Cabinet of Ministers Regulations No 821 in 2011 (19 October. No 60-57) amended the Cabinet of 31 October 2006, regulations No 899 "Outpatient treatments and medicines for the purchase of medical equipment for the refund order" Issued in accordance with article 5 of the law on Pharmacy's paragraph 20 1. make a Cabinet of 31 October 2006, regulations No 899 "Outpatient treatments and medicines for the purchase of medical equipment for the refund order" (Latvian journal, 2006, 180. No; 2007, 2008 54 no; , 53, 150. no; 2009, 22, 138, 155. no; 2010, 18, 94.172.206., no; 2011, 35, 51 no) 1.1. the following amendments: replace 4.2 3., paragraph 10, in the introductory part of paragraph 11, 17, 18, and 19, paragraph 18.1, in the introductory part of paragraph 20, 21, 22 in the introduction, and paragraph 37.1 29.1. the introductory part of point 38, 38.1, 38.3 points in the introductory paragraph, the introductory part of paragraph 43, 44 and 45 of the introduction, in paragraphs 44.1 47. the introductory part of point, 49, 50, 51, 53, 50.1. and 54, 55 of the introductory paragraph 58. in point, and 61.1, 61.2, 61.2 in the introductory part of paragraph 1, in the introductory part of paragraph 62, 62.1 points, 63, introductions to 63.7., 64.1, 65, 66 and 68, and 82.1 in 73.2. and 115.1 points, the words "health economics Centre" (the fold) with the words "national health service" (fold);
1.2. to replace 4.1 and 29.2 points, 63.6., 67, 67.1, the introductory part of paragraph 68, the introductory part of paragraph 69, 70, 71, 76 and introductions to 79, 82, in the introductory part of paragraph 82.2., 83, 84 and 87 of the introductory paragraph, 87.1, 87.4, 87.5 and. 92. the introductory part of point, 93.1, 94, 95, 96, 100, 101, 103, 100.1, 104 and 113 points in the "settlement" of the health centre (the fold) with the words "national health service" (fold);
1.3. to supplement subparagraph 6.1 after words "in the name of the medicinal product in General" with the words "corresponding to the" anatomic therapeutic chemical classification of the seven-character code (hereinafter referred to as the pharmaceutical generic name) ";
1.4. to complement the 35 in the third sentence by the following: "the reference price may be only one reference medicinal products listed in group or medical device.";
1.5. make 48 as follows: "48. The national health service has the right to review a number of patients, if analysis data suggest about the possibilities of specific medicinal products or medical devices for the planned compensation funds within bear medicine or medical equipment the purchase of larger number of patients."
1.6. to make 59 and 60 by the following: "59. The national health service, within 30 days after a decision on the medication or medical equipment into the C list prepared and signed a contract with the applicant about the specific medicinal products or medical devices quantity delivery free of charge medical authority that the national health service has entered into an agreement for the health services.
60. The national health service on medicinal products or medical devices into the C list shall be published in the newspaper "journal". The national health service's decision on the medicinal products or medical devices into the C list shall enter into force the day of its publication in the newspaper "Latvian journal". ";
1.7. put 2 section 61.2 by the following: "2. the countervailable 61.2 to include in the list of medicinal products, medicinal products and medical devices for a certain period of time. Compensation base price reduction for a certain period of time acceptable to the extent that it does not affect the reference price, and for a certain period at a reduced price is comparable to the reference price, ";
1.8. to express a point following 62.2: "38.6 To the compensation base price review by the applicant, the application of basic price compensation for review must be submitted by 15 October (if the changes expected with January 1) or 15 April (if the changes expected by July 1). The national health service received information within three working days on its internet site in the section "compensatible medication". Applicants have the right to seven working days beginning with the day after the application deadline (15 October or April 15), the national health service to submit a new application for compensation for the reduction of the base price below the lowest appropriate reference group prices offered under this rule 38.2 above about. The national health service information about the new offer price immediately on its internet site. If the national health service, gathering information on the new offer price, finds that a number of the applicants offered the lowest price of the relevant reference group is the same, the relevant applicants are prompted repeatedly to reduce proposed price, without applying the provisions referred to in paragraph 23.7. ";
1.9. Express 64 as follows: "64. National health service shall inform the applicant in writing of the decision taken and 10 days after its adoption will insert the appropriate information in the National Health Service Web site, as well as 15 days before the date of entry into force of the decision to inform the Health Ministry. The national health service changes in the list of eligible medicines, as well as part of the decision on the inclusion in the list shall be published in the Gazette C "journal". ";
1.10. to express a point following 64.2: ' 64.2 national health service that rule 61.2 3. the decision referred to in the basic price of the refund and the pharmacy price reduction for a certain period of time electronically notify the applicant, the Ministry of Health, the health inspectorate, the pharmacies that have agreements with the national health service, and medicine lieltirgotav no later than 30 days before the date of application of reduced prices, without making changes to the list of eligible medicines. Decision on compensation the basic price and drugstore price reduced for a certain period of time (A) the list of medicinal products or medical devices to electronically notify all relevant reference group of medicines or medical devices. ';
1.11. delete paragraph 67, the words ' economic Health Center ";
1.12. the deletion of 67.1 67.1. subparagraph 2 and 3, the words "health economics Centre";
1.13. make 71.4. subparagraph by the following: "71.4. schedule reserve 5%, less of the total financial resources rule 71.1, 71.2 this.., 71.3 and 71.6. funds referred to in paragraph;";
1.14. supplement with 71.6. subparagraph by the following: "the resources trapped in 71.6. existing persons.";
1.15. in paragraph 72 of the following expressions: "72. Information on the necessary financial resources for the national health service is obtained: 72.1. This provision 71.3. in the case referred to in subparagraph multiplied by the projected number of patients (taking into account management information system data for the previous period) with the next calendar year financial resources per patient;
72.2. This provision 71.6. in the case referred to in subparagraph multiplied by the prisons administration estimated the number of the specific patient diagnosis and diagnosis groups in the previous period, the country spent about financial resources for one patient the appropriate diagnosis or diagnose group. ";
1.16. in paragraph 75 of the following expressions: "75. National health service review eligible medicines specialties set includes medicines and medical devices and set the financial resources provided, where a decision has been taken about the changes in the list of eligible medicines.";
1.17. supplement with 79.1 points as follows: "calculation of the outpatient visits 79.1 number of family physician specialty, at a family doctor's appointments include the voluntary quality evaluation system of family doctor non nursing or physician assistant visits to get the amount of medicines or medical devices the recipe without a family doctor visit.";
1.18. delete paragraph 80;
1.19. the deletion of paragraph 83, the words "and to the economic center of health";
1.20. supplement 84 behind the words "on health services" with the words "or on the amount of the countervailable financial medicine and medical equipment for invoicing the relevant medical specialty";
1.21. supplement with 84.1, 84.3 points to 52.3 and by the following: "If the patient is 84.1 compensation procedures not previously received in the framework of the specific diagnosis for the eligible list (A) the medicinal product or medical device, a doctor on the special recipes for this diagnosis of the form extracts the General name or general medical device name.
If this provision accordingly 52.3 89 the drug or medical device use gives the desired therapeutic effect, the treatment continues with them. If they do not produce the desired therapeutic effect, the doctor instead of grass or other statement medical devices, starting with the lowest price generic name. Justification medicinal products or medical devices for the doctor tells the patient change the medical card. On the observed side effects doctor reported to the State Agency of medicines according to the legislation on medicinal products and medical devices, pharmacovigilance surveillance.

84.3 this provision if the doctor 84.1 in the case referred to in paragraph is prescribed by manufacturer-specific medicinal products or medical devices, the name national health service shall inform health inspection. ';
1.22. Express 88 and 89 the following wording: "88. eligible medicines and medical equipment service patient, which is not a reference medicinal product or medical device or not the cheapest generic name, pharmacy provides two days of special recipes. Reference, as well as cheaper generic name within the eligible medicines and medical equipment availability, which reference the Group of drugs or medical devices in pharmacies were requested last month, pharmacy provides throughout the pharmacy during the work item form for at least five days of moderate consumption. Reference, as well as cheaper generic name within the eligible medicines and medical equipment availability, which reference the Group of drugs or medical devices not required pharmacy last month, the pharmacy shall ensure, not later than 12 hours after receiving the special recipes for cities or 24 hours outside the city. If the deadline laid down in this paragraph ends outside pharmacies, medicinal products and medical devices must be available at the pharmacy within one hour of the pharmacy's working time.
89. If a doctor prescribing medication, taking eligible drug generic name, the pharmacist is obliged to issue the cheapest for this name, pharmaceutical form and strength corresponding to the eligible products. If the doctor when the eligible medical device, use a general name, the pharmacist is obliged to issue the cheapest for this name and use the appropriate eligible medical device. Methods prohibited under these conditions does not provide adequate medicinal products or medical devices. ';
1.23. make 91 as follows: "91. If the medicine is not lieltirgotav can purchase eligible list of medicinal products and medical devices for the base price or refund if you are not eligible for medicinal products and medical devices in existence, or lieltirgotav if the medicine of the lieltirgotav does not support the provision in paragraph 88 of the deadlines of the countervailable drug and medical equipment supplies, pharmacy shall inform health inspection. ';
1.24. delete paragraph 97;
1.25. Express 98. paragraph by the following: "98. National health service up to 10 January of the current year and 10 July gathers information for the previous six months received applications for medicinal products and medical equipment the purchase of compensation in the cases provided for in this chapter (even when drugs and medical equipment refused compensation), assess it and, if necessary, submit proposals to the Ministry of health of the necessary amendments to annex 1 of these rules.";
1.26. the express point 102 the following: "102. National health service denied the purchase of medicinal products, if: is taken negative 102.1. the decision on the concerned medicinal product or medical device into the list of medicinal products eligible for the specific diagnosis and treatment for eligible medicines list includes other drugs with the same indications registered;
102.2. drugs and medical devices to compensate for the purchase of individual cases in the year allocated funds are spent;
102.3. konsilij decision does not comply with the provisions referred to in paragraph 93 of the requirements;
102.4. patient under these rules referred to in annex 1. diagnosis are available other eligible list of medicinal products with the same medicinal general name or the name of the same medical device;
102.5. The national health service said that drug or medical device choice is not justified;
102.6. in accordance with the regulations on the procedure for the classification of medicinal products medicinal products classified as non-prescription drugs, other than that necessary for patients with cystic fibrosis life function. ";
1.27 104.1 points to express the following: "these rules 104.1 monitoring carried out within its competence, the national health service and health inspection. ';
1.28. the supplement to chapter XIII of the following paragraph 118: "118. This rule 62.2 requirements referred to in 2011, starting with the 1st of November, and a new application for compensation under the base price below the respective reference groups prices offered under this rule 38.2 points in approximately may be submitted within seven working days beginning with the day after the November 1.";
1.29. replace paragraph 3 of annex 3, the words "health economics Centre" with the words "national health service".
2. This provision 1.1., 1.2., 1.3., 1.5., 1.6, 1.8, 1.9, 1.10, 1.11, 1.12, 1.13, 1.15, 1.16, 1.17.., 1.18, 1.19, 1.20., 1.24, 1.25, 1.26, 1.27, 1.28.. and 1.29. subparagraph shall enter into force on 1 November 2011.
3. This rule 1.4, 1.7, 1.14, 1.21, 1.22 and 1.23 point. shall enter into force on January 1, 2012.
Prime Minister v. dombrovsky Health Minister j. Bārzdiņš