The Value Of The Item And The Amount Of Reimbursement Of Health Care For 1. Half-Year 2001

Original Language Title: hodnota bodu a výše úhrad zdravotní péče pro 1. pololetí 2001

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487/2000 Sb.



REGULATION OF THE GOVERNMENT



of 18 July 2003. December 2000,



fixing the value of the item and the amount of reimbursement of health care covered by the

public health insurance for 1. half-year 2001



The Government decrees referred to in § 17 paragraph. 5 of Act No. 48/1997 Coll., on public

health insurance and amending and supplementing certain related

laws, as amended by Act No. 2/1998 Coll. (hereinafter the "Act"):



§ 1



This regulation lays down the values of the point and the amount of reimbursement of health care paid for by

from public health insurance. half of 2001 for health care

in health care, including specialist medical

institutes for long-term patients, hospitals and medical facilities

returning under the list of health interventions

with point values, ^ 1) (hereinafter referred to as "the Ordinance"), the length of the day no. 00005

and the amount of the remuneration for the provision of emergency care in non-

medical facilities.



§ 2



(1) the Medical care provided in the medical facilities of the constitutional

care, with the exception of health care in specialised therapeutic institutes,

Sanatorium for long-term patients and in medical devices

returning the day care Decree No. 00005 (hereinafter referred to as "bed

device "), at 1. half of 2001 under contractual arrangements between pays

health insurance and in-patient facilities



and) flat-rate,



(b) according to the list of health performance) listed in the notice, or



(c) the design of the device socket) on the combined payment with the payment for the

the diagnosis.



(2) Inpatient facilities and health insurance company may agree on a different

the method of payment, than is provided for in paragraph 1, where the total amount of the remuneration

will be higher than the remuneration provided for in paragraph 1 (b). and) or (b)).



(3) the procedure for the calculation of flat rates, the amount of the value of the point and the conditions for reimbursement

referred to in paragraph 1 (b). and (b))) shall be established in annex 1 to this

of the regulation.



(4) the amount of remuneration referred to in paragraph 1 (b). (c)) shall negotiate in the contract between the

health insurance and the amount of fasility, payment

the provision of acute care will be provided with payment for the diagnosis and

other health care will be covered by a flat rate.



(5) If an inpatient facility and health insurance company will agree to supplement

contract, or out a new contract, containing new health performances

provided by the device, or will agree a new structure

Healthcare, health insurance is bound to these

in fact, the total amount of payments for 1. half of 2001 include.



(6) If, in the 1. half of 2001 income from a selection of premium

one insured higher than the approved plan provides a disability insurance

health insurance for the year 2001, will increase the health insurance company

the value of the point set out in annex 1 to this regulation, no so much per mile,

how much per mile increased premiums on the insured's choice of one over

the amount referred to in the health insurance plan. This increase in pay

health insurance lůžkovému devices to 30. November 2001.



(7) beyond the standard rates referred to in paragraph 1 (b). and health)

the insurance company will provide in the 1. half of 2001 cover



and for kardiovertry and later) for cardiac pacemakers, including electrodes,

provided in the case of reimplantací (performances no 55217 and 55219 referred to in

the Decree), which were provided in the 1. half of 2001,



(b)) for the neuromodulační enhancers that have been provided in the 1. half of the

2001 in the treatment of epilepsy and Parkinson's disease,



(c)) for neuromodulační promoters and intrathekální pumps, provided by

treatment of chronic painful conditions. half of 2001 in the bed

the establishments listed in the annex 3 to this Regulation [peripheral

nerve stimulation (PNS), stimulation of the spinal cord or the rear roots

(CCT), deep brain stimulation, and korová for the promoters of the front corners

Spinal (SARS) with transversálních lesions of spinal]; inpatient facilities

referred to in annex 3 to this Regulation may apply to the sum of the

health insurance companies in the Czech Republic up to 30 programmable

prostheses,



(d)) for the treatment of in vitro fertilization, which was granted in the 1. half of the

2001 sleeper devices implementing the standard treatment of sterility

her method of fertilization,



(e)) for the health centre performance no 18051, 18052, 18510, 18513,

18521, 18522, 18530, 18550, 18560, 18570, and 18590 18580 list

health procedures referred to in the Decree, which was provided in the 1.

half of 2001, in the amount of CZK 1 per point, with no performances for health.

18521, 18522, 18530, 18550, 18560, 18570, 18580 and 18590, referred to in

the Decree, provides for overhead costs in the amount of 4 points per minute,



(f)) for a particularly charged to medicinal products intended to treat hemophilia,

listed in annex 4 to this regulation, provided in the 1. half-year 2001

in the inpatient facilities,



(g)) of a particularly charged to medicinal products intended to treat HIV/AIDS

(antiretroviral medicinal products and medicinal products intended to treat

opportunistic infections), provided in the 1. half of 2001 in the bed

equipment listed in annex 5 to this regulation,



(h)), the medicinal product particularly charged Cerezyme, to treat disease

Morbus Gaucher, provided only the clinic of child and adolescent

Medicine of the General faculty hospital in Prague 1. half of 2001,



I) for health performance intensive care no 00651 00652,.,,, 00653 00656

00657 00658, 00661,, according to the list, 00665 00668 health performance

referred to in the Decree, granted in treating extensive burns at 1.

half of 2001, in the amount of CZK 1 per point in the bed of the establishments listed in the

Annex 6 to this regulation, as follows:



1. in adults



1.1 when Burns over 40% of the surface of the body,



1.2 when Burns over 10% of the surface of the body, while inhalation

popáleninovém trauma,



1.3 when Burns, electric shock,



2. for the children



2.1. from 2 to 5 years of age, when burns in the range above 10% of the surface of the body,

children from 6 to 10 years while Burns in the range of 15% of the surface of the body and the

children from 11 years of age in the range of burns over 40% of the surface of the body,



2.2 when inhalation popáleninovém trauma or burns electric

shock,



(j)) of a particularly charged given in medicinal products 1. half-year 2001

in the treatment of cystic fibrosis in in-patient establishments listed in annex No.

7 to this regulation; the list of medicinal products is charged separately

given in annex 8 to this regulation,



separately charged to) for medicinal products granted in 1. half of 2001 for

selected risk groups oncologically ill children treated at the

workplaces Pediatric Oncology inpatient establishments listed in the annex.

9 to this regulation; the list of medicinal products is charged separately

contained in annex 10 to this regulation.



§ 3



(1) the health care provided by specialised therapeutic institutes in 1.

half of 2001 according to the contractual arrangements between the paid by the health insurance company

and professional medical Institute



and) flat-rate, or



(b)) combined.



(2) the procedure for calculating the flat-rate remuneration and combined way, above

remuneration, the amount of the value of the point and the conditions for reimbursement referred to in paragraph 1 (b). and) and

(b)) shall be established in annex 2 to this regulation.



(3) if the professional therapeutic Institute and the health insurance company will negotiate a supplement

to the contract, or out a new contract, containing new health

performances, provided by professional medical Institute, or negotiating a new

the structure provided by the health care, health insurance company is required to

These facts in the total amount of payments for 1. half of 2001 include.



§ 4



(1) the health care provided in hospitals for long-term patients in the 1.

half of 2001 according to the contractual arrangements between the paid by the health insurance company

and medical facilities, according to the list of medical procedures referred to in

the Decree.



(2) the remuneration referred to in paragraph 1 shall be the value of the item in the amount of CZK 1.



(3) the value of the direction set out in the Decree, assigned to the point value

ošetřovacího of the day no. 00024 referred to in the Decree, is increased by 60 points

compared to the 1. half of the year 2000.



(4) the flat-rate amount shall be reimbursed medicinal products pursuant to § 17 paragraph.

6 of the Act, shall be increased by $ 10, compared to 1. half of the year 2000.



§ 5



(1) the health care provided in health facilities

returning the length of the day no. 00005 referred to in the decree in the 1.

half of 2001 according to the contractual arrangements between the paid by the health insurance company

and medical facilities, according to the list of medical procedures referred to in

the Decree.



(2) the remuneration referred to in paragraph 1 shall be the value of the item in the amount of CZK 1.



(3) the value of the direction set out in the Decree, assigned to the point value

ošetřovacího of the day no. 00005 referred to in the Decree, is increased by 60 points

compared to the 1. half of the year 2000.



(4) the flat-rate amount shall be reimbursed medicinal products pursuant to § 17 paragraph.

6 of the Act, shall be increased by $ 10, compared to 1. half of the year 2000.



§ 6



Reimbursement of emergency health care, if there is no contract between the

medical facilities and health insurance company, is in the 1. half-year 2001

performed by health performance as follows:



and) dental out-patient care are reimbursed according to the rates in force for
health care provided by dentists in the 1. half year 2001, ^ 2)



(b)) other health care are reimbursed by the health performance

referred to in the decree and the point value is determined in the amount of Czk 0.82;

the health insurance company may, on the basis of the law ^ 3) exercise regulatory

as with mechanisms of health care facilities.



section 7 of the



In cases where the number of points used for payment reported on the basis of

the list of medical procedures referred to in the Decree, valid until 30 June.

in June 2000, and at the same time point rating of these health interventions

different according to the list of medical procedures in force from 1 January. July 2000,

be translated at the point of performance evaluation of health 1. half of 2000 on

value according to the list of medical procedures in force from 1 January. July 2000.



§ 8



This Regulation shall enter into force on 1 January 2005. January 1, 2001.



The President of the Government:



Ing. Zeman in r.



Minister of health:



Prof. MUDr. Fisher, PhD. in r.



Annex 1



The calculation of remuneration, flat-rate, above the value of the point and the conditions

the remuneration pursuant to § 2 (2). 1 (a). and (b)))



And)



Procedure for determining the flat-rate remuneration:



1.



Reimbursement of healthcare provided by sleeper devices includes:



and acute care) remuneration reported on hospitalizačních accounts

including relevant performance complement (hereinafter referred to as the "hospital

remuneration "),



(b)) reimbursement of out-patient ambulatory care reporting on accounts, including

the relevant performance of the complement (hereinafter referred to as "ambulatory payment"),



(c) the reimbursement of transport performance), health (hereinafter referred to as "the remuneration of transport"),



(d) remuneration of other outputs) of health care, if the bed equipment

provides performance complement for other medical devices, where appropriate,

other contracted performances (hereinafter referred to as "other remuneration").



If any of these kinds of health care inpatient facilities

does not, then it is not part of the remuneration.



2.



Procedure for determining the flat-rate for 1. half of 2001:



The flat rate is calculated for each type of health care referred to in

point 1 (a). and (d))) of the amount of performance 1. half of the year 2000, which were

fasility reported and health insurance company recognized by 1. January

2000 to 30. November 2000, as follows:



The total volume of performances (and especially the points charged to medicinal products and

posted material) is divided by the number of unique treated policyholders,

who have been in inpatient facilities provided health care. Unique

the policyholder, which means a beneficiary, regardless,

How many times the bed on this device showed the insured person in specified

period of health care. Performances and unique treatment of insured persons are

be calculated separately for each type of remuneration referred to in paragraph 1 (b). and (d)).)



The flat rate includes:



and the number of points per 1) unique treated insured persons,



b) flat rate for a particularly charged medicinal products and separately billed

material on 1 unique treated policyholders, in CZK.



2.1 the lump-sum rate of inpatient

sum sum BH ZH

PHB =-------PHZ =-------

sum of the sum of the UH UH



where:



PHB = number of points per 1 insured persons treated for unique

1. half-year 2000

BH = the number of points for each hospitalization, including the points for

the category of the patient, for 1. half of the year 2000 of the bed

the devices, which were reported by the device

and health insurance company recognized by 1. January 2000 to

November 30, 2000, in addition to the points:

and health performances) paid in excess of the flat-rate

hospital or included in another flat-rate,

declared and recognized health performances provided when the

hospitalization in the fields of medicine, that are no longer for the

1. half 2001 contracted,

(b)) for the declared and recognised health performances provided when the

hospitalization in the fields of medicine, that are no longer for the

1. half 2001 contracted.

PHZ = flat rate for a particularly charged to medicinal products

and posted the material provided in the 1. half of the

2000, in addition to the insured hospitalized separately

posted in medicinal products and especially the posted

the material, which are in the 1. half of 2001 covered above and beyond

flat rate includes or included in other

a flat rate, which have been reported by device

and health insurance company recognized by 1. January 2000 to

November 30, 2000 on 1 unique treated

the insured person.

ZH = remuneration for medicinal products and specially charged separately

posted material provided in 1. half-year 2000

hospitalized insured, in addition to the extra charged

medicinal products, and particularly of the posted material, which

are in the 1. half of 2001 paid in excess of the flat-rate

hospital or included in another flat rate,

that have been reported and health equipment Center

insurance recognised from 1. January 2000 to 30. November

2000.

UH = the number of unique treated policyholders who were

in the 1. half of 2000 provided them hospitalized and

health performance were fasility reported

and health insurance company recognized by 1. January 2000 to

November 30, 2000.



2.2 the flat rate for outpatient

sum sum for BA

PAB =-------PAZ =-------

the sum of the sum of the UA UA



where:



PAB = number of points per 1 insured persons treated for unique

1. half of the year 2000.

BA = number of points for all of the health performance

in the dispensaries, for 1. half of 2000 that were patient

the device reported and health insurance company recognized by

1 January 2000 to 30. November 2000, in addition to the points:

and health performances) paid in excess of the flat-rate

outpatient or included in another flat-rate,

(b)) for the declared and recognised health performances provided

in the dispensaries in the fields of medicine, that are no longer for the

1. half 2001 contracted.

PAZ = flat rate for a particularly charged to medicinal products

and posted the material provided in the 1. half of the

2000 in ambulances treated the insured, in addition to the particularly

posted in medicinal products and especially the posted

the material, which are in the 1. half of 2001 covered over

beyond the standard rate for outpatient or included in other

a flat rate, which have been reported by device

and health insurance company recognized by 1. January 2000 to

November 30, 2000 on 1 unique treated

the insured person.

A = remuneration for medicinal products and specially charged separately

posted material provided in 1. half-year 2000

in ambulances treated the insured, in addition to the particularly

posted in medicinal products and especially the posted

the material, which are in the 1. half of 2001 covered over

beyond the standard rate for outpatient or included in other

a flat rate, which have been reported by device

and health insurance company recognized by 1. January 2000 to

November 30, 2000.

UA = the number of unique treated policyholders who were

in the 1. half of 2000 in ambulances treated and jim

provided by the health services which have been patient

the device reported and health insurance company recognized by

1 January 2000 to 30. November 2000.



2.3 the flat rate for medical transport

the sum of the BD sum ZD

PDB =-------PDZ =------

sum sum UD UD



where:



PDB = number of points per 1 insured persons treated for unique

1. half-year 2000

BD = number of points for all of the health performance

medical transport in the 1. half of the year 2000 of the bed

the devices, which were reported by the device

and health insurance company recognized by 1. January 2000 to

November 30, 2000, in addition to the points:

and health performances) paid in excess of the flat-rate

for medical transport or included in another flat-rate

rates,

(b)) for the declared and recognised health performances provided when the

medical transport in the fields of medicine, which are no longer

for the 1. half of 2001 contracted.

PDZ = flat rate for a particularly charged to medicinal products

and posted the material provided in the 1. half of the

2000 in the medical transport insurance policy holders, in addition to the treated

separately charged of medicinal products and

the posted material, which are in the 1. half-year 2001

paid in excess of the flat-rate shipping for health

or included in another flat rate, which have been

fasility reported and health insurance company

recognised from 1. January 2000 to 30. November 2000 on

1 unique treated policyholders.

ZD = remuneration for medicinal products and specially charged separately

posted material provided in 1. half-year 2000

medical transport of the insured, in addition to the specially treated

posted in medicinal products and especially the posted

the material, which are in the 1. half of 2001 covered over

framework of a flat rate for health or shipping included

in another flat rate, which were fasility

reported and health insurance company recognized by 1. January

2000 to 30. November 2000.
UD = the number of unique treated policyholders who were

in the 1. half of 2000 in the medical transport, transported,

where appropriate, treated and health performances

were reported and health equipment Center

insurance recognised from 1. January 2000 to 30. November

2000.



2.4 the flat rate for other health performances

sum sum REV. BJ

PJB =-------PJZ =-------

sum sum UJ UJ



where:



PJB = number of points per 1 insured persons treated for unique

1. half-year 2000

BJ = number of points for all other health performances

in the 1. half of the year 2000, the socket device, which were

fasility reported and health insurance company

recognised from 1. January 2000 to 30. November 2000, in addition to

points:

and health performances) paid in excess of the flat-rate

for other medical performance or included in other

flat-rate,

(b)) for the declared and recognised by other medical performance provided

in the fields of medicine, that are no longer for 1. half of the

2001 contracted.

PJZ = flat rate for a particularly charged to medicinal products

and posted the material provided in the 1. half of the

2000 when other medical procedures, which

the insured, in addition to specially charged to medicinal products

and especially of the posted material, which are in the 1. half of the

2001 paid in excess of the flat-rate tariffs for other health

performance or included in another flat rate, which have been

fasility reported and health insurance company

recognised from 1. January 2000 to 30. November 2000 on

1 unique treated policyholders.

ZJ = remuneration for medicinal products and specially charged separately

posted material provided in 1. half-year 2000

other health insurance policy holders, which, in addition to performance

separately charged to medicinal products and especially the posted

the material, which are in the 1. half of 2001 covered above and beyond

flat rates for other health performance or included

in another flat rate, which were fasility

reported and health insurance company recognized by 1. January

2000 to 30. November 2000.

UJ = the number of unique treated policyholders, which were

in the 1. half of 2000 provided other health services

that have been reported and health equipment Center

insurance recognised from 1. January 2000 to 30. November

2000.



3.



The determination of the amount of the flat-rate payment for 1 point



For the 1. half of 2001 the amount of flat-rate payments for the 1 point for

specific inpatient facilities. This is based on the amount of individual payments for 1

in point 1. half of the year 2000, which modifies a differentiated increase of the remuneration

in 3 zones (described in section 3.2).



3.1 the individual amount of remuneration for the 1 point (IVCB). half-year 2000

represents the proportion of the total remuneration without separately charged

medicinal products and especially the posted material on 1 point.

It is determined by the following formula:



the sum of PAYMENT-from

1.2000 2000 1.

IVCB = -----------------------------------

1. the sum of 2000 POINTS.

1.2000



where:



REMUNERATION 1.2000 = remuneration for all health

the performances, including the categories of the patient,

provided by the in-patient facilities

in the 1. half of the year 2000, that have been reported

and recognised from 1. January 2000 to

November 30, 2000, to the remuneration

not health services

are in the 1. half of 2001 covered above and beyond

flat rate.

1.2000 = remuneration separately charged medicinal

preparations and posted the material,

In addition to specially charged to medicinal

products and especially the posted material,

paid in excess of the flat-rate,

provided by the in 1. half of the year 2000, which

were reported by device

and health insurance company recognized by

1 January 2000 to 30. November 2000.

POINTS 1.2000 = number of points in the health, transport

performances and for the category of patient provided

the fasility in 1. half of the

2000 fasility

reported and health insurance accepted

from the 1. January 2000 to 30. November 2000.



3.2 the lump-sum payment for 1 point for 1. half of 2001 (VCB) consists of

individual amount of remuneration for 1 point, recorded a 1. half of the year 2000.

Shall be determined as follows:



and if the calculated IVCB) is less than $ 0.89 then VCB for 1.

half of 2001 is $, 0.89



(b)) if the calculated IVCB is equal to 0.89 Eur or less than or equal to 0.99

CZK, added to this price 0.01 Kč (VCB = IVCB + 0.01)



(c)) if the calculated IVCB is equal to or higher than CZK 1, the

the calculated price (VCB = IVCB).

The flat-rate payment for 1 item must be increased in cases referred to in § 2

paragraph. 6 of this government regulation.



4.



The calculation of the total remuneration for provided health care



4.1 the lump-sum payment for different types of health care referred to in section 1

(a). and (d))) up to 1 unique treated the insured person is made up of

by multiplying the number of points on 1 unique treated the insured a lump

remuneration for 1 point and by adding the volume of flat rates for a particularly charged

medicinal products and separately charged materials paid on 1 unique

treated policyholders.



The calculation of the lump-sum payment to the insured for 1 unique treated

different types of health care referred to in point 1 (a). and (d))) up to 1.

half of 2001 is the following:

PHC = (PHB * VCB) + PHZ

PAC = (PAB * VCB) + PAZ

PDC = (PDB * VCB) + PDZ

PJC = (PJD * VCB) + PJZ



where:



PHC = lump sum payment to the hospital 1 unique

treated insured persons

PAC = standard outpatient reimbursement on 1 unique treated

the insured's

PDC = flat-rate remuneration of transport on 1 unique treated

the insured's

PJC = flat-rate reimbursement on the other 1 unique treated

the insured's



4.2 payment for different types of health care referred to in section 1

(a). and (d))) will be calculated so that the flat-rate payment on

1 the insured multiplied by the number of unique treated unique

the treated policyholders in the reporting period, as follows:



HU = PHC TO UHV

AU = PAC OF UAV

DU = PDC * UDV

JU = OF THE UJV PJC



where:



HU = hospital reimbursement

AU = outpatient reimbursement

DU = transportation reimbursement

JU = other remuneration

UHV = the number of inpatients treated with the unique

insured persons who have been granted medical care,

reported at 1. half of 2001 and recognised health

the insurance company

UAV = the number of unique treated policyholders who have been

outpatient health care, reported

in the 1. half of 2001 and recognised health insurance

UDV = the number of unique treated policyholders who have been

health right provided, reported in 1. half of the

2001 and recognised health insurance

UJV = the number of unique treated policyholders, which other

the performances given, reported in 1. half of 2001 and recognised

health insurance company



4.3 the total remuneration (CU) is the sum of the individual types of payments:



CU = HU + AU + DU + JU



Part of the total remuneration are on payment procedures under section 2

paragraph. 5 of this government regulation.



5.



Calculation of the remuneration in regulating the prescription of medicinal products and

medical devices:



In the calculation of the total health care payments according to section 4.3 on

apply regulatory mechanisms, which are based on a comparison of average

the reimbursement of prescribed medicines and medical devices to 1

treated policyholders between 1. half of 2000 and 1. half of 2001. From

the comparison excludes medicinal products and medical devices

revision approved by the doctor.



5.1 in the event that the average payment for prescribed medicines and

medical devices to 1 in 1. insured persons treated, or in the 2.

quarter of 2001, in addition to medicinal products and medical devices

approved review physician exceeds 102% of the average of the reference

remuneration, which is made up of remuneration for the prescribed medicines and

medical devices on the 1-in-1 the insured person treated. half of the year 2000,

the reduction shall be fixed in the amount of 60% of the total, which exceeded

calculated as the product of the number of insured persons treated in the period and the amount of

exceeding the cost of medicinal products and medical devices to 1

treated insured persons compared to 102% of the average of the reference remuneration for medicinal

products and medical devices to 1 treated policyholders.



5.2 If the average payment for prescribed medicines, medical

resources on 1 the insured person in the treated 1. half of 2001 has reached 102

% of the average of the reference remuneration, which is made up of remuneration for prescribed

medicinal products and medical devices to 1 the insured person treated in

1. half of the year 2000, in addition to medicinal products and medical devices

the review will be approved by a physician, payment for the 1. half of 2001 increased
about 40% of savings. This saving is calculated as the product of the treated

the number of insured persons in the period and amount of the costs to the Betterment of the medicinal

products and medical devices to 1 the insured compared to treated

102% of the average of the reference remuneration for medicinal products and medical

resources on 1 the insured person treated.



6.



Monthly backup will provide a health insurance company in the amount of lůžkovému equipment

106% one sixth volume of payment that have been this lůžkovému device

paid in 1. half of the year 2000.



(B))



When determining the remuneration referred to in the list of medical procedures referred to in

the Decree



1.



Point value is determined in the amount of Czk 0.89.



2.



Method of payment according to § 2 (2). 1 (a). (b)) may be applied only for the bed

the device, which is significantly fluctuating volume provided by the health care

paid from public health insurance, where it is not possible to establish

flat rate over the reference period because of the small number of treated

competent health insurance policyholders and where inpatient facilities in

average of one health insurance company charged more than 300 000 CZK

the calendar quarter.



3.



If the Contracting Parties agree, this variant can choose

the case of the higher volume of the Bill, however, must be met

within the volume of the provided health care.



Annex 2



Procedure for calculating the flat-rate remuneration and combined way, above

remuneration, the amount of the value of the point and the conditions for reimbursement under section 3 (3). 1 (a). and)

and (b))



And)



Procedure for determining the flat-rate payments for health care



Remuneration is 110% of the volume of the comparison of remuneration. Matching the volume of payment

is equal to the payment for health care provided in the appropriate 1.

half of the year 2000, declared and recognised from 1. January 2000 to 30. November

2000, and the comparison of the volume is not remuneration for

provided health care in the comparison period, in cases where this

the care is no longer in the treatment provided to the Institute, or is paid

otherwise.



1.



The condition of the above remuneration for provided health care is that the reported

the number of care days in the 1. half of 2001 must be at least 95% of the number of

care days reported in 1. half of the year 2000. In the event that the professional

therapeutic Institute reports less than 95% of care days provided for,

will be provided for the total lump-sum rate for 1. half of 2001 under the bed

care has been reduced by a percentage which was filled with a fixed limit to the number of

care days.



2.



Calculation of the remuneration in regulating the prescription of medicinal products and

medical devices:



2.1. In the case that the average payment for prescribed medicines and

medical devices to 1 in 1. insured persons treated, or in the 2.

quarter of 2001, in addition to medicinal products and medical devices

approved review physician exceeds 102% of the average of the reference

remuneration, which is made up of remuneration for the prescribed medicines and

medical devices on the 1-in-1 the insured person treated. half of the year 2000,

the reduction shall be fixed in the amount of 60% of the total, which exceeded

calculated as the product of the number of insured persons treated in the period and the amount of

exceeding the cost of medicinal products and medical devices to 1

treated insured persons compared to 102% of the average of the reference remuneration for medicinal

products and medical devices to 1 treated policyholders.



2.2 If the average payment for prescribed medicines, medical

resources on 1 the insured person in the treated 1. half of 2001 has reached 102

% of the average of the reference remuneration, which is made up of remuneration for prescribed

medicinal products and medical devices to 1 the insured person treated in

1. half of the year 2000, in addition to medicinal products and medical devices

the review will be approved by a physician, payment for the 1. half of 2001 increased

about 40% of savings. This saving is calculated as the product of the treated

the number of insured persons in the period and amount of the costs to the Betterment of the medicinal

products and medical devices to 1 the insured compared to treated

102% of the average of the reference remuneration for medicinal products and medical

resources on 1 the insured person treated.



(B))



When remuneration combined way:



1.



Inpatient care will be paid for by payment for day care and for performances,

which show the receipt and examinations referred to in the list of the layoff

health procedures referred to in the notice. Point value is CZK 1. This

method of payment shall apply only to specialized therapeutic institutes, which are

contracted health-care-only performances of the day.



2.



Outpatient care and medical transportation will be covered by a flat rate.

The flat rate is calculated from the volume of performance 1. half of the year 2000, which

Professional therapeutic Institute have been reported and recognized health insurance

from the 1. January 2000 to 30. November 2000, as follows:



The total volume of health performance (especially the healing post points

preparations and posted material) is divided by the number of unique

insured persons who have been treated in the specialized treatment of the Institute granted

health care. Unique products treated with the policyholder shall mean one

beneficiary, regardless of how many times the professional therapeutic Institute reported on

of the insured person within a specified period of time health care. Performances and

the unique treatment of insured persons shall be calculated separately for outpatient care and

medical transport.

The flat rate includes:



and the number of points per 1) unique treated insured persons,

b) flat rate for a particularly charged medicinal products and

posted material on 1 unique treated insured persons

in CZK.



2.1 the lump-sum rate of outpatient



sum sum for BA

PAB =-------PAZ =-------

the sum of the sum of the UA UA



where:



PAB = number of points per 1 insured persons treated for unique

1. half-year 2000

BA = number of points for all of the health performance

in the dispensaries in the 1. half of 2000 the vocational

treatment of the Institute, which has been recognized and acknowledged by

1 January 2000 to 30. November 2000, in addition to the points:

and health performances) paid in excess of the flat-rate

outpatient or included in another flat-rate,

(b)) for the declared and recognised health performances provided

in the dispensaries in the fields of medicine, that are no longer for the

1. half 2001 contracted.

PAZ = flat rate for a particularly charged to medicinal products

and posted the material provided in the 1. half of the

2000 in ambulances treated the insured, in addition to the particularly

posted in medicinal products and especially the posted

the material, which are in the 1. half of 2001 covered above and beyond

flat rate for outpatient or included in another flat-rate

the rate, which has been a professional therapeutic Institute reported

and health insurance company recognized by 1. January 2000 to

November 30, 2000 on 1 unique treated

the insured person.

A = remuneration for medicinal products and specially charged separately

posted material provided in ambulances treated

the insured, in addition to specially charged to medicinal products

and especially of the posted material, which are in the 1. half of the

2001 paid in excess of the standard rate for outpatient or

included in the other flat rate and were granted

in the 1. half of the year 2000 and that have been reported and recognized by

1 January 2000 to 30. November 2000.

UA = the number of unique treated policyholders who were

in the 1. half of 2000 in ambulances treated and health

the performances were recorded and recognised from 1. January 2000 to

November 30, 2000.



2.2 the flat rate for medical transport

the sum of the BD sum ZD

PDB =-------PDZ =------

sum sum UD UD



where:



PDB = number of points per 1 insured persons treated for unique

1. half-year 2000

BD = number of points for all of the health performance

medical transport in the 1. half of 2000 the vocational

treatment of the Institute, which has been recognized and acknowledged by

1 January 2000 to 30. November 2000, in addition to the points:

and health performances) paid in excess of the flat-rate

for medical transport or included in another flat-rate

rates,

(b)) for the declared and recognised health performances provided when the

medical transport in the fields of medicine, which are no longer

for the 1. half of 2001 contracted.

PDZ = flat rate for a particularly charged to medicinal products

and posted the material provided in the 1. half of the

2000 in the medical transport insurance policy holders, in addition to the treated

separately charged to medicinal products and especially the posted

the material, which are in the 1. half of 2001 covered above and beyond

flat rate for medical transport or included in other

a flat rate, which were qualified medical Institute

reported and health insurance company recognized by 1. January

2000 to 30. November 2000 to 1 unique treated

the insured person.

ZD = remuneration for medicinal products and specially charged separately

posted material provided in the medical transport

treated separately charged to the insured, except medicinal
products, and particularly of the posted material, which are

in the 1. half of 2001 paid in excess of the flat-rate tariffs for

medical transport or included in another flat rate

and were provided in the 1. half of 2000 and which were

recorded and recognised from 1. January 2000 to 30. November

2000.

UD = the number of unique treated policyholders who were

in the 1. half of 2000 in the medical transport, transported,

where appropriate, treated and health performances have been reported

and recognised from 1. January 2000 to 30. November 2000.



3.



The determination of the value of the point value of 1 point. half of 2001 (CB)

fixed in the amount of Czk 0.89.



4.



Calculation of the remuneration for health care



The flat-rate payment for outpatient care and health services on 1 unique

treated the insured person is made by multiplying the number of points on 1 of the unique

treated the insured's flat-rate remuneration for 1 point and by adding volume

a flat rate for a particularly charged medicinal products and separately charged

materials paid on 1 unique treated policyholders.



4.1 calculation of the lump-sum payment on 1 unique treated

the insured person for each of the types of health care for

1. half of the year 2001 is as follows:



PAC = (PAB * CB) + PAZ

PDC = (PDB * CB) + PDZ



where:



PAC = standard outpatient reimbursement on 1 unique treated

the insured's

PDC = flat-rate remuneration of transport on 1 unique treated

the insured's



4.2 payment for outpatient care and medical transport

calculated so that the flat-rate payment shall be multiplied by the number of

unique treated policyholders in the reporting period,

as follows:



AU = PAC OF UAV

DU = PDC * UDV



where:



AU = outpatient payment = payment DU transport

UAV = the number of unique treated policyholders who have been

outpatient health care, reported

in the 1. half of 2001 and recognised health insurance

UDV = the number of unique treated policyholders who have been

health right provided, reported in 1. half of the

2001 and recognised health insurance



4.3 the total remuneration (CU) is the sum of outpatient (AU)

and transportation reimbursement (DU):



CU = AU + DU



4.4 Further performances are part of the remuneration of health under section 3

paragraph. 3 of this government regulation.



5.



Calculation of the remuneration in regulating the prescription of medicinal products and

medical devices:



In the calculation of the total remuneration of health care referred to in section 4 shall apply

regulatory mechanisms that are based on a comparison of the average of the remuneration

at the prescribed medicinal products and medical devices to 1

treated policyholders between 1. half of 2000 and 1. half of 2001. From

the comparison excludes medicinal products and medical devices

revision approved by the doctor.



5.1 in the event that the average payment for prescribed medicines and

medical devices to 1 in 1. insured persons treated, or in the 2.

quarter of 2001, in addition to medicinal products and medical devices

approved review physician exceeds 102% of the average of the reference

remuneration, which is made up of remuneration for the prescribed medicines and

medical devices on the 1-in-1 the insured person treated. half of the year 2000,

the reduction shall be fixed in the amount of 60% of the total, which exceeded

calculated as the product of the number of insured persons treated in the period and the amount of

exceeding the cost of medicinal products and medical devices to 1

treated insured persons compared to 102% of the average of the reference remuneration for medicinal

products and medical devices to 1 treated policyholders.



5.2 If the average payment for prescribed medicines, medical

resources on 1 the insured person in the treated 1. half of 2001 has reached 102

% of the average of the reference remuneration, which is made up of remuneration for prescribed

medicinal products and medical devices to 1 the insured person treated in

1. half of the year 2000, in addition to medicinal products and medical devices

the review will be approved by a physician, payment for the 1. half of 2001 increased

about 40% of savings. This saving is calculated as the product of the treated

the number of insured persons in the period and amount of the costs to the Betterment of the medicinal

products and medical devices to 1 the insured compared to treated

102% of the average of the reference remuneration for medicinal products and medical

resources on 1 the insured person treated.



Annex 3



A list of bed establishments-center for the treatment of chronic pain

States

+--+--------+---------------------------------+----------+

| # | IDN | The name of the registered equipment | Head Office |

+--+--------+---------------------------------+----------+

|1. | 00023884 | Homolce Hospital | Prague 5 |

+--+--------+---------------------------------+----------+

|2. | 00064203 | Teaching hospital in motol | Prague 5 |

+--+--------+---------------------------------+----------+

|3. | 61,383,082 | Central military hospital Prague | Prague 6 |

+--+--------+---------------------------------+----------+

|4. | 00159816 | The University Hospital. Anna | Brno |

+--+--------+---------------------------------+----------+

| 5. | 65,269,705 | Faculty hospital Brno | Brno |

+--+--------+---------------------------------+----------+

| 6 | 00098892 | Faculty hospital Olomouc | Olomouc 5 |

+--+--------+---------------------------------+----------+



Annex 4



List of proprietary medicinal products for the treatment of hemophilia,

which are covered in the form of medicinal products, particularly those posted above

beyond the flat rate

+---+-------------------------------------+---------------------+

|č. | Code Name | The add-on name |

+---+-------------------------------------+---------------------+

' |1 '. BEBULIN TIM 4 03051 | | inj sic 1x600ut + sol |

+---+-------------------------------------+---------------------+

|2. 03052 BEBULIN TIM 4 | | inj sic 1 x 1.2 ku + sol |

+---+-------------------------------------+---------------------+

| 3. 08607 BEBULIN TIM 4 | | inj sic 1x200ut + sol |

+---+-------------------------------------+---------------------+

| 4. | 1000UT | BERIATE 44999 P inj sic 1ku + 10 ml |

+---+-------------------------------------+---------------------+

| 5. | 1000UT | BERIATE P 45000 inj sic 1ku + 10 ml |

+---+-------------------------------------+---------------------+

| 6. | 250UT | BERIATE 45001 P inj sic 250ut + 2.5 ml |

+---+-------------------------------------+---------------------+

| 7. | 250UT | BERIATE 45002 P inj sic 250ut + 2.5 ml |

+---+-------------------------------------+---------------------+

| 8. | 500UT | BERIATE 45003 P inj sic 500ut + 5 ml |

+---+-------------------------------------+---------------------+

| 9. | 500UT | BERIATE 45004 P inj sic 500ut + 5 ml |

+---+-------------------------------------+---------------------+

| 10 | 59486 MONOCLATE-P | inj sic 1x250ut |

+---+-------------------------------------+---------------------+

| 11. | 59487 MONOCLATE-P | inj sic 1x500ut |

+---+-------------------------------------+---------------------+

12. | 59488 MONOCLATE-P | inj sic 1x1000ut |

+---+-------------------------------------+---------------------+

| 13. | 60379 HAEMOCTIN SDH 250 | 1x250ut + inj sic sol |

+---+-------------------------------------+---------------------+

| 14 | 60380 HAEMOCTIN SDH 500 | 1x500ut + inj sic sol |

+---+-------------------------------------+---------------------+

| 15 | 60381 HAEMOCTIN SDH 1000 | 1x1ku inj sic + solv. |

+---+-------------------------------------+---------------------+

| 16 | 75079 IMMUNINE 600I. E. | + 5 ml inj sic 1x600ut |

+---+-------------------------------------+---------------------+

| 17 | 75080 IMMUNINE 120I. E. | + inj sic 1.2 to 10 ml |

+---+-------------------------------------+---------------------+

| 18. | 83452 KOATE HP 250I. U. | + 5 ml lyo inj 1x250ut |

+---+-------------------------------------+---------------------+

| 19 | 83453 KOATE HP 500I. U. | + 5 ml lyo inj 1x500ut |

+---+-------------------------------------+---------------------+

| 20. | 83454 KOATE HP 1000I. U. | + 1000ut lyo inj 10 ml |

+---+-------------------------------------+---------------------+

| 21 | FACTOR IX 83781 P CENTEON 300UT | 300ut + 10 inj sic |

+---+-------------------------------------+---------------------+

| 22. | 83782 FACTOR IX P CENTEON 600UT | + 20 ml inj sic 600ut |

+---+-------------------------------------+---------------------+

| 23. | 83783 FACTOR IX P CENTEON 1200UT | inj sic 1.2 to + 30 ml |

+---+-------------------------------------+---------------------+

| 24 | 83785 HAEMATE P inj sic | 1x250ut |

+---+-------------------------------------+---------------------+

| 25 | 83786 HAEMATE P | 1x500ut inj sic |

+---+-------------------------------------+---------------------+

| 26. | HAEMATE inj 83787 P | 1x1ku sic |

+---+-------------------------------------+---------------------+

| 27. | 85676 FEIBA TIM 4 inj sic 1x500ut + sol |

+---+-------------------------------------+---------------------+

| 28. | 85677 FEIBA TIM 4 inj 1x1ku sic + solv. |

+---+-------------------------------------+---------------------+

| 29 | 87238 FANHDI 250 IU | inj sic 1x250ut + sol |

+---+-------------------------------------+---------------------+

| 30. | 87239 FANHDI 500 IU | inj sic 1x500ut + sol |

+---+-------------------------------------+---------------------+

| 31. | 87240 FANHDI 1000 IU | inj sic 1x1ku + sol |
+---+-------------------------------------+---------------------+

| 32. | 88335 HAEMATE P | inj sic 1x250ut |

+---+-------------------------------------+---------------------+

| 33. | 88336 HAEMATE P | inj sic 1x500ut |

+---+-------------------------------------+---------------------+

|. | 88337 HAEMATE P | inj sic 1x1ku |

+---+-------------------------------------+---------------------+

|. | 88800 PORCINE FACTOR VIII: C (HYATE: C) inj 20 ml/400-700ut |

+---+-------------------------------------+---------------------+

| 36. | 89027 IMMUNATE STIM PLUS 250 | inj sic 1x250ut + sol |

+---+-------------------------------------+---------------------+

|. | 89028 IMMUNATE STIM PLUS 500 | inj sic 1x500ut + sol |

+---+-------------------------------------+---------------------+

| 38 | 89029 IMMUNATE STIM PLUS 1000 | inj sic 1x1ku + solv. |

+---+-------------------------------------+---------------------+

|. | 89825 NOVOSEVEN 1.2 MG (= 60KU) inj sic 1 x 1.2 mg + sol |

+---+-------------------------------------+---------------------+

| 40. | 89826 NOVOSEVEN 2.4 MG (= 120KU) inj sic 1 x 2.4 mg + sol |

+---+-------------------------------------+---------------------+

|. | 91689 KRYOBULIN TIM 3 | + inj 1x1ku sic 40 ml |

+---+-------------------------------------+---------------------+

|. | 91690 KRYOBULIN TIM 3 | + inj 500ut sic 20 ml |

+---+-------------------------------------+---------------------+

|. | 91691 KRYOBULIN TIM 3 | + inj 250ut sic 10 ml |

+---+-------------------------------------+---------------------+

|. | 92641 NOVOSEVEN 4.8 MG (= 240KU) inj sic 1 x 4.8 mg + sol |

+---+-------------------------------------+---------------------+

|. | 97407, 250 I.U. | 1x250ut inj sic |

+---+-------------------------------------+---------------------+

|. | 97408, 500 I.U. | 1x500ut inj sic |

+---+-------------------------------------+---------------------+



Annex 5



The list of selected inpatient facility-center for the treatment of HIV/AIDS

+--+--------+------------------------+------------------------------------+

| # | IDN | The name of the registered equipment | Head Office | The workplace |

+--+--------+------------------------+----------------+-------------------+

|1. | 65,269,705 | Faculty hospital Brno | Brno-Bohunice | clinic infectious |

| | | | | diseases |

+--+--------+------------------------+----------------+-------------------+

|2. | 00179906 | University Hospital | Hradec Králové | infectious clinic |

+--+--------+------------------------+----------------+-------------------+

|3. | 00843989 | University Hospital | Ostrava-Poruba | clinic for treatment |

| | | first | infectious diseases ' | |

| | | | | & AIDS |

+--+--------+------------------------+----------------+-------------------+

|4. | 00669806 | University Hospital | Pilsen | AIDS Center |

| | | | infectious diseases clinic | |

+--+--------+------------------------+----------------+-------------------+

| 5. | 00064211 | University Hospital On | Prague 8 | AIDS Center |

| | | The NA bulovce hospital | infectious diseases clinic | |

+--+--------+------------------------+----------------+-------------------+

| 6 | 00673544 | Masaryk hospital | Ústí nad Labem | Department of portable |

| | | first | | diseases |

+--+--------+------------------------+----------------+-------------------+

| 7 | 00072711 | Hospital České Budějovice Czech | | infectious Department |

| | | České Budějovice | | Hospital |

+--+--------+------------------------+----------------+-------------------+



Annex 6



List of in-patient medical facilities-center for the treatment of burns

+--+--------+------------------------+----------------+--------------------+

| # | IDN | The name of the registered equipment | Head Office | The workplace |

+--+--------+------------------------+----------------+--------------------+

|1. | 00064173 | University Hospital | Prague 10 | Department of burns |

| | | Královské Vinohrady | | medicine |

+--+--------+------------------------+----------------+--------------------+

|2. | 00843989 | University Hospital | Ostrava-Poruba | Burns |

| | | first | | Center |

+--+--------+------------------------+----------------+--------------------+

|3. | 65,269,705 | Faculty hospital Brno | Brno | Center (clinic) |

| | | | | Burns and |

| | | | | Reconstructive |

| | | | | surgery |

+--+--------+------------------------+----------------+--------------------+



Annex 7



List of in-patient medical facilities-center for treatment of cystic

Fibrosis

+--+--------+-------------------------+--------------+--------------------+

| # | IDN | The name of the registered equipment | Head Office | The workplace |

+--+--------+-------------------------+--------------+--------------------+

|1. | 00064203 | University Hospital | Prague 5 | 2. The children's clinic |

| | | in motol | | THORN |

+--+--------+-------------------------+--------------+--------------------+

|2. | 65,269,705 | Faculty hospital Brno | Brno | Infectious diseases clinic of the DFN |

+--+--------+-------------------------+--------------+--------------------+

|3. | 00179906 | Faculty hospital Hradec | Hradec Králové | The children's clinic |

| | | Kings | | |

+--+--------+-------------------------+--------------+--------------------+

|4. | 00669806 | Faculty hospital Pilsen | Pilsen | The children's clinic |

+--+--------+-------------------------+--------------+--------------------+

| 5. | 00098892 | University Hospital | Olomouc | The children's clinic |

| | | Olomouc | and THORN clinic | |

+--+--------+-------------------------+--------------+--------------------+



Annex 8



The list of medicinal products for the treatment of cystic fibrosis, that are

paid in excess of the flat-rate

+---+-------------------------+------------------+

|č. | Kód | The name |

+---+-------------------------+------------------+

| Parenteral antibiotics: |

+---+-------------------------+------------------+

' |1 '. | 83736, 90485 | Netromycine |

+---+-------------------------+------------------+

|2. |, 03952, 11785 03951 | Amikin |

+---+-------------------------+------------------+

| 3. | 76353, 76354, 76355 | Fortum |

+---+-------------------------+------------------+

| 4. | 83487 | Meronem |

+---+-------------------------+------------------+

| 5. |, 84783 84784 | Tazocin |

+---+-------------------------+------------------+

| 6. |, 91560 91559, 96040 | Ciprobay, Ciprinol |

+---+-------------------------+------------------+

| 7. | 61178 | Colimycine |

+---+-------------------------+------------------+

| Pancreatic substitution: |

+---+-------------------------+------------------+

| 8. | 68989 | Kreon 25 000 |

+---+-------------------------+------------------+

| 9. | 44015 | Kreon 10000 |

+---+-------------------------+------------------+

| 10 | 97756 | Panzytrat 20 000 |

+---+-------------------------+------------------+

| Nutritional preparations: |

+---+-------------------------+------------------+

| 11. | 75588 | Paediasure |

+---+-------------------------+------------------+

12. | 75153 | Fantomalt |

+---+-------------------------+------------------+

| DNáza: |

+---+-------------------------+------------------+

| 13. | 77521 | Pulmozyn |

+---+-------------------------+------------------+



Annex 9



List of inpatient health care facility-workplaces for the treatment

oncologically ill children

+--+--------+---------------------------+-------+-------------------------+

| # | IDN | The name of the registered equipment | Head Office | The workplace |

+--+--------+---------------------------+-------+-------------------------+

|1. | 00064203 | Teaching hospital in motol | Prague 5 | Department of children's Oncology |

+--+--------+---------------------------+-------+-------------------------+

|2. | 65,269,705 | Faculty hospital Brno | Brno | Department of children's Oncology |

+--+--------+---------------------------+-------+-------------------------+



Annex 10



The list of medicinal products for the treatment of oncologically ill children, which

are paid in excess of the flat-rate

1. Erythropoietin

2. Interferon alpha,

3. the Interleukin 2,

4. Amifostin,

5. the Lipo-somatic Amphotericin B.



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

with point values, as amended by Decree No. 55/2000 Coll., Decree No.

135/2000 Coll. and Decree No 449/2000 Sb.



2) Journal of MZ amount No 13/2000.



§ 40 paragraph 3). 2 of Act No. 48/1997 Coll., on public health insurance

and amending and supplementing certain related laws, as amended by

amended.

Related Laws