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The State Compulsory Health Insurance Central Fund Rules

Original Language Title: Valsts obligātās veselības apdrošināšanas centrālā fonda nolikums

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The Republic of Latvia Cabinet of Ministers of 12 May 1998 rules no. 176 in Riga (No. 24, § 18) state compulsory health insurance central fund rules Issued under Cabinet installations article 14 of the law 3 (I). General questions 1. compulsory health insurance fund Centre (hereinafter referred to as the Central Fund) is the national civiliestād, which operates under the Ministry of welfare. Central Foundation is a national sickness fund's obligations and the successor in title.
2. the Central Fund is a legal person. It has its own stamp with the updated state of the Republic of Latvia in the small coat-of-arms images and the full name of the Central Fund, as well as the budget account in the Treasury account.
II. The central task of the Foundation and features 3. Central Fund administered by the national budget of the "health care" and national specialty health care budget.
4. The Central Fund has the following tasks: 4.1 the procedures laid down in the laws of the State budget and national specialty health care budget to ensure payment for treatment provided by the authorities of health services organization and marketing;
4.2. perform the payment for health care services utilization of the funds assigned to the sickness funds, accounting treatment institutions and pharmacies, as well as to control the use of those funds.
5. the Central Fund will perform the following functions: 5.1. legislation in the order and according to the Ministry of welfare requirements and model agreements for approved contracts with medical institutions and local authorities on issues related to payment for health care's services;
5.2. mutual fund settlement services provided for the population monitoring of treatment services;
5.3. the Ministry of welfare tasks involving legislation to develop projects in matters related to health care financing and payment for health care services;
5.4. develop proposals for medical institutions of economic management methods for planning and improvement;
5.5. develop and submit for the approval of the Minister of welfare: 5.5.1. methodology for the settlement to between sickness funds and medical institutions that provide outpatient medical treatment;
5.5.2. the methodology by which to settlement between sickness funds and medical institutions that provide inpatient medical treatment;
5.5.3. the methodology in a settlement between the sickness funds and pharmacies;
5.5.4. the methodology by which to settlements for citizens of other countries provided medical services, including billing for services rendered in accordance with the agreements;
5.5.5. the methodology that the sickness funds are to mutual settlements for the citizens of treatment services;
5.5.6. the treatment of persons of the amount of work and the quality evaluation criteria and the methodology for its application;
5.5.7. medical service price and tariff methodologies for market participants v;
5.6. organizes the central record keeping and accounting of the Fund shall be drawn up of statistical records and reports;
5.7. the separate health care system toward economic economic analysis;
5.8. collects and analyzes financial economic sickness funds and statistical information;
5.9. the control of the medical institutions in the financial transaction and financial audit;
5.10. organise training of sickness funds and further training;
5.11 review the submissions and complaints about the competence of the Central Fund questions;
5.12. inform the citizens about the order in which health care is provided, and within their competence, provide necessary assistance for citizens rights.
III. Central Fund the rights and responsibilities of officers 6. in order to ensure the execution of tasks and functions, the Central Fund shall have the following rights: 6.1. to request and receive, free of charge from the sickness funds, medical institutions and pharmacies, the central tasks of the Fund the necessary information and documents, as well as to check the veracity of the data and accuracy;
6.2. control the minimum health care services and the national programme of health care services to the use of the funds allocated to health insurance funds as well as medical institutions and pharmacies (regardless of their business and the type of property);
6.3. control the Welfare Minister, approved the settlement methodology and documentation, medical treatment in the movement of funds, institutions and pharmacies;
6.4. recourse in order to recover funds used for the criminal acts of natural persons, legal persons, as well as the fault of the victims.
7. the Central Fund officials are responsible for the decisions and actions of compliance with laws and regulations.
IV. The Central Fund and Administration 8. central financial resources of the Fund in accordance with the laws and regulations of the national budget from grants from the general revenue, revenue for the fees and other revenue for the current year's State budget law.
9. The Central Fund headed by a Director. Central is the Director Officer (Officer candidate). The Central of the Director nomination at the recommendation of the Minister of welfare is approved by the Cabinet of Ministers. Central Director of the Foundation shall be appointed and relieved of the post of Welfare Minister.
10. Central: the Director 10.1. directs the Central Fund's work and is personally responsible for the central task and function of the Fund;
10.2. in matters within their competence, p atstāvīg decide the central activities of the Fund related issues;
10.3. the representative of the Central Fund and the sickness funds (with the authorisation of the relevant sickness funds) State and local government institutions, as well as the international level;
10.4. other laws and rules are array in the form prescribed by the Central Fund property and funds;
10.5. laws and other regulations in accordance with the procedure laid down by the central contracts for the technical operations of the Fund;
10.6. approve the Central Fund of the State dug up st;
10.7. closing contracts with Central Fund employees, appointed and released from Office by the Central Fund officials (servants candidates);
10.8. establish a central fund employees and civil servants (officials of the candidate) work and duties and responsibility i; prēm and otherwise 10.9. stimulates the Central Fund for employees and officers (civil servants candidates);
10.10. in matters within their competence, shall issue orders, instructions and give tasks that are mandatory for all employees and the Central Fund for civil servants (officials are candidates for those).
V. Central reorganisation and winding up of the Fund's Central Fund 11. reorganization and liquidation of the laws are carried out.
Vi. Transition issues 12. This rule 5.9 shall enter into force by 1 July 1998.
13. Be declared unenforceable in the Cabinet of Ministers on 4 June 1996 the rules no 198 "public sickness funds regulations" (Latvia's journal, 1996, no. 99).
 
Prime Minister G. Coast-Minister of Welfare economy Minister l. Strujevič in