Cabinet of Ministers Regulations No. 654 in 2012 (25 September. No 53 23) amendments to the Cabinet of Ministers on 19 December 2006, regulations No. 1046 "health care organization and financing arrangements" Issued in accordance with article 4 of the law on medical treatment, first subparagraph 1. make Cabinet on 19 December 2006, the provisions of no. 1046 "health care organization and financing arrangements" (Latvian journal, 2006, 208. No; 2007, 146.207. no; 2008, no. 118, 202; 2009, 25, 49, 104, 157, 183. 206. no; 2010, 16, 65, 89, 130, no. 161; 2011, 2., 8., 66, 90, 102, 158, 205. no; 2012, 52, 100, 134 no). the following amendments: 1. Express 14.6. subparagraph by the following: ' 14.6. for stem cell banking and cell bank maintenance; " 1.2. the Supplement 14.22.3. section behind the words "physician home visits to" with the words "children, the State limited liability company" children clinical University Hospital "palliative care study records, and"; 1.3. to complement the 14.26.3. section behind the words, "with predictable (imminent) disability" with the words and figures "and diseased persons aged 15 years up to the age, which according to the existing laws of the old-age pension is granted (hereinafter referred to as the working-age) under this provision." point; 97.6 1.4. the Supplement 14.37.9. section behind the words "individual rehabilitation plan" with the words "and the number and diseased persons of working age under this provision subparagraph"; 97.6. 1.5. to complement the 29 behind the words "media" with the words "or services home page on the internet, where the area concerned is not possible the information notified the local media"; 1.6. make 56.9 points as follows: "the payment for outpatient laboratory 56.9 Services service from the funds made available to the family doctor and secondary ambulatory health-care specialists are controlled in accordance with the provisions of chapter V1 If outpatient laboratory service provider has provided services in the month that the payment amount is greater than 5 000 lats, then by making outpatient laboratory services pay for the service provider, the service will apply a factor of 0.9 whole amount payable in the month concerned. "; 1.7. to supplement the rules with 97.5. and 97.6. subparagraph by the following: "97.5. the payment for health care services provided to a person with a disability, the forecast established in accordance with the laws and regulations, according to the actual number of days this provision 22. Annex 3 days laid down in the tariff, and the tariff for manipulation of these rules in annex 18. marked with an asterisk (*); payment for such 97.6. health care services provided to the diseased persons continued working-age to prevent disability, membership according to the actual number of days this provision 22. Annex 3 days laid down in the tariff, and the tariff for manipulation of these rules in annex 18. marked with an asterisk (*): 97.6.1. medical rehabilitation services under the rehabilitolog or physical medicine and rehabilitation physician of the rehabilitation plan developed in patients after stroke After kardioķirurģiskaj operations, and after the great joint arthroplasty; 97.6.2. in accordance with decision konsilij the doctor in which the presence of a high uptime threatening, specified the applicable treatments and based their choice to prevent the accession of disability for persons suffering for more than three months: 97.6.2.1. surgical or rehabilitation services for patients with injuries, politraum, dorsopātij, nerve, nerve roots and Plexus pathology, izgulējum, Burns, frostbite; 97.6.2.2. Interventional Cardiology services patients after infarction; 97.6.2.3. surgical services for patients with imminent blindness (cataract, glaucoma and other eye diseases and their subsidiary body). "; 1.8. to supplement the provisions of the following paragraph 102.2: "102.2 medical authorities carrying out systematic big joint arthroplasty, create and maintain such patient waiting lines: 102.2 Arthroplasty 1. as a matter of urgency under this provision 32. criteria referred to in the annex; 102.2 2. Arthroplasty with 50% of the expenses; Arthroplasty 3. General Arthroplasty 102.2. "; 1.9. to express a point following 103.1: "this rule 103.1 22.3.2.27.1., 3.2.27.1.1 3.2.27.3., 3.2.27.4., 3.2.27.6. and above the specified tariff treatment of one patient by taking elective Arthroplasty, including Arthroplasty in a matter of urgency, based on the rules referred to in Annex 32 medical indications that patients approved by the medical institution created a big problem doctor konsilij joints, includes all the materials needed for Arthroplasty."; 1.10. the deletion of 103.2 points; 1.11. to express a point following 103.3, "103.3 the tariff treatment of one patient, if the patient and the medical establishment agreed in writing, shall be borne by the patient Arthroplasty Arthroplasty spending 50%, this provision is specified in annex 3.2.27.2 22, 3.2.27.5 and 3.2.27.7. in."; 1.12. supplement with 103.4 and 103.5 points as follows: 103.4 service planning "elective hip arthroplasty of the means necessary to provide 90% of cases the use of the cementējam endoprotēz, 10% of cases – bezcement and the use of hybrid endoprotēz according to the rules referred to in Annex 32 medical indications. The medical establishment, performing elective hip replacement Arthroplasty, respect this proportion. 103.5 If patient who is in the standby line for hip arthroplasty, choose another type of endoprotēz than pay State, the patient pays 22. these provisions prescribed in paragraph 3.2.27.1.2 of annex a of the tariff treatment of one patient (50% of patient treatment full tariff without endoprotēz value) and the full price of the selected endoprotēz according to the invoice issued by the authority. Service authority pays the treatment this provision in subparagraph 3.2.27.1.2 of annex 22 specific patient treatment tariff (50% of patient treatment full tariff without the endoprotēz value). "; 1.13. delete paragraph 2 and 130.9 130.9 2.1; 1.14. Express 2.2, 130.9 130.9. the introductory part of point 3, 3.1 and 3.2 130.9 130.9. subparagraph by the following: "2.2 if actual 130.9 laboratory study planned for settlement funds have exceeded the period corresponding to the full months for which data are available the service management information system, additional financial resources appropriated an amount corresponding to the difference between the actual period of laboratory examination and planned for this period, the amount of financial resources by applying the coefficient corresponding to the remaining months of the calendar year concerned and, in the case of laboratory examination for extra pay a certain amount of financial resources – up to this amount, and the means used for this rule 110.3 1., 2., and 3.110.3 110.3 laboratory referred to the service fee, if the Cabinet is not ruled otherwise; 3. financial resources 130.9 diagnostic study, specialists and days fixed for payment of services provided for those secondary ambulatory directs health care providers that health care services are provided not less than 90% of the contract volume of the planned financial assessment period, which corresponds to full months for which data are available the service management information system, in that order, if the Cabinet is not ruled otherwise: 130.9 3.1 funding priority shifts to those health care providers that no less than 85% of the total contract amount spent on children provided by the health services fee, as well as health care providers who provide haemodialysed, chemotherapy and radiation therapy services days site, provides expert advice and in Oncology, hematology and radiation therapy services; 130.9 3.2. the remaining financial means in proportion to the amount of the planned Treaty and subject to the remainder of the calendar year concerned months redirects overall diagnostic study, and daily inpatient services provided for payment; " 1.15. delete paragraph 3.3 130.9; 1.16. Express 130.9 3.4. subparagraph by the following: "If the 130.9 3.4 secondary ambulatory health-care services provided in the service assigned to pay a certain amount of financial resources, the allocation of financial resources, not exceeding that amount;" 1.17. delete paragraph 3.5 of 130.9; 1.18. delete paragraph 154; 1.19. the express section 233.3 5 by the following: "5.233.3 rehabilitation services for patients with diagnosis I60 I61, I63, I64, I69, and children, the State limited liability company" children clinical University Hospital "palliative care study accounting;"; 1.20. supplement with 304. paragraph by the following: "304.  in 2012, in addition to the payment of funds for patient observācij hospital admissions department under this provision 22. point 1 of the annex service distributed in the following order: 304.1. This provision of the annex 24 1.1.1., 1.1.2, and 1.1.3 treatment referred to in paragraph authorities increase the contractual benefits for patient observācij up to 24 hours of total funding for 2012, setting it in this: 304.1.1. State limited liability company "children clinical University Hospital"-$ 147 819; 304.1.2. public limited liability company "Paul stradins clinical University Hospital"-$ 117 128; 304.1.3. limited liability company "Riga Eastern clinical University Hospital" – Ls 178 836; 304.2. other provisions of the annex 1 of 24 in the medical institutions of the premium on patient observācij up to 24 hours of total funding for 2012 determined, obtained, this provision 22. Annex 1 of the 5 point amounts in box one twelfth times six. If the medical establishment is provided for observācij of patients in less than six months, then the funding paid for patient observācij, the rules of calculation in annex 1, paragraph 22, of the concerned point 5 amounts shown in box one twelfth times the number of months in which the medical establishment under service management information system the information entered on the health services has provided patient observācij. Specific funding for the months when the patients were not provided, observācij service medical authority directs secondary ambulatory health services. "; 1.21. delete paragraph 12.17. of annex 2; 1.22. Express 17. point 1 of the annex by the following: "1. the criteria for the calculation of the premium fixed for urgent medical assistance (SMPP) operation: no PO box The number of Cabinet level medical treatment and patient load of care load of 1.1 persons. level 1 1 1 1 1 3.5 4.5 4.5 3.5 3.5 4.5 1.2. 2. level 2/1 7.5 4.5 1.3. 3. level 3/2 12.0 7.5 "1.23. Express 17.10.1. subparagraph by the following:" 10.1.  level 1 – urgent medical assistance and trauma provides one doctor with one nurse or medical assistant for the 24-hour or 24-hour (weekends and public holidays (24-hour) and weekdays (16.00 – 08.00)) mode or one doctor's Assistant, 24-hour or 24-hour (weekends and public holidays (24-hour) and weekdays (16.00 – 08.00)) mode. If the patient's condition of treatment a person assessed as severe, which requires hospitalization, is called the emergency medical team to deliver the appropriate level of the patients in the hospital; " 1.24. delete paragraph 13 of Annex 17; 1.25. Express 18.1202. paragraph by the following: "1202. 20282 * Artroskopisk shoulder joints in subakromiāl decompression or stabilising operations (pay only outpatient or day hospital. 24-hour hospital in cases where payment is not possible contraindications take days in hospital). Hide with manipulation 20,288,344.85 "1.26. Express 18.1204. point as follows:" 1204. 20284 * Artroskopisk shoulder rotator tendons of suturing. Hide with manipulation 20,288,319.54 "1.27 Supplement 18. attachment with 1330.1 and 1330.2 point as follows:" the abdominal aortic 1330.1 22011 Arthroplasty surgery with endoprotēz value of 7689.63 the chest aorta 1330.2 22012 Arthroplasty surgery without stentprotēz 1150.40 "the value of 1.28. supplement with 1355.1 and annex 18, paragraph 1355.2 as follows:" 1355.1 22048 * bonus on abdominal aortic endoprotēz 1441.00 1355.2 the extension of the use of the supplement for stentprotēz 22049 chest aorta for Arthroplasty 1.29. "6769.15 express" section of annex 18 other sections not included manipulation (manipulation 60001-60339; 60400-60413) "in paragraph 3 of the introductory paragraph by the following:" 3. the health care home Assistant set levels (feldšer) or sisters work and pay (except to the patient that requires long-term artificial lung ventilation and services lists using 60250 60251, tampering, 60252): level 1 (oral medication distribution; subcutaneous injections, intrakutān; Intramuscular injection; injection intravenously; primary-healing wound care, removal of thread; kolostom care; ileostom care; not frostom care cistostom care) – manipulation 60259; level 2 (infūz, intravenously; secondary healing wounds pārsiešan; izgulējum care; the trophic ulcers treatment; tube feeding through the probe; traheostom; gastrostom care care; urinary catheter care; home care for children up to 14 years) – manipulation 60260. "; 1.30. Express 18.3030. Annex paragraph by the following: "3030. 60009 * bonus on drugs in patients with diagnoses N70, N71, N, N, N 73.3 73.0, O85, O86 73.5, T81, which transferred from other hospitals for surgical treatment and intensive therapy on the clinical University Hospital (one days) 52.20 "1.3.1. Express 18.3032 and 3033. Annex, paragraph by the following:" 3032. * Do not operate on patients 60011 treatment Department of national kardioreanimācij society with limited liability "children clinical University Hospital" (on one of the days). Hide together with manipulation and 30.99 60028 60031 3033. 60012 * 0.1% of the premium for the drug methadone solution (Methadon oral solution) once a 0.69 "1.32 express 18.788. paragraph by the following:" 3036. treatment of thoracic surgery 60015 Department of university hospitals. Service ' thoracic surgery ' patients 0.00 "1.33 express 18.3042 and 3043 annex. the following paragraphs:" 3042. the Cpr State 60028 society with limited liability "children clinical University Hospital" (on one of the days). Hide together with manipulation and 30.99 3043 60031 60011. the Surgery treatment of patients 60031-kardioreanimācij of the national society with limited liability "children clinical University Hospital" (including medicine) (for one days). Hide together with manipulation and 60028 81.00 60011 "1.34. supplement with 3.9 Annexes 19. subparagraph by the following:" 9. the Group of experts 3.9: no PO box Specialty name 3.9.1. Gynecologist, birth * note. * Taking a previously investigated patients artificial fertilization service receipt line specialized medical institution. ";
1.35. to supplement annex 19 with 6.9. subparagraph by the following: "6.9. 9. the Group of experts shall 12.00 "1.36. Express 22. point 1 of the annex by the following:" 1. the fixed premium for the ambulances and patient Admissions Office action no PO box Hospital (hospital or group) name number of specialists of the premium Fixed annual amount (Ls) premium on patient observācij of up to 24 hours per year ($) 1.1. State limited liability company "children clinical University Hospital" 13 810 485 204 323 1.2. State limited liability company "Paul stradins clinical University Hospital" 9 596 360 138 630 1.3. Limited liability company "Riga Eastern clinical University Hospital" 13 843 058 236 582 1.4. Limited liability company "liepājas regional hospital" 7 463 835 33 270 1.5. Society with limited liability "Ziemeļkurzem regional hospital" 7 463 835 32 346 1.6. Limited liability company "Daugavpils regional hospital" 7 463 835 83 028 1.7. Municipal limited liability company "Rezekne hospital" 7 463 835 29 233 1.8. Limited liability company "Vidzeme hospital" 7 463 835 32 662 1.9. Limited liability company "Jelgava City Hospital" 7 463 835 38 304 1.10. Limited liability company "Jēkabpils district Central Hospital" 7 463 835 35 653 1.11. Limited liability company "seaside hospital" 3 198 787 8658 1.12. Society with limited liability "the OGRE district hospital" 3 198 787 14 665 1.13. Limited liability company "Tukums hospital" 3 198 787 13 449 1.14. Limited liability company "Kuldīga hospital" 3 198 787 11 601 1.15. Limited liability company "Preili hospital" 3 198 787 3794 1.16. Limited liability company "Krāslava hospital" 3 198 787 6104 1.17. Madona district municipal limited liability company "Madona hospital" 3 198 787 12 890 1.18. Limited liability company "award and Gulbene Hospital Association "3 198 787 15 735 1.19. Limited liability company "Cēsis clinic" 3 198 787 15 127 1.20. Limited liability company "Alūksne hospital" 3 198 787 8074 1.21. Limited liability company "Dobele and surroundings in the hospital" 3 198 787 12 403 1.22. State limited liability company "national rehabilitation center" "" 1.23 1 61 841 Vaivara. The Riga Municipal limited liability company "Riga City maternity House" 4 247 365 1.24. State limited liability company "Riga psychiatric and addiction centre ' 2 122 440 1.25. The Riga Municipal limited liability company "Riga hospital 2 ' 2 132 524 1.26. State limited liability company "Orthopaedics and orthopaedic hospital" 4 265 049 1.27. State limited liability company "State hospital" of Straupe 1 61 252 "1.37 to make 22.2.1.16. subparagraph by the following:" 2.1.16. Kohleār implant implantation in children 0-17 H 90.3 60093; 18159; 18160; 18161; 18162 "1.38 Express 22.2.1.27.1. section of the annex as follows:" 2.1.27.1. including hip replacement Arthroplasty with cementējam of endoprotēz M-9.9 M 10.5; 84.1 m; 87.0 m; 96.0 m; S + 72.0 20230 20234; 20230 + 20234 + 30,753 "1.39. Supplement 22. attachment with 2.1.27.1.1 and 2.1.27.1.2 the following subparagraph:" 2.1.27.1.1 Hip Arthroplasty with bezcement fixation or hybrid type endoprotēz M-9.9 M 10.5; 84.1 m; 87.0 m; 96.0 m; S + 72.0 20231 20233; 20231 + + 20244 20233; 20276 + 20400; + + 20400 30,753 20276 2.1.27.1.2 Hip Arthroplasty without endoprotēz (with 50% of pay) M-9.9 M 10.5; 84.1 m; 87.0 m; 96.0 m; S 72.0 20230; 20231; 20276 "1.40. Express 2.1.27.2 in annex 22. subparagraph as follows:" 2.1.27.2. Hip Arthroplasty with cementējam of endoprotēz (with a 50% pay) 9.9 M-M 10.5; 84.1 m; 87.0 m; 96.0 m; S + 72.0 20230 20234; 20230 + 20234 + 30,753 "1.41. Supplement 22. Annex paragraph 2.1.56. and 2.1.57., the following wording:" 2.1.56. Abdominal aortic Arthroplasty 71.4, s I, I, I, 71.0 71.3 79.1, 70, S 2.1.57 I 21.7 22011. Thoracic aortic Arthroplasty I 65.0; (I) 71.0; (I) 71.1; (I) 71.2; (I) 71.5; (I) 71.6; (I) 44.6; (I) 71.9; S 25.0 22012 "1.42 express 22. subparagraph 3.2.27.1 of the annex by the following:" 3.2.27.1. including hip replacement Arthroplasty with cementējam endoprotēz of 001.10 001.10 1 001.10 1 001.10 1 001.10 1 1 "1.43. Supplement 22. attachment with 3.2.27.1.1 and 3.2.27.1.2 the following subparagraph:" 3.2.27.1.1 Hip Arthroplasty with bezcement fixation or hybrid type endoprotēz 1 1 1 1 666.70 666.70 666.70 666.70 1 666.70 3.2.27.1.2 Hip Arthroplasty without endoprotēz (with 50% of pay) 318.55 318.55 318.55 318.55 318.55 "1.44. Express 22. subparagraph 3.2.27.2 of the annex the following a. : ' 3.2.27.2. Hip Arthroplasty with cementējam of endoprotēz (with a 50% pay) 500.55 500.55 500.55 500.55 500.55 "1.45 to supplement annex with 22 and paragraph 3.2.56.3.2.57. by the following:" 3.2.56. Abdominal aortic Arthroplasty 8 860.00 3.2.57. Thoracic aortic Arthroplasty 12 946.80 "1.46. Express 22. section 3.5 of the annex by the following:" 3.5. One days charge the patient care that requires long-term artificial lung ventilation 16.11 clean 16.11 clean 16.11 clean 16.11 clean 16.11 clean 16.11 clean "1.47. Supplement 16.11 clean 16.11 clean 22. attachment with 5.465.1 and 5.465.2 the following subparagraph:" the abdominal aortic 5.465.1 22011 Arthroplasty surgery with endoprotēz value 5.465.2 22012 breast aortic Arthroplasty surgery without stentprotēz "the value of 1.48 to supplement annex 24 to 5. Note as follows:" (5) if any of the provisions of annex 24 7.2 or 7.3. in those treatment institutions in the application of the services of the bull that close contact with this treatment in contract for a lower level of urgent medical service of the pirmsslimnīc of the step, the provision of service by reviewing the hospital's financial volume, ensure appropriate contract. "; 1.49. the supplement to Annex 31 1.5. subparagraph by the following: "1.5. Imūnbioloģisk preparations: 1.5.1 to Tetan gene; 1.5.2. Diphtheri the antitoxin; 1.5.3. Botulinum antitoxin (A); 1.5.4. Botulinum antitoxin B; 1.5.5. Botulinum antitoxin E; 1.5.6. Snake venom antiser; 1.5.7. Rab in serum; 1.5.8. Rab to gene. "; 1.50. Express 32. attachment as follows: "Annex 32 Cabinet on 19 December 2006, regulations no 1046 of the medical indications for Arthroplasty of large joints as a matter of urgency and the bezcement component selection Arthroplasty 1. Clinical indications for Arthroplasty of large joints as a matter of urgency: 1.1. hip joint arthroplasty in a matter of urgency: 1.1.1 the femur head diversion more than 10 mm cranial during the year; 1.1.2. the femur head diversion medial behind Koher lines; 1.1.3. the koksartroz of both hip joints, if after one hip replacement surgery leg length difference is greater than 30 mm; 1.1.4. rapidly progressive hip joint degeneration or Contracture patients younger than 50 years; 1.1.5. don't thing thighbone neck fracture; 1.2. the knee arthroplasty in a matter of urgency: 1.2.1 knee lateral or medial focused deformation greater than 25 degrees; 1.2.2. knee high lielkaul kondiļ of the defect, which exceeds the small distal lielkaul heads; 1.2.3. the knee extension shortfall more than 20 degrees; 1.2.4. the rapidly progressive joint degeneration or Contracture patients younger than 50 years; 1.2.5. paraartikulār are unhealed broken bones or joints joints for endoprotezēt with degenerative changes; 1.3. joint arthroplasty of the shoulder as a matter of urgency: 1.3.1. shoulder bone heads or pseidartoz thing to fracture and not not possible an adequate osteosintēz; 1.3.2. the shoulder proximal end of bone tumor; 1.3.3. the shoulder joints of manžet of artropātij of advanced rotator with glenoīd edge wear more than 2 mm and subakromiāl space reduction below 5 mm (according to the datortomogrāfisk examinations); 1.3.4. rheumatoid arthritis patients with glenoīd edges or central wear over 2 mm (according to the datortomogrāfisk examinations); 1.4. other emergency cases, according to the national society with limited liability "Orthopaedics and orthopaedic hospital" konsilij's opinion.
2. the medical indications for Arthroplasty of the hip joint bezcement component selection: 2.1. expressed in hip joint hole (acetabul) dysplasia (not development) or collapse, which the endoprotēz of the cementējam of the primary component, stable fixation is not possible and the need to create additional backing from the autokaul, allokaul or metal augment; 2.2. the upper end of the tibia proximal congenital or acquired (disease, trauma or surgery) bone in form and structure, which is not possible in this zone of the endoprotēz component, stable fixation with cement, but the endoprotēz of the possible bezcement of the distal part of the Shank Bone in the channel ieķīlēšan; 2.3. the upper part of the kortikāl proximal bone layer defects after the metal latch removal of bone. " 2. provisions applicable to the 1 October 2012. Prime Minister v. Minister of health I dombrovsky. Cricket»