



Resolution of disputes



(1) the Contracting Parties shall resolve any disputes relating to the implementation of the

the Treaty primarily by negotiation representatives of the parties, and that

as a general rule within 14 calendar days from the challenges of one of the Contracting Parties.

If there is no agreement between them, the issues discussed in the

the conciliation negotiations. This does not affect the right of Contracting Parties to apply their

entitled to dispute in court or in arbitration proceedings under the Special

^ law 15), if the Contracting Parties on the settlement of disputes in

arbitration agree in the contract.



(2) the conciliation negotiations suggests one of the Contracting Parties. The proposal must

contain accurate and sufficiently detailed definition of the dispute. Zhastníkem

the conciliation negotiations is the Contracting Party that submitted the proposal for the consideration of the

the dispute, a Contracting Party that is a proposal for the consideration of the dispute addressed to,

the representative of the relevant group of medical facilities

represented their interest associations ^ 16) under section 17 (3)

the law and the representative of the insurance company. To discuss the dispute, each Contracting

Party may invite a maximum of two professional adviser. The conciliation negotiations with the

terminates the registration, containing a settlement or the conclusion that the conflict has not been removed

with an indication of the opinions of both parties.



1) Act No. 48/1997 Coll., on public health insurance, as amended by

amended.



1) Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Law No 160/1992 Coll., on health care in non-State medical

establishments, as amended.



2) Act No. 551/1991 Coll., on general health insurance company, in the text of the

amended.



Law No. 280/1992 Coll., on departmental, industry, corporate, and other

health insurance, as amended.



3) Council Regulation (EEC) No 1408/71 and 574/72.



4) Eg. Communication from the Ministry of Foreign Affairs No. 130/2002 SB., m.s.,

the negotiation of a Treaty between the Czech Republic and the Federal Republic of

Yugoslavia on social security,



Communication from the Ministry of Foreign Affairs No. 83/2000 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Croatia on the social

security,



Communication from the Ministry of Foreign Affairs No. 135/2004 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Turkey on the social

Security.



5) section 10 of Act No. 526/1990 Coll., on prices, as amended.



6) Law No. 101/2000 Coll., on protection of personal data and on amendments to certain

laws, as amended.



7) Act No. 435/2004 Coll., on employment, as amended,

regulations.



8) Law No. 95/2004 Coll., on conditions for the acquisition and recognition of professional

competence and specialized competence to perform medical

the professions of doctor, dentist and pharmacist.



Law No 96/2004 Coll., on conditions for the acquisition and recognition of competence to

the exercise of paramedical professions and to pursue activities

related to the provision of health care and to change some of the

related laws.



9) Decree No. 49/1993 Coll., on technical and substantive requirements

equipment of medical devices, as amended.



10) Act No. 20/1966 Coll. on health care of the people, as amended

regulations.



Decree No 385/2006 Coll., on the medical documentation, as amended by the Decree of the

No 479/2006 Sb.



11) Law No 111/1994 Coll. on road traffic, as amended

regulations.



Decree No. 478/2000 Coll., implementing the law on road transport,

in the wording of later regulations.



Decree No. 134/1998 Coll. issuing the list of medical procedures with

point values, as amended.



12) Act No. 563/1991 Coll., on accounting, as amended.



13) § 67 b) of Act No. 20/1966 Coll., on the health care of the people, in the text of the

amended.



for example, law No 14) 123/2000 Coll., on medical devices and on
changes to some related laws, as amended.



15) Act No. 216/1994, Coll., on arbitration proceedings and enforcement of arbitral

the findings, in the wording of Act No. 245/2006.



16) Act No. 83/1990 Coll. on Association of citizens, as amended

regulations.



§ § 20f and subs. Act No. 40/1964 Coll., the civil code, as amended by

amended.



Annex 8



Framework contract for medical equipment and health care

the insurance company



THE FIRST PART OF THE ANNEX



General provisions



Article 1



Contractual relations



(1) a framework agreement lays down the conditions under which the contract is concluded

between medical devices for pharmaceutical care (hereinafter referred to as "device

pharmaceutical care ") and insurance companies, and in order to ensure the factual

performance in the provision of and payment of pharmaceuticals, foods for special medical

purposes and medical resources from public health

Insurance ^ 1) (hereinafter referred to as "paid to pharmaceuticals, foods for special medical

purposes and medical devices)



(2) the legal relationships in the contract concluded between the

insurance ^ 2) and devices for pharmaceutical care shall not depart from the

the provisions of the framework contract in accordance with this Ordinance, with the exception of those

provisions, for which such a possibility this framework contract expressly

lists.



PART TWO OF THE ANNEX TO



Of the Treaty



Article 2



Conclusion of contracts



(1) the legal relationship between the insurance company and the equipment pharmaceutical care is governed by the

a written contract concluded under this framework contract, legal

the rules governing the public health insurance and the provision of

health care, and even in the case where the undertaking fulfils the role of a temporary

institutions in the implementation of the rights of the European Union ^ 3) or on the basis of the

international agreements on social security concluded by the Czech

Republic ^ 4). In matters not regulated by these laws and regulations and

the contract shall be governed by the commercial code.



(2) the basic condition for the conclusion of a contract is the permission of the medical

the equipment for the provision of health care in the field.



(3) the contract contains the



and) the rights and obligations of the Contracting Parties,



(b) the implementation of the remuneration provided by) the way medicines, foods for special

medical and health resources,



(c)) the conditions to maintain the quality control method of providing pharmacy

care, the accuracy and validity of the posted amounts



d) range and method of mutual communication of the information necessary to check the

performance of the contract,



(e)) the provisions on the resolution of conflicts in the course of the negotiations, where appropriate, the provisions of

about the use of arbitration,



(f) the period of application of the Treaty), the way and the reasons for her termination,



(g)) the provisions on the acceptance of and compliance with the agreed procedure for

acquisition, transmission and evaluation of documents in accordance with the methodology,

rules and uniform data interface, produced by the universal

health insurance in the Czech Republic in cooperation with the representatives of

insurance companies and representatives of professional associations of health care providers

and issued a general health insurance company in the Czech Republic, the applicable

at the time of conclusion of the contract,



(h) the provisions on the method of introduction) of medical equipment with any

changes to the methodology and rules, including the method of transmission of these changes.



(4) the contract may also contain other arrangements necessary for the implementation and

check if they are in accordance with this agreement and the legal framework

provisions.



Article 3 of the



The rights and obligations of the parties



(1) the Contracting Parties



and when reporting and shall comply with), payment of the financed by drugs, food for

Special medical purposes and medical devices agreed

the methodology, rules and data interface; the contract shall specify the version number

at the time of conclusion of the contract,



(b) undertake their employees) with regard to the protection of the rights and interests of policyholders

equipment care and insurance companies, to maintain the mandatory confidentiality

about personal information ^ 5), and the facts on which the learned in the exercise of

his Office or employment, or during the processing of the data from the information

the system on the basis of the contract, where applicable, in connection with a ^ 2).



(2) the equipment pharmaceutical care



and paid to pharmaceuticals,) provides food for special medical purposes and

medical devices in accordance with the legislation in the fields of medicine and

the scope of the agreed and defined in the Treaty, for which it is materially and

technically equipped and staffed to ensure



(b)) to be paid by the Food Drug Administration, provides for special medical purposes and

medical devices to the insured from the EU under the same conditions as the

the insured the insurance company, in the range from the documents submitted by them, so

to avoid discrimination or favoritism, and even

If the beneficiary of EU health care paid for in cash,



(c)) is responsible for the fact that his staff ^ 6), who will be insured

provide in the contract negotiated paid health care, meet the

the requirements laid down by law for the performance of this activity ^ 7),



(d)) shall ensure the treatment with medicines and medical devices

the conditions for the maintenance of the quality, efficacy and safety of medicinal products and

medical devices for insured persons and the conditions for their issue in

accordance with a special law ^ 8),



(e)) is responsible for the implementation of the substantive and technical conditions laid down for the

It provided paid health care according to a special legal

^ Code 9)



f) corresponds to in the preparation of medicinal products for their quality and

safety training for insured persons,



(g)) has a range of covered drugs, foods for special

medical and health resources available in the Czech Republic

in the range usually doctors in the předepisovaném region, which

It will allow to satisfy the policyholder usually after application of the recipe (voucher)

without unnecessary demands on their financial participation; in their activities

progresses efficiently and economically. For this purpose, shall ensure in that

the range of pharmaceutical products, foods for special medical purposes and medical

resources to be available to fully paid and at least

consuming products



(h) the obligation to replace) the medicinal product in the cases provided for in

in section 32 of the Act; in the case of a refund of the medicinal product in accordance with

special legal regulation ^ 10), in compliance with the highest

the economy of this refund,



I will not withdraw from the insured person), if it does not result from legal

regulations, no financial remuneration for provided medicines, food for

Special medical purposes and paid for by the insurance company, medical devices



j) shall notify, in case of impossibility to provide pharmaceutical care

the insured the nearest available care facilities,



to the right of the policyholder to making) grant financed by drugs, food

for special medical purposes and medical devices by changing the

the insurance undertaking or in any other way,



l) showing when concluding a contract with an insurance company proof of insurance

liability for damage caused to citizens in connection with the provision

financed by the drugs, foods for special medical purposes and health

resources and will be insured for the entire duration of the contractual relationship with the

the insurance company.



(3) the insurance company



and pay device care) paid to pharmaceuticals, food for

Special medical purposes and medical devices it provided

the insured and the insured from the EU, who have chosen the insurance company's

the institution of manner in the implementation of the rights of the European Union ^ 3) in accordance with the

law and treaty,



(b)) at the request of the device sees pharmaceutical treatments without undue delay

the jurisdiction of the insured person to the insurance undertaking in cases where it is not available

insurance card and his personal data are available,



(c)) will not require preferential treatment of their policyholders at the expense of policyholders

other insurance companies, or direct its clients to selected

of the equipment pharmaceutical treatments,



(d)) provides the facility of care in order to ensure uniform conditions

the agreed methodology, rules, data interface and the appropriate dials

issued by the general health insurance company for reporting and calculation of the remuneration

paid for by the health care



(e) the establishment of care) acquainted with the agreed changes to the methodology,

rules and with the changes at least one month and the dials with the change

the data interface at least two months before the date of their

the validity of. In the case of changes to the legislation, which does not allow this period

keep, can be referred to commensurately reduced.



Article 4 of the



The remuneration provided by medicinal products, foods for special medical

purposes and medical devices



' (1) medicinal products within the meaning of special legal regulation ^ 11),

foods for special medical purposes and medical devices in the

the meaning of special legal regulation ^ 12) shall be borne by the undertaking in accordance with

special legislation ^ 13) or according to the applicable price laws

issued by the Ministry of Finance of ^ 14).



(2) pharmaceutical treatments for claims for reimbursement of issued

financed by the drugs, foods for special medical purposes and health
the funds under the agreement, the insurance company passes between the Contracting Parties

once or twice a month, recipes and vouchers for health

resources in batches along with billing invoice with attachments. Invoice

contains elements of the accounting document ^ 15). The essentials of the annex are

contained in the methodology or in accordance with the methodology shall specify in the contract. In

If the invoice does not contain particulars of the accounting document and annex

does not contain the particulars referred to in the agreed methodology or the contract has

the insurance company right to refuse and return without undue delay device

pharmaceutical treatments to complement, where appropriate, to correct; in this case, running

the period up to the maturity date of its renewed takeover of the insurance company.



(3) Documents (recipes containing particulars set out specific legal

Regulation ^ 8)) to be paid by pharmaceuticals, foods for special medical purposes

and medical devices provided by the insurance company and the insured

insurance policy holders in the EU, who have the insurance company selected as the institution of manner

in the implementation of the rights of the European Union ^ 3), passes the equipment pharmaceutical care

the insurance company, together with a breakdown by the deadline and in the manner set out in the methodology

and data interface and agreed in the contract (on an electronic medium, or

in electronic form or on paper).



(4) the insurance company performs for its clients and policyholders from the EU who

the insurance company selected as the institution of manner in the implementation of the rights of

The European Union ^ 3), the reimbursement of medicines, foods for special medical purposes and

medical devices. By providing a payment does not affect the right of

insurance companies to carry out subsequent checks paid the Bill in

the extent and under the conditions laid down by the relevant legislation and

the Treaty.



(5) where the insurance company misconduct in the Bill submitted to the device

Additionally, i.e. pharmaceutical treatments. After the payment and the establishment of care to

10 working days from the receipt of the written call the insurance company

the amount itself does not settle, or they can demonstrate the legitimacy of the sale of the disputed

of the amount, or unless otherwise agreed between the Contracting Parties, dates of payment,

undertaking unilateral offsetting receivables reduced equipment

pharmaceutical care of the appropriate remuneration for the amount of the Bill paid by the

drugs, foods for special medical purposes and medical devices

presented in the following billing period.



(6) If an undertaking when the control detects errors in the annexed documents

caused by the equipment or negligence of duties of care equipment

pharmacy care, incorrect document. In the record of the discarded documents

the reason for the eviction of the document and marks the amount of remuneration shall be reduced by the

the amount of margin facilities of care. Corrected documents can

the equipment pharmaceutical care charge in the following term, together with the

the next transmitted to billing. Unjustifiably excluded documents insurance company

pay, or pay the equipment pharmaceutical treatments applied penalty.



(7) Remuneration provided by the drug, charged covered food for

Special medical purposes and medical devices, in compliance with the

the conditions stipulated in the contract, shall be made upon delivery of the Bill

the insurance company or on an electronic medium in electronic form and its

the subsequent revision of the insurance company through the information system within 30

calendar days and when you pass the Bill the insurance company on paper

documents and its subsequent revision of the insurance company through the

the information system within 50 calendar days from the date of receipt of the invoice

to the insurance undertaking unless the contracting parties otherwise. The time limit is due

complied with, if a payment on the last day of the period is credited to the account

medical equipment.



Article 5



Check



(1) the insurance undertaking in accordance with section 42 of the Act and the Treaty control

picking and post financed by the drugs, foods for special medical purposes

and medical devices in their volume and maintenance conditions

quality, including compliance with the prices, through its information

system, audit practitioners and other professional workers in

health, eligible for the review activities (hereinafter referred to as "professional

workers "). The review by a doctor and a pharmacist means a revision.



(2) the establishment of care will provide an insurance undertaking in the performance of the checks

the necessary assistance, in particular submitted required documents, shall be communicated

data and provides explanations. The review will allow doctors and expert

workers of the insurance undertaking, usually after the previous discussion, the entrance to the

its object, and the inspection of the documentation directly related to the

by checking the charged drug, foods for special medical

purposes and medical devices.



(3) in the case of control devices (IP) in care will be on the

the site handled a record indicating the most important findings and

the opinions of the equipment pharmaceutical treatments. This entry does not replace a message

in accordance with paragraph 4.



(4) a report containing the conclusions of the inspection, the insurance company will process and transmit

the equipment pharmaceutical care within 15 calendar days after the completion of the inspection;

If not possible, for objective reasons, this deadline, notify the

the insurance company this fact to the equipment pharmaceutical treatments. A check will be

completed normally within 30 calendar days of its initiation.



(5) the Equipment pharmaceutical care is authorized, within 15 calendar days from the

taking over the control of the insurance company, in writing, the conclusion may submit reasoned objections. To

the opposition of the insurance undertaking shall inform the opinion within 30 calendar days of their

delivery. If not possible, for objective reasons, these deadlines,

extend the time limit at the request of the Contracting Parties to the

twice. The insurance company shall inform in due time the equipment pharmaceutical

care, whether confirmed or amended conclusions of the inspection. The opposition does not have the

the perspective of the financial claims of the insurance undertaking to the equipment pharmaceutical care

suspensory effect. This does not prejudice the right of the equipment pharmaceutical care

apply its disagreement with the decision of the insurance undertaking in other proceedings.



(6) if the check shows the unlawfulness or incorrectness of the statement

financed by the drugs, foods for special medical purposes and health

funds, insurance company according to § 42 paragraph 3 of the law of such care

bears and is empowered to follow the penalty arrangements referred to

in the contract. In the case that the conclusions of the inspection they prove unjustified,

the insurance company the equipment pharmaceutical care, the amount on the basis of the

remuneration provided declined checks wrongly paid by the drug,

foods for special medical purposes and medical devices.

The equipment pharmaceutical care is entitled to proceed under penalty

the arrangements referred to in the Treaty.



Article 6 of the



Penalty arrangements



(1) the Contracting Parties for non-compliance with contractual obligations and infringement of

the contracts referred to in paragraph 2 or of other reasons stipulated in the contract

can negotiate a contractual penalty and its amount.



(2) for breach of contract shall be the cases when



and) Contracting Party



1. the false, incomplete or misleading information in the conclusion

of the Treaty, or in its implementation,



2. fail to comply with the provisions of the Treaty, with the consequence of the proven neúčelného

expending the resources of public health insurance,



3. fails to provide the information in the contract negotiated,



(b) the establishment of care)



1. unlawfully (e.g. issue of the nepředepsaného, or incorrectly

replaced by pharmaceuticals, foods for special medical purposes or

medical device or billing public health

insurance nehrazeného pharmaceuticals, foods for special medical purposes

or medical device) or multiple drug charges

foods for special medical purposes and medical devices,



(c) the insurance company)



1. the payment shall be reduced or, unjustifiably refuses to legally endorsed,

financed by the drugs, foods for special medical purposes and health

resources,



2. carry out the payment of legally endorsed, financed by drugs, food for

Special medical purposes and medical devices with delay, in addition to

in cases where it is not responsible for the delay.



(3) the application of a sanction shall not affect the right of Contracting Parties to return

compensation for unlawfully or wrongly charged and reimbursed medicines,

foods for special medical purposes and medical devices.



Article 7



The period of application, the method and the reasons for the termination of the contract



The contract is concluded for a period of 5 years, unless otherwise agreed by the Contracting Parties

otherwise.



Article 8 of the



The contract or its part shall lapse:



and the day) took the decision on the cancellation or change

registration under Act No. 160/1992 Coll., on health care in non-State

medical devices, as amended, or to

cancellation or change of the provisioning of the Charter, issued by the equipment pharmaceutical treatments,



(b) on the date of demise) of medical equipment or the insurance company or the date of death

natural persons, which was the operator of medical equipment,



(c)) of the date specified in the written notice to the insurance company, if the device
pharmaceutical care of severe health or operational reasons cannot

paid health care continue to provide.



Article 9



Before the expiry of the agreed period, you can terminate the agreement upon written notice to the

notice period of five months, which begins the first day of the month

following the delivery of the notification to the other Contracting Party, if in

as a result of serious circumstances cannot reasonably expect more performance

of the Treaty, and that, in the event that the



and) Contracting Party



1. the stated in the conclusion of the contract or the performance of other Contracting

in a mistake in the things essential to the performance of the contract,



2. in contractual relations, the rough way infringed the obligation to a major

saved it to the competent legislation on public health

insurance or health care, or the provision of the Treaty,



3. enter into liquidation or on its property, the Court will declare bankruptcy,



(b) the establishment of care over) written warning



1. proven repeatedly wrongly accounted for medicinal products and medical

resources,



2. requests, in conflict with the law from policy holders financial reimbursement

for medicinal products and medical devices, paid for by the insurance company,



3. fails to provide the necessary assistance for the performance of control activities

carried out by the insurance company in accordance with the law,



4. provides health care without adequate substantive and technical

equipment and staffing,



(c) the insurance company)



1. through the written warning repeatedly wrongly bears gear

of care provided to be paid by drug and medical devices



2. fails to meet payment deadlines agreed in the contract,



3. through the written warning repeatedly exceeds the range of the control

the activities provided for by the law.



Article 10



Before the expiry of the agreed period, you can terminate the contract



and if so) lays down the law



(b)) a written agreement of the Contracting Parties under the conditions and within the time limit

referred to in this agreement.



Article 11



Mutual communication of information and transmission of documents necessary for the verification of compliance with

of the Treaty



(1) the Contracting Parties



and) use to uniquely identify the equipment pharmaceutical treatments, in

accordance with the methodology, the organization identification number (IČ), identification

device number (IČZ), the identification number of the workplace (IČP)



(b) shall communicate the information required's) to check the performance of the contract.



(2) the equipment pharmaceutical care



and shall notify, at the latest) within 30 calendar days of the other Contracting

side of the facts, which would substantially affect the implementation of the

the contract, for example. the emergence of computer system faults, changes to the data referred to

in the contract.



Article 12



Resolution of disputes



(1) the Contracting Parties shall resolve any disputes relating to the implementation of the

the Treaty primarily by negotiation representatives of the parties, and that

as a general rule within 14 calendar days from the challenges of one of the Contracting Parties.

If there is no agreement between them, the issues discussed in the

the conciliation negotiations. This does not affect the right of Contracting Parties to apply their

entitled to dispute in court or in arbitration proceedings under the Special

^ Law 16), if the Contracting Parties on the settlement of disputes in

arbitration agree in the contract.



(2) the conciliation negotiations suggests one of the Contracting Parties. The proposal must

contain accurate and sufficiently detailed definition of the dispute. A participant in the

the conciliation negotiations is the Contracting Party that submitted the proposal for the consideration of the

the dispute, a Contracting Party that is a proposal for the consideration of the dispute addressed to,

a representative of the respective group of the equipment pharmaceutical care

represented their interest associations ^ 17) under section 17 (3)

the law and the representative of the insurance company. To discuss the dispute, each Contracting

Party may invite a maximum of two professional adviser. The conciliation negotiations with the

terminates the registration, containing a settlement or the conclusion that the conflict has not been removed

with an indication of the opinions of both parties.



1) Act No. 48/1997 Coll., on public health insurance, as amended by

amended.



Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Law No 160/1992 Coll., on health care in non-State medical

establishments, as amended.



2) Act No. 551/1991 Coll., on general health insurance company, in the text of the

amended.



Law No. 280/1992 Coll., on departmental, industry, corporate, and other

health insurance, as amended.



3) Council Regulation (EEC) No 1408/71 and 574/72.



4) Eg. Communication from the Ministry of Foreign Affairs No. 130/2002 SB., m.s.,

the negotiation of a Treaty between the Czech Republic and the Federal Republic of

Yugoslavia on social security,



Communication from the Ministry of Foreign Affairs No. 83/2000 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Croatia on the social

security,



Communication from the Ministry of Foreign Affairs No. 135/2004 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Turkey on the social

Security.



5) Law No. 101/2000 Coll., on protection of personal data and on amendments to certain

laws, as amended.



6) Act No. 435/2004 Coll., on employment, as amended,

regulations.



7) Law No. 95/2004 Coll., on conditions for the acquisition and recognition of professional

competence and specialized competence to perform medical

the professions of doctor, dentist and pharmacist.



Law No 96/2004 Coll., on conditions for the acquisition and recognition of competence to

the exercise of paramedical professions and to pursue activities

related to the provision of health care and to change some of the

related laws.



8) Act No. 79/1997 Coll., on pharmaceuticals and on amendments and additions to some

related laws, as amended.



Decree No. 61/1990 Coll. on the management of health care needs, in

as amended.



Decree No. 343/1997 Coll., laying down the method of prescribing

medicinal products, the particulars of medical regulations and the rules of their

of use, as amended.



Decree No. 255/2003 Coll., laying down proper pharmaceutical practice,

further conditions for the preparation and editing of the medicinal products, issues and

treatment with medicinal products in health care facilities and more

the conditions for the operation of pharmacies and other operators, of the issuing of medicinal

preparations.



9) Decree No. 49/1993 Coll., on technical and substantive requirements

equipment of medical devices, as amended.



10) section 49 of Act No. 79/1997 Coll.



11) § 2 (2). 3 of Act No. 79/1997 Coll.



12) Law No. 123/2000 Coll., on medical devices and on the change

certain acts, as amended.



13) Decree No 532/2005 Coll. on the payment of medicines and foods for special

medical purposes, as amended.



14) section 10 of Act No. 526/1990 Coll., on prices, as amended.



15) Act No. 563/1991 Coll., on accounting, as amended.



16) Act No. 216/1994, Coll., on arbitration proceedings and enforcement of arbitral

the findings, in the wording of Act No. 245/2006.



17) Act No. 83/1990 Coll. on Association of citizens, as amended

regulations.



§ § 20f and subs. Act No. 40/1964 Coll., the civil code, as amended by

amended.



Annex 9



Framework contract for health care facilities providing care and Spa

health insurance companies



THE FIRST PART OF THE ANNEX



General provisions



Article 1



Contractual relations



(1) a framework agreement lays down the conditions under which the contract is concluded

between the health establishments providing care and Spa

insurance companies, for the purpose of providing benefits in kind in the provision and

payment of paid health care ^ 1).



(2) the legal relationships in the contract concluded between the

insurance ^ 2), and medical devices shall not deviate from the

the provisions of the framework contract in accordance with this Ordinance, with the exception of those

provisions, for which such a possibility this framework contract expressly

lists.



The SECOND PART of ANNEX 1



Of the Treaty



Article 2



Conclusion of contracts



(1) the legal relationship between the insurance company and medical facilities is governed by the

a written contract concluded under this framework contract and legal

the rules governing the public health insurance and the provision of

health care, and even in the case where the undertaking fulfils the role of a temporary

institutions in the implementation of the rights of the European Union ^ 3) or on the basis of the

international agreements on social security concluded by the Czech

Republic ^ 4).



In matters not regulated by these laws and regulations and the contract shall be governed by

the commercial code.



(2) the basic condition for the conclusion of a contract is the permission of the medical

the equipment for the provision of health care in the field.



(3) the contract includes:



and) the rights and obligations of the Contracting Parties,



(b) the quality and effectiveness of the) conditions of the provision of health care, in particular

the kind, scope, and extent of provided health care according to the types of care, which

is a medical device authorized to provide, including the factual and

technical equipment and staffing,



(c) point values) ^ 5), the amount of the reimbursement paid by health care and regulatory
limitation of the volume of paid health care provided in accordance with the Decree

issued under section 17, paragraph. 6 of the Act,



(d) the implementation of the remuneration provided by) the way of health care,



(e)) the conditions required to check the performance of the contract, including the accuracy and

the legitimacy of the posted amounts



f) range and method of mutual communication of the information necessary to check the

performance of the contract,



(g)) the provisions on the resolution of conflicts in the course of the negotiations, where appropriate, the provisions of

about the use of arbitration,



(h) the period of application of the Treaty), the way and the reasons for her termination,



I) provisions on the acceptance of and compliance with the agreed procedure for

acquisition, transmission and evaluation of documents in accordance with the methodology,

rules and uniform data interface, produced by the universal

health insurance in the Czech Republic in cooperation with the representatives of

insurance companies and representatives of professional associations of health care providers

and issued a general health insurance company in the Czech Republic, the applicable

at the time of conclusion of the contract,



j) provisions on how to get started with any medical facility

changes to the methodology and rules, including the method of transmission of these changes.



(4) the contract may also contain other arrangements necessary for the implementation and

check if they are in accordance with this agreement and the legal framework

provisions.



Article 3 of the



The rights and obligations of the parties



(1) the Contracting Parties:



and when reporting and shall comply with), payment of paid health care agreed

the methodology, rules and data interface; the contract shall specify the version number

at the time of conclusion of the contract,



(b) undertake their employees) with regard to the protection of the rights of insured persons, to the

maintaining the confidentiality of the personal data required ^ 6) and facts

which to learn in the performance of their duties or employment or in

processing of data from the information system on the basis of the Treaty, or of the

connection with a ^ 2).



(2) medical device:



and provides paid health care) in accordance with the legislation in

proficiency and the extent of the agreed and defined in the Treaty, for which the

It is factually and technically equipped and staffed to ensure



(b)) provides health care paid for by the insured from the EU under the same

conditions as to the insured the insurance company, in the range from applicants

documents, so as to avoid discrimination or preference,

and even in the event that the beneficiary from the EU, responsibility for health care in the

cash,



(c)) is responsible for the fact that his staff ^ 7), who will be insured

provide in the contract negotiated paid health care, meet the

the conditions laid down by law for the performance of this activity ^ 8).



(d)) is responsible for this, that health care workers are paid

health care on the basis of the indications of the attending doctor,



(e)) is responsible for the implementation of the substantive and technical conditions laid down for the

It provided health care under a special legal regulation, ^ 9),



(f)) provides health care paid for by the "lege artis" without excess

the cost, however, with a view to making the necessary diagnostic

or therapeutic effect was achieved with regard to individual health

the status of the insured person,



(g)) to provide health care to the policyholder in accordance with section 33 of the Act, and

special legal regulation ^ 10),



h) will lead to eligibility made health care in

conclusive form of health documentation on the treatment of policyholders, in which

the performances will be recorded, on-demand made by the medical health care

including medical transportation, prescribed medicines and medical

resources and retained in her Inbox results requested and carried out

examination and treatment, in accordance with a special law ^ 11),



I) shall ensure that, in the absence of an agreed in the contract holders

performance, the crowd another qualified holder performance and contract

agreed cases shall notify the insured and the insurance company,



(j)) after their spa treatment final report to policyholders

the attending doctor, in order to ensure continuity of health care and to avoid

duplicate the implementation of diagnostic and treatment procedures,



to refuse receipt of the policyholder) in your care,



(l) the right of the insured person making the) freedom of choice of doctor, medical

equipment or the provision of health care paid for by any of the

registration fees or with various donations and granted

health care paid for by the insurance company will not be from the insured person, if it

did not result from legislation, to collect any financial remuneration,



the right of the insured person making m) on the provision of paid health care

changing the insurance undertaking or in any other way,



n) will not discriminate between insured persons of one or more insurance undertakings in

detriment of policyholders of insurance companies and worsen the availability

health care paid for by the insurance company a priority the provision of care

paid for by other means,



notify the insurance undertaking) in accordance with section 55 of the Act injuries or other damage

the health of the persons who provided paid health care, if you have reason to

suspecting that they were caused by acts legal or natural person,



p) matches under special legislation ^ 12) for correct and complete

fill in the form of a recipe; also responsible for the correct and complete filling

voucher for medical devices or voucher to the examination/treatment

or to the medical transport. When prescribing was not

respected prescribing restrictions arising from legislation and the

undertaking this medicinal product or medical device equipment

pharmacy care, an insurance undertaking has the right to require

medical device reimbursement of amounts paid,



q) showing when concluding a contract with an insurance company proof of insurance

liability for damage caused to citizens in connection with the provision

health care and will be insured for the entire duration of the contractual relationship with the

the insurance company.



(3) an insurance undertaking:



and will pay the medical facility) made paid health care,

clearly documented and reasonably provided to the insured and the

insurance policy holders in the EU, who have the insurance company selected as the institution of manner

in the implementation of the rights of the European Union ^ 3) in accordance with the law and

the Treaty,



(b)), on request, sees therapeutic equipment without undue delay

the jurisdiction of the insured person to the insurance undertaking in cases where it is not available

insurance card and his personal data are available,



(c)) will not require preferential treatment of their policyholders at the expense of policyholders

other insurance companies,



(d)) is authorised to control compliance with the contractually agreed payment in kind and

technical conditions and staffing financed by health care

provided by the medical establishment, under the Treaty,



e) provides medical equipment to ensure uniform conditions

the agreed methodology, rules, data interface and the appropriate dials

issued by the general health insurance company for reporting and calculation of the remuneration

paid for by the health care



(f) medical device with familiar) the agreed changes to the methodology,

rules and with the changes at least one month and the dials with the change

the data interface at least two months before the date of their

the validity of. In the case of changes to the legislation, which does not allow this period

keep, can be referred to commensurately reduced.



Article 4 of the



Remuneration provided paid health care



(1) Remuneration provided by the paid care is stipulated in Appendix to the Treaty

under special legislation, in accordance with the valid price Výměrem

The Ministry of finance for the relevant period.



(2) Between the parties must always be agreed in advance to increase or

the reduction of the volume of provided paid health care due to changes

capacity, the structure of the medical equipment, changes or reconstruction

Instrumentation as specified in the contract.



(3) medical devices for the filing of claims for reimbursement provided

paid for by the health care bill passes the insurance company once a month

care provided an invoice with attachments, if the Contracting Parties

agree on passing the Bill over a longer period. The invoice contains

Essentials of accounting document ^ 13). The essentials of the annex are contained in the

the methodology or in accordance with the methodology shall specify in the contract. In the case of

that the invoice does not contain particulars of the accounting document and annex does not contain

requirements of the agreed methodology or a contract, an insurance undertaking has the right to

reject it and return without undue delay the medical device to

complement, where appropriate, to correct; in this case, the running period of maturity

to date her repossess the insurance company.



(4) the Medical device is responsible for the completeness, formal and factual

the accuracy of the documents and their transfer in the manner agreed in the methodology

and data interface. Documents for paid care provided

the insured the insurance companies and the insured from the EU, who have chosen the insurance company's

as the institution of manner in the implementation of the rights of the European Union ^ 3), passes

medical devices, together with a breakdown of the insurance undertaking in the term and

in the manner agreed in the contract (or on an electronic medium in

electronic form or on paper).
(5) if the undertaking establishes in the accounts before making reimbursement of incorrectly

or vyúčtovanou care, reimbursement of that part of the increase in care

the term to maturity. The insurance company provable way shall notify the

medical devices range without undue delay and the reason

made, but outstanding care. The insurance company will invite medical

a device to repair improperly accounted for care or to support the provision of

paid health care. Duly granted and vyúčtovanou care insurance company

will pay in the next term.



(6) the insurance company performs for its clients and for insured persons of the EU who

the insurance company selected as the institution of manner in the implementation of the rights of

The European Union ^ 3), the reimbursement of paid health care, accounted in accordance with the

the law and the contract. If on verification finds errors in the

documents, in accordance with the methodology and rules. Denial of payment or

part of the payment the insurance company without undue delay, medical devices

justify in writing. By providing a payment shall not prejudice the right of an insurance undertaking to

the implementation of subsequent checks paid the Bill to the extent and for the

the conditions laid down by the legislation and the contract.



(7) where the insurance company misconduct in the Bill submitted to the medical

Additionally, i.e. the device. After payment and medical equipment to 10

working days from the receipt of the written call the insurance company the amount

itself does not settle, or they can demonstrate the legitimacy of the disputed amount charged or

not unless otherwise agreed between the Contracting Parties, dates of payment, insurance company

unilateral offsetting claims will reduce the medical facility of the

the amount of the remuneration for the employers of health care bill

presented in the following billing period.



(8) the payment of health care paid for by margin provided, in compliance with the

the conditions stipulated in the contract, shall be made upon delivery of the Bill

the insurance company or on an electronic medium in electronic form within 30

calendar days and when you pass the Bill the insurance company on paper

documents within 50 calendar days from the date of receipt of the invoice to the insurance undertaking,

unless the contracting parties otherwise. Payment deadline is not respected,

If a payment on the last day of the period is credited to the account of the medical

the device.



(9) in the event of failure of the system, preventing the timely calculation

the implementation of the Bill or of the remuneration paid by health care, provide

insurance medical facility within the agreed time of payment advance

in the amount of average monthly volume reported by the health care

calculated from the last calendar quarter of two closed, if

the Contracting Parties agree otherwise in a given case.



Article 5



Check



(1) the insurance undertaking in accordance with section 42 of the Act and the Treaty control

the use and provision of paid health care in its volume and

quality, including compliance with the prices, through its information

system, audit practitioners and other professional workers in

health, eligible for the review activities (hereinafter referred to as "professional

workers ").



(2) in the framework of their competence review doctors and specialist

staff permissions to control whether the method shall be considered paid

health care was indicated with regard to the State of health of the insured person, the

in accordance with the current available knowledge of medical science and has not been

unnecessarily economically challenging.



(3) in the cases provided for by the legislation of the auditing physician assesses and

the rationale for treating physician proposed or carried out by the

a treatment procedure and approved, whether the procedure used the insurance company will pay.

The decision to use a treatment procedure, including pharmacotherapy is in

the competence of the physician.



(4) a medical facility shall provide to the insurance undertaking in the performance of the checks

the necessary assistance, in particular submitted required documents, shall be communicated

data and provides explanations. The review will allow doctors and expert

workers insurance companies access to its object, the inspection

medical documentation in accordance with the particular legal

Regulation ^ 14) and other documents directly related to the

by checking the charged health, pharmaceuticals and

medical devices, including a particularly charged drug and especially

the posted material.



(5) in the case of inspections (investigation) in the medical device will be on

the site handled a record indicating the most important findings and

the opinions of the medical device. This entry does not replace a message

in accordance with paragraph 6.



(6) a report containing the conclusions of the inspection, the insurance company will process and transmit

medical device within 15 calendar days after the completion of the inspection;

If not possible, for objective reasons, this deadline, notify the

the insurance company this fact to the medical facility. A check will be

completed normally within 30 calendar days of its initiation.



(7) the Medical device is authorized within 15 calendar days from the

taking over the control of the insurance company, in writing, the conclusion may submit reasoned objections. To

the opposition of the insurance undertaking shall inform the opinion within 30 calendar days of their

delivery. If not possible, for objective reasons, these deadlines,

can be used at the request of the competent contracting party to extend to the double.

The insurance company shall inform in due time the medical device to determine whether

confirms or alters the conclusions of the inspection. The opposition has in terms of

financial claims against the insurance company's medical device suspensory

effect. This does not prejudice the right of the medical device to

disagreement with the decision of the insurance undertaking in other proceedings.



(8) if the check shows the unlawfulness or incorrectness of the statement

paid for by the health care or her unjustified provision, insurance company

According to § 42 paragraph 3 of the Act, such care does not pay and is entitled to

follow the penalty arrangements referred to in the Treaty. In the event that the

the conclusions of the inspection they prove unjustified, the insurance company

medical devices the amount on the basis of checks decreased

reimbursement provided paid health care. Medical equipment is

entitled to proceed under penalty arrangements referred to in the Treaty.



Article 6 of the



Penalty arrangements



(1) the Contracting Parties for non-compliance with contractual obligations and infringement of

the contracts referred to in paragraph 2 or of other reasons stipulated in the contract

can negotiate a contractual penalty and its amount.



(2) for breach of contract shall be the cases when



and) Contracting Party



1. the false, incomplete or misleading information in the conclusion

of the Treaty, or in its implementation,



2. fail to comply with the provisions of the Treaty, with the consequence of the proven neúčelného

expending the resources of public health insurance,



3. fails to provide the information in the contract negotiated,



(b)) medical equipment



1. unlawfully or multiple charges to health care,



2. fails to provide the required reports resulting from the legislation of the

governing the public health insurance,



3. unreasonably delay has provided paid health care,



4. repeatedly violated the obligation to report to the insurance undertaking in accordance with § 55

law, injuries or other damage to the health of the insured person caused by an act

legal or natural person,



(c) the insurance company)



1. the payment shall be reduced or refused unjustifiably provided paid health

care,



2. carries out the payment lawfully made provided paid health

care with the delay, except in cases where it is not responsible for the delay.



(3) the application of a sanction shall not affect the right of Contracting Parties to return

remuneration for improperly or incorrectly vyúčtovanou and paid paid

health care.



Article 7



The period of application, the method and the reasons for the termination of the contract



The contract is concluded for a period of 5 years, unless otherwise agreed by the Contracting Parties

otherwise.



Article 8 of the



The contract or its part shall lapse:



and the day) took the decision on the cancellation or change

registration under Act No. 160/1992 Coll., on health care in non-State

medical devices, as amended, or to

cancellation or change of formation or Foundation Act, issued by the

the medical device, if as a result of this cancellation, the respectively.

changes, lost medical equipment to provide permission paid

health care in the fields of medicine and the extent of the agreed and defined in the

the Treaty,



(b) on the date of demise) of medical equipment or the insurance company or the date of death

natural persons, which was the operator of medical equipment,



(c)) of the date specified in the written notice to the insurance company, if the medical

devices from major health or operational reasons cannot health

continue to provide care,



d) date on which the medical facility lost its factual, technical or

personnel prerequisites for the provision of health care within the agreed

the extent provided for by law or the contract, within the meaning of article. 3

paragraph. 2 (a). and medical equipment), if the deficiencies did not

After subsequently set a reasonable time limit; the contract or its part

expires only in part defining the scope of the contracted health care in
which medical equipment does not comply with the law or the contract

set assumptions, unless it was so severe the circumstances for which

You cannot expect a further performance of the contract in its entirety.



Article 9



Before the expiry of the agreed period, you can terminate the agreement upon written notice to the

notice period of five months, which begins the first day of the month

following the delivery of the notification to the other Contracting Party, if in

as a result of serious circumstances cannot reasonably expect more performance

of the Treaty, and that, in the event that the



and) Contracting Party



1. the stated in the conclusion of the contract or the performance of other Contracting

in a mistake in the things essential to the performance of the contract,



2. in contractual relations, the rough way infringed the obligation to a major

saved it to the competent legislation on public health

insurance or health care, or the provision of the Treaty,



3. repeated breach of an obligation arising out of section 41 of the Act,



4. enter into liquidation or on its property, the Court will declare bankruptcy,



(b)) medical equipment



1. without prior agreement with the insurance company for no reason does not provide health

care within the agreed scope and quality,



2. through the written warning without previous agreement with the insurance company repeatedly

charges care provided in excess of the stipulated kind,

expertise and scope of activities,



3. through written notice to the insured person unreasonably limits the

insurance companies opening period agreed in the contract,



4. provides health care without adequate substantive and technical

equipment and staffing,



5. proven does not provide the insured health care quality and "lege

Artis ", or repeatedly refuses to provide health care from other,

than the statutory reasons,



6. calls, in conflict with the law from policy holders financial reimbursement

for health care paid for by the insurance company or the policyholder for the adoption of the

care,



7. a written warning over proven repeatedly wrongly charged

health care,



8. does not provide the necessary assistance for the performance of control activities

carried out by the insurance company in accordance with the law,



(c) the insurance company)



1. through the written warning repeatedly illegally fail to pay

the medical equipment provided paid health care,



2. fails to meet payment deadlines agreed in the contract,



3. through the written warning repeatedly exceeds the range of the control

the activities provided for by law,



4. provide the third party data on medical devices above and beyond

the law or the contract.



Article 10



Before the expiry of the agreed period, you can terminate the contract:



and if so) lays down the law



(b)) a written agreement of the Contracting Parties under the conditions and within the time limit

referred to in this agreement.



Article 11



Mutual communication of information and transmission of documents necessary for the verification of compliance with

of the Treaty



(1) the Contracting Parties:



and) use to uniquely identify the medical equipment, in

accordance with the methodology, the organization identification number (IČ), identification

device number (IČZ), the identification number of the workplace (IČP)



(b) shall communicate the information required's) to check the performance of the contract,



(c)) shall ensure permanently accessible and clear information on the existence of a contractual

the relationship and the rights arising from it for the insured person,



d) may pass the information necessary to assess the quality and effectiveness of

provided paid health care, to the extent and under the conditions

stipulated in the contract.



(2) medical device:



and the insurance company shall, when) about suspected non-compliance procedure

"lege artis", that medical devices have been in the provision of paid

health care used in accordance with the specific legislation of the 15 ^ ^)



(b)) shall immediately notify, not later than 30 calendar days, the other Contracting

side of the facts, which would substantially affect the implementation of the

the contract, for example. the emergence of computer system faults, changes to the data referred to

in the contract, if the



1. cancellation of the workplace or the part thereof without compensation, or

conclusion for more than 30 calendar days,



2. to leave the employee specifically referred to in the Treaty,



3. the failure of the instruments necessary for the implementation of performance without compensation on the

For more than 30 calendar days.



Failure to comply with the obligations referred to in points (a) or (b))), or late

compliance with the obligations referred to in point (a) (b)) shall be considered violations of the

significant contractual obligations.



(3) the insurance company



and) can provide a medical facility in the generalized form of the information

needed to developing its activities or to his scientific and research

activities and to control the quality of health care provided by employers, and it

to the extent and under the conditions stipulated in the contract,



(b)) is authorized to disclose information about the amount of reimbursement of health care provided

medical facilities



(c)) may publish on its website within the list of

medical device trade name or business name and address of the medical

his expertise and equipment, telephone, or e-mail links or

For more information of mutually agreed,



Article 12



Resolution of disputes



(1) the Contracting Parties shall resolve any disputes relating to the implementation of the

the Treaty primarily by negotiation representatives of the parties, and that

as a general rule within 14 calendar days from the challenges of one of the Contracting Parties.

If there is no agreement between them, the issues discussed in the

the conciliation negotiations. This does not affect the right of Contracting Parties to apply their

entitled to dispute in court or in arbitration proceedings under the Special

^ Law 16), if the Contracting Parties on the settlement of disputes in

arbitration agree in the contract.



(2) the conciliation negotiations suggests one of the Contracting Parties. The proposal must

contain accurate and sufficiently detailed definition of the dispute. A participant in the

the conciliation negotiations is the Contracting Party that submitted the proposal for the consideration of the

the dispute, a Contracting Party that is a proposal for the consideration of the dispute addressed to,

the representative of the relevant group of medical facilities

represented their interest associations ^ 17) under section 17 (3)

the law and the representative of the insurance company. To discuss the dispute, each Contracting

Party may invite a maximum of two professional adviser. The conciliation negotiations with the

terminates the registration, containing a settlement or the conclusion that the conflict has not been removed

with an indication of the opinions of both parties.



1) Act No. 48/1997 Coll., on public health insurance, as amended by

amended.



Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Law No 160/1992 Coll., on health care in non-State medical

establishments, as amended.



2) Act No. 551/1991 Coll., on general health insurance company, in the text of the

amended.



Law No. 280/1992 Coll., on departmental, industry, corporate, and other

health insurance, as amended.



3) Council Regulation (EEC) No 1408/71 and 574/72.



4) Eg. Communication from the Ministry of Foreign Affairs No. 130/2002 SB., m.s.,

the negotiation of a Treaty between the Czech Republic and the Federal Republic of

Yugoslavia on social security,



Communication from the Ministry of Foreign Affairs No. 83/2000 Coll., on negotiation of the m.s.

Treaty between the Czech Republic and the Republic of Croatia on the social

security,

The communication from the



Ministry of Foreign Affairs No. 135/2004 Coll., on negotiation of the Treaty, m.s.

between the Czech Republic and the Turkish Republic on social security.



5) section 10 of Act No. 526/1990 Coll., on prices, as amended.



6) Law No. 101/2000 Coll., on protection of personal data and on amendments to certain

laws, as amended.



7) Act No. 435/2004 Coll., on employment, as amended,

regulations.



8) Law No. 95/2004 Coll., on conditions for the acquisition and recognition of professional

competence and specialized competence to perform medical

the professions of doctor, dentist and pharmacist.



Law No 96/2004 Coll., on conditions for the acquisition and recognition of competence to

the exercise of paramedical professions and to pursue activities

related to the provision of health care and to change some of the

related laws.



9) Decree No. 49/1993 Coll., on technical and substantive requirements

equipment of medical devices, as amended.



10) Decree No. 58/1997 Coll., laying down the list of indicator for

Spa care for adults, children and adolescents.



11) Act No. 20/1966 Coll. on health care of the people, as amended

regulations.



Decree No 385/2006 Coll., on the medical documentation, as amended by the Decree of the

No 479/2006 Sb.



12) Decree No. 343/1997 Coll., laying down the method of prescribing

medicinal products, the particulars of medical regulations and the rules of their

of use, as amended.



13) Act No. 563/1991 Coll., on accounting, as amended.



14) § 67 b) of Act No. 20/1966 Coll., on the health care of the people, in the text of the

amended.



15) for example, law No. 121/2000 Coll., on medical devices and on

changes to some related laws, as amended.



16) Act No. 216/1994, Coll., on arbitration proceedings and enforcement of arbitral

the findings, in the wording of Act No. 245/2006.
17) Act No. 83/1990 Coll. on Association of citizens, as amended

regulations.



§ § 20f and subs. Act No. 40/1964 Coll., the civil code, as amended by

amended.



1) Act No. 551/1991 Coll., on the Czech General health insurance company

Republic, as amended.



Law No. 280/1992 Coll., on departmental, industry, corporate, and other

health insurance, as amended.



2) Act No. 20/1966 Coll., on the health care of the people, as amended

regulations.



Law No 160/1992 Coll., on health care in non-State medical

establishments, as amended.



Law No. 245/2006 Coll., on public nonprofit constitutional health

facilities and on amendment to certain laws.



3) Decree No. 134/1998 Coll. issuing the list of health interventions

with point values, as amended.