The Saeima has adopted and the President promulgated the following laws: the law on the amendments to the medical treatment Act to make (the Saeima of the Republic of Latvia and the Cabinet of Ministers rapporteur, 1997, no. 15; 1998, nr. 7; 2000, no. 13, no. 15; 2001; 2004, nr. 9, 13, 14; 2005; 2006, no. 14. No; 2007, 8, 21, 24 no; 2008, 13 no, 10, 15, 2009. no; Latvian journal, 2009, 200, 205. no; 2010, no. 105, 170; 2011, 62 no; 2012, 108 no; 2013, 87 no) the amendments are as follows: 1. Article 1: to supplement paragraph 3 after the words "local authorities" with the words "economic enforcers and"; make paragraph 9 by the following: "9) medical technology — used in treatment methods, medical devices and medicines;" Express 21 as follows: "21) medical devices — any instrument, apparatus, appliance, software, material or other article, used alone or in combination with other devices, including with the software that the manufacturer for use in medicine, to diagnose, prevent, monitor and treat diseases or facilitate their progress, diagnose, monitor, treat, or compensate for the injuries or physical deficiencies, explore, replace or change a person's anatomical or physiological processes , control, and which comprises the expected on its surface or the human body the human body is not achieved by pharmacological, immunological or metabolic means, but with the following features can help ensure medical device; " to supplement the article with a paragraph 29 by the following: "29) telemedicine: remote health service delivery through information and communication technologies. It includes necessary medical treatment data and secure transmission of information in text, sound, picture, or other format. " 2. Article 2 shall be supplemented by the words "and establish a special medical institutions operating provisions of the regulatory framework". 3. Supplement article 3 first paragraph, after the words "measures" with the words "including telemedicine and medicinal products and medical devices". 4. in article 9.1: turn off in the first paragraph, the words "methodological recommendations"; to turn off the second paragraph, the words "and methodological recommendations". 5. Add to article 29 paragraph 2 of the second paragraph after the word "analyst" with the words "podolog, beauty specialist (cosmetology)". 6. To express the following chapter VII: "Chapter VII nurse and physician assistant profession article 44. (1) medical nurse is a person who acquired education according to the law "on the regulated professions and the recognition of professional qualifications" requirements. (2) the professional activities of Nurses, according to competence: 1) performs patient care; 2) participate in treatment; 3) hosts patient care work; 4) deals with patient education of health issues; 5) vocational work. Article 45. (1) the physician's Assistant is a medical person who obtained the average vocational education or the first level of higher professional education, or higher education according to the accredited physician assistant studies program. (2) physician assistant professional activities according to the competence of individual professional and disease diagnosis and treatment, as well as in cooperation with the physicians providing preventive measures. " 7. Article 68: to complement the seventeenth of the sentence the following wording: "a decision on the need to continue to provide to a patient without his consent for psychiatric help a psychiatric medical institution for six months or more for the help discontinuance of a psychiatrist konsilij is entitled to adopt again, following the procedure laid down in this article."; make part of the 20th by the following: "(20) patient, who placed in the treatment of a psychiatric medical institution in accordance with the procedure laid down in this article is the right more frequently than once every two months to submit a district (City) Court (according to the psychiatric hospital's location) application with a request to review the decision on psychiatric assistance to a patient without his consent." 8. Supplement article 69.1 of law with the following: "article 69.1. (1) a patient who is stacionēt psychiatric medical institution without his consent, and the patient that the treatment in a psychiatric hospital as medical coercive means in criminal proceedings, are: 1) the patient rights act patient rights; 2) the right to receive and send mail, receive mail (contributions), to use the means of communication, to communicating with people outside the psychiatric treatment services, to meet up with relatives and other persons, as well as the right to a daily walk. Treatment for these rights a person shall immediately inform his patients in intelligible form and taking into account the patient's age, maturity and experience. If necessary, treatment of personal information shall be referred to repeatedly. (2) If there is an imminent threat that the patient psychic disturbance can cause injury to yourself or other persons or patients are showing violence against other people, the doctor has the right to prohibit patient appointment with relatives and other persons, and the daily walk. Ban immediately repealed if patients pose no longer exists. The doctor to the patient's medical documentation reflects the application of the ban reason and duration. (3) the cabinet shall determine the list of items that are prohibited for a psychiatric medical institution and receive shipments (inputs). (4) the doctor, individually after assessing the case, may take a decision on the meeting with the relatives of the patient and other persons in the presence of the person of medical treatment, if necessary for reasons of security or requested by the visitor or patient. The decision taken and the reasons for the doctor reflects the patient's medical documentation. (5) if the treatment has reasonable doubt that at the patient or his possessions are objects which medical institution is prohibited, the doctor has the right to make decisions for the patient and his belongings. The decision taken and the reasons for the doctor reflects the patient's medical documentation. The medical establishment ensure that patient screening is carried out for the same gender treatment. (6) where there is an imminent threat that the patient psychic disturbance can cause injury to yourself or other persons or patients are showing violence against other people and with the verbal persuasion have failed to stop threats, psychiatric medical institutions have the right to use such restrictive features: 1) physical limitations, using physical force to control the movement of the patient; 2) mechanical restriction, using restrictive links or belt; 3) entering the patient medication against his will; 4) into the observation room. (7) the Restrictive measures forced the patient may be applied only if the patient of stacionēt psychiatric medical institution without his consent, and the patient that the treatment in a psychiatric hospital as medical coercive means. Restrictive means, subject to the conditions referred to in this article, the right to apply also when psychiatric help is provided to a patient without his consent prior to this law, the eleventh subparagraph of article 68 of the judge's decision. (8) the decision concerning restrictive measures adopted and implemented by the medical doctor. The restrictive measures are proportional to the direct threats posed by the patient, and their application to stop immediately if the patient can pose no longer exists. The doctor to the patient's medical documentation reflects the restrictive features of the application, specifying a restrictive application of the reasons start and end time, and the seriousness of the injury, if any, incurred by the patient or medical treatment. (9) the cabinet shall determine the order in which the patient limiting using restrictive means. (10) the patient shall have the right in the second and sixth doctors referred to decisions within one month of the challenge medical authorities, who considered the application and the decision shall be taken within seven days. The head of the hospital's patients have the right decision one month to challenge the health inspection of the application review and decision within 20 days. Health inspection decision for the patient has the right to one month to appeal the district (City) Court. District (municipal) Court judgment may not be appealed. " 9. Put the title of chapter XIII and article 74 of the following: "chapter XIII treatment services or the suspension or the health services provided for the suspension of article 74. The decision on treatment services or the suspension or the health services provided by the suspension, if the scope of the regulatory treatment have been violated laws and regulations, adopt health inspection Manager or his Deputy or health inspection control department heads or their deputies. " 10. Express article 75 fourth, fifth, sixth, seventh, eighth and ninth subparagraph by the following: "(4) if the notice contains the irregularities are not rectified within the time limit set in article 74 of this law, the officials referred to in the decision of the relevant authority or body treatment the suspension or on health care service stop. (5) treatment services or the suspension provides treatment services manager, participating officials, which acted on medical institutions or the suspension or its authorized person. Treatment services provided in the health care service of the suspension provide the hospital's Manager. (6) treatment services or the suspension or the health care services provided by the suspension shall be made so as to: 1) can seamlessly to prevent any irregularity; 2) minimise space and equipment damage weather or corrosion; 3) cause as little hindrance as possible to the unit and other equipment. (7) the medical authorities or the control of suspension of or the provision of health care services the stop control shall ensure that officials decided on the suspension or interruption of health services, or its authorised officer. (8) medical establishment or the operation or provide a health care service may be suspended without notice if the scope of the regulatory treatment of infringements resulting in threats to human health and life. (9) an official who has the power to make this article the decision referred to in the eighth, it takes three working days after becoming aware of it, this article is the eighth in the field of treatment referred to in the governing legislation and it will be executed immediately. " 11. Article 76 of the expression as follows: "article 76. (1) for the treatment of the field found the laws regulating the prevention of irregularities in the medical establishment concerned shall be notified in writing to the officer who made the decision about treatment services or the suspension or provide health care in the service stop. This officer shall, within five working days of receipt of the check that the violations are corrected. (2) if all the offences referred to in the written warning or decision about treatment services or the suspension or the provision of health care services, the suspension has been resolved, the appropriate officer within three working days after the examination, issue a written authorization for treatment services or the restore or health care service delivery. (3) if all the offences referred to in the written warning or decision about treatment services or the suspension or the provision of health care services, the suspension is not rectified, appropriate officer within three working days after the inspection, notify a refusal to issue the permit authority or body treatment or health care services. " 12. Express 77. the first paragraph by the following: "(1) an application to which the contested decision of the health inspection of the hospital's or the suspension or to provide health care services in the suspension without prior notice, the appearance and the decision shall be taken within 10 working days of the receipt of the application." 13. Supplement article 79 with 1.1 part as follows: "(11) the inclusion of health information Data system is the entry or structured electronic document filing online mode. The record confirms with a secure electronic signature or other authentication tools and procedures that can ensure the authenticity of the recording and confirm the identity of the signer. System authentication tools, as well as ensuring the authenticity of records procedure procedure determined by the Cabinet of Ministers. " 14. To supplement the law with the following chapter XV: "chapter XV hospital's operating the special provisions of article 81. (1) If the delay is related to contracts for the supply of goods, purchase or delivery of the service and the debtor is the medical establishment that it fulfils the criteria in accordance with the laws and regulations in the field of public procurement or public institutions the criteria in accordance with the laws and regulations of the public service procurement (public subscriber), the delay is appropriate for civil law rules applicable to contracts for the supply of goods, the purchase or delivery of the service pursuant to this article shall be laid down in the second subparagraph the debtor's delay. (2) If the medical establishment referred to in the first subparagraph in cases within 60 days of the civil code 1668.2 referred to in the first paragraph of the terms of accession are not made the payment delay occurs with all the resulting consequences. " 15. transitional provisions: replace paragraph 17, the number and the word "2014" with a number and the word "2016"; transitional provisions be supplemented with 19, 20 and 21 as follows: "Cabinet of Ministers until 19 March 2014 1 December issue of this law article 69.1 of the third part of these provisions. 20. The Cabinet of Ministers by 2015. the January 1 article 69.1 of the Act issued by the ninth part of these provisions. To the Cabinet of Ministers regulations referred to the entry into force of the restriction, patients with restrictive features, carried out in approved medical technologies. 21. Article 81 of this Act shall not apply to contracts concluded before this law, article 81 of the date of entry into force, and the contracts concluded in accordance with the laws and public procurement or concession allocation area by article 81 of the date of entry into force of procurement or concession in the laws of procedure laid down in this law are underway 81. date of entry into force of article. " 16. Add to the informative reference to European Union directives, with 5, 6, and 7, paragraph by the following: "(5)) of the European Parliament and of the Council of 5 September 2007 of Directive 2007/47/EC amending Council Directive 90/385/EEC on the approximation of the laws of the Member States relating to active implantable medical devices, Council Directive 93/42/EEC concerning medical devices and Directive 98/8/EC concerning the placing of biocidal products on the market; 6) the European Parliament and of the Council of 16 February 2011-2011/7/EU directive on combating late payment in commercial transactions; 7) the European Parliament and of the Council of 9 March 2011 the 2011/24/EU directive on the application of patients ' rights in cross-border healthcare. " The Parliament adopted the law in 2014 on 11 September. The President of the Parliament instead of the President s. Āboltiņ in Riga 2014 October 1