Amendments To The Cabinet Of Ministers Of 14 June 2005, The Regulation No 418 "outpatient Treatments And Medicines For The Purchase Of Medical Equipment For The Refund Order"

Original Language Title: Grozījumi Ministru kabineta 2005.gada 14.jūnija noteikumos Nr.418 "Ambulatorajai ārstēšanai paredzēto zāļu un medicīnisko ierīču iegādes izdevumu kompensācijas kārtība"

Read the untranslated law here: https://www.vestnesis.lv/ta/id/124839

Clarifies 14.02.2006., Journal No. 26 (3394) Cabinet of Ministers Regulations No 1035 Riga, 2005 (December 27. 77 58) amendments to the Cabinet of Ministers of 14 June 2005, the Regulation No 418 "Outpatient treatments and medicines for the purchase of medical equipment for the refund order" Issued in accordance with article 4 of the law on medical treatment to make the Cabinet of Ministers of 14 June 2005, the Regulation No 418 "Amb powers of treatments and medicines for the purchase of medical equipment for the refund order" (Latvian journal, 2005, 99 no) the following amendments: 1. Replace paragraph 24, the words "k-correction factor percentage" with the words "k-correction factor".
2. Express 28 the following: "(A) the medicinal product in the list of 28 groups the interchangeable drug groups, taking into account the pharmaceutical form, strength of the medicinal product, as well as the size of the packaging, compliance with treatment (therapeutic dose titrācij (gradual dose reduction or increase), course of treatment, which lasts up to one month, to two months, to three months). Each group determines the reference medicinal product, which is the cheapest drugs in the group in question. "
3. Make the following paragraph 19.4.: 31.3. various medicinal products "General nosa Kuma reference price is calculated according to the strength used in the ATC/DDD classification, except in accordance with the documentation are submitted to the clinical therapeutic daily dose not match the defined daily dose. In this case, the reference price used to calculate the therapeutic daily dose; ".
4. a add to 19.5. section behind the words "different pharmaceutical form" with the words "interchangeable drug groups".
5. Express 22.0. subparagraph as follows: "the same indications necessary 35.4. combined use of drug costs may not exceed the eligible list of medicines to be used separately for the same medicines cheaper in general name drug costs."
6. Supplement with 21.8 points by the following: "(B) the list to be included in evaluating the 21.8-one name in medical equipment costs, note that different manufacturers ' identical to medical devices for use in per-unit costs may vary by no more than 20%, taking into account the cheaper medicines countervailable in the list of the same name for use for identical medical device unit cost."
7. Supplement with 42.1 points as follows: "in addition to these provisions 42.1. the information referred to in paragraph 42 of the medicinal products or medical devices, which cost more than 3000 dollars per patient per year, if it is not possible to apply the medical criteria for drug control, drug-price public agency decision shall indicate the specific medicinal products or medical devices or quantity the number of patients that the medication or medical equipment acquisition expenses may offset from the purchase of medicines for the allocation of compensation."
8. Supplement with 27.6. subparagraph by the following: "27.6. If the applicant refuses to enter into this terms of agreement referred to in paragraph 50.2."
9. Supplement with 45.6. subparagraph by the following: "the applicant does not comply with 28.3. This provision of the Treaty referred to in paragraph 50.2 conditions."
10. Express 50 as follows: ' 50. Health compulsory insurance State agency administered by the purchase of medicinal products in the distribution of funds allocated for compensation, taking into account the planned prescribed prescription number and schedule in one recipe of prescriptions and the purchase of medical equipment for the average costs, with the exception of the following provisions of this disease 1. diagnosis groups included in annex and diagnosis, which the purchase of medicinal products that are assigned to the compensation funds are distributed based on the estimated number of patients and the planned one patient for medicinal products and medical equipment acquisition average cost of expenditure : 50.1. diagnosis group "3. Blood and hematopoietic organs diseases and immune disorders";
50.2. diagnosis group "5. Tumors";
50.3. diagnosis groups "8. Endocrine, nutritional and metabolic diseases ' diagnosis ' E 10.0-10.9 Insulīnatkarīg diabetes mellitus", "E-E Insulīnneatkarīg in 11.9 11.0 diabetes", "Akromegālij and the hipofiziār E 22.0 gigantism", "E", "E Hipopituitārism 14.3 21.3 not elsewhere specified small body";
50.4. the diagnosis groups "10. Infectious and parasitic diseases ' diagnosis ' (B) 11.2-chronic viral hepatitis B 18.2";
50.5. the diagnosis groups "13. Congenital malformations, deformations and chromosomal abnormalities" diagnosis "Congenital abnormalities syndrome 87.1 (Q) to do a little body" minējoš, "Q-Q 59.9 96.0; Q 96.8; Q Turner (Turner) 96.9 sin Drôme ";
50.6. diagnosis groups "14. Nervous system disease" diagnosis "G35 multiple sclerosis";
50.7. diagnosis group "15. Mental and behavioural disorders";
50.8. diagnosis groups "16. Factors affecting health and contact with the health care workers ' diagnosis ' Z-93.1 artificial hole 93.6 Z" and "Z" Transplanted kidney 94.0;
50.9. diagnosis groups "17. diseases of Uro system" diagnosis "N 11.2; 12.8 n.; N 11.7. Chronic renal failure "."
11. Supplement with 50.1, 50.2, 50.4, 50.5, 50.3, 50.6 and 50.7 points by the following: "health statistics and 50.1 medical technologies State agency once a year to 31 October submit health compulsory insurance State Agency forecasts the number of patients in the next year on patients with the provisions referred to in paragraph 50 of the diagnoses.
50.2 this rule 42.1 in the case referred to in paragraph health compulsory insurance State Agency has the authority to enter into contract with the applicant for specific medicinal products or medical devices fees from the amount of the purchase of medicinal products granted compensation features. The conditions in the contract that if demand exceeds the duration of the contract the contract medicine and medical equipment, for the remaining quantities of the required quantity for the applicant pay from its own funds and medical supplies free of charge the person whose right to prescribe certain medicines or medical devices are determined by agreement between the hospital and the health compulsory insurance State Agency.
This rule 50.3 50.2 referred to a contract with the applicant for health compulsory insurance State Agency closed after receiving this rule 42.1 the price referred to in the decision of the national agencies, which contains specific medicinal products or medical devices or a specific number of patients a year and followed the treatment cost estimates and the total funding required.
50.4 this rule 42.1 of the medicinal products referred to in point discharge may initiate, subject to the following conditions: 50.41. Health compulsory insurance State agency with the applicant concluded that rule 50.2 of the Treaty referred to in paragraph 1;
2. the relevant treatment 50.4 professionals konsilij have made a decision about a particular medicine or medical product use, need for a given patient, the decision stating the diagnosis, the diagnosis code according to the ICD-10 version, the name of the medicinal product and dosage, necessity of the use of the medicinal product and the recommended duration of the course. The doctor will send the decision to the konsilij health compulsory insurance State Agency. Health compulsory insurance State agency decision recorded and inform this rule 50.2 of treatment referred to in point person for the opportunities make specific drugs or medical devices. If this rule 50.2 points specified in a contract referred to in medicine or medical devices, for which a fee from the purchase of medicinal products granted the compensation funds is exceeded, the health compulsory insurance State Agency shall record the appropriate therapeutic professionals konsilij decision and shall send to the applicant, informing about the treatment of the person shall deliver the specific patient requires drugs or medical devices.
50.5 health compulsory insurance State Agency for each medicinal product and medical devices for which adopted that rule 42.1 points in that decision, the patient records, which the pharmaceutical acquisition expenses are compensated, as well as the treatment of the person that the medicinal product concerned on the statement.
50.6 If a patient stopped the use of the medicinal product concerned, that rule 50.2 of treatment referred to in paragraph 1 the person not later than the time of the 30dien inform the health compulsory insurance State Agency.
50.7 health compulsory insurance State Agency sends this rule 50.2 points in a copy of the contract in the medicinal products the price of State Agency. "
12. Express 53 by the following: "53. Eligible list of medicinal products and medical devices to specific recipes form statement the doctor that this right is established in accordance with the agreement between the hospital and the health compulsory insurance State Agency."
13. Express 56 the following: "56. Pharmacy, which has agreements with health insurance were compulsory youth national agency of medicinal products and medical devices, the purchase of which is partially or completely covered from the purchase of medicines for the allocation of compensation."

14. To supplement the rules with 56.1 points as follows: "provide countervailable 56.1 pharmacy drug list drugs and medical devices issued not later than two days after special recipes."
15. Replace paragraph 59, the words "determine the pharmacy" with the words "determine the pharmacy by such terms".
16. Replace paragraph 61 of the introductory part, the words "confirming the diagnosis and the need for the use of the medicinal product" with the words "indicating the diagnosis, the diagnosis code according to the ICD-10 version, the name of the medicinal product and gave the Administration the need and justification for the recommended duration of the course".
17. Delete paragraph 67.
18. Make 1.18.2. subparagraph by the following: "18.2.
The neck and torso injuries consequences T 91.1; T 91.2; T 90 19. Replace 91.3 "in annex 3 of the second column of the table in the title the words" pharmaceutical producer price (LCY) "with the words" the producer price (LCY) ".
20. Replace annex 4 table title in the third column the words ' correction factor (%) "with the words" adjustment factor ".
21. To supplement annex 6 to 2.20, 2.21 and 2.22. section following. the information: "2.20 redak.
T the vertebral column fracture effect of 91.1 2.21.
T 91.2 other pelvic fractures of the thoracic and the effects of 2.22.
T 91.3 spinal cord injury effects ".
Prime Minister a. Halloween Health Minister g. Smith Editorial Note: the entry into force of the provisions by 31 December 2005.