348/2016 Sb.
DECREE
of 19 December 2003. October 2016
on the determination of the values of the point, the amount of the reimbursement paid services and regulatory
limits for the year 2017
The Ministry of health shall lay down pursuant to § 17 para. 5 of Act No. 48/1997
Coll., on public health insurance and amending and supplementing certain
related laws, as amended by Act No 117/2006 Coll., Act No.
245/2006 Coll., Act No. 261/2007 Coll., Act No. 298/2007 Coll., Act No.
369/2011 Coll. and Act No. 200/2015:
§ 1
This Decree provides for the year 2017, the point values, the amount of the reimbursement paid by the
services provided to the insured under section 2 (2). 1 of Act No. 48/1997
Coll., on public health insurance and amending and supplementing certain
related laws, as amended, (hereinafter referred to as the "Act")
and paid services provided by insurance policy holders from other Member
States of the European Union, European economic area and the Swiss
the Confederation by the directly applicable European Union legislation
governing the coordination of social security systems ^ 1) and the insured
other States with which it has concluded international Czech Republic
agreement on social security and related to the area covered by the
^ 2), services (hereinafter referred to as "foreign insured person") and regulatory constraints for
the remuneration referred to in § 3 to 19, provided by these Contracting providers
health services (hereinafter referred to as "provider"):
and bed care providers) and providers of special inpatient care
According to § 22a of the Act,
(b)) in the field of General providers practical medicine and providers
in the field of practical medicine for children and adolescents,
(c) specialized outpatient care providers), ISP
hemodialysis health care and service providers in the fields of medicine, and 919 905
927 pursuant to Decree issuing the list of medical procedures with
point values of ^ 3) (hereinafter referred to as "the list of performance"),
d) providers of out-patient care in the fields of medicine and 603 604 by list
performance,
e) providers in the field of dentistry,
(f)) in the fields of medicine outpatient care providers 222, 801, 802, 804,
805, 806, 807, 808, 809, 810, 812-819, 822 and 823 by list
performances (hereinafter referred to as "listed expertise"),
g) providers of outpatient care in the fields of medicine, 911 914, 916, 921 and
925 by list of performances
h) ambulatory care providers in the fields of medicine and 902 917 by list
performance,
I) providers of emergency medical services, transportation providers
patients, health care providers of transport services,
medical emergency services providers and providers of emergency
services in the field of dentistry,
j) providers of rehabilitation care and Spa Clinic ozdravovnami and
to care providers).
§ 2
(1) the reference period means for the purposes of this order the year 2015.
(2) the Rated period shall mean for the purposes of this order the year 2017.
(3) In the reference period are included with all paid services
in 2015, provided the provider reported to 31. March 2016 and
health insurance recognised until 31 March 2006. may 2016. The rating period
included are all paid for services provided in the year 2017,
the provider reported to 31. March 2018 and health insurance company
recognised until 31 March 2006. may 2018.
(4) a unique insured for the purposes of this order shall mean the insured person
health insurance companies treated by the provider in a specific expertise in
investigational or reference period, at least once, with the fact that it is not
applicable, whether it is a treatment within their own health services
or health services requested, if it is not stipulated otherwise.
If the insured person by the provider in a specific expertise
treated in the period or the period of reference more than once, includes
the number of unique insured persons the competent health insurance company
treated in the skill only once. In the case of merge
health insurance companies, the number of unique policy holders make it as
the sum of the unique policy holders of health insurance companies that have merged.
If the insured person during the reference period the insured more than one
health insurance companies, the number of unique treated insured persons are
counted only once.
(5) the global unique by the insured person for the purposes of this Ordinance means
the insured person health insurance companies treated bed care provider in
any expertise within custom or requested health care services
in the reference period or at least once, if not further
unless otherwise provided for. If the insured person by the provider, regardless of
on it, in which expertise, treated in the period or reference
period more than once, includes the number of global unique insured persons
the health insurance companies treated the only provider
once. In the event of a merger of health insurance companies, the number of global
unique counts as the sum insured global unique
policy holders of health insurance companies that have merged. If it has been
the insured person during the reference period the insured more than one health
insurance companies, the number of global unique treated insured persons are
counted only once.
(6) when calculating the total number of declared and health provider
insurance company approved for medical procedures (hereinafter referred to as "the power")
the reference periods referred to in annexes 5 and 8 of this Decree, the following points
means points calculated according to the list of performances, in the version in force on 1 January.
January 2017, which aren't counted points for paid services
granted to foreign insurance policy holders.
(7) if in the period to merge two health
insurance companies, used for calculation of the sum of the remittance information for the reference
the period of the merged health insurance companies.
§ 3
In the case of the provision of paid services to foreign persons with
provides for the payment of the same amount as in the case of Czech policy holders.
§ 4
(1) for the paid services provided by providers of inpatient care, with
except for covered services provided by providers of subsequent bed
care, providers of long-term care beds and special providers
bed care, the point value, the amount of the reimbursement paid services and regulatory
limit fixed in annexes no. 1, 9, 10, 12, 13 and 14 of this Ordinance.
(2) for the paid services provided by providers of subsequent bed care,
providers of long-term care beds, special out-patient care
provided under section 22 (b). (c)) and e) of the Act and the specific provider
inpatient care, paid a flat rate per day of hospitalisation or
According to the list of performances, with the point value, the amount of the reimbursement paid by the services and
regulatory restrictions set out in annex 1 to this notice.
§ 5
For paid services supplied by providers in the field of General
practical medicine and providers in the field of practical medicine for
children and adolescents paid a combined kapitačně power payment
combined kapitačně power payment with calling kapitace or
According to the list of performances with the point value, the amount of the reimbursement paid by the services and
regulatory restrictions set out in annex 2 to this Decree.
§ 6
For specialized out-patient care provided by your ISP
outpatient care paid for by list of performances with the point value, the amount of
reimbursement covered services and regulatory restrictions set out in annex 3 to the
This Decree.
§ 7
For out-patient care provided by providers of outpatient care in
603 and 604 specializations according to the list of performances by the score from the list
performance point value, the amount of the reimbursement paid services and regulatory constraints
down in annex 4 to this notice.
§ 8
(1) for the paid for services supplied by providers in the field of dental
medicine paid for by list of performances with the point value shall be
0.95 €.
(2) the amount of the reimbursement paid by the services supplied by providers in the industry
Dentistry which are not fully provided for in paragraph 1 and the relevant regulatory
the restrictions are set out in annex 11 to this Decree.
(3) the health insurance fund shall limit the amount of payment to providers in the field of dental
medicine so that the sum of the cost of health insurance
spent on paid services supplied by providers in the field of dental
medicine in the year 2017 does not exceed the total amount of these costs
disability insurance plan provided for in the health insurance companies. If
overrunning of the total amount of remuneration paid for services provided by the
providers in the field of dentistry, provided for in the health insurance
health insurance plan for these services was caused by the employers '
by providing a greater volume of urgent care from 2015, health
the insurance company will pay this higher volume.
§ 9
For the paid services provided by providers of outpatient care in
According to the list of specified fields of medicine paid for by the performance, the value of point
and the amount of the reimbursement paid services set out in annex 5 to this Decree.
§ 10
For the paid services provided by providers of outpatient care in
proficiency 911, 914, 916, 921 and 925, according to the list of procedures paid for by
According to the list of performances with the point value and the amount of the reimbursement paid services
down in annex 6 to this Ordinance.
§ 11
For the paid services provided by providers of outpatient care in
fields of medicine and, according to the list of 902 917 performances paid by list
performance point value and the amount of the reimbursement paid services set out in annex
# 7 of this Decree.
§ 12
(1) for the paid services provided by emergency medical providers
services paid for by list of performance shall be in the amount of point value
1.13 Eur, with the exception of contracts of transport, according to the list of codes
performances, for which the value of the point of 1.12 Eur, and with the exception of
performance no 06714 according to the list of performances for which the value of the point
in the amount of CZK 1. The maximum reimbursement to the provider for the reported performance of no.
06714 according to the list of performances in the period does not exceed the limit of payment
for these performances in 2016.
(2) for the paid services provided by transport providers
urgent care paid for by list of performance shall be the value of point in the
EUR 1.12 Eur, with the exception of contracts of transport, according to the list of codes
performances, for which the value of the item in the amount of $1.11, and with the exception of
performance no 06714 according to the list of performances for which the value of the point
in the amount of CZK 1. The maximum reimbursement to the provider for the reported performance of no.
06714 according to the list of performances in the period does not exceed the limit of payment
for these performances in 2016.
section 13 of the
For the paid services provided by providers of medical transport
services paid for by list of performances with the point value and the amount of reimbursement
covered services set out in annex 8 to this Ordinance.
§ 14
For the paid services provided by providers within the medical
emergency services or emergency services in the branch of dental medicine
paid by list of performance shall be the value of the item in the amount of CZK 1.
§ 15
(1) for the complete spa sanatorium rehabilitation care for adults
provided by the Spa provider in healthcare facilities
hospital rehabilitation care down payment for one day stay in the
When piece measures 104% of the contractually agreed remuneration for one day stay for 2016.
If the payment for one day stay for 2016 negotiated to 31.
December 2016, the remuneration in the amount of Czk 1 092. Payment for accommodation
and diet Guide to the insured shall be at the same level as remuneration for the
These folders for insured persons, which is provided by the comprehensive Spa
hospital rehabilitation care.
(2) for the complete spa sanatorium rehabilitation care for children and
youth under 18 years of age provided in healthcare facilities
Spa sanatorium rehabilitation care provider shall be the remuneration for the
one day stay of 104% of the contractually agreed remuneration for one day
stay in the year 2016. If the payment for one day stay for 2016
negotiated to 31. December 2016, the remuneration in the amount of Czk 1 404.
Remuneration for the Board and lodging Guide to the insured shall be at the same
amount as remuneration for these folders for insured persons, which is provided by the
comprehensive Spa sanatorium rehabilitation care.
(3) For contributory Spa sanatorium rehabilitation care for adults
provided by the Spa provider in healthcare facilities
hospital rehabilitation care down payment for one day stay in the
When piece measures 104% of the contractually agreed remuneration for one day stay for 2016.
If the payment for one day stay for 2016 negotiated to 31.
December 2016, the remuneration in the amount of $395.
(4) for contributory Spa sanatorium rehabilitation care for children and
youth under 18 years of age provided in healthcare facilities
Spa sanatorium rehabilitation care provider shall be the remuneration for the
one day stay of 104% of the contractually agreed remuneration for one day
stay in the year 2016. If the payment for one day stay for 2016
negotiated to 31. December 2016, the remuneration in the amount of $499.
(5) For contributory Spa sanatorium rehabilitation care shall be
payment of 30 € for the reported performance no 09543 according to the list. This
the performance of an insurance company may be banned up to three times during a single
treatment of the insured person.
(6) for the paid services provided in Sanatorium schools shall be the remuneration for the
one day stay in the amount of $839.
section 16 of the
(1) for each provider reported and recognized by the health insurance company
performance no 09543 according to the list of performance shall be the remuneration in the amount of CZK 30.
The maximum reimbursement to the provider for the reported feats no 09543 according
list of performances in the period does not exceed the amount equal to the
the victim's number of performances no 09543 according to the list of services, as amended by
effective in 2014, declared to the health insurance company in 2014.
(2) in the case of a provider that did not exist in 2014, arose during a
2014 or did not have a contract with a health insurance company,
It's the health insurance numbers of performances no 09543 comparable
providers in 2014.
(3) the remuneration referred to in paragraphs 1 and 2 shall not count towards the maximum remuneration for
paid services.
(4) the provisions of paragraphs 1 and 2 shall not apply to the provider
Spa sanatorium rehabilitation care in the provision of subsidised
Spa sanatorium rehabilitation care.
§ 17
(1) for each provider reported and recognized by the health insurance company
performance no 09552 according to the list of performance shall be the remuneration in the amount of $13.
The maximum reimbursement to the provider for the reported feats no 09552 according
list of performances in the period does not exceed the amount equal to the
třináctinásobku number of the recipes in 2014, on the basis of which it was issued
a medicine partly or fully paid from public health
insurance.
(2) in the case of a provider that did not exist in 2014, arose during a
2014 or did not have a contract with a health insurance company,
It's the health insurance numbers of recipes comparable providers
in 2014.
section 18
Reported for each provider and health insurance company recognized performance
No 78890 according to the list of performance shall be the remuneration in the amount of $10,000. This
reimbursement is not included in the amount of the remuneration paid for services provided for under the
section 2.1.1, and 3.5, 4, and 6 of annex 1 to this notice.
§ 19
For paid services supplied by providers in expertise 005-
hospital pharmacy paid according to performance point value list
down in the amount of CZK 1.
section 20
This Decree shall enter into force on 1 January 2000. January 2017.
Minister:
Mudr. Němeček, MBA, in r.
Č. 1
The value of the item, the amount of the reimbursement paid services and regulatory restrictions pursuant to § 4
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 2
The value of the item, the amount of the reimbursement of health care and regulatory restrictions pursuant to § 5
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 3
The value of the item, the amount of the reimbursement and regulatory restrictions in accordance with § 6
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 4
The value of the item, the amount of the reimbursement and regulatory restrictions pursuant to § 7
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 5
Point value and the amount of the reimbursement in accordance with § 9
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 6
Point value and the amount of the reimbursement in accordance with § 10
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 7
Point value and the amount of the reimbursement in accordance with § 11
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 8
Point value and the amount of payments under section 13 of the
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 9
The contractually agreed remuneration individually-Group related to the
the diagnosis according to the classification with the indexes of these groups
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 10
Remuneration in the form of flat-rate case-the group related to the diagnosis according to the
Classification indexes of these groups
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 11
The amount of the reimbursement paid by the services according to § 8 para. 2
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 12
Medicines extracted from the payment of the second lump sum
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 13
The payment order of the payment in the form of flat-rate case-related Group
to the diagnosis according to the classification of the second lump sum payment exempt
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
Č. 14
Popměru the number of insured persons that factor health insurers in a given
the District of
_________________
*) Note. ASPI: the attachment is available on the website http://ftp.aspi.cz/opispdf/2016.html#castka_137.
1) European Parliament and Council Regulation (EC) No 883/2004 on the coordination
systems of social security, as amended.
European Parliament and Council Regulation (EC) no 987/2009
down detailed rules for the application of Regulation (EC) No 883/2004 on the coordination
of social security systems.
The European Parliament and of the Council Regulation (EU) no 1231/2010, which
extends the scope of Regulation (EC) No 883/2004 and Regulation (EC) No.
987/2009 to nationals of third countries, to which this regulation
do not yet apply only because of their nationality.
2) for example, the communication from the Ministry of Foreign Affairs No. 130/2002 Coll., m.
with the negotiation of the Treaty, between the Czech Republic and the Federal Republic of
Yugoslavia on social security, the communication of the Ministry of foreign
things no 135/2004 Coll., m. s., the negotiation of the Treaty between the Czech Republic and
The Turkish Republic on social security, the Ministry of communication
Foreign Affairs No 2/2007 Sb. m. s., the negotiation of the agreement between the Czech
Republic and the Republic of Macedonia concerning social security.
3) Decree No. 134/1998 Coll. issuing the list of medical procedures
with point values, as amended.
