117/2006 Coll.
LAW
Dated 14 March 2006
Amending some laws in the field of public health insurance
Parliament has passed this Act of the Czech Republic:
PART ONE
Changing the law on public health insurance
Article 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 ruling 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., Law no. 320 / 2002 Coll., Act no. 222/2003 Coll
., Act no. 274/2003 Coll., Act no. 362/2003 Coll., Act no. 424/2003
., Law no. 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., Law no. 350 / 2005 Sb., Act no. 361/2005 Coll
. and Act no. 47/2006 Coll., is amended as follows:
First In § 17 para. 2 second sentence after the word "public interest"
inserted the words "to ensure the quality and accessibility of health care
functioning health system and its stability within the financial possibilities
public health insurance system ( 'the public interest'). "
Second In § 17 paragraph 4 reads:
"(4) The list of medical performances with point values are compiled in
conciliation with representatives
a) General Health Insurance Company of the Czech Republic and other
health insurance,
b) the relevant professional associations of health care providers as
representatives of the medical device
c) professional organizations established by law,
d) professional scientific societies,
e) interest associations insured.
when concluding an agreement, the list of medical procedures with point values
submitted to the Ministry of health to assess in terms
accordance with the law and the public interest. If the result of an agreement
in accordance with the law and the public interest, issued by the Ministry of health
as a decree. If no agreement or if it finds the
Ministry of health that the agreement is not in accordance with legal regulations or public
interest, decide on the list of medical procedures with point values
Ministry of health and issue a decree. ".
Third In § 17 paragraph 5 reads:
"(5) The point, the amount of reimbursement of health care covered by health insurance
and regulatory restrictions on the volume of provided health care paid
public health insurance is always for the following calendar year
agreed in conciliation Representatives
General health insurance Company of the Czech Republic and other health insurance companies and the relevant professional associations
providers as representatives of the Contracting
medical equipment. the convener and guarantor of the proper conduct of conciliation
Ministry of health. If the agreement | || assess its content Ministry of health in terms of compliance with
law and the public interest. If the result of an agreement in accordance with
law and the public interest, issued by the Ministry of health
as a decree. Failing in conciliation on the outcome
90 days before the end of the calendar year, or if it finds the
Ministry of health, the outcome of the conciliation
not in accordance with the law or the public interest, provides point values,
level of reimbursement for health care covered by health insurance and regulatory
reduce the volume of provided health care covered by public health insurance
for the following calendar year
Ministry of health decree. ".
Fourth In § 17 paragraphs 6-11 deleted.
Former paragraphs 12-14 are renumbered 6 to 8
Fifth In § 17, paragraph 8 is deleted.
6th In § 40 par. 2 "(§ 17 para. 13)" is replaced by "(
§ 17 par. 7)."
7th In § 41 paragraph. 6 letter a) to e) are added:
"A) within 10 hours, the recalculated number equals zero,
b) 100 hours, the recalculated number equals 0.25,
C) up to 200 hours, the recalculated number equals 0.50
D) up to 300 hours, the recalculated number equals 0.75,
E) above 300 hours, the equivalent number is equal to one. ".
Eighth in § 41 paragraph. 7, second sentence, the number" 12 "is replaced by" 10 ".
|| |
PART TWO Amendment to the Act on premiums for general health insurance
Article II of the Act no. 592/1992 Coll., on premiums for general health insurance, | || wording of the 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., Act 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., and Act no. 62/2006 Coll., is amended as follows:
First In § 3, paragraph 2, including footnote no. 21a reads:
"(2) self-employed person is liable to pay a premium
assessment basis pursuant to paragraph 1, but less than the maximum
assessment base. If the calculation basis under paragraph 1 is less than the minimum calculation
the foundation is self-employed
obliged to pay the insurance premium from the minimum calculation basis, unless
stated otherwise. the minimum calculation basis means
50% twelve times the average monthly wage in the national economy; maximum
assessment base is CZK 486,000. the average monthly wage in the national economy
for the purposes of this Act an amount that
is calculated as the product of general assessment base determined
Cabinet Regulation for purposes of pension insurance per calendar year;
the two years preceding the calendar year for which the average wage
discovers a conversion rate set by government regulation
for the purposes of pension insurance for adjustment of this general assessment base
^ 21); The calculated amount is rounded to the nearest
crown.
21a) § 17 par. 2 and 4 of the Act no. 155/1995 Coll., As amended
regulations. ".
2. In § 3b words" premium State ^ 37 ) "is replaced by" premium
state (§ 3c) "and a footnote. 37 is deleted.
3rd § 3c including footnote no. 37 reads:
"§ 3c
The assessment base for insurance premiums paid by the state for the person for whom it is
under special legislation premium payer state ^ 37), the
provides for the calendar year. The assessment base pursuant to the first sentence
25% of the average monthly wage in the national economy (§ 3a par. 2).
Calculated amount is rounded up to whole crowns.
37) Act no. 48/1997 Coll., As amended. ".
Fourth in § 14 para. 3," 60% of the returned overpaid "is replaced
" Returned overpayment. "
PART THREE Amendment to Act no. 438/2004 Coll., amending Act no. 551/1991 Coll., on
General health insurance Company of the Czech Republic,
as amended, Act no. 280/1992 Coll., on departmental, professional, enterprise and
other health insurance companies, as amended, Act
no. 592/1992 Coll., on premiums for universal health insurance, as
amended, and Act no. 48/1997 Coll., on public health
insurance and amending and supplementing some related laws, as amended
Article III
Act no. 438/2004 Coll., amending Act no. 551/1991 Coll., on
General health insurance Company of the Czech Republic, as amended
, Act No. . 280/1992 Coll., on departmental, professional, enterprise and
other health insurance companies, as amended, Act No.
. 592/1992 Coll., On premiums for general health insurance, as
amended, and Act no. 48/1997 Coll., On public health
insurance and amending and supplementing some related laws, as amended || | amended, is amended as follows:
First In Art. VI, point 4 is deleted.
Second Article. VI, Section 5, the words "and point 4. B)" are deleted.
PART FOUR
Amendment of the General Health Insurance Company of the Czech Republic
Article 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. and
Act no. 438/2004 Coll., is amended as follows:
First In § 6, paragraph 4 reads:
"(4) Health insurance plans, financial statements and annual report for last year
under paragraph 3 approve a government proposal
Chamber of Deputies of the Parliament in relation to the terms of debate on the state budget
and final state account . Approval by health insurance plans
and approved the annual report and audited accounts
Insurance Company will publish in a manner allowing remote access. ".
Second In § 6, paragraphs 8 to 11 are added:
"(8) Proposal for a health insurance plan submitted to the insurance company assessment
Ministry of Health and through the Ministry of Finance.
(9) The Ministry of Health and Ministry of Finance will assess
submitted by health care insurance plan in terms of compliance with laws and regulations
terms consistent with the public interest.
(10) If the draft health insurance plan contravenes legislation
or public interest, return the Ministry of health Pojišťovna proposal
health insurance plan for reprocessing.
(11) In case the Ministry of health and Ministry of Finance
after assessing the health insurance plan consistent with the law and the public interest
finds that the proposal is not a health insurance plan with
these aspects contradict submit a draft health insurance plan
government. ".
Third In § 7, paragraph 2 reads:
"(2) In the case of receivership shall be subject to the decisions and legal acts
Director of Insurance and other organs of Insurance approval
forced administrator, otherwise they are void. A trustee is empowered to make decisions and
legal acts otherwise vested in the Director
Insurance Insurance or another body. ".
Fourth In § 8. 1, first sentence, the words "Ministry of Health"
words "and the Ministry of Finance" in the second sentence, the words
"Ministry of Health", the words "in agreement with the Ministry of Finance
"and the third sentence, the words" this ministry "is replaced
" the Ministry of health and Ministry of Finance. "
Fifth In § 8, paragraph 3 reads:
"(3) Amount repayable financial assistance from the state budget may amount to a maximum of 50%
proven to lack of funds caused
increased range of health services. The provision
repayable financial assistance, the Government decides on the proposal of the Minister | || health. ".
6th § 14 including the title reads:
"§ 14
Directors (1) Statutory authority Insurance Director Insurance, which on a proposal
government elected Chamber of Deputies.
(2) Director of Insurance refers to the government's proposal, the Chamber of Deputies of the Parliament
.
(3) The head of the regional branch director is appointed and dismissed by the director
Insurance. ".
7th § 15 reads:
"§ 15
(1) Insurance Director is elected for four years.
Director of Insurance can be appealed before the end of the period for which he was elected.
(2) Director of Insurance can only be a citizen of the Czech Republic who
a) has full legal capacity
b) is impeccable,
c) has completed university education. | ||
(3) as blameless for the purposes of this Act, a person who
not been convicted of a property crime or intentional offense
.
(4) the office of Director Insurance companies ends
a) the expiration of the term,
b) withdrawal of the Chamber of Deputies,
c) the date of receipt of the written statement of resignation to the President of the Chamber of Deputies
,
d) the effective date of the judgment, which was deprived of
legal capacity or limited in legal capacity,
e) the effective date of the judgment, which was condemned
criminal offense referred to in paragraph 3,
F) death.
(5) Election of Directors Insurance held the sixtieth
day before the expiration of the term of the incumbent Director of Insurance.
(6) ends when the performance of the Director of Insurance prior to the expiration of his term of office
, within a period longer than the period referred to in paragraph 5
, the election shall take Insurance Director within 60 days of which ended
performance of the former director Insurance.
(7) If the Director of Insurance elected to the expiry of the term of the previous director
Insurance, a new election shall be held within 60 days.
To the election of a new Director of Insurance Executive Director for Insurance
senior employee Insurance companies, which perform this function
The Board delegates Insurance; the same applies in the case, unless
Insurance Director elected within the period under paragraph 6
(8) The Director Insurance, director of the regional branch Insurance
or another managerial post Insurers can not because of a conflict of interest
hold person who
A) he is a member of the statutory body, supervisory board member of a legal
person who is the supplier of goods or services, banking, or
employee or a similar legal relationship to that legal entity,
B) as an individual entrepreneur supplying goods or services in banking,
C) is in the position of a person close to the persons referred to in subparagraphs a) and b). ".
Eighth in § 18 Paragraph 1 reads:
" (1) Members of the institution Insurance or his substitute may be only
upstanding citizen of the Czech Republic with permanent residence in the Czech Republic
who has reached the age of at least 25 years of age and is fully eligible to make
legal acts. Body member Insurance and chief executive office, chief executive
possibly lower organizational units or their representative
may be due to a conflict of interests person who
A) he is a member of the statutory body, supervisory board member of a legal
person who is the supplier of goods or services, banking,
B) as an individual entrepreneur supplying goods or services in banking,
C) is in the position of a person close to the persons referred to in subparagraphs a) and b). ".
Ninth in § 18 par. 4 of the second sentence deleted.
10th V § 20 paragraph 2 reads:
"(2) the Board of Trustees consists of 10 members appointed by the government and 20 members elected
Chamber of Deputies by the principle of proportional representation
political parties in Parliament. Board members appointed by the Government
appoint and dismiss the government by the Minister of Health
. Board members elected by the Chamber of Deputies of the Parliament
elected and dismissed by the Parliament. ".
11th in § 20 paragraph 5 reads:
" (5) The Governing Council decides by vote. Decisions
Governing Council must be approved by a majority of all the members of the Board.. "
12th in § 20, paragraphs 6 and 7 are deleted.
13th in § 21 paragraph 3 reads:
"(3) The Supervisory Board consists
A) 3 members, on a proposal from the Minister of Finance, Minister of Labour and Social Affairs and
Health Minister appoint and dismiss the government,
B) 10 members elected and removed by the Parliament;
During the occupation of the Supervisory Board shall be governed by the principle
proportional representation of political parties in the Chamber of Deputies of the Parliament
.. "
14th in § 21 the following paragraph 4 is added: | ||
"(4) The Supervisory Council decides by vote. Decisions
Supervisory Board must be approved by a majority of all the members of the Supervisory Board. ".
15th in § 24a, the following paragraph 4 is added:
" (4) In breach of confidentiality is not
provide information to the Ministry of health or the Ministry of Finance for
ensure fulfillment of statutory tasks. ". Article V
|| Transitional provisions | 1st Performance of the Director General health insurance Company of the Czech Republic
(hereinafter the "insurance Company"), which performs the function of the date of
force of this Act, shall expire on the last day of the calendar month in which this Act
acquired effectiveness. Until the election of a new director
Insurance Executive Director for the senior employee Insurance companies, which
delegated this function to authorize the Board Insurance.
second term of office of members of the institutions Insurance companies who act as
Insurers body member on the date of entry into force of this law ends
Last day of the calendar month in which this Act came
efficiency.
PART FIVE
Changing the law on ministries, professional, corporate and other health insurance companies
Article VI
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
. and Act no. 438/2004 Coll., is amended as follows:
First In § 7 para. 1, in the second sentence, the words "this ministry,"
replace the words "Ministry of Health and Ministry of Finance" and the third sentence
after the words "Ministry of Health", the words "in agreement with
Ministry of Finance. "
Second In § 7, paragraph 2 reads:
"(2) In the case of receivership shall be subject to the decisions and legal acts
director of employee insurance and other organs employee
insurance approval conservator, otherwise they are void. Forced
administrator is empowered to make decisions and legal acts which otherwise vested in the Director
employment insurance or other authority
employee insurance. ".
Third Under § 9, the following § 9a is inserted:
"§ 9a
(1) The statutory body employee insurance is the director. The director of employee insurance
appointed and dismissed by the Administrative Board employee insurance
.
(2) The Director of Employment insurance is appointed for a term of 4 years.
Director of Occupational insurance may be canceled even before the expiry of the period
to which he was appointed.
(3) the director of the employee insurance may be a citizen of the Czech Republic
that
a) has full legal capacity
b) is impeccable and
c) has completed university education.
(4) a person of integrity for the purposes of this Act, a person who
not been convicted of a property crime or intentional offense
if her never to have been convicted.
Integrity shall be evidenced by an excerpt from criminal records, which must be
older than 3 months.
(5) the Director employment insurance is not due to a conflict of interests
by a person who
a) is a member of statutory body, supervisory board member of a legal
person who is the supplier of goods or services, employment insurance, or
is an employee or a similar legal relationship to the legal
person
B) a natural person doing business supplies goods or services
employee insurance, or
C) is in the position of a person close to the persons referred to in subparagraphs a) and b).
(6) The office of the Director of Employee insurance ends
A) the expiration of the term,
B) appeal,
C) the date of receipt of the written statement of resignation to the Governing Board
D) the effective date of the judgment, which was deprived of
legal capacity or limited in legal capacity,
E) the effective date of the judgment which has been convicted of a criminal offense
referred to in paragraph 4, or
F) death.
(7) Whenever an employee director
insurance before the expiration of his term of office, appoints new Director The Board
employee insurance company within 60 calendar days. Until the appointment of a new director
employee insurance companies perform this function
senior employee health insurance, which perform this function
entrusts the Board of Directors. ".
Fourth § 10 reads:
| || '§ 10
(1) The bodies of employee insurance companies are
director of employee insurance, Management Board and the Supervisory Board.
(2) The Board decides on employee insurance
A) approval of the health insurance plan, financial statements and annual reports
,
B) approval of principles of contracting policy,
C) applications for employment insurance on the loan
D) the purchase of real estate
E) purchase of tangible fixed assets costing more than 1
000 000 CZK,
F) acceptance of a guarantor's obligation
G) use of reserve fund,
H) other important matters related to the activities of insurance and employee
you decide to reserve.
(3) The Board of employee insurance consists of five members appointed
government and 10 members elected by the employer and the insured employee
insurance, and the way that five members are elected from among the candidates submitted
representative organizations of employers 5 members and is elected
of candidates submitted by the representative trade union organizations
. Method of elections and electoral regulations set by the Ministry of Health
decree.
(4) The Board employee insurance company decides a vote.
The adoption of the decision of the Board must be approved by a majority
all members of the Board of Trustees employee insurance.
(5) The Supervisory Board consists of employee insurance
A) 3 members, on a proposal from the Minister of Finance, Minister of Labour and Social Affairs and
Health Minister appoint and dismiss the government,
B) six members elected by employers and insured employee
insurance, and the way that the three members are elected from among candidates submitted
representative organizations of employers and 3
members are elected from among candidates submitted by the representative trade | || organizations. Method of elections and electoral regulations set by the Ministry of Health
decree.
(6) The Supervisory Council decides by vote. Decisions
Supervisory Board must be approved by a majority of all the members of the Supervisory Board.
(7) Board members can not simultaneously be a member of the Supervisory Board and vice versa.
Board members can not be a member of the Supervisory Board or a four-year term
following the termination of his membership in the Board;
It also applies to the Supervisory Board member in the event of his membership of the Management Board
.
(8) The term of office of authority employee insurance is 4 years.
Members of the body can be relieved from office even before the expiration of the term.
(9) A member body employee insurance companies can perform again the same function
maximum of two consecutive four-year terms.
(10) Member of the Management Board and the Supervisory Board does not perform its function in
employment contract of the employee insurance; He is entitled to compensation
expenses related to performance features and performance it can provide
remuneration specified in the health insurance plan.
(11) Rules negotiations and decision-making bodies
employee insurance stipulated in the Statute employee insurance.
(12) The members of the authority employee insurance companies can not because of a conflict of interest
hold person who
A) he is a member of the statutory body, supervisory board member of a legal
person who is the supplier of goods or services, employment insurance, or
is an employee or a similar legal relationship to the legal person
, || |
B) a natural person doing business supplies goods or services employee
insurance company,
C) is in the position of a person close to the persons referred to in subparagraphs a) and b).
(13) Members of the institution insurance company employee or his substitute can only be blameless
Czech citizen with permanent residence in its territory
who has reached the age of at least 25 years.
Board member's employment insurance and chief executive office, possibly leading executive
lower organizational units or their representative must be
citizen who is an employee or similar relationship to the body, which is concluded
employment insurance contract
for payment of health care. ".
5th § 15 reads:
" § 15
(1) Insurance Company is obliged to ensure, through
auditora11) or legal entity that is registered in the list of auditors
^ 11) (hereinafter the "auditor")
A) the financial statements employee insurance company,
B) the Annual Report employment insurance for the year.
(2) Proposal health insurance plan presents employment insurance
to assess the Ministry of Health and Ministry of Finance.
(3) The Ministry of Health and Ministry of Finance will assess
submitted health insurance plans for compliance with the laws and regulations
terms consistent with the public interest.
(4) In case the Ministry of Health and Ministry of Finance after
assess compliance health insurance plan with the law and the public interest
finds that the proposal is not a health insurance plan with
these aspects in conflict, submit a draft health insurance plan
Government.
(5) In case if it finds that the proposed health insurance plan
contradicts the legislation or public interest, to return employee insurance proposal
health insurance plan for reprocessing.
(6) The draft health insurance plan, financial statements and annual report for last year
under paragraph 3 approve a government proposal
Chamber of Deputies following the terms
discussing the draft state budget and final state account .
Approved the annual report employment insurance appropriate publicity. ".
Sixth in § 22, the following paragraph 4 is added:
" (4) For the breach of confidentiality shall not provide
information to the Ministry of health or the Ministry of Finance for
ensure fulfillment of statutory tasks. ".
seventh In § 22a paragraph. 3 sentence first, second and third deleted.
|| | eighth in § 22b paragraph 4 is deleted. Article VII
Transitional provisions If the health insurance company paid to the Security Fund pursuant to § 22a of Act No.
. 280/1992 Coll., as amended effective on the effective date of this Act
, the contribution for 2005 before the effective date of this Act
is obliged Hedge fund this post
health insurance to return within 30 days of the entry into force of this Act.
PART SIX EFFECT
Article VIII this Act shall take effect on the first day of the calendar month following the date
his publication.
Zaorálek vr Klaus vr
Pp. Sobotka
