Change In The Law On Public Health Insurance And Related. Acts

Original Language Title: změna zákona o veřejném zdravotním pojištění a souvis. zákonů

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Read the untranslated law here: https://portal.gov.cz/app/zakony/download?idBiblio=75482&nr=369~2F2011~20Sb.&ft=txt

369/2011 Coll.


LAW
Dated 6 November 2011

Amending Act no. 48/1997 Coll., On public health insurance and
amending and supplementing some related laws, as amended
regulations, and some other laws

Parliament has passed this Act of the Czech Republic:
PART ONE


Changing the law on public health insurance

Art. I

Law no. 48/1997 Coll., On public health insurance and amending and supplementing certain
related laws, as amended by Act no. 242/1997
Coll., Act no. 2/1998 Coll. Act no. 127/1998 Coll., Act no. 225/1999
Coll., Act no. 363/1999 Coll., Act no. 18/2000 Coll., Act no. 132/2000 Coll
. Act no. 155/2000 Coll., the Constitutional court judgment promulgated under no.
167/2000 Coll., Act no. 220/2000 Coll., Act no. 258/2000 Coll., Act. || | 459/2000 Coll., Act no. 176/2002 Coll., Act no. 198/2002 Coll., Act no. 285/2002 Coll
., Act no. 309/2002 Coll., Act no. 320 / 2002 Coll., Act no. 222/2003 Coll
., Act no. 274/2003 Coll., Act no. 362/2003 Coll., Act no. 424/2003
., Act. 425/2003 Coll., Act no. 455/2003 Coll., Act no.
85/2004 Coll., Act no. 359/2004 Coll., Act no. 422/2004 Coll., Act. || | 436/2004 Coll., Act no. 438/2004 Coll., Act no. 123/2005 Coll., Act no. 168/2005 Coll
., Act no. 253/2005 Coll., Act no. 350 / 2005 Coll., Act no. 361/2005 Coll
., Act no. 47/2006 Coll., Act no. 109/2006 Coll., Act no. 112/2006 Coll
., Act. 117/2006 Coll., Act no. 165/2006 Coll., Act no. 189/2006 Coll
., Act no. 214/2006 Coll., Act no. 245/2006 Coll., Act. || | 264/2006 Coll., Act no. 340/2006 Coll., the Constitutional court judgment
promulgated under no. 57/2007 Coll., Act no. 181/2007 Coll., Act.
261 / 2007 Coll., Act no. 296/2007 Coll., Act no. 129/2008 Coll., Act no. 137/2008 Coll
., Act no. 270/2008 Coll., Act no. 274/2008 Coll ., Act no. 306/2008 Coll
., Act no. 59/2009 Coll., Act no. 158/2009, Law no. 227/2009
Coll., Act no. 281/2009 Coll. Act no. 362/2009 Coll. and Act No.
. 298/2011 Coll., Is amended as follows:

First In § 1 point. b) the words "under this Act provided
health care" is replaced by "on the basis of this law
health insurance paid medical services (hereinafter" paid
Services ")."

Second In § 1, the existing text becomes paragraph 1 and the following paragraph 2
which including footnote no. 49 reads:

"(2) This Act shall apply unless directly applicable regulations
European Union on the coordination of social security systems
otherwise ^ 49).

"49) For example, the European Parliament and Council Regulation (EC) no. 883/2004 on
coordination of social security systems, as amended by European
Parliament and Council Regulation (EC) no. 988/2009 and Commission Regulation (EU) no. 1244/2010,
Regulation of the European Parliament and Council Regulation (EC) no. 987/2009 laying down
implementing Regulation (EC) no. 883/2004 on the coordination of systems
social security, as amended by Commission Regulation (EU) no.
1244/2010, the European Parliament and Council Regulation (EU) no. 1231/2010,
extending the provisions of Regulation (EC) no. 883/2004 and Regulation (EC) No.
. 987/2009 to nationals of third countries to which this Regulation
otherwise excluded because of their nationality and
Regulation of the European Parliament and Council Regulation (EU) no. 492/2011 dated April 5
2011 on freedom of movement for workers within the Union. ".

Third In § 7 para. 1 point. d) the words "mother and" the words
"people on

Fourth In § 8. 1 point. f) Section 2 "has been granted
health care covered by health insurance" is replaced by "not
provided paid services."

Fifth In § 8. 4, third sentence, the words "payment of care covered by health insurance
" is replaced by "providing paid services."

6th In § 11 para. 1 letter a) to d) shall be added:

"A) to choose the health insurance company, unless otherwise provided herein.
Health insurance can be changed once every 12 months, and it always
1 January of the following calendar year; registration is insured
or his legal representative is obliged to submit the selected health insurance
later than 6 months before the requested date change.
Application to change the health insurance company on January 1 of the calendar year may apply for only one
; for any further applications for registration has been disregarded, even if

If they are filed within the prescribed period. Date of entry into the health insurance
into liquidation or from the date of receivership over
health insurance or the date on which the Ministry of Health based on findings
imbalances in the economy of health insurance-19) announced in a media
are those insured health insurance
entitled to change the health insurance company and within a shorter period, and it always
first day of the calendar month, but no earlier than the first day of the following calendar month
. Changing health insurance done for people
minors and persons without legal capacity
their legal representative. At birth, the child's right to choose the health insurance
apply. The date of birth of the child becomes the policyholder
health insurance company that insured the child's mother on the day of his birth.
Change health insurers child can perform his legal representative
until after the birth number allocation child, and the date specified in this
provision. Asks if the insured or the insured's legal representative
health insurance in accordance with this provision, it is
health insurance company is obliged to meet his request without delay.
Health insurance policyholder is entitled to determine the period during which it will be at
affiliation or relationship with insured health insurance company to terminate itself.
The health insurance company is not entitled to accept insured in other
deadlines than those specified in that provision

B) the choice of healthcare providers (hereinafter "Provider")
who is contracted to the competent health insurance company, and
selection of medical equipment that provider;
when registering the provider may assert this right once every three months
,

C) at the time and the local availability of paid services provided to contracting providers
competent health insurance company,

D) to provide paid services to the extent and under the conditions set
this Act, the provider must not be paid for these services
accept any payment from the insured ".

7th In § 11 para. 1 point. e) the word "installation" is replaced
"provider".

8th In § 11 para. 1 point. f) the words "health care" is replaced
"health services".

9th In § 11 para. 1, after letter f) a new point g), added:

"G) to provide information about the health insurance provided to him
paid services."

Existing letters g) to k) are renumbered h) to l).

10th In § 11 para. 1 point. i) the words "health care facility is obliged to '
replaced by" provider is required. "

11th In § 11 para. 1 point. j) the word "establishment" is replaced by
"provider", the word "installation" is replaced by "provider" and
word 'mandatory' is replaced by the word "obliged".

12th In § 11 para. 1, comma at the end of point k) is replaced by a period and
letter l) shall be deleted.

13th In § 11 paragraph 2 reads:

(2) If the insured person for that he paid services are not provided in
accordance with this Act, may lodge a complaint under the Act on Health
services. ".

14th Footnote. 22 and 23 are deleted.

15th In § 11 par. 3 of the second to fourth sentence are deleted.

16th In § 11 par. 3 point. a) the words "health care provided or
prescribed by a doctor or health care facilities mentioned in the second sentence
and the third, which is partly covered" is replaced by "reimbursable services provided
provider established special regulation governing
service relationship of professional soldiers, which are partly paid
".

17th In § 11 par. 3 point. b) the words "preventive care covered by health insurance
" is replaced by "paid services".

18th In § 11 para. 5, the word "doctor" is replaced by "provider" and
word "transport" is replaced by "medical transport".

19th In § 12 letter d) reads:

"D) to cooperate in the provision of health services and control
during an individual treatment process and adhere provider
established treatment regimen."

20th In § 12 letter. h) the words "health care" is replaced
"health services" and the words "and medical devices" are replaced
"foods for special medical purposes

Medical devices ".

21st In § 12, at the end of the text of letter k) the words ";
if the insured person in the place of permanent residence nobody is obliged
competent health insurance company, also the address of residence in the Czech Republic
where predominantly resides (hereinafter "residence") ".

22nd In § 12 letter. m) the words "health care facility" is replaced by
"providers".

23rd In § 12 letter. n) the words "health care facility" is replaced by
"providers", the word "care" is replaced by "service" and the words
"provided health care and the level of reimbursement" is replaced
"provided medical services and the amount of payment. "

24th The heading of Part Five reads: "TERMS OF SERVICE paid."

25th The heading of § 13 reads: "Reimbursements services".

26th In § 13 para. 1 introductory part, the words "care provided"
replaced by "services rendered".

27th In § 13 para. 1 point. a) the word "responsible" is replaced by
"match", the word "the" before the word "their" and
word "safe" before the word "safe".

28th In § 13 para. 1 point. a) and b) the word "is" is replaced with "shall".

29th In § 13 para. 1 point. c) the word "her" is replaced by "their"
and the word "of" is replaced by "their".

30th In § 13 paragraph 2 reads:

"(2) are borne by the service to the extent and under the conditions laid down in this Act


A) preventive health care, dispensary, diagnostic, therapeutic,
medical rehabilitation, medical rehabilitation spa, critiques,
nursing, palliative care and health of the donor blood, tissues and cells or organs
related their collection, in all its forms
provision under the Act on health services,

B) the provision of medicines, foods for special medical purposes
, medical devices and dental products,

C) Transportation of the insured and the reimbursement of travel expenses

D) collection of blood and tissues, cells and organs for transplantation and
necessary handling (storage, storage, processing and examination
)

E) shipments of the living donor to the sampling point and from this place to a place
provision of health care associated with the collection from this place and
reimbursement of travel expenses

F) the transport of deceased donors to the sampling point and from this place,

G) transport of the collected tissues, cells and organs

H) inspection of the deceased insured and autopsy, including transportation,

I) guide the insured stay in the medical facility inpatient care

J) health care related to pregnancy and childbirth, whose
mother asked about his secrecy persons in connection with childbirth;
this care paid by health insurers, based on the identification data
insured for reimbursement requests the provider. ".

31st In § 13 paragraph 3 is repealed.

The former paragraphs 4 to 9 shall be renumbered 3 to 8

32nd In § 13 para. 3-8, the words "health care" is replaced
"health services".

33rd In § 13 par. 3 in the first sentence the words "care given"
replace the words "service above" and in the second sentence, the word "such" is replaced
word "such".

34th In § 13 para. 4, the word "care, which is designated as"
replace the words "services, which are designated" and "care that"
be replaced by "services".

35th In § 13 para. 5, the word "they" is replaced by "that"
words "healthcare facility is obliged" is replaced by "provider
obliged", the words "medical devices" shall be replaced
'provider "and the words" published in the medical "is replaced
" provider published in the areas of health, "and the words
" accessible place and "is inserted after the word" further ".

36th In § 13 para. 6-8, the words "medical devices" are replaced
word "Provider".

37th In § 13 para. 6 of the first sentence the number "6" is replaced by "5" and the word
"obliged" is replaced by "obliged".

38th In § 13 para. 8, the number "8" is replaced by "7"
words "medical devices" are replaced by "providers" words

"Paragraph. 3 "is replaced by" paragraph. 2 ", the word" spent "is replaced
word" incurred "and the word" avoid "with" prevent ".

39th In § 14, the words "care provided" replaced by "
services rendered" and the words "necessary and urgent treatment, which" shall
words "emergency health care which."

40th In § 15 para. 2, after the word "insurance" the word "further".

41st In § 15 par. 3 of the introductory part of the provision reads:

"(3) Reimbursements services include health care provided on the basis of a recommendation authorizing
provider in the field of gynecology and obstetrics
in connection with artificial insemination, and more than three times per
life, or if it was in the first two cases transferred to the genital organs of women
only one embryo resulting from fertilization of a human egg and sperm outside the woman's body
four times in a lifetime. "

42nd In § 15 para. 5 sentence Fourth, § 16a par. 2 point. b) f)
§ 16a paragraph. 4 and § 22 point. c) the word "constitutional"
replaced by the word "bed".

43rd In § 15 para. 6 letter f) reads:

F), which may be issued without a prescription. ".

44th In § 15 par. 7, the words "healthcare provided" shall be
words "health services".

45th In § 15 para. 10, the words "medical establishment" is replaced by
"providers" and end the text of the paragraph, the word
"provider".

46th In § 15 para. 14, second sentence, the words "paid care further excludes"
replaced by "Reimbursements services will not include" and the third sentence
word "performance" is replaced by "service", the word "power"
replaces the word "service", the word "finance ^ 26)" is replaced by
"health" and end the text of the paragraph the words ";
case for reimbursement at the request of the Police of the Czech Republic, the provider sends the bill
Interior Ministry, not later than the 15th calendar day
month following the calendar month in which the healthcare services were provided
".

47th Footnote. 26 is deleted, including references to a note
footnote.

48th In § 15 paragraph 15 reads:

"(15) Medical services in orphanages for children under 3 years of age
health workers, who are employed
providers of health services in this medical facility, the
paid from the budget of the founder. From the founder's budget will also pay
ambulance, with the exception of health care services according to §
28th ".

49th In § 16 paragraph 1 reads:

"(1) The respective health insurance company pays in exceptional cases
health services otherwise not covered by health insurance if
provision of such health services only option in terms
state of health of the insured.".

50th In § 16 para. 2 the words "health care" is replaced
"health services".

51st In § 16a par. 1 introductory part of the provision reads:

The insured or for him by his legal representative, he is obliged
connection with providing paid services to pay providers who
paid for services provided, the regulatory fee ".

52nd In § 16a par. 1 point. a) Section 1, "a medical practitioner
practitioner for children and adolescents, female doctor or
visit, during which were examined by a dentist"
replaced by "provider in the doctor
field of general practice medicine, practical medicine for children and adolescents, gynecology and obstetrics
, or a visit, during which were examined by a doctor
provider in the field of dentistry. "

53rd In § 16a par. 1 point. a) Section 2 "
providing specialized outpatient care" is replaced by "provider
specialist outpatient care."

54th In § 16a par. 1 point. a) Section 3 reads:

Third visiting service provided by a physician providers in the field of general
practical medicine and practical medicine for children and adolescents ".

55th In § 16a par. 1 letter e) reads:

"E) 90 CZK for the use of emergency medical services or emergency
services in dentistry (hereinafter referred to as" emergency service ") in
weekdays 17 to 7 pm and on Saturdays, Sundays and feast,
unless this period is scheduled surgery time provider

Providing emergency services; regulatory fee for the use
emergency services are not paid, if the subsequent adoption
insured in inpatient care. "

56th In § 16a par. 1 point. f) the words "institutional care (§ 23)
complex spa care or inpatient care in specialized children's hospitals and sanatoriums
(§ 34)" is replaced by "in-patient care, including inpatient
spa treatment rehabilitation care" .

57th In § 16a par. 3 point. e) the word "doctor" shall be inserted
"provider".

'58. In § 16a par. 5, the words "receiving medical facility that"
replaced by "TV provider that" the word "chosen" is
replaced by the word "chosen" and "Sanitation is obligated" to | || replaced by "the provider is required."

59th In § 16a Paragraph 6 reads:

"(6) Regulatory fee pursuant to paragraph 1. a) to e) shall be paid
providers in connection with providing paid services.
Regulatory fee under subsection 1. f) to pay providers within 8
calendar days after hospitalization, except in cases where the
insured is hospitalized for more than 30 days; In this case
the regulatory fee is paid on the last day of the calendar month.
Provider is obliged to issue an insured person or his legal representatives
upon request proof of payment of the regulatory fee, with
reference number of the insured, the amount of the regulatory fee, stamping
providers and signature of the person who adopted a regulatory fee and
case of providers of pharmaceutical care, with or without the name of the medicinal
preparation or food for special medical purposes and the amount of the supplement
which is included in the limit under § 16b paragraph. 1. ".

60th In § 16a par. 7, the words "healthcare facility shall"
replaced by "The provider is required" and "
provided health care" are replaced by "provided paid services."

61st In § 16a par. 8, "Pharmaceutical care is obliged to '
replaced by" provider of pharmaceutical care is required "and the words
" limit referred to in paragraph 1 "is replaced by" limit under § 16b paragraph. || | 1 ".

62nd In § 16a par. 9, the first sentence the words "Medical equipment is obliged
" is replaced by "The provider is required", the words "or 3" is
replaced by "up to 4" and the second sentence, the words "medical
device "are replaced by" providers ".

63rd In § 16a par. 10, the term "medical device" is replaced by
"Provider" and the words "paid care, which" shall be replaced
"paid services", the word 'not' is replaced by || | "subject", the words "violation of this Act" is replaced
"breaches of duty" and the words "medical devices"
replaced by "providers".

64th In § 16a par. 11, the words "medical devices" are replaced
word "providers" and "health care" is replaced
"paid services".

65th In § 16a par. 11, § 39a paragraph. 2 point. b) § 39a paragraph. 3 point f), §
39b paragraph. 2 point. d) § 39d paragraph. 1, § 39f paragraph. 6 point. f) the words
"paragraph. 3 "are replaced by" paragraph. 2 ".

66th In § 16b paragraph. 2 first and second sentences, the words "co-payments" are inserted
words "chargeable to the limit" and the words "medical devices"
be replaced by "providers".

67th In § 17 paragraph 1 reads:

"(1) In order to ensure substantive performance in providing services to policyholders paid
General Health Insurance Company
Czech Republic and other health insurers, established under a different legal regulation
^ 28), contracts with providers of the provision and payment of reimbursable
services. A contract for the provision and payment of reimbursable services can only conclude
health services provider is authorized to provide.
Contract does not require the provision

A) emergency care insured

B) insured health services in detention or prison
imprisonment or security detention
provider designated by the Prison Service,

C) insured health services, which is
protective treatment ordered by a court, in the case of health services provided in connection

With a disease for which the insured is obliged to undergo treatment. ".

68th In § 17 paragraph 2 deleted.

Former paragraphs 3-8 become paragraphs 2 to 7

69th In § 17 para. 2 first sentence, the words "health care facility"
replaced by "provider" and the words "medical devices"
replaced by "providers" in the second sentence, the words "health care
" replaced by "paid services" in the last sentence, the words
"provided health care" are replaced by "provided paid
services", the words "health care" is replaced by "paid services"
words "provided care "is replaced by"
provided paid services "and" health care provision "shall be replaced
" provision and payment of reimbursable services. "

70th In § 17 para. 2, third sentence deleted.

71st In § 17 paragraph 3 reads:

"(3) providers and other entities providing paid services are required in the bill
health insurers indicate the number of insured, which
paid services provided.".

72nd In § 17 para. 5 of the first sentence the words "The point of the above payments
health care covered by health insurance" is replaced
"Unless this Act provides otherwise, the point values, the amount of reimbursement paid
Services" , the words "medical devices" shall be replaced
"providers" in the fifth sentence, the word "result" is replaced by
"agreement", the words "health care covered by health insurance and
regulatory restrictions on the volume rendered medical care covered by public health insurance
"is replaced by" reimbursable services and regulatory constraints
"in the last sentence, the words" medical devices "
be replaced by" provider ".

73rd In § 17 para. 6 the words "medical establishment" is replaced by
"providers" and the word "installation" is replaced by
"providers".

74th In § 17 para. 7 point. a) the introductory part, the words
"medical establishment" is replaced by "provider" and
words "health care" is replaced by "paid services".

75th In § 17 para. 7 point. a) 1, the word "establishment" is replaced
word "providers", the words "medical devices" is
replaced by "medical devices" and "the establishment"
replaced by "provider" .

76th In § 17 para. 7 point. a) paragraphs 2 and 3, the word "establishment" is replaced
word "providers".

77th In § 17 para. 7 point. b) the words "health care facility"
replaced by "providers".

78th In § 17 para. 7 point. c) the words "health care facility"
replaced by "providers" and the words "means of medical technology
" is replaced by "medical devices".

79th In § 17 at the end of paragraph 7 is replaced by a comma and a letter
e), added:

"E) account submitted in accordance with the implementing legislation and
price provision to persons authorized to carry human remains by
law on funeral services, transportation of the body of the deceased insured for dissection and autopsy
.".

80th In § 17, paragraph 8 shall be added:

"(8) A natural person or legal entity which, pursuant to the Act on
Health Services issued a certificate of compliance with the conditions for
continue providing health services under the authority of the deceased
provider, has for 90 days date of issue of this certificate
entitled to reimbursement of health services provided to the extent
arising from a contract for the provision and payment of reimbursable services
concluded between the deceased and the health insurance provider. ".

81st In § 17a first sentence the words "and rehabilitation" are deleted,
words "sojourn services" is replaced by "providing
residential social services", the words "these devices" are replaced
words " providers "and in the second sentence, the words" of the device "
replaced by" the provider of "words" and rehabilitation "
was deleted and the word" installation "is replaced by" provider ".

82nd § 18 including the title reads:

"§ 18

Terms of paid services

(1) Unless otherwise provided herein, provide paid services others

Healthcare professionals than doctors, with the exception of clinical psychologists,
solely on the basis of an indication of the attending physician of the insured (hereinafter
"doctor"). ".

(2) The treating physician, for the purposes of health insurance means

A) the authorizing physician providers

B) providers of specialized outpatient physician care

C) physician providers dunking or

D) a doctor with specialized qualifications provider of inpatient care. ".

83rd § 19 to 21, including headings deleted.

84th In § 22 of the introductory part, the words "reimbursed care" are replaced
words "paid by service".

85th In § 22 letter. a) the words "registered physician,
registered general practitioner for children and adolescents" are replaced
"authorizing provider of outpatient care in the field of general
practice medicine or in practical medicine for children and adolescents
".

86th In § 22 letter. e) the words "and rehabilitation" are deleted, as
word "facilities" shall be inserted the word "residence" and the words "these devices"
be replaced by "providers of residential social services."

87th The heading of § 22a reads: "Special patient care."

88th In § 22a, the word "treatment" is replaced by "service is fenced and
treatment".

89th § 23 to 24, including titles repealed.

90th § 25 and 26, including titles added:

"§ 25

Guide Staying insured inpatient care

(1) If the insured while hospitalized in a medical facility
inpatient care required daylong present guide due

A) the state of health of the insured, or

B) the need to train guide insured medical care and rehabilitation
accompanied by the insured, the insured is staying guide to
completion of the sixth year of age accompanied by an insured
including paid service; stay guide insured older than 6 years are paid by
only with the consent of a review physician.

(2) Stay guide the health insurance company with which the insured
accompanied insured.

§ 26

Facilities insured after hospitalization

(1) is borne by the services and facilities insured medicines
foods for special medical purposes and medical devices
after hospital discharge for 3 days or in justified cases also
other period absolutely necessary.

(2) If the insured is released into home care to pass, not
provider for the duration of culverts entitled to charge
health insurance costs for inpatient care, with the exception of medicines and medical devices
which insured the duration passes
rigs. ".

91st § 27 including footnotes Nos. 32 and 33 deleted.

92nd § 28 including the title reads:

"§ 28

Emergency Medical Service and Emergency Services

(1) Reimbursements services include medical procedures performed within
emergency medical services.

(2) Reimbursements services include medical procedures performed within
emergency services, even if they were
emergency medical procedures performed by a doctor outside his expertise. ".

93rd In § 29 paragraph 1 is deleted.

Paragraphs 2 to 5 shall be renumbered 1 to 4

94th In § 29 para. 1 introductory part of the provision: "
-funded services are preventive inspections that are carried out."

95th In § 29 para. 1 at the end of the text of letter c) the words "
but not before 18 months after the last preventive examinations".

96th In § 29 par. 2 the introductory part of the word "dentistry"
replaced by "dentistry".

97th In § 29 par. 3, after the word "gynecology" the words "and
obstetrics".

98th In § 29 paragraph 4 is deleted.

99th In § 30 paragraph. 1, the words "covered care includes:" is replaced
'services are fenced "and the words" paid care "is replaced
" paid services ".

100th In § 30 paragraph. 2 of the introductory part of the provision reads:

"Borne services are further".

One hundred and first In § 30 paragraph. 2 point. a) and b) the word "settlement" is replaced by
'recovery'.

102nd In § 30 paragraph. 2 point. b) Section 3 reads:

"3. Tuberculosis for policyholders who meet indications for vaccination

Prescribed by the law governing
vaccination against infectious diseases, including tuberculin test carried out in cases where the
be vaccinated child older than 6 weeks; vaccination in this case
made only if the tuberculin skin test is negative. "

103rd In § 30 paragraph. 2 point. b) Section 4, the words "long-term medical patients
" is replaced by "in health facilities provider
long-term inpatient care."

104th In § 30 paragraph. 2 point. b) Section 5 reads:

"5. against pneumococcal infections, when 3 doses of vaccine were administered
into the seventh month of the age of the insured; paid service is also
booster made by the fifteenth month of age of the insured;
paid service is even further vaccinations carried out after the deadlines laid down in
this provision if there has been a postponement of the application of one or more doses of vaccine
due to the health status of the insured. "

105th In § 30 paragraph. 2 point. b) The final part of the provision repealed.

106th In § 30 paragraph. 2 at the end of subparagraph b) the following point 6 is added:

'6. Human Papillomavirus three doses of the vaccine, for girls
if vaccination started from thirteenth to consummation consummation
fourteenth year of age. ".

107th In § 30 paragraph. 2 point. c) the words "institutions" shall be replaced
"in health facilities provider".

108th In § 30 paragraph. 2 point. d) the words "medical devices"
replaced by "providers".

109s. In § 30 paragraph. 2 point. e) the introductory part of
word "diagnosis" is replaced by "diagnosis" and the words "
medical devices" are replaced by "in health care facilities
providers."

110th In § 30 paragraph. 3, introductory part of the provision reads:

-Funded services are not. "

111th In § 30 paragraph. 3 point. c) the word "diagnosis" is replaced by
"diagnostics".

112th In § 31 para. 1 introductory part, the words "paid care"
replaced by "paid services".

113th In § 31 para. 2, "the registering doctor" shall be replaced
"authorizing physician providers."

114 respectively. In § 31 paragraph 3 is deleted.

115th The heading of § 32 reads: "The provision of medicines and medical
resources".

116th In § 32 par. 1 and 3, the words "medical devices"
replaced by "medical devices".

117th In § 32 par. 3 the words "medical devices"
replaced by "medical devices" and the words "health
documentation" is replaced by "medical documentation".

118th In § 32 para. 4, the words "medical facility authorized"
replaced by "authorized provider".

119th In § 32 par. 5, the words "medical establishment" is replaced by
"providers".

120th In § 32, the following paragraph 6 is added:

"(6) The breach of obligations under paragraph 4 shall not provide,
offered or promised money or monetary benefit, advantage or
donation of property or non-pecuniary nature that gives
provider authorized to dispense medicines at the same time a reduction of claim
health insurance provider authorized to supply medicinal products
resulting from the applicable reimbursement medicine
competent health insurance company. Said does not apply to cases where the
reduce the price of medicine will that
provider authorized to supply medicinal products to apply the full amount of regulated prices and
sales performance, ie in the case of reduced selling prices of medicinal
product. ".

121st The heading of § 33 reads: "Medical rehabilitation".

122nd In § 33 paragraph 1 reads:

"(1) is covered by a further medical rehabilitation care provided
as a necessary part of the healing process, which provide recommended
doctor and the doctor confirmed the audit.
Proposal on medical rehabilitation care administered in the form of health insurance doctor
registering the provider or physician during hospitalization;
Case of providing spa treatment rehabilitation care proposal contains
also determine the degree of urgency. ".

123rd In § 33 par. 2, after the word "spa" and the word "spa"
words "medical rehabilitation".


124th In § 33 para. 3-7, the word "spa" the words "
medical rehabilitation".

125th In § 33 para. 4 of the first sentence, the word "constitutional" is replaced by
"sleeping" in the third sentence after the word "spa" the words
"medical rehabilitation" in the fourth sentence, the word "patient" is replaced
word "insured person" under the word "spa" the words "
medical rehabilitation", the word "spa treatment" shall be replaced
"medical equipment providers
spa treatment rehabilitation care" and words "residential care facility" shall be replaced
"medical equipment provider-patient care."

126th In § 33 para. 5, second sentence, the words "Health insurance pays'
replaced by" services are borne. "

127th In § 33 par. 6, the second sentence is replaced by the phrase "Trans-insured
younger than 18 years of medical device provider of inpatient care in a medical facility
provider of spa treatment rehabilitation
care physician is examined in the audit.".

128th In § 34 para. 1, second sentence, the word "pre-printed"
deleted and the third sentence, the word "hospital" is replaced by "hospitalization".

129th In § 34 par. 2, second sentence, the words "spas"
replaced by "in health facilities provider
spa treatment rehabilitation care" and the words "spa facilities" shall
words "in a medical facility spa Hospital
provider of rehabilitation care. "

130th In § 34 par. 3, the words "baby spa" are replaced by "
medical facility spa treatment rehabilitation care."

131st § 35 including the heading deleted.

132nd In § 35a, the words "removal of tissue" the words "cell and the" under
word "tissue" is inserted after the word "cell" and the words "whose
policyholder's beneficiary" shall be replaced with the word "donor ".

133rd In the title of § 36, the word "transport" is replaced by "Transport".

134th In § 36 paragraph 1 reads:

"(1) borne by the insured transportation in the Czech Republic
to contract providers, providers of contractual
to the place of residence or place of residence or residential facility
social services between the providers and within contractual
provider, in the event that the insured health condition does not allow transporting
normally without using the medical transport services.
If the disease was insured in the place of residence, the transfer
permanent residence, which is more distant than the place of residence, covered
only if it attending physician
necessarily requires the medical condition of the insured . Transportation is made vehicles contractual
medical transport services. If the attending physician indicates
accompaniment of the insured, the health insurance company, which pays transportation
insured, transportation and accompanying persons, and to the same extent as the transport
insured. ".

135th In § 36 para. 2, the word "right" is replaced by "Transport"
words "medical device that is able to" shall be replaced
"provider that is able to" and the words "health care" are replaced
words "health service".

136th In § 36 par. 3 point. b) the word "operators" is replaced
'medical service providers "and the word" transport "is replaced
word" transportation ".

137th In § 36 par. 3 point. c) the word "right" is replaced by
"carriage", the word "service" is replaced by the word "transportation" and
word "transport" is replaced by "carriage".

138th In § 36 para. 4 the word "service" is replaced by "transportation" and
word "tissue" is inserted after the word "cell".

139th In § 37 para. 1, the word "right" is replaced by "carriage".

140th In § 37 para. 2, the word "service" is replaced by the word "transportation" for
word "vehicle", the words "controlled by another person" and at the end
text of the paragraph the words "in the amount corresponding to the distance | || nearest contractual provider who is able
required to provide health services. "

141st In § 38 the words "paid care includes" are replaced by "
borne by them as well."

142nd § 39 including the title reads:


"§ 39

Tour of the deceased insured and autopsy

Reimbursed service includes a tour of the deceased insured person, dissection, transportation to
autopsy and autopsy transportation to the place where the death occurred, or to
place of burial, if such a place as remote or closer than the place ,
where the person died. Not paid by autopsy and forensic autopsy
and transportation for such autopsies from them. ".

143rd Footnote. 41 and 42 are deleted.

144th In § 39a par. 2 letter a) reads:

"A) the average manufacturer price consideration medicine or food
for special medical purposes from three European Union member states, with the exception
Bulgaria, the Czech Republic, Estonia, Luxembourg, Germany, Austria
, Romania , Cyprus and Malta (hereinafter referred to as "ground reference basket")
which have the lowest price consideration medicine or food
for special medical purposes, if it is judged
medicine or food for special medical purposes for market in at least three countries
reference basket ".

145th In § 39b at the end of paragraph 12 is replaced by a comma and
point d), which reads:

"D) amounting producer prices recorded in any European Union country
for each individual medicinal product with the same combination of active substances and their contents
if this price is lower than the reimbursement is calculated according || | letters a), b) and c) ".

146th In § 39b paragraph. 13 letter a) reads:

'A) in the amount of producer prices recorded in any European Union country
for each individual medicinal product with the same combination of active substances and their contents
".

147th In § 39b paragraph. 14 point. d) the words "the procedures of § 39b to 39i
to determine or change" is replaced by "procedure for determining
or change."

148th In § 39b paragraph. 14 point. e) the words "for highly innovative medicinal products
" is replaced by "orphan drugs".

149th In § 39b at the end of paragraph 14 is replaced by a comma and
letter g), added:

"G) the procedure for determining reimbursement of medicinal products including high
innovative products.".

150th In § 39c paragraph. 11 letter a) reads:

") The desired properties of the medicinal product for the procedure under paragraph 2
point. and),".

151st In § 39c paragraph. 11 at the end of the text of letter h), the words
"including the desired properties of the least expensive medicine."

152nd In § 39d paragraph 1 reads:

"(1) If it is in the public interest (§ 17 para. 2), the Department will decide on the amount and terms
temporary reimbursement of highly innovative product which is known
insufficient data on cost effectiveness or
treatment outcomes in clinical use, and only when justified by the available data adequately
significantly benefit highly innovative product for the treatment and meets
highly innovative product other conditions for the determination of the remuneration
and if it is paid from public funds in at least two countries
reference basket. In determining the basic remuneration
Department progresses according to § 39c accordingly. ".

153 above. In § 39f, the following paragraph 12 is added:

"(12) A trade secret can be for highly innovative products
mark the selected part of the contractual arrangements between the parties
pursuant to paragraph 2, which regulate the limitation of the impact of reimbursement on
financial resources or health insurance which can
affect the cost-efficiency, including the information referred to in paragraph 11 point. c)
f) and i). ".

154th In § 39 grams, the following paragraph 12 is added:

"(12) The appellate authority is not bound by the grounds of appeal in the event that
contested decision must be annulled because of its non-compliance with laws and regulations.
In such a case, the appellate body's other objections parties
not deal with. ".

155th In § 40 paragraph 2 reads:

"(2) Health insurance companies are obliged to pay providers
or entities referred to in § 17 para. 7, who in accordance with this Act
paid services provided to the insured provided these services within
agreed in the contract pursuant to § 17 para. 1. Unless
between the health insurer and provider contract negotiated, and if
health insurance under this Act shall be obliged
provided health services to pay, pay them at the same time as providers with whom
health insurance company signed a contract in accordance with § 17 para. 1. ".


156th In § 40 par. 3 point. a) the words "paid care" is replaced
"paid services", the words "health care" is replaced
"paid services", the words "or reported residence" is replaced
'residence or place of residence ", the words" other law "is
replaced by the word" law "and" recommended speed.
Recommended speed for the purposes of this Act means the speed "are replaced
word" speed ".

157th In § 40 par. 3 point. b) the words "paid care" is replaced
"paid services", the words "provide paid care" is replaced
"provide urgent and acute paid services," the word "its" is replaced by
" their "words" in emergency and acute care "
shall be deleted and the words" planned paid care "is replaced
" scheduled paid services. "

158th In § 40 paragraph 6 reads:

"(6) Health insurance leads

A) list of contracted providers; The list, which contains information
referred to in point b), each health insurance company is obliged to publish
manner allowing remote access,

B) a summary of health professionals providing services funded by
individual contracting providers in the division doctor, dentist and
healthcare worker pursuing paramedical profession
under the law on paramedical professions, who have a medical
made health insurance performances
list of medical procedures with point values ​​(hereinafter referred to as the "bringer of power");
for this purpose, providers are required to disclose health insurance
for the previous quarter, within 30 days, a list of individual holders
performance on the last day of the quarter, with the name
surname, title, personal identification number and category of the wearer's performance by the
list of medical services with point values;
provider has an obligation to fulfill, even if health insurance companies will only give you
changes that have occurred since the previous report. ".

159 aircraft. In § 42 paragraph 1 reads:

"(1) Health insurance companies monitor the use and provision of services
paid their bill and health insurance company in terms of volume and quality
, including adherence to the prices of providers and the insured.".

160th In § 42 par. 3 of the introductory part, the words "means
medical technology" is replaced by "
foods for special medical purposes and medical devices" and "spa stay"
be replaced by "Spa Hospital rehabilitative care. "

161st In § 42 par. 3 letter a) reads:

A) rendered paid services correspond to services paid by health insurance vyúčtovaným
".

162nd In § 42 par. 3 point. b) the words "means of medical technology
" is replaced by "foods for special medical purposes and
medical devices".

163rd In § 42 par. 3 point. c) § 46 para. 2 of the introductory part of the provision and the
§ 46 paragraph. 2 point. d) the words "health care" is replaced
"paid services".

164th In § 42 par. 3 of the final part, the words "health care
" is replaced by "paid services", the words "such care" is
replaced by "such services", the word "installation" is replaced by || | "providers" and "health care facility" shall be replaced
"provider".

165th In § 42 para. 4, third sentence, the words "medical devices"
be replaced by "provider".

166th In § 42 para. 7 the words "medical devices" are replaced
words "provider".

167th In § 43 para. 2 first sentence the words "health care provided"
replaced by "paid for services rendered," and in the second sentence, the words
'paid health care "is replaced by" reimbursable services
paid ".

168th In § 44 para. 4 the word "constitutional" is replaced by "twin"
words "domestic constitutional order medical facility" shall
words "internal regulations provider-patient care" and "health care
" is replaced by "paid services".

169. In § 44, after paragraph 4 the following paragraph 5 is added:

"(5) For repeated violations providers in §

11 paragraph. 1 point. d) stores respective health insurance provider
fine of up to CZK 1 000 000; when determining the amount of the fine takes into account the seriousness of the infringement
, particularly the manner of its commission and its
consequences and the circumstances under which it was committed; a fine may be imposed within
1 year from the date when the health insurance company discovered violations
obligation, but no later than 3 years after the date on which the breach occurred
; the repeated imposition of fines is the reason for terminating a contract for the provision and payment
paid services without applying the notice period
according to § 17 para. 2. '.

The former paragraph 5 is renumbered paragraph 6.

170th In § 44 para. 6 after the word "fine" the words "imposed by
paragraphs 1-5."

171st In § 45 para. 1, the word "care" is replaced by "service".

172nd In § 45 para. 5, the words "Medical devices that are
entitled" are replaced by "providers who are authorized" and
word 'must' is replaced by the word "required".

173rd In § 45a Paragraph 1 reads:

"(1) The health insurance fund, which does not proceed in accordance with § 17 para. 1
2, 5-7, § 46 para. 1 and § 52 paragraph. 2, the Ministry of Health fined
up to 10 million CZK. The fine is the revenue of the state budget
. The health insurance company is obliged to pay the fine from its
operational fund. ".

174th § 45b shall be deleted.

175th Part Nine headline reads: "network of providers of medical services."

176th In § 46 paragraph 1 reads:

"(1) The health insurance company is obliged to ensure the provision of paid
services to their clients, including their location and time availability.
Fulfill this duty via providers with whom
concluded a contract on the provision and payment of reimbursable services. These providers
form a network of contracted providers, health insurers (hereinafter
"network"). ".

177 cells. In § 46 para. 2 point. a) the words "medical devices" are replaced
word "provider".

178th In § 46 par. 2 letter b) reads:

B) if the service provider paid by the Prison Service ".

179th In § 46 para. 2 point. c) the words "health care facility"
be replaced by "provider".

180th In § 46 para. 2 point. d) the words "health care provided."
replaced by "provided paid services.".

181st In § 46 at the end of paragraph 2 is replaced by a comma and a letter
e), added:

E) in the case of highly specialized care provided by a provider
who has been providing such health care granted under the Act on the statute
health services center highly specialized health care
. ".

182nd In § 46 paragraph 3 and 4 added:

"(3) In case of change of the legal form of the provider who has a
contract for the provision and payment of paid services, and in case if
founder of a limited liability company a natural person who has || | concluded a contract for the provision and payment of paid services, whose
authorized to provide healthcare services as individuals cease to exist
when granting authorization to provide these health services as
limited liability company, a tender takes place only when
if there is an extension of the scope provided paid services.

(4) of the selection procedure may propose health insurance or
candidate. Tenderer means a service provider authorized to provide health care
in the relevant field, or a natural or legal person
wishing to provide health services and is able
within the period specified in the tender notice prerequisites for providing health
services in the respective field of health care. ".

183rd In § 47 para. 1 the words "point of operation of medical equipment
" is replaced by "spot delivery of health services" and
words "constitutional spa and health" are replaced by "bed and
spa treatment rehabilitation."

184th In § 47 para. 2 point. a) the words "range of health care" are replaced
words "range paid services" and "should be provided" with
replaced by "shall be provided".

185th In § 47 at the end of paragraph 2 is replaced by a comma and
letter d), which reads:

D) the date from which it is necessary to ensure the provision of health services,

Which are the subject of the tender. ".

186th In § 48 par. 1 point. d) the words "health care facility"
replaced by the word "candidate".

187th In § 48 par. 3, the words "health care facilities participating in the tender
" replaced by "which people participated
tender".

188th In § 50 para. 1, "is entitled to provide health care in the relevant field
" is replaced by "meets or is within the period specified in the tender
able to fulfill the prerequisites for providing
paid services in the respective the healthcare industry, which is subject
tender ".

189th In § 51 paragraph 1 reads:

"(1) When assessing applications, the committee members have particular regard to the good reputation
candidate to candidate experience in the relevant field
to disciplinary measures imposed by the Act on the Czech Medical Chamber, the Czech Dental Chamber and
Czech chamber of Pharmacists, the ethical approach to
patients on complaints about the provision of health services. Members
Commission is assessing the applicant's intent on providing paid services
healthcare field, which is the subject of the tender, and his
capabilities to meet the prerequisites for ensuring the paid services within
set in the tender notice. ".

190th In § 52 paragraph 2 reads:

"(2) Health insurance account the results of the tender at
contracts for payment and paid services.
Outcome of the selection process does not create a right to a contract with health insurer
. The health insurance company is authorized to conclude a contract with
bidder only if it was the conclusion of such agreements in the selection procedure
recommended. ".

191st § 54 including the heading and footnote no. 48 repealed. ".

192nd The heading of § 55 reads: "Reimbursement of paid services incurred in
result of an infringement against the insured."

193rd In § 55 paragraph. 1-5, the words "care covered by health insurance
" is replaced by "paid services".

194 cm. In § 55 paragraph. 2, first sentence, the words "medical facilities must '
replaced by" providers are obliged "and the words" provided
health care "are replaced by" provided paid services. "

195th Annex no. 1 reads:

"Annex no. 1 to the Act no. 48/1997 Coll.

LIST health procedures not covered by health insurance OR
paid only under certain conditions

List of abbreviations and symbols ------------------------------------- ----------
-----------------------------------------
Identification, Explanation
symbol
---------- ------------------------------------ ------------------------------------------ ODB expertise


KAT categories of health performance in terms of reimbursement from health insurance
- symbols N, Z, W - see below

N performance indicated in the column KAT symbol "N" - health performance of Abel fundamentally
health insurance, the exception may be prior permission
physician reviewer for the particular insured, due to its
serious health condition (or a special health care needs)

W power indicated in the column KAT symbol "W "- health
performance fully covered by health insurance only when certain conditions or
limited the maximum rate paid, it is not necessary approval of the review
doctor

From the performance indicated in the column KAT symbol "Z" - health performance fully
paid health insurance only under certain conditions and after approval
physician reviewer

dg. diagnosis

pore. no. serial number of performance
---------- -------------------------------- ----------------------------------------------
- ----------------------------------------- --------- -----------------------------------
ODB name
---------- ----------------------------------- -----------------------------------------
001 general practice

002 Practical medicine for children and adolescents

014 General Dentistry - dentist - dentist

015 Orthodontics

201 Rehabilitation and Physical Medicine

401 Occupational Medicine

404 Dermatovenerologie

504 Vascular Surgery

601 Plastic Surgery

603 Obstetrics and Gynaecology


605 Oral and Maxillofacial Surgery

606 Orthopaedics

701 Otorhinolaryngology

Ophthalmology 705

706 Urology

808 Forensic Medicine

809 Radiology and Imaging

903 Clinical speech therapy

911 General Nurse

999 Universal medical services - with no ties to the expertise
----------- --------------------------- ------------------------------------------------ || |
List of health care services from public health insurance
not covered or reimbursed under certain conditions
------------- -------------- ----------------------------------------- --------- ----------------------------
Pore. ODB name of health performance KAT reimbursement conditions
no.
------------------------------- -------------- ----------------------- --------------------------- ----------
The first 001 health education activities N

Second 002 health education activities N

3rd 014 Fissure sealing - Tooth N

4th 014 dental dam - one jaw N

014 5th trephination alveoli N

014 6th augmentation, guided tissue regeneration and implant N
in dentistry

014 7th makeshift bridge made in the general N

8th 014 Repair fixed restorations in the office N

015 9th Professional orthodontic consultations at the request of the patient N


504 10th and Reconstruction. Iliac int. and other procedures N
vascular impotence

603 11th Recanalisation fallopian tube after previous sterilization N


12th 701 Indirect laryngoscopy with instillation of drug into the larynx N


706 13th implantation of penile prostheses N

706 14th Penis - kavernosometrie N

706 N 15th Kavernosografie

903 16th Speech preventive screening - screening N
Field

001 17th Investigations carried out in the workplace occupational health professional W Power will be paid if
jenezbytný to determine
epidemiological situation in the workplace

18th 014 W power injection of anesthesia will be paid except
intraligamentární anesthesia

19th 014 Comprehensive examination by a physician providers in the field W Power will be paid only when
dentist taking over the insured to care
when registering insured

20th 014 Checking oral hygiene - prophylactic W reimbursed twice a year

21st 014 Removing tartar - prophylactic W reimbursed annually

22nd 014 Local fluoridation with desiccation W paid for the use of
aminofluoridem with no carrier

Filling 23rd 014 permanent tooth (regardless of the number W reimbursed only when using
facets, including the reconstruction of the corner) nedózovaného amalgam
within the entire dentition, when
use samopolymerujícího
composite only in the range
canines including

014 24th photocomposit filling permanent tooth (bezW reimbursed for children up to the age
regardless of the number of facets, including 18 years in a range of canines, including
corner of reconstruction and completion of plastic)

25th 014 W Root canal treatment paid for the use
Registered material
Method central pin

014 26th Transitional splint without preparation - the tooth W reimbursed when using
Self-curing
Composite resin

014 27th Transitional plate with dissection - the tooth W reimbursed when using
Self-curing
Composite resin

28th 201 Determination of long-term rehabilitation W reimbursed once during treatment
Past plan based on rehabilitation conference

401 29th Investigations workplace insured W Power will be paid only

in terms of risk of professional examinations for the indication
imminent damage, or suspected
Professional ensuing disability

30th 601 Breast and pull the earlobe odstálého W Full payment to 10 years of age
child over 10 years of medical
Insurance does not cover

31st 701 Tests for aggravation and simulation WV cases of proven simulation
not reimbursing

32. 705 Application of contact lenses W Power will be paid after surgery
cataract

33. 808 Consultation findings by the medical examiner W Power will be paid if
nažádost attending physician
required to explain the findings
particular case

34. A comprehensive health assessment 911 W Power will be paid only upon
insured person's state of the environment practitioner's recommendation
taking over the insured to
doctor indicated temporary or
long-term nursing care
Household

35. 911 Targeted control of the insured in the home W Power will be paid after the previous
indication practitioner
which can be single or
expressing a specific frequency
Visits to a certain period

36. 911 Nursing simple intervention in the domestic environment W Power will be paid after the previous
indication practitioner
which can be single or
expressing a specific frequency
Visits to a certain period

37 911 Comprehensive care nursing needs W Power will be paid after the previous
or still insured in the home indicate practitioner
which can be single or
expressing a specific frequency
Visits to a certain period

38. Psychotherapy 999 Support - Implementation of W Power will be paid only on one
nepsychiatrem insured physician annually
in one industry after a detailed
enrollment in medical
documentation

39. 999 Interview with the family doctor W Power will be paid at one
insured persons aged 15 years
more than twice a year,
an adult once a year after
detailed enrollment in medical
documentation

40. 999 Educational interview the doctor with the patient or family W reimbursed only if medical
indication justified in writing
vezdravotnické documentation
and a signed edukovaného
or his legal representative

41. 999 Consilium physician providers W Power paid only if there is
specialized outpatient care practitioner request

42. 404 Epilation and 30 minutes from the exercise will be paid only
u dg. E00 - E07 (disorders of the thyroid gland
, hormonal disorders)
E10 - E14 (diabetes)
E20-E35 (diencefalohypofyzární
disorders)

43. Correction of 601 small congenital anomalies of the pinna Z
and surroundings (growths before auricle)

44. Of the 601 xanthelasma

45. 601 face ptosis surgery - upper, lower Z


46. ​​601 ptosis surgery of the face - total (smasZ
lifting)

601 47. Operation of hard and soft nose for functional Z
failure

48. 601 Rhinoplasty - nose soft Z

49. 601 Rhinoplasty - nose saddle (L-graft, including sampling) Of


50. Of the 601 Rinofyma

51. Of the 601 surgery gigantomastie

52. 601 Breast ablation preserving areola Z

53. 601 areomamilárního complex Reconstruction Of

54. 601 capsulotomy sleeve implant Z

55. 601 Removing the implant breast kapsulektomií Z

56. 601 Implantation tissue expander

57. 605 Enlarging the chin bone, cartilage or prostheses

60. 605 Subperiosteal implant - one jaw Z

61. 605 Correction Brady

62. 606 osteotomy of the proximal femur Z

63 606 Extension, shortening the long bones Z

64. Of the 701 Septoplasty

65. Of the 705 laser iridotomy performance is covered in the implementation
NA1 eye most times, when
another embodiment is to be paid
require the consent of a review physician

66. 705 Dermatoplastika one eyelid or Z
blepharochalasis - exize one cap
+ Fat removal and fold

67. 705 Laser coagulation of the retina from the performance is covered in the implementation
NA1 eye most five times, at
another embodiment is to be paid
require the consent of a review physician

68. 705 facelift leather swivel lid Z
flap or sliding

69. 706 Transurethral Thermotherapy of prostate Z

70 706 Penis - intracavernous injection of vasoactive substances from


71. 706 ligature of the vas deferens - Vasectomy Reversal Of

72. 999 equipment for patient care outside hospitals Z ".
-------------- -------------------- ---------------------------------- ---------------- ---------------------


196th Attachments Nos. 2 and 3 added:

"Appendix. 2 to Act no. 48/1997 Coll.

List of groups S

--------- -------------------------------------- ------------------------------------------------ || | No name group of medicines
of
--------- ---------------------------- -------------------------------------------------- --------
1 anti-ulcer drugs from the group of proton pump inhibitors, oral

2 prokinetic oral

3 antiemetics from SETRON

4-inflammatory drugs for inflammatory bowel disease, oral

5 anti-inflammatory drugs for inflammatory bowel disease, rectal

6 micronized multienzyme pancreatic preparations

7
short-acting insulins
8
intermediate-acting insulins
9 insulins long-acting

10 oral antidiabetics of the biguanide class

11 oral antidiabetic sulphonylurea

12 Vitamin D and its analogues, oral

13 Vitamin D and its analogues, parenteral administration

14 calcium salts, for oral administration

15 potassium, oral

16 antithrombotics from the group of vitamin K antagonists

17 antithrombotics from heparin

Antithrombotics 18 acting via the anti-Xa (low
heparins and similar drugs)

19 antiplatelet agents - except aspirin

20 antifibrinolytic oral

21 antifibrinolytic parenteral administration

22 haemostatics (vitamin K), oral administration

23 coagulation factor VIII

24 coagulation factor IX

25 iron salts, oral

26 iron salts in combination with folic acid, oral administration

27 iron salts, parenteral administration

28 erythropoietin and other drugs with a similar mechanism of action

29 substituents plasma and plasma proteins (albumin)

30 R plasma and plasma proteins (other)


31 total parenteral nutrition (components for systems all in one)

32 intravenous saline solutions

33 intravenous solutions of glucose

34 solutions for peritoneal dialysis

35 solutions for hemodialysis

36 cardiac glycosides, oral

37 antiarrhythmics class I and III, oral

38 adrenaline

39 nitrates and molsidomine for chronic oral administration

40 nitrates for acute treatment

41 antihypertensives - antiadrenergic agents, oral

42 drugs for pulmonary hypertension

43 Diuretics lower diuretic effect, oral

44 high diuretic effect, oral

45 diuretics, high effect of parenteral administration

46-sparing diuretics, oral

47 selective beta-blockers, oral

48 calcium channel blockers of the dihydropyridine group operating délenež 24 hours
Oral

49 calcium channel blockers other groups, oral, acting
Less than 24 hours

50 calcium channel blockers other groups, oral, acting
more than 24 hours

51 ACE inhibitors acting longer than 24 hours

52 drugs that affect the renin-angiotensin system, with the exception of ACE-uptake inhibitor

53 lipid-lowering medicines from statin group

54 lipid lowering drugs of the fibrate class

55 antifungals for topical use

56 antipsoriatic for topical use

57 antibiotics for topical use

58 corticosteroids used for topical therapy - weak and moderate
1st and 2nd generation

59 corticosteroids used for topical therapy - weak and moderate
3rd and 4th generation

60 corticosteroids used for topical therapy - strong and very strong
1st and 2nd generation

61 corticosteroids used for topical therapy - strong and very strong
3rd and 4th generation

62 drug against acne for topical use

63 gynecological antifungals, antibiotics and chemotherapeutics for topical
use

64 drugs increasing uterine tone

65 lowering drugs tone uterus

66 prolactin inhibitors

67 male sex hormones

68 female sex hormones from the group of estrogens, oral

69 female sex hormones from the group of estrogens parenteral administration

70 female sex hormones from the group of progestogens

71 gonadotropins and other ovulation stimulants

72 other sex hormones, androgens and hormone modulators

73 Urinary antispasmodics

74 drugs used in benign prostatic hyperplasia

75 anterior pituitary hormones and their analogs

76 hormones, posterior pituitary, and their analogues

77 hypothalamic hormones and their analogs

78 Corticosteroids for systemic use, oral

79 corticosteroids for systemic use, parenteral administration

80 thyroid hormones

81 antithyroid drugs

82 glucagon

83 homeostatika calcium

84 tetracycline antibiotics, oral

85 with a broad spectrum penicillins and penicillin including inhibitors
betalactamases, oral

86 penicillins susceptible to beta-lactamase oral

87 other beta-lactam antibiotics, oral

88 sulfonamides and trimethoprim, oral

89 macrolide antibiotics, oral

90 lincosamide antibiotics, oral

91 aminoglycoside antibiotics

92 quinolone chemotherapeutics, oral

93 imidazole and nitrofuran chemotherapy, oral

94 antifungals for systemic use, oral

95 anti-mycobacterial agents

96 systemic antiviral treatment for herpes, cytomegalovirus infection
and some other viral infections, oral

97 antiretrovirals

98 immunoglobulins, normal human

99 human tetanus immunoglobulin

100 human immunoglobulins against hepatitis

101 other human immunoglobulins specific


102 cytostatic from the group of alkylating agents, oral

103 cytostatic agents from the group of alkylating agents, parenteral administration

104 antimetabolites - folic acid analogs, oral

105 antimetabolites - folic acid analogues, parenteral administration

106 antimetabolite - purine and pyrimidine analogs, oral

Antimetabolites 107 - purine analogues parenteral administration

108 antimetabolite - pyrimidine analogs, other routes of administration

109 alkaloids from Vinca and analogues

110 podophyllotoxin derivatives, oral

111 podophyllotoxin derivatives, other routes of administration

112 taxanes

113 anthracyclines and their derivatives

114 cytotoxic antibiotics

115 platinum cytostatics

116 cytostatics - tyrosine kinase inhibitors, oral

117 cytostatics - monoclonal antibody

118 hormonal drugs with a cytostatic effect, parenteral administration

119 hormone antagonists - anti-estrogens, oral

120 antagonists of hormones - androgens, oral

121 aromatase inhibitors

122 interferons used in oncology

123 interferons and glatiramer acetate used in neurology

124 interferons used in hepatology

125 immunosuppressive drugs - m-TOR inhibitors, oral

126 immunosuppressive drugs - calcineurin inhibitors, oral

127 immunosuppressive drugs, TNF alpha inhibitors

128 NSAIDs, oral

129 NSAIDs, rectally

130 Central muscle relaxants, oral

131 antiuratika, oral

132 drugs acting on bone mineralization - bisphosphonates, oral

133 local anesthetics of amide groups

134 analgesics - strong opioids, oral

135 analgesics - strong opioids, transdermal

136 analgesics - morphine, parenteral administration

137 analgesics - opioids weak, oral

138 analgesics - strong opioids for treatment of breakthrough pain

139 analgesics - antipyretics, oral

140 antimigrenics

141 AEDs from barbiturates

142 AEDs from hydantoinátů, oxazolidines and succinimides

143 AEDs from the group of benzodiazepines and carboxamides

144 antiepileptics from fatty acid derivatives

145 anticholinergic antiparkinsonics

146 dopaminergic antiparkinsonian from levodopa and their derivatives

147 antiparkinsonics from dopamine agonists

148 antiparkinsonics acting on MAO and COMT

149 antipsychotics - neuroleptics classic, first class, oral

150 antipsychotics - neuroleptics classic, II. class, oral

151 antipsychotics with a low antipsychotic potential oral

152 Antipsychotics - antagonists, serotonin and dopamine receptors

153 Antipsychotics - multireceptoroví antagonists

154 lithium

155 antipsychotics, neuroleptics parenteral applications - depot preparations

156 anxiolytics, oral

157 anxiolytics, rectally

158 antidepressants non-selectively inhibiting the reuptake of monoamines
Oral

159 antidepressants - selective serotonin neurotransmitters acting on one
system, oral

160 antidepressants - selective serotonin acting on a transmitter two
systems, oral

161 central stimulants - oral

162 medicament for the treatment of Alzheimer's disease (cholinesterase inhibitors)

163 parasympathomimetics oral

164 drugs used in the treatment of dizziness, oral

165 antimalarials

166 anthelmintics

167 anti-allergy drugs, including nasal corticosteroids

168 of inhaled sympathomimetic

169 inhaled corticosteroids

170 inhaled anticholinergics

171 leukotriene modifiers, oral

172 non-sedating antihistamines

173 Ophthalmological - antibiotics

174 Ophthalmological - chemotherapeutics

175 Ophthalmological - Antivirals

176 Ophthalmological - corticosteroids


177 Ophthalmological - non-steroidal anti-inflammatory drugs

178 antiglaucoma from agonists and parasympathomimetics

179 antiglaucoma from beta-blockers

180 antiglaucoma of prostaglandins and prostanoids

181 mydriatics and cycloplegics

182 Ophthalmological - Antialergics

183 therapeutic allergen extracts standardized injectors filing

184 therapeutic allergen extracts standardized injection

185 basic antidotes

186 antidotes used in the cytostatic treatment, oral

187 antidotes used in the cytostatic treatment, parenteral administration

188 defined mixtures of amino acids phenylalanine

189 defined mixtures of amino acids selected amino acids (other than phenylalanine
) for further metabolism disorders

190 individually prepared radiopharmaceuticals for diagnosis

191 individually prepared radiopharmaceutical therapy

192 erythrocyte preparations

193 platelet preparations

194 products from plasma

195 leukocyte preparations
--------- ----------------------------------- -------------------------------------------------- -

Annex No. 3 to Act. No. 48/1997.
SECTION
A

List of abbreviations and symbols

In the list of medical devices not covered by the
health insurance and medical devices in the list of reimbursable by health insurance
at
providing ambulatory health care services have the abbreviations and symbols meaning:

A) group
1 bandages, patches
2 aids for incontinence
3 ostomy supplies
4 of orthopedic and prosthetic devices serially produced
5 of orthopedic and prosthetic devices individually made
6 stockings and girdles
7 truck accessories including disability
8 hearing aid accessories including
9 glasses and optical aids 10
aids and respiratory inhalation
11 equipment for diabetics
12 aids for the disabled
13 further unspecified aids
14 aids for the visually impaired
15 compensation aids for the hearing impaired 16

footwear, orthopedic aids for 17 laryngektomované

B) abbreviation db decibel


diopter DPT KT compression grade polyvinyl chloride PVC

SRT threshold of verbal clarity

C) shortcuts specialization and designation of special focus workplaces
ALG Allergology and Clinical Immunology CHR surgery

DIA endocrinology and diabetology DRV dermatovenerologie


FON foniatrie GER geriatrics
J16 professional workplaces with activities angiologic and lymphology
NEU neurology, pediatric neurology
OHM Oncology and Hematology Ophthalmology

OPH ORP orthopedic prosthesis orthopedics ORT


PED OTO Otolaryngology paediatrics practical medicine for children and adolescents
PRL general practice
REH rehabilitation and physical medicine doctor
S3 owning a certificate entitling him ORL Society
issuing a prescription and hearing aids covered by public
health insurance
S4 professional workplaces ophthalmic dispensing of special optical aids
S5 special health insurance scheme for the approval of the physician reviewer

TRN TRA Trauma and Pneumology phthisiology TVL

URN Sports Medicine Urology and Nephrology
SECTION B


List of medical devices not covered by public health insurance
in providing ambulatory health care services
----------------- ----------- -------------------------------------------------- ---------------------
Item Group Name kind (type) of a medical device NOTE

------------------------------ ----------------- -------------------------------------------------- -
1 1 patches except hypoalergických
patches

2 1 patch for corns

3 2 diaper PVC

4 2 washers PVC

5 4 tennis shoe

6 4 orthosis sports

7 7 accessory to the stroller - the worktop

8 7 accessories to the stroller - storage basket

9 7 accessories to the stroller - raincoat

10 7 accessories for the truck - the worktop


11 7 accessories truck - raincoat

12 7 Accessories for electric trucks - control for accompaniment

13 11 strips to diagnostic determination of cholesterol

14 12 accessories for walkers that are beyond their function

15 13 eye dropper

16 13 rod eye

17 13 breast pump

18 13 technical rubber finger

19 13 bed medical

20 13 IUD

21 13 pillow including coating

22 16 neortopedické insoles

23 Repair of medical devices except for wheelchairs and strollers and individually manufactured
orthopedic prostheses and repair hoists and adjustable beds
----------------- --------------------- -------------------------------------------------- -----------
SECTION C


List of medical devices covered by public health insurance
in providing ambulatory health care services
----------------- ----------- ------------------------------- ------------------- -------------------------------------------------- ----------
Item Group Title species (type) Limitations Limitations of the amount of reimbursement
medical
----------------------------- ----------------- means
------------- ------------------------------------- ------------------------------------------
1 1 means a classic wound healing, max. Size 10 x 10 cm 100%; max. 4 per CZK 1 pc; A

2 1 nonwoven max. Size 10 x 10 cm; 100%; max. CZK 50 100 pieces; A
max. 100 pieces per month;

3 1 devices for moist wound max. Size 20 x 20 cm; 100%; max. 200 CZK 1 pc; A
wounds after prescribing CHR, DRV, J16; when
treatment for longer than nine months after
approval of the review doctor
Only for stoma patients

4 1 hypoallergenic plasters to 18 years, only for stoma patients and 100%; max. 30 CZK per pack; A
diabetics
5 1 elastic bandage max. Size 14 cmx 5 m 100%; max. 50 CZK per 1 pc; A

6 1 bandage hydrophilic sterile max. Size 12 cmx 5 m 100%; max. 15 CZK per 1 pc; A

7 1 bandage flexible hose 100%; max. 30 CZK per 1 pc; A

8 1 wound swabs max. 1,000 units per year; 100%; max. 70 CZK per 1 000 pieces; A
Prescribing DIA

9 1 cellulose wadding max. 500 g of 100%; max. 50 CZK per 500 g; A

10 2 absorbents for the max. 150 pieces per month 100%; max. CZK 450 per 150 pieces; A
incontinent - inserts
light incontinence

11 2 absorbents for the max. 150 pieces per month 100%; max. CZK 900 per 150 pieces; A
Central incontinence
- Fee diapers

12 2 absorbents for the max. 150 pieces per month 100%; max. CZK 1,700 per 150 pieces; A
severe incontinence -
nappy

13 two fixation of absorbent max. 24 pieces per year 100%; max. CZK 190 per 24 pc; A
The fee for diapers

14 2 urinal condoms max. 30 pieces per month 100%; max. 700 CZK for 30 items; A

15 2 bags collecting urinal max. 10 pieces per month 100%; max. CZK 500 per 10 pc; A


16 3 pads colostomy max. 10 pieces per month 100%; max. CZK 3,000 for 10 pieces; B


17 3 ileostomy pads max. 15 pieces per month 100%; max. CZK 4,500 for 15 pieces; B


18 3 pads urostomy max. 15 pieces per month 100%; max. CZK 4,500 for 15 pieces; B


19 3 caps ostomy max. 30 pieces per month; 100%; max. CZK 3,100 for 30 pieces; B
After approval by the review doctor

20 3 corks ostomy max. 30 pieces per month; 100%; max. CZK 3,100 for 30 pieces; A
After approval by the review doctor

21 3 systems colostomy max. 60 pieces per month 100%; max. CZK 4,000 for 60 pieces; B
two-piece sealed - bags

22 3 systems colostomy max. 60 pieces per month 100%; max. CZK 7,500 for 60 pieces; B

piece sealed - bags
(Including support)

23 3 systems ileostomy max. 30 pieces per month 100%; max. CZK 9,000 for 30 pieces; B
piece drain - bags

24 3 systems ileostomy max. 30 pieces per month 100%; max. CZK 8,500 for 30 pieces; B
piece drain - bags
(Including support)

25 3 systems urostomy two-piece max. 30 pieces per month 100%; max. CZK 5,500 for 30 pieces; B
- Bags

26 3 systems urostomy max. 30 pieces per month 100%; max. CZK 9,000 for 30 pieces; B
piece - bags
(Including support)

27 3 strips and retaining max. 2 pieces per year, after the approval of 100%; max. 600 CZK per 2 pcs; A
means for stoma patients physician reviewer

28 3 ostomy irrigation systems - max. 2 sets of equipment, including 100%; max. CZK 2,800 for 2 sets; A
sets and accessories per year; After approval of the review
doctor

29 3 ostomy systems - at max. 1 system (10-washers, 100% max. 13 000 CZK per 1 system;
A temporary ostomy continence 60 pieces sealed bags and 15 pieces of equipment
temporary continence
stoma) per month; after being approved
physician reviewer

30 3 ostomy pads - Drainage max. 10 pieces per month; 100%; max. CZK 3,000 for 10 pieces; B
After approval by the review doctor

31 3 Ostomy Systems - Drainage max. 30 pieces per month; 100%; max. CZK 8,500 for 30 pieces; B
piece - bags after the approval of the review doctor
(Including support)

32 3 Ostomy Systems - Drainage max. 30 pieces per month; 100%; max. CZK 7,000 for 30 pieces; B
two-piece - bags after the approval of the review doctor

33 3 means ostomy - 100%; A
fill and leveling

34 3 ostomy devices - thickening max. 30 pieces per month; 100%; max. 360 CZK for 30 items; A
for ileostomiky

35 3 ostomy devices - cleaning 100%; max. CZK 350 per month; A


36 3 washes faceplate 100%; max. CZK 300 per month; A


37 3 ostomy devices - protective 100%; max. 1 000 CZK per month; A

38 3 ostomy devices - deodorant, after approval by the review doctor 100%; max. CZK 350 per month; A

39 4 brace mass-produced max. 1 units per year at 100% of the prescription; A
ORT, ORP, REH, CHR, NEU, TRA, TVL

40 4 stub sleeve max. 8 units per year 100%; A

41 4 jockstrap max. 2 pieces per year 100%; max. 130 CZK per 2 pcs; A

42 4 mammary prostheses max. 1 pc for two years; 100%; max. 1,800 CZK per 1 pc; A
After prescribing CHR, OHM, PRL

43 4 mammary prostheses adhesive max. 1 pc for two years; at 100%; max. 3,000 CZK per 1 pc; A
lymph edema; After prescribing
OHM, J16

44 4 mammary prostheses postoperative max. 1 pc in rámci1 operations; 100%; max. 500 CZK for 1 pc; A
After prescribing CHR, OHM

45 4 compression bra max. 1 pc per year; at 100%; max. 1,300 CZK per 1 pc; A
lymph edema;
After prescribing CHR, OHM

46 5 brace made individually after prescribing ORP, ORT, REH, 100%; A
CHR, NEU and after approval of the review
doctor

47 5 prostheses made individually max. 1 pc for two years; 100%; A
After prescribing CHR, ORP, ORT
and after approval by the review doctor

48 5 upper and lower dentures max. 1 pc for two years; 100%; A
limbs - basic design for a prescribed ORP, REH, ORT

49 5 modular prosthesis upper and max. 1 pc for two years; 100%; A
the legs, which are over prescribing of the ORP, REH, ORT

made of modular and approval by the review doctor
semi-finished products and assemblies, including
tensile upper limbs prostheses

50 5 myoelectric prostheses, max. 1 pc in 5 years (in case of 100%;
A loss of both upper extremities disability in both legs 1 pair per
unilateral amputation or 5 years); After prescribing ORP, REH,
functional impairments second ORT and after approval of the review
upper extremity doctor S5

51 6 compressive elastic max. 2 pairs per year; 100%; max. 820 CZK for 2 pairs; A
stockings calf II. K. T prescription PRL, CHR, INT, DRV,
J16

52 6 compressive elastic max. 2 pairs per year; 100%; max. 900 CZK for 2 pairs; A
stockings calf III. K. T prescription CHR, INT, DRV, J16

53 6 compressive elastic max. 2 pairs per year; 100%; max. 2,000 CZK per 2 pairs; A
stockings calf IV. K. T prescription CHR, INT, DRV, J16

54 6 compressive elastic max. 2 pairs per year; 100%; max. 1,050 CZK per 2 pairs; A
Stockings polostehenní II. K. T prescription PRL, CHR, INT, DRV,
J16

55 6 compressive elastic max. 2 pairs per year; 100%; max. 1,200 CZK per 2 pairs; A
Stockings polostehenní III. K. T prescription CHR, INT, DRV, J16

56 6 compressive elastic max. 2 pairs per year; 100%; max. 2,600 CZK per 2 pairs; A
Stockings polostehenní IV. K. T prescription CHR, INT, DRV, J16

57 6 compressive elastic max. 2 pairs per year; 100%; max. 1,200 CZK per 2 pairs; A
stockings thigh II. K. T prescription PRL, CHR, INT, DRV,
J16

58 6 compressive elastic max. 2 pairs per year; 100%; max. 1,200 CZK per 2 pairs; A
stockings thigh III. K. T prescription CHR, INT, DRV, J16

59 6 compressive elastic max. 2 pairs per year; 100%; max. 3,000 CZK per 2 pairs; A
stockings thigh IV. K. T prescription CHR, INT, DRV, J16

60 6 elastic compression max. 2 pieces per year, after prescribing 100%; max. 700 CZK per 2 pcs; A
thigh stockings with fastening PRL, CHR, INT, DRV, J16
waist II. K. T

61 6 elastic compression max. 2 pieces per year, after prescribing 100%; max. 750 CZK per 2 pcs; A
thigh stockings with fastening CHR, INT, DRV, J16
waist III. K. T

62 6 elastic compression max. 2 pieces per year, after prescribing 100%; max. 800 CZK per 2 pcs; A
thigh stockings with fastening CHR, INT, DRV, J16
waist IV. K. T

63 6 elastic compression max. 2 pieces per year, after prescribing 100%; max. 1,900 CZK per 2 pcs; A
Women's tights PRL, CHR, INT, DRV, J16 and after
II. KT revision doctor's approval

64 6 elastic compression max. 2 pieces per year, after prescribing 100%; max. 2,000 CZK per 2 pcs; A
Women's tights CHR, INT, DRV, J16 and after
III. KT revision doctor's approval

65 6 elastic compression max. 2 pieces per year, after prescribing 100%; max. 2,000 CZK per 2 pcs; A
Women's tights CHR, INT, DRV, J16 and after
IV. KT revision doctor's approval

66 6 elastic compression max. 1 units per year at 100% of the prescription; max. CZK 950 per 1 pc; A
tights CHR, INT, DRV, J16 and after
Pregnancy II. KT revision doctor's approval

67 6 elastic compression max. 1 units per year at 100% of the prescription; max. 1,300 CZK per 1 pc; A
tights CHR, INT, DRV, J16 and after
Pregnancy III. and IV. KT revision doctor's approval

68 6 arm sleeve set II. KT max. 2 pieces per year, after prescribing 100%; max. 1,000 CZK per 2 pcs; A
CHR, INT, DRV, J16, OHM and after
approval of the review doctor

69 6 arm sleeve set III. max. 2 pieces per year, after prescribing 100%; max. 1,000 CZK per 2 pcs; A
and IV. KT CHR, INT, DRV, J16, OHM


70 6 elastic compression max. 2 pieces per year, after prescribing 100%; max. 4,000 CZK per 2 pcs; A
tights and leg warmers II., III. CHR, INT, DRV, J16 and after
and IV. KT - individually revision doctor's approval
made technology
circular knitting

71 6 elastic compression max. 2 pieces per year, after prescribing 100%; max. 15 000 CZK per 2 pcs; A
tights and leg warmers II., III. J16 and after approval of the review
and IV. KT - individually physician S5
made of flat knitting technology


72 6 episode ankle and knee part max. 2 pieces per year, after prescribing 100%; max. 260 CZK per 2 pcs; A
II. and III. KT CHR, ORT, REH, PRL, DRV, J16

73 6 tool for putting max. 1 units per year at 100% of the prescription; max. 300 CZK for 1 pc; A
PRL elastic compression, CHR, INT, DRV, J16
stockings II., III. and IV. KT

74 7 Health stroller max. 1 pc for 3 years; 100%; max. 21 000 CZK per
REH prescription, ORT, NEU and 1 each; A
approval of the review doctor

75 7 Health stroller - Accessories max. 1 pc for 3 years; 100%; max. 5,000 CZK per 1 pc; A
REH prescription, ORT, NEU after
approval of the review doctor

76 7 truck mechanic - basic max. 1 pc in 5 years; 100%; max. 9,000 CZK per 1 pc; A
REH prescription, ORT, NEU, INT
and after approval by the review doctor

77 7 truck mechanic - lightweight max. 1 pc in 5 years; 100%; max. 19 000 CZK per 1 pc; A
REH prescription, ORT, NEU, INT
and after approval by the review doctor

78 7 truck mechanic - active max. 1 pc in 5 years; 100%; max. 21 000 CZK per 1 pc; A
REH prescription, ORT, NEU, INT
and after approval by the review doctor

79 7 truck mechanic - Children max. 1 pc in 5 years; 100%; max. 21 000 CZK per 1 pc; A
REH prescription, ORT, NEU after
approval of the review doctor

80 7 truck mechanic - Special max. 1 pc in 5 years; 100%; max. 55 000 CZK per 1 pc; A
Having regard to the degree and severity of prescribing REH, ORT, NEU after
Disability revision doctor's approval

81 7 truck mechanic - Accessories max. 1 pc in 5 years; 100%; A
REH prescription, ORT, NEU, INT
and after approval by the review doctor

82 7 leather gloves for wheelchair max. 2 pairs per year, 100%; max. 300 CZK for 2 pairs; A
(A mechanical wheelchair)

83 7 truck with electric drive max. 1 pc for 7 years; 100%; max. 136 000 CZK per 1 pc; A
- To operate normally prescribing REH, ORT, NEU, INT
exterior and approval by the review doctor

84 7 truck with electric drive max. 1 pc for 7 years; 100%; max. 115 000 CZK per 1 pc; A
- The standard for light traffic prescribing REH, ORT, NEU, INT and
usually in the interior after the approval of the review doctor S5

85 7 electric wheelchair - Accessories max. 1 pc for 7 years; 100%; A
REH prescription, ORT, NEU, INT
and after approval by the review doctor

86 7 repair truck mechanic, after the approval of the physician reviewer 90%
electrical and medical stroller

87 8 hearing aid for aerial power lines max. 2 pieces for 5 years; from 0 to 100%; max. 10 600 CZK per 2 pcs; A
- For moderate to 7 years; After prescribing FON
hearing loss from 30 dB to
59 db SRT

88 8 hearing aid for aerial power lines max. 2 pieces for 5 years; from 0 to 100%; max. 11 600 CZK per 2 pcs; A
- For heavy and very heavy 7 years; After prescribing FON
from hearing loss above 60 dB and
SRT above, residual hearing, deafness

89 8 hearing on the bone conduction - max. 2 pieces for 5 years; from 0 to 100%; max. 22 000 CZK per 2 pcs; AND

bilateral hearing loss at 7 years; After prescribing FON
anomaly canal and after approval of the review doctor
and middle severe transfer
hearing loss, chronic
discharge from the middle states after
kofochirugických operations
unsolvable allergy
fitting, bad effect
hearing on aerial power lines

90 8 hearing aid for aerial power lines max. 2 pieces for 5 years; from 7 to 100%; max. 10 600 CZK per 2 pcs; A
- Moderate for 18 years; After prescribing FON, OTO
hearing loss from 30 dB to S3
59 db SRT

91 8 hearing aid for aerial power lines max. 2 pieces for 5 years; from 7 to 100%; max. 5,800 CZK per 2 pcs; A
- For heavy and very heavy 18; After prescribing FON, OTO
hearing loss from 60 db SRT, S3
remnants of hearing and deafness

92 8 hearing on the bone conduction - max. 2 pieces for 5 years; from 7 to 100%; max. 6,800 CZK per 2 pcs; A
bilateral hearing loss at 18 years; After prescribing FON
anomaly aa canal after the approval of the review doctor
middle with severe transfer
hearing loss, chronic
discharge from the middle ear, states
After kofochirugických
operations unsolvable
Allergies to fitting
bad effect on hearing
Air lines

93 8 hearing aid for air max. 1 pc in 5 years; 18 years; 100%; max. 2,700 CZK per 1 pc; A
Leadership - for moderate after prescribing FON, OTO S3
hearing loss from 40 dB to 59 db SRT

94 8 hearing aid for air max. 1 pc in 5 years; 18 years; 100%; max. 3,900 CZK per 1 pc; A
Leadership - for heavy after prescribing FON, OTO S3
hearing loss from 60 dB to
79 db SRT

95 8 hearing aid for air max. 1 pc in 5 years; 18 years; 100%; max. 5,100 CZK per 1 pc; A
Leadership - for very heavy after prescribing FON, OTO S3
hearing loss, loss of
80 db SRT, remnants of hearing and deafness

96 8 hearing on the bone conduction - max. 1 pc in 5 years; 18 years; 100%; max. 6,800 CZK per 1 pc; A
Hearing loss in both sides after prescribing FON, OTO S3 and after
anomaly canal and approval of the review doctor
middle with severe transfer
hearing loss, chronic
discharge from the middle ear, states
After kofochirugických
operations unsolvable
Allergies to fitting
bad effect hearing

97 8 hearing aid battery to the max. 4 pc for 5 years; 100%; max. 80 CZK for 4 pieces; A
FON prescription, OTO S3

98 8 jackass adapter to the suspension max. 1 pc in 5 years; 100%; max. 90 CZK per 1 pc; A
hearing aid prescription FON, OTO S3

99 8 earmould - individually made max. 2 pieces for one year; 18 years; 100%; max. 700 CZK per 2 pcs; A
After prescribing FON, OTO S3

100 8 earmould - individually made max. 1 pc in 5 years; 18 years; 100%; max. 350 CZK for 1 pc; A
max. 2 pieces for 5 years - only
deaf and blind; After prescribing after
FON, OTO S3

101 8 fitting ear protection - max. 1 pc for two years; 18 years; 100%; max. 250 CZK 1 pc; A
individually made with otevřenýmstředouším states; after
Prescribing OTO and after approval
physician reviewer

102 8 earmould - mass-produced max. 1 pc in 5 years; 100%; max. 20 CZK per 1 pc; A
FON prescription, OTO S3

103 9 rim spectacles max. 3 pieces per year - up to 6 years; 100%; max. 300 CZK per 1 piece
max. 1 pc per year - 6 to 15
flight; two pairs of glasses due to refractive
defect + - 3 DPT into the distance; after
Prescribing OPH

104 9 rim spectacles max. 1 pc for three years - from 15 years; 100%, max. 150 CZK 1 pc; A
two pairs of glasses due to refractive error
+ - 3 DPT into the distance; after

Prescribing OPH

105 9 eyeglass lens is spherical, toric max. 3 times per year - up to 6 years; 100%; A
max. 1 per year - 6 to 15 years;
max. 1 per 3 roky- 15 years;
without changing the correction; epileptics,
eyed - always tempered finish;
After prescribing OPH

106 9 lenticular lens spectacle max. 3 times per year - up to 6 years; 100%; A
max. 1 per year - 6 to 15 years;
max. 1 per 3 roky- 15 years;
without changing the correction; of + - 10
DPT; up to 3 years in aphakia; after
Prescribing OPH

107 9 high refraction spectacle lens max. 3 times per year - up to 6 years; 100%; A
max. 1 per year - 6 to 15 years;
max. 1 per 3 roky- 15 years;
without changing the correction; myopia over
-10 DPT; disorders of the central
field of view; After prescribing OPH
and after approval by the review doctor

108 9 bifocal spectacle lens, max. 2 per year - up to 6 years; 100%; A
Franklin, sealing, max. 1 per year - 6 to 18 years;
grinded, silicate, plastic without changing the correction; strabismus;
aphakia; After prescribing OPH; by
18 years of not reimbursing

109 9 prismatic spectacle lens max. 3 times per year - up to 6 years; 100%; A
max. 1 per year - 6 to 15 years;
max. 1 per 3 roky- 15 years;
without changing the correction; diplopia;
strabismus; After prescribing OPH

110 9 prismatic foils - soft, hard max. 3 times per year - up to 6 years; 100%; A
max. 1 per year - 6 to 15 years;
max. 1 per 3 roky- 15 years;
without changing the correction; diplopia;
strabismus; After prescribing OPH

111 9 plastic lens spectacle - spherical, toric max. 2 per year - up to 6 years; 100%; A
max. 1 per year - 6 to 15 years;
max. 1 per 3 roky- 15 years;
without changing the correction; 15 years
+ - 10 DPT; 15 years of + - 3
DPT; After prescribing OPH

112 9 of absorbent layers on spectacle lenses max. 3 times a year - to 6 years; 100%; A
max. 1 per year - 6 to 15 years;
max. 1 per 3 roky- 15 years;
without changing the correction; aphakia,
pseudoaphakia, diseases and defects
photophobia interdependent; after
Prescribing OPH

113 9 hyperokulární spectacle lens max. 2 per year - 18; 100%; A
max. 1 per 3 roky- 18 years;
without changing the correction; After prescribing
OPH and after approval of the review
doctor

114 9 soft contact lens max. 2 per year - up to 15 years; 100%; A
max. 1 per year - from 15 years;
without changing the correction; refraction; over
+ - 10 DPT; afakiealespoň
in one eye, astigmatism
irregularis, anisometropia 3 DPT
and more; After prescribing OPH

115 9 contact lens tough max. 2 per year - up to 15 years; 100%; A
max. 1 per 2 roky- 15 years;
without changing the correction; keratoconus
astigmatism irregularis, 15
years in aphakia; After prescribing OPH
and after approval by the review doctor

116 9 contact lens hard - max. 2 per year - up to 15 years; 100%; A
individually made max. 1 per 2 roky- 15 years;
without changing the correction; keratoconus
irregularis astigmatism; 15

years in aphakia; After prescribing OPH
and after approval by the review doctor

117 9 contact lens max. 2 per year - up to 15 years; 100%; A
stenopeutická, color, therapeutic max. 1 per year - from 15 years;
without changing the correction; Only serious
diseases of the cornea, iris or
combination; After prescribing OPH
and after approval by the review doctor

118 9 occluder gel, plaster, plastic, after prescribing OPH 100%; A

119 9-telescope system remotely max. 1 pc for 7 years; 100%; max. 8,000 CZK per 1 pc; A
and to close with accessories prescribing OPH S4A after approval
physician reviewer

120 9 aspherical loupe magnifying 4x or more max. 1 pc in 5 years; 100%; max. 1,500 CZK per 1 pc; A
OPH prescription S4A after approval
physician reviewer

121 9 spherical magnifying loupe to 4x max. 1 pc in 5 years; 100%; max. 100 CZK for 1 pc; A
Prescribing OPH

122 9 glass eye prosthesis max. 2 pieces per year, after prescribing 100%; max. 800 CZK for 1 pc; A
OPH

123 9 acrylic prosthetic eye - max. 2 pc for 3 years; 100%; max. 2,000 CZK per 1 pc; A
individually made prescribing and OPH after approval
physician reviewer

124 10 applicators aerosol products after prescribing TRN ALG, OTO, 100%; max. 500 CZK for 1 pc; A
PED; 18 years poschválení
physician reviewer

125 10 Compressor inhalers max. 1 pc in 5 years; 100%; max. 4,500 CZK per 1 pc; A
Prescribing TRN ALG, OTO and after
approval of the review doctor

126 10 ultrasonic inhaler max. 1 pc for 10 years; 100%; max. 4,500 CZK per 1 pc; A
Prescribing TRN ALG, OTO and after
approval of the review doctor

127 10 oxygen concentrator after prescribing tRNA after the approval of 100%; A
physician reviewer

128 10 tools for application max. 1 pc. for two years; 100%; max. 300 CZK for 1 pc; A
powder inhaled forms of drugs under the prescription of prescription
restrictions drugs

129 10 CPAP device after prescribing TRN, NEU and 100%; max. 40 000 CZK per 1 pc; A
approval of the review doctor S5

130 10 BPAP device after prescribing TRN, NEU and 100%; max. 60 000 CZK per 1 pc; A
approval of the review doctor S5

131 10 personal spirometer after prescribing TRN ALG and 100%; max. 300 CZK for 1 pc; A
approval of the review doctor

132 10 nebulizer inhaler to (attachment) max. 1 pc for two years; 100%; max. 600 CZK for 1 pc; A
Prescribing TRN ALG, OTO and after
approval of the review doctor

133 11 applicator insulin - insulin pen max. 1 pc for 3 years; max. 2 pieces of 100%; max. 1,500 CZK per 1 pc; A
3 years for concurrent application
two types of insulin; after
Prescribing DIA

134 11 applicator for application insulin max. 1 pc for 3 years; 100%; max. 1 200 CZK 1 pc; A
syringe prescription DIA

135 11 applicator collecting blood using a lancet max. 1 pc in 5 years; 100%; max. 250 CZK 1 pc; A
Prescribing DIA

136 11 meter - for diabetics max. 1 pc for 10 years; 100%; max. 1,000 CZK ZA1 pieces; A
treated with intensified prescription DIA and after approval
insulin regimen (3 doses physician reviewer
daily or insulin pump)
for diabetics with unstable
2 doses of insulin daily

11 137 needles on the syringes after prescribing DIA 100%; max. CZK 120 per 100; AND

the insulin

138 11 needles for insulin pens max. 200 pieces per year; 100%; max. CZK 530 per 200 pieces; A
Prescribing DIA

139 11 needle to neinzulínovým feathers max. 100 pieces per year; 100%; max. CZK 270 per 100 pieces; A
Prescribing DIA

140 11 Complete the application (syringe after prescribing DIA 100% max. CZK 370 per 100; A
with a fixed needle)

141 11 lancets for blood sampling max. 100 pieces per year; 100%; max. CZK 300 per 100; A
Prescribing DIA

11 142 diagnostic strips for glucose measurement max. 400 pieces per year; 100%; max. CZK 3,200 per 400 pieces; A
Prescribing DIA

max. 1,000 units per year; to 100%; max. 8,000 CZK per 1 000 pieces; A
patients treated with intensified
insulin regimen or
Insulin pump; after
Prescribing DIA and after approval
physician reviewer

max. 1,800 units per year - up to 18 years 100%; max. 14 CZK 400 per 1 800 pieces; A
and pregnant diabetic women; after
Prescribing DIA and after approval
review doctor,

11 143 insulin pump max. 1 piece or set of 2% for 4100; max. 100 000 CZK per 1 piece or 1 set; A
years; After prescribing DIA and after
approval of the review doctor S5

144 11 infusion sets for insulin pump metal after prescribing DIA 100%; max. CZK 160 per one hundred; A

145 11 infusion sets Teflon after prescribing DIAa after the approval of 100%; max. CZK 300 per one hundred; A
the insulin pump physician reviewer

146 11 injection syringe to inject insulin after prescribing DIA 100%; max. CZK 230 per 100; A

147 12 crutches max. 1 pair for two years 100%; max. 400 CZK for 1 pair; A


148 12 forearm crutches max. 1 pair or 1 piece of 2 years 100%; max. 300 CZK for 1 pc; A

149 12 walker max. 1 pc in 5 years; 100%; max. 7,000 CZK per 1 pc; A
REH prescription, NEU, ORP and after
approval of the review doctor

150 12 stick max. 1 pc 3 years 100%; max. 130 CZK for 1 pc; A

151 12 bed positioning with electrical max. 1 pc for 10 years; 100%; max. 30 000 CZK per 1 pc; A
Setting prescription REH, ORT, NEU after
approval of the review doctor S5

152 12 the toilet seat max. 1 pc in 5 years; 100%; max. 4,000 CZK per 1 pc; A
REH prescription, ORT, NEU, PRL, GER

153 12 extension for WC max. 1 pc for 3 years; 100%; max. 1 200 CZK 1 pc; A
REH prescription, ORT, NEU, PRL, GER

154 12 seat in the bathtub and the shower max. 1 ksza 5 years; 100%; max. 2,000 CZK per 1 pc; A
REH prescription, ORT, NEU, PRL, GER

155 12 pointing devices max. 1 pc for 10 years; 100%; max. 60 000 CZK per 1 pc; A
REH prescription, ORT, NEU after
approval of the review doctor

156 12 accessories to the positioning device max. 1 pc for 10 years; 100%; max. 10 000 CZK per 1 pc; A
REH prescription, ORT, NEU after
approval of the review doctor

157 12 jack mechanical, electrical, max. 1 pc for 10 years; 100%; max. 30 000 CZK per 1 pc; A
Hydraulic prescription REH, ORT, NEU after
approval of the review doctor

158 12 bed positioning with max. 1 pc for 10 years; 100%; max. 15 000 CZK per 1 pc; A
mechanical adjustment prescription REH, ORT, NEU after
approval of the review doctor

159 13 wig max. 1 units per year at 100% of the prescription; max. 1,000 CZK per 1 piece
OHM, DRV, INT


160 13 bedsore pad max. 1 pc for 3 years; 100%; A
REH prescription, ORT, NEU after
approval of the review doctor

161 13 protective helmet max. 1 pc for two years; 100%; max. 2,500 CZK per 1 pc; A
REH prescription, NEU, PSY and after
approval of the review doctor

162 13 catheter for intermittent catheterisation max. 150 pieces per month; 100%; max. CZK 7,500 per 150 pieces; A
- Coated prescription URL and after approval
physician reviewer

163 13 catheter for intermittent catheterisation max. 150 pieces per month; 100%; max. CZK 2,300 per 150 pieces
- Uncoated prescription URL and after approval
physician reviewer

164 14 white cane for the blind max. 3 pieces per year at 100%; A
OPH prescription, PRL

165 14 aids for the blind max. 1 pc for 7 years; 100%; max. 2,000 CZK per 1 pc; A
OPH prescription, PRL and after
approval of the review doctor

166 15 induction hundred amps max. 1 pc for 7 years, 100%; max. 1,000 CZK per 1 pc; A
FON prescription, OTO S3

15 167 hearing aids for max. 1 pc for 7 years; 100%; max. 2,000 CZK per 1 pc; A
Guests prescription FON, OTO S3 and after
approval of the review doctor

168 16 orthopedic shoes for children - individually max. 3 pairs per year; 100%; max. 6,000 CZK per 3 pairs
made prescription REH, ORT, ORP and after
approval of the review doctor

169 16 orthopedic shoes for children - standard max. 3 pairs per year; 100%; max. 3,000 CZK per 3 pairs
produced prescription REH, ORT, ORP and after
approval of the review doctor

170 16 orthopedic shoes - max. 1 pair for two years; 50%
individually made - simple prescription REH, ORT, ORP

171 16 orthopedic shoes - max. 1 pair for two years; 90%
individually made - the prescription REH, ORT, ORP
complicated and very complex

172 16 shoes for diabetics max. 1 pair for two years; 100%; max. 1,000 CZK per 1 pair
Prescribing DIA and after approval
physician reviewer

173 16 orthopedic insert - max. 1 pair for two years; 100%; max. 100 CZK for 1 pair
individually made prescription REH, ORT, ORP

174 16 orthopedic insert - max. 2 pairs per year; 100%; max. 600 CZK for 2 pairs
individually made - children's prescription REH, ORT, ORP

175 16 orthopedic pad - Special max. 2 pairs per year; after 80%
REH prescription, ORT, ORP

176 17 tracheostomy tube of precious metal max. 3 pieces per year; 18; 100%; max. 10 500 CZK per 3 pieces; A
OTO prescription, FON and after
approval of the review doctor

177 17 tracheostomy tube of noble metal max. 2 pieces for 5 years; 18 years; 100%; max. 4,000 CZK per 2 pcs; A
After prescribing OTO, FON

178 17 tracheostomy tube max. 3 pieces per year; 18; 100%; max. 10 500 CZK per 3 pieces; A
Silicone pediatric prescribing OTO, FON and after
approval of the review doctor

179 17 tracheostomy tube silicone max. 2 pieces per year, 18 years; 100%; max. 4,000 CZK per 2 pcs; A
OTO prescription, FON and after
schválenírevizním doctor

180 17 aspirator electrical, mechanical, max. 1 pc in 5 years; 100%; max. 4,000 CZK per 1 pc; A
OTO prescription, TRN and after
approval of the review doctor

181 17 accessories for breast pump - max. 150 pieces per year; 100%; max. CZK 1,000 per 150 pieces; A
suction catheter prescription OTO, TRN and after

approval of the review doctor

182 17 accessory cannula tracheostomy max. 1 per year; After prescribing 100%; max. 2,000 CZK per
OTO, FON 1 package complete accessories; A


183 17 accessories for the voice prosthesis max. 1 per year; After prescribing 100% max. 12 500 CZK per 1 package of complete
OTO, FON and approval of inspection equipment; A
doctor

184 17 electrolaryng max. 1 pc for 10 years; 100%; max. 15 500 CZK per 1 pc; A
Prescribing FON and after approval
physician reviewer

185 17 electrolaryng battery to the max. 1 pc for two years; 100%; max. 700 CZK for 1 pc; A
After prescribing FONA after approval
physician reviewer
----------------- ---------------------------- -------------- ------------------------------------ -------------------------------------------

Symbols refunding limits

A - Remuneration of the end consumer price
medical device design in the least economically challenging depending on the extent and severity
disability (hereinafter "the least economically demanding variant
"); price economically least demanding option
medical device detects the health insurance market research.

B - Remuneration of price economically least demanding
variants of the whole system consisting of the medical devices group no. 3 of this section
.. "

197th Annex no. 4 in Section A the "Dental alloys for making
dental products in the basic design" in the table
words "Wiron 99" is replaced by "nickel alloy for ceramic and resin
facets", the words "Koldan, Konstrulit" is replaced
"stříbrocínová, stříbroměděná spare alloy" and the words "Oralium,
Kdynium (K1)" is replaced by "chrome cobalt,
chromkobaltmolybdenová alloy for skeletons."

198th in the Annex. 4 section a, "Dental alloys for making
dental products in the basic implementation" text "
Health insurance pays for the fabrication of molded reinforcement for removable partial refunds
with simple retention elements (products with codes 82001, 82002,
72001, 72002). price cast reinforcement is added to the cost of dental
product. the product "repair sensing apparatus with the imprint" (code 86081 and
76081) is not included in the price orthodontic screw. In the case of screw
its price added to the cost of dental product. "
Replaced by" Health insurance pays for the fabrication of molded reinforcement for
removable partial reimbursements with simple retention elements (
products with codes 82001, 82002 , 72001, 72002). Price cast reinforcement is added to the price
dental product. In the article "repair or modification
sensing apparatus with the imprint" (code 86081 and 76081) is not included in the price
orthodontic screw. If you use a screw with its price
added to the cost of dental products. ".

199th Annex no. 4 Section A under "Health insurance does not cover"
words "Troubleshooting the statutory warranty period" shall be replaced
"to eliminate defects covered by the statutory guarantee".

200th Annex no. 4 Section C above the table heading "Corrections sensing
compensation rebasing" is replaced by "Repairs and modifications dentures, rebasing
".

Two hundred and first Annex no. 4 of Section C of codes 72320, 76080, 76081, 82320, 86080 and 86081
in the column "dental product"
word "fix" the words "or treatment".

202nd Annex no. 4 of Section C of codes 72331, 72332, 82331 and 82332 in
column "dental product" word "fix" is replaced
word "Edit".

203rd Annex no. 4 of Section C of codes 72351, 72352, 72353, 72354,
82351, 82352, 82353 and 82354 in the column "dental product"
word "rebasing" is replaced by "Edit - rebasing".

204th Annex no. 4 Section C in "Orthodontic products" text

"76036 Curtains, GLIDE canopy b P 965 - 76,037
curtains, GLIDE caret c P 603 -"

replaced by "76037 Curtains, GLIDE canopy b P 965 -

76,038 curtains, GLIDE caret c P 603, -. "

Art. II
Transitional provisions


First Health insurance provider change on the first day of the calendar quarter may
after the effective date of this Act done only if
prior to the effective date of this Act, an application was made to change
health insurance for the first day of the calendar quarter,
following the date of application.

Second When providing medical care under § 15 par. 3 of Law no. 48/1997
Coll., Which began before the effective date of this Act shall
proceed according to § 15 par. 3 of Law no. 48/1997. , as amended, effective
effective date of this Act unless the conditions are met in
therein.

Third On the effective date of this law is still valid and effective payment
those medicines which can be issued without a medical prescription
expire. Proceedings for denial of reimbursement
these medicines are not kept, and if kept, the effective date of this Act
such a procedure is terminated.

Fourth Proceedings to cancel the payment of medicines and foods for special medical purposes
, the price for the end consumer is less than or equal to 50
CZK are not kept, and if kept, the effective date of this Act
such proceedings stops.
PART TWO


Amendment to the Act on premiums for general health insurance

Art. III

Act no. 592/1992 Coll., On premiums for general health insurance, as amended
Act no. 10/1993 Coll., Act no. 15/1993 Coll., Act no. 161/1993 || | Coll., Act no. 324/1993 Coll., Act no. 42/1994 Coll., Act no. 241/1994
Coll., Act no. 59/1995 Coll., Act no. 149/1996 Coll ., Law no. 48/1997
Coll., Act no. 127/1998 Coll., Act no. 29/2000 Coll., Act no. 118/2000
Coll., Act no. 258/2000 Coll., Act no. 492/2000 Coll., Act no. 138/2001
Coll., Act no. 49/2002 Coll., Act no. 176/2002 Coll., Act no. 309/2002 || | Coll., Act no. 424/2003 Coll., Act no. 437/2003 Coll., Act no. 455/2003
Coll., Act no. 53/2004 Coll., Act no. 438/2004 Coll ., Act no. 123/2005
Coll., Act no. 381/2005 Coll., Act no. 413/2005 Coll., Act no. 545/2005 Coll
., Law no. 62/2006 Coll., Act no. 117/2006 Coll., Act no. 189/2006
Coll., Act no. 214/2006 Coll., Act no. 264/2006 Coll., Act no. 261/2007 || | Coll., Act no. 296/2007 Coll., Act no. 306/2008 Coll., Act no. 227/2009
Coll., Act no. 281/2009 Coll., Act no. 285/2009 Coll ., Act no. 362/2009
Coll., Act no. 73/2011 Coll., Act no. 138/2011 Coll., Act no. 298/2011 Coll
. and Act no. 329/2011 Coll., is amended as follows:

First In § 12 para. 2, the words "health care" are replaced
words "provided medical services covered by public health insurance
under the law on public health insurance (hereinafter
" paid services ")".

Second In § 20 para. 1 the words "health care fully or partially covered by health insurance
" is replaced by "paid services".

Third In § 21 paragraph. 1, the word "was" is replaced by the word 'have' and the words
"paid separately expensive health care (hereinafter referred to as" costly care ")" is
replaced by "paid separately expensive paid services (hereinafter
just "expensive paid services") ".

Fourth In § 21a paragraph. 2 "expensive care means healthcare
paid by public health insurance provided" replaced
"expensive-funded services are the paid services rendered" and
word "which" is replaced by the word "whom".

Fifth In § 21 paragraph. 3, the words "costly care" is replaced by "expensive
paid services."

6th In § 21a paragraph. 4, 6, 7 and 11, the words "expensive treatment" is replaced
"expensive paid services."

7th In § 21a paragraph. 5, the words "expensive care" is replaced by "expensive
paid services."

8th In § 21 paragraph. 11 of the last sentence, the words "
medical devices that expensive care provided" replaced by "
medical service providers under the Act on Health Care Services
(hereinafter" Provider "), who expensive paid services provided "and
words" health care facilities are required to "shall be replaced
" providers are required. "

9th In § 21a Paragraph 12 reads:

"(12) The relevant health insurance company is obliged to notify the administrator account
promptly cases where under the control of providers declined

Payment of expensive paid services and the amount of this reduction. In cases where the
health insurance under the law on public health insurance
entitled to reimbursement for paid services that
incurred as a result of culpable infringement by a third person
insured is entitled to a claim by paragraphs 3 to resolution
reimbursement of expenses, and it only costs that are not a substitute this
covered. ".

10th Footnote. 40b is deleted.
PART THREE


Amendment of the General Health Insurance Company of the Czech Republic

Art. IV

Act no. 551/1991 Coll., On General Health Insurance Company
Czech Republic, as amended by Act no. 592/1992 Coll., Act no. 10/1993 Coll.
Law no. 60 / 1995 Coll., Act no. 149/1996 Coll., Act no. 48/1997 Coll.
Act no. 305/1997 Coll., Act no. 93/1998 Coll., Act no. 127/1998 Coll .,
Act no. 69/2000 Coll., Act no. 132/2000 Coll., Act no. 220/2000 Coll.
Act no. 49/2002 Coll., Act no. 420/2003 Coll., Act no. 455/2003 Coll.
Act no. 438/2004 Coll., Act no. 117/2006 Coll., Act no. 261/2007 Coll.
Law no. 296 / 2007 Coll., Act no. 362/2009 Coll., Act no. 188/2011 Coll.
And Act no. 298/2011 Coll., Is amended as follows:

First In § 2, paragraph 2 deleted.

Former paragraphs 3 and 4 become paragraphs 2 and 3

Second In § 4, at the end of subparagraph d), the comma is replaced by a full stop and letter e)
deleted.

Third In § 5 letter a) reads:

"A) Payments for health services covered by public health insurance
(hereinafter" paid services ")
under contracts entered into with persons authorized to provide health services under
law on health services (hereinafter "provider"),".

Fourth In § 5. b) the word "health" is replaced by "paid".

Fifth In § 5, letter e) shall be deleted.

Existing letter f) shall become point e).

6th § 6 para. 6 the words "health care paid" shall be replaced
"paid for services paid", the words "medical devices"
replaced by "providers" and "health care reimbursement" will be replaced
the words "provision and payment of reimbursable services."

7th In § 7 para. 1 point. a) the words "health care covered by public health insurance
" is replaced by "paid services".

8th In § 7 para. 1 point. b) the words "health care" is replaced
"paid services".

9th In § 7, paragraph 2 reads:

"(2) The insurance company may create a fund prevention. The Fund can prevent over
beyond paid service pay health services with demonstrable
preventive, diagnostic or therapeutic effect, they are provided
insured in respect of their existing or impending
disease. Means prevention fund can also be used to implement preventative health programs
used for the detection of serious diseases
to support rehabilitation and reconditioning activities
leading to a demonstrable improvement in the health status of the insured and to support
projects supporting an increase in the quality of health care
healthy way of life and health of the insured. The source of the Fund are funds from
share in profit after taxation provided for by statutory authorities
Insurance of activities beyond the implementation of public health insurance
The insurance company conducted in accordance with the laws and statutes
Insurance and Financial funds pursuant to § 6. 7. ".

10th Footnote. 9 is repealed.

11th In § 7 para. 6 the words "medical devices ^ 5)" is replaced
"provider".

12th Footnote. 5 is repealed.

13th In § 8 par. 2, the words "provided health care" is replaced
"provided paid services."

14th In § 8 par. 3 of the word "health" is replaced by
"paid".

15th In § 20 para. 1 point. c) the words "health care facility"
replaced by "providers".

16th In § 24 paragraph 3 reads:

"(3) The insurance company is obliged by its information system serving
at the written request of the authorizing provider of outpatient care in the field
general practice or in practical medicine
for children and adolescents about paid services which were provided
its policy holders, who are registered with such a provider,

Other providers including the provision of medicines and medical devices
; The insurance company provides this information
charge.

17th In § 24b paragraph. 1 "paragraph. 4 "are replaced by" paragraph. 3

18th Footnote. 8b is repealed.
PART FOUR


Changing the law on ministries, professional, corporate and other health insurance companies


Art. In

Act no. 280/1992 Coll., On Departmental, Professional, Enterprise, and other
health insurance, as amended by Act no. 10/1993 Coll., Act no.
15/1993 Coll., Act no. 60/1995 Coll., Act no. 149/1996 Coll., Act no.
48/1997 Coll., Act no. 93/1998 Coll., Act no. 127/1998 Coll., Act.
225/1999 Coll., Act no. 220/2000 Coll., Act no. 49/2002 Coll., Act no. 420/2003 Coll
., Act no. 438/2004 Coll., Act No. . 117/2006 Coll., Act no. 267/2006 Coll
., Act no. 261/2007 Coll., Act no. 296/2007 Coll., Act no. 351/2009 Coll
., Act no. 362/2009 Coll., Act no. 188/2011 Coll. and Act No.
. 298/2011 Coll., Is amended as follows:

First In § 4 para. 1 letter a) reads:

A) persons authorized to provide health services under the Act on
health services (hereinafter "Provider")

Second In § 4 para. 1 point. b) c) and § 22b paragraph. 3, the words "
medical devices" are replaced by "provider

Third § 6 para. 4 of the last sentence, the words "health care facility"
replaced by "providers".

Fourth In § 6a sect. 3, the second sentence is replaced by the phrase "In the exercise of this scope
performs particularly payments to providers, or other
entities that provide health insurance to policyholders liquidated
health services covered by public health insurance in accordance with the law | || public health insurance (hereinafter referred to as "paid services"). ".

Fifth In § 6a sect. 3, third sentence, the words "health care" is replaced
"provided paid services."

6th In § 8 paragraph 1 reads:

(1) Insurance Company performs public health insurance. ".

7th In § 8 paragraph 2 deleted.

Existing paragraph 3 shall be renumbered 2.

8th In § 8 par. 2 the words "health care paid" shall be replaced
'healthcare services paid ".

9th In § 10 paragraph. 12, second sentence, the words "payment of health care"
replaced by "the provision and payment of reimbursable services" and the words
"provision of medical care" is replaced by "
providing paid services."

10th In § 12 para. 2 point a) is deleted.

Existing letters b) to d) is renumbered a) to c).

11th In § 13 letter a) reads:

A) payments for services paid under the contracts concluded with providers. "

12th In § 13 point. b) the word "health" is replaced by "paid".

13th In § 13 letter e) shall be deleted.

Existing letter f) shall become point e).

14th In § 15 par. 3 of the words "health care paid" shall be replaced
"paid for services provided", the words "medical devices"
replaced by "providers" and "health care reimbursement" will be replaced
the words "provision and payment of reimbursable services."

15th In § 16 para. 2 the words "health care paid" shall be replaced
'healthcare services paid ".

16th In § 16 par. 3, the words "preventive care covered by health insurance
" is replaced by "paid services".

17th In § 16 paragraph 4 reads:

"(4) Insurance Company may create fund prevention. The Fund
prevention may be beyond the paid services pay for medical services for
which is proven preventive, diagnostic or therapeutic effect and
which are provided to insured persons in connection with their
existing or impending disease. The Fund's resources can be used for prevention
implementation of preventive healthcare programs used to detect
serious diseases, to support the rehabilitation and reconditioning activities
leading to a demonstrable improvement in the health status of the insured and
to support projects that support improving the quality of health care ,
healthy way of life and health of the insured. The source of the Fund's financial resources
proportion of positive economic result after taxation
provided statutory authority employee insurance activity, which
beyond the implementation of public health insurance employee

Insurance carried out in accordance with the laws and statutes
employment insurance and income pursuant to § 19 para. 1. ".

18th Footnote. 17 is deleted.

19th In § 17 para. 1 the words "health care covered by public health insurance
" are replaced by "provided paid services."

20th In § 18 par. 1 sentence Fourth, the words "health care" are replaced
words "paid services".

21st In § 19 par. 3 the words "medical devices ^ 13)"
be replaced by "provider".

22nd Footnote. 13 is deleted.

23rd In § 21 paragraph 3 reads:

"(3) Insurance Company is obliged by its information system
serve upon the written request of the authorizing provider
outpatient care in general practice or in the field
practical medicine for children and adolescents about paid services
which were provided to the insured persons who are in such
registered providers, other service providers including
prescription medicines and medical devices; this information
Insurance Company provided free of charge. ".

24th Footnote. 21 is deleted.

25th In § 22a paragraph. 2, the words "health care provided by health facilities
" is replaced by "paid for services rendered
providers" and the words "medical devices" shall be replaced
"providers".

26th In § 22b Sec. 1, the words "medical establishment" is replaced by
"providers" and "health care, which" shall be replaced
"paid services".

27th In § 22b Sec. 2 point. a) the words "health care
practical physician and general practitioner for children and adolescents" are replaced
"paid registrants services provider in the field of general
practical medicine and practical medicine for children and adolescents."

28th In § 22b Sec. 2 point. b) the words "outpatient care
specialists" are replaced by "reimbursable services provider in
different field than specified in subparagraph a)."

29th In § 22b Sec. 2 point. c) the word "constitutional"
replaced by the word "bed".

30th In § 22c, the words "medical devices"
replaced by "providers".

31st In § 23 para. 1 the words "health care is provided on the basis
law on universal health insurance, 8 ^)" is replaced by "
are provided paid services."

32nd Footnote. 8 is repealed.

Art. VI


Transitional provisions
Fund balances to cover preventive care and specific
health care health insurance companies transferred within 30 days from the date of entry into force of this Act
as an extraordinary allocation fund
basic health insurance.
PART FIVE



EFFICIENCY
Art. VII

This Act shall take effect on the first day of the fourth month
following the date of its publication.
Nemcova vr

Klaus vr


Nečas