Key Benefits:
ACT
of 27 August 2004
o public health care benefits financed by public funds
SECTION I
General provisions
Chapter 1
Subject and subjective scope and explanation of statutory terms
Article 1. [ Substantive Scope] The Act shall specify:
1) the conditions for granting and the extent of health care benefits financed from public funds;
2. the rules and mode of financing of the benefits referred to in point 1;
2a) the rules and mode of qualification of health care benefits as guaranteed benefits;
3) the task of the public authorities in ensuring equal access to the benefits referred to in point 1;
4) the principle of universal-compulsory and voluntary health insurance;
(5) the institutional and procedural basis for the application of Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004. on the coordination of social security systems (Dz. Urz. EC L 166, 30.04.2004, p. 1, from late. zm.; Dz. Urz. EU Polish Special Edition, rozdz. 5, t. 5, str. 72, z późn. zm.), Regulation (EC) No 987/2009 of the European Parliament and of the Council of 16 September 2009. concerning the implementation of Regulation (EC) No 883/2004 on the coordination of social security systems (Dz. Urz. EU L 284, 30.10.2009, p. 1, from late. zm.) and Regulation (EU) No 1231/2010 of the European Parliament and of the Council of 24 November 2010. extending Regulation (EC) No 883/2004 and Regulation (EC) No 987/2009 to nationals of third countries who are not yet covered by these Regulations solely on the ground of their nationality (Dz. Urz. EU L 344, 29.12.2010, p. 1);
6) the rules of operation, organization and tasks of the National Health Fund, hereinafter referred to as the "Fund";
6a) the rules for the operation, organisation and task of the Agency for the Evaluation of Medical Technologies and Codification, hereinafter referred to as "the Agency";
(7) the principles of supervision and control over the financing and implementation of the benefits referred to in point 1.
Article 2. [ Persons with a right to benefit from public health care benefits] 1. To the use of health care benefits financed from public funds under the principles laid down in the Act shall have the right:
1) persons covered by the general-compulsory and voluntary health insurance, hereinafter referred to as "insured",
2) other than insured persons residing in the territory of the Republic of Poland who hold Polish citizenship or obtained in the Republic of Poland a refugee status or subsidiary protection, or a residence permit the time granted in connection with the circumstance referred to in Article 159 par. 1 point 1 lit. c or d of the Act of 12 December 2013. o foreigners (Dz. U. Entry 1650, of late. zm.), meeting the income criterion referred to in art. 8 of the Act of 12 March 2004. of social assistance (Dz. U. of 2016 r. items 930 and 1583), for which no circumstances have been found, referred to in art. 12 of this Act, on the basis of and within the limits specified for the insured,
3) other than those mentioned in points 1 and 2 of the person who has not completed 18. Years of age
(a) having Polish citizenship, or
b) which obtained in the Republic of Poland the refugee status or supplemental protection or temporary residence permit granted in connection with the circumstance referred to in art. 159 par. 1 point 1 lit. c or d of the Act of 12 December 2013. o foreigners, having their place of residence on the territory of the Republic of Poland
4) other than those mentioned in points 1-3 of the person holding a place of residence on the territory of the Republic of Poland, which are during pregnancy, childbirth or addiction:
(a) having Polish citizenship, or
b) which obtained in the Republic of Poland the refugee status or subsidiary protection, or a temporary residence permit granted in connection with the circumstance referred to in art. 159 par. 1 point 1 lit. c or d of the Act of 12 December 2013. o foreigners
-hereinafter referred to as 'the recipients'.
2. Persons who do not possess Polish citizenship, other than the provider, provide health benefits on the basis specified in the separate provisions and international agreements.
Article 3. [ Insured] 1. The safes are:
1) persons holding the nationality of a Member State of the European Union or a Member State of the European Free Trade Agreement (EFTA), residing in the territory of a Member State of the European Union or a Member State The European Free Trade Agreement (EFTA),
2) persons without citizenship of a Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA)-parties to the agreement on the European Economic Area or the Swiss Confederation, which are staying on the territory of the Republic of Poland on the basis of a visa in order to perform work, a temporary residence permit excluding an authorisation granted on the basis of art. 181 par. 1 of the Act of 12 December 2013. o foreigners, permanent residence permits, residence permits for a long-term resident of the European Union, consent to stay for humanitarian reasons, consent for tolerated stay,
2a) persons who have obtained in the Republic of Poland the refugee status or subsidiary protection or enjoy temporary protection in its territory,
(3) persons without citizenship of a Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA) legally residing in a territory other than the Republic of Poland of a Member State of the Union European or Member State of the European Free Trade Agreement (EFTA)
-if they are subject to an Article 66 compulsory sickness insurance or insurer shall be voluntarily insured under the rules laid down in the Article. 68;
(4) persons having the nationality of a Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA), not residing in the territory of a Member State of the European Union or of a Member State The European Free Trade Agreement (EFTA), if they are subject to the obligation of health insurance on the territory of the Republic of Poland and are covered by:
(a) pension and disability insurance under the provisions of the Act of 13 October 1998. o Social Security System (Dz. U. of 2016 r. items 963, 1247 and 1579),
(b) the social insurance of farmers under the provisions of the Act of 20 December 1990. o social insurance of farmers (Dz. U. of 2016 r. items 277).
2. Security is also provided:
1) students and participants of doctoral studies who study in the Republic of Poland, and graduates who take place in the Republic of Poland a compulsory internship, without citizenship of a member state of the European Union or a state of the European Free Trade Agreement (EFTA) and not the persons referred to in paragraph 1. 1 point 3,
2) members of the nuns and alumni of higher clergy and theological seminars, postulants, novices and juniors of the orders and their counterparts who do not hold the citizenship of a Member State of the European Union or a Member State The European Free Trade Agreement (EFTA)-the parties to the Agreement on the European Economic Area and are not the persons referred to in paragraph 1. 1 point 3 and stay in the territory of the Republic of Poland on the basis of a visa, a temporary residence permit, a permanent residence permit, a residence permit for a long-term resident of the European Union, consent for a stay on humanitarian grounds, consent to stay tolerated or have obtained in the Republic of Poland refugee status or subsidiary protection or benefit from temporary protection in its territory,
2a) (repealed)
3. an adaptation internship,
4) holding Polish language courses and preparatory courses for the taking of teaching in the Polish language referred to in the regulations on higher education, not possessing the nationality of a Member State of the European Union or a Member State The European Free Trade Agreement (EFTA) and not the persons referred to in paragraph 1. 1 point 3
-if they are insured voluntarily in accordance with the rules laid down in the Article. 68;
5) the members of the families of the persons referred to in the mouth. 1 (1) and (3), residing in the territory of a Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA), if they are not persons subject to the health insurance obligation referred to in art. 66 (1) 1, subject to Article 66 (1) 2 and 3, nor are they entitled to health care benefits under the rules on coordination;
6) the members of the families of the persons referred to in the mouth. 1 points 2 and 2a, residing in the territory of the Republic of Poland if they are not persons subject to the obligation of health insurance, referred to in art. 66 (1) 1, subject to Article 66 (1) 2 and 3.
Article 4. [ Persons not subject to compulsory insurance] Insurance is not subject to, subject to Article 3, foreigners residing in the territory of the Republic of Poland, including foreigners employed in foreign diplomatic representations, consular offices, missions, special missions or international institutions, unless the agreements International ratified by the Republic of Poland provides otherwise.
Article 5. [ Definitions] The terms used in the Act shall mean:
1. outpatient health care-providing healthcare benefits to persons who do not require treatment in 24-hour or all-day conditions;
2) a pharmacy-a public pharmacy or a pharmacy point with which the Fund has concluded an agreement for the issue of a medicinal product, a foodstuff intended for particular nutritional uses and a medical device subject to a refund;
(2a) continuity of health care provision-the organisation of health care provision ensuring the continuation of the diagnostic or therapeutic process, in particular limiting the risk of disruption of the treatment process witnesses within the scope of a given scope of health care services implemented on the basis of a contract for the provision of health care services, on the day of submission of the offer in the proceedings for concluding contracts;
3) family member-the following persons:
(a) the child's own child, spouse, child, grandchild or foreign child for whom custody has been established, or a foreign child within the foster family or family home, to be completed for 18 years and if he/she learns further in the schools, teachers ' training establishments, university or doctoral research unit-for the completion of 26 years, whereas if there is a judgment with a significant degree of disability or other treatment on an equal footing-without limitation age,
(b) the spouse,
(c) pre-insured persons who have been insured in the common household;
4) a health insurance feller-a feller or a senior richer providing health care services to the healthcare provider with whom the provision of health care services has been concluded;
5) an invalid war or military person-the person referred to in art. 6-8 or in art. 30 of the Act of 29 May 1974. the procurement of war and military invalids and their families (Dz. U. of 2016 r. items 871);
(5a) the civilian blind victim of hostilities-the person referred to in art. 1 (1) 2 of the Act of 16 November 2006. with a cash benefit and the civil rights of the blind victims of the cessation of hostilities (Dz. U. Entry 1824, of 2010. items 1465 and 2011 items 696);
(6) institution paying the pension, the institution paying the structural pension in accordance with the provisions on structural measures, the provisions on the promotion of rural development from the appropriations under the Guarantee Section of the European Fund Agricultural Guidance and Guarantee, or in support of rural development, with the contribution of the European Agricultural Fund to Rural Development;
7) Combatant-the person referred to in art. 1-4 of the Act of 24 January 1991. about combatants and some individuals who are victims of war repression and post-war period (Dz. U. of 2016 r. items 1255);
7a) comprehensiveness of health care benefits-the possibility of realization of health care benefits in a given range covering all stages and elements of the process of their implementation, in particular the structure of health care benefits in the given the scope;
8) the beneficiary-organisation, entity, public administration authority and the business unit referred to in art. 42 par. 1 of the Act of 24 April 2003. about the activity of the public benefit and about the volunteer (Dz. U. of 2016 r. items 239 and 395);
9) medicine-a medicinal product within the meaning of the Act of 6 September 2001. -Pharmaceutical law (Dz. U. of 2008 items 271, with late. zm.);
10) (repealed)
11) a prescription drug-a medicinal product which is drawn up in a pharmacy on the basis of a medical prescription;
12) (repealed)
13) (repealed)
14) doctor of health insurance-doctor, dental practitioner, with whom the Fund has entered into an agreement for the provision of health care services, or a doctor, dental practitioner who is employed or pursues a profession in the healthcare provider with whom the Fund has entered into an agreement for the provision of health care services;
14a) migration of insured persons-the use of insured persons and persons entitled to health care benefits under the rules on coordination, registered in a given provincial branch of the Fund, from the health care benefits provided by healthcare providers who have entered into contracts for the provision of health care services with other branches of the Fund, or the acquisition by the insured persons and persons entitled to health care benefits under the rules on coordination, registered in a given provincial branch of the Fund, medicines and articles medical, free of charge, for a lump sum payment or for partial payment, in pharmacies operating on the territory of other branches of the Fund's voivodship;
(15) minimum remuneration-the minimum remuneration referred to in Article 2. 3-5 of the Act of 10 October 2002. with a minimum wage for work (Dz. U. of 2015 items 2008 and 2016 items 1265);
15a) National Health Account-a summary of all health expenditure, taking into account the sources of health funding, providers of medical services and the functions of these services, based on the principles of transparency and reliability of the collected the data;
16) (repealed)
17. disabled-the person referred to in art. 4-5 and 62 of the Act of 27 August 1997. about professional and social rehabilitation and employment of people with disabilities (Dz. U. of 2011 r. items 721, of late. zm.);
17a) night and public health care-the provision of health care in the field of primary health care provided by the healthcare providers outside the working hours specified in the contracts for the provision of basic health care, in In particular, on holidays and holidays, in the event of a sudden illness or a sudden deterioration in the health of the recipient, which is not a sudden condition;
18) an adaptation internship-an applicant on an adaptation period within the meaning of the provisions of the Act of 22 December 2015. on the rules for the recognition of professional qualifications acquired in the Member States of the European Union (Dz. U. of 2016 r. items 65);
19) a homeless person leaving homelessness-a person subject to an individual scheme of homelessness in accordance with the provisions on social assistance;
(20) a person who receives a pension or an annuity, a person who is covered by a pension provision or a structural pension under the Law of 26 April 2001. Structural reforms in agriculture (Dz. U. Entry 539, 2003 items 2273 and 2004 items 873) or the Act of 28 November 2003. on the promotion of rural development from the Guarantee Section of the European Agricultural Guidance and Guarantee Fund (Dz. U. of 2014 items 1613 and from 2016. items 1579), and a person receiving a pension from abroad;
21. a person carrying out non-agricultural activities, a person referred to in art. 8 ust. 6 of the Act of 13 October 1998. the social security scheme;
22) repressed person-person referred to in art. 12 (1) 2 point 1 of the Act of 24 January 1991. about the combatants and some of the victims of war repression and post-war period;
23) a person entitled to health care benefits on the basis of the rules on coordination-a person who is not insured in the Fund and holds the right to health care benefits under legislation other than the Republic of Poland of a Member State of the European Union or a Member State of the European Free Trade Agreement (EFTA), and which is entitled to the territory of the Republic of Poland to provide health care from health insurance on the basis of the provisions of coordination;
24) a cooperating person-a person referred to in art. 8 ust. 11 of the Act of 13 October 1998. the social security scheme;
25) nurse of primary health care-a nurse who has completed a specialization training in nursing: family, pediatric, environmental, environmental and family nursing care, chronically ill and disabled, care long-term, in the protection of working health, the environment of teaching and education, conservative education, health promotion and health education or the completed qualification course in the field of nursing: family, pediatric, environmental, environmental/family, chronically ill and disabled, long-term care, in the protection of working health, the environment of teaching and education, conservative education, health promotion and health education or is a specialization training in nursing: family, pediatric, care long-term, the environment of teaching and education, conservative education, health promotion and health education, or a qualification course in the field of nursing: family, pediatric, long-term care, the environment of teaching and education, Conservativeness, health promotion and health education or holds a title professional nursing master and at least three years of seniority in primary health care, the provider with whom the Fund has entered into an agreement for the provision of health care services, or who is employed or pursues a profession in the the healthcare provider with whom the Fund has entered into an agreement for the provision of health care services;
26) a nurse or a midwife of health insurance-a nurse or midwife who is a provider with whom the Fund has entered into a contract for the provision of health care services, or a nurse or a midwife employed or practising profession in the healthcare provider with whom the Fund has entered into an agreement for the provision of health care services;
27) basic health care-health care, diagnostic, therapeutic, rehabilitation and nursing care in the field of general medicine, family medicine, internal diseases and paediatrics, provided by ambulatory care health;
28) a midwife of primary health care-a midwife who has completed a specialisation training in nursing: family, environmental, environmental and health care promotion and health education, or has completed the qualification course in the field of family nursing, environmental, environmental and family nursing, health promotion and health education, or taking a specialisation training in the field of nursing: family or health promotion and health education, or taking a course qualification in the field of nursing: family or the promotion of health and health education, or the professional title of the Master of Obstetrics and at least three years of seniority in primary health care providing benefits in primary health care, which is the provider with whom The Fund has entered into an agreement for the provision of health care services or which is employed or carried out by the provider with whom the Fund has entered into an agreement for the provision of health care services;
28a) advice on the future-outpatient clinic of the hospital treating the hospital, located in the building or assembly of buildings marked with the same address as the hospital, or other addresses, but located next to the hospital and creating functional the whole in which the same or similar types of services are provided in the hospital;
29) the health needs-the number and type of health care benefits that should be provided to preserve, restore or improve the health of the given group of recipients;
29a) the health policy programme-a team of planned and intended health care activities assessed as effective, safe and justified, enabling the achievement of the targets to be attained within a certain period of time by which the targets are detected. and the implementation of specific health needs and improvement of the health status of a particular group of witnesses, developed, implemented, implemented and financed by a minister or local government unit;
30) a health programme-a team of planned and intended health care activities assessed as effective, safe and justified, enabling the achievement of the targets to be attained within a certain period of time by which they are detected and the implementation of specific health needs and the improvement of the health status of a particular group of witnesses, developed, implemented, implemented and financed by the Fund;
31) the average remuneration-the average monthly salary in the enterprise sector from the previous quarter, including the outcry from the profit, announced by the President of the Central Statistical Office in the Official Journal of the Republic of Poland "Monitor Polski";
(32) the rules on coordination-the provisions on the coordination of social security schemes for the provision of health benefits in kind as laid down in Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004. on the coordination of social security systems, in Regulation (EC) No 987/2009 of the European Parliament and of the Council of 16 September 2009 concerning the implementation of Regulation (EC) No 883/2004 on the coordination of social security systems and in Regulation (EU) No 1231/2010 of the European Parliament and of the Council of 24 November 2010 extending Regulation (EC) No 883/2004 and Regulation (EC) No 987/2009 to nationals of third countries who are not yet covered by those Regulations solely on the grounds of their nationality and the decisions adopted pursuant to the provisions of the of those Regulations;
32a) bill-an invoice within the meaning of the Act of 11 March 2004. o Tax on goods and services (Dz. U. of 2016 r. items 710, z Late. zm.) or an account within the meaning of the Act of 29 August 1997. -Tax Ordinance (Dz. U. of 2015 items 613, of late. zm.);
32b) referral in electronic form, and in paper form in the case of:
(a) the lack of access to the ICT system referred to in Article 7 of the Act of 28 April 2011. o System of information in health care (Dz. U. of 2016 r. items 1535 and 1579),
(b) persons with an unestablished identity,
(c) the referral to the care and care establishment and the nursing care facility,
(d) referral to psychological studies and consultations,
(e) a referral from the scope of employment law,
(f) referral for rehabilitation medications,
(g) the referral referred to in Article 42b (b) 3;
32c) the IOWISZ system-the ICT system referred to in art. 31a of the Act of 28 April 2011. o System of information in health care;
33) the state of emergency-the state referred to in art. 3 point 8 of the Act of 8 September 2006. o State Medical Rescue Agency (Dz. U. of 2013 r. items 757, with late. zm.);
33a) sanitary transport-the carriage of persons or biological materials and materials used for the provision of health care services, requiring special transport conditions;
33b) the foodstuff of a particular nutritional purpose-a foodstuff intended for particular nutritional uses within the meaning of the Act of 12 May 2011. refund of medicines, foodstuffs intended for particular nutritional uses and medical devices (Dz. U. of 2016 r. items 1536 and 1579), hereinafter referred to as "the refund act";
34) the provision of health care-health benefits, health benefits in kind and the accompanying provision;
35) guaranteed benefit-the provision of health care financed in full or co-financed by public funds on the basis of and within the scope set out in the Act;
36) specific provision-the provision of health care in all fields of medicine, with the exception of the benefits provided in the area of basic health care;
37) health benefits in kind-related to the treatment of medicines, foodstuffs for particular nutritional uses and medical devices;
(38) accompanying benefit-accommodation and adequate health care in the hospital or other medicinal facility of a medicinal product in a type of stationary and 24-hour health care services within the meaning of rules on medical treatment, transport and sanitation, and accommodation outside the medicinal plant, where the necessity of the medicinal product is based on the conditions laid down for the benefit in question guaranteed;
(39) a high-pecciary provision-the provision of health care or a medical procedure which together meets the following criteria:
(a) the provision of a benefit requires a high level of technical advancement of the healthcare provider and of the advanced skills of the persons providing
(b) the unit cost of the benefit is high;
40) health benefit-an action for the prevention, preservation, rescue, restoration or improvement of health and other medical treatment resulting from the treatment process or the separate provisions governing the rules for their provision;
41. the provider:
(a) an entity carrying out a medicinal activity within the meaning of the provisions on medicinal activities,
(b) a natural person other than those referred to in point (a) who has acquired the professional powers to provide health services and who grants them in the course of his business activity,
(c) (repealed)
(d) a body carrying out procurement activities in medical devices;
42) medical procedure-diagnostic, therapeutic, nursing, prophylactic, rehabilitation or case-law proceedings taking into account the indications to be carried out, carried out under the conditions of specified health infrastructure at the use of medicinal products and medical devices;
(42a) the benefit tariff-a list of the benefits guaranteed with the relative values assigned to them, excluding those guaranteed, the financing rules of which are laid down in the refund act;
(42b) medical technology-medicines, devices, diagnostic and therapeutic procedures used in specified indications, as well as organizational supportive systems, within which health benefits are performed;
43) social insurance-insurance as defined in the Act of 13 October 1998. the social security scheme;
(44) Social insurance of farmers-insurance as defined in the Act of 20 December 1990. about the social insurance of farmers;
44a) an authorized soldier or employee-soldier or an employee of the military referred to in art. 6 of the Act of 17 December 1998. the principles of the use or residence of the Armed Forces of the Republic of Poland outside the State (Dz. U. of 2014 items 1510), who suffered an injury or fell ill while performing work tasks outside of the state;
44b) aggrieved veteran-a person with the status of veteran aggrieved party given under art. 5 par. 1 of the Act of 19 August 2011. about the veterans of activities outside the state (Dz. U. Entry 1203);
45) volunteer-the person referred to in art. 2 point 3 of the Act of 24 April 2003. about the activity of the public benefit and about the volunteer;
46) medical devices-medical devices, in vitro diagnostic medical devices, equipment for medical devices, equipment for in vitro diagnostic medical devices and active implantable medical devices within the meaning of the provisions of the Act of 20 May 2010 about medical devices (Dz. U. of 2015 items 876 and 1918 and from 2016. items 542, 1228 and 1579).
Chapter 2
Tasks of public authorities
Article 6. [ Job directory] The tasks of public authorities in ensuring equal access to health care benefits include in particular:
1. creating the conditions for the functioning of the health system;
2) the analysis and evaluation of the health needs and the factors causing them to be changed;
3) the promotion of health and prevention, aimed at creating conditions conduit to health;
4) financing in the mode and on the principles defined by the Health Care Benefits Act.
Article 7. [ Municipal tasks] 1. The communes ' own tasks in ensuring equal access to health care services shall be in particular:
1) the development and implementation and evaluation of the effects of health policy programmes resulting from the identified health and health needs of the municipality's inhabitants;
2) communicate to the district the information about the health policy programmes implemented;
3) initiating and participating in the setting of directions for local actions aimed at finding local residents with harmful factors for health and their consequences;
4) take other actions resulting from the recognized health needs and the state of health of the inhabitants of the municipality.
2. The tasks of the commissioned municipalities are to issue the decisions referred to in art. 54, in the case of non-insured persons who meet the income criterion referred to in Article 54. 8 of the Act of 12 March 2004. of social assistance, for which there is no circumstance referred to in Article 12 of this Act.
3. In order to determine the income situation and the property of the recipient referred to in paragraph. 2, a family environmental interview shall be carried out on the principles and in the mode set out in the provisions on social assistance.
4. The municipality receives a grant from the state budget to finance the costs of carrying out the task referred to in the paragraph. 2 and 3.
Article 8. [ Welcome Tasks] The own tasks to ensure equal access to the health care services carried out by the county shall be in particular:
1) the development and implementation and evaluation of the effects of health policy programmes resulting from the identified health and health needs of the district residents-after consultation with the relevant territorially municipalities;
2) forwarding the marshal of the voivodship of information about implemented in the district of the public health policy programmes;
3) initiating, assisting and monitoring the activities of the local self-government community in the field of health promotion and health education conducted in the district;
4) to stimulate action on individual and collective responsibility for health and health;
5) take other actions resulting from the identified health needs.
Article 9. [ Voivodship Tasks] The own tasks in ensuring equal access to health care services carried out by the regional government shall be in particular:
1) development and implementation and evaluation of the effects of health policy programs resulting from the discernised health needs and health status of the voivodship residents-after consultation with the relevant territorially municipalities and powiats;
2) forwarding of information to the voivodship of health policy programmes carried out in the voivodship;
3. the development and implementation of programmes other than those referred to in point 1 for the implementation of health care tasks;
4) inspire and promote efficiency gains solutions, including restructuring in health care;
5) taking other actions resulting from the recognized health needs of the inhabitants of the voivodship.
Art. 9a. [ Satisfaction of the needs of the local government in the field of health protection] In order to meet the needs of the local government in the field of health protection, the local government unit, taking into account in particular the regional map of health needs, priorities for regional health policy and the state of accessibility to health care benefits in the area of the voivodship, can finance for residents of this community the benefits guaranteed.
Article 9b. [ Financing of guaranteed benefits referred to in art. 9a] 1. The guaranteed benefits referred to in art. 9a, shall be financed on the basis of an agreement concluded between the local government unit and the healthcare provider established by means of a contest of tenders.
2. For the contest of tenders referred to in paragraph. 1, the provisions of Article 1 shall apply mutatis mutandis. 48b (b) 2-4 and 6.
3. In the case where the unit or units of local government are within the meaning of the provisions on the activity of the medicinal product:
1) entities forming the subject of the medicinal product,
2) the sole or majority shareholders, or shareholders in a capital company that is a medicinal product
-which grants the benefits guaranteed to the extent corresponding to the contract referred to in paragraph 1 (2). 1, this agreement shall be included in the first place with that entity.
4. In the case referred to in paragraph. 3, there shall be no contest of tenders referred to in paragraph 1. 1. The provisions on public procurement shall not apply to the conclusion of that agreement.
5. The agreement referred to in paragraph 5. 1, shall specify in particular:
1) the type, scope and number of guaranteed benefits, the conditions and the organisation of the provision of those benefits;
2. its duration;
3) the amount of the obligation and the rules of settlement, taking into account the benefit tariff, in the event of its determination;
4) the manner and mode of control of performance of the contract.
6. Where the provider is a party to the contract for the provision of health care benefits concluded with the Fund, the contract referred to in the paragraph shall be provided. 1, may include only guaranteed benefits granted over the amount of the Fund's commitment to the healthcare provider in a given range.
7. The conclusion of the contract referred to in paragraph 1 1, the provider, who is also a party to the contract for the provision of health care services concluded with the Fund, is obliged to inform the competent local director of the Fund's provincial branch. The service provider is obliged to send to the branch office within a period of up to 10. the day of each month, for the previous month, a copy of the clearing documents presented to the local government unit.
Article 10. [ Jobs of water] 1. The tasks of the wojewater for the provision of equal access to health care services shall be in particular:
1) evaluation of the implementation of the tasks of government administration implemented by the local government units;
2. the transmission of the Minister of Health to the Minister for Health by 15 February of each year, the annual information on health policy programmes implemented last year, and the health policy programmes planned for that year.
2. Information on the health policy programmes referred to in paragraph. 1 point 2, art. 7 ust. 1 point 1, art. 8 pt. 1 and art. Article 9 (1), in particular, shall include:
1) the name of the health policy programme;
2) to identify the entity developing, implementing, implementing and financing the health policy programme;
3) the type and extent of the health care benefits provided under the health policy programme.
3. The Minister responsible for health shall determine, by means of a regulation, the manner and time limits for the communication of information on health policy programmes and the model of the document containing that information, taking into account the scope of the data referred to in paragraph 1. 2.
Article 11. [ Tasks Of The Minister Of Health] 1. The tasks of the Minister responsible for health matters within the scope of the Law shall be in particular:
1) conducting and complicity in conducting education in preventing and solving problems associated with negative effects on health of environmental and social factors;
2) (repealed)
3) the development, financing and evaluation of the effects of health policy programmes, as well as the supervision of their implementation;
(3a) the eligibility of health care benefits as guaranteed benefits;
4) financing from the state budget, from the part remaining at the disposal of the minister responsible for health, the benefits guaranteed within the scope specified in the law, including in relation to persons entitled to health care benefits on the basis of the rules on coordination;
(4a) the planning, transmission and settlement of the grant from the State budget referred to in Article 97 ust. 8;
5) co-operation with non-governmental organisations of a regional or national health care working;
6) supervise the supervision of health insurance within the scope set out in Chapter VII;
7) the approval of the Fund's financial plan in consultation with the Minister responsible for public finance;
8) the opinion of the Fund's financial statements;
9) submission to the Sejm of the Republic of Poland by 31 August of the following year of the annual report on the activities of the Fund prepared in the mode referred to in art. 187;
9a) appointing and revoking the President of the Fund, the deputies of the Fund's President, the members of the Fund Board, the directors of the Fund's voivodship and members of the Fund's provincial branches;
10. exercise supervision of the Agency;
11) approval of the Agency's financial statements.
1a. The Minister responsible for Health shall calculate the average costs referred to in Article 4. 94 and 95 of Council Regulation (EEC) No 574/72, having regard in particular to the National Health Account.
1b. The National Health Account shall be drawn up on the basis of research carried out on a duty basis within the meaning of the Act of 29 June 1995. o public statistics (Dz. U. of 2016 r. items 1068).
1c. Social Insurance Company, Kasa Rolniczego Ubezpieczenia Społecznego (Agricultural Social Insurance Fund), Central Statistical Office, governmental authorities, bodies of local authorities, healthcare providers and other institutions undertaking tasks in the field of social security the organisation, financing and provision of public health care services shall provide free of charge information necessary for the calculation referred to in paragraph 1. 1a.
1d. For the purposes of the calculations referred to in paragraph 1. 1a, through health care benefits provided in the framework of health insurance should be understood all health care benefits, the cost of which has been incurred by entities belonging to the public finance sector, listed in rules on public finances.
2. To the tasks of the Minister responsible for public finance in the field covered by the Law, shall in particular:
1) supervising the supervision of the financial economy of the Fund in accordance with the principles provided for in this Act;
2) approving the financial statements of the Fund, after obtaining the opinion of the Minister responsible for health, and submitting the report together with the opinion of the Minister competent for health of the Sejm of the Republic of Poland by 31 August of the year following the year to which the report relates.
SECTION II
Health care benefits
Chapter 1
General provisions
Article 12. [ Compatibility with other statutes] The provisions of the Act do not violate the provisions on health care benefits granted free of charge regardless of the entitlement for health insurance on the basis of:
1) (repealed)
(1a) Article 161 and art. 170 of the Act of 21 November 1967. of the universal duty of defence of the Republic of Poland (Dz. U. of 2016 r. items 1534);
2. Article 21 (1) 3 of the Act of 26 October 1982. of the upbringing in sobriety and counteracting alcoholism (Dz. U. of 2016 r. items 487);
3. Article 26 par. 5 of the Act of 29 July 2005. anti-drug addiction (Dz. U. of 2016 r. items 224 and 437);
4. Article 10 of the Act of 19 August 1994. on the protection of mental health (Dz. U. of 2016 r. items 546 and 960);
5) art. 415 para. 1 point 5 of the Act of 12 December 2013. o foreigners;
6) the provisions of the Act of 5 December 2008. o Prevention and control of infections and infectious diseases in humans (Dz. U. of 2013 r. items 947, of late. zm.)-in the case of health care services related to the eradication of diseases, infections and infectious diseases;
7) the provisions of the Act of 8 September 2006. o State Medical Rescue;
8) (repealed)
9. Article 6 para. 1 point 5 of the Act of 7 September 2007. o Karcie Polaka (Dz. U. of 2014 items 1187, of 2015 items 1274 and from 2016. items 753);
10) art. 16 ust. 1 and Art. 25 of the Act of 22 November 2013. about proceedings against persons with mental disorders creating a threat of life, health or sexual freedom of other persons (Dz. U. of 2014 items 24 and of 2015 items 396);
11) art. 20 of the Act of 7 February 2014. with the participation of foreign officers or employees in joint operations or joint rescue operations on the territory of the Republic of Poland (Dz. U. Entry 295).
Art. 12a. [ Exemption of application of the law] The provisions of the Act, with the exception of the rules governing the rules and mode of funding from the state budget of health care benefits and the rules governing the right to health care benefits under the rules on coordination, do not apply to persons to whom health benefits are provided free of charge, irrespective of the health insurance entitlements, on the basis of art. 102 points 1 and art. 115 § 1 of the Act of 6 June 1997-Code of Executive Penal (Dz. U. Entry 557, of late. zm.).
Article 13. [ Financing of health care benefits granted to recipients other than insured persons] The provision of health care provided to the recipients other than the insured persons shall be financed from the State budget, unless otherwise provided for in separate provisions.
Art. 13a. [ Delegation] The Minister for Health in consultation with the Minister of Justice and the Minister responsible for internal affairs shall determine, by means of a regulation, the way and mode of financing from the state budget of health care benefits:
1) awarded to the recipients referred to in art. 2. 1 points 2 to 4,
2) referred to in art. 12 points 2-6 and 9-11, art. 12a, art. 15 para. Article 2 (2) and (2) 42j
-having regard to the principles and the way in which public funds are spent and the need to ensure the effectiveness of health care provision.
Article 14. [ Entities obliged to finance public health care benefits] On the basis of and within the limits set by the law, the bodies responsible for financing public health care benefits shall be: the competent ministers or the Fund.
Article 15. [ Benefits to the benefit of the benefit provider] 1. The recipients have, on the basis specified in the Act, the right to health care benefits, the purpose of which is to preserve health, prevent diseases and injuries, early detection of diseases, treatment, care and prevention disability and its limitation.
2. The holder shall have guaranteed benefits from the scope of:
1) primary health care;
2. ambulatory specialist care;
3) hospital treatment;
4) psychiatric care and treatment of addictions;
5) medical rehabilitation;
6) care and caring benefits in the course of long-term care;
7) dental treatment;
8) spa treatment;
9) supplies of medical devices, on behalf of the authorized person, and their repairs, as referred to in the refund act;
10) medical rescue;
11) palliative and hospice care;
(12) high-pecciary benefits;
13) health programmes;
14) medications, foodstuffs intended for particular nutritional uses and medical devices available in the prescription pharmacy;
(15) the programme of the medicines referred to in the provisions of the refund act;
16) medicines used in the chemotherapy specified in the provisions of the refund act;
17) medications not authorized for admission to trading on the territory of the Republic of Poland, brought from abroad under the conditions and in accordance with the procedure laid down in the art. 4 of the Act of 6 September 2001. -Pharmaceutical law, provided that a decision has been given in relation to these medicines to grant a refund on the basis of the refund act;
18. foodstuffs intended for particular nutritional uses, brought from abroad under the conditions and in accordance with the conditions laid down in the Article. 29a of the Act of 25 August 2006. on food safety and nutrition (Dz. U. of 2015 items 594 and 1893 and from 2016. items 65, 1228 and 1579), provided that a refund has been granted in respect of those measures on the basis of the refund act.
3. (repealed)
Article 16. [ Benefits of the ineligible person] 1. The holder on the basis of the Act shall not be entitled:
1) decisions on the ability to drive motor vehicles and other judgments and medical certificates issued at the request of the provider, if they are not related to further treatment, rehabilitation, incapacity for work, continuing education, participation of children, pupils, listeners in the training of teachers and students in sports activities and in organised recreation, and where they are not issued for the purpose of social assistance, family support and foster care system, case-law on disability, obtaining a nursing allowance, or determination of the causes and type of injury related to the use of violence in the family;
1a) a medical certificate or a certificate issued by a midwife, issued at the request of the provider, if they are not issued for the purpose of obtaining the supplement for the birth of the child or a one-time oblivion with the birth of the child;
2) the provision of health care not qualified as guaranteed.
2. Costs of the examination, the issue of the decision or the certificate, on the order of the prosecutor or the court, in connection with proceedings conducted on the basis of separate laws, shall be covered by the part of the state budget, the disposal of which shall be, respectively, the Minister Justice, First President of the Supreme Court, or the President of the Supreme Administrative Court.
3. Paragraph Recipe 2 shall not exclude the possibility for the party to pay the costs of the examination or of the award of a decision or of the attestation referred to in that provision on the basis of separate provisions.
4. Costs of the examination, the issue of the decision or the certificate, relating to the ruling on the incapacity to work for the purposes of the annuity, the determination of the social security entitlements, shall be financed by the entity on which the order is carried out examination, judgment or certificate issued.
5. The Council of Ministers shall determine, by way of regulation, the manner and mode of financing of the costs referred to in paragraph 1. 4, taking into account the purpose of the decision or the certificate and the conduct of the study.
Article 18. [ Expenses to be incurred by a person resident in a 24-hour benefit centre] 1. A witness who is in a care, nursing and care facility or in a medical rehabilitation facility, who provides 24-hour benefits, shall bear the costs of nutrition and accommodation. The monthly fee shall be set at a rate corresponding to 250% of the lowest pension, except that the fee may not be higher than the amount corresponding to 70% of the monthly income of the recipient within the meaning of the provisions on social assistance.
2. Monthly fee for the meals and accommodation of the child to complete 18. year of life, and if you shape further-to the completion of 26. a year of living in a care, nursing care, nursing or rehabilitation facility, which provides 24-hour benefits, shall be set at a level corresponding to 200% of the lowest retirement pension, except that the charge does not may be higher than the amount corresponding to 70% of the monthly income per person in the family within the meaning of the provisions on social assistance. In the case of a child deprived of the care and education of the parents placed in the care and care facility, in the nursing care facility or in the rehabilitation facility by the court, the charge shall be not less than 200% of the lowest pensions.
3. The payment referred to in paragraph The second sentence, in the case of a child deprived of the care and education of the parents placed in the care and care facility, in the care and care establishment or in the medical rehabilitation facility by the court, shall be borne by the district competent for the purposes of place of birth of the child If the district competent for the place of birth of the child cannot be determined, the county seat of the court where the child has been placed in the care and treatment facility, in the establishment, shall be charged with the payment of the fee. nursing care or in a medical rehabilitation facility.
4. The competent municipality due to the place of birth of the child shall be subject to the co-financing of the fee referred to in the paragraph. Second sentence, in the case of a child deprived of the care and education of the parents placed in the care and care establishment, in the care and care establishment or in the medical rehabilitation facility by the court, in the amount of:
1) 10% of the first year of the child's stay in the care and care facility, in the nursing care facility or in the medical rehabilitation facility;
2) 30% in the second year of the child's stay in the care and care facility, in the nursing care facility or in the medical rehabilitation facility;
3) 50% in the third year and subsequent years of the child's stay in the care and care facility, in the nursing care facility or in the medical rehabilitation facility.
(5) If it is not possible to establish a municipality due to the place of birth of the child, the competent authority for co-financing the fee referred to in paragraph 1 shall be applicable. Second sentence, in the case of a child placed in foster care, is the municipality of the seat of the court, which has ruled on the placement of the child in the care and care facility, in the nursing care facility or in the rehabilitation facility Medicinal product.
6. To the periods of the child's stay in the care and care facility, in the nursing care facility or in the medical rehabilitation facility referred to in the mouth. 4, shall include periods of residence of the child after 1 January 2012. in foster care.
7. Where the fee referred to in paragraph is applicable The second sentence, the district, the parents of the child placed in the care and care establishment, the nursing care facility or the medical rehabilitation facility shall be obliged to reimburse the district to the amount of the fee paid. The provisions of Article 4 193 2 and 6-8, art. 194 and art. 195 of the Act of 9 June 2011. to support family and foster care system (Dz. U. of 2016 r. items 575 and 1583), applies mutatis mutandis.
Art. 18a. [ Starosta control authority] 1. The Starosta exercises control over the quality of care provided by care and care facilities, nursing care establishments or medical rehabilitation facilities for children deprived of the care and upbringing of parents placed in these facilities by the court.
2. The Starosta in connection with the control referred to in paragraph. 1, shall have the right, in particular to:
1) requests for information, documents and data, necessary for the exercise of control;
2) entrance in the day to the premises and premises of the inspected entity;
3) requests from employees of the inspected entity to provide the information in oral and written form;
4) observations of children placed in controlled establishments.
3. In the case where it is apparent from the control of the control centre that the care and care facility, the nursing or care centre or the medical rehabilitation facility does not fulfil its functions or does not properly fulfil its functions, the starosta shall notify the competent authority of the the court.
Art. 18b. [ Assessment of the situation placed in the child's establishment, unaccompanied by the care and parental education] The head of the care and care facilities, the care-care establishment or the medical rehabilitation establishment, in cooperation with the staff member designated by the apprentice staff centre, assesses the situation of the child deprived of the the care and education of the parents placed in these facilities by the court. To the terms and principles of the assessment of the child's situation, the provisions of the Act of 9 June 2011. on the promotion of a family and foster care system for the periodic assessment of the situation of a child placed in an institutional replacement foot, shall apply accordingly.
Art. 18c. [ Relevant application of the provisions] The provisions of the Act of 9 June 2011 shall apply to persons leaving after reaching the full age of the care-care establishment, the nursing care facility or the medical rehabilitation facility. on the support of the family and foster care system for the substitutable persons leaving the institutional replacement care, shall apply mutatis mutandis.
Article 19. [ Non-immediate provision] 1. In the state of emergency health care provision shall be provided to the provider immediately.
2. Where the provision of health care in a state of emergency is provided by a provider who has not entered into a contract for the provision of health care services, the provider shall have the right to these benefits to the necessary extent.
3. In the absence of the possibility of providing the health care benefits specified in the contract for the provision of health care services for reasons attributable to the healthcare provider or in connection with the occurrence of force majeure, the provider ensures, in the case referred to in the paragraph. 1, the provision of health care services by another provider.
4. A healthcare provider who has not entered into a contract for the provision of health care services shall have the right to pay for the provision of health care provided to the recipient in the emergency. The remuneration shall take into account only the reasonable costs of providing the necessary healthcare services.
5. In order to obtain the remuneration referred to in paragraph. 4, the provider submits an application to the entity obliged to finance the health care benefits along with the account, a list of the health care benefits provided and their costs and a written presentation of the circumstances of the provision of benefits justifying their funding from public funds.
(6) The entity responsible for the financing of public health care benefits shall have the right to review the validity of the application referred to in paragraph 1. 5. Rules of Art. 64 shall apply mutatis mutandis.
Article 20. [ Health Care Benefits Order] 1. The provision of health care in hospitals and specialist benefits in outpatient health care shall be awarded according to the order of the application in the days and hours of their award by the provider who has entered into an agreement for the provision of benefits health care.
The list of responders shall not be included in the list of responders who continue to receive the treatment in the healthcare provider concerned.
1b. Tickets and alerts on the waiting list for the benefit shall be made each day during the hours of the provision of health care services by the provider concerned.
2. The provider referred to in paragraph 2. 1:
1) determine the order in which the provision of health care is provided on the basis of the application of the certificate
2) inform the written witness of the qualification for medical category, determined in accordance with the medical criteria specified in the provisions issued on the basis of the paragraph. 11, and the time limit for providing the benefit, and justifies the reasons for the choice of the
3) enter with the consent of the provider or his statutory representative:
(a) sequence number,
(b) date and time of entry,
(c) the name of the operator,
(d) the PESEL number and, in the absence thereof, the number of the document confirming the identity of the operator,
(e) the identification or reason for the acceptance,
(f) the address of the operator,
(g) telephone number or indication of other means of communication with the recipient or his/her guardian,
(h) the date of delivery,
(i) the name and signature of the person making the alert
-in the subsequent position of the waiting lists for the provision of the benefit;
4) enter the date and cause of the deletion of the provider from the waiting list for the benefit;
5. shall keep the original paper sent by the recipient in the case of health care benefits granted on the basis of a referral.
2a. In the case of health care benefits provided on the basis of referral, the operator shall be obliged:
1) provide the provider with the original of the referral in paper form, not later than within 14 working days from the date of making the entry on the waiting list, under the rigorous of the deletion from the waiting list, or
2) make available to the provider, before entering the post on the waiting list, the access code for referral in electronic form and the PESEL number, and in the case of a person who does not have a given PESEL number-the number of the passport or other document a confirmatory identity.
2aa. The provisions of Article 1 shall apply to the time limit for the delivery of the originator in paper form. 165 of the Act of 17 November 1964. -Code of Civil Procedure (Dz. U. of 2014 items 101, of late. zm.).
2b. In the case of the deletion of the operator from the waiting list as a result of the resignation of the provision of the benefit, failure to report for the prescribed period of the provision of the benefit or termination by the provider of the execution of the contract for the provision of benefits health care provider:
1) reimburse the recipient of the original of the referral, in the case of referral in paper form, or
2) allows the re-use of the referral in electronic form by an appropriate change of its status in the ICT system referred to in Art. 7 of the Act of 28 April 2011. o System of information in the protection of health, in the case of referral in electronic form.
3. The provision of the activities referred to in paragraph shall be carried out by the provider. Article 2 (2), (2) and (3), shall be equivalent to an obligation to provide a given health care benefit.
4. The waiting list for the provision is an integral part of the medical documentation carried out by the provider.
(5) A waiting list shall be carried out in such a way as to ensure respect for the principle of fair, equal, non-discriminatory and transparent access to health care services and in accordance with the medical criteria laid down in the provisions of the Paragraph 1. 11.
6. The provider shall determine the order of the parties and ensure that the waiting lists are carried out correctly, or that the persons responsible for the performance of those tasks are appointed.
7. In the event of a change in the state of health of the recipient, indicating the need prior to the set date of the provision of the benefit, the operator shall inform the provider, who, if it is due to medical criteria, corrects the time limit for the provision of the benefit, and shall inform the recipient immediately of the new time limit.
8. In the event of the occurrence of circumstances that could not be foreseen at the time of the determination of the time limit for the provision of health care, and which prevent the retention of the term resulting from the waiting list, the healthcare provider informs the recipient in any way available to change the date resulting from the change in the order in which the benefit is to be provided and the reasons for it. This provision also applies to the case of a change in the time limit for providing health care to an earlier one. In the case where the operator does not agree to the change of the deadline for providing the health care to the earlier, the provider informs about the possibility of changing the term of the next provider from the waiting list, in accordance with the order established by the notification.
9. In the case where the operator is not allowed to appear to the healthcare provider within the time limit specified in the paragraph mode. 2, 7 or 8, or if he has resigned from the provision of health care, he is obliged to notify the provider immediately.
10. In order to receive a given health care benefit, the operator may sign on one of the waiting lists of one of the healthcare providers.
10a. In the event of termination of the contract for the provision of health care services, the provider entered on the waiting list of the provider who performed the contract may sign on the waiting list maintained by another the provider of a contract for the provision of health care services in a given range.
10b. The provider, to whom the operator is notified, shall determine the order of acceptance, taking into account the date of filing in the healthcare provider who completed the performance of the contract for the provision of health care benefits.
10c. The provider, who has completed the implementation of the contract for the provision of health care services, shall be obliged to issue a certificate of entry to the waiting list with the date of the declaration to the recipient. No fee shall be paid for the issue of the certificate.
10d. The branch of the Fund Branch informs in every way available to the recipients entered on the waiting lists of the provider who completed the implementation of the contract for the provision of health care services, of the possibility of providing the benefit health care by other healthcare providers who have entered into a contract for the provision of health care benefits with this branch and the first free date of providing the benefit.
10e. In the event of non-declaration of the date of the provision of the benefit, the operator shall be deleted from the waiting list, unless it is prima facie evidence that the non-declaration has occurred due to force majeure.
10f. An application for reinstatement on the waiting list shall be notified immediately, no later than within 7 days from the date of cessation of the reason for failure to report for the prescribed period of providing the benefit. In case of restoration to the list of pending recipe (s). 10b shall apply mutatis mutandis.
10g. Lists of waiting lists for the benefits referred to in paragraph. 1, shall be carried out in electronic form.
11. The Minister responsible for health will determine, by regulation, after consulting the General Medical Council and the General Council of Nurses and the Nurses, Medical criteria to be followed by the healthcare provider by placing the witnesses to the waiting lists, taking into account current medical knowledge.
12. For the recipients of the diagnosis aimed at the diagnosis of malignant tumours, hereinafter referred to as "oncological diagnostics", or treatment to cure this tumor, hereinafter referred to as "oncological treatment", the healthcare provider conducts a separate waiting list for the provision of the benefit. The provisions of paragraph 1 shall not apply to this list. 11.
13. The provider shall affix to the recipient, with the exception of the holder in the emergency, on the list referred to in paragraph. 12, on the basis of the diagnosis and oncological treatment card referred to in art. 32a ust. 1, and the following medical criteria based on current medical knowledge:
1) the health status of the recipient;
2) prognosis as to the further course of the tumor;
3) coexisting diseases affecting the cancer, for which the benefit is to be provided;
4) the threat of occurrence, perpetuation or deepening of disability.
14. The provisions of the paragraph. 12 and 13 do not apply to malignant skin malignancies, except for skin melanoma.
Article 21. [ Periodic evaluation of the waiting list for the benefit] 1. The waiting lists for the benefit shall be periodically, at least once a month, to be evaluated:
1) a team of assessment of the admissions set up by the provider who has entered into a contract for the provision of health care services-in the case of hospitals;
2) the manager of the healthcare provider who has entered into a contract for the provision of health care services-in the case of specialist benefits in outpatient health care;
(3) the provider, in the case other than those referred to in points (1) and (2).
2. The assessment team shall consist of:
1) doctor specialist in treatment specialty;
2) doctor specialist in non-treatment speciality;
3) a nurse in chief, and in the absence of it-another nurse or midwife.
2a. Where the assessment team is acting in a public health care establishment or a budgetary unit, the social council referred to in Article 2 shall be adopted by the Commission. 48 of the Act of 15 April 2011. about the activity of the medicinal product (Dz. U. of 2016 r. items 1638), may appoint a representative of his representative, who performs a medical profession and who is not an employed person, to assess the reception of his or her medical profession.
3. The provider referred to in paragraph 3. In accordance with Article 1 (1), the President of the team shall designate the persons referred to in paragraph 1. 2, as well as the team's operating mode.
4. To the tasks of the assessment team, the manager of the healthcare provider or the provider referred to in paragraph 1. In accordance with Article 1 (1), a list of pending lists shall be carried out in respect of:
1. the correctness of the documentation;
2) the time of waiting for the provision;
3) the legitimacy and reasons for changes in the time limits for the provision
(5) The assessment team shall draw up an assessment report each time and submit it to the healthcare provider referred to in paragraph 1. 1 point 1.
6. Where the healthcare provider referred to in paragraph 6 is subject to the application of the provisions of the 1 point 1, does not provide the benefits of a doctor specialist in the treatment specialty, it is a part of the admission evaluation team which are included in the person referred to in paragraph 1. 2 points 2 and 3.
7. Where the healthcare provider referred to in paragraph 1 is subject to the application of the provisions of the 1 point 1, the quality management team shall operate, meeting the conditions laid down in paragraph 1. 2, it shall perform the tasks referred to in paragraph. 4 and 5.
Article 23. [ Information to be provided to the Fund by the provider] 1. The healthcare provider referred to in art. 20 para. 1, shall report monthly to the provincial branch of the Fund competent for the place of the provision of benefits, information on the waiting lists for the provision of benefits, including:
1) the data referred to in art. 20 para. 2 point 3 (a) c and d, regarding persons waiting on the last day of the month;
2) the number of waiting and average waiting time calculated in the manner specified in the regulations issued on the basis of art. 190 par. 1;
3) the data specified in the provisions issued on the basis of art. 190 par. 1.
2. The information referred to in paragraph. 1 point 2, and the possibility of providing a benefit by other providers with a contract for the provision of health care services, a branch office of the Fund competent for the place of the provision of the provision publishes on its own site website, updating them at least once a month.
3. The branch of the Fund of the Fund informs the recipient, at his request, of the possibility of providing health care by the providers who have entered into a contract for the provision of health care benefits with this branch, the average time the expectations for the provision of health care and the first free date for the provision of the benefit.
4. The provider shall report at least once a week to the provincial branch of the Fund competent for the place of the provision of benefits information on the first free date of delivery of the benefit.
5. The information referred to in paragraph 1 4, the branch office of the Fund competent for the place of the provision of the provision publishes on its website, updating it at least once a week.
6. The provider, on the motivated request of the director of the Fund's branch office, shall be obliged to deliver immediately other than those specified in the paragraph. 9 information on the implementation of the obligations referred to in paragraph 1. 1-5, 7, and 8.
7. In the case of reasonable suspicion of non-performance or improper exercise by the provider of the duties referred to in art. 20 and art. 21, the director of the provincial branch of the Fund shall carry out the inspection of that provider in accordance with the procedure laid down in Art. 64.
8. The President of the Fund creates a central list of information on the number of waiting for the provision of health care and the average waiting time in individual branches of the Fund on the basis of the information referred to in paragraph. 2 and 4, transferred by the Provincial branches of the Fund.
(9) The President of the Fund shall provide information to the recipients of the information contained in the list referred to in paragraph 1. 8, and the information referred to in paragraph. 4, in particular by a free telephone line.
(10) The President of the Fund shall communicate the information referred to in paragraph 1 to one month. 8, to the system of information in health protection referred to in the Act of 28 April 2011. o System of information in health care.
11. The provision of the paragraph. 1 shall not apply to the healthcare providers who carry out waiting lists for the provision of a benefit in an application made available by the President of the Fund in accordance with art. 190 par. 1a.
Art. 23a. [ Allowing dating electronically to visit] 1. The healthcare provider referred to in art. 20, it is obliged to enable the recipients to date electronically on the visit, to monitor the status on the waiting list for the provision and to notify the date of the provision of the benefit.
2. The healthcare provider referred to in art. 20, transmits the data contained in the waiting lists for the provision to the system of information in health protection referred to in the Act of 28 April 2011. o System of information in health care.
3. The Minister of Health, in consultation with the Minister responsible for IT, will determine, by way of regulation, the minimum functionality for ICT systems enabling the services referred to in paragraph to be implemented. 1 and 2, bearing in mind the need to ensure unrestricted access to the data contained in the waiting lists for the provision of the benefit, while ensuring the protection of the personal data of the recipients before unauthorised access and disclosure and the integrity of the information and communication systems enabling the verification of the waiting lists based on the data collected in the health information system.
Article 24. [ Disable] Art. 19-23 shall not apply to the health care benefits of transplants awarded to persons who are included in the national list of persons waiting for transplantation of cells, tissues and organs, in accordance with the provisions on collection and transplantation cells, tissues and organs.
Article 24a. [ Disable] Art. 20-23 shall not apply to an authorised soldier or servant. These persons shall benefit from the health care benefits referred to in Article 4. 20, in the treatment of injuries and diseases acquired during the performance of tasks outside of the state, apart from the order.
Article 24b. [ Exclusion of provisions in relation to veteran injured party] Art. 20-23 does not apply to the veteran of the injured party. This person shall benefit from the health care benefits referred to in Article 4. 20, in the treatment of injuries and diseases acquired during the performance of tasks outside of the state, apart from the order.
Article 24c. [ Veteran's Rights of Affected Person] 1. Veterans of aggrieved shall have the right to use beyond the order of stationary and 24-hour health care benefits other than those referred to in art. 20, in the treatment of injuries and diseases acquired during the performance of tasks outside the State.
2. The injured veteran shall have the right to the indefinite duration of treatment for the health care benefits referred to in the paragraph. 1.
Article 27. [ prophylactic benefits] 1. The benefits for health care, disease prevention and early detection of diseases include:
1. to promote pro-health behaviour, in particular by encouraging individual responsibility for their own health;
2) early, multi-peculiar and comprehensive care of a child endangered with disabilities or disabled;
3) preventive medical examinations for the early diagnosis of diseases, with particular reference to cardiovascular diseases and cancer diseases;
4) health promotion and prevention, including dental prophylaxis involving children and adolescents to the completion of 19. year of life;
5) conducting prophylactic studies involving pregnant women, including prenatal studies recommended in risk groups and in women over 40. the year of life and the preventive dentistry;
6) preventative health care for children and young people in the environment of teaching and education;
7. exercise of preventive vaccination;
8) the performance of sports medicine research involving children and young people up to the completion of 21. the year of life and the players between 21. 23. year of age, who are not paid in connection with the cultivation of sport.
2. (repealed)
3. The Minister of Health, in consultation with the Minister competent for education and education, after consulting the President of the Fund, the Chief Medical Council, the Chief Council of Nurses and the Midwives and the National Council of Diagnosis In the course of the regulation, the organisation of preventive health care for children and young people covered by the compulsory schooI and the obligation to learn and educate in secondary schools for their completion, as well as the scope of the information to be provided on the water supply of the provider of the preventive care for these people, taking into account dental prophylaxis and health promotion, and in the case of children and young people educating in schools-prevention in the teaching environment.
4. The Minister competent for health in consultation with the Minister competent for physical culture, after consulting the President of the Fund and the Supreme Medical Council, will determine, by means of the regulation, the mode of adjudication of the ability to perform the given sport by children and youth to the completion of 21. the year of life and by the players between 21. 23. year of life, taking into account the need to protect the health of children and adolescents.
Article 28. [ Rules on the choice of the healthcare provider] 1. The witness shall have the right to choose the provider providing primary health care benefits from among those healthcare providers who have entered into contracts for the provision of health care services, subject to Art. 56b and art. 69b of the Act of 21 November 1967. of the universal duty of defence of the Republic of Poland, art. 153 (1) 7a of the Act of 12 October 1990. o Border Guard (Dz. U. of 2016 r. items 1643) and art. 115 § 1a of the Executive Penal Code.
1a. The witness, by making the choice of the provider referred to in paragraph 1, shall be selected. 1, at the same time making the choice of the doctor referred to in art. 55 par. 2a, nurses of primary health care or midwife of primary health care.
1b. The operator shall make the choice referred to in paragraph 1. 1a, may choose:
1) the doctor referred to in art. 55 par. 2a, the nursing care of primary health care or the midwife of primary health care in the same healthcare provider or in different services, or
2) the doctor referred to in art. 55 par. 2a, the nurse of primary health care or the midwife of primary healthcare that is provided to the healthcare providers.
1c. The witness shall have the right to the free choice referred to in paragraph 1. 1 or 1a, not more than three times in a calendar year, and in the case of each subsequent change brings a fee of 80 zlotys.
1d. The witness shall not bear the fee referred to in paragraph 1. 1c, in case of change of your place of residence or in case of the cessation of the provision of health care services by the chosen provider, the doctor referred to in art. 55 par. 2a, the nurse of primary health care or the midwife of primary health care in the selected healthcare provider, or for other reasons resulting from the healthcare provider's website.
2. The fee referred to in paragraph. 1c, is the income of the entity liable to finance public health care benefits.
Article 29. [ The right of choice of the provider of ambulatory specialised services] The operator shall have the right to choose the provider of outpatient benefits from among those healthcare providers who have entered into contracts for the provision of health care, subject to the provisions of Article 4 (1) of the basic Regulation. 56b and art. 69b of the Act of 21 November 1967. of the universal duty of defence of the Republic of Poland, art. 153 (1) 7a of the Act of 12 October 1990. o Border Guard and Art. 115 § 1a of the Executive Penal Code.
Article 30. [ Right of choice of hospital] The operator shall have the right to choose the hospital from among the hospitals which have entered into a contract for the provision of health care services, subject to the provisions of Article 4 (1). 56b and art. 69b of the Act of 21 November 1967. of the universal duty of defence of the Republic of Poland, art. 153 (1) 7a of the Act of 12 October 1990. o Border Guard and Art. 115 § 1a of the Executive Penal Code.
Article 31. [ The right to choose a dentist] 1. The witness shall have the right to choose a dental practitioner from among dental practitioners who have entered into a contract for the provision of health care services, subject to art. 56b and art. 69b of the Act of 21 November 1967. of the universal duty of defence of the Republic of Poland, art. 153 (1) 7a of the Act of 12 October 1990. o Border Guard and Art. 115 § 1a of the Executive Penal Code.
2. (repealed)
3. Children and adolescents to complete 18. the year of birth and pregnant women and the period of addiction shall be entitled to the supplementary health benefits of the dental practitioner and dental materials used for the granting of these benefits, which are eligible as a guaranteed benefit for those benefits. of persons.
4. The benefits referred to in paragraph. 3, shall be provided upon presentation of a confirmatory document:
1) age-in the case of children and adolescents;
2) pregnancy or crews-in the case of women.
Chapter 1a
Eligibility of health care benefits as guaranteed benefits
Art. 31a. [ Grounds for qualification of the provision of health care as a guarantee guarantee] 1. The basis for the qualification of the provision of health care as a benefit guaranteed in the field referred to in art. 15 para. Paragraphs 1 to 8 and 10 to 13 shall be assessed in accordance with the following criteria:
1) the impact on improving citizens ' health, taking into account:
(a) health priorities as defined in the provisions adopted on the basis of the paragraph 2,
(b) the maturity, morbidity or mortality rates determined on the basis of current medical knowledge;
2) the consequences of the consequences of illness or health status, in particular leading to:
(a) premature death,
(b) incapacity for self-existence within the meaning of the provisions on pensions from the Social Insurance Fund,
(c) incapacity to work within the meaning of the provisions on pensions and pensions from the Social Insurance Fund,
(d) chronic suffering or chronic illness,
(e) the quality of life;
3) the importance for the health of citizens, taking into account the necessity:
a) saving lives and getting a full recovery,
(b) to save lives and improve health,
(c) prevention of premature death,
(d) improving the quality of life without significant impact on its length;
4) clinical efficacy and safety;
5) the ratio of the health benefits to health risks;
6) the ratio of costs to the health effects obtained;
7) the financial implications for the health care system, including for entities obliged to finance health care benefits from public funds.
2. The Minister for Health shall determine, by regulation, health priorities with a view to the state of health of the public and to the health effects of the highest value.
Article 31b. [ Qualifying Party] 1. Qualification of the provision of health care as a benefit guaranteed in the scope referred to in art. 15 para. 2 paragraphs 1 to 8 and 10 to 13 shall be carried out by the Minister responsible for health after obtaining the recommendation of the President of the Agency, taking into account the criteria laid down in the Article. 31a (a) 1.
2. The qualification of the provision of health care as a guaranteed benefit shall be carried out by the Minister responsible for health, taking into account, in the field referred to in art. 15 para. 2:
1. point 9. the criteria laid down in Article 3. 12 points 4-6 and 9 of the Law on refunds;
(2) points 14 to 16 of the criteria laid down in Article 4 (2 12 of the Act on refunds;
(3) points 17 to 18 of the criteria set out in Article 3. 12 points 3-6, 8-11 of the Law on refunds.
Article 31c. [ Request for preparation by the Agency of the recommendation for a given health care benefit] 1. The Minister of Health shall instruct the President of the Agency to prepare the recommendation for the given health care provision on his eligibility as a guaranteed benefit, together with a determination of the level of funding in the amount of the health care or the percentage or method of its financing.
2. The order shall include a description of the provision of health care and a description of the disease and the state of health in which it is granted, and its impact on improving the health of citizens.
3. The President of the Agency shall, immediately upon receipt of the request, consult:
1) national consultants from the field of medicine suitable for a given health care benefit in the scope referred to in paragraph. 2;
2) the President of the Fund to the extent referred to in art. 31a (a) 1 point 7.
4. The entities referred to in paragraph. 3, are required to issue an opinion within 30 days from the date of receipt of the descriptions referred to in the paragraph. 2.
(5) The President of the Agency shall submit without delay the opinions referred to in paragraph 1. 3, The Council of Transparency referred to in art. 31s.
6. The Council of Transparency shall provide a position on:
(1) the eligibility of the healthcare provision in question as a guaranteed benefit, including the establishment of the level or the way in which it is financed, or
2) the invalidity of qualifying a given health care benefit as a guaranteed benefit.
7. The President of the Agency, taking into account the position of the Council of Transparency and the criteria laid down in art. 31a (a) 1, issues recommendations on:
(1) the eligibility of the healthcare provision in question as a guaranteed benefit, including the establishment of the level or the way in which it is financed, or
2) the invalidity of qualifying a given health care benefit as a guaranteed benefit.
(8) The President of the Agency shall immediately forward a recommendation to the Minister for Health.
9. The President of the Agency shall immediately place the orders and recommendations on the Agency's website and in the Agency's Public Information Bulletin on the principles set out in the provisions on access to public information.
Art. 31ca. [ Recommendation on the appropriateness of the use of medicines within the Preventive Vaccination Plan] 1. The Minister competent for health may instruct the President of the Agency to prepare a recommendation on the appropriateness of the use of medicines within the framework of the Preventive Vaccination Plan referred to in the provisions on prevention and control of infections and diseases human.
2. Upon receipt of the order referred to in paragraph. 1, the President of the Agency shall invite the responsible entity within the meaning of the Act of 6 September 2001. -Pharmaceutical law to be transferred:
1) clinical analysis,
2) economic analysis,
3) analysis of the impact on the budget of the entity obliged to finance the benefits from public funds
-referred to in art. 25 pt. 14 (a) First indent of the third indent of the refund act within 3 months from the date of receipt of the call.
3. For the preparation of the recommendation referred to in paragraph. 1, the provisions of Article 1 shall apply. 31c par. 3-9. The recommendation shall be issued within 2 months from the date of receipt of the analyses referred to in paragraph 1. 2 or from the expiry of the time limit for their transmission.
4. In the event of failure to submit the analyses referred to in paragraph 1. 2, the President of the Agency shall issue a recommendation on the basis of available data.
Art. 31d. [ Delegation] The Minister responsible for Health shall determine, by means of regulations, within the various fields referred to in Article. 15 para. 2 points 1 to 8 and 10 to 13, lists of benefits guaranteed with the definition of:
1. the level or method of financing of the guaranteed benefit in question referred to in Article 1. 18, art. 33 and art. 41, taking into account the content of the recommendations and taking into account the criteria set out in Article 31a (a) 1;
(2) the conditions for the implementation of the guaranteed benefit, including medical staff and equipment and medical equipment, having regard to the need to ensure the quality of the health care benefits and of the proper provision of the health care services concerned; the security of those benefits.
Art. 31e. [ Removal of the provision of health care from the list of guaranteed benefits] 1. The Minister responsible for Health may remove the provision of health care from the list of guaranteed benefits or make a change in the level or method of financing, or the conditions for the implementation of the guaranteed benefit, acting on its own initiative or on the the proposal, taking into account the criteria set out in Article 31a (a) 1.
1a. Removal of a given health care benefit from the list of guaranteed benefits or a change in the level or method of financing shall take place upon the recommendation of the President of the Agency.
2. Conclusions on the matters referred to in paragraph. 1, may submit to the minister competent for health matters:
1) consultants of the country of medicine suitable for a given health care benefit;
(2) associations which are, in accordance with the provisions of their statutes, of national scientific associations, through the consultants referred to in point 1;
3. The President of the Fund;
4) associations and foundations, whose statutory objective is to protect the rights of the patient-through the consultants referred to in point 1.
3. Conclusions on the matters referred to in paragraph. 1, they shall contain:
1. the designation of the entity referred to in paragraph 1. 2;
2. the registered office of the entity referred to in paragraph 2. 2, or its address;
(3) an indication of whether the application concerns:
(a) the removal of the health benefit in question from the list of guaranteed benefits or
(b) changes in the level or method of financing or the conditions for the implementation of the guarantee;
4) a justification indicating the impact of a given health care provision on the state of health of citizens and the financial implications for the health care system;
5) the date of the application;
6) a list of documents attached to the application confirming the validity of the application;
7) the signature of the person authorized to submit the application.
Art. 31f. [ Assessment of the request for removal of the health care benefit from the list of guaranteed benefits] 1. The Minister of Health shall, within 30 days from the date of the impact of the application referred to in art. 31e par. 1, makes its formal assessment, in terms of compliance with the requirements laid down in Art. 31e par. 3.
2. In the event of a statement of formal deficiencies of the application, the Minister responsible for Health shall call upon the person who submitted the application referred to in Article. 31e par. 1, to complete it within a period of not more than 14 days.
3. In the event of failure to supplement the formal deficiencies of the application referred to in Article 31e par. 1, shall be left unrecognizable.
4. To the actions taken by the Minister responsible for health matters referred to in paragraph. 1-3, the provisions of the Code of Administrative Procedure apply.
5. The Minister of Health, after receipt of the complete application referred to in art. 31e par. 1, instruct the President of the Agency to prepare the recommendation referred to in art. 31e par. 1, setting a time limit for its preparation, as soon as it informs the person who submitted the application.
Article 31g. [ Report on the assessment of the provision of health care] 1. the President of the Agency, upon receipt of the order referred to in art. 31f ust. 5, assesses the provision of health care and prepares, in accordance with the order, a full or summary report, on:
1) the removal of a given health care benefit from the list of guaranteed benefits, or
2. changes in the level or method of financing the guarantee benefit
-hereinafter referred to as 'the report on the assessment of the provision of health care'.
2. The report on the assessment of health care provision shall include:
1) a description of the provision of health care covered by the contract, with particular regard to the availability of alternative healthcare provision in a given disease, state of health or indication;
2) a description of the disease, the state of health or indications in which the provision of health care covered by the contract is provided, taking into account:
(a) the impact of health care provision on the health status of citizens, including maturity, morbidity, mortality or mortality,
(b) the effects of the disease or health status;
3. indication of scientific evidence concerning:
(a) clinical efficacy and safety,
(b) the ratio of costs to health effects,
(c) the financial implications for the health care system, including those required to finance public health care benefits;
4) an indication of scientific evidence in the form of secondary studies or guidelines of clinical practice;
5) data on the costs of healthcare provision and its component elements;
6) determine the terms of financing from public health care benefits covered by the contract in other countries, with particular reference to countries with the level of gross domestic product close to the Republic of Poland.
Art. 31h. [ Reporting to the Consultative Council on the assessment of the provision of health care] (1) The President of the Agency shall submit the report on the assessment of health care provision to the Council of Transparency as soon as possible, as referred to in Article 31s.
2. The Council of Transparency on the basis of the report on the assessment of the guaranteed benefit prepares immediately for the President of the Agency a position in the scope of:
1) the removal of a given health care benefit from the list of guaranteed benefits, or
2. changes in the level or method of financing the guarantee benefit.
3. The President of the Agency, taking into account the position prepared by the Council of Transparency, shall issue a recommendation on:
1) the removal of a given health care benefit from the list of guaranteed benefits, or
2. changes in the level or method of financing the guarantee benefit.
(4) The President of the Agency shall immediately forward the recommendation to the Minister for Health and to the body which has submitted the application referred to in Article 4. 31e par. 1.
5. The President of the Agency shall immediately place the orders referred to in Article 5. 31f ust. 5, reports on the assessment of health care provision and the posts and recommendations on the Agency's website and in the Agency's Public Information Bulletin on the principles set out in the provisions on access to public information.
Art. 31j. [ Delegation] The Minister for Health shall determine, by means of a regulation, the manner and procedures for the preparation of a report on the assessment of the provision of health care, taking into account the knowledge of the evaluation of medical technologies.
Art. 31k. [ Delegation] The Minister responsible for Health shall determine, by means of a regulation, the models of proposals for the removal of the health care benefit in question from the list of guaranteed benefits or changes in the level or method of financing the guaranteed benefit, or the conditions for its implementation, with a view to harmonising the information and the documents transmitted and ensuring the transparency of applications.
Article 31l. [ Exclusion of provisions of the Code of Administrative Procedure] The provisions of the Code of Administrative Procedure shall not apply to qualifying proceedings under the conditions laid down in this Chapter, subject to the provisions of Article 4 (1) of the basic Regulation. 31f ust. 4.
Chapter 1aa
Ratification Of Health Care Benefits
Art. 31la. [ Agency tarification plan] 1. The tarification of health care benefits shall be carried out on the basis of the Agency's tariff plan drawn up for the calendar year.
(2) The President of the Agency shall draw up a draft tarification plan for the Agency and submit it to the President of the Fund and to the Council for the purposes of the Tarsification Council referred to in Article 3. 31sa, by 1 June of the year preceding the year to which the plan relates. The President of the Fund and the Council for Tarfications shall provide opinions within 14 days from the date of receipt of the plan. The failure to deliver an opinion within this time limit shall be tantamount to a positive opinion.
(3) The President of the Agency shall forward to the Minister responsible for health the tariff schedule of the Agency with the opinion of the President of the Fund and of the Council for the Tarsification matters referred to in Article 3 (1) of the Regulation. 31sa, for approval by 16 June of the year prior to the year to which the plan relates.
4. The Minister of Health shall approve the plan for the tarification of the Agency within 14 days from the date of its receipt.
5. The Minister responsible for health may within the time limit referred to in paragraph. 4, recommend that amendments be made to the Agency's schedule of tarification, specifying a time limit of 7 days for their introduction.
6. In the absence of a schedule of tarification within the time limit referred to in paragraph 1. 3, the failure of the Agency to amend the changes referred to in paragraph 3. 5 or the non-approval of the plan, the Minister responsible for health shall draw up a plan of tarification of the Agency.
Art. 31lb. [ Determination of the benefit tariff in a given range or type] 1. The President of the Agency shall determine the tariff of benefits, in a given range or type, in the form of a notice published in the Public Information Bulletin of the Agency and on the Agency's website.
2. Before determining the tariff of benefits in a given range or type, the President of the Agency shall consult the Council for the matters of Tarsification referred to in art. 31sa.
3. The Council for Tarsification referred to in art. 31sa, issue an opinion within 30 days from the date of receipt of the benefit tariff in a given range.
Art. 31lc. [ Permission to collect and process the data necessary for the determination of the benefit tariff] 1. The Agency shall be entitled to collect and process the data necessary to determine the benefit tariff.
2. In order to specify the benefit tariff, the Agency shall have the right to process the following data to the recipients:
1) the PESEL number, and in the case of its absence-the type and number of the document confirming the identity;
2. address of the place of residence;
3) on the provision and financing of health care benefits.
3. The entities required to finance health care benefits from public funds shall make the data referred to in paragraph free of the Agency free of charge. 2, necessary for the determination of the benefit tariff.
4. In the event of the need to obtain data from entities other than those mentioned in the paragraph. 3, the Agency shall conclude agreements with those entities which ensure the highest quality and completeness of the transmitted data, selected in the proceedings announced by the Agency. The Agency shall conclude agreements on the basis of a procedure laid down by the Agency ensuring respect for the principle of transparency and equal treatment of entities and on the conclusion of an agreement with an entity which satisfies objective, proportionate and non-discriminatory the conditions laid down in that proceeding.
5. To conclude the agreements referred to in paragraph. 4, no public procurement rules shall apply. The agreement may provide for remuneration for the transmission of data if the parties so decide.
6. [ 1] The contract referred to in paragraph 1 shall be concluded. 4, with the entity providing the provider is the use of the cost account by this provider, drawn up on the basis of the recommendations referred to in paragraph. 7.
7. The Minister responsible for Health shall determine, by means of a regulation, recommendations concerning the standard of the cost account with the providers referred to in paragraph 1. 6, guided by the need to unify the way of identifying, collecting, processing, presenting and interpreting information on the costs of health care benefits.
Chapter 1b
Agency for the Evaluation of Medical Technology and Tarsification
Art. 31m. [ Legal nature] 1. The Agency is a state organizational unit with legal personality, supervised by the Minister of the Health Affairs.
2. The Agency operates on the basis of the Act and the Statute.
3. The seat of the Agency is the capital city of Warsaw.
4. The Minister responsible for health shall, by means of a regulation, give the Agency a statute setting out in particular the organisational structure of the Agency with a view to the smooth performance of the Agency's tasks.
Article 31n. [ Tasks] The tasks of the Agency shall be:
1) the implementation of tasks related to the assessment of health care services in the scope of:
(a) to issue recommendations on:
-the qualification of the health care provision as a guarantee,
-the determination or modification of the level or method of financing the guarantee,
-the removal of a given health care benefit from the list of guaranteed benefits,
(b) the development of reports on the assessment of health care benefits,
(c) the preparation of the verification analyses referred to in Article 35 of the Act on refunds;
(1a) the establishment of the benefit tariff;
(1b) drawing up proposals for recommendations on the standard of the cost account referred to in the provisions adopted on the basis of art. 31lc ust. 7;
2) the development, verification, collection, sharing and dissemination of information on the methodology for conducting the evaluation of medical technologies, medical technologies developed in the Republic of Poland and other countries and the principles of determining benefits tariffs;
3) opinion on projects of health policy programmes;
4) conducting a training activity in the scope of tasks referred to in points 1 to 3;
5) the implementation of other tasks commissioned by the minister competent for health matters.
Art. 31o. [ President of the Agency] 1. The Agency shall be the President of the Agency.
2. The scope of the President of the Agency shall be:
1) the execution of the orders referred to in art. 31c par. 1 and Art. 31f ust. 5;
2) cooperation with the Fund, the Office for the Registration of Medicinal Products, Medical Devices and Biocidal Products, the authorities of government and self-government administration and entities operating in other countries activities in the field of assessment of care benefits health;
3) the exercise of labour law activities in relation to the employees of the Agency;
4) the performance of other tasks commissioned by the minister competent for health matters;
5. publication in the Public Information Bulletin of the Agency:
(a) the verification analyses of the Agency, together with the analysis of the applicant referred to in Article 25 pt. 14 (a) c and Art. 26 point 2 (a) h and the refund act,
(b) Transparency Council positions,
(c) recommendations of the President of the
(d) reports on the assessment of the provision of health care,
(e) opinions on projects of health policy programmes,
(f) the agenda, the work plan of the Council of Transparency and the minutes of its meetings.
3. The President of the Agency shall direct the Agency and represent it externally.
4. The President of the Agency shall perform his duties with the assistance of the Deputy President of the Agency for the Evaluation of Medical Technologies and the Deputy President of the Agency for Tarsification. The responsibilities of the Deputy President of the Agency shall be determined by the statutes of the
Art. 31p. [ Appointment and appeal of the President of the Agency] 1. The President of the Agency shall be appointed by the Minister responsible for health from among persons selected on the basis of open and competitive recruitment referred to in art. 31r.
2. The Deputy President of the Agency shall be appointed by the Minister responsible for health, at the request of the President of the Agency, from among persons selected on the open and competitive recruitment referred to in art. 31r.
3. The tenure of the President of the Agency and the Deputy President of the Agency shall be 5 years.
4. The President of the Agency or the Deputy President of the Agency may be a person who:
1) holds a master's professional title or equivalent in the field of medical, pharmaceutical, economic, legal or technical sciences;
2) have knowledge of health protection and assessment of health care services, pharmacoeconomics, systems of financing health services and economics of health;
3) has a minimum of 3 years of employment in managerial positions in:
a) scientific units within the meaning of the Act of 8 October 2004. on the principles of financing science (Dz. U. of 2008 items 1049) [ 2] or
(b) the bodies subordinate to or supervised by the Minister responsible for health matters;
4) has not been convicted by a final sentence for intentionally committed crime or treasury offense;
5) enjoys full public rights.
5. The Minister of Health shall dismiss the President of the Agency and the Deputy President of the Agency from the post office before the end of the term of office in the case of:
1) a flagrant violation of the law;
(2) loss of capacity to perform duties due to sickness or other obstacles which permanently prevent the exercise of official duties;
3) resignation from the post;
4) convict the final sentence for intentionally committed crime or treasury offence;
5. infringements of the provisions of Article 31q. 1;
6) the unveiled performance of obligations under the Act or the Statute.
(6) The remuneration of the President of the Agency and the Deputy President of the Agency shall be determined by the Minister responsible for health.
Art. 31q. [ Prohibition of taking additional employment without the consent of the Minister of Health] 1. The President of the Agency and the Deputy President of the Agency shall not be allowed to undertake additional employment without the written consent of the Minister responsible for health, or to perform activities or to undertake activities which are not compatible with the duties to be carried out.
2. The employees exercising statutory or statutory tasks of the Agency may not undertake additional gainful activities without the written consent of the President of the Agency.
3. The recruitment of vacancies in the Agency shall be open and shall take place in competitive mode. The provisions of Article 4 107a (a) 2-Article 107g shall apply mutatis mutandis.
Art. 31r. [ Nabór to the position of President of the Agency] 1. Information about the appointment of the President of the Agency shall be announced by placing the notice in a place which is widely available at the Agency's premises and in the Public Information Bulletin of the Agency and the Public Information Bulletin of the Chancellery of the President of the Board Ministers. The notice shall include:
1. the name and address of the Agency;
2. determination of the position;
3) requirements related to the position resulting from the provisions of law;
4) the scope of the tasks performed on the post;
5) an indication of the required documents;
6) deadline and place of submission of documents;
7. information on the methods and techniques of recruitment.
2. The term referred to in paragraph 1 point 6, shall not be less than 10 days from the date of publication of the notice in the Information Bulletin of the Public Chancellery of the Prime Minister.
3. The recruitment of the position of the President of the Agency shall be carried out by a team appointed by the Minister responsible for health, with at least 3 persons whose knowledge and experience provide a guarantee of the selection of the best candidates. In the course of the selection, the applicant shall assess the applicant's professional experience, the knowledge necessary to carry out his duties as a recruitment, and the managerial competence.
4. Evaluation of the knowledge and managerial competence referred to in paragraph. 3, may be made on the order of the team by a non-member of the team who has the appropriate qualifications to make this assessment.
5. Member of the team and the person referred to in paragraph. 4, they have the obligation to keep in secret information concerning the applicants for the post obtained during the recruitment process.
6. In the course of the selection, the panel will emerges no more than 3 candidates, which are presented by the Minister of Health.
7. The assembly shall draw up a protocol containing the following:
1. the name and address of the Agency;
2) determining the position for which the recruitment was conducted, and the number of candidates;
3) forenames, surnames and addresses of no more than 3 of the best candidates ranked according to the level of meeting the requirements laid down in the announcement of the borderline;
4. information on the methods and techniques used for the recruitment;
5) justification of the choice made or the reasons for the nominee's failure;
6) composition of the team.
8. The result of the recruitment shall be announced immediately by the inclusion of the information in the Public Information Bulletin of the Agency and the Public Information Bulletin of the Chancellery of the Prime Minister. Information on the outcome of the recruitment shall include:
1. the name and address of the Agency;
2) determination of the position for which the recruitment was conducted;
3) the names of the selected candidates and their place of residence within the meaning of the provisions of the Civil Code or the information about the failure of the candidate.
9. Setting up in the Public Information Bulletin of the Chancellery of the Prime Minister of the Council of Ministers announcement of the recruitment and the result of this recruitment is free of charge.
10. The provisions of the paragraph. 1-9 shall apply to recruitment for the post of Deputy President of the Agency.
Art. 31s. [ Transparency Council] 1. The President of the Agency shall act as the Council of Transparency, which shall act as an advisory and advisory function.
2. The Council of Transparency shall include:
1) 10 persons with experience, recognised acquis and at least a scientific degree of doctor of medical sciences or related fields, or other fields appropriate for carrying out the assessment of health care benefits, including ethics;
2) 4 representatives of the minister competent for health matters;
3) 2 representatives of the President of the National Health Fund;
4) 2 representatives of the President of the Office for Registration of Medicinal Products, Medical Devices and Biocidal Products;
5) 2 representatives of the Ombudsman's Rights Ombudsman.
3. The members of the Council of Transparency shall appoint a minister competent for health, with the members referred to in paragraph 1. 2 points 5 to 5, shall be appointed at the request of the competent authorities.
4. The tenure of a member of the Transparency Council shall be 6 years. Where a member of the Council of Transparency is cancelled before the expiry of his term of office, the term of office of the member appointed to him shall expire on the date of expiry of the term of office of the member revocation.
5. Members of the Council of Transparency shall enjoy:
1) a remuneration not exceeding PLN 3500 per share in each meeting of the Transparency Council, however, not more than 10,500 PLN per month;
2) reimbursement of the costs of the journey in the amount and under the conditions stipulated in the provisions issued on the basis of art. 77 5 § 2 of the Labour Code (Dz. U. of 2016 r. items 1666).
6. The tasks of the Council of Transparency shall be:
1) preparing and presenting the positions referred to in art. 31c par. 6 and art. 31h ust. 2;
2) preparing and presenting the positions referred to in art. 35 par. 1 point 2 of the refund act;
3) issuing opinions on projects of health policy programmes;
4) the implementation of other tasks commissioned by the President of the Agency;
5. to issue an opinion within the scope referred to in art. 15 para. 3, art. 33 (1) 2 and Article 40 of the Act on refunds.
7. A member of the Council of Transparency may only be a person:
1. which:
(a) has the knowledge and experience in the field of health care services, giving a guarantee of the correct performance of the duties of a member of the Council of Transparency,
(b) has not been lawfully convicted of a deliberate offence or a deliberate tax offence,
(c) enjoy full public rights;
2) to which the circumstances set out in the paragraph are not applicable. 8 and art. 21 of the Act on refunds;
3) whose candidacy has been accepted by the Minister of Health.
8. The members of the Council of Transparency, their spouses, descending and preliminary lines in a straight line and persons with whom the members of the Transparency Council remain in the common borrowing may not:
1) be members of the bodies of commercial companies or representatives of entrepreneurs conducting business activity in the field of manufacture or marketing of the drug, a foodstuff for special nutritional uses, a medical device;
2) be members of the bodies of commercial companies or representatives of entrepreneurs conducting economic activity in the field of advice related to the refund of medicines, foodstuffs for particular nutritional uses, medical devices;
3. be members of the bodies of cooperatives, associations or foundations operating in the activities referred to in points 1 and 2;
4) hold shares or shares in commercial companies operating as referred to in points 1 and 2 and shares in cooperative societies referred to in points 1 and 2;
5) conduct business activities within the scope referred to in points 1 and 2.
9. The candidates for the members of the Transparency Council before calling for the composition of the Council, and the members of the Transparency Council before each meeting of this Council, shall make a statement of the non-Western circumstances referred to in the paragraph. 8, under penalty of criminal liability for making false statements, hereinafter referred to as the "declaration of absence of conflict of interest", concerning their own and their spouses, descending and preliminary in the straight line and the persons with whom they remain in common Borrowing. The applicant shall be obliged to conclude a clause with the following content: "I am aware of the criminal responsibility for making a false statement." This clause replaces instructing the body of criminal responsibility for making false statements.
10. (repealed)
11. (repealed)
(12) Persons who are not members of the Transparency Council, who are intending to ask for expert opinions or other studies for that Council, shall make a declaration of the existence or absence of the circumstances referred to in the paragraph before the adoption of the request. 8, for individual proposals which are the subject of the Council's deliberations in the field referred to in paragraph 1. 6, under the penalty of criminal liability for making false statements, hereinafter referred to as the "declaration of conflict of interest". The applicant shall be obliged to conclude a clause with the following content: "I am aware of the criminal responsibility for making a false statement." This clause replaces instructing the body of criminal responsibility for making false statements.
13. In the case of disclosures of conflicts of interest, a member of the Transparency Council, at its own request or a request by the person chairing a meeting of the Council of Transparency, may be excluded from the vote or from participation in the proceedings of the Transparency Council, within the scope of exposed conflict. A member of the Transparency Council is not participating in the vote on the exemption.
14. If the circumstances referred to in paragraph 1 8 and 9 permanently prevent the Member of the Council of Transparency from carrying out its tasks properly, the Council of Transparency may designate it as a member of the time limit for its removal.
(15) In the meetings of the Transparency Council, experts in the field of medicine concerned may take part in the proposals or information in question, and other persons invited by the President of the Council of Transparency, without the right to vote. Those persons shall be obliged to submit the declarations referred to in paragraph 1. 8 and 9.
16. The Minister of Health shall refer a member of the Transparency Council, either on his own initiative or at the motivated request of the President of the Agency, before the end of his term of office, in the case of:
1) to resign from the post;
(2) sickness which permanently prevents the performance of the tasks entrusted;
3) convict the final sentence for intentionally committed crime or treasury crime;
4. non-application of the required declarations referred to in paragraph 1. 8 and 9;
5) the uneffective expiry of the period referred to in paragraph. 14;
6. evasion of the duties of a member of the Council of Transparency or of the misconduct of those obligations.
(17) Of the members of the Transparency Council, a 10-member Assembly shall be drawn up before each meeting, the composition of which shall be drawn up by drawing lots, in such a way as to ensure that each of the entities referred to in paragraph 1 shall be drawn up. 2 points 3 to 5, he had one representative.
(18) The work of the Council of Transparency shall be chaired by the President by two Vice-Presidents. The President and the Vice-Presidents shall be elected from among the members of the Transparency Council at the first meeting by an absolute majority of votes in the presence of at least 2/3 of its members in a secret ballot. The Chairperson or Vice-Chair of the Transparency Council shall hold a meeting of the Pool referred to in paragraph. 17.
19. The team referred to in paragraph. 17, adopt resolutions which are the positions of the Transparency Council, subject to the prior presentation of a written opinion attached to the dossier by each member participating in the meeting. Resolutions of the Panel shall be taken by a simple majority of votes in the presence of at least 2/3 of its members. In the event of an equal number of votes, the vote of the Transparency Council is decided.
20. Position of the Council of Transparency as referred to in Article 35 par. 1 point 2 of the refund act, contains:
1. determining whether a medicine, a foodstuff intended for a particular nutritional purpose and a medical device should be financed by public funds;
2. laying down detailed conditions for the entry of the refund, foodstuff for particular nutritional uses and medical devices in the field of:
(a) indications in which the medicinal product, foodstuff intended for particular nutritional uses and a medical device is to be covered by a refund,
(b) the suggested level of the payment referred to in Article 3. 14 of the Act on refunds,
(c) suggestions for inclusion in the existing or the creation of a new limit group referred to in Article 3 (1) of the EC Regulation. 15 of the Act on refunds,
(d) comments and suggestions for the description of the drug programme, if applicable,
(e) proposals for the risk sharing instruments referred to in Article 4. 11 (1) 5 of the Act on refunds;
(3) justification.
21. The team may decide by an absolute majority of the votes to be adopted by the Council of Transparency in full composition. The provisions of the paragraph 19 and 20 shall apply mutatis mutandis.
(22) The detailed work of the Council of Transparency shall lay down the rules of procedure adopted by that Council and approved by the President of the Agency.
(23) The Declaration of Conflict of Interest shall also consist of persons who submit comments to the Agency's public verification analysis or in connection with the public agenda for the Council of Transparency. The comments submitted shall be considered by the Agency and set out in the Agency's Public Information Bulletin, including a declaration of interest.
24. Declarations of a lack of conflict of interest shall verify the Central Anticorruption Bureau.
(25) The Minister responsible for Health will determine, by regulation, the amount of the remuneration of the members and the President of the Council of Transparency, taking into account the scope of its tasks.
Art. 31sa. [ Council for Tarfication] 1. The President of the Agency shall act as the Council for the issue of Tarsification, which shall act as an advisory and advisory function.
2. The tasks of the Council for the Tarsification shall be:
1. opinion:
(a) the tariff plan for the Agency,
(b) the methodology for tarification of benefits,
(c) the provision of the benefit tariff and the changes thereto;
2) the implementation of other tasks commissioned by the President of the Agency.
The Council shall be composed of ten members appointed by the Minister responsible for health matters, including three members from among the persons notified by the representative organisations of the persons concerned within the meaning of Article 3 (1) of the Council Regulation. 31sb ust. 1 and two members reported by the President of the Fund.
4. Selection of the three members of the Council for the Tarsification of the persons notified by the representative organisations of the services within the meaning of the Article. 31sb ust. 1 makes the Minister responsible for health, taking into account the criterion of the number of persons employed and the persons providing health care services in total, with the providers associated with the representative organisation of the healthcare providers which carried out the reports.
5. The tenure of the Council for the Taratification shall be 6 years. Where a member of the Council for Tarfications is cancelled before the expiry of the term of office, the term of office of the member appointed for his place shall expire on the date of expiry of the term of office of the Council for the issue of Tarsification.
6. The Minister of Health shall refer the member of the Council to the matters of Taratification on the reasoned request of the President of the Agency before the expiry of the term of office in the case of
1) to resign from the post;
(2) a disease which permanently prevents the duties of a member of the Council for the Tarsification;
3) convict the final sentence for intentionally committed crime or treasury crime;
4) evasion of the duties of a member of the Council for the purposes of the Taratification or improper performance of those duties;
(5) failure to comply with the conditions referred to in paragraph 1. 7 or 8;
6. the non-application of the declaration referred to in paragraph 1. 9.
(7) A member of the Council for the purposes of the Tarsification may be a sole person who:
1) have the knowledge and experience in the financing of health care services, giving a guarantee of the proper exercise of the duties of a member of the Council for the Tarsification Affairs;
2) has not been convicted by a final sentence for intentionally committed crime or treasury offense;
3) benefit from full public rights;
4) is not a member of the Transparency Council or of the Economic Commission referred to in art. 17 of the Act on refunds.
(8) The members of the Council for the codification, their spouses, their descendants, their consents in a straight line and persons with whom the members of the Council remain in the common borrowing shall not:
1) be members of the bodies or representatives of entrepreneurs performing business activities in the field of advisory related to the tariff or accounting of health care benefits;
2) hold shares or shares in the entities referred to in point 1;
3) perform business activities in the field of advisory related to tarification and accounting of health care benefits;
4) perform gainful activities in the field of counseling related to tarification and clearing of health care benefits on the basis of contracts with the entities set out in points 1 to 3.
9. The candidates for the members of the Council for the Taratification and the members of the Council for the issue of the codification shall make a declaration of the non-Western circumstances referred to in the paragraph. 8, under penalty of criminal liability for making false statements, hereinafter referred to as the "statement of absence of conflict of interest", concerning their own and their spouses, descending and preliminary in the straight line and the persons with whom they remain in common Borrowing. The applicant shall be obliged to conclude a clause with the following content: "I am aware of the criminal responsibility for making a false statement." This clause replaces instructing the body of criminal responsibility for making false statements.
(10) Persons who are not members of the Council for the purposes of the Tarsification, which is intended to instruct the preparation of an expert or other study for that Council, shall, before the adoption of the order, make a declaration of the existence or absence of the circumstances referred to in the paragraph 8, under the rigorous criminal responsibility for making false statements. The applicant shall be obliged to conclude a clause with the following content: "I am aware of the criminal responsibility for making a false statement." This clause replaces instructing the body of criminal responsibility for making false statements.
(11) The experts and other persons invited by the President of that Council, without the right to vote, may take part in the meetings of the Council for the Taratification. The persons concerned shall be subject to paragraph 1. 8 and 10.
12. In the event of disclosing the conflict of interest of a member of the Council for Tarsification, the Council shall exclude that member from participation in the work of that Council, and shall inform the President of the Agency thereof.
13. A certificate of absence of conflict of interest shall be verified by the Central Anticorruption Bureau.
(14) The Council shall be chaired by two Vice-Presidents, by the Council's work on the Taratification. The Chairperson and the Vice-Presidents shall be elected from among the members of the Council for the Taratification at the first meeting by a majority of 2/3 of the votes in the presence of at least half of its members in a secret
15. The Council shall adopt resolutions by a simple majority of votes in the presence of at least half of its members. In the event of an equal number of votes, the vote of the President of the Council for Tarfication
(16) The detailed operating mode of the Council for Tarsification shall be determined by the Rules of Procedure adopted by the Council and approved by the President of the Agency.
17. The members of the Council for the Tarsification shall have:
1) a remuneration not exceeding PLN 3500 per share in each meeting of this Council, however not more than 10,500 PLN per month;
2) reimbursement of the costs of the journey in the amount and under the conditions stipulated in the provisions issued on the basis of art. 77 5 § 2 of the Labour Code.
(18) The Minister responsible for Health will determine, by regulation, the remuneration of the members and the President of the Council for Tarsification, taking into account the scope of its tasks.
Art. 31sb. [ Representative of the organisation of the services of the providers] 1. A representative organisation of the providers shall be considered to be the organisation which brings together the providers with a total number of persons employed and persons providing health care benefits in total at least 10 000. A person entitled to represent this organization will submit to the Minister responsible for Health, no later than 30 April, a statement confirming the number of persons employed and persons providing health care benefits under the rigorous criminal liability for the submission of false statements. The applicant shall be obliged to conclude a clause with the following content: "I am aware of the criminal responsibility for making a false statement." This clause replaces instructing the body of criminal responsibility for making false statements.
2. The Minister responsible for Health shall keep a list of representative organisations of the providers.
3. In the case of a representative organisation of the healthcare providers included in the list of representative organisations of the providers, the statement referred to in paragraph 1 shall be added to the list of representative organisations. 1 shall be submitted annually, not later than 30 April. Failure to make such a statement within the time limit shall result in the removal of such an organisation from the list of representative organisations of the providers.
4. The Minister of Health shall make available a list of representative organisations of the healthcare providers, together with the statements referred to in paragraph 1. 1 and 3, in the Public Information Bulletin of the office serving the Minister responsible for health and on the website of that office.
Art. 31t. [ Financing of Agency activities] 1. The Agency shall act on the basis of the annual financial plan approved by the Minister responsible for health, covering the revenues and costs of the Agency.
2. The Agency's revenue shall be:
1) income from the fees for the evaluation of reports on the assessment of health care benefits and the development of these reports;
(1a) a copy of the tarification of the benefits referred to in paragraph 1. 5-8;
2) subsidies aimed at financing or financing the costs of carrying out investments;
(3) Subjective grants for the implementation of the tasks of the Agency referred to in Article 31n, point 1 (a) a and points 2, 3 and 5;
4) donations and records;
5. investment income;
6. other revenue.
3. The President of the Agency shall post on the Agency's website and in the Public Information Bulletin, information on donations received containing:
1) the amount of donations;
2) the date of filing of the donation;
3) the name or the name (company) of the donor.
4. The costs of the Agency shall be:
1) the activities of the Agency, in particular depreciation costs, real estate maintenance costs and technical infrastructure, the cost of salaries including derived, diets and reimbursements of travel expenses;
2) the execution of tasks commissioned within the scope specified in the Act;
3) the activities of the Transparency Council and the Council for Tarsification;
4) the cost of acquiring the data necessary to set the benefit tariff;
5) other costs resulting from the separate provisions.
5. The amount of the deduction for the tarification of benefits for a given year shall be determined taking into account:
1) the amount of the Agency's cost of tarification as set out in the Agency's financial plan in the previous year and the anticipated execution of the Agency this year;
(2) the difference between the planned and the executed amount of the Agency's cost of tarification in the year prior to 2 years in the year in question;
3) the draft tarification plan for a given year.
6. The determination of the amount of the write-off on the tarification of the benefits referred to in paragraph 1 5, requires a positive opinion of the Minister responsible for health issues issued in consultation with the Minister responsible for public finance.
7. In the absence of a positive opinion, referred to in paragraph. The amount of the allowance for the tariff of benefits shall be fixed by the Minister responsible for health matters in consultation with the Minister responsible for public finance.
8. In the event of failure to set the amount of the write-off on the tarification of benefits in accordance with the paragraph. 7, that value shall be taken as a result of the Agency's financial plan in the previous year.
9. The amount of the deduction for the tarification of the benefits referred to in paragraph. 5, 7 and 8, shall be equal to not more than 0,07% of the planned revenue for the health insurance premiums for that year in the financial plan of the Fund referred to in Article 3. 121 (1) 3 or para. 4, or para. 5, or art. 123 3.
10. The President of the Agency shall inform the President of the Fund of the amount of the write-off on the tarification of benefits for the year.
(11) The fees for rewriting on the tarification of benefits shall be allocated by the Agency only to cover the costs of the tariff of benefits. The Agency may purchase fixed assets relating to the tarification of benefits from the write-off of benefits in the tarification of benefits. The depreciation costs of these assets are costs in terms of the tarification of benefits.
12. The Agency shall be required to operate, within the framework of the establishment plan of accounts, the accounting records in such a way as to separate costs, revenues and fixed assets in the scope of tarification.
13. A copy of the tarification of benefits shall be transferred by the Fund to the Agency in twelve equal monthly instalations until the last day of the month.
(14) From the amount not transferred by the Fund within the period of the write-off of the benefits of the Agency, interest shall be paid on the basis of interest on the basis and in the amount specified for the tax arrears.
Art. 31u. [ Primary and Backup Fund] 1. A basic fund and a backup fund of the Agency shall be established.
2. The basic fund of the Agency shall reflect the net equivalent of fixed assets, intangible assets and other assets constituting the Agency's equipment as at the date of its commencation of its activities.
3. The reserve fund of the Agency shall be increased by the approved net profit for the financial year and shall be reduced by the approved net loss for the financial year.
4. The approved net profit for a given financial year shall, in the first instance, cover the loss from previous years.
5. The Agency shall conduct its accounts under the conditions laid down in the Act of 29 September 1994. of accounting (Dz. U. of 2016 r. items 1047), excluding art. 80 par. 3 of this Act.
6. The President of the Agency shall prepare an annual report on the Agency's activities and a report on the implementation of the financial plan for the previous
(7) The President of the Agency shall, by 30 April of each year, submit to the Minister for Health the approval of the Minister for Health the financial statements together with the reports referred to in paragraph 1. 6.
Art. 31v. [ Supervision of the activities of the Agency] 1. The Minister of Health shall exercise supervision over the activities of the Agency, applying the criterion of legality, reliability, advisability and economic activity.
2. The supervision referred to in paragraph 2. 1, the provisions of Article 1 shall apply mutatis mutandis. 173 (1) 2-9, art. 174-177, art. 178 (1) 1-3, art. 179, 181, 183 and 184.
3. In the framework of supervision, the Minister responsible for health shall be entitled in particular to:
1) requests made available to him by the Agency of documents relating to its activities or copies thereof;
2) requests for any information and explanations, concerning the activities of the President of the Agency, the Deputy President of the Agency and the Council of Transparency and the staff of the Agency.
4. The Minister for Health, presenting the request referred to in paragraph 1. 3, indicates the date of its implementation.
5. In the event of a statement, on the basis of the information obtained, the explanations and the documents referred to in paragraph. 3, cases of breaches of the law or of the Agency's statutes, the Minister responsible for health shall notify the Agency of the irregularities found and shall issue recommendations aimed at the removal of the irregularities found and the adaptation of the irregularities detected. the provisions of law or statutes, setting a time limit for the removal of the irregularities found and the adjustment of the activity to the law.
Art. 31w. [ Grounds for the imposition of a penalty on the President of the Agency or of his/her deputy and of the Member of the Council of Transparency] In the event of a breach by the Agency of the law or of the statutes, and in the event of refusal to provide explanations and information referred to in art. 31v par. 3, the Minister responsible for health may impose on the President of the Agency or the Deputy President of the Agency and on a member of the Council of Transparency responsible for these infringements or failure to provide explanations and information a penalty of up to three times the monthly salary of that person, calculated on the basis of the salary for the last three months preceding the month in which the penalty was imposed, irrespective of any other supervision measures provided for in the law.
Art. 31x. [ Delegation] The Minister responsible for Health shall determine, by means of a regulation, the detailed manner and mode of control of the Agency with the aim of ensuring the proper implementation of the supervision referred to in Article 31v par. 1.
Chapter 2
Coverage of health care benefits
Article 32. [ Benefits Range] The provider shall have the right to benefits in the field of diagnostic tests, including medical laboratory diagnostics, performed on the basis of referral of a health insurance physician, health insurance feller or referral of nurses or a midwife referred to in art. 15a ust. 6 of the Act of 15 July 2011. about the professions of nursing and midwife (Dz. U. of 2016 r. items 1251 and 1579), which is a health insurance nurse or a midwife of health insurance.
Article 32a. [ The right to oncological treatment on the basis of the diagnosis and oncological treatment card, without a referral] 1. A witness in which the doctor referred to in art. 55 par. 2a, stated the suspected malignancy, has the right to oncological diagnostics on the basis of the diagnosis and oncological treatment card, without the referral referred to in art. 32.
2. A witness in whom:
1) as a result of oncological diagnostics was found malignant tumor,
2) a doctor providing ambulatory specialist benefits or hospital benefits has stated malignant neoplasm
-has the right to oncological treatment on the basis of the diagnosis and oncological treatment card, without the referral referred to in art. 57 (1) 1 or Art. 58.
3. The provisions of the paragraph. 1 and 2 do not apply to malignant skin malignancies, except for skin melanoma.
4. The diagnosis and treatment of oncological treatment shall be issued by the physician concerned, as appropriate, to the physician referred to in Article 4. 55 par. 2a or paragraph 2 point 2.
5. A doctor providing ambulatory specialist benefits or hospital benefits, which has found a malignant neoplasm, is making a notification to the Malignancy Notification Charter directly to the National Cancer Register, referred to in rules issued on the basis of art. 20 para. 1 of the Act of 28 April 2011. o System of information in health care.
6. The doctor referred to in the mouth. 5, entered in the diagnostic and oncological treatment card number of the Ticket Card number of malignant tumours transmitted by the National Cancer Register.
7. The operator intending to use the oncological diagnosis or oncological treatment shall leave the diagnostic and oncological treatment card to the healthcare provider in which the benefits will be provided.
8. In the event of the need to amend the healthcare provider referred to in paragraph. 7, the diagnostic and oncological treatment card shall be issued to the provider.
9. The doctor referred to in art. 55 par. 2a, may issue diagnostics and oncological treatment cards, if the individual tumour recognition rate is not lower than the minimum tumour recognition rate, if the individual tumour recognition rate is determined for it by the provincial branch of the Fund.
10. A tumour's recognition index shall not be determined if, from the start of the medical advice referred to in Article 4 (1), the 55 par. 2a, diagnostic and oncological treatment cards of the number of witnesses to whom this doctor issued these cards and which were performed on the oncological diagnostics and the diagnosis was made, did not exceed 30.
11. Branch of the voivodship of the Fund, with which the doctor referred to in art. 55 par. 2a, has concluded an agreement for the provision of health care services, or with which he has entered into an agreement providing a basic healthcare provider with whom he provides health care services, informs the doctor and the provider of the provision of health care services. the individual tumour recognition rate.
12. The provincial branch of the Fund shall inform the doctor and the provider referred to in the paragraph. In the absence of a minimum rate of tumour recognition and the obligation of the doctor referred to in Article 11, a failure to reach a minimum rate of diagnosis of tumours and 55 par. 2a, training in early diagnosis of tumors, conducted by the entity authorized to conduct post-graduate training of physicians and dental practitioners.
13. The doctor referred to in art. 55 par. 2a, may not issue diagnostics and oncological treatment cards from the day of receipt from the provincial branch of the Fund of information referred to in paragraph. 12, until the day of presentation of the Fund's branch of the Fund by the doctor of the document confirming the completion of training in the field of early diagnosis of tumours.
14. If the doctor referred to in art. 55 par. 2a, will issue a diagnostic and oncological treatment card after receiving from the provincial branch of the Fund the information referred to in the paragraph. 12, and before the presentation of the Fund to the provincial branch of the document confirming the completion of the training in the field of early diagnosis of tumours, the branch of the Fund shall be entitled to impose a contractual penalty in the amount specified in the contract referred to in paragraph 1. 11.
15. If you change the doctor referred to in art. 55 par. 2a is followed in connection with the circumstances referred to in paragraph. (13) This amendment shall not be included in the amendments from which the number of which is subject to the payment of the fee referred to in Article 3 (1) (a) of the Regulation, 28 para. 1.
16. Branch of the Fund's voivodship, at the request of properly healthcare provider of the basic health care or the doctor referred to in art. 55 par. 2a, which has entered into a contract for the provision of healthcare services, or the healthcare provider for outpatient care or hospital services, allocates the number of unique numbers identification of diagnostic and oncological treatment cards. Healthcare providers shall assign to doctors providing healthcare benefits ranges of numbers which are unique numbers identifying the diagnostic and oncological treatment cards.
17. The ranges of numbers, which are unique numbers identifying the diagnostic and oncological treatment cards, can be used only once.
18. The Minister for Health shall determine, by means of a regulation:
1) how to determine an individual tumor recognition rate,
2) minimum cancer recognition rate
-taking into account the need to ensure the reliable and objective nature of this indicator.
Article 32b. [ Charter of Diagnostic and Oncological Treatment] 1. The provider drawing up medical records concerning oncological diagnostics or oncological treatment is obliged to draw up and transmit to the holder, free of charge, the holder of the diagnosis and treatment of oncological copy of this documentation for which the performance of the service provider does not levy the fee referred to in Article 28 para. 1 of the Act of 6 November 2008. about the rights of the patient and the Ombudsman for Patient Rights (Dz. U. of 2016 r. items 186, 823, 960 and 1070). A copy of the medical documentation concerning oncological diagnostics and oncological treatment shall constitute an annex to the diagnostic and oncological treatment card.
2. In the case of:
1) when, as a result of oncological diagnostics, no malignant tumor has been found, the provider leaves the diagnostic and oncological treatment card with the provider who has performed the diagnostic;
2) termination of oncological treatment, the healthcare provider leaves the diagnostic and oncological treatment card with the provider, who has completed this treatment.
3. In the cases referred to in paragraph. 2, the provider shall transfer the diagnostic and oncological treatment card together with a copy of the medical documentation concerning the oncological diagnosis or the oncological treatment of the doctor referred to in art. 55 par. 2a, indicated by the recipient in the declaration of choice referred to in art. 56 par. 1. The diagnosis and treatment of oncological treatment shall be attached to medical records.
4. The diagnostics and oncological treatment card shall contain:
1) the designation of the patient, allowing the identification of his/her identity:
(a) name and surname (s),
b) date of birth,
(c) gender designation,
(d) address of residence,
e) the PESEL number, if given, in the case of a newborn-the PESEL number of one of the parents or legal guardian, and in the case of persons who do not have a given PESEL number-the type and number of the document confirming the identity,
(f) where the recipient is a minor, totally incapacitated or unable to give an informed consent, the name and first name (s) of the statutory representative or of the beneficial owner within the meaning of Article 3 (1) of the Rules of Law. 3 para. 1 point 1 of the Act of 6 November 2008. about the rights of the patient and the Ombudsman for the Rights of Patient, and the address of his residence;
2) the designation of the healthcare provider, including the doctor, who has provided health care benefits;
3. the date of preparation;
4) data on symptoms;
5. data on diagnostic tests;
6) data on referral to a specialist doctor;
7) data on oncological diagnostics;
8) recognizing;
9) data on the assessment of the quality of oncological diagnostics;
10) a plan for oncology treatment;
11) a unique identification number;
12) end date of oncological treatment;
13) the number of the Cancer Notification Card issued by the National Cancer Register;
14) the doctor's data referred to in art. 55 par. 2a, indicated by the recipient in the declaration of choice referred to in art. 56 par. 1.
5. The Minister of Health shall determine, by means of a regulation, the model of the diagnostic and oncological treatment, with the aim of ensuring proper implementation of oncological diagnostics or oncological treatment.
Article 33. [ Directing for spa treatment] 1. Medical treatment or health rehabilitation may be provided by the healthcare provider on the basis of a referral issued by a medical practitioner.
2. The direction referred to in paragraph 2. 1, requires confirmation by the provincial branch of the Fund competent for the place of residence of the recipient, and if it is not possible to determine the place of his residence-branch office of the Fund competent for the seat of the healthcare provider, who issued a referral. To confirm and refuse to confirm the referral referred to in paragraph 1. 1, the provisions of the Code of Administrative Procedure shall not apply.
3. The operator shall bear the costs of the trip to the spa treatment or spa rehabilitation and spa treatment or health rehabilitation and partial payment for meals and accommodation in the spa sanatorium. The entity obliged to finance the health care benefits from public funds shall cover up to the amount specified in the contract of the provincial branch of the Fund from the spa sanatorium the difference in the cost of the food and accommodation of the insured.
4. Children and young people up to the age of 18, and if they are still in education until the completion of the age of 26, children with disabilities to a significant degree-without age limit, and children entitled to survivor's pension do not pay for the cost of food and accommodation in a children's health resort, spa spa for children and a spa spa.
5. The Minister of Health, after consulting the President of the Fund and the General Medical Council, will determine, by means of a regulation:
1) how to issue a referral to spa treatment or health care rehabilitation by a health insurance doctor,
2) the mode of confirmation of the referral to spa treatment or health rehabilitation and the pattern of this referral
-taking into account the need to verify the purposefulness of the referral to spa treatment or health rehabilitation.
Art 33a. [ Nursing or caring benefits] 1. The benefits of nursing or caring for long-term care shall be provided by the holder, on the basis of the referral of the health insurance physician.
2. The Minister of Health, after consulting the President of the Fund and the Supreme Medical Council and the General Council of Nurses and Po³êders, will determine by way of regulation:
1) the manner and mode of directing the persons to the care and care facilities,
2) the documentation required for the directing of persons to the care and nursing care facilities, including designs: the application for referral to the establishment, medical certificate and nursing interview,
3) method of determining the payment for the stay in the care and care and care facilities
-having regard to the need to harmonise the operating procedures for the plants and to verify the advisability of the referral to the establishments.
Article 33b. [ Ensuring accommodation] 1.Where the state of health of the healthcare provider requires medical procedures for hospital treatment, but does not require the provision of 24-hour or all-day health care services in suitably furnished, regular the premises of the medicinal product, the provider shall provide, free of charge, at the request of the operator, accommodation in a different place where the hotel services are provided within the meaning of the provisions of the Act of 29 August 1997. about tourist services (Dz. U. of 2016 r. items 187 and 1334) in the area of short-term, generally available landings, apartments and rooms. This information shall be noted in the medical documentation.
2. A witness who uses the accommodation on the basis of the mouth. 1, free of charge, at its request, transport from the place of this accommodation to the place of delivery of benefits. This information shall be noted in the medical documentation.
3. A provider who has provided accommodation on the basis of the mouth. 1, shall be liable for the damage referred to in art. 25 par. 1 point 1 of the Act of 15 April 2011. of medical activity, resulting solely from the grant or omission of health care benefits.
Article 35. [ The right to free medicines, foodstuffs and medical devices entitled to the healthcare provider admitted to the hospital] An operator admitted to a hospital or other medicinal plant in a kind of stationary and 24-hour health care provision within the meaning of the provisions on medical activity and at the same time as the the provision of medical and nursing, diagnostic and rehabilitation procedures by the persons entitled to provide benefits, as well as the provision of emergency assistance by those entities, to provide for free of charge, foodstuffs and foodstuffs. special nutritional uses and medical devices, if they are necessary to perform the benefit.
Article 40. [ Permission to supply medical devices] Supplies of medical devices shall be granted to the recipients on the basis of an order or a prescription issued by an authorized person referred to in Article 4. 2 (14) of the refund act, under the conditions laid down in that Law.
Article 40a. [ Conditions for obtaining supplies of medical devices] Supplies of medical devices shall be granted to the recipients on the basis of an order issued by a physiotherapist referred to in the regulations on the profession of physiotherapist, under the rules laid down in the refund act.
Article 41. [ The conditions for granting free transit of the sanitary means of transport] 1. The holder, on the basis of the order of the health insurance medical insurance or the health insurance feller, shall be entitled to a free passage of means of sanitary transport, including the air, to the nearest medical body referred to in rules on medical treatment, providing benefits in the appropriate area and back, in the cases of:
1) the need for immediate treatment in the medicinal product;
2) resulting from the need to preserve the continuity of treatment.
2. The holder, on the basis of the order of the health insurance medical insurance or the health insurance feller, shall be entitled to a free passage of means of sanitary transport-in the case of the dysfunction of the traffic organ preventing the use of public transport, in order to receive treatment, to the nearest healthcare provider in the right range, and back.
3. In cases not mentioned in the paragraph. 1 and 2 on the basis of the health insurance or health insurance cover provided by the health insurance provider, the operator shall be entitled to a journey by means of sanitary means of transport for payment or for partial payment of the health insurance.
4. (repealed)
Article 41a. [ Free sanitation transport security] Security of the sanitary transport referred to in art. 201 § 2 of the Code of Criminal Executive Code, shall be entitled free of charge in connection with the execution of the guaranteed benefit in the indicated psychiatric facility.
Article 42. [ Health care benefits covered from the part of the budget of which the Minister of National Defence is the possknow] 1. The provision of health care not qualified as guaranteed benefits and paid health care provided to the authorized servicemen or employees also after their release from the service or termination of the employment contract, in connection with traumas and diseases acquired during the performance of tasks outside the State, shall be borne by the State budget of the part of which the Minister of National Defence is at its disposal.
1a. Benefits of health care not qualified as guaranteed benefits and paid health care provided to veterans injured in the treatment of injuries and diseases acquired while performing tasks outside the State shall be covered by the State budget, of the part of which the Minister of National Defence, the Minister responsible for the Interior, the Head of the Internal Security Agency or the Head of the Intelligence Agency, respectively, shall be at the disposal.
2. Benefits of health care not qualified as guaranteed benefits and paid health care benefits provided to the policemen, officers of the Border Guard, officers of the Government Protection Bureau, guards of the State Guard The fire, as well as the staff of such services, and after their release from the service or termination of the employment contract, in connection with injuries acquired in the performance of tasks outside the State, shall be borne by the budget of the State of the part of which the Minister has been held Competent for internal affairs.
2a. The President of the Council of Ministers, the Minister of National Defence and the minister responsible for internal affairs, each in their scope, will determine, by means of a regulation:
1) the detailed conditions for receiving the health care benefits referred to in the paragraph. 1a,
2. the procedure for dealing with the cases referred to in point 1,
3) the manner and mode of financing of the costs incurred
-having regard to the principle of public spending.
Chapter 2a
Health care benefits granted outside the country
Article 42a. [ Financing of the costs of health care benefits granted outside the country] The Fund finances the costs of health care benefits granted outside the country:
1) on the basis of the reimbursement of costs referred to in Article 42b;
2) in accordance with the rules on coordination;
3) on the basis of the decision of the director of the provincial branch of the Fund, referred to in art. 42i ust. 2 and 9, or the decision of the President of the Fund referred to in art. 42j ust. 1 and 2.
Article 42b. [ Right to receive from the Fund a reimbursement of the costs of healthcare provision] 1. The holder shall be entitled to receive from the Fund reimbursement of the costs of the provision of health care, which is a guarantee guaranteed, granted in the territory other than the Republic of Poland of a Member State of the European Union, referred to as hereinafter referred to as "reimbursement".
2. The provision of the paragraph. 1 shall not apply to:
1) mandatory preventive vaccination;
2) long-term care, if its aim is to support persons in need of assistance in carrying out the routine activities of everyday life;
3. the allocation and access of organs intended for transplantation, covering the activities referred to in Article 4 (2). 3 para. 3 of the Act of 1 July 2005. o collection, storage and transplantation of cells, tissues and organs (Dz. U. of 2015 items 793, 1893 and 1991).
3. The condition of receipt of reimbursement of expenses shall be obtained by the recipient, before the benefit of the benefit referred to in the paragraph. 1, subject to reimbursement of costs, appropriate referral or transfer orders of sanitary means, in accordance with art. 32, art. 33 (1) 1, art. 33a ust. 1, art. 41 or Art. 57-59 and the provisions issued on the basis of art. 31d.
4. Directing or order for the passage of sanitary means of transport required in accordance with the mouth. 3, may also be issued by a doctor performing a profession in another than the Republic of Poland of a member state of the European Union. Such a referral or order shall be treated as a referral or a request to a health insurance physician.
5. In the case of the benefit referred to in paragraph. 1, from the scope of health treatment, the condition for receiving reimbursement is to confirm the referral in accordance with art. 33 (1) 2, in relation to the speciality of health treatment, prior to the use of these benefits.
6. In the case of the benefit referred to in paragraph. 1, from the scope set out in Art. 15 para. 2 point 15, the condition for the reimbursement of costs is:
1) the qualification of the patient by the provider to a given leverable program;
2) non-existence of criteria for exclusion from the programme specified in the description of the drug programme.
7. Where, during the course of the treatment, the beneficiaries under the le programme have developed the criteria for exclusion referred to in paragraph 1 above, they shall be subject to the conditions of the application of the Article 6 (2), the reimbursement shall cover the cost of the health care benefits granted until such time as those criteria have been set up.
8. In the case of the benefit referred to in paragraph. 1, granted under the health programmes referred to in art. 15 para. The requirement for reimbursement is to meet the requirements for the patient's participation in the programme.
9. In the case of the benefit referred to in paragraph. 1, included in the list referred to in Article 42e ust. 1, the condition of reimbursement of costs is the prior issue of consent by the director of the Fund's branch of the Fund to obtain a given health care benefit in another than the Republic of Poland of a member state of the European Union. Prior authorisation shall also cover the provision of health care which has not been directly subject to that consent if it has proved necessary in connection with the provision of approved health care services.
(10) The holder shall be entitled to reimbursement of the costs of a medicinal product, a foodstuff intended for particular nutritional uses or a medical device, contained in the designation in question in the list referred to in Article 3. 37 par. 1 of the Act on refunds, in the field of medicines, foodstuffs for particular nutritional uses or medical devices referred to in art. 6 para. 1 point 1 of the refund act, or included in that list the equivalent refunded in a given indication, within the meaning of the Article. 2 item 13 of the refund act, which was purchased in the pharmacy operating in the territory:
1) a Member State of the European Union, on the basis of a prescription issued in a territory other than the Republic of Poland of a Member State of the European Union by a person entitled to issue prescriptions in accordance with the laws of that State;
2) other than the Republic of Poland of a Member State of the European Union, on the basis of the cross-border prescription referred to in the provisions issued on the basis of art. 45 par. 5 of the Act of 5 December 1996. about the professions of a doctor and a dental practitioner (Dz. U. of 2015 items 464, of late. zm.), issued by a person entitled within the meaning of the refund Act, at the request of a patient who intends to implement it in another than the Republic of Poland of a Member State of the European Union, hereinafter referred to as the "cross-border recipe".
11. The holder shall be entitled to reimbursement of the costs of purchase or repair of a medical device as a guaranteed certificate, which has been purchased or has been subject to repair in the territory of:
1) a Member State of the European Union, on the basis of an order issued in a territory other than the Republic of Poland of a Member State of the European Union by a person entitled to issue it in accordance with the provisions of that State;
2) other than the Republic of Poland of a Member State of the European Union, on the basis of an order issued by a person entitled, referred to in art. 2 (14) of the refund act, under the conditions laid down in that Law.
12. Repayment of the cost of a drug, foodstuff intended for a particular nutritional purpose or medical device referred to in paragraph. Article 10 (1) applies only to medicines, foodstuffs intended for particular nutritional uses or medical devices which are being ordained in accordance with the indications referred to in the medical documentation corresponding to the indication of the indications covered by the refund for of a medicinal product, a foodstuff intended for particular nutritional uses or a medical device, as specified in the list referred to in Article 37 par. 1 of the refund act.
Article 42c. [ Reimbursement of costs] 1. The Fund shall reimburenter the costs in the amount corresponding to the amount:
1) the financing of a given guarantee benefit applied in the settlements between the Fund and the healthcare providers under the contract for the provision of health care benefits;
(2) the financing of the guaranteed benefit in question-in the case of benefits referred to in Article 15 para. 2 point 12, medical rescue operations carried out by medical rescue teams and the benefits provided under the health programmes financed from the state budget;
(3) the limit on the financing of the medicinal product concerned, a foodstuff intended for particular nutritional uses or medical devices contained in the designation in question in the list referred to in Article 3 (2) of the Regulation. 37 par. 1 of the refund act, taking into account the repayments referred to in Article 14 of the Act on refunds, in the field of medicines, foodstuffs for particular nutritional uses or medical devices referred to in art. 6 para. 1 point 1 of the refund act, or included in that list the equivalent refunded in a given indication, within the meaning of Article 1 of the Act on refunds. 2 point 13 of the refund act;
4) corresponding to the value of the medical device, not higher than the limit of funding from public funds for a given medical device resulting from the provisions issued on the basis of art. 38 par. 4 of the Act on refunds, taking into account the provisions of Article 47 para. 1-2a-in the case of benefits referred to in Article 15 para. 2 point 9.
2. Where a medical procedure performed in a territory other than the Republic of Poland of a Member State of the European Union is within the scope of guaranteed benefits, without having an exact equivalent among medical procedures performed in the country, for the basis of reimbursement of costs, the amount of financing of the medical procedure, falling within the scope of these benefits, the most similar in medical terms to the procedure performed in the territory other than the Republic of Poland, shall be taken as the basis for reimbursement of costs. of a Member State.
3. Where the application for reimbursement concerns at least two of the benefits referred to in art. 42b (b) 1 which shall be accounted for by the Fund under one guaranteed benefit, shall be taken as the basis for the reimbursement of costs.
4. In the case of submission of separate claims for reimbursement, concerning at least two of the benefits referred to in Article 42b (b) 1, settled by the Fund under one guaranteed benefit, the total amount of the reimbursement received on the basis of those applications may not exceed the amount of financing of that benefit.
5. Where, for a given guaranteed benefit, there exists within the country the same amount of financing used in the accounts between the entity responsible for financing the health care benefits from public funds and healthcare providers, the basis for reimbursement shall be the amount of the amount of financing at the date of 1 January of the year in which the grant of the benefit covered by the application for reimbursement referred to in Article 1 is completed. 42d ust. 1.
6. Where, for a given guaranteed benefit, there is a differentiation in the amount of funding used in the accounts between the entity responsible for the financing of public health care benefits for the guaranteed benefit in question, healthcare providers, the basis for reimbursement is the weighted average of the amount of financing calculated for this guaranteed benefit at the date of 1 January of the year in which the grant of the benefit covered by the application for reimbursement is completed. the costs referred to in Article 42d ust. 1.
7. If the determination of the reimbursement basis is not possible by the application of the provisions of the paragraph. The amount of the financing, or the weighted average of the amounts of financing calculated on the basis of the date of delivery of the benefit covered by the application for reimbursement, shall be taken as the basis for reimbursement of costs. the costs referred to in Article 42d ust. 1.
8. In the case of guaranteed benefits in the form of a lump sum payment for the readiness to provide benefits, the basis for reimbursement is calculated on the territory of the country the average amount of financing of the benefits from the given range, granted to one patient, in the last full quarter preceding the quarter in which the provision of those benefits was completed, in particular the average amount of funding:
(1) benefits guaranteed to one of the recipients in a hospital emergency department or in an emergency room;
2) a one-time intervention by the medical rescue team.
9. In the case of health care benefits financed from the state budget, from the part remaining at the disposal of the minister responsible for health, the weighted average referred to in the paragraph. 6, and the average amount of the financing referred to in paragraph 1. 8, the minister responsible for health matters.
(10) In the case of a medicinal product, a foodstuff intended for particular nutritional uses or a medical device, the reimbursement of costs shall be the amount of public funding determined in accordance with the mouth. 1 (3) or (4), applicable at the date of purchase.
11. Where the number of DDD, within the meaning of the refund Act, in the package of a medicine purchased in another than the Republic of Poland of a European Union Member State is different from the number of DDD in the package of medicine mentioned in the list referred to in art. 37 par. 1 of the refund act, the amount of reimbursement of costs increases or decreases in proportion to the ratio of DDD in the package of the medicine purchased in another than the Republic of Poland of the Member State of the European Union and the number of DDD of the medicine mentioned in the list referred to in Article 37 par. 1 of the refund act.
12. The reimbursement of costs shall be made in the Polish currency.
(13) Repayment of costs may not exceed the amount of expenditure actually incurred by the recipient in the performance of the benefit in question referred to in Article 4. 42b (b) 1, determined using the average rate for a given currency advertised by the National Bank of Poland, in force on the date of issue of the account referred to in art. 42d ust. 5 point 1.
14. The reimbursement of costs shall be applied to the Article. 50a ust. 2.
Article 42d. [ Request for reimbursement] 1. The administrative decision on the reimbursement of costs shall issue, at the request of the recipient or his statutory representative, hereinafter referred to as the "request for reimbursement", the director of the branch of the provincial branch of the Fund competent for the place of residence the recipient in the territory of the Republic of Poland, and in the case of:
1) insured persons and members of their families residing in a territory other than the Republic of Poland of a Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA)-director the provincial branch of the Fund indicated in the notification to health insurance;
2) the persons referred to in art. 2. 1 point 3 (a), not domiciled in the territory of the Republic of Poland-the director of the provincial branch of the Fund chosen by the recipient.
2. Director of the provincial branch of the Fund determined in accordance with the paragraph. 1 shall issue an administrative decision refusing reimbursement if:
1. the request for reimbursement shall apply to health care services which do not meet the criteria laid down in the Article. 42b (b) 1, 10-12 or
2. the application for reimbursement shall relate to the benefits referred to in Article 3. 42b (b) 2, or
3. the conditions for the possession of a referral or order referred to in Article 3 shall not be fulfilled. 42b (b) 3-5, prescriptions referred to in art. 42b (b) 10 point 1, or a cross-border prescription or an order referred to in Article 3 (1). 42b (b) 11, or
4) the conditions referred to in Article 4 are not fulfilled. 42b (b) 6 or 8, or
5) the operator, prior to granting him the benefits of health care, has not obtained the consent referred to in art. 42b (b) 9, or
6) the operator has not submitted documents containing sufficient data on the diagnostic or therapeutic process, allowing to identify the health care benefits to which the claim for reimbursement is requested, or
7) the operator has not documented the fact of covering all the costs of the health care benefits to which the claim for reimbursement is requested, or
8) the provision of health care to which the claim for reimbursement relates have been qualified by the Fund for settlement on the basis of the rules on coordination, or
(9) a request for reimbursement has been made after the expiry of the period referred to in paragraph 1. 12.
3. The provision of the paragraph. 2 (5) shall not apply if the operator, after 30 days from the date of submission of the complete application for consent referred to in Article 3, has been submitted after 30 days from the date of submission of the complete application for consent 42b (b) 9, due to the urgent need to take the treatment necessary to save life or health, resulting from the confirmed clinical condition, has given itself to such treatment in the territory other than the Republic of Poland of a Member State of the Union European.
4. The request for reimbursement shall include:
1) first and last name, date of birth, the PESEL number of the provider, and in the case of its absence-the number of the document confirming the identity;
2. the address of the place of residence of the provider and the address for correspondence;
3) first and last name, date of birth, PESEL number of the statutory representative of the provider, and in the case of its absence-the number of the document confirming the identity, if the application for reimbursement is submitted by a statutory representative;
4. the address of the place of residence and the address for correspondence of the statutory representative of the provider, if the application for reimbursement is submitted by a statutory representative;
5) the date and state of the provision of health care to which the claim for reimbursement is applied;
6. the total amount that has been paid for the provision of health care to which the claim for reimbursement is applied, with the currency;
7) the telephone number or e-mail address of the provider or his statutory representative, if he has;
8) the number of the decision of the director of the provincial branch of the Fund referred to in art. 42f ust. 1, if the provision of health care to which the claim for reimbursement relates is included in the list referred to in Article 42e ust. 1;
9) the bank account number, where the reimbursement is to be made by bank transfer and in the case of an account held abroad-also other necessary data of that account;
10) the name and address of the holder of the bank account, if that account does not belong to the recipient, to whom the claim for reimbursement is requested;
11) the address to which the postal transfer is to be transferred, if the reimbursement is to be made by post-mail transfer;
(12) an inventory of the annexes to the application for reimbursement;
13) statement of the person making the application, submitted under the rigorous criminal liability with art. 233 § 1 and 2 of the Penal Code, that the data contained in the application is in accordance with the facts.
5. The application for reimbursement shall be accompanied by:
1) the original of an account issued in another than the Republic of Poland of a Member State of the European Union by a health care provider or the original of an account issued in a Member State of the European Union by a pharmacy or the supplier of medical devices;
2) a document confirming the payment of the total cost of the benefit to which the claim for reimbursement applies, where this does not follow from the document referred to in point 1;
3. the original or a copy, as appropriate:
(a) the referral or order referred to in Article 42b (b) 3-5,
(b) the prescriptions referred to in Article (b). 42b (b) 10 point 1, or a cross-border prescription,
(c) the order referred to in Article 42b (b) 11.
6. The account referred to in paragraph 1 Article 5 (1) contains:
1) the data of the issuer of the account and the date of its issue;
2) the data of the provider to whom the request for reimbursement is requested;
(3) the data necessary to identify the benefit covered by the claim for reimbursement, in particular the information enabling the International Classification of Medical Procedures and the International Statistical Classification (International Classification) of the Medical Procedures Classification (ICCD-9) to be specified Diseases and Health Problems and CD-10, or data on medicines released, foodstuffs for particular nutritional uses or medical devices.
7. Where the account referred to in paragraph is referred to in paragraph 1. Article 5 (1) does not contain the data referred to in paragraph 1. The data should be included in the application for reimbursement of the costs of the dossier.
8. In the case of benefits referred to in art. 15 para. 2 point 15, the application for reimbursement shall be accompanied by a certificate of the appellant confirming the qualification of the relevant drug programme and a copy of the medical documentation.
9. Where the application for reimbursement concerns a medicine, a foodstuff for a special purpose or a medical device referred to in art. 42b (b) 10 (1), the application shall also be accompanied by a copy of the medical documentation, which results from the medical validity of the prescription for the medicinal product, the special-purpose food or the medical device to which the application relates.
10. Where the documents referred to in the paragraph are referred to in paragraph 1. 5-9, are written in a foreign language, to the application for reimbursement of costs should be accompanied by translation of these documents into Polish. The translation does not have to be drawn up by a sworn translator.
11. The provisions of the paragraph. 5 point 3 (a) a and the mouth. 8 shall not apply to the application for reimbursement of the costs relating to the provision of health care to which the operator has obtained the consent referred to in Article 42b (b) 9.
12. The application for reimbursement shall be submitted within 6 months from the date of issue of the account for the provision of health care to which this application applies.
(13) Where the examination of a request for reimbursement does not require an investigation procedure, the decision referred to in paragraph 1 shall not be required. 1 or 2, it shall be issued within 30 days of the initiation of the proceedings.
(14) Where the examination of a request for reimbursement requires an investigation to be carried out, the decision referred to in the paragraph shall be taken. 1 and 2, shall take place within 60 days of the date of initiation of the proceedings. Where the investigation requires an addendum by the operator or his/her legal representative of a request for reimbursement or correspondence with a national institution, the period shall not be included in that period:
1) from the day of the call for completion of the application until the date of receipt of this supplement by the branch of the Fund's voivodship or until the date of the unsuccessfully expiry of the period appointed to supplement the application for reimbursement;
2) from the day of sending the query to the national institution until the date of receipt by the branch of the voivodship of the Fund's response
15. Where the examination of a request for reimbursement requires an investigation to be carried out with the participation of a national contact point for cross-border healthcare, acting in a different way than the Republic of Poland of the country No reimbursement shall be made within six months of the date of initiation of the procedure. If no conclusive arrangement has been made in the above time limit to determine the amount of reimbursement of the costs to be paid to the operator, the reimbursement shall be effected without delay after the expiry of that period, corresponding to the amount to be considered in the case in question, the most likely basis for reimbursement. In the proceedings, concerns shall be settled in favour of the recipient.
16. The commencation of the processing of applications for reimbursement shall be carried out in accordance with the order of the impact to the competent branch of the Fund
17. The reimbursement of costs shall take place within 7 days from the day of the day after the branch of the Fund of the Fund to inform the decision referred to in the paragraph. 1, it has become final, subject to art. 42h ust. 1.
(18) The reimbursement shall be made by means of a transfer to the bank account provided in the request for reimbursement or by post-mail.
19. From the decisions referred to in paragraph. 1 and 2, shall be entitled to appeal to the President of the Fund.
20. In the case of:
1) the repeal of the decision referred to in the paragraph. 1, and consideration of the matter as to the substance,
2) the repeal of the decision referred to in paragraph. 1, in the case of resumption of proceedings,
3) the annulment of the decision referred to in the paragraph. 1
-after the reimbursement fund has been reimbursed by the Fund, the operator who has received the reimbursement shall be obliged to reimburse the amount unduly received.
21. The amount referred to in paragraph. 20, shall be subject to enforcement of enforcement proceedings in the administration. The director of the provincial branch of the Fund shall issue an administrative decision establishing the obligation to reimbursing that amount, its amount and the date of payment.
22. From the amount referred to in paragraph. 20, the statutory interest shall be charged for the delay, starting from the date on which the payment deadline expired.
23. The decision referred to in paragraph 1 shall not be issued. 21 if, from the date of the repeal or the annulment of the decision referred to in the paragraph, 1, 5 years have elapsed.
24. The claim for reimbursement of the amount referred to in paragraph 1. 20, the statute of limitation shall expire within 5 years from the date on which the decision establishing that duty became final.
(25) The Minister responsible for Health will determine, by means of a regulation, a model application for reimbursement, with a view to ensuring the efficiency of the reimbursement procedure.
Art. 42e. [ List of health care benefits] 1. The Minister of Health may determine, by means of a regulation, a list of health care benefits for which reimbursement of expenses requires the consent referred to in Article. 42b (b) 9, with a view to the well-being of the recipients and the economic and the specificity of the expenditure of public funds.
2. The list referred to in paragraph 1. 1, contains:
1) the provision of health care subject to the planning requirements necessary to ensure sufficient and continuous access to the full range of high quality health care or resulting from the need to control costs and avoid mismanagement in the use of financial, technical and human resources and, at the same time, the granting of which requires:
a) stay patient in hospital up to the next day or
(b) the use of high-specialised and costly infrastructure or apparatus and medical equipment;
2) the provision of health care creating a particular risk to the life or health of the recipient.
3. The Minister responsible for Health shall issue the regulation referred to in paragraph. 1, or amend it if it is found that the absence of such a list or its amendment will result in the unleaned security of access to health care services on the territory of the country.
Article 42f. [ Application for consent to obtain a given health care benefit] 1. The consent referred to in art. 42b (b) 9, it shall issue, by way of an administrative decision, at the request of the recipient, his statutory representative, spouse, relative or duty to the second degree in a straight line, a person remaining in a common loan or a person authorized by the the recipient, the director of the provincial branch of the Fund competent due to the place of residence of the recipient on the territory of the Republic of Poland, and in the case of:
1) insured persons and members of their families residing in a territory other than the Republic of Poland of a Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA)-director the provincial branch of the Fund indicated in the notification to health insurance;
2) the persons referred to in art. 2. 1 point 3 (a), not domiciled in the territory of the Republic of Poland-the director of the provincial branch of the Fund chosen by the recipient.
2. The director of the provincial branch of the Fund may, by way of administrative decision, refuse the consent referred to in art. 42b (b) 9, if the provision of health care covered by the application:
1) is not a guaranteed certificate;
2) may be granted in the country by a provider with a contract for the provision of health care services, within a time limit not exceeding the time of waiting referred to in the paragraph. 4 point 2 (h);
3. it creates a significant risk to the health of the recipient, which does not offset the potential health benefits that he or she may derive from obtaining that benefit;
4) creates a significant health risk to the public;
5) to be awarded by a health care provider operating in a different than the Republic of Poland of a Member State of the European Union, which has significant doubts in respect of compliance with quality standards and security, established by the State in which it grants health benefits.
3. The application referred to in paragraph 1. 1, requires, in the relevant part, the fulfilment by a health insurance doctor having a 2nd degree specialization or the title of a specialist in the field of medicine appropriate due to the extent of the requested treatment or diagnostic tests.
4. The application referred to in paragraph 1. 1, contains:
1) in the part filled by the witness, his statutory representative, spouse, relative or duty to the second degree in a straight line, a person remaining in a common loan or a person authorized by the recipient of:
(a) the name, date of birth, the PESEL number of the holder and, in the absence thereof, the number of the document confirming the identity,
(b) the address of the place of residence and the address to the correspondence of the operator,
(c) first and last name, date of birth, PESEL number of the statutory representative of the holder, spouse, relative or duty to the second degree in a straight line, the person remaining in the common loan or the person authorised by the recipient, and in the absence thereof, the number of the document confirming the identity, if the application consists of a statutory representative, a spouse, a relative or a duty to a second degree in a straight line, a person remaining in a common loan or a person authorized by the the recipient,
(d) the address of the place of residence and the address for correspondence of the statutory representative of the holder, spouse, relative or duty to a second degree in a straight line, a person remaining in a common loan or a person authorized by the the recipient, if the application consists of a statutory representative, a spouse, a relative or a duty to a second degree in a straight line, a person remaining in a common loan or a person authorised by the recipient,
(e) the telephone number or e-mail address of the operator, his legal representative, spouse, relative or duty to a second degree in a straight line, the person remaining in the common loan or the person authorised by the the recipient, if he has,
(f) an indication of the health care provider, acting in another Member State of the European Union, to provide the health care services to which the application relates, together with the reasons for that,
(g) the statement, submitted under penalty of criminal liability with Article 233 § 1 and 2 of the Penal Code, that the data contained in the application is in accordance with the facts;
2) in the part filled by the doctor referred to in the paragraph. 3:
(a) the name of the doctor who completed the application;
(b) the stamp of the doctor who completed the application containing the number of the profession,
(c) the stamp of the healthcare provider in which the doctor who has completed the application shall provide health care,
(d) the clinical diagnosis of the health problem, which is the reason for the application, and the coexisting diagnosis, with the application of the International Statistical Classification of Diseases and the Health Problems of ICD-10,
(e) information on the current course of the disease and the treatment applied,
(f) a forecast for the likely further course of the disease,
(g) an indication of the specific range of treatment or diagnostic tests to which the application relates,
(h) determination of the acceptable waiting time for the healthcare provider to whom the application relates,
(i) justification for the
(j) the inventory of the application.
5. The application referred to in paragraph 1. 1:
1. the medical records and the written information referred to in Article shall be included in the document. 20 para. 2 (2) and, in the case of medical records drawn up in a foreign language, the translation of this documentation into Polish; translation need not be made by a sworn translator;
2) may be accompanied by a statement that the person is aware on the basis of the application referred to in the paragraph. 1, opposing the consent of the article referred to in Article 42i ust. 1.
6. When considering the application referred to in paragraph. 1, account shall be taken of the urgency of the case assessed taking into account the current state of health of the provider, the degree of perceived ailment or the nature of his disability, the history of the disease and the anticipated development of the disease.
7. From the decision referred to in paragraph. 2, shall have recourse to the President of the Fund.
8. If the application referred to in paragraph 1, fulfils the conditions for the consent referred to in art. 42i ust. 1, the director of the provincial branch of the Fund shall issue such consent, unless the operator has made the declaration referred to in the paragraph. 5 point 2.
Article 42g. [ Exemption of application of the law] Art. 42b-42f does not apply to persons:
1) referred to in art. 66 (1) 1 point 16 and their family members residing in the territory of a Member State of the European Union listed in Annex No 3 to Regulation (EC) No 987/2009 of the European Parliament and of the Council of 16 September 2009. concerning the implementation of Regulation (EC) No 883/2004 on the coordination of social security systems;
2) reported for health insurance as members of the families of the persons referred to in art. 66 (1) 1 points 1 to 15a, 17, 20 to 37 if they are resident in the territory of another Member State of the European Union than the person who has notified the family member to health insurance and the State of residence is listed in Annex 3 to Regulation (EC) No 987/2009 of the European Parliament and of the Council of 16 September 2009. on the implementation of Regulation (EC) No 883/2004 on the coordination of social security systems.
Art. 42h. [ Suspension of the payment of amounts due for reimbursement to the end of the calendar year] 1. Where the costs of carrying out the tasks resulting from the art are carried out. 42b in the calendar year concerned shall reach the limit of the reserve referred to in Article 42b. 118 (1) 2 point 1 (d) and the reserve referred to in Article 2 (1) (d) and the reserve referred 118 (1) 5, the Fund shall suspend payment of amounts due in respect of reimbursement by the end of that calendar year. The President of the Fund shall immediately inform, by means of an announcement on the websites of the Fund's headquarters and branches of the Fund and in the Public Information Bulletin of the Fund, the suspension of payment of these amounts.
2. Where, before the end of the first half of a given calendar year, the level of 50% of the limit referred to in paragraph 2 is exceeded. 1, the President of the Fund shall immediately inform, by means of an announcement on the websites of the Fund's headquarters and branches of the Fund and in the Public Information Bulletin of the Fund, about the expected date of suspension of payment of amounts due by virtue of the reimbursement.
3. Where the revenues from the contribution to the universal health insurance, realised as due for the period from the beginning of the calendar year concerned, are lower than the revenue planned for that period, the amount of the limit referred to in paragraph. 1, shall be reduced by the amount of the difference between the revenue planned and the realised revenue, but not more than the amount of the reserve referred to in Article 3. 118 (1) 5.
4. Disbursements suspended on the basis of the paragraph. 1 shall be carried out by 31 January of the following year, within the limit referred to in paragraph 1. 1.
(5) The holder shall not be entitled to suspend payment of the payment of the amount due in respect of the reimbursement referred to in paragraph 1. 1.
Article 42i. [ Consent to the provision of health care or its continuation in another Member State of the European Union or a Member State of the European Free Trade Agreement] 1. The director of the provincial branch of the Fund shall issue to the recipient, the person entitled to health care benefits on the basis of the provisions on coordination or the person referred to in art. 12a, hereinafter referred to as "the applicant", at the request of the applicant, his statutory representative, spouse, relative or duty to the second degree in a straight line, the person remaining in the common loan or the person authorized by the applicant, the competent institution, the institution of the place of residence, the institution of the place of stay or of the liaison body in another Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA), hereinafter referred to as 'authorised entity', by administrative decision, to grant approval the European Free Trade Agreement (EFTA) concerned, in the cases referred to in the coordination rules, in another Member State of the European Union or in a Member State of the European Free Trade Agreement (EFTA).
2. The director of the provincial branch of the Fund may issue the applicant who has obtained the consent referred to in the paragraph. 1, at the request of the rightholder, by administrative decision, the consent to cover the costs of transport:
1) to the place of granting benefits in another Member State of the European Union or a Member State of the European Free Trade Agreement (EFTA)-the cheapest means of communication possible to apply in the current state of health, in cases justified by the health status;
2) to the place of treatment or residence in the country-the cheapest means of communication possible to apply in the current state of health, in cases justified by the health condition.
3. The consent referred to in the paragraph. 1 and 2, shall issue the Director of the provincial branch of the Fund competent due to the place of residence of the recipient on the territory of the Republic of Poland, and in the case of:
1) insured persons and members of their families residing in a territory other than the Republic of Poland of a Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA)-director the provincial branch of the Fund indicated in the notification to health insurance;
2) the persons referred to in art. 2. 1 point 3 (a), not domiciled in the territory of the Republic of Poland-the director of the provincial branch of the Fund chosen by the recipient;
3) persons entitled to health care benefits on the basis of the regulations on coordination having their place of residence on the territory of the Republic of Poland-director of the provincial branch of the Fund competent for the place of residence persons entitled to health care benefits on the basis of the provisions on coordination within the territory of the Republic of Poland;
4) the persons referred to in art. 12a-Director of the provincial branch of the Fund competent due to the place of residence of these persons on the territory of the Republic of Poland.
4. The application referred to in paragraph 1. 1, requires, in the relevant part, the fulfilment by a health insurance doctor having a 2nd degree specialization or the title of a specialist in the field of medicine appropriate due to the extent of the requested treatment or diagnostic tests.
5. The application referred to in paragraph 1. 1, contains:
1) in the part filled by the applicant, his statutory representative, spouse, relative or duty to the second degree in a straight line, a person remaining in a common loan or a person authorized by the applicant:
(a) the name, date of birth, the applicant's PESEL number and, in the absence thereof, the number of the document confirming the identity,
(b) the address of the place of residence and the address of the applicant's
(c) first and last name, date of birth, PESEL number of the legal representative of the applicant, spouse, relative or duty to the second degree in a straight line, the person remaining in the common loan or the person authorised by the applicant, and in the absence of a document confirming the identity if the application consists of a statutory representative, a spouse, a relative or a duty to a second degree in a straight line, a person remaining in a common loan or a person authorised by the the applicant,
(d) the address of the place of residence and the address for correspondence of the statutory representative of the applicant, spouse, relative or duty to the second degree in a straight line, the person remaining in the common loan or the person authorized by the applicant, if the application consists of a statutory representative, a spouse, a relative or a duty to a second degree in a straight line, a person remaining in a common loan or a person authorised by the applicant,
(e) the telephone number or e-mail address of the applicant, his legal representative, spouse, relative or duty to the second degree in a straight line, the person remaining in the common loan or the person authorised by the applicant, if it has,
(f) an indication of the health care provider operating in another Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA) in which the provision of care is to be provided the health of which the request relates, together with the reasons for the
(g) the statement, submitted under penalty of criminal liability with Article 233 § 1 and 2 of the Penal Code, that the data contained in the application is in accordance with the facts;
2) in the part filled by the doctor referred to in the paragraph. 4:
(a) the name of the doctor who completed the application;
(b) the stamp of the doctor who completed the application containing the number of the profession,
(c) the stamp of the healthcare provider in which the doctor who has completed the application shall provide health care,
(d) the clinical diagnosis of the health problem, which is the reason for the application, and the coexisting diagnosis, with the application of the International Statistical Classification of Diseases and the Health Problems of ICD-10,
(e) information on the current course of the disease and the treatment applied,
(f) a forecast for the likely further course of the disease,
(g) an indication of the specific range of treatment or diagnostic tests to which the application relates,
(h) determination of the acceptable waiting time for the healthcare provider to whom the application relates,
(i) justification for the
(j) the inventory of the application.
6. To the medical documentation attached to the application referred to in paragraph. 1, rule of art. 42f ust. Paragraph 5 (1) shall apply mutatis mutandis.
7. The application referred to in paragraph 1. In addition to the elements listed in paragraph 2, point 1. 5 contains an indication by the physician completing the proposed means of transport, together with the reasons for the request.
8. The application referred to in paragraph 1. In addition to the elements referred to in paragraph 2, point 2. Article 5 (1) contains:
1. the name and address of the health care provider in another Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA) in which the applicant is staying;
2) an indication of the place of treatment in the country if the application concerns the coverage of transport costs to the place of treatment.
9. Where the applicant is hospitalised in a territory other than the Republic of Poland of a Member State of the European Union or a Member State of the European Free Trade Agreement (EFTA), using the benefits provided on the basis of the rules on coordination, the director of the competent provincial branch of the Fund shall issue, at the request of the rightholder, by means of an administrative decision, the consent to cover the costs of transport to the place of further treatment in the country-the cheapest means of transport possible to be used in the current state of health applicant, when the anticipated costs of further treatment abroad exceed the costs of transport and treatment in the country.
10. The application referred to in paragraph 1. 9, the provisions of the paragraph. 8 shall apply mutatis mutandis.
11. The application referred to in paragraph 1. 9, shall be accompanied by:
1) the documentation drawn up by the hospital referred to in paragraph. 9, containing current clinical diagnosis, description of the current health status of the applicant, determination of the probable extent and duration of further treatment and an indication of the means of transport that can be used in the current state of health the applicant;
2) a preliminary estimate of the further treatment drawn up by the hospital referred to in paragraph. 9;
3) translation into the Polish language of the documents referred to in points 1 and 2; translation need not be made by a sworn translator.
12. From decisions refusing to release the deaths referred to in paragraph. 1, 2 and 9, shall have recourse to the President of the Fund.
Article 42j. [ Directing to be carried out outside the country of treatment or diagnostic test] 1. The President of the Fund may at the request of the applicant, his statutory representative, spouse, relative or duty to the second degree in a straight line, the person remaining in the common loan or the person authorized by the applicant, by decision administrative, direct the applicant to conduct outside the country of treatment or diagnostic tests belonging to guaranteed benefits which are not currently carried out in the country, guided by the need to grant such benefits in order to save lives or improve the health of the applicant.
2. In the cases referred to in paragraph. 1 The President of the Fund may, at the request of the applicant, his statutory representative, spouse, relative or duty to the second degree in a straight line, the person remaining in the common loan or the person authorised by the applicant, by decision administrative, give consent to cover the costs of transport to the place of granting benefits abroad or the place of treatment or residence in the country the cheapest means of communication possible to apply in the current state of health, in cases justified health.
3. The application referred to in paragraph 1. 1, requires, in the relevant part, the fulfilment by a health insurance doctor having a second degree specialisation or the title of specialist in the field of medicine appropriate due to the extent of the requested treatment or diagnostic tests, and the scientific title of the professor or the academic degree of habilitated doctor of medical sciences.
4. The application referred to in paragraph 1. 1, contains:
1) in the part filled by the applicant, his statutory representative, spouse, relative or duty to the second degree in a straight line, a person remaining in a common loan or a person authorized by the applicant:
(a) the name, date of birth, the applicant's PESEL number and, in the absence thereof, the number of the document confirming the identity,
(b) the address of the place of residence and the address of the applicant's
(c) first and last name, date of birth, PESEL number of the legal representative of the applicant, spouse, relative or duty to the second degree in a straight line, the person remaining in the common loan or the person authorised by the applicant, and in the absence of a document confirming the identity if the application consists of a statutory representative, a spouse, a relative or a duty to a second degree in a straight line, a person remaining in a common loan or a person authorised by the the applicant,
(d) the address of the place of residence and the address for correspondence of the statutory representative of the applicant, spouse, relative or duty to the second degree in a straight line, the person remaining in the common loan or the person authorized by the applicant, if the application consists of a statutory representative, a spouse, a relative or a duty to a second degree in a straight line, a person remaining in a common loan or a person authorised by the applicant,
(e) the telephone number or e-mail address of the applicant, his legal representative, spouse, relative or duty to the second degree in a straight line, the person remaining in the common loan or the person authorised by the applicant, if it has,
(f) the statement, submitted under penalty of criminal liability with Article 233 § 1 and 2 of the Penal Code, that the data contained in the application is in accordance with the facts;
2) in the part filled by the doctor referred to in the paragraph. 3:
(a) the name of the doctor who completed the application;
(b) the stamp of the doctor who completed the application containing the number of the profession and the title or degree of scientific,
(c) the stamp of the healthcare provider in which the doctor who has completed the application shall provide health care,
(d) the clinical diagnosis of the health problem, which is the reason for the application, and the coexisting diagnosis, with the application of the International Statistical Classification of Diseases and the Health Problems of ICD-10,
(e) information on the current course of the disease and the treatment applied,
(f) a forecast for the likely further course of the disease,
(g) an indication of the specific range of treatment or diagnostic tests to which the application relates,
(h) an indication of the foreign health care provider in which the health care services to which the application relates are to be provided, together with the reasons for the granting of the health care services concerned,
(i) justification for the
(j) the inventory of the application.
5. The application referred to in paragraph 1. 2, the provisions of art. 42i ust. 7 and 8 shall apply mutatis mutandis.
6. The basis for the examination of the application referred to in paragraph. 1, there is medical documentation. In the case of medical documentation prepared in a foreign language, the application shall be accompanied by a translation of this documentation into Polish. The translation does not have to be drawn up by a sworn translator.
7. Decisions on the matters referred to in paragraph 1 and 2, they are final. They shall be entitled to an administrative court from those decisions.
8. The costs arising from the mouth. 1 and 2 shall be financed from the budget of the State, from the part which remains at the disposal of the Minister responsible for health.
Art. 42k. [ Delegation] 1. The Minister of Health, after consulting the General Medical Council, will determine, by regulation, the manner and criteria for determining the acceptable waiting time for selected ranges of health care benefits, taking into account present, based on proven scientific evidence and medical practice and the need for proper implementation of the coordination rules.
2. The Minister responsible for health shall determine, by means of a regulation:
1) the mode of submission and consideration of the applications referred to in art. 42f ust. 1, art. 42i ust. 1, 2, 9 and Art. 42j ust. 1 and 2, and the models of those applications,
2) the mode of covering the costs referred to in art. 42i ust. 2 and 9 and Art. 42j ust. 1 and 2
-with a view to ensuring the efficiency of the proceedings and the advisability of disbursing public funds.
Chapter 3
Special entitlements to health care benefits
Article 43. [ Privileges of the Deserved Honorary Donor of Blood and the Deserved Donor Transplant] 1. A witness who holds the title of "Deserved Honorary Donation" or "Deserved Donor Transplant" and will present the identity of the "Deserved Honorary Donor" or "Deserved Donor Transplant", free of charge, up to the limit of the limit the financing referred to in Article 6 para. 2. of the refund act, supplies of medications included in the list:
1) referred to in art. 37 of the refund act, within the scope of the category referred to in Article 6 para. 1 point 1 lit. and this Act,
2) medications that a provider holding the title of "Deserved Honorary Blood Donor" or "Deserved Transplant Donor" may use in connection with donation of blood or in connection with the donation of bone marrow or other regenerating cells and tissues, or Frequency
-on the basis of a prescription issued by a person authorised within the meaning of Article 4 (1) 2 item 14 of the refund act.
2. The person presenting the prescription for execution shall be obliged to show the document referred to in the paragraph. 1.
3. The person implementing the prescription shall record the number and type of document confirming the powers referred to in paragraph 1. 1:
1) on the reverse of the prescription, in the case of a prescription in paper form;
2) in the electronic document associated with the prescription in electronic form.
4. The Minister of Health, after consulting the President of the Fund, the Chief Medical Council and the Chief Medical Board of the Pharmacy, will determine, by way of regulation, a list of medications which the supplier holding the title of " Honorary Honorary Donor Blood "or" Deserved Transplant Donor " may be used in relation to blood donation or due to the donation of bone marrow or other regenerating cells and tissues or organs, taking into account in particular the need to ensure the protection of his health, Availability of medicines, safety of their use and ability the payment of the entity liable for the financing of public health care benefits.
Art. 43a. [ Free supplies of medications] 1. Witnesses, after completion of 75. a year of life, free of charge supplies of medicines, foodstuffs for particular nutritional uses and medical devices as specified in the list referred to in Article 37 par. 1 of the law on refunds fixed in accordance with the procedure laid down in paragraph 1. 2, on the basis of a prescription issued by the primary health care physician referred to in art. 55 par. 2a, the primary health care nurse or a practitioner who has ceased to pursue the profession and has issued a prescription for himself or her spouse, preliminary or descendants in a straight line and siblings.
2. The Minister of Health shall indicate from among the medicines, foodstuffs intended for particular nutritional uses and medical devices specified in the list referred to in art. 37 par. 1 of the Law on refunds, medicines, foodstuffs for particular nutritional uses and medical devices which are issued free of charge to the recipients referred to in paragraph 1. 1, having regard to:
1. to meet the health needs of the recipients referred to in paragraph 1. 1;
2) the availability and safety of the use of medicines, foodstuffs for particular nutritional uses and medical devices;
(3) the annual expenditure limit provided for that purpose in the Finance Act for the year in question;
(4) the ratio of the costs to the health effects of the medicine, the foodstuff for particular nutritional uses and the medical device as compared to the cost/effect ratio for the health effects of the medicines, special foodstuffs the nutritional uses and medical devices included in that list.
3. Medications, foodstuffs for particular nutritional uses and medical devices referred to in paragraph 1, shall be financed from the state budget in the part constituting the payment of the recipient referred to in art. 6 para. 2 points 2 and 3 of the refund act, covering the amount up to the financing limit, and the payment of the difference between the retail price of the drug in question, the foodstuff for particular nutritional uses and the medical device and the amount of the limit funding.
4. The provisions of the paragraph. 3 shall be without prejudice to the obligations of the Fund in respect of the amount of the financing of health care benefits under the powers referred to in Article 3. 43 and art. 44-46 and Art. 7a ust. 1 point 2 of the Act of 19 June 1997. prohibiting the use of articles containing asbestos (Dz. U. of 2004 items 20, 959, 1252 and 2135, of 2005. items 72 and 2009 items 106), in the case referred to in art. 44a (b) 2 of the Act on refunds.
5. The Minister of Health shall determine, by means of regulations, the manner and mode of financing from the budget of the state of medicines, foodstuffs for particular nutritional uses and medical devices referred to in paragraph. 1, with a view to ensuring the economy and the fairness of the expenditure of public funds and the effectiveness of health care provision.
Article 44. [ Persons Entitled to Free Prescription Drugs] 1. The individuals referred to in art. 66 (1) 1 point 2 shall be free of charge, up to the amount of the funding limit referred to in Article 3. 6 para. 2 of the law on refunds, supplies of medicines to be covered by the list referred to in Article 37 par. 1 of the refund act, in respect of the category referred to in Article 6 para. 1 point 1 lit. a refund act, and prescriptions.
1a. An eligible soldier or worker shall be entitled free of charge, up to the amount of public funding, to the supplies of medicines included in the list referred to in Article 4. 37 par. 1 of the refund act, in respect of the category referred to in Article 6 para. 1 point 1 lit. and the Act on refunds, and prescription drugs, for the duration of treatment of injuries or diseases acquired during the performance of tasks outside the State.
1b. An eligible soldier or employee in the event of an overrun of the funding limit referred to in Article 37 par. 2 item 6 of the refund act shall have the right to finance the amount beyond that limit. The funding may be made from the state budget appropriations, from the part remaining at the disposal of the Minister of National Defence.
1c. The injured veteran is entitled to free supplies of medicines included in the list referred to in art. 37 par. 1 of the refund act, in respect of the category referred to in Article 6 para. 1 point 1 of this Law, and prescription drugs, for the duration of treatment of injuries or diseases acquired during the performance of tasks outside the State.
2. The individuals referred to in paragraph. 1, 1a and 1c, the prescription may be issued by an authorized person within the meaning of the article. 2 item 14 of the refund act.
3. The persons referred to in paragraph. 1, 1a and 1c, shall be required to show the prescriptive document certifying the entitlement.
4. The person presenting the prescription for execution shall be obliged to show the document referred to in the paragraph. 3.
5. The person implementing the prescription shall be obliged to note the number and type of document confirming the powers referred to in the paragraph. 1, 1a and 1c:
1) on the reverse of the prescription, in the case of a prescription in paper form;
2) in the electronic document associated with the prescription in electronic form.
6. The Minister of National Defence will determine, by means of the regulation, the conditions and the mode of applying for the financing of the costs referred to in the paragraph. 1b. The Regulation should ensure the efficiency of the proceedings and the adequacy of the funding to be granted in relation to the price of the drug.
Article 45. [ Persons Entitled to Free Prescription Drugs] 1. Personalities:
1) which are military invalids,
2) which have suffered bodily harm in the circumstances referred to in art. 7 and art. 8 of the Act of 29 May 1974. the supply of war and military invalids and their families and not included in any of the groups of invalids,
3. as listed in Article 42 and art. 59 of the Act of 29 May 1974. the procurement of war and military invalids and their families
-free of charge, up to the amount of the public funding limit for the medicines included in the list referred to in Article 3 (1) of the Regulation. 37 par. 1 of the refund act, in respect of the category referred to in Article 6 para. 1 point 1 lit. and the refund act.
2. The individuals referred to in paragraph. 1, the prescription may be issued by an authorized person within the meaning of the Article. 2 item 14 of the refund act.
3. The persons referred to in paragraph. 1, shall be required to show the prescriptive document certifying the entitlement.
4. The prescribing of the prescription shall be entered on the prescription of the PESEL number of the person referred to in the paragraph. 1.
5. The person presenting the prescription for execution shall be obliged to show the document referred to in the paragraph. 3.
(5a) The person implementing the prescription shall record the number and type of documentary evidence of the powers referred to in paragraph 1. 1:
1) on the reverse of the prescription, in the case of a prescription in paper form;
2) in the electronic document associated with the prescription in electronic form.
6. (repealed)
Article 46. [ Persons Entitled to a free supply of medications marked with the symbols 'Rp' or 'Rpz'] 1. Personalities:
1) invalids of war,
2. repressed persons,
(3) the spouses of the persons referred to in points (1) and (2), which are dependent on their dependants,
4. entitled to the survivor's pension in the widow or in the widow of:
(a) fallen soldiers,
(b) deceased invalids of war,
(c) repressed persons,
5) soldiers of the deputy military service referred to in art. 1 (1) 1 of the Act of 2 September 1994. on the cash benefit and the powers of the soldiers of the deputy military service forcibly employed in coal mines, quarries, uranium ore plants and construction battalions (Dz. U. of 2014 items 1373), who received a one-off compensation in connection with forced employment in the facilities of acquiring and enriching uranium ore, specified in art. (a) 1 of this Act,
6. other than those referred to in point 5, the soldiers of the alternative military service referred to in Article 6 (1) (a) of the military service referred to in Article 6 1 (1) 1 of the Act of 2 September 1994. on the cash benefit and the powers conferred on the soldiers of the Deputy Military Service forcibly employed in coal mines, quarries, uranium ore and construction battalions, for which it has been ordered invalidity resulting from compulsory employment, in the places referred to in art. 1 (1) 1 of this Act,
7) civilian casualties of war
-there shall be free supplies of medicines of the availability category "Rp" or "Rpz" and foodstuffs intended for particular nutritional uses covered by the refund decision, admitted to trading on the territory of the Republic of Poland.
2. The individuals referred to in paragraph. 1, the prescription may be issued by an authorized person within the meaning of the Article. 2 item 14 of the refund act.
3. The prescribing of the prescription shall be entered on the reception of the PESEL number of the person referred to in the paragraph. 1.
4. The persons referred to in paragraph. 1, shall be required to show the prescriptive document certifying the entitlement.
4a. The document referred to in paragraph 1. 4, confirming the holding of powers by the soldiers of the deputy military service referred to in the mouth. 1 (5) and (6) is a certificate issued at the request of a person entitled by the Head of the Office for the Affairs of the Combatants and of the Represonated Persons.
5. The person presenting the prescription for execution shall be obliged to show the document referred to in the paragraph. 4.
6. The person implementing the prescription shall record the number and type of document confirming the powers referred to in paragraph. 1:
1) on the reverse of the prescription, in the case of a prescription in paper form;
2) in the electronic document associated with the prescription in electronic form.
Article 47. [ Privileges of war and military invalids, civil blind victims of hostilities and repressed] 1. War and military insurgents, civilian blind victims of hostilities and repressed persons shall have the right to free medical devices for the purposes of the request of the authorized person referred to in art. 2 item 14 of the refund act, up to the amount of the public funding limit laid down in the provisions issued on the basis of art. 38 par. 4 of the Act on refunds.
2. An authorized soldier or an employee, in the treatment of injuries or diseases acquired during the performance of tasks outside the State, shall be entitled to free medical devices for the order of the authorized person referred to in art. 2 item 14 of the refund act, up to the amount of the public funding limit laid down in the provisions issued on the basis of art. 38 par. 4 of the Act on refunds.
2a. Veteran injured in the treatment of injuries or diseases acquired during the performance of tasks outside of the State shall be entitled to free medical devices for the order of the authorized person referred to in art. 2 item 14 of the refund act, up to the amount of the public funding limit laid down in the provisions issued on the basis of art. 38 par. 4 of the Act on refunds.
2b. In the case where the price of medical devices is higher than the amount of the public funding limit specified in the provisions issued on the basis of art. 38 par. 4 of the Act on refunds, then the injured veterans referred to in paragraph. 2a, serves the right to finance an amount that goes beyond the amount of public funding, as defined in the rules adopted on the basis of art. 38 par. 4 of the Act on refunds.
2c. The grant referred to in paragraph 1. 2b, may be made from the resources of the state budget, from the part remaining at the disposal of the Minister of National Defence-with regard to the veterans of the injured-soldiers, from the part remaining at the disposal of the minister competent for internal affairs-in refer to veterans of the injured-officers of the Police, Border Guard, Government Protection Bureau and the State Fire Service, with the part remaining at the disposal of the Head of the Internal Security Agency-with regard to the veterans aggrieved-officers of the Internal Security Agency or of the part remaining in The Head Of The Intelligence Agency-with regard to veterans of aggrieved-officers of the Intelligence Agency.
2d. The President of the Council of Ministers, the Minister of National Defence and the Minister responsible for internal affairs, each to its extent, shall determine, by means of the regulation, the conditions and the procedure for applying for the financing of the costs referred to in paragraph. 2b. The Regulation should ensure the efficiency of the proceedings in these matters and the adequacy of the funding to be granted in relation to the price of medical devices.
2e. The persons referred to in paragraph 1. 1-2a shall be required to show the order of the document certifying the entitlement.
2f. The issuing of the order shall be entered on the order type, number, date of issue and the expiry date of the document confirming the powers referred to in paragraph. 1-2a.
3. Rules of Art. 38 par. 2 and 3 of the refund act shall apply mutatis mutandis.
Art. 47a. [ Powers of the recipient of the donor] 1. A witness who is a living donor of an organ within the meaning of the provisions of the Act of 1 July 2005. the collection, storage and transplantation of cells, tissues and organs shall be entitled to tests for the monitoring of the health status of the medicinal product which has taken the organ, every 12 months from the date of collection No longer than for 10 years.
2. The medicinal product which has made the organ donation shall immediately communicate the results of the tests referred to in paragraph 1. 1, to the register of living donors carried out on the basis of the provisions of the Act referred to in paragraph. 1.
3. The Minister of Health shall determine, by means of a regulation, the nature and extent of the studies of live donors of the organs carried out as part of the monitoring of their state of health, having regard to the control of their health status associated with the donation of the organ.
Article 47b. [ Proof of entitlement document] 1. An authorized soldier or an employee benefits from the health care benefits referred to in art. 24a, art. 44 par. 1a, art. 47 para. 2 and Article 57 (1) 2 point 12, on the basis of a document confirming the entitlement.
1a. The injured veteran benefits from the health care benefits referred to in art. 24b, art. 24c, art. 44 par. 1c, art. 47 para. 2a and Art. 57 (1) 2 point 13, on the basis of a document confirming the entitlement of the rights.
2. The President of the Council of Ministers, the Minister of National Defence and the minister competent for internal affairs, each to its extent, shall determine, by means of regulations, the entities entitled to issue the documents referred to in the paragraph. 1 and 1a, the models of these documents, the mode of issue, exchange or return, as well as the data contained in those documents, with a view to the implementation of the powers resulting from the law and guided by the need to ensure the efficiency of the proceedings at the the issue of supporting documents.
Article 47c. [ Persons Entitled to benefit from health care services outside the order] 1. The persons referred to in art. 43 par. 1, the invalids of the war and the military and the combatants have the right to use beyond the order of health care services and the pharmaceutical services provided in pharmacies.
2. Using outside the order of health care benefits in the field of health care benefits in hospitals and specialist benefits in outpatient health care means that the healthcare provider grants these benefits out of order the receipts resulting from the waiting list referred to in Article 20 para. 2.
3. The healthcare provider grants health care benefits referred to in the paragraph. 1 and 2, on the day of filing.
4. Where a provision is not possible on the date of notification, the provider shall set a different time limit beyond the order of receipt resulting from the waiting lists. The provision of outpatient care may not be provided at a later date than within 7 working days from the date of notification.
5. In the places of registration of patients for the provision of health care benefits, in the places of granting of primary health care benefits and in pharmacies, respectively the provider or the manager of the pharmacy gives a written notice of the the powers specified in the paragraph. 1-4.
6. The provisions of the paragraph. 2-4 shall apply to the health care benefits provided outside the order under Article 4. 24a-24c.
Chapter 4
Health programmes and health policy programmes
Article 48. [ Development, implementation, implementation and financing of health programmes and health policy programmes] 1. Health programmes may develop, implement, implement and finance the Fund, and health policy programmes can develop, implement, implement and finance ministers and local government units. The Fund shall implement health policy programmes commissioned by the Minister responsible for health.
2. The programs of the left referred to in art. 15 para. In accordance with Article 2 (2) of the Financial Regulation, the Minister for Health and Health shall be responsible for the implementation, implementation, financing, monitoring, supervision and control of the Fund, except where otherwise provided for in the separate provisions. The provisions of paragraph 1 shall apply to those programmes. 3 and 5 and Art. 48b (b) 5 and 6.
3. The programmes referred to in paragraph 1. 1, shall concern in particular:
1) important epidemiological phenomena;
2) other than those referred to in point 1 of the relevant health problems affecting the whole or specified group of users, with the existing possibilities to eliminate or reduce these problems;
3) implementation of new medical procedures and preventative actions.
4. The programmes of health policy developed, implemented, implemented and financed by local government units, where they concern the guaranteed benefits covered by the programmes referred to in the paragraph. 1, carried out by the Ministers and the Fund, must be coherent with them in substance and organisation.
5. The programmes referred to in paragraph 1. 1, may be implemented in one year or many years.
Art. 48a. [ The draft health policy programme] 1. The Minister and the local government unit shall draw up a draft of the health policy programme on the basis of the maps of health needs referred to in art. 95a ust. 1 and 6. The draft health policy programme shall be forwarded to the Agency for its opinion.
2. The provision of the paragraph. The second sentence shall not apply to the health policy programme as a continuation of the programme implemented in the previous period.
3. The Agency shall draw up an opinion on the draft health policy programme within 2 months from the date of receipt of the draft of this programme on the basis of the criteria referred to in:
1. 31a (a) 1-in the case of health policy programmes developed by the Minister;
2. Article 31a (a) 1 and Art. 48 (1) 4-in the case of health policy programmes developed by the local government unit.
Art. 48b. [ Choice of program realizer] 1. In the case of health policy programmes, the selection of the programme shall be carried out by means of a contest of tenders.
2. The award of the tender referred to in paragraph 2 shall be submitted. 1, the minister or local government unit shall announce at its registered office and on its website at least 15 days before the expiry of the designated time limit for the submission of tenders.
3. In the notice referred to in paragraph. 2, shall specify in particular:
1) the subject matter of the tender;
2) the requirements placed on the tenderers, which are necessary for the implementation of the health policy programme;
3. the time limit and place of submission of tenders.
4. In the unregulated range in the Act to the mode of conducting the contest of tenders and the conclusion of contracts for the implementation of the health policy programme shall apply accordingly the provisions of the Civil Code concerning the tender procedure.
5. The Fund shall select the operator of the health programme and shall conclude an agreement with it on the basis and in accordance with the procedures laid down for the provision of health care contracts.
6. The selection of the programmers of the programmes referred to in art. 48 (1) 1, no public procurement rules shall apply.
Chapter 5
Documents used to confirm and verify the right to health care benefits
Article 49. [ Health Insurance Card] 1. A document confirming the right of the insured to health care benefits and the confirmation of the execution of health care services is the health insurance card.
2. The Health Insurance Card is an electronic type card.
3. The Health Insurance Card shall contain in particular the following data:
1) first name (s) and surname;
2) date of birth;
3) the PESEL number, and in the case of non-possession of the PESEL number-the number of the passport or other document confirming the identity;
(4) the identification number of the health insurance institution;
5) 2-character ISO 3166-1 code for the Republic of Poland;
6) the expiration date of the card;
7) the identification number of the card.
4. The function of the health insurance card may also be performed by another electronic type document, if it contains the data indicated in the paragraph. 3 points 1 to 3 and fulfil the functions referred to in paragraph 3. 1.
5. The Health Insurance Card may act as a European Health Insurance Card.
6. The health insurance card shall be issued free of charge. In case of loss of the health insurance card for issuing a new card, a fee of 1.5% of the minimum wage is collected.
7. The director of the provincial branch of the Fund may, in particularly justified cases, exempt the insured from the obligation to incur the fee referred to in the paragraph. 6. Rules of Art. 109 and 110 shall apply mutatis mutandis.
8. (repealed)
9. The Council of Ministers shall determine by way of regulation:
1) the model of the health insurance card and the way of its implementation, having regard to the provisions of the European Union on the model of the European Health Insurance Card,
2) model application for the issue of the health insurance card,
3) the detailed scope of the data contained on the health insurance card and their format,
4) the mode of issuing and cancelling the health insurance card
-having regard to the need to identify insured persons, to confirm the rights of insured persons for the provision of health care and the electronic confirmation of the benefits provided, the need to ensure transparency of the data contained in the card health insurance and the efficiency of the procedure on the issue and cancellation of the health insurance card.
10. The regulation referred to in paragraph 1. 9, it may also specify documents that may serve as a health insurance card, taking into account the possibility of these documents being confirmed by those documents of the right to health care benefits and the function of confirming the provision of those benefits.
Article 50. [ Documents presented by the recipient of the applicant for the provision of health care] 1. The owner of the applicant for the provision of health care is obliged to present:
1) the health insurance card-in the case of the insured person and the persons to whom the art is applied. 67 par. 4-7;
2) the document referred to in art. 54 para. 1-in the case of an operator other than the insured person.
2. Presentation by the provider of the documents referred to in the paragraph. 1, it is not required if the following conditions are met:
1) the operator shall confirm his/her identity by showing the identity card, passport, driving licence or school ID card; the school ID card can be provided only by a person who has not completed 18. year of life;
(2) a provider or a person who is not a provider of a person entitled to do so within the meaning of the Article. 2 item 14 of the refund act will be granted confirmation of the right to health care benefits of the person applying for the provision of health care in the manner specified in the mouth. 3.
3. The right to health care benefits can be confirmed on the basis of the electronic document referred to in art. 3 point 2 of the Act of 17 February 2005. information on the activities of entities carrying out public tasks (Dz. U. of 2014 items 1114 and 2016 items 352 and 1579), drawn up, on the basis of the PESEL number, by the Fund for the healthcare provider or non-certified person within the meaning of the Art. 2 item 14 of the refund act and sent by means of electronic communication within the meaning of art. 2 point 5 of the Act of 18 July 2002. on the provision of services by electronic means (Dz. U. of 2016 r. items 1030 and 1579) with the assurance of the integrity and confidentiality of the data contained in it and the authentication of the parties entitled to process such data.
4. The Minister competent for health, after consulting the President of the Fund, shall determine, by means of a regulation, the conditions which must be fulfilled by the provider or not being a provider of a person entitled under the terms of Article. 2 item 14 of the refund act, applying to the Fund for electronic document referred to in paragraph 2. 3, bearing in mind the need to ensure the integrity and confidentiality of the data processed.
5. The electronic document referred to in paragraph 1. 3, contains the name and the number of the PESEL of the provider, as well as the information, according to the state at the date of drawing up the document, about the right to health care benefits.
6. In the case of failure to confirm the right to health care benefits in the manner set out in the mouth. 1 or 3 the person concerned on presentation of the document referred to in paragraph 1. 2 point 1, may present another document confirming the right to health care benefits, and if such a document does not have, make a written statement about the right to receive health care benefits.
7. The holder of the declaration referred to in the paragraph. 6, it is obliged to conclude a clause of the following content: "I have the right to use public health care benefits.".
7a. In the situation of awarding stationary or round-the-clock health care services, the statement referred to in paragraph 6, covers the period from the date of commencence of the provision until the date of termination of the provision, however not longer than the end of the month following the month of commencing of the provision. Where the provision of health care takes longer, the operator shall submit a subsequent declaration which shall cover a period of not more than one month.
8. The statement referred to in paragraph 1. 6, contains the name, address of residence, indication of the basis of the right to health care benefits, the PESEL number and an indication of the document on the basis of which the provider confirmed the identity of the recipient, and in the case of persons No PESEL number-the data referred to in Article 188 par. 4 point 9. A person who is an authorised person within the meaning of Article 4 (1) of the Rules of 2 item 14 of the refund act confirms the signature in the statement of data identifying the document on the basis of which the identity is confirmed.
9. In the case of the licensees of minors and other persons who do not have full capacity for legal action, the statement referred to in paragraph 1 shall be provided. 6, submits a statutory representative or a legal or factual guardian within the meaning of the Act of 6 November 2008. about the rights of the patient and the Ombudsman for the Rights of Patient The provisions of the paragraph 7 and 8 shall apply mutatis mutandis.
(10) The Minister responsible for Health shall determine, by means of a regulation, the models of the claims referred to in paragraph 1. 6 and 9, with a view to ensuring legibility of statements.
11. In emergencies or where, due to the state of health, it is not possible to submit a statement as referred to in paragraph. 6, the provision of health care is granted despite the lack of confirmation of the right to health care benefits in the manner indicated in the mouth. 1, 3 or 6. In such a case, the person who is granted the health care benefit shall be obliged to present a document confirming the right to health care benefits or to make the declaration referred to in the paragraph. 6, within 14 days from the start of the provision of health care provision, and if the benefit is provided in the hospital ward, within 7 days from the date of termination of the provision of health care-under the rigorous of the burden of the the costs of the benefits granted to it.
12. Later than those provided for in the paragraph. 11, however, for a period of not more than one year, counting from the date of expiry of those time limits, the presentation of a document confirming the right to health care services or the submission of the declaration referred to in paragraph 1. 6, may not give rise to a refusal by the provider to exempt the operator from the obligation to bear the costs of the provision of health care or to reimbursing those costs.
13. Claims on the basis of the paragraph. 11 shall be statute of limitation with the expiry of five years from the date of expiry of the time limits laid down in paragraph 11.
14. In the case of children, to complete 3. month of life, which does not hold the PESEL number, the confirmation referred to in paragraph. 3, takes place on the basis of the PESEL number of the person obliged to report the child to health insurance.
15. The fund shall not refuse to provide the provider with the financing of the provision of health care due to the lack of the right to the health care benefits of the person who has obtained this benefit, or to demand from a non-financial person who is entitled to the benefit of the person entitled to receive the health care allowance art. 2 point 14 of the Act on reimbursement of the costs of health care incurred by the Fund despite the lack of the right to health care benefits of the person who obtained this benefit on the basis of a prescription issued by a person entitled, if:
(1) at the date of the grant of the benefit, confirmed, in the manner prescribed in paragraph 1, 3, the right of the provider to the benefits of health care or the healthcare provider of that on that day presented a document confirming the right to health care benefits or made the statement referred to in the mouth. 6,
2) the operator within the time limit presented a document confirming the right to health care benefits or made the declaration referred to in the paragraph. 6, in the cases referred to in paragraph 1. 11
-if this benefit has been carried out under the terms of the contract for the provision of health care which is concluded with the provider or that is not provided by a person entitled under the terms of Article 3 (1) (a) of the basic Regulation. 2 item 14 of the refund act.
16. Where the provision of health care has been granted despite the lack of the right to health care benefits as a result of:
1) the use of a health insurance card or other document confirming the right to health care benefits by a person who has lost that right within the period of validity of the card or other document, or
(1a) confirmation of the right to benefits in the manner set out in the paragraph. 3 persons referred to in art. 52 par. 1, or
2. the submission of the declaration referred to in paragraph. 6
-the person to whom the provision of health care is granted is obliged to pay the costs of the benefit.
17. The provision of the paragraph. Article 16 (2) shall not apply to a person who, at the time of making the declaration referred to in paragraph 2, is in receipt of a declaration 6, acted in the justified erroneous belief that he had the right to health care benefits.
18. Costs of health care benefits granted in the cases referred to in the paragraph. 16 which the Fund has incurred in accordance with the paragraph. 15, shall be subject to enforcement of enforcement proceedings in the administration. The director of the provincial branch of the Fund shall issue an administrative decision establishing the obligation to bear the costs and their amount and the time limit for payment. The provisions of the Code of Administrative Procedure shall apply to the proceedings concerning the establishment of costs.
19. From the amount of receivables referred to in paragraph. 18, the statutory interest shall be charged for the delay, beginning on the date on which the due date for payment of those duties expired.
20. The decision referred to in the paragraph shall not be issued. 18 if, from the date on which the provision of the healthcare provision referred to in paragraph is completed. 15, 5 years have elapsed.
21. The claims referred to in paragraph 1 18, the statute of limitations shall expire 5 years from the date on which the decision fixing the duties has become final.
22. The director of the provincial branch of the Fund may waive in whole or in part the repayment of the duties established in the decision referred to in the paragraph. 18, or postpone the repayment of that claim, or spread it into instalments, applying the rules laid down in the art. 56-58 of the Act of 27 August 2009. on public finances (Dz. U. of 2013 r. items 885, as late. zm.).
Article 50a. [ Establishing of entities which should bear the costs of the benefit to be accounted for] 1. The Fund shall determine the entities that should incur the costs settled by the Health Care Fund and shall charge these entities with the costs, taking into account art. 50 par. 15 and 16.
2. In the case of health care benefits lasting more than one day, for which more than one entity has been established, which should bear the cost of the calculated health care benefit, incurred by the Fund the cost of that provision divided is in proportion to the duration of its duration. In determining the cost of this benefit, no Article shall apply. 44 and Art. 45 of the Act of 15 April 2011. Medical activity.
3. Receivables for the realization of health care benefits provided:
1) the insured,
2) persons entitled to benefits on the basis of the rules on coordination,
3) the persons referred to in art. 2. 1 points 2 to 4 and Article 1 12 points 2 to 4, 6 and 9
-the provider may present in a single account together.
Article 51. [ European Health Insurance Card] 1. In order to confirm the right to health care benefits provided to the recipient, in accordance with the rules on coordination, in the territory other than the Republic of Poland of a Member State of the European Union or a Member State The European Free Trade Agreement (EFTA), the provincial branch of the Fund competent for the place of residence of the recipient on the territory of the Republic of Poland shall issue, on the basis and within the scope of the rules of coordination, The European Health Insurance Card or a certificate of right to those benefits.
2. The European Health Insurance Card and the certificate referred to in paragraph 2. 1, for insured persons and members of their families residing in a territory other than the Republic of Poland of a Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA) issue a branch of the Fund's voivodship indicated in the notification to health insurance, and in the case of the persons referred to in art. 2. 1 point 3 (a), not domiciled in the territory of the Republic of Poland-branch office of the Fund chosen by the recipient.
3. Provisions issued on the basis of art. 49 (1) Article 9 (4) shall apply mutatis mutandis.
Article 52. [ Certificate] 1. A person entitled to health care benefits on the basis of the provisions on coordination, in order to use these benefits from health insurance in the territory of the Republic of Poland, branch of the Fund shall issue a document confirming the right to health care benefits, hereinafter referred to as 'the attestation'.
2. The certificate shall contain the following data:
1. forenames and surname;
2) date of birth;
3) the PESEL number, and in the case where the person referred to in the mouth. 1, this number has not been given, either the series and the number of the passport or the identification number of another document on the basis of which it is possible to establish personal data;
4. address of the place of residence;
5) the name of the foreign institution, at the expense of which will be provided to health care benefits;
6) address of residence or stay in the territory of the Republic of Poland;
(7) the extent of the health care benefits provided for under the coordination provisions;
8) the period of the service of health care benefits in the territory of the Republic of Poland;
(9) the number of the certificate.
3. The Minister of Health, after consulting the President of the Fund, shall determine, by regulation, the method of issuing the certificate and its design, taking into account the data referred to in paragraph. 2, and the documents on the basis of which the attestations are issued, guided by the need to ensure access to health care benefits and to reliably confirm the right to these benefits.
Article 53. [ A document confirming the right to health care benefits of a person entitled under the rules of coordination] 1. A document confirming the right to health care benefits of a person entitled to health care benefits under the rules on coordination shall be a certificate issued by the Fund or a document confirming the right to these benefits, issued by a foreign competent institution.
1a. In the case of the issue of the certificate referred to in paragraph 1. 1, the right of the person entitled to health care benefits under the rules on coordination may be confirmed in the manner specified in art. 50 par. 1 or paragraph 3.
2. If the certificate or document referred to in paragraph 1, will not be presented in the case of:
1) the state of emergency,
2) childbirth
-the provisions of the Article 50 par. 11-15 and 18-22 shall apply mutatis mutandis.
Article 54. [ The decision of the mayor as a confirmation of the right to health care benefits] 1. A document confirming the right to health care benefits of the healthcare provider referred to in art. 2. 1 point 2, is the decision of the mayor (mayor, president) of the competent municipality on the basis of the place of residence of the provider, confirming this right.
2. The decision referred to in paragraph. 1, should include the PESEL number of the provider.
3. The decision referred to in paragraph 3. 1, appears after:
1. the submission by the provider referred to in paragraph 1. 1, documents confirming residing in the territory of the Republic of Poland and supporting documents:
a) possession of Polish citizenship or
(b) possession of refugee status, or
(c) the inclusion of subsidiary protection, or
(d) possession of a temporary residence permit granted in connection with the circumstance referred to in Article 159 par. 1 point 1 lit. c or d of the Act of 12 December 2013. o foreigners;
2) conducting a family environmental interview;
3) statement of the fulfilment of the income criterion referred to in art. 8 of the Act of 12 March 2004. social assistance;
4) the finding of the absence of the circumstances referred to in art. 12 of the Act of 12 March 2004. of social assistance, as a result of carrying out a family environmental interview as referred to in point 2.
4. The decision referred to in paragraph 1 shall be adopted by the Commission. 1, shall be issued at the request of the provider and, in the case of emergency, at the request of the healthcare provider, immediately after the provision of the benefit.
5. Wójt (mayor, president) of the municipality competent due to the place of residence of the provider may initiate proceedings for the purpose of issuing the decision referred to in the paragraph. 1, also from the office or at the request of the competent branch of the Fund's provincial office
6. In the case of the decision referred to in the paragraph. 1, wójt (mayor, president) of the municipality competent due to the place of residence of the recipient is obliged to deliver within 7 days from the day of its issuance, a copy of this decision to the competent branch of the Fund.
7. The right to health care benefits on the basis of the decision referred to in the paragraph. 1, shall be entitled for a period of 90 days from the date specified in the decision, which shall be:
1) the day of the application,
2) in the case of the provision of benefits in the emergency-the date of granting of the benefit
-unless during this period the operator will be covered by health insurance.
8. In the case of the decision referred to in the paragraph. 1, ex officiated by the mayor (mayor, president) of the municipality competent due to the place of residence of the recipient, the right to health care benefits shall be entitled from the date specified in the decision for a period of 90 days from that date.
9. Wójt (mayor, president) of the municipality competent due to the place of residence of the recipient, referred to in art. 7 ust. 2, it shall immediately determine the expiry of the decision referred to in paragraph 1. 1, where during the period referred to in paragraph. 7 and 8:
1) the operator will be covered by health insurance or
2) in the event of the occurrence of the circumstances referred to in the paragraph. 10.
10. The witness referred to in art. 7 ust. 2, is obliged to immediately inform the mayor (mayor, president) of the municipality competent on account of his/her place of residence o:
1) any change in the income or property situation;
2) covered by health insurance.
11. Wójt (mayor, president) of the municipality competent due to the place of residence of the provider may authorize the head of the social assistance centre to arrange matters and issue decisions on his behalf concerning the confirmation of the right to benefits health care.
12. The provisions of the paragraph. 1-11 shall not apply to medical rescue operations provided to recipients other than those insured by the units of the system referred to in Article 3. 32 par. 1 point 2 of the Act of 8 September 2006. o State Medical Rescue, in non-hospital conditions.
SECTION III
Rules for the provision of health care benefits
Article 55. [ Principles of Health Care Benefits] 1. The provider granting benefits in the scope of primary health care shall be obliged in particular to proceedings in accordance with the scope of tasks specified in the provisions issued on the basis of the paragraph. 6 for the physician referred to in paragraph 6. 2a, nurses of primary health care or midwife of primary health care.
2. The provider providing the benefits in the field of primary health care shall provide to the recipients, in the costs of their own activity, in accordance with the scope referred to in the paragraph. 1, in particular access to:
1) outpatient care, including care in the house of the sick;
2) diagnostic tests.
2a. Benefits of primary health care may give the doctor, with whom the Fund has entered into an agreement for the provision of health care services or who is employed or performs a profession in the provider with whom the Fund has entered into an agreement on provision of basic health care benefits:
1) having the title of a specialist in the field of family medicine or
2) undergoing specialisation training in the field of family medicine, or
3) having a 2nd degree specialization in the field of general medicine, or
4) having specialization I degree in the field of general medicine, or
5) having a specialization I or II degree or a specialist's title in the field of internal diseases, or
6) having specialization I or II degree or the title of specialist in the field of pediatrics
-within the scope of their qualifications confirmed by the relevant documents, subject to Article 14 of the Act of 24 August 2007. to amend the Act on health care benefits financed from public funds and certain other laws (Dz. U. Entry 1172), hereinafter referred to as "the doctor of primary health care".
2b. Doctors referred to in paragraph 2a points 4-6, are required within 3 years from the day of commencating the provision of health care in primary health care to complete the course in the field of family medicine organised by the Centre for Medical Postgraduate Education. The costs of the course shall be borne by the doctor or the provider, with whom the Fund has entered into a contract for the provision of basic health care.
3. On the provision of night and Christmas health care, a branch of the Fund's voivodship shall contain a separate agreement.
4. The provider providing benefits in the field of primary health care is obliged to inform the recipients of the rules and organization of the night and public health care, in particular by placing the information at the place of the the provision of benefits and at the premises of the healthcare provider.
5. The person providing health care benefits outside the seat of the healthcare provider and organizational units of the healthcare provider shall enjoy the legal protection provided in the Code of Penal Penal for Public Officials.
6. The Minister of Health, after consulting the President of the Fund, the Chief Medical Council and the Chief Councils of Nurses and Midwives, will determine, by way of regulation, the scope of the health care primary care, nurses basic health care and primary health care, taking into account the need to ensure the complexes of the benefits provided and the good of the patient.
Article 56. [ Declaration of Choice] 1. Selection as referred to in art. 28 para. 1 and 1a, the witness confirms the declaration of will, hereinafter referred to as the "declaration of choice", which is a document in the form of:
1) paper or
2) an electronic, certified electronic signature or a signature of a confirmed ePUAP-trusted profile within the meaning of the regulations on the information technology of the entities carrying out public tasks.
1a. The choice referred to in paragraph shall be made by the holder of the selection. 1, it does not bind it to the healthcare provider providing night-time benefits and Christmas health care.
1b. The choice referred to in paragraph shall be made by the holder of the selection. 1, may be effected by means of the system referred to in art. 10 of the Act of 28 April 2011. o System of information in health care.
2. The declaration of choice shall include:
1. data relating to the operator:
(a) first and last name,
(b) the family name,
c) date of birth,
(d) sex,
(e) the PESEL number, where this is granted,
f) place of study-in the case of students and students,
(g) home address,
(h) telephone number;
(2) a term which shall be carried out once a year;
3) the number of the health insurance card-in the case of insured persons;
4) the code of the Branch's provincial branch;
(4a) data relating to the provider, including his (business) name, place of office and place of the provision of benefits;
5) the name of the doctor of primary health care, nursing primary health care or obstetric primary health care;
6) the date of making the choice;
7) signature of the provider or his legal guardian;
8) signature of the person accepting the selection declaration.
3. The Minister of Health, after consulting the General Medical Council and the Chief Councils of Nurses and Midwives, will determine, by means of a regulation, the models of the selection declaration, taking into account the possibility of selecting the primary care physician health care, primary health care nurses and midwifery health care providers who provide benefits in the same healthcare provider or in different healthcare providers or providers, and the need to provide transparency of the data contained in the selection declaration.
4. The granting provider of benefits in the scope of primary health care is obligatory:
1) make available to the provider a declaration of choice and verify the correctness of its completion;
2) before the adoption of the declaration of choice check the entitlements to use the health care benefits specified in the Act.
5. The completed declarations of the choice of the provider shall be kept in their premises, ensuring that they are accessible to the providers who have submitted them, subject to the requirements of the Act of 29 August 1997. on the protection of personal data (Dz. U. of 2016 r. items 922).
5a. In the case referred to in paragraph 1. 1b, the declaration of choice of the provider shall be kept in the basic module referred to in Article 4. 14 para. 1 point 1 of the Act of 28 April 2011. o System of information in health care.
6. In case of cessation of the provision of health care services by the chosen primary health care physician, nurse of primary health care or midwife of primary health care in the chosen provider of the choice declarations they shall remain valid for the choice of the healthcare provider until the choice of another primary health care professional, nursing primary health care, midwife of primary health care or the choice of a new healthcare provider.
Article 57. [ Directing on ambulatory specialist benefits] 1. Ambulatory specialist benefits financed from public funds shall be awarded on the basis of the referral of the health insurance physician.
(1a) If, as a result of public-funded screening tests performed in children, there has been a finding of congenital diseases, the provision of ambulatory specialised services financed by public funding in the field of treatment those diseases shall be followed without the referral referred to in paragraph 1. 1.
2. The direction referred to in paragraph 2. 1, is not required for benefits:
1) gynaecologist and obstetrician;
2) dentists;
3) (repealed)
4) venerologa;
5) oncologist;
6) (repealed)
7. psychiatrists;
8) for patients with tuberculosis;
9) for people infected with HIV;
10) for invalid war and military invalids, repressed persons and combatants;
10a) for civilian blind victims of hostilities;
11) for persons who are addicted to alcohol, narcotic drugs and psychotropic substances-in the area of retreat treatment;
12) for an authorized soldier or employee, in the treatment of injuries or diseases acquired during the performance of tasks outside of the State;
13) for veteran aggrieved, in the treatment of injuries or diseases acquired while performing tasks outside the state.
3. Ambulatory specific benefits referred to in paragraph 1. 1, may also be given in the future guidance counseling.
Article 58. [ Right to hospital treatment] The healthcare provider has the right to hospital treatment in the hospital, which has entered into a contract for the provision of health care services, on the basis of referral of a doctor, dental practitioner or a feller, if the purpose of treatment cannot be achieved by treatment ambulatory.
Article 59. [ Right to rehabilitative treatment] The operator shall have the right to rehabilitation of the medicinal product in the healthcare provider who has entered into an agreement for the provision of health care services, on the basis of the referral of the health insurance physician.
Article 59a. [ Sings issued by doctors performing profession in other than the Republic of Poland of the Member States of the European Union] 1. The routes issued by doctors performing the profession in other than the Republic of Poland of the Member States of the European Union shall be treated as a referral within the meaning of the Act, if they meet the requirements specified therein.
2. To refer the paragraph referred to in paragraph 1. 1, issued in a foreign language, shall be accompanied by his translation into Polish. The translation does not have to be drawn up by a sworn translator.
Article 59b. [ Issued notice] 1. In the case of a referral in electronic form, the operator shall receive an information about the issued referral containing the following data:
1) the access key to the referral;
2. the code of access to the referral;
3) the identifier of the set of referrers;
4) the date of issue of the referral;
5) the name and surname of the provider;
6. the name of the person issuing the referral;
(7) the number of the exercise of the profession of the person issuing the referral;
8) the telephone number of the contact person to the person issuing the referral;
9) the name of the document, if it is different from the "referral";
10) the type of referral in accordance with the classification of the referrals used in the Medical Information System referred to in the Act of 28 April 2011. o System of information in health care;
11) information "case of urgency", if applicable;
(12) designation of the type of entity to which the operator is referred, if applicable;
(13) indicated by the person issuing the place of execution, if applicable.
2. The information referred to in paragraph 1. 1, the witness shall receive:
1) to the e-mail address indicated in the system of information in health protection, referred to in the Act of 28 April 2011. o System of information in health care;
2) to the indicated in the system of information in health protection, referred to in the Act of 28 April 2011. o System of information in health protection, telephone number, in the form of a text message containing the access code referred to in paragraph. 1 point 2, and information on the requirement of the document number confirming the identity in the execution of the referral;
3) in the absence of an indication in the system of information in health protection referred to in the Act of 28 April 2011. a system of information in the health protection of the data referred to in points 1 and 2, and at any request to the provider, in the form of a printout, and, in the case of a health benefit, at the place of call and the impossibility of providing information in the form of a a printout, in another agreed form.
3. The information referred to in paragraph 1 2 point 3, issue the person issuing the referral.
(4) Information on the issue issued shall not include any other content, in particular of the nature of the advertisement.
5. The information on the issued referral does not replace the referral.
Article 60. [ Providing health care without referral] In health emergencies, health benefits are granted without a required referral.
Article 61. [ Ambulatory specialist benefits paid by the benefit provider] The ambulatory benefits provided to the operator without the referral of the health insurance medical professional shall be paid to the operator, except in the cases referred to in Article 4 (1). 47a, 57 par. 2 and Art. 60.
Article 64. [ Control of the provision of benefits to the benefit of the recipients] 1. The entity obliged to finance health care benefits from public funds may carry out a control of the provision of benefits to the recipients, and in particular the control of:
1) the organization and manner of providing health care benefits and their availability;
2) the provision of health care services in terms of compliance with the requirements laid down in the contract for the provision of health care services;
3) the legitimacy of the choice of medicines, foodstuffs for particular nutritional uses and medical devices used in the treatment, rehabilitation and diagnostic tests;
4) compliance with the rules of issue of prescriptions;
5) medical records relating to health care services financed from public funds.
2. The entity obliged to finance the benefits from public funds in the authority to carry out the checks shall specify the subject matter and scope of the inspection and shall indicate the person authorized to carry out the inspection. The provisions of Article 4 173 (1) 5-9 shall apply mutatis mutandis.
3. The control of medical records, quality and legitimacy of the provided health benefits shall be carried out by authorised employees of the entity obliged to finance the benefits from public funds, having a medical education corresponding to the scope of the control.
4. The control of medical records and the quality and legitimacy of the health care provided, the entity obliged to finance the benefits from public funds may commission, if necessary, a person with medical education corresponding to the scope of the checks carried out and, if necessary, to examine or resolve specific issues requiring special qualifications, to appoint a specialist in the field concerned.
5. The provider shall be obliged to submit to the body responsible for the financing of the public service benefits of the requested documentation and to provide any information and assistance necessary in connection with the control carried out.
(5a) The inspecting person, hereinafter referred to as the 'controller', may draw up or require the provider to draw up the necessary write-downs or extracts from the documents, as well as of the statements and calculations made out on the basis of the documents.
5b. Compliance with the originals of documents, copies and extracts, and of the compilations and calculations referred to in paragraph. 5a, certifies the provider or the person authorised by him. In the event of refusal, the confirmation shall be made by
6. A protocol shall be drawn up from the course of the checks carried out, which shall be signed by the controller and the provider.
6a. The provider may, within seven days of receipt of the audit protocol, declare a reservation in writing to the said protocol.
6b. Reservations to the control protocol shall be considered by the controller within 14 days. The controller shall carry out their analyses and, where necessary, take additional checks and, where the validity of the reservations is established, amend or supplement the relevant part of the control protocol.
6c. In the event of failure to take account of the reservations in whole or in part, the controller shall immediately forward in writing its position to the applicant.
6d. The provider may refuse to sign the protocol by submitting, within 7 days from the date of its receipt, a written explanation of the refusal.
6e. The refusal to sign the control protocol and to provide an explanation of the controller makes reference to the protocol.
6f. The refusal to sign the protocol by the provider shall not prevent the protocol from being signed by the controller and the implementation of the inspection arrangements.
7. The entity obliged to finance the benefits from public funds shall draw up a post-control presentation containing an assessment of the activities of the healthcare provider and of the audit recommendation in the event of irregularities.
(8) The holder may, within seven days from the date of receipt of the post-control occurrence, raise objections to the entity responsible for financing the benefits of public funds. Reservations shall be considered within 14 days. If the reservation is not taken into account, the provider shall immediately inform the person concerned.
9. The provider shall be obliged, within 14 days from the day of receipt of the post-control occurrence, or from the date of receipt of the information on the failure to take notice, to inform the entity liable to finance the benefits from the public funds the manner in which the audit recommendations are carried out and the actions taken or the reasons for not taking these measures.
(10) The Minister responsible for Health will determine, by way of regulation, the detailed way and mode of control by the operator to finance public health care benefits, taking into account the proper implementation of the the objectives of the control and the provision of speed and effectiveness.
11. The provisions of the paragraph. 1-10 shall apply mutatis mutandis to the carrying out of checks on contracts for the performance of medical rescue operations referred to in the Act of 8 September 2006. o State Medical Rescue.
SECTION IV
Rules for health insurance
Chapter 1
Health insurance obligation
Article 65. [ General principles on health insurance] Health insurance is based, in particular, on the following principles:
1) equal treatment and social solidarity;
2) provide the insured with equal access to health care benefits and the selection of the providers from among those providers who have entered into an agreement with the Fund, subject to Art. 56b and art. 69b of the Act of 21 November 1967. of the universal duty of defence of the Republic of Poland, art. 153 (1) 7a of the Act of 12 October 1990. o Border Guard and Art. 115 § 1a of the Executive Penal Code.
Article 66. [ Persons Subject To Compulsory Health Insurance] 1. The obligation to health insurance shall be subject to:
1. persons fulfilling the conditions for the placing of social insurance or social insurance of farmers, who are:
a) employees within the meaning of the Act on Social Insurance System,
(b) farmers or their household members within the meaning of the rules on social insurance for farmers,
(c) persons carrying out non-agricultural activities or persons cooperating with them, with the exception of persons who have suspended the pursuit of economic activities on the basis of the provisions on freedom of establishment,
(d) the persons performing the work,
(e) persons performing work on the basis of a agency contract or contract or other service agreement to which the provisions of the Civil Code relating to the order or persons cooperating with them apply,
(f) clerical persons,
(g) members of agricultural production cooperatives, cooperative machinery rings or members of their families,
(h) persons receiving social benefits paid during the period of leave and persons receiving social benefits paid for the duration of the professional retraining and the search for new employment, as well as the persons receiving the remuneration either during the period of use of the mining benefit or during the period of use of the retraining scholarship, resulting from separate provisions or collective agreements,
(i) persons receiving training benefits paid after the establishment of employment;
2) soldiers carrying out primary military service, military training, military exercises and serving as a candidate, preparatory service or military service in the event of a mobilization announcement and during the war-unless they are subject to the obligation insurance for another title;
(3) persons holding a replacement service;
4) persons subject to military qualification serving in the Police, the Border Guard and the Government Protection Bureau;
5. professional soldiers and soldiers holding an overtime primary military service and periodic service;
6) policemen;
7. officers of the Internal Security Agency;
8. officers of the Intelligence Agency;
8a) officers of the Central Anti-Corruption Bureau;
8b) military officers of the Military Counterintelligence Service;
8c) officers of the Military Intelligence Service;
9) officers of the Bureau of Government Protection;
10) officers of the Border Guard;
11) officers of the Customs Service;
12) Prison Guard officers;
13) officers of the State Fire Brigade;
(14) Members who draw up parliamentary salaries and Senators, who draw up a senatorial salary;
15) judges and prosecutors;
15a) a jury which is not subject to a compulsory health insurance for another title;
(16) persons in charge of a pension, a person who is in a resting state receiving a salary or a family salary, and persons who take up a salary after being released from the service or a cash benefit of the same nature;
(17) students and listeners of teacher training establishments within the meaning of the provisions on the education system which are not subject to compulsory health insurance for another title;
18) children staying in establishments performing rehabilitation, educational or welfare functions or in homes of social assistance not subject to the obligation of health insurance for another title;
(19) children up to the beginning of the implementation of the school obligation not in establishments referred to in point 18, which are not subject to compulsory health insurance for another title, subject to the provisions of Article 4 (1) (b) of the basic Regulation. 81 (1) 8 point 3;
20) students and participants of doctoral studies not subject to the obligation of health insurance of another title, excluding persons referred to in art. 3 para. 2 point 1;
21) alumni of higher clergy and theological seminaries, postulants, novices and juniors of male and female nuns and their counterparts, excluding the persons referred to in art. 3 para. 2 point 2;
22) listeners of the National School of Public Administration;
23) persons taking a sports scholarship after the completion of 15. a year of life which is not subject to a health insurance obligation for another title;
(24) an unemployed person not subject to a health insurance obligation for another title;
24a) persons receiving a scholarship during the period of training, internship, or professional preparation of adults, for which they have been directed by an entity other than a district labour office, not subject to a health insurance obligation for another title;
(25) persons receiving pre-retirement or pre-retirement benefits and non-retirement benefits or pre-retirement benefits for the reasons set out in the art. 27 ust. 1 points 3 to 6 and paragraph. 2 of the Act of 14 December 1994. about employment and counteracting unemployment (Dz. U. 2003 r. items 514, of late. zm.) [ 3] not subject to a health insurance obligation for another title;
26) persons receiving permanent benefit from social assistance not subject to a health insurance obligation for another title;
27) persons who have obtained in the Republic of Poland refugee status or subsidiary protection, covered by an individual integration programme on the basis of social assistance regulations, not subject to the obligation of health insurance from another title;
(28) persons taking charge of a special care allowance or a supplement to the family allowance for the single raising of the child and the loss of the right to unemployment benefit as a result of the expiry of the statutory period of its collection, granted on the basis of the provisions of family benefits, which are not subject to the obligation of health insurance for another title;
28a) persons receiving nursing benefits granted on the basis of family benefits provisions, not subject to compulsory health insurance from another title;
28b) persons who charge a care allowance granted under the provisions on the establishment and payment of allowances to guardians who are not subject to the obligation of health insurance for another title;
29) homeless persons coming out of homelessness not subject to the obligation of health insurance from another title;
30) persons covered by the individual programme of social employment or implementing a social contract as a result of the application of the procedure referred to in art. 50 par. 2 of the Act of 20 April 2004. on the promotion of employment and labour market institutions (Dz. U. of 2016 r. items 645, 691, 868, 1265 and 1579), not subject to a health insurance obligation for another title;
31) combatants and persons repressed not to receive social insurance in the Republic of Poland or not to collect pensions or pensions;
31a) civilian blind victims of hostilities, not subject to the obligation of health insurance from another title;
(32) persons enjoying parental leave not subject to compulsory health insurance for another title;
32a) the persons referred to in art. 6a par. 1 of the Act of 13 October 1998. the social security scheme, which is not subject to the obligation of health insurance for another title;
33) persons entitled to maintenance benefits on the basis of a court settlement or a final court decision not subject to the obligation of health insurance from another title;
34) farmers and their domestic workers, who are not subject to social insurance of farmers by virtue of the Act of 20 December 1990. o social insurance of farmers, which is not subject to health insurance obligations under points 1 to 33 and 35 to 37;
35) members of supervisory boards holding a place of residence on the territory of the Republic of Poland;
36) applicantes of the National School of Judiciary and Prosecution;
(37) persons who charge teachers ' compensation benefits.
2. The status of a family member of the insured person and the status of a member of the family who is a person entitled to health care benefits under the rules on coordination shall be exempt from the health insurance obligation of the titles referred to in paragraph. 1 points 17-20, 26-28b, 30 and 33.
3. The provision of the paragraph. 2 shall not apply to the spouses against whom the separation of the final judgment is adjudicated.
Article 67. [ Obtaining the right to health care benefits] 1. The obligation of health insurance shall be deemed to be fulfilled after the notification to the health insurance of a person subject to that obligation in accordance with the provisions of the art. 74-76 and the payment of the contribution within the period and under the conditions laid down in the Act.
1a. The provision of the paragraph. 1 shall not apply to the persons referred to in Article. 66 (1) 1 point 8a, and the members of their families.
2. The person subject to the obligation of health insurance after the notification to health insurance obtains the right to health care benefits.
3. The person subject to the obligation of health insurance shall be obliged to report to the health insurance of the family members referred to in art. 3 para. 2 points 5 and 6. Persons who do not report to the health insurance themselves inform the entity competent to make a notification to health insurance of family members subject to notification to health insurance, within 7 days from the date of the existence of the circumstances causing the notification to be made. Family members acquire the right to health care benefits from the day of the notification to health insurance.
3a. In the case of family members to cover health insurance, it is sufficient to report to health insurance by one person subject to the obligation of health insurance, with the fact that grandchildren can only be declared in case none from parents is not subject to the obligation of health insurance on the basis of art. 66 (1) 1 or is not a person entitled to health care benefits on the basis of the rules on coordination for the performance of work or self-employment or voluntary insurance.
4. The right to the health care benefits of the persons referred to in the paragraph. 2 and 3, they shall cease after 30 days from the date of expiry of the health insurance obligation.
5. The right to health care benefits for persons who have graduated from the school:
1) over-secondary-shall expire six months after the end of the study or the deletion from the list of pupils;
2) higher-shall expire 4 months after the completion of the studies or doctoral studies or the deletion from the list of students or participants in doctoral studies.
6. The person referred to in the mouth. 2, despite the expiry of the insurance obligation he has with the family members referred to in art. 3 para. In accordance with Article 2 (2) (2), (2) (2) and (6), the right to health care benefits during the period of collection of benefits granted by that person on the basis of sickness insurance or accident insurance rules which are not included in the basis of the health insurance contribution assessment.
7. The person applying for a pension or a pension despite the expiry of the insurance obligation shall have with the family members referred to in art. 3 para. In the case of sickness insurance benefits during the period covered by the pension scheme, the amount of the pension is to be used for the duration of the treatment.
Article 68. [ Voluntary insurance] 1. A person not mentioned in the article. 66 (1) 1, an employee staying on leave free of charge, Member of the European Parliament elected in the Republic of Poland or a person not mentioned in art. 66 (1) 1 to which the Article shall apply. 11 (1) 3 lithium e Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004 on the coordination of social security systems, may insure voluntarily on the basis of a written application lodged in the Fund, if it is domicially resident in the territory of the Republic of Poland.
2. The use of a volunteer for health insurance may be reported if it is not covered by a health insurance from another title.
3. The person referred to in the mouth. 1, is obliged to report to the Fund of family members referred to in art. 3 para. 2 points 5 and 6, within 7 days from the date specified in the contract referred to in paragraph. 5, or from the date of the circumstances causing the notification to be made.
4. The basis for the contribution of the contribution paid by:
1) the person referred to in the mouth. 1, the amount of the monthly income declared, but not lower than the amount corresponding to the average remuneration;
2) the beneficiary referred to in paragraph 2. 2, shall be the amount corresponding to the minimum wage;
3) the person referred to in art. 3 para. 2 points 1 to 4 shall be the amount corresponding to the special care allowance provided under the provisions on family benefits.
5. The person referred to in the mouth. 1, is covered by health insurance as of the date specified in the contract concluded by that person with the Fund, and ceases to be it covered by the day of termination of the contract or after the expiration of the month of uninterrupted arrears in the payment of contributions.
6. Volunteer referred to in the mouth. 2, shall be covered by health insurance as of the date specified in the contract concluded by the beneficiary of the Fund, and shall cease to be covered by it from the day of termination of the contract or after the expiration of the month of uninterrupted arrears in the payment of contributions.
7. The concept of the person referred to in paragraph 1. 1, the health insurance depends on the payment of the fee on the account of the Fund.
8. The amount of the fee shall be subject to the period during which the person referred to in the mouth. 1, has not been covered by health insurance, and shall be:
1) 20% of the income accepted as the basis of the contribution rate for a person whose interruption in health insurance and the payment of contributions is uninterruptive from 3 months to a year;
2) 50% of the income accepted as the basis of the contribution rate for a person whose interruption in health insurance and the payment of contributions is uninterrudent over the year to 2 years;
3) 100% of the income accepted as the basis of the contribution rate for a person whose interruption in health insurance and the payment of contributions is uninterrudent over 2 years and up to 5 years;
4) 150% of the income accepted as the basis of the contribution rate for a person whose interruption in health insurance and the payment of contributions is a non-interruption of more than 5 years to 10 years;
5) 200% of the income accepted as the basis of the contribution rate for a person whose interruption in health insurance and the payment of contributions is a non-interruption of more than 10 years.
8a. In the case of seafarers who are persons referred to in art. 3 para. 1 points 1 and 2, with the exclusion of persons staying in the territory of the Republic of Poland on the basis of the consent to stay on humanitarian grounds or the consent for tolerated stay, and in point 2a, excluding persons enjoying temporary protection in the territory The Republic of Poland, to the period referred to in paragraph. 8, not including the period of their employment on vessels of foreign affiliation.
9. The fee does not apply to persons mentioned in art. 3 para. 2.
10. When calculating the fee to the period during which the insured person is not voluntarily insured, the period of independent health insurance shall be calculated on the basis of the existing provisions.
11. In justified cases, at the request of the person referred to in the paragraph. 1, the Fund may waiver the collection of the fee or distribute it to monthly instalments, however, no more than on 12 instalments.
12. The right to health care benefits of the person referred to in the mouth. 1, and notified to the Fund of the members of her family, referred to in art. 3 para. 2 points 5 and 6, and the volunteer referred to in paragraph 2. 2, shall be entitled from the day of coverage of the health insurance and shall expire after 30 days from the date of cessation of health insurance in the Fund.
Article 69. [ Date of expiry and expiry of the health insurance obligation] 1. The obligation of health insurance of the persons referred to in art. 66 (1) 1 point 1 lit. a and c-and, it arises and expires on the dates specified in the social insurance regulations.
1a. For the health insurance of persons who, under the provisions on freedom of economic activity, have suspended the pursuit of economic activities, the Article shall apply mutatis mutandis. 68.
2. The obligation of health insurance of the persons referred to in art. 66 (1) 1 point 1 lit. (b) and point 34, shall arise from the date of the notification to insurance under the rules on social insurance of farmers, and shall cease on the last day of the month in which the circumstances justifying the insurance are established.
3. An employee enjoying free leave loses the right to benefits from health insurance after 30 days from the day of the start of the leave.
4. After the expiry of the obligation of health insurance, any person may insure themselves on the rules laid down in art. 68.
Article 70. [ The day of appointment or referral to the service as a date for the establishment of the insurance obligation] 1. The obligation of health insurance of the persons referred to in art. 66 (1) 1 point 2-4, arises from the day of appointment or referral to the service, and shall expire on the date of dismissal from that service.
2. The obligation of health insurance of the persons referred to in art. 66 (1) 1 points 5 to 13 and 15, shall arise from the date of establishment and shall expire on the date of establishment of the relationship.
Article 71. [ The date of granting of the emoluments as the date of the health insurance obligation] The health insurance obligation of the persons referred to in Article 66 (1) 1 point 14, shall arise from the date on which the emoluments are granted, and shall expire on the date of the loss of the entitlement to the emoluments.
Article 72. [ Establishment of a health insurance obligation in the case of retiring persons or an annuity] 1. The obligation of health insurance of persons receiving a pension or an annuity shall arise from the date on which the payment of the pension is entitled, and shall expire on the date of cessation of the collection of the benefit.
2. In the event of a suspension of the right to a social pension in the event of the attainment of the revenue from the titles listed in the Article 10 para. 5 of the Act of 27 June 2003. about social renewal (Dz. U. of 2013 r. items 982 and 1650 and of 2014 items 1175 and 1682), including in the event of the attainment of the income abroad of these titles, the right to benefits from health insurance expires after 90 days from the date of cessation of health insurance in the Fund.
3. Paragraph Recipe 1 shall apply, mutatis mutandis, to persons who are in a state of resting for the emoluments or who have received family emoluments and persons who charge a salary after discharge from service or in cash benefits of the same nature.
Article 73. [ Other cases of inception and expiry of the health insurance obligation] Compulsory health insurance:
1) students and hearers referred to in art. 66 (1) 1 point 17, shall arise from the date of admission to the school or establishment of initial teacher education, and shall expire on the date of completion of the school or the teacher training establishment, or the removal from the list of pupils or listeners;
2) children referred to in art. 66 (1) In accordance with Article 18 (1) (b) of the European Council, the Council, acting in accordance with the conditions laid down in Article 4 (1) of the Council, shall act as a member of the Council and the Council of the European Council.
3) children referred to in art. 66 (1) 1 point 19, arises from the date of recognition by the centre of social assistance the validity of the cover of health insurance, and expires on the date of recognition that it has established the validity of the coverage of the health insurance, not later than the date on which the child begins the implementation of the school obligation; the social assistance centre may refuse to recognise the validity of the health insurance cover or to recognise that it has established the necessity and validity of the child-health insurance covering the conditions laid down in Article 4 (1) of the basic Regulation. 66 (1) In accordance with Article 18 (1), point 19, where on the basis of a family interview (environmental) finds that the material conditions of a child's legal or factual custodial enable his health insurance to be insured under the conditions laid down in Article 68;
4) the persons referred to in art. 66 (1) 1 points 20 and 22, arise from the date of immatriculation or admission to doctoral studies and make a declaration of an independent health insurance obligation from another title, and expires on the date of completion of studies or doctoral studies, or the deletion from the list of students or the deletion from the list of participants in doctoral studies;
5) the persons referred to in art. 66 (1) 1 point 21, arises from the day of admission to a higher seminary or theological seminary or to the order or his/her counterparts, and shall expire on the date of completion of the 25th. the year of life or the occurrence of a higher seminal or theological seminary or religious or religious seminary or his/her counterparts;
6) the persons referred to in art. 66 (1) 1 point 23, arises from the date of granting the scholarship, and expires on the date of the loss of the right to download it;
7) the persons referred to in art. 66 (1) In accordance with Article 18 (1) (b) of Regulation (1) (b) of Regulation (No) (1) (a)
7a) of the persons referred to in art. 66 (1) 1 point 24a, arises from the date of acquisition of the right to a scholarship, and expires on the date of the loss of the right to it;
(8) persons receiving pre-retirement benefits or pre-retirement benefits shall cover the period from the date on which the right to a pre-retirement benefit is granted until the date of the loss of the right to receive the pension and, in the case of a pre-retirement benefit, to the right to revocation, and with regard to persons not receiving a pre-retirement pension or a pre-retirement benefit for the reasons referred to in art. 66 (1) 1 point 25-covers the period from the date of registration to the employment office until the grant of the right to a pre-retirement pension or to a pre-retirement pension;
9) the persons referred to in art. 66 (1) 1 point 26, covers the period from the date on which the allowance is granted until the date of the loss of the entitlement to the allowance;
10) the persons referred to in art. 66 (1) 1 points 28 and 28a cover the period from the date of granting of the nursing care, special care allowance or the supplement to the family allowance for the single raising of the child and the loss of the right to unemployment benefit as a result of the passage the statutory period of its collection until the date of the loss of the right to download them;
10a) of the persons referred to in art. 66 (1) 1 point 28b, covers the period from the date of acquisition of the right to the benefit of the procurator, not earlier than from the date of entry into force of the Act of 4 April 2014. to establish and disburse allowances for carers (Dz. U. of 2016 r. items 162 and 972) until the date of the loss of the right to download;
11) the persons referred to in art. 66 (1) Point 29 shall be created from the date of the start of the implementation of the individual programme of homelessness and shall expire on the date of completion of the programme or the cessation of the implementation of the programme within the meaning of the provisions on social assistance;
12) the persons referred to in art. 66 (1) Point 27 shall arise from the date of commencation of the implementation of the individual integration programme and shall expire on the date of termination or suspension of the implementation of that programme;
13) the persons referred to in art. 66 (1) 1 point 30:
(a) shall arise after 30 days from the date of commencement of the implementation of the individual social employment programme and shall expire on the date of completion of the programme or the cessation of implementation of the programme within the meaning of the provisions on social employment,
(b) shall arise after 30 days from the date of signature of the social contract and shall expire on the date of completion of the social contract or the cessation of the implementation of the social contract referred to in the provisions on social assistance;
14) the persons referred to in art. 66 (1) 1 point 31, arises from the date of the submission to the Head of the Office for the Affairs of the Combatants and the People of Represented declarations on the independence of the social security system and the absence of any other title to cover the health insurance, and expires on the date of cessation of those conditions;
14a) of the persons referred to in art. 66 (1) 1 point 31a, arises from the date of submission to an annuity, within the meaning of the provisions on pensioners and pensions from the Social Insurance Fund, a statement on the absence of another title to cover health insurance, and shall expire on the date of cessation of this condition;
15) the persons referred to in art. 66 (1) 1 point 32, shall arise from the date of the start of the leave and shall expire on the date of the leave;
15a) of the persons referred to in art. 66 (1) 1 point 32a, arises from the date of entry into pension and disability insurance in connection with the exercise of the personal care of the child, and shall expire on the date of termination of the care for the child;
16) the persons referred to in art. 66 (1) 1 point 33, shall arise from the date on which the maintenance is due and shall expire on the date on which the provision ceases to be due;
17) the persons referred to in art. 66 (1) 1 point 35, arises from the day of appointment as a member of the supervisory board and expires on the date of cessation of the performance of that function;
17a) court jurors referred to in art. 66 (1) 1 point 15a, arises from the day of choice for the post of a court juror, and expires on the date of expiry of the term of office or the prior expiry of the mandate;
18) the persons referred to in art. 66 (1) 1 point 36, arises from the date of granting the scholarship, and expires on the date of the loss of the right to download it;
19) the persons referred to in art. 66 (1) Article 1 (37) covers the period from the date on which the right to the teacher compensation benefit is granted until the date on which the right to download is lost.
Article 74. [ Adequate application of the rules on the rules, mods and timing of the notification to social security or to the social insurance of farmers] 1. To health insurance of persons covered by social insurance or social insurance of farmers, persons referred to in art. 75 and art. 76 and their family members shall apply, mutatis mutandis, to the rules, mods and timing of the notification to social security or to social security of farmers and to the deregation of such insurance, subject to Article 4 (1) of the basic Regulation. 75 par. 1-2a, art. 77 and Art. 86 (1) 6.
2. To the health insurance of the persons referred to in art. 66 (1) The rules governing the rules, procedures and timing of the notification to social security and the deregation of such insurance shall apply mutatis mutandis, subject to Article 1, points 2 to 8 and 8b-15 and their family members. 77.
3. The persons referred to in art. 66 (1) 1 point 1 (c), which are entrepreneurs within the meaning of the provisions on freedom of economic activity, on the basis of those provisions may make a notification to health insurance, notification to health insurance of family members, notification unenrollment from health insurance or a change in the data shown in these notifications.
Article 75. [ The subject is required to notify persons subject to health insurance] 1. The persons taking out a pension or an annuity shall report to the health insurance business unit of the Social Insurance Institution referred to in the provisions on the social security system, competent to issue the decision on the benefits matters, Kasa Agricultural Social Insurance, the competent pension authority or the institution paying the pension, or the bank making the payment of the pension from abroad to 15. on the day of the month following the month in which the insurance obligation arose or changes were made regarding that obligation.
1a. In the case of payment of a pension from another Member State, the bank shall direct to the branch office of the Fund, the competent due to the place of residence of the person receiving such a benefit, the inquiry concerning the subject of the by this person of health insurance in the Republic of Poland.
1b. In the case referred to in paragraph 1. 1a, the notification to health insurance takes place up to 15. on the day of the month following the month in which the bank received information from the provincial branch of the Fund confirming the subject of a given person's health insurance in the Republic of Poland for the collection of the Polish pension or annuity.
2. Persons taking preretirement benefit or a pre-retirement benefit shall report to the health insurance of the Social Insurance Institution as defined in the provisions on the social security system up to 15. on the day of the month following the month in which the insurance obligation arose or changes were made regarding that obligation.
2a. Persons collecting teachers ' compensating benefits shall report to the health insurance of the Social Insurance Institution as defined in the provisions on the social security system up to the 15th day of the month following the month in which the insurance obligation arose or changes were made regarding this obligation.
3. Persons who charge a salary in a state of resting or family emoluments, as well as persons receiving a salary after discharge from the service or a cash benefit of the same nature, shall report to the health insurance provider paying that a salary or benefit.
3a. Persons referred to in art. 66 (1) 1 point 15a, reports to the health insurance court, in which the juror performs his/her function.
4. The persons referred to in art. 66 (1) 1 points 17, 18 and 20, report on health insurance, respectively, schools, teacher training establishments, higher education establishments, doctoral programmes, rehabilitation, nursing or caring facilities and aid houses I.
5. Children referred to in art. 66 (1) In accordance with Article 18 (1) (b) of the basic Regulation, the Commission shall, in accordance with the provisions of Article 4 (1), notify the health insurance centre of
6. The persons referred to in art. 66 (1) 1 point 21, he reports to health insurance a correspondingly higher seminal or theological seminary or order or his equivalent.
7. The persons referred to in art. 66 (1) 1 point 22, reports to the health insurance of the National School of Public Administration.
8. The persons referred to in art. 66 (1) 1 point 23, he shall report to the health insurance provider a scholarship.
9. The persons referred to in art. 66 (1) 1 point 24, shall report to the health insurance of the competent district office of work.
9a. The persons referred to in art. 66 (1) In accordance with Article 1 (1) (a), the following shall be notified to the health insurance of the operator (beneficiary) for the training, internship, or professional preparation of adults, which shall be:
1) the local government unit and its organizational unit, with the exception of the voivodship and the district labour office,
2) Militia Job Hufiec,
(3) the employment agency,
4) training institution,
5) the institution of social dialogue,
6. the local partnership institution,
(7) a non-governmental organisation for the development of human resources and the prevention of unemployment,
8) scientific unit,
9) employers ' organization,
10) trade union,
11) voivodship advisory centre,
12) Centre for occupational and psychological counselling
-making use of public Community and public funds on the basis of a contract for co-financing of the project or of the decisions referred to in the Act of 20 April 2004. o National Development Plan (Dz. U. of 2014 items 1448 and 1856 and 2015 items 1240), Law of 6 December 2006. the rules for the conduct of development policy (Dz. U. of 2016 r. items 383 and 1250) or the Act of 11 July 2014. on the principles of implementation of the cohesion policy programmes financed in the financial perspective 2014-2020 (Dz. U. of 2016 r. items 217 and 1579).
10. Persons referred to in art. 66 (1) 1 point 26, it shall report to the health insurance centre of the social assistance centre.
11. The persons referred to in art. 66 (1) 1 point 28-28b, reports to the health insurance of the mayor, mayor, or president of the city.
12. The persons referred to in art. 66 (1) 1 points 29 and 30, notify to the health insurance a social assistance centre implementing an individual social work programme or an individual programme of exit homelessness or a social assistance centre implementing a social contract as a result of the application of the procedure referred to in Article 50 par. 2 of the Act of 20 April 2004. on the promotion of employment and labour market institutions.
13. The persons referred to in art. 66 (1) 1 point 27, reports to health insurance a district assistance centre with a family realizing an individual integration programme.
14. The persons referred to in art. 66 (1) The Head of the Office for the Affairs of the Combatants and the Represonated Persons shall be notified to the health insurance of 1 point 31.
14a. The persons referred to in art. 66 (1) 1 point 31a, shall report to the health insurance business unit of the Social Insurance Institution, specified in the regulations on the social insurance system, in which the statement referred to in art is made. 73 point 14a.
15. The persons referred to in art. 66 (1) 1 point 32, it shall report to health insurance in a registered monthly report headed to the Social Insurance Institution of the employer or the agricultural production cooperative.
15a. The persons referred to in art. 66 (1) 1 point 32a, shall report to the health insurance of the Social Insurance Institution, as defined in the provisions on the social security system.
16. The persons referred to in art. 66 (1) In accordance with the provisions of Article 1 (1) of the basic law, the following shall be notified to sickness insurance in the form of a sickness insurance fund. These persons are obliged to immediately submit to the Agricultural Social Insurance Office a declaration for health insurance.
17. The persons referred to in art. 66 (1) 1 point 35, it shall report to the health insurance of the entity in which the supervisory board operates.
18. The persons referred to in art. 66 (1) 1 point 36, reports to the health insurance of the National School of Judiciary and Prosecutor's Office.
Article 76. [ Self-reporting persons] Persons not listed in Article 74 and 75 for health insurance are reporting themselves.
Article 76a. [ Unenrollment from health insurance] 1. The person in respect of whom the title for health insurance has expired shall be unregistered with that title together with the family members.
2. The person subject to the obligation of health insurance, who has reported to the Fund of the members of the family, shall be obliged to inform the entity competent to make the deregiation about the circumstances causing the necessity of their deregional discharge from health insurance, within 7 days from the date of the existence of these circumstances.
3. The health insurance registration shall be carried out by the operator responsible for the filing of the application.
Article 77. [ The authorities to whom the notification of persons subject to health insurance is addressed] 1. Requests for health insurance and the registration of health insurance records referred to in art. 74-76a, they are directed to the Social Insurance Institution or the Agricultural Social Insurance Fund.
1a. Requests for health insurance and the registration of persons referred to in Article 4 of the health insurance. 66 (1) 1 point 8a, and members of their families, shall be addressed to the Fund's headquarters.
1b. The notifications referred to in paragraph 1. 1, addressed to the Social Insurance Institution, may be within the time limit set for the submission of those declarations to the tax office where the service centre is operated. The tax office shall be notified to the Social Insurance Institution no later than the next working day, counting from the date of the impact of those documents.
1c. In the case referred to in paragraph. 1b, the date of filing of the application to the Social Insurance Institution shall be considered the day of submission of the declaration to the tax office.
2. The notifications referred to in paragraph. 1, they shall contain:
1) indication of the provincial branch of the Fund competent for the place of residence on the territory of the Republic of Poland, and in case of lack of residence in the territory of the Republic of Poland-indication of the voivodship branch The fund selected by the person notified for health insurance;
2) (repealed)
3) surname and first name;
4) date of birth;
(4a) sex;
5. address of residence;
6) PESEL number, and in the case where the insured has not been given the PESEL number-the series and the number of the ID card or passport.
3. In case of notification to health insurance of members of the families referred to in art. 3 para. 2 points 5 and 6, the insured person shall send to the Social Insurance Institution or the Agricultural Social Insurance Fund, respectively, the data referred to in paragraph 2. 2 and the following data concerning the family member:
1. surname and first name;
2) date of birth;
3) address of residence;
4) the degree of kinship;
5) information on a significant degree of disability;
6) the PESEL number, and in the case where a member of the family has not been given the PESEL number-the series and the number of the ID card or passport;
7) information on staying in a common household with the insured person-in the case of persons referred to in art. 5 point 3 (c)
Article 78. [ Control bodies for the implementation of health insurance tasks] At the request of the Minister responsible for public finance, the control of the implementation of health insurance tasks prescribed by the provisions of the Act shall be carried out:
1) the minister responsible for social security in the Social Insurance Institution;
2) Minister responsible for Rural Development in the Agricultural Social Insurance Fund.
Chapter 2
Contributions to health insurance
Article 79. [ Premium contribution] 1. The contribution to health insurance amounts to 9% of the basis of the contribution dimension, subject to art. 82 and 242.
2. The contribution is monthly and indivisible.
Article 80. [ Fixing the amount of the contribution to the farmer's health insurance] 1. (repealed)
2. A farmer conducting business in the field of special agricultural production in the meaning of the Act of 20 December 1990. o social insurance farmers pay contributions to health insurance from the declared base of the premium dimension:
1) corresponding to the income determined for the taxation of personal income tax, in the amount not lower than the amount corresponding to the minimum wage;
(2) corresponding to the minimum wage, in the case of activities which are not subject to income tax on natural persons.
3. (repealed)
4. The contribution of the farmer to health insurance covers the members of his family, if they are not household members within the meaning of the Act of 20 December 1990. o social insurance of farmers.
Article 81. [ Other cases determining the amount of the contribution base] 1. To determine the basis for the assessment of the contributions to the health insurance of the persons referred to in art. 66 (1) For the purposes of Article 1 (1) (a), (d) and (3), (11) and (35), the provisions on the basis of the assessment of the contributions to the pensions of those persons shall apply, subject to paragraph 1 (a), 5, 6 and 10.
2. The basis for the contribution of the contribution to the health insurance of the persons referred to in art. 66 (1) 1 point 1 (c) shall be the declared amount, but not less than 75% of the average monthly remuneration in the enterprise sector in the fourth quarter of the previous year, including the profit payments made by the President of the Chief Office Statistical in the Official Journal of the Republic of Poland "Monitor Polski". The new contribution shall be valid from 1 January to 31 December of the year concerned.
2a. Basis for the contribution of the contribution to the health insurance of persons referred to in Article 66 (1) 1 point 1 lit. as a nanny, as referred to in the Act of 4 February 2011. on the care of children under the age of 3 (Dz. U. of 2016 r. items 157), taking care of children on the basis of the activation contract constitutes income, with the proviso that the basis of the assessment of the health insurance contributions paid by the Social Insurance Institution from the state budget appropriations constitutes the amount not higher than the amount of the minimum wage for the work of the calendar year in question, determined in accordance with the provisions on the minimum wage for work.
3. The basis for the contributions of the persons referred to in art. 66 (1) 1 points 5 to 10, 12 and 13 shall be the amount corresponding to the emolemation of such persons.
4. The basis for the contributions of the persons referred to in art. 66 (1) Article 1 (1) and (4) shall be equal to the amount corresponding to the special care allowance enjoyed by the provisions on family benefits.
5. When establishing the basis for the assessment of the health insurance contributions of the persons referred to in paragraph 1. 1, there shall be no exemption of remuneration for the duration of incapacity for work as a result of illness or isolation in relation to an infectious disease, and the restriction referred to in Article shall not apply. 19 (1) 1 of the Act of 13 October 1998. the social security system.
6. The basis of the assessment of the contribution to health insurance will be reduced by the amount of the contributions to the pension, disability and sickness insurance contributions financed by insured persons who are not members of the contributions, deducted by the payers of the funds the insured person, in accordance with the provisions on the social security system.
7. The basis of the contributions ' contributions to the officers of the State Fire Service in the service of the candidate shall be the amount corresponding to the minimum wage.
8. The basis for the assessment of health insurance premiums for:
1) the persons referred to in art. 66 (1) 1 points 14 and 15, shall be the amount corresponding to the salary or salary of such persons;
1a) persons referred to in art. 66 (1) 1 point 15a, is the amount of the diet obtained;
2) the persons referred to in art. 66 (1) 1 point 16, is the amount of the pension, the pension less the amount of the overpayment of the benefit, excluding allowances, allowances, cash benefits and energy lump sum, the cash equivalent of the right to free coal and the deputatu either the amount of salary collected in the state of rest or family salary, the amount of the emoluments collected after discharge from the service or to the cash benefit of the same nature;
3) the persons referred to in art. 66 (1) 1 point 17 to 20, is the amount corresponding to the special care allowance provided under the provisions on family benefits;
4) the persons referred to in art. 66 (1) 1 points 22 and 23, is the amount corresponding to the amount of the scholarship charged;
5) the persons referred to in art. 66 (1) 1 point 24 is the amount corresponding to the amount of the unemployment benefit paid or the scholarship, and in the case of non-collection by the unemployed person or the scholarship, the amount corresponding to the amount of unemployment benefit referred to in art. 72 par. 1 point 2 of the Act on the promotion of employment and labour market institutions;
(5a) persons referred to in Article 66 (1) 1 point 24a, is the amount corresponding to the amount of the scholarship charged;
6) the persons referred to in art. 66 (1) In the case of unemployment benefit, the amount of the pension is calculated on the basis of the amount of the pension and the amount of the pension is paid to the pension.
6a) the persons referred to in art. 66 (1) 1 point 37, shall be the amount of the teacher compensation payment;
7) the persons referred to in art. 66 (1) Article 1 (26) is the amount corresponding to the amount of the benefit granted to the permanent social assistance allowance;
8) the persons referred to in art. 66 (1) 1 points 27, 29 and 30, is the maximum amount of the standing allowance from social assistance;
9) the persons referred to in art. 66 (1) 1 points 28 and 31, is the amount corresponding to the special care allowance enjoyed under the provisions on family benefits;
9a) of the persons referred to in art. 66 (1) 1 point 31a, shall be the amount corresponding to the amount of the social pension;
9b) persons referred to in art. 66 (1) 1 point 28a, is the amount corresponding to the amount of the nursing allowance entitled under the provisions on family benefits;
9c) the persons referred to in art. 66 (1) Article 1 (1) (b) of the basic Regulation shall apply to the following provisions: (a) the amount of the allowance referred to in paragraph 1 (1) (b) of the basic Regulation shall be that of the
10) the persons referred to in art. 66 (1) 1 points 32 and 32a, is the amount corresponding to the amount of the special care allowance available under the provisions on family benefits;
11) the persons referred to in art. 66 (1) Article 1 (1) (1) of the basic Regulation shall be equal to the amount actually received by the alimony, but no higher than the amount of the special care allowance granted under the provisions on family benefits;
12) (repealed)
13) the persons referred to in art. 66 (1) 1 point 36, is the amount corresponding to the amount of the scholarship charged.
9. In the case of the grant of the insured person's right to a pension, pension or benefits from social security or cash benefits for civil war victims for the period for which the insured person charged a benefit from another competent pension authority or an allowance, an allowance, a training allowance, a scholarship or another cash benefit for non-work or a pre-retirement pension or a pre-retirement benefit in the amount of the advance payment on the income tax of the persons concerned physical and health insurance contribution-Social Insurance Institution the determination of the basis for the assessment of health insurance contributions shall subtract those amounts from the benefit granted.
10. The basis for the assessment of health insurance contributions for the persons referred to in art. 66 (1) 1 point 1 lit. (f) and point 21, with the exception of persons who are taxable persons who are taxable persons of income tax or of a flat-rate income tax on the income of the clergy, shall be the amount corresponding to the special care allowance legal basis on the basis of the provisions on family benefits.
(11) The Council of Ministers shall determine by way of regulation a detailed way of setting the basis for the assessment of the health insurance of farmers, their household members and those who take out the pension, as well as the time limits and the mode of payment of their pension, Having regard to the need to ensure timely payment of contributions.
Article 82. [ Payment of the contribution to health insurance by the insured person with income from more than one source] 1. Where the insured person receives income from more than one title to cover the health insurance obligation referred to in art. 66 (1) 1, the contribution to health insurance is paid for each of these titles separately.
2. Where, under one of the titles to cover the health insurance cover referred to in Article 66 (1) 1 insured obtains more than one income, the contribution to health insurance is paid from each of the revenues generated separately.
3. If the insured person carrying out non-agricultural activities receives income from more than one of the activities referred to in paragraph 3. 5, the contribution to health insurance is paid separately from each type of activity, subject to the paragraph. 4.
4. If the insured person carrying out the non-agricultural activity receives income from more than one company within the same type of activity referred to in paragraph 1, 5 points 1 to 5, the contribution to the health insurance is paid separately from each of the companies carried out.
5. The activities of the activities are:
1) business activity carried out in the form of a civil company;
2) business activity carried out in the form of a one-man limited liability company;
3) business activity carried out in the form of an open company;
4) business activity carried out in the form of a limited partnership;
5) business activity carried out in the form of a partner company;
6) performing creative or artistic activity as a creator or artist;
7) pursuit of a free profession within the meaning of the flat-rate income tax provisions on certain revenues achieved by natural persons;
8) pursuit of a free profession, from which revenues are income from business activities within the meaning of the provisions on income tax from individuals;
(9) other than those referred to in points 1 to 8, non-agricultural economic activities carried out on the basis of the provisions on economic activity or other specific provisions.
6. In the case of the confluent of titles to cover the health insurance obligations referred to in art. 66 (1) 1, a contribution financed by the State budget shall be paid only if there is no other title to be covered by the health insurance obligation. In such a case, the insured person is obliged to inform the payer of the contributions to pay contributions from another title to cover the health insurance obligation.
7. In the case of the confluent of titles to cover the health insurance obligation referred to in art. 66 (1) 1 where, within each of these titles, the contribution is financed by the State budget, the contribution shall be paid exclusively for the title which arose at the earliest. If the titles have been created simultaneously, the contribution shall be paid from the first reported title to cover the health insurance.
8. The contribution to health insurance shall not be paid by the person whose pension or disability pension does not exceed the monthly minimum wage, from the title to cover the health insurance obligation referred to in art. 66 (1) 1 point 1 (c), where the person concerned:
1) obtains additional revenue for this title in the amount not exceeding monthly 50% of the amount of the lowest pension; or
2) pays the income tax in the form of a tax card.
9. The contribution to health insurance shall not be paid by a person passed to a moderate or significant degree of disability from the title to cover the health insurance obligation referred to in art. 66 (1) 1 point 1 (c), where the person concerned:
1) obtain income from this title in the amount not exceeding monthly 50% of the amount of the lowest pension, or
2) pays the income tax in the form of a tax card.
9a. The contribution to health insurance is not paid by the person whose maternity allowance does not exceed the monthly amount of the parental benefit referred to in the rules on family benefits, from the title to the obligation health insurance referred to in art. 66 (1) 1 point 1 lit. c.
10. The contribution to health insurance shall be paid in the amount not exceeding the amount of the advance payment on personal income tax, where the person included in the moderate or significant degree of disability is obtained the revenue only for the health insurance obligation referred to in Article 4 (1) of the basic Regulation. 66 (1) 1 point 1 lit. c.
11. Where a clerical person who is not a taxable person of a flat-rate income tax on the income of the clergy, he/she shall obtain the income only from the title to cover the health insurance obligation referred to in:
1. 66 (1) 1 point 1 lit. a or
2. Article 66 (1) 1 point 16
-the contribution to health insurance is paid only in respect of the title of the person who receives the income.
Article 83. [ Calculation of the contribution base of the contribution to health insurance] 1. Where the contribution to health insurance calculated by the payer referred to in art. 85 (1) 1-13, in accordance with the provisions of art. 79 and 81 is higher than the advance on income tax on natural persons calculated by this payer in accordance with the provisions of the Act of 26 July 1991. o Income tax on individuals (Dz. U. 2012 r. items 361, of late. zm.), the contribution calculated for each month is reduced to the amount of that advance.
2. In the case of non-calculation of the advance on income tax on natural persons by the payer, on the income constituting the basis of the contribution dimension, in accordance with the provisions of the Act of 26 July 1991. on personal income tax, the contribution calculated for the individual months is down to the amount of 0 PLN.
3. If the basis for calculating the contribution to health insurance is:
1) the income of the insured person free of income tax on the basis of art. 21 (1) 1 point 23c and point 46 of the Law of 26 July 1991. on personal income tax, from which the payer does not calculate the advance payment for that tax,
(2) the income of a member of the foreign service performing official duties in a foreign establishment, excluding the foreign and other benefits of that person,
3) the income of the insured person free of income tax on the basis of art. 21 (1) 1 point 74 of the Act of 26 July 1991. o personal income tax, from which the payer does not calculate the advance payment for this tax, in relation to the insured persons referred to in art. 66 (1) 1 point 16,
4) the income of the insured person exempt from tax on the basis of the double taxation conventions or other international agreements from which the payer does not calculate the advance payment for this tax, in relation to the insured persons referred to in art. 66 (1) 1 (1) and (16),
5) other than those mentioned in point 4 the income of the insured, from which the payer does not calculate the advance on income tax on natural persons under the Art. 32 par. 6 of the Act of 26 July 1991. o personal income tax,
6) income for the execution of work on the basis of a contract of order or another agreement for the provision of services, to which in accordance with the provisions of the Civil Code apply the provisions concerning the order, or the revenue for the performance of the function of a member of the Board under the provisions of the Act of 26 July 1991. on income tax on natural persons, levy a flat rate income tax
-the contribution to health insurance of the payer shall be calculated in accordance with the provisions of art. 79 and 81.
Article 84. [ Payment of the contribution] 1. The contribution to health insurance pays the person subject to health insurance, subject to Art. 85 and 86.
2. Where the payment of the income giving rise to the assessment of the contributions to health insurance is made by the bailey, the contribution to health insurance pays the insured directly to the bank account indicated by the competent branch Voivodship Fund.
3. In paying the contribution to health insurance, the insured person mentioned in the mouth. 2 shall indicate:
1. surname and first name;
2. address of residence;
3) the PESEL number, and in the case of its unnamed-number and a series of another document confirming the identity of the insured mentioned in the mouth. 2 or the number of the document confirming his right to health care benefits on the basis of the rules on coordination;
4) the period to which the contribution to health insurance applies.
Article 85. [ Payers required to pay the contributions for the insured] 1. For a person remaining in employment, in a business relationship or serving as a substitute service, he shall collect as a payer, collect from the income of the insured person and pay off the employer, and in the case of payment of the employee benefits from Employee Benefit Fund Referred to in the law of 29 December 1993. the protection of employees ' claims in the event of the insolvency of the employer (Dz. U. of 2002. items 85, of late. zm.) [ 4] -the entity that is required to pay the benefits.
2. For the person receiving the training benefit paid after the establishment of employment the contribution as a payer shall calculate, collect from the income of the insured person and return the entity which pays the benefit.
3. For the officers referred to in art. 81 (1) 7, the composition of the calculation, finances from own resources and draining the school of the State Fire Service.
4. For the person performing the work on the basis of contract contract, agency contract or other contract for the provision of services and for the person with it the cooperating contributor as a payer calculates, takes from the income of the insured and discharges the procurator, subject to art. 86 (1) 1 point 13a.
5. Social benefit paid during the period of leave or social benefit paid for the duration of the professional retraining and the search for new employment, the person collecting the remuneration entitled during the period of use a scholarship for retraining or during the period of use of the mining premium as a payer shall be calculated, collected from the income of the insured person and discharged by the person paying the benefit, the allowance or the remuneration.
6. For an unemployed person who receives an allowance or a scholarship of a premium as a payer, he shall receive from the income of the insured person and pay the appropriate district labour office.
6a. Per person referred to in art. 66 (1) In accordance with Article 1 (1) (a), the contribution from the income of the insured person and the head of the (beneficiary) to the training, internship, or professional preparation of the adults shall be taken from the income of the insured person.
7. As members of agricultural production cooperatives and cooperatives of agricultural machinery rings and their family members, the contribution as a payer shall be calculated, collected from the income of the insured person and discharged by the cooperative.
8. For the person collecting the salary of a member as a payer shall calculate, collect from the income of the insured person and pay the Chancellery to the Sejm, and for the person collecting the emoluments of the senator-the Chancellery of the Senate.
(9) For a person who receives a pension as a payer, he shall collect, from the amount of the pension or pension referred to in Article, the amount of the pension. 81 (1) Article 8 (2) and (2) 9, and discharge the organizational unit of the Social Insurance Institution as defined in the social security system regulations, competent to issue decisions in matters of benefits, Kasa Rolniczego Social Insurance, another competent authority pension or pension institution or bank making the payment of a pension or pension from abroad.
10. For a person who receives a pre-retirement benefit or a pre-retirement pension contribution as a calculated payer, he/she shall collect from the amount of the pre-retirement benefit or the pre-pension benefit and discharge the organisational unit of the Social Insurance Institution. specified in the social security system regulations.
10a. Per person collecting the teacher's compensation contribution as a payer shall calculate, collect from the amount of the teacher compensation benefit and discharge the organizational unit of the Social Insurance Institution as defined in the regulations o social security system.
11. For a person who receives a salary in a state of rest or family emoluments, his salary after discharge from the service or a cash benefit of the same nature as a contributor, he shall collect the income from the insured person's income and pay off the payment. is a salary or benefit.
12. Per person referred to in art. 66 (1) 1 point 22, the contribution as a payer shall be calculated, collected from the income of the insured person and discharged by the National School of Public Administration.
13. Per person referred to in art. 66 (1) 1 point 23, the contribution as a payer shall be calculated, collected from the income of the insured person and discharged by the payer of the scholarship.
(14) For the person who cooperates with the non-agricultural worker, the activity of the component shall be calculated, discharged and financed by the person who is engaged in the non-agricultural activity.
15. The employer or the agricultural production cooperative shall be calculated by the person using the parental leave for health insurance.
15a. For the persons referred to in art. 66 (1) 1 point 32a, the contribution to health insurance as a payer calculates the Social Insurance Institution.
16. As a member of the Supervisory Board, the contribution as a payer shall be calculated, collected from the income of the insured person and discharged by the entity in which the supervisory board operates.
17. For the person referred to in art. 66 (1) 1 point 15a, the contribution as a payer calculates, takes from the income of the insured person and discharges the court in which the juror performs his function.
18. For the person referred to in art. 66 (1) 1 point 36, benefiting from the benefit referred to in Article 1 42 par. 1 of the Act on the National School of Judiciary and Prosecutor's Office, the contribution as a payer calculates, takes from the income of the insured and drained the National School of Judiciary and Prosecution Service.
Article 86. [ Contributions paid to the insured person by other entities] 1. Contribution to health insurance:
1) (repealed)
2) the persons referred to in art. 66 (1) 1 point 2, pays off the state budget, from the part remaining at the disposal of the Minister of National Defence;
3) the persons referred to in art. 66 (1) 1 point 4, shall be paid from the State budget, from the part which is at the disposal of the Minister responsible for internal affairs;
4) children, pupils and hearers referred to in art. 66 (1) In accordance with the provisions of Article 1 (1), points 17 and 18, which are in a rehabilitation, educational, care or social function, or in the home of social assistance, pay the institution or house, and the students and listeners not in such a facility or house, if not they are subject to a sickness insurance obligation for another title, pay a school or a teacher training establishment to which the student or earner attends;
5) children referred to in art. 66 (1) 1 point 19, it pays for the social assistance centre;
6) the persons referred to in art. 66 (1) 1 point 20, a higher school or a doctoral student shall be paid by a doctoral student in which they are held;
(7) unemployed persons who are not receiving allowance or a scholarship, and persons who do not benefit from a pre-retirement pension or a pre-retirement pension, for the reasons set out in the art. 27 ust. 1 points 3 to 6 and paragraph. 2 of the Act of 14 December 1994. o employment and counteracting unemployment , pay the competent office of work;
8) the persons referred to in art. 66 (1) 1 point 26, pays the social assistance centre;
9) the persons referred to in art. 66 (1) 1 point 28-28b, paid for the mayor, mayor or president of the city;
10) the persons referred to in art. 66 (1) 1 point 27, pays a district assistance centre to the family implementing an individual integration programme;
11) the persons referred to in art. 66 (1) 1 points 29 and 30, it pays for the social assistance centre implementing an individual programme of homelessness or for participation in a social integration centre or a social assistance centre implementing a social contract as a result of a social contract the application of the procedure referred to in Article 50 par. 2 of the Act of 20 April 2004. Promotion of employment and labour market institutions;
12) the persons referred to in art. 66 (1) 1 point 31, pays the Head of the Office for Combatants and Represonated Persons;
13) the persons referred to in art. 66 (1) 1 points 31a-32a, pays the Social Insurance Institution;
13a) persons employed as a nanny as referred to in the Act of 4 February 2011. taking care of children under the age of 3, pays the Social Insurance Institution-from the basis of the amount not higher than the amount of the minimum wage for the work determined in accordance with the provisions on the minimum wage for the work;
14) the persons referred to in art. 3 para. 2 points 1 and 4, if they are recognized as persons of Polish origin within the meaning of the repatriation regulations or hold a valid Pole's Card, pay a school higher or an organizational unit conducting a doctoral degree in which those persons are held or will Studies;
15) the persons referred to in art. 66 (1) 1 point 36, not benefiting from the benefit referred to in Article 1 42 par. 1 of the Act on the National School of Judiciary and Prosecutor's Office, pays the National School of Judiciary and Prosecutor's Office.
2. The contributions to the health insurance of the persons referred to in paragraph. 1 points 2-15, as well as persons who have been granted pension under the provisions on the provision of war and military invalids and members of their families, as well as persons who lost sight as a result of hostilities in the years 1939-1945 or explosion non-pains and unexploded non-burns, receiving income from a pension or pension exempt from personal income tax on the basis of separate provisions, shall be financed by the State budget.
2a. (repealed)
3. From the State budget to the contributions listed in the paragraph. 1 points 4 and 7 receive local government units as special-purpose subsidies for government administration tasks.
4. Contributions to the health insurance of the clergy and the alumni of higher clergy and theological seminars, postulants, novices and juniors and their counterparts, excluding persons who are taxpayers of income tax on persons physical or flat-rate income tax on the income of the clergy, shall be financed from the Kościelny Fund.
5. The payment of the contributions referred to in paragraph 5. 4, the Kościelny Fund receives subsidies from the state budget.
6. The contribution to the health insurance of the persons referred to in art. 66 (1) Article 1 (1) (b), shall be paid from the first day of the month in which the application for insurance under the social insurance rules of the farmers has been lodged, until the last day of the month in which the circumstances justifying the subject have been laid down health insurance.
Article 87. [ Requirements concerning the mode of payment of contributions by persons and organisational units referred to in art. 84-86] 1. The persons and organizational units referred to in art. 84-86, shall be required, without prior notice, to pay for and to settle the health insurance premium for each calendar month in accordance and on the basis and within the time limits laid down for the social security contributions and, if so, to those persons and units do not apply to social insurance regulations-within a period of up to 15. on the following month.
2. In the case of the accounting of sickness insurance contributions from pensions, pensions, teacher compensation benefits, pension and pension benefits, and cash benefits for civilian blind victims of action The Cessation Of Hostilities of the Social Insurance Institution, as defined by the social security system, is:
1) does not pass the names of monthly reports;
2) shows the contributions in a separate statement of account.
3. From unpaid health insurance contributions, interest shall be charged on the basis and in the amount specified for the tax arrears.
4. Contribution to health insurance:
1) persons listed in Art. 66 (1) 1 point 1 lit. a and c-i, paragraphs 2-8, 8b-33 and 35 and in art. 68 are paid and evidenced in the Social Insurance Institution, subject to point 2;
1a) persons listed in Art. 66 (1) 1 point 8a shall be paid and recorded at the headquarters of the Fund;
2. persons referred to in Article. 66 (1) 1 point 1 lit. b and point 16 collecting pension benefits from the Agricultural Social Insurance Fund and persons referred to in art. 66 (1) 1 point 34 shall be paid and evidenced in the Agricultural Social Insurance Fund;
3) persons mentioned in Art. 66 (1) 1 point 36 shall be paid and recorded in the Social Insurance Institution.
5. forthwith, not later than within 3 working days from the date of the impact of the health insurance contributions, the Agricultural Social Insurance Fund shall transfer the collected health insurance premiums together with the collected interest for delay to the centre Fund.
6. The Social Insurance Institution shall transfer the collected contributions to health insurance and receivables from contributions immediately to the Fund's head office, not later than within 3 working days from the date of their impact on the account referred to in art. 47 para. 4 point 2 of the Act of 13 October 1998. the social security system.
7. The Social Insurance Institution, the Agricultural Social Insurance Fund and the entity obliged to transfer the contributions for the persons referred to in Art. 66 (1) 1 point 8a, they shall transfer free of charge to the central fund of the Fund or, at its request, to the provincial branch of the Fund, the data on insured persons and the health insurance of the members of the families of the insured persons referred to in the Article. 188 par. In accordance with Article 4 (4), points 1, 7 to 9 and 13, and for the health insurance contributions paid for them, as provided for in the notification referred to in Article 4 (1) (a) of the Regulation 77 par. 1 and 3, and in the monthly monthly report, and the interest on late payment, within 15 working days from the date of the impact of the contributions and the interest and the documents enabling them to be determined and distributed to the insured persons.
8. The Social Insurance Institution, the Agricultural Social Insurance Fund and the entity obliged to transfer the contributions for the persons referred to in Art. 66 (1) 1 point 8a, shall transmit free of charge to the Fund's headquarters or to the Fund's branch office, at their request, data related to:
1) setting out the appropriate legislation necessary to confirm the right to health care benefits in accordance with the rules on coordination;
2) confirmation of the right to health care benefits in respect of accidents at work or occupational disease in a Member State of the European Union or a Member State of the European Free Trade Agreement (EFTA) in accordance with the provisions o coordination, concerning:
(a) a detected breach of the performance of the organism by accident at work,
(b) the name, type or category of the occupational disease and the detected breach of the organism's performance as a result of that disease,
(c) payment of sickness and rehabilitation benefits in respect of accidents at work and the grant of invalidity pensions in connection with accidents at work and the period for which they have been paid,
(d) the recognition of the event by the Social Insurance Institution or the Agricultural Social Insurance Fund in the event of an accident at work.
9. The Social Insurance and Social Insurance Fund shall transfer the data referred to in Article to the Fund's central office. 188 par. Paragraphs 1, 3, 4, 7 to 10 and 13 contained in the notification referred to in Article 4 (1), (3), (4), (7) 77 par. 1 and 3, after carrying out their verification of compliance with the data covered by the PESEL records.
9a. Where the Fund, on the basis of the data received from the Social Insurance Institution and the Agricultural Social Insurance Fund, determines that a person is subject to a health insurance obligation at the same time, both for the coverage of the social insurance and social insurance of farmers, shall provide this information to the Agricultural Social Insurance Fund (Agricultural Social Insurance Fund).
10. The Social Insurance Institution and the Social Insurance Fund shall report to the Fund's head office a report containing information, broken down by insured person, of the health insurance premium due, specified in the notification referred to in Article 77 par. 1, and in imitated monthly reports, for a given quarter, no later than the last day of the second month following this quarter.
10a. Up to 10. on the day of each month, the authority carrying out the central PESEL record shall transmit to the Fund's headquarters in electronic form:
1) a collection of newly acquired in the previous month of the PESEL numbers and corresponding to them: names, surnames and surnames of the pedigree and an indication of the type and number of the document confirming the identity of the person concerned;
2) a collection containing the PESEL numbers and corresponding names, surnames and surnames of the pedigree of the persons whose death was reported in the previous month;
(3) information on the change of the data covered by the files referred to in points 1 and 2.
10b. The format of the transmitted data referred to in paragraph. 10a, shall be agreed by the authority conducting the records of the PESEL numbers and the Fund.
10c. The Social Insurance Institution, the Agricultural Social Insurance Fund and the entity obliged to transfer the contributions for the persons referred to in Art. 66 (1) For the purposes of Article 1 (1) (a), they shall transmit to the Fund headquarters data relating to all persons receiving allowances referred to in Article 1 (1) (a). 67 par. 6, and of all persons who have applied for a pension, referred to in art. 67 par. 7, subject to paragraph. 10f, as well as workers benefiting from free leave.
10d. Scope of data for all persons entitled to the allowance referred to in Art. 67 par. 6, and of all persons who have applied for a pension, referred to in art. 67 par. 7, includes the data referred to in art. 188 par. 4 points 1, 3, 4, 7 and 9, the title of the entitlement and the date of the corresponding establishment and the right to the allowance or the date on which the application for a pension is notified and, in the case of the persons referred to in Article 4, the date of application of the application for a pension or an allowance 67 par. 6-also the period for which entitlement to the benefit is granted, as defined in the decision of the Social Insurance Institution.
10e. The scope of data relating to workers benefiting from free leave shall include the data referred to in Article 4. 188 par. 4 points 1, 3, 4, 7 and 9, and the date on which the unpaid leave begins and ends.
10f. Pension authority competent in accordance with the provisions of the Act of 10 December 1993. o procurement of occupational pensions and their families (Dz. U. of 2016 r. items 1037) and the Act of 18 February 1994. on the pensions of police officers, the Internal Security Agency, the Intelligence Agency, the Military Counterintelligence Service, the Military Intelligence Service, the Central Anti-Corruption Bureau, the Border Guard, the Government Security Office, the State Security Office Fire Service and Prison Service and their families (Dz. U. of 2016 r. items 708) issue to the person who has applied for a pension, a certificate confirming the submission of the application and shall transmit immediately a copy of that certificate to the provincial branch of the Fund competent due to the place of residence of that person.
10g. The certificate referred to in paragraph 1. 10f, contains the data referred to in art. 188 par. 4 points (1), (3), (4), (7) and (9), the title of the entitlement and the date of application for a pension.
11. The Minister of Health, in consultation with the Minister responsible for Social Security, after consulting the President of the Fund, the President of the Social Insurance Institution and the President of the Agricultural Social Insurance Fund, will determine, by way of regulation, detailed scope and method of transfer to the Fund's headquarters and the provincial branch of the Fund by the Social Insurance Institution, the Agricultural Social Insurance Fund and the entity obliged to transfer the contributions for the persons referred to in Article 66 (1) 1 point 8a, data on persons covered by the health insurance and the payment of contributions and persons referred to in paragraph 1. 10c-10e, taking into account the need to ensure the confidentiality and integrity of the data transmitted.
12. The Council of Ministers shall determine by way of regulation, the time limits, scope and mode of verification of the insured data referred to in paragraph. 9, and the way in which the Social Insurance Institution and the Agricultural Social Insurance Fund are to be processed in the event of a finding of non-compliance and of the necessary adjustments to be made in the event of a finding of non-conformity of the data transmitted, the need to ensure confidentiality of the data transmitted
Article 88. [ Deduction of collection costs and records of premiums] The costs of collection and recording of health insurance premiums are deducted by the Social Insurance Institution and by the Agricultural Social Insurance Fund of 0,20% of the amount of that part of the contributions transferred to the Fund's central office, which have been identified (assigned to a specific insured person) also in terms of the amount of the payments.
Article 89. [ Interest on arrears on amounts not submitted at the time of contributions] From the amount not submitted by the Social Insurance Institution, the Agricultural Social Insurance Fund and the entity obliged to transfer the contributions for the persons referred to in Article. 66 (1) 1 point 8a, contributions to health insurance together with the interest due, the President of the Fund shall levy interest on arrears on the basis and in the amount specified for the tax arrears.
Article 90. [ Conducting checks on the performance of the duties of the payers to report insured persons to the Fund and to pay the contribution] 1. The Social Insurance Institution and the Agricultural Social Insurance Fund shall carry out checks on the performance of the duties of the payers in respect of the declaration of insured persons in the Fund and the payment of the contribution.
2. The Minister responsible for Social Security, at the request of the Minister responsible for health, may oblige the Social Insurance Institution to carry out the inspection referred to in the paragraph. 1, at the same time defining its scope and subject-matter.
2a. The Minister for Rural Development, at the request of the Minister responsible for health matters, may oblige the Agricultural Social Insurance Bank to carry out the checks referred to in paragraph. 1, at the same time defining its scope and subject-matter.
3. The scope of the control referred to in paragraph. 1, the control of reliability shall be:
1) the notification to health insurance of the persons covered by this insurance;
(2) the declared basis for the calculation of the contribution to health insurance, the regularity of the calculation, the payment and the payment of the premium.
4. The Fund shall analyse the data obtained from the Social Insurance Institution and the Agricultural Social Insurance Fund, referred to in paragraph 1. 3, and shall apply with applications to these institutions.
5. The provisions of the paragraph. 1-4 shall not apply to the person liable for the transfer of the contributions for the persons referred to in Article 4. 66 (1) 1 point 8a.
Article 91. [ Information relating to the amount of the payment of the health insurance contributions and the resources transferred under this Title to the Fund] 1. The Social Security and Social Insurance Institution for Social Insurance monthly report to the Minister of Public Finance and the Minister for Health Information on the amount of contributions paid in respect of contributions to the health insurance and funds transferred from that title to the Fund.
2. The Minister responsible for public finance in consultation with the Minister responsible for health may determine, by means of a regulation, the detailed scope of the data contained in the information referred to in the paragraph. 1, taking into account the need to ensure sound and fair management of public funds.
Article 92. [ Delegation] The Council of Ministers shall determine by way of regulation in a separate manner:
1) the insurer against the persons referred to in art. 66 (1) 1 points 5 to 8 and 8b-13, which, by virtue of the defence or security requirements of the State, have been seconded to the performance of the work or designated to serve outside the parent undertaking,
2) the reporting and deregation of health insurance of the persons referred to in art. 66 (1) 1 point 8a, and their family members, and the transfer of health insurance premiums
-having regard to the reasons for the defence of the State.
Article 93. [ Rules on the collection of health insurance premiums and interest on arrears] 1. The contributions to health insurance and interest receivables for late payment unpaid on time shall be subject to the rules laid down in the social security scheme.
2. The claims on health insurance contributions shall be subject to an limitation on the rules laid down in the social security scheme.
Article 94. [ Reimbursement rules for unduly paid contributions] 1. The reimbursement of unduly paid health insurance premiums shall be subject to the rules laid down in the provisions on the social security system.
2. (repealed)
3. From unduly levied pension, pension, retirement benefit, retirement benefit, teacher compensation payment or cash benefits for civilian victims of the war contribution to health insurance is not subject to return.
Article 95. [ Deduction of contribution to health insurance] 1. The contribution to health insurance is deductible:
1) from personal income tax-under the conditions laid down in the Act of 26 July 1991. with personal income tax;
2) from the lump sum on the income recorded, the tax card and the lump-sum income tax on the income of the clergy-under the conditions laid down in the Act of 20 November 1998. with a flat-rate income tax on certain income generated by natural persons (Dz. U. Entry 930, of late. zm.).
2. The deductions referred to in paragraph 1. 1, they shall not cause a reduction in the income of local government units.
CHAPTER IVA
Assessment of health needs
Art. 95a. [ Regional health needs map] 1. A regional map of health needs is drawn up for the voivodship area, hereinafter referred to as the "Regional Map", which takes into account the specificity of the health needs of local communities.
2. The Regional Map for a given voivodship shall draw up the appropriate voivodship in consultation with the Provincial Council for Health Neals, referred to in art. 95b.
3. The Regional Map shall be drawn up once every 5 years.
4. The National Institute of Public Health-National Institute of Hygiene prepares the project of the Regional Map, in particular on the basis of epidemiological, demographic and data data from the register of entities performing the activity of the medicinal product, and forward it to the competent water in the period ending on 15 October of the year preceding 1 calendar year of the first year of the Regional Map.
5. Wojewoda na podstawie draft, o którym mowa w ust. 4, draws up the Regional Map and transfers it to the National Institute of Public Health-the State Hygiene Plant by the date of 1 February of the year preceding the first year of the Regional Map.
6. The National Institute of Public Health-National Institute of Hygiene on the basis of the Regional Map shall draw up the National Map of Health Neals, hereinafter referred to as the "Nationwide Map".
7. The National Map and Regional Maps, hereinafter referred to as "maps", the National Institute of Public Health-National Institute of Hygiene shall transfer the Minister of Health to the Minister for Health for approval by 1 April of the year preceding the first year. the use of these maps.
8. The Minister of Health shall approve the maps by the date of 1 June of the year preceding the first year of the maps. Prior to the approval, the Minister responsible for Health may make changes to the maps.
9. The approved maps are published on the pages of the Public Information Bulletin of the Office serving the Minister responsible for Health and the Officially serving the voyeurs.
10. National Institute of Public Health-State Hygiene Plant monitors the timeliness of the maps. The National Institute of Public Health-The State Hygiene Plant shall transmit to the Minister responsible for health the results of the monitoring of maps for the previous year by 30 June.
10a. The Minister responsible for Health may make a change of maps on the basis of the information received as a result of the monitoring referred to in paragraph. 10, within 2 months from the date of receipt of this information.
11. The Minister responsible for Health will determine, by means of a regulation, the scope of the content of maps, guided by the need to ensure an effective tool of planning to secure the proper availability of health care services, taking into account the specificity of the health needs of local communities.
Article 95b. [ Provincial Council For Health Needs] 1. It is created by the Provincial Council for Health Needs, hereinafter referred to as the "Provincial Council". The Provincial Council is composed of consultants of the voivodship and eight members of the distinguished public health knowledge established by the voivodship, in the This:
1) one representative of the wojewater;
2) one representative of the Marshal of the voivodship;
3) one representative of the director of the Fund's branch office;
4) one representative of the National Institute of Public Health-State-owned Hygiene Plant;
5) one representative of the Voivodship Statistical Office;
6) one representative of higher education institutions in medical directions established in the voivodship;
7) one representative of the district of powiats of a given voivodship;
8) one representative of the representative employers ' organisations.
2. The work of the Provincial Council shall be headed by a representative of the voivodship as its chairman.
3. The organizational support of the Provincial Council shall be provided by the office serving the wojewater.
4. The Provincial Council shall act on the basis of the Rules of Procedure adopted by the Council.
5. The subjects referred to in paragraph 5. 1 points 3 to 5 and the Central Statistical Office shall transmit the data necessary for the preparation of the Regional Map, free of charge, at the request of the voyeurist within 14 days.
Art. 95c. [ Priorities for Regional Health Policy] 1. On the basis of the Regional Map of wojewoda, in agreement with the Provincial Council, the priorities for the Regional Health Policy shall be set by 1 September of the year preceding the first year of the priorities, bearing in mind the health status of the regions. citizens and obtain the health effects of the highest value. The priorities shall be fixed for the period of time for which the Regional Map is drawn up.
2. The Wojewoda in consultation with the Provincial Council shall update the priorities for regional health policy in the event of the change of the Regional Map referred to in art. 95a ust. 10a, within a period of 2 months from the date of the amendment.
Art. 95d. [ Opinion of the voivodship about the speciality of the establishment of new medicinal product in the voivodship] 1. The wojewoda or minister competent for health, hereinafter referred to as the "issuing authority", gives an opinion on the advisability of the investment consisting in the creation of a new province:
1) a medicinal entity which is to carry out medicinal activities in the field of hospital treatment, or new units or organizational cells of the medicinal plant of the medicinal product, by which the medicinal product is to be performed in the scope of hospital treatment, or other investment in this respect, of a value exceeding PLN 3 million over a period of 2 years, carried out by the applicant entity referred to in art. 95e ust. 1;
2) the entity performing the medicinal activity, which is to carry out the activity of the medicinal product on the outpatient care, or of the new units or the organizational cells of the medicinal plant of the medicinal product, by which it has be performed in the field of outpatient care, or other investment in this range exceeding PLN 2 million over a period of 2 years, carried out by the applicant entity referred to in art. 95e ust. 1;
3) the entity performing the medical activity, which is to perform the medical activity in the field of hospital treatment, outpatient care specialist or primary health care, or new units or organizational cells of the plant the medicinal product by which the medicinal product is to be performed in the field of hospital treatment, outpatient care or primary health care, or other investment in that area, to which the operator the applicant referred to in Article 95e ust. 1, intends to obtain funding from European funds.
2. The opinion referred to in paragraph 2. 1, does not appear in relation to:
1) a hospital emergency department;
2) a hospital emergency department for children;
3) trauma centre;
4) a trauma center for children.
3. The Minister responsible for Health shall be the issuing authority referred to in paragraph 1. 1, where the applicant entity referred to in Article 95e ust. 1, is:
1. the medicinal product for which the person forming is the water-water body;
2) a medicinal entity created or carried out by a medical university referred to in art. 2. 1 point 13 of the Act of 15 April 2011. of therapeutic activities;
3) the research institute referred to in art. 3 of the Act of 30 April 2010. o research institutes (Dz. U. of 2016 r. items 371, 1079 and 1311), in so far as it carries out medicinal activities;
4. the entity resulting from the transformation of the medicinal product or the research institute referred to in points 1 to 3;
5) wojewoda, if it is an entity intending to carry out the activity of the medicinal product;
(6) a medical university, if it is an entity intending to carry out a medicinal activity.
4. To determine the value of the investments referred to in paragraph. Points 1 and 2 shall include the following types of costs incurred or planned:
1) preparation for the implementation of construction investment and other changes in the construction site referred to in art. 3 point 1 of the Act of 7 July 1994. -Building law (Dz. U. of 2016 r. items 290, 961, 1165 and 1250), hereinafter referred to as the "construction object", together with supporting services, including investor support, and the purchase of a construction object, in particular the development of design documentation, purchase and preparation of the land for construction, and expert opinions, certificates, operas, studies, geodesic measurements and geological work and archaeological work, concerning construction investment;
2) the realization of construction investment and other changes in the construction site together with the accompanying services, including investor support;
3) the purchase of a construction site;
(4) the purchase or production of a fixed asset, with the exception of those whose initial value does not exceed the amount specified in the Article. 16f par. 3 of the Act of 15 February 1992. o corporate income tax (Dz. U. of 2014 items 851, with late. zm.), subject to point 5;
5) purchase or manufacture in its own scope of a fixed asset, regardless of its value and other items, if they are the first equipment of the construction works;
6. transport and assembly and other costs incurred for the transfer of a durable medium for use;
(7) changes in the middle of a permanent improvement in the meaning of the accounting rules;
8. purchase of intangible assets, if:
(a) its initial value is higher than the amount specified in the Article. 16f par. 3 of the Act mentioned in point 4,
b) is the first equipment of the building object-no matter its value;
(9) other, where, on the basis of separate provisions, the financing or financial contribution from the State budget for investment is subject to financing or financing.
Art. 95e. [ Minister's opinion on the advisability of creating in the area of the voivodship of new medicinal 1. The opinion referred to in art. 95d ust. 1, it shall be issued, at the request of the entity performing the medicinal activity or the entity intending to pursue the activity of the medicinal product, hereinafter referred to as the "applicant".
2. An application for an opinion referred to in art. 95d ust. 1, it consists of a body issuing an opinion in paper or electronic form bearing a qualified electronic signature or an electronic signature confirmed with a trusted ePUAP profile within the meaning of the regulations on information technology bodies performing public tasks.
3. An application for an opinion referred to in art. 95d ust. 1, contains:
1) the designation of the authority issuing the opinion;
2) the name and surname (company) of the applicant entity and its KRS number in the case of legal persons or the REGON or NIP number in the case of natural persons or organizational units without legal personality;
3) the designation of the seat or address of residence, or the address of the applicant;
4) indication of the type of investment: establishment of a new entity performing the activity of the medicinal product, new business units or cells of the medicinal plant of the medicinal product or other investment;
5) a description of the investment referred to in art. 95d ust. 1, containing:
(a) the scope of the investment,
(b) the justification for the investment,
(c) the investment period,
(d) indication of the place of execution
(e) the sources of financing of the investment and the types of costs incurred or planned referred to in Article 3. 95d ust. 4, and in the case of construction investment, also its estimated value per group of costs,
(f) other information on investments;
6) completed form of the Instrument for Assessment of Investment Requests in the Health Sector and its number generated through the IOWISZ system not earlier than the month before the day of submission of the application;
7) indication of the planned date of commencation of the investment, if applicable;
8) the statement referred to in the paragraph. 4;
9. the date of its preparation;
10) the signature of the person authorized to submit it.
4. An application for an opinion referred to in art. 95d ust. 1, consists of a rigorous criminal liability for making false statements. The applicant party shall be obliged to make a declaration of the following content: 'I am aware of the criminal responsibility for making a false statement.'. This clause replaces instructing the body of criminal responsibility for making false statements.
(5) The application shall be accompanied by the original or a copy of the document certifying the authorisation of the person referred to in paragraph 1. 3 point 10 to act on behalf of the applicant entity.
6. Application for the opinion referred to in art. 95d ust. 1, shall be subject to a fee of 4000 PLN. The fee is the income of the state budget Confirmation of the payment of the fee shall be attached to the application.
Art. 95f. [ Consideration of applications] 1. Applications for an opinion referred to in art. 95d ust. 1, shall be considered according to the order of their influence.
2. The issuing authority shall verify the completeness of the request for an opinion referred to in Article 4. 95d ust. 1. In the event of a deficiency in formal applications, the Authority shall invite them to complete within 7 days from the date of service of the request, subject to the application for an opinion referred to in Article 6. 95d ust. 1, without consideration.
3. The opinion referred to in art. 95d ust. 1, it shall be issued only on the basis of:
1) the information provided in the application;
2) the priorities for the regional health policy referred to in art. 95c;
3) data from the register of entities performing the activity of the medicinal product;
4) the Regional Maps or the National Maps;
5) the opinion of the director of the competent provincial branch of the Fund-in the case when the body issuing the opinion is the voivodship;
6) the opinion of the President of the Fund-in the case where the issuing authority is the minister competent for health matters;
7) the information provided in the other, previously submitted applications referred to in Art. 95e ust. 1, and the opinions issued, referred to in art. 95d ust. 1, to the extent that they take into account the implementation of the maps and the priorities for regional health policy referred to in art. 95c.
4. Within 7 days from the date of submission of the complete application for the opinion referred to in Art. 95d ust. 1, the issuing authority shall transmit, through the IOWISZ system, completed by the entity requesting the form of the Instrument for Assessment of Investment Applications in the Health Sector for an opinion:
1) the director of the competent branch of the Fund's voivodship-in the case when the body issuing the opinion is the water-water;
2. the President of the Fund, where the issuing authority is the Minister for Health.
5. The subjects referred to in paragraph 5. 4 shall issue the opinions referred to in paragraph 1. 3 points 5 and 6, within 14 days from the date of service, through the IOWISZ system, the application of the Instrument for Assessment of Investment Applications in the Health Sector. These opinions shall be transmitted respectively to the water body or the Minister responsible for health via the IOWISZ system.
6. The opinions referred to in paragraph 1. 3 points 5 and 6, appear on the Form of the Instrument for Assessment of Investment Applications in the Health Sector on the basis of the data contained in the application, taking into account:
1) the priorities for regional health policy as referred to in art. 95c;
2) data from the register of entities performing the activity of the medicinal product;
(3) Regional map-where the issuing authority is the water or the minister responsible for health, and the investment to which the application relates only meets the health needs of a local nature;
4) The National Map-where the issuing authority is the minister competent for health, and the application concerns an investment other than the one specified in point 3.
7. In the event of a failure of the IOWISZ system lasting for more than an hour, preventing the operation referred to in paragraph. 4-6, the time limit referred to in paragraph 4 respectively. 4 or 5 shall be extended for the duration of the failure.
8. The minimum number of points required to obtain the positive opinion referred to in art. 95d ust. 1, shall not be higher than 50% of the maximum number of points possible to obtain in the Form of the Instrument for Assessment of Investment Applications in the Health Sector. If less than the minimum number of points is obtained, a negative opinion shall be issued.
9. The applicant, the body issuing the opinion, the President of the Fund and the director of the Fund's branch office, each within the scope of its property, shall fill in, through the IOWISZ system, the form of the Instrument for Evaluation of Investment Requests in the Sector Health, evaluating the speciality referred to in art. 95d ust. 1, by the award of points for the fulfilment of the individual criteria by the applicant entity and the reasons for that assessment. The authority issuing the opinion, the President of the Fund and the director of the Fund's branch office shall draw up a statement of reasons only if the proposed assessment or justification for the assessment of the criterion is different from the one submitted by the applicant in the The form of an instrument for evaluation of investment proposals in the health sector.
Art. 95g. [ Feedback] 1. The opinion referred to in art. 95d ust. 1, it shall appear within 45 days from the date of submission of the complete application for its release.
2. The opinion referred to in art. 95d ust. 1, contains:
1) the designation of the authority issuing the opinion;
2) determination of the date and place of its issue;
3) a sign of the opinion;
4) the name and surname (company) of the applicant entity and its KRS number in the case of legal persons or the REGON or NIP number in the case of natural persons or organizational units without legal personality;
5) determine whether the opinion is positive or negative;
6) the total score of the point calculated according to the provisions issued on the basis of art. 95h;
7) generated electronically a statement of the points awarded by the competent authority issuing the opinion, the President of the Fund or the Director of the Fund's competent branch, for the fulfilment of the individual criteria by the applicant and their justification;
8) instructing the possibility of bringing a protest to the minister responsible for health containing an indication of the timing of the protest, as well as the form and mode of his contribution-in the case of a negative opinion;
9. signature with the name and official position of the person authorised to issue an opinion or, if this opinion has been issued in the form of an electronic document-qualified electronic signature or electronic signature confirmed a trusted ePUAP profile within the meaning of the regulations on the information technology of the entities carrying out public tasks.
Art. 95h. [ Delegation] The Minister for Health shall determine by way of regulation:
1) model of the application containing the form of the Instrument for Assessment of Investment Applications in the Health Sector, with an indication of the criteria for assessing the investment, assigning them weights and determining the scale of the points possible to obtain within the scope of the individual criteria,
2) the method of calculating the total point score for making the assessment of the speciality referred to in art. 95d ust. 1, including the calculation of this result by each of the entities referred to in Article. 95f ust. 9,
3) the minimum number of points required to obtain a positive opinion, referred to in art. 95d ust. 1
-with a view to taking into account the maps and priorities for regional health policy as referred to in Article 3. 95c, ensuring the uniformity of proposals, a comparable and consistent methodology for assessing the objectives of investments and their transparency and their convergence with the essential needs of health.
Art. 95i. [ Protest] 1. Where the opinion referred to in art is concerned 95d ust. 1, is negative, the applicant shall be entitled to an appeal in the form of a protest.
2. The protest shall be submitted to the minister competent for health matters within 14 days from the date of service of the opinion referred to in art. 95d ust. 1. Where water is the opinion of the issuing authority, the protest shall be brought to the public by means of a protest.
3. The Protest is made in paper or electronic form bearing a qualified electronic signature or an electronic signature confirmed with a trusted ePUAP profile within the meaning of the regulations on computerization of the activities of implementing entities public tasks. The protest shall contain:
1) the designation of the body to which the protest is lodged;
2) the name and surname (company) of the applicant entity and its KRS number in the case of legal persons or the REGON or NIP number in the case of natural persons or organizational units without legal personality;
3) the designation of the seat or address of residence, or the address of the applicant;
4) the sign of the opinion from which the protest is brought, the designation of the authority issuing the opinion and the date and place of the opinion;
5) the justification of the protest, including the indication of the criterion, with the assessment of the fulfilment of which the protest party does not agree, together with the reasons for it;
6) the statement referred to in the paragraph. 4;
7) signature of the person authorized to bring protest.
4. The Protest consists of a rigorous criminal liability for making false statements. The protest appellant is obliged to make a statement of the following contents: "I am aware of the criminal responsibility for making a false statement.". This clause replaces instructing the body of criminal responsibility for making false statements.
5. The protest shall be accompanied by the original or a copy of the document attesting to the authorisation of the person referred to in paragraph. 3 point 7 to act on behalf of the protest appellant.
6. The Minister of Health shall consider the protest within 30 days from the date of its service.
7. As a result of consideration of the protest, the minister competent for health issues an opinion on the protest, through the IOWISZ system, awarding the points for the fulfilment of the individual criteria and justifying their number on the basis of:
1) the information provided by the applicant entity;
(2) the reasons set out in the protest;
3) the appropriate map;
4) the priorities for regional health policy, referred to in art. 95c;
5) data from the register of entities performing the activity of medicinal products.
8. The opinion on the protest includes:
1) the designation of the body examining the protest;
2) the name and surname (company) of the applicant entity and its KRS number in the case of legal persons or the REGON or NIP number in the case of natural persons or organizational units without legal personality;
3) determination of the date and place of consideration of the protest;
4) determine whether the protest is considered positively or negatively;
5) the total point score calculated in accordance with the provisions issued on the basis of art. 95h;
6) generated electronically a statement of the points awarded for the fulfilment of the individual criteria and their justification, by the protest appellant and the minister competent for health matters as a result of the examination of the protest;
7) instructing on the possibility of bringing a complaint to the voivodship of the administrative court, in the mode and on the principles laid down in art. 95j, indicating the time limit for lodging a complaint;
8. signature, giving the name and official position of the person authorised to deliver an opinion on the protest or, if this opinion has been issued in the form of an electronic document-qualified electronic signature or signature an electronic validated ePUAP profile within the meaning of the regulations on computerisation of the activities of the entities performing public tasks.
9. The Protest shall not be subject to consideration if, despite the correct instruction referred to in art. 95g ust. 2 point 8:
1) was brought after the deadline,
2) does not meet the requirements set out in the paragraph. 3 second sentence
-the Minister responsible for health shall inform the appellant in writing, within seven days of the day of the protest.
10. In the case referred to in paragraph. (9) The authority issuing the opinion shall issue an order in respect of the failure to examine the protest to which the provisions of the Code of Administrative Procedure are applicable.
11. To the proceedings referred to in art. 95d-95g and paragraph. 1-9, the provisions of the Code of Administrative Procedure do not apply, with the exception of provisions concerning the exclusion of the employee and the body, the powers of attorney, the service, the method of calculating the time limits, the issuing of certified copies or a copy of the case file, (1)
Art. 95j. [ The complaint to the provincial administrative court] 1. After exhaustion of the appeal proceedings before the minister competent for health in case of maintaining a negative opinion on the protest party, who received this opinion, may in this regard bring a complaint to the voivodship court in accordance with art. 3 § 3 of the Act of 30 August 2002. -Right of proceedings before administrative courts (Dz. U. of 2016 r. items 718, 846, and 996).
2. The complaint referred to in paragraph 1, shall be submitted within 14 days from the date of service of the opinion on the protest directly to the competent provincial administrative court together with the complete documentation on the case. The application shall be subject to a permanent entry.
3. To the complaint referred to in paragraph. 1, shall be attached:
1) an application for an opinion referred to in art. 95d ust. 1;
2) protest;
3) the opinion referred to in art. 95d ust. 1, and an opinion on the protest.
4. To the complaint referred to in paragraph. 1, the Annexes may be attached containing the information justifying the transfer.
5. The Tribunal shall decide on the matter in the field referred to in paragraph 1. 1, within 30 days from the day of lodging the complaint.
6. The application of the action referred to in paragraph 1 1, after the time limit referred to in paragraph 1. 2, shall result in leaving it without consideration.
Art. 95k. [ Cassation complaint to the Supreme Administrative Court] 1. An entity that has lodged a complaint referred to in art. 95j ust. 1, or the minister competent for health may lodge a cassation complaint to the Supreme Administrative Court within 14 days from the date of service of the decision of the voivodship administrative court. The lodging of a complaint after that date shall result in the application being left unprocessed. Article Recipe 95j ust. 2 shall apply mutatis mutandis.
2. The complaint referred to in paragraph 1. 1, shall be considered within 30 days from the date of its lodging.
3. The right to lodge a complaint to the administrative court does not adversely affect the erroneous instruction or lack of an instruction referred to in art. 95i ust. 8 point 7.
4. In the area of unregulated in art. 95y and mouth. 1-3 to proceedings before administrative courts shall apply accordingly to the provisions of the Act of 30 August 2002. -The right to proceedings before administrative courts laid down for the acts or acts referred to in Article 3 § 2 point 4 excluding art 52-55, art. 61 § 3-6, art. 115 -122, art. 146, art. 150 and Art. 152 of this Act.
CHAPTER V
National Health Fund
Chapter 1
General provisions
Article 96. [ National Health Fund] 1. The National Health Fund, which is a state organisational unit with legal personality, is established.
2. The Fund shall consist of:
1. the Fund's head office;
2) Provincial branches of the Fund.
3. The seat of the Fund is the capital city of Warsaw.
4. In the headquarters of the Fund and in the branches of the Voivodship Fund, organisational cells for uniformed services shall be established.
5. The drivers of the organizational cells referred to in the mouth. 4:
1) at the Fund's headquarters-shall be appointed by the President of the Fund at the joint request of the Minister of National Defence, the Minister responsible for the internal affairs and the Minister of Justice;
2) in the branches of the Voivodship Fund-appoints the director of the provincial branch of the Fund at the joint request of the Minister of National Defence, the Minister of the competent for internal affairs and the Minister of Justice.
6. Provincial divisions of the Fund shall be created in accordance with the territorial division of the State. In the voivodship departments, field facilities may be established under the rules laid down in the Fund's statutes.
7. The Fund operates on the basis of statute and statute.
8. The Minister of competent health matters, by way of regulation, gives the Fund the statutes, specifying in particular the organisational structure of the Fund, including the headquarters and branches of the Fund and the seat of those branches, having regard to performing the tasks efficiently by the Fund.
Article 97. [ Fund Tasks] 1. The Fund manages the financial resources referred to in art. 116.
2. The Fund shall act on behalf of the insured person and the persons entitled to those benefits on the basis of the rules on coordination in respect of the funds derided from the health insurance contributions.
3. The scope of operation of the Fund shall also include in particular:
1) determining the quality and availability and analysis of the costs of health care services to the extent necessary for the proper conclusion of contracts for the provision of health care services;
2) conducting competitions of offers, negotiations and concluding contracts for the provision of health care services, as well as monitoring of their implementation and settlement;
2a) the financing of health care benefits provided to the persons referred to in art. 2. 1 points 3 and 4 and in Article 12 points 2-4, 6 and 9;
2b) financing of guaranteed benefits as defined by the regulations issued on the basis of art. 31d to the extent specified in art. 15 para. 2 point 12;
2c) the financing of medicines, foodstuffs intended for particular nutritional uses and medical devices entitled to the recipients referred to in Article 3 (1) of the EC 43a ust. 1;
3) financing of health care benefits provided to the recipients other than the insured persons fulfilling the income criterion referred to in art. 8 of the Act of 12 March 2004. social assistance for which no circumstances have been identified, referred to in Article 12 of this Act;
(3a) financing of medical rescue operations to the recipients;
(3b) the financing of the health care benefits referred to in Article 3 42j;
3c) the reimbursement of costs in the case of guaranteed benefits financed from the state budget, subject to the Art. 42b (b) 2, including medical rescue operations carried out by medical rescue teams, referred to in the Act of 8 September 2006. o State Medical Rescue;
4) develop, implement, implement, finance, monitor, supervise and control health programmes;
5) the execution of commissioned tasks, including those financed by the minister competent for health matters, in particular the implementation of health policy programmes;
6. monitoring of medical ordination;
7. the promotion of health;
8) conduct the Central List of Insured Persons;
9) conducting editorial promotion and information activities in the field of health protection;
(10) the calculation of the amounts referred to in Article 4 and art. 34 of the Law on refunds and in Article 102 (1) 5 point 29;
11) monitoring and coordinating the implementation of the powers resulting from the art. 24a-24c, art. 44 par. 1a-1c, art. 47 para. 2 and 2a, art. 47c and Art. 57 (1) 2 points 10, 12 and 13;
12) carrying out the tasks of the National Contact Point for Cross-border Healthcare, hereinafter referred to as "NCPs".
3a. The tasks of the Fund shall be the settlement with the competent institutions or institutions of the place of residence in the Member States of the European Union or of the Member States of the European Free Trade Agreement (EFTA):
1) the costs of health care benefits financed from the state budget from the part remaining at the disposal of the minister responsible for health, referred to in art. 11 (1) 1 point 4;
2) the medical costs of emergency operations carried out by medical rescue teams, referred to in the Act of 8 September 2006. o State Medical Rescue, with the exception of the medical costs of rescue operations performed by aeronautical rescue teams
-in relation to the persons entitled to those benefits under the rules on coordination.
3b. The Minister for Health, after final settlement with the healthcare provider of the benefits referred to in Article 3 (2) of the Rules of the European Union. 11 (1) Article 1 (4), shall be charged to the Fund for the costs of these benefits and shall provide the necessary documentation on the benefits provided, together with a copy of the document confirming the entitlement to such benefits under the coordination provisions. The funds reimbursed by the institution of a Member State of the European Union or a Member State of the European Free Trade Agreement (EFTA) the Fund shall transfer to the account of the minister of the minister competent for health within 14 days of the day Identify the return base.
3c. In the case of the clearing by the Fund of the costs of medical rescue operations granted to persons entitled to these benefits under the provisions on coordination by the teams of medical rescue, the Fund shall notify the competent water supply o the accounts payable to him under that title. Funds reimbursed by the institution of a Member State of the European Union or of a Member State of the European Free Trade Agreement (EFTA) the Fund shall transfer to the account of the office of the competent voyewater within 14 days from the date of identification return base. The provision shall not apply to air medical rescue teams as referred to in the Act of 8 September 2006. o State Medical Rescue.
The Fund is the competent institution, the institution of the place of residence, the institution of the place of stay and the liaison body in respect of the health benefits in kind, within the meaning of the rules on coordination, and, at the head of the Fund, the point of view of the contact as referred to in Regulation (EC) No 987/2009 of the European Parliament and of the Council of 16 September 2009 concerning the implementation of Regulation (EC) No 883/2004 on the coordination of social security systems for the exchange of data within the framework of the Electronic Exchange of Social Security Information System in matters of physical health care.
4. The Fund shall conduct the Central List of Insured in order to:
1) confirmation of the right to benefits from health insurance;
2) processing of data about insured persons in the Fund;
3) processing of data on persons entitled to health care benefits on the basis of the rules on coordination;
4) processing of data on individuals other than the insured persons entitled to health care benefits under the provisions of the Act;
5) the issue of certificates and attestative services in the field of its activities;
6) accounting for the costs of health care benefits, including those provided on the basis of the rules on coordination.
5. The Fund does not carry out economic activities.
6. The Fund may not be the owner of entities carrying out medicinal activities within the meaning of the provisions on medical activity.
7. The tasks of the Fund referred to in paragraph 1 3 points 1, 2, 4, 6 and 11 with regard to the medicinal entities supervised by the Minister of National Defence, the Minister of Justice and the Minister responsible for internal affairs shall implement the organizational cell of the branch of the Fund of the Fund, of which Article 96 (1) 4.
8. The Fund shall receive a grant from the State budget to finance the costs of carrying out the tasks referred to in paragraph. 3 points 2a-2c, 3 and 3b. The grant does not take account of administrative costs.
9. (repealed)
Article 97a. [ National Contact Point for Cross-border Healthcare] 1. The Fund's head office operates KPK.
2. KPK and provincial branches of the Fund shall grant patients from other Member States of the European Union, at their request, the necessary information concerning:
1) the rights of the patient regulated on the basis of the universally applicable law;
2) the providers, in relation to the types of activity performed;
3) persons carrying out medical professias, in the exercise of the right to pursue the profession and the imposed restrictions on the exercise of this right, on the basis of available public registers;
4) applicable on the basis of the provisions of the standards of quality and safety of health services and the applicable regulations on the assessment of the providers in terms of application of these standards and supervision of the providers;
5) the facilities of a given hospital facilities for people with disabilities;
6) the rules of pursuing claims for infliction of damage or harm in connection with the granting of health benefits by the entity performing the medicinal activity in the territory of the Republic of Poland and the rules and mode of determination of compensation or redress in the case of medical events, within the meaning of the Act of 6 November 2008. about the rights of the patient and the Ombudsman for the Rights of Patient
3. The information referred to in paragraph 1. 2, NCPs and provincial branches of the Fund shall grant directly or through the use of available means of communication, in particular by telephone, in written form or by electronic mail, where possible, including in other languages of the official European Union.
4. The PSC shall cooperate with the European Commission and the national contact points for cross-border healthcare activities operating in the other Member States of the European Union, in particular as regards the exchange of information referred to in paragraph 1. 2.
5. At the request of the national contact points for cross-border healthcare services operating in other than the Republic of Poland, the Polish Member States of the European Union, in cooperation with the Fund's voivodships, shall provide the necessary aid in explaining the contents of accounts and other documents issued to patients from other than the Republic of Poland of the European Union Member States by Polish healthcare providers, pharmacies and suppliers of medical devices.
6. KPK refers to national contact points for cross-border healthcare, operating in other than the Republic of Poland of the Member States of the European Union, queries on the content of accounts and other documents issued by health care providers, pharmacies and suppliers of medical devices operating in the territory of those countries.
7. KPK and provincial branches of the Fund shall provide patients with information concerning the necessary elements of the cross-border prescription.
8. The NCPs shall include on their website and in the Public Information Bulletin of the Fund up-to-date information on the contact details of national contact points for cross-border healthcare in other countries of the European Union.
9. KPK will post on its website, at the request of interested entities, hyperlinks to the websites of associations and foundations acting for the promotion of the Polish medical services sector.
10. KPK and provincial branches of the Fund shall grant to the recipients and persons performing medical profession, either directly or through the use of available means of communication, in particular by telephone, in written form or by mail online, information on:
1) the possibility of obtaining a refund of the eligible costs in the case of obtaining in another Member State of the European Union a particular provision of health care;
2) the health care benefits included in the list referred to in art. 42e ust. 1;
3) the mode of processing and execution of requests for reimbursement;
4) the mode of processing of applications for consent, referred to in art. 42b (b) 9.
11. In the sharing of the information referred to in paragraph. 10 points 1, KPK and provincial branches of the Fund make a clear distinction between the powers resulting from the art. 42b and the powers resulting from the rules on coordination.
12. Voivodship departments of the Fund shall grant to the recipients, directly or through the use of available means of communication, in particular by telephone, in written form or by e-mail, information on approximate the amount of reimbursement of the costs to be reimbursed in the event of obtaining a specific healthcare benefit in another Member State of the European Union.
13. The information referred to in paragraph 1. 10 and 12, also included on the websites of KPK and the Fund's branches and in the Public Information Bulletin of the Fund, with the fact that information on the amount of reimbursement may be limited to selected benefits guaranteed.
Article 98. [ Organs] 1. The Organs of the Fund shall be:
1. the Board of the Fund;
2. The President of the Fund;
3) the board of branches of the Provincial Fund;
4) directors of provincial branches of the Fund.
2. In cases not reserved to the scope of tasks of the Fund Board, the Board of the Fund's provincial branch or the Director of the provincial branch of the Fund shall be the competent authority of the Fund.
3. Technical-organizational service:
1) the Fund's Board and the President of the Fund-shall provide the Fund's head office;
2) the Board of the provincial branch of the Fund and the Director of the Fund's provincial branch-shall provide a branch of the Fund
Article 99. [ Council of the Fund] 1. The Board of the Fund shall be composed of ten members appointed by the Minister responsible for health matters, including:
1. one member shall be appointed from among the candidates designated by the Ombudsman;
2. two members shall be appointed from among the candidates designated by the Social Dialogue Council;
3. one member shall be appointed from among the candidates designated by the local authority of the Commission of the Joint Government and the Local Government;
4) one member is appointed from among the candidates designated by the patient's rights organisations, reported within 14 days from the date of publication on the pages of the Public Information Bulletin of the Office serving the Minister the competent health authority of the notice of intention to appoint a member of the Fund's Board;
5) one member is appointed from among the candidates designated jointly by the Minister of National Defence, the Minister of Justice and the Minister responsible for internal affairs;
6) one member shall be appointed from among the candidates designated by the Minister responsible for public finance affairs;
7) one member shall indicate the President of the Council of Ministers;
8) two members shall indicate the minister competent for health.
2. The term of office of members of the Fund Board shall be 5 years.
3. The Board of the Fund shall act on the basis of its Rules of Procedure.
4. The Board of the Fund shall elect its chairman, who shall convene the meetings and shall be chaired by them.
5. The Fund's Board shall consist of persons who meet the following criteria together:
1) have not been legally convicted of a criminal offence committed intentionally;
(2) have a higher education;
3) have the knowledge and experience of the proper exercise of the duties of a member of the Board of the Fund;
4) they have the necessary powers to sit on the supervisory board of one-person companies of the State Treasury, in accordance with separate regulations.
6. The members of the Board of the Fund shall not be simultaneously:
1) employees of the Fund;
2. the providers;
3) the owners of the pharmacy, the pharmaceutical wholesalers or the operator of the medicinal products and medical devices;
4. the holding of shares or shares in the companies engaged in the entities referred to in points 2 and 3;
5) the persons referred to in art. 112 (1) 1 points 2 to 8, with the exception of the staff of the offices serving the ministers who are the entities in which they are forming.
7. The Minister for Health shall determine, by way of ordinance, the remuneration of the members of the Board of the Fund, taking into account the tasks of the Council.
Article 100. [ Tasks of the Fund Board] 1. The tasks of the Board of the Fund shall:
1) controlling the current activity of the Fund in all areas of its activities;
2. establishment:
(a) the Fund's work plan for that year,
(b) a factual plan of investment expenditure;
3. opinion:
(a) the draft financial plan for the year concerned,
(b) the remuneration system of the Fund's staff;
4. receiving:
(a) reports on implementation of the Fund's financial plan
(b) periodic and annual reports on the activities of the Fund;
5) taking resolutions in matters concerning the assets of the Fund and investments exceeding the scope of the statutory mandate for the President of the Fund and the acquisition, disposal and burdens of real estate constituting the property of the Fund, as well as taking resolutions on the matters referred to in Article 129 (1) 2;
6) check the proper implementation of the financial plan of the Fund;
6a) making the selection of the statutory auditor to audit the financial statements of the Fund;
7) inference to the President of the Fund to carry out a check of the correctness of the proceedings on the conclusion of contracts for the provision of health care services or their implementation;
8) express an opinion on the candidate for the President of the Fund or candidates for his deputies;
9) express an opinion on the appeal of the President of the Fund or its deputies.
10) (repealed)
(1a) The Fund's Board may, by way of resolution, authorise the President of the Fund to make changes to the investment expenditure plan in kind up to the amount specified by the Council or to the extent specified by the Council.
2. In order to carry out its duties, the Board may request the President of the Fund for reports and explanations.
3. The Fund Board shall not have the right to issue the President of the Fund with binding orders concerning the current activities of the Fund.
4. Resolutions of the Fund Board shall be decided by a majority of votes in the presence of at least half of the statutory number of Council members. In the event of an equal number of votes, the President of the Council shall vote.
5. The Minister of Health shall refer the member of the Fund Board before the end of the term of office in the case of:
1) resignation from the post;
2. the loss of the capacity to perform the duties assigned to him by a long-term illness lasting at least six months, confirmed by a medical certificate;
3) unjustified absence at the 4th successive meetings of the Board of the Fund;
4) infringements of the provisions of art. 99 par. 5 and 6;
5) the final conviction for a crime committed intentionally.
6. Before the expiry of the term of office of a member of the Fund of the Fund, the Minister responsible for health may also appeal on the basis of the request of the body which requested his appointment.
7. In the event of an appeal of a member of the Board of the Fund or of his death before the expiry of his term of office, the Minister responsible for health shall appoint a new member for the remainder of this term of office The provisions of Article 4 99 par. 1 shall apply mutatis mutandis.
8. The provision of the paragraph. 7 shall not apply where, by the end of the term of office of a member of the Board of the Fund, less than 3 months have been left from the date of the appeal or of his death.
9. The President of the Council of the Fund invites you to attend the meetings of the Board, as observers, representatives of: the Supreme Medical Council, the Chief Council of Nurses and the Midwives, the Chief Pharmacy Board, the National Council of Diagnosticians The laboratory and the National Council of Physiotherapists.
10. Board of the Fund in relation to the task referred to in paragraph. 1 point 1:
1) may delegate its members to the independent exercise of control activities;
2) has an insight into any documents related to the activities of the Fund.
11. (repealed)
12. The Fund's Board shall express the opinions referred to in paragraph 1. 1 points 8 and 9, within no more than 14 days. Failure to express an opinion within this time limit is tantamount to giving a positive opinion.
Article 101. [ Entities entitled to request a meeting of the Board of the Fund] 1. The President of the Fund or at least three members of the Fund Board may request the convening of a meeting of the Board of the Fund, giving the proposed agenda. The President of the Board of the Fund shall convene a meeting no later than 14 days from the date of receipt of the request.
2. If the President of the Board of the Fund does not hold a meeting in accordance with the paragraph 1, the applicant may request the Minister responsible for health with a request to convene a meeting, stating the reason, date, place and proposed agenda.
Article 102. [ President of the Fund] 1. The activities of the Fund shall be headed by the President of the Fund, which represents the Fund outside.
2. The President of the Fund shall be appointed by the Minister responsible for health, from among persons selected by means of open and competitive recruitment after consultation of the Fund Board. The Minister responsible for health shall refer the President of the Fund after consulting the Fund Board.
3. In the event of gross violation of duties, the Minister responsible for health may cancel the President of the Fund without consulting the opinion referred to in paragraph. 2. In such a case, the Minister responsible for Health shall entrust the Fund to one of the Deputy President of the Fund and shall immediately inform the Board of the appeal of the Fund, stating its reasons.
4. (repealed)
5. The scope of action of the President of the Fund in particular shall be:
1) conduct the financial economy of the Fund;
2. the efficient and secure management of funds and the administration of the Fund, including the management of the general reserve referred to in art. 118 (1) 5;
3. the borrowing, on behalf of the Fund, of obligations, including loans and loans, subject to art. 100 para. 1 point 5;
4) preparing and presenting to the Fund Board annual forecasts, referred to in art. 120 (1) 1 and 3;
5) developing the draft financial plan of the Fund on the basis of the projects of financial plans of the Fund branches of the Fund, the forecasts referred to in art. 120 (1) 1 and 2;
6) draw up the annual financial plan of the Fund after receiving the opinion of the Board of the Fund, the committee responsible for public finances and the committee responsible for the health of the Sejm of the Republic of Poland;
7) drawing up the draft of the Fund's work plan;
8) implementation of the Fund's annual financial plan and work plan;
9) drawing up the draft of the investment spending plan in kind for the following year;
10. draw up a report on the implementation of the financial plan of the Fund for the year concerned, and immediately submit it to the Minister responsible for public finance;
11. drawing up periodic and annual reports on the activities of the Fund, containing in particular information on the availability of health care services financed from the Fund's resources;
12. supervising the accounts carried out in the framework of the implementation of the coordination provisions;
13) drawing up analyses and assessments on the basis of the information referred to in art. 106 (1) 10 point 5, transferred by the Provincial branches of the Fund;
14) presentation of the Fund to the Fund of the Fund for the remuneration of staff of the Fund;
15) the performance of the function of the employer within the meaning of the provisions of the Labour Code in relation to persons employed at the Central Fund;
16) the presence of a request to the Minister responsible for health matters for the cancellation of the director of the Fund's branch office;
17) (repealed)
18. implementation of the resolution of the Fund's Board;
19) presenting to the Fund of the Fund other information about the work of the Fund-in the form, scope and deadlines specified by the Fund's Board;
20) the transmission of the Minister of the Fund to the competent health affairs of the Fund subject to the Article 163, within 3 working days from the date of their adoption;
21) supervising the implementation of tasks of the Fund's voivodships;
21a) the carrying out of the checks referred to in Article 64 and 189, if it is apparent from the information obtained that such a check must be carried out;
22) coordinate the cooperation of the Fund with the authorities of government administration, health care institutions, social security institutions, self-governments of medical professions, trade unions, employers ' organisations, the organisations of the providers and the insured persons;
23) forwarding the Fund's branches to the implementation of health policy programmes commissioned by the competent minister;
24) taking decisions on the matters specified in the Act;
24a) consideration of appeals against administrative decisions referred to in art. 50 par. 18;
24b) consideration of appeals against administrative decisions referred to in art. 53 (1) 2a of the refund act;
25) setting uniform ways of carrying out the statutory tasks implemented by the Fund's voivodship branches;
(26) the transmission of the ministers responsible for the health of the amounts referred to in Article 4 (2). 4 and art. 34 of the Law on refunds;
26a) transmission of the monthly summary of the quantities of reimbursable prepackages of medicines, foodstuffs for particular nutritional uses and unit medical devices, together with the code of the code, to the competent health care ministies. identification of EAN or other code corresponding to the EAN code issued on the basis of art. 43a ust. 1, by the deadline of 20. the day of the month following the month to which the statement relates;
27. monthly information on the amount of the refund, together with a percentage of the total budget for the refund, as referred to in the refund act, shall be published on the monthly basis;
28) the collection and processing of information concerning the final decisions of the courts referred to in the refund act; the information shall not be made available;
29) the collection and processing of information concerning the agreements referred to in art. 41 of the Act on refunds;
30) (repealed)
31) making monthly information available to the public about the amount of refund and the amount of refunded prepackages of medicines, foodstuffs intended for particular nutritional uses and unit medical devices together with an indication of the EAN identification code or other code corresponding to the EAN code;
32. monitoring, supervising and controlling the implementation of the decision on the subject of the refund of the risk sharing instruments referred to in Article 11 (1) 5 of the Law on refunds and informing the Minister of Health on the fulfilment by the applicant of the provisions contained in that Decision;
33) the implementation of the tasks referred to in art. 22 of the Act of 19 August 2011. about the veterans of activities outside the state;
34) the conduct and maintenance of the electronic monitoring system of the lear programmes referred to in Article 188c.
6. In the case of absence or temporary inability to perform the function, within a period of not more than 6 months, the President of the Fund shall replace, on the basis of his written authorization, one of the deputies of the Fund's President. Where it is not possible to grant such an authorisation, the Minister responsible for health shall be given the authority.
6a. In the event of the death of the President of the Fund or of the cancellation of the function, until the appointment of the new President of the Fund his duties shall be the Deputy President appointed by the Minister responsible for health matters.
7. The President of the Fund may grant to the Deputy President, the Chief Accountant of the Fund and the staff of the Fund of the Fund of Plenipotentiaries to carry out certain legal acts and authorisations to make certain factual activities in the performance of the tasks referred to in paragraph 1. 5.
8. Plenipotentiaries and entitlements referred to in paragraph. 7, shall be given in writing under the rigorous annulment.
Art. 102a. [ Requirements for the candidate for the position of President of the Fund] 1. The position of the President of the Fund may occupant a person who:
1) has a higher master's or equivalent education in the field of law, economics, medicine, health care organization or management;
2) is a Polish citizen;
3) benefit from full public rights;
4) she was not convicted of a final sentence for a deliberate offense or a deliberate treasury offence;
5) has managerial competence;
6) have at least 6-year-old work placer, including at least 3-year-old seniority in the managerial position;
7) has knowledge of the scope of matters belonging to the Fund's properties.
2. Information on the position of the President of the Fund shall be announced by placing the notice in a place which is widely available at the seat of the Fund and in the Public Information Bulletin of the Fund and the Public Information Bulletin of the Chancellery of the President Council of Ministers. The notice shall include:
1. the name and address of the Fund;
2. determination of the position;
3) requirements related to the position resulting from the provisions of law;
4) the scope of the tasks performed on the post;
5) an indication of the required documents;
6) deadline and place of submission of documents;
7. information on the methods and techniques of recruitment.
3. The term referred to in paragraph 2 point 6, shall not be less than 10 days from the date of publication of the notice in the Information Bulletin of the Public Chancellery of the Prime Minister.
4. The recruitment for the position of the President of the Fund shall be carried out by a team, appointed by the Minister responsible for health, with at least 3 persons whose knowledge and experience give a guarantee of the selection of the best candidates. In the course of the selection, the applicant shall assess the applicant's professional experience, the knowledge necessary to carry out his duties as a recruitment, and the managerial competence.
5. Evaluation of the knowledge and managerial competence referred to in paragraph. 4, may be made on the order of the team by a non-member of the team who has the appropriate qualifications to make this assessment.
6. Member of the team and the person referred to in paragraph. 5, they have the obligation to keep in secret information concerning the applicants for the post obtained during the recruitment process.
7. In the course of the selection, the panel will emerges no more than 3 candidates, which are presented to the Minister of Health.
8. The team shall draw up a protocol of the following:
1. the name and address of the Fund;
2) determining the position for which the recruitment was conducted, and the number of candidates;
3) forenames, surnames and addresses of no more than 3 of the best candidates ranked according to the level of meeting the requirements laid down in the announcement of the borderline;
4. information on the methods and techniques used for the recruitment;
5) justification of the choice made or the reasons for the nominee's failure;
6) composition of the team.
9. The result of the recruitment shall be announced immediately by the inclusion of the information in the Public Information Bulletin and the Public Information Bulletin of the Chancellery of the Prime Minister. Information on the outcome of the recruitment shall include:
1. the name and address of the Fund;
2) determination of the position for which the recruitment was conducted;
3) forenames, the names of the selected candidates and their place of residence within the meaning of the provisions of the Civil Code or information about the failure of the candidate.
10. Setting up in the Public Information Bulletin of the Chancellery of the Prime Minister of the Council of Ministers announcement of the recruitment and the result of this recruitment is free of charge.
Article 103. [ Deputy President] 1. The President of the Fund shall perform his duties with the assistance of three Deputy Prime Minister.
2. The Minister of Health shall, at the request of the President of the Fund, after consultation of the Board of the Fund, appoint, of the persons selected on the basis of an open and competitive recruitment, Deputy President. The Minister of Health shall refer to the Deputy Prime Minister at the request of the President of the Fund, after consulting the Board of the Fund.
3. The Deputy Chairman of the uniformed services shall appoint, from among the persons selected by means of an open and competitive recruitment, the Minister responsible for health, at the joint request of the President of the Fund, the Minister of National Defence, the minister competent for affairs and the Minister of Justice, after consulting the Board of the Fund. The Minister responsible for Health shall refer the Deputy President to the uniformed services at the joint request of the President of the Fund, the Minister of National Defence, the Minister responsible for the internal affairs and the Minister of Justice, after consulting the Council Fund.
4. The detailed responsibilities of the Deputy Prime Minister shall be defined by the statutes of the Fund.
5. (repealed)
6. The President of the Fund and his alternates shall not at the same time:
1) the members of the Fund Board and the Board of the Fund's provincial branch
2) employees of the Provincial branches of the Fund;
3. the providers;
4) owners or employees of a pharmacy, a pharmaceutical wholesaler or an entity producing medicinal products and medical devices;
5. the holders of shares or shares in the companies carrying out the entities providing the providers and entities referred to in point 4;
6) the persons referred to in art. 112 (1) 1 points 2 to 8.
6a. The main accounting officer of the Fund shall apply the provisions of the paragraph accordingly. 6 points 2 to 5.
7. The President of the Fund shall not perform any economic activity.
8. The duties of the Deputy Prime Minister shall be in particular:
1) supervising and coordinating the activities of organizational cells for the affairs of uniformed services;
(1a) supervise and coordinate the activities linked to the implementation of the right to benefits for insured persons referred to in Article 5 points 44a and 44b;
(1b) consideration of individual cases relating to the implementation of the right to benefits for insured persons referred to in Article 3 (1) (b) of the EC 5 points 44a and 44b;
2) coordination of cooperation with the Minister of National Defence, the Minister of Justice and the Minister competent for internal affairs.
Article 103a. [ Nabór as Deputy Prime Minister and Deputy Prime Minister for Uniforms Services] 1. The team carrying out the recruitment for the posts referred to in art. 103 (1) 2 and 3, shall be appointed by the President of the Fund.
2. To conduct recruitment for the posts referred to in art. 103 (1) Articles 2 and 3 shall apply mutatis mutandis. 102a.
Article 104. [ Messages published by the President in,, Polish Monitor ''] 1. The Fund's annual financial plan, financial report of the Fund, report on the activities of the Fund The President of the Fund shall publish, in the form of a communication, in the Official Journal of the Republic of Poland "Monitor Polski".
2. The plans and reports referred to in paragraph 2. 1, and the annual work plan of the Fund shall be published on the Ministry's website serving the Minister responsible for Health and on the Fund's website.
Article 105. [ Bulletin of the National Health Fund] The President of the Fund for information and promotion purposes shall issue the Bulletin of the National Health Fund.
Article 106. [ Provincial Council of the Fund] 1. The provincial branches of the Fund operate in the provincial branches of the Fund of the Fund of an opinion-supervisory nature.
2. The Board of the provincial branch of the Fund shall be composed of nine members who are insured persons residing in the area of operation of a given branch of the provincial branch of the Fund, appointed by the Minister responsible for health matters, including:
1) two members shall be appointed from among the candidates designated by the state's purse seismist;
2. two members shall be appointed from among the candidates designated by the competent water-water;
3) one member is appointed from among the candidates designated by the convention of powiats from a given voivodship;
4) one member shall be appointed from among the candidates designated by the relevant local provincial council of social dialogue;
5) one member is appointed from among the candidates designated by the patient's rights organisations, reported within 14 days from the date of publication on the pages of the Public Information Bulletin of the Office serving the Minister the competent health of the notice of the intention to appoint a member of the Board;
6. one member shall be appointed from among the candidates designated by the representative employers ' organisations;
7) one member is appointed from among the candidates designated jointly by the competent head of the voivodship of the military staff, the competent commandant of the Voivodship Police and the competent commandant of the Provincial Fire Service.
3. The tenure of the Board of the Provincial Branch of the Fund shall be four years, counting from the date of the first meeting of the Board of the provincial The first meeting of the Board of the Provincial Branch of the Fund shall be convened by the Minister for Health
4. The Chairman of the Board of the Provincial Branch of the Fund invites to participate in the meetings of the Board of the Branch of the Voivodship Fund, as observers, representatives of the competent district medical council, the district council of nurses and midwives and the district council of the Pharmacy, the National Council of Laboratory Diagnostics and the National Council of Physiotherapists.
5. Where more than one district medical council is operating in the area of the province, the district council of nurses and midwives or the district council of the pharmacy, these councils shall delegate the joint representative to attend the meetings of the branch of the branch office. Voivodship Fund.
6. The councils of the Provincial branches of the Fund may consist only of persons who:
1) enjoy full public rights;
(2) have a higher education;
3) they have not been legally convicted of a crime committed intentionally.
7. The members of the Board of the Provincial Branch of the Fund may not be simultaneously:
1) directors of provincial branches of the Fund and employees of the Fund's provincial branch;
2) the President of the Fund;
3) the Deputy President of the Fund;
4. staff of the Fund's head office;
5. the providers;
6) owners or employees of a pharmacy, a pharmaceutical wholesaler or an entity producing medicinal products and medical devices;
(7) the holders of shares or shares in the companies engaged in the entities referred to in points 5 and 6;
8) the persons referred to in art. 112 (1) 1 points 2 to 8, with the exception of the staff of the offices serving the ministers who are the entities in which they are forming.
8. Members of the Councils of the Provincial branches of the Fund shall elect from among their chairman.
9. The Board of the Provincial Branch of the Fund shall act on the basis of the regulations enacted.
10. The tasks of the provincial branch of the Fund shall be:
1) opinion of the project of the financial plan of the Fund's provincial branch;
2) the establishment plan of the branch of the Fund's provincial branch;
3) the opinion of the report on the implementation of the financial plan of the Fund's branch of the Fund for the year;
4) monitor the correctness of the proceedings on the conclusion of contracts for the provision of health care services and the implementation of such contracts;
5) monitoring, on the basis of the information provided by the director of the voivodship branch of the information referred to in art. 23 (1) 2 and 4, the way of carrying out the obligations referred to in Article 4 by the healthcare providers. 20 and art. 21;
6) controlling the current activity of the Fund's provincial branch in all areas of its activities;
7) presence to the director of the voivodship branch with the application for the initiation of an inspection in the art mode. 64;
8) presence to the director of the voivodship branch to carry out an audit of the implementation of concluded contracts for the provision of health care
9) make periodic analyses of complaints and requests made by insured persons, excluding cases subject to medical supervision;
10) occurrence to the President of the Fund for carrying out the inspection of the Fund's branch office;
11) issue an opinion on the candidate for the position of the director of the Fund's provincial branch;
12) the presence of a request to the Minister responsible for health matters for the cancellation of the director of the Fund's branch office in the cases referred to in art. 107 (1) 4.
11. Resolutions of the provincial branch of the Fund shall be decided by a majority of votes in the presence of at least half of the statutory number of council members. In the event of an equal number of votes, the President of the Council shall decide.
12. In order to carry out its duties, the Board of the Fund's branch office may request the director of the provincial branch of the reports and explanations.
13. The Board of the Fund Branch of the Fund shall not have the right to issue the director of the branch office of the Fund for binding orders concerning the current activities of the Fund's branch office.
14. Board of the provincial branch of the Fund in connection with the task referred to in the paragraph. 10 point 6:
1) may delegate its members to the independent exercise of control activities;
2) has an insight into any documents related to the activities of the Fund's provincial branch.
15. The Minister of Health shall refer a member of the Board of the provincial branch of the Fund before the expiry of his term of office in the case of
1) resignation from the post;
2. the loss of the capacity to perform the duties assigned to it by a long-term illness lasting at least 6 months, confirmed by a medical certificate;
3) unjustified absence at the 4th successive meetings of the Board of the Provincial Branch of the Fund;
4) infringements of the provisions of the paragraph 7;
5) the final conviction for a crime committed intentionally.
16. In the case of dismisses of a member of the Board of the provincial branch of the Fund or his death before the expiry of the term of office of that Board, the Minister responsible for health shall appoint a new member for the remainder of this term The provisions of the paragraph 2 shall apply mutatis mutandis.
17. The provision of the paragraph. 16 shall not apply where, by the end of the term of office of a member of the Board of the Provincial Branch of the Fund, less than 3 months are left from the date of its appeal or death.
18. Members of the Board of the Provincial Branch of the Fund shall not be entitled to remuneration
19. Members of the Board of the Branch shall be entitled to reimbursement of travel expenses, accommodation and subsistence allowance under the rules laid down in the provisions on the amount and conditions for determining the claims of the employee employed in the state or local government a unit of the budget sphere for a business trip within the country.
Article 107. [ Director of the Fund's provincial branch] 1. The director of the provincial branch of the Fund directs the provincial branch of the Fund and represents the Fund outside in the scope of the properties of the given branch.
2. The Director of the provincial branch of the Fund shall appoint and dismiss the Minister responsible for health, after consulting the Board of the Fund's branch office and the President of the Fund. Failure to deliver an opinion within 14 days is tantamount to accepting the candidate of the director of the provincial branch of the Fund or with the consent of his appeal.
3. The director of the provincial branch of the Fund may be the person who:
1) has a higher education;
2) have the knowledge and experience giving a handle to the proper performance of the duties of the Director;
3) she was not legally convicted of a crime committed intentionally.
4. The Board of the provincial branch of the Fund may request the Minister responsible for health matters for the appeal of the director of the provincial branch of the Fund, where the director of the provincial branch of the Fund:
1) will not present the council of the provincial branch of the Fund:
(a) the draft financial plan of the Fund's provincial branch
(b) the draft work plan of the Fund's provincial branch
c) reports on the implementation of the financial plan of the Fund's branch of the Fund for the year,
(d) the annual forecast of revenue and costs of the Fund's provincial branch;
2) shall not grant, within the period prescribed by the Board of the Fund's branch office, information on the current activity of the Fund's provincial branch;
3) blatantly violates statutory obligations.
5. The tasks of the director of the provincial branch of the Fund shall:
1) the efficient and secure management of the financial resources of the Fund's branch office;
2) preparation and presentation of the Board of the Provincial Branch of the Fund Annual forecasts of revenues and costs;
3) preparing and presenting the council of the provincial branch of the Fund of the project of the financial plan of the provincial branch of the Fund for the next
3a) drawing up the plan for the purchase of benefits;
4) drawing up the project of the work plan of the Fund's branch office;
5) implementation of the financial plan of the provincial branch of the Fund and the work plan of the Fund's branch office;
6) drawing up a report on the implementation of the financial plan of the Fund's branch of the Fund for the year;
7) drawing up periodical and annual reports on the activities of the Fund's provincial branch;
8) carry out procedures for the conclusion of contracts for the provision of health care services, including high-pecciary benefits;
9) making selection of the realisers of health policy programmes, including on behalf of a given minister;
10) concluding and settling contracts for the provision of health care services, including high-specialist benefits and lear programmes specified in the provisions of the refund Act, and the conclusion and settlement of contracts for the implementation of health programmes;
11) the implementation of the task referred to in art. 108;
12) control and monitoring:
(a) Medical ordinations,
(b) the implementation of contracts for the provision of healthcare services,
(c) the implementation of the right to benefits for insured persons referred to in Article 5 points 44a and 44b;
13) carry out checks on the healthcare providers, pharmacies and persons referred to in the refund act, with the exception of the doctor of health insurance, the health insurance feller, health insurance nurses and midwife health insurance referred to in art. 15a ust. 1 and 2 of the Act of 15 July 2011. about the nursing and midwife's professions;
14) monitoring of the advisability, provided under contracts, health care benefits;
15) the performance of the function of the employer within the meaning of the provisions of the Labour Code in relation to persons employed in the Fund's provincial branch;
16) issuing individual decisions in matters of health insurance;
17) granting, at the request of the President of the Fund or the Board of the Fund's branch office, information about the current activity of the voivodship branch;
18) perform other tasks specified in the Act;
19) conduct of proceedings for the conclusion of contracts with the authorising teams of medical rescue teams for carrying out medical rescue operations, concluding, clearing and controlling the implementation of these contracts, on the basis of the Act of 8 September 2006. o State Medical Rescue;
20) containment of voluntary health insurance contracts referred to in art. 68;
21) (repealed)
22) (repealed)
23. issuing administrative decisions referred to in art. 50 par. 18;
24. issuing the administrative decisions referred to in Article 52a (e) 2a of the refund act.
6. The director of the provincial branch of the Fund shall not be simultaneously:
1) the President of the Fund or its deputy;
2. the Fund's chief accountant;
3. a staff of the Fund's headquarters;
4) a provider;
5) the owner or employee of a pharmacy, a pharmaceutical wholesaler or an entity producing medicinal products and medical devices;
6) the holder of shares or shares in the companies carrying out the entities providing the providers and entities referred to in point 5;
7) the person referred to in art. 112 (1) 1 points 2 to 9.
7. The director of the provincial branch of the Fund shall not perform business activity.
8. The director of the provincial branch, performing the tasks referred to in the paragraph. 5, cooperates with the bodies of local government units, providers of providers and insured persons operating in the given voivodship, in order to continuously monitor and secure the health needs of the recipients on the premises of the Voivodship and the proper implementation of the Fund's tasks
Art. 107a. [ Recruitment for candidates for work in the Fund] 1. The recruitment of candidates for employment in the Fund shall be open and competitive.
2. The notice of the establishment shall be published in the Public Information Bulletin, as referred to in the Act of 6 September 2001. on access to public information (Dz. U. of 2015 items 2058 and from 2016. items 34, 352 and 996), and in a place commonly available in the organisational unit in which the recruitment is conducted.
Article 107b. [ Information on candidates reporting to the recruitment] Information on candidates who have made reference to recruitment shall constitute public information within the scope of the requirements set out in the notice of recruitment.
Article 107c. [ Deadline for submission of documents] The time limit for the submission of documents, as specified in the notice of appointment, shall not be less than 14 days from the date of publication of this notice in the Public Information Bulletin.
Article 107d. [ Disseminating the list of candidates] 1. After the expiry of the time limit for the submission of the documents specified in the notice of recruitment, the list of candidates who meet the formal requirements specified in the notice of recruitment shall be disseminated without delay, by placing it in a widely available place in the organisational unit in which the recruitment is carried out, and by publishing it in the Public Information Bulletin.
2. The list referred to in paragraph. 1, contains the name of the candidate and his/her place of residence within the meaning of the provisions of the Civil Code.
Art. 107e. [ Minutes of call for candidates] 1. A record of the recruitment of candidates for job vacancies in the Fund shall be drawn up.
2. The Protocol shall include in particular:
1) determining the position of the work for which the recruitment was conducted, the number of candidates and the names, surnames and addresses of no more than 5 of the best candidates ranked according to the level of meeting the requirements laid down in the announcement of the appointment;
2. information on the methods and techniques used for the recruitment;
3) justification of the choice made.
Article 107f. [ Disseminating information on recruitment results] 1. Information on the result of recruitment shall be disseminated within 14 days from the date of employment of the selected candidate or termination of the recruitment, where no candidate has been employed in his result.
2. The information referred to in paragraph 1. 1, contains:
1. the name and address of the office;
2) determine the position of the work;
3) the name of the candidate and his place of residence within the meaning of the provisions of the Civil Code;
4) justification of the choice made by the candidate or justification for the non-employment of any candidate.
3. Information on the result of recruitment shall be disseminated in the Public Information Bulletin and in a place which is widely available in the organisational unit where the recruitment was conducted.
Art. 107g. [ Employment of another person in the list] If the employment relationship of a person who has been chosen by recruitment has ceased within three months of the date of establishment of the employment relationship, another person may be recruited from among the best candidates listed in the minutes of the recruitment. The provisions of Article 4 107f shall apply mutatis mutandis.
Article 108. [ Objectives financed by the Fund's provincial branch] 1. The branch of the Fund shall finance:
1) a healthcare provider established in the area of the voivodship with which the contract for the provision of health care services is concluded, the costs of health care benefits granted on the territory of a given voivodship to the recipient other than the insured, meeting the income criterion referred to in Article 8 of the Act of 12 March 2004. social assistance for which there is no evidence of the existence of the circumstances referred to in Article 12 of this Act, subject to the paragraph. 2,
2) the pharmacy, established on the territory of the voivodship, the costs of medicines, foodstuffs for particular nutritional uses and medical devices issued to the person referred to in point 1
-in so far as the financing of such costs does not follow the provisions laid down in the Article. 12 and 13 or international agreements.
1a. The branch of the Fund shall finance the healthcare provider established on the territory of the voivodship with which the contract for the provision of health care services is concluded, the costs of health care benefits granted on the territory of a given voivodship to persons, o which are referred to in art. 2. 1 points 3 and 4 and in Article 12 paragraphs 2 to 4, 6 and 9, subject to paragraph 1. 2.
2. The costs of treating the health care of the recipient referred to in paragraph. 1 point 1 and in paragraph. 1a, shall be borne by the provincial branch of the Fund competent for its place of residence and, if the place of residence cannot be determined, the branch office of the Fund competent due to the place of issue of the referral referred to in art. 33 (1) 1.
Article 109. [ Consideration of individual cases in the field of health insurance] 1. The director of the provincial branch of the Fund shall consider individual matters in the field of health insurance. Individual cases of health insurance include matters relating to the coverage of health insurance and the establishment of the right to benefits.
2. The cases referred to in paragraph 2. 1, there are no cases in the scope of extinction and collection of health insurance contributions belonging to the characteristics of social security bodies.
3. An application for consideration of the case referred to in the paragraph. 1, report the insured and, in the field of health insurance coverage, may report in particular the Social Insurance Institution, the Agricultural Social Insurance Fund or a family member of the insured person, also in relation to the coverage insurance during the period preceding the submission of the application.
3a. Where the applicant is the Social Insurance Institution or the Agricultural Social Insurance Fund, the application referred to in paragraph 1 shall be added to the application referred to in paragraph 1. 3, the applicant shall attach copies of the documents held and information justifying the content of the request.
4. The director of the provincial branch of the Fund shall consider the matters referred to in the paragraph. 1, within a period of not more than 30 days from the day of their transfer, by issuing a decision. The reasons for the decision shall be taken from the office
5. An appeal against the decision issued in the cases referred to in the paragraph. 1, shall be submitted to the President of the Fund within 7 days from the date of its receipt.
6. In the cases referred to in paragraph. 1, to the extent not regulated by this Act, the provisions of the Code of Administrative Procedure shall apply.
Article 109a. [ Individual interpretations] 1. The director of the provincial branch of the Fund shall issue the individual interpretations referred to in art. 10 of the Act of 2 July 2004. about the freedom of economic activity (Dz. U. of 2015 items 584, as late. zm.), w zakresie matters concerning coverage of health insurance. Individual interpretations together with the application for interpretation, after deletion of the identifying data of the applicant and other entities indicated in the interpretation, the director of the Fund's branch office shall immediately transfer to the head office The Fund, which shall immediately include it in the Public Information Bulletin.
2. The cases referred to in paragraph 2. 1, there are no cases concerning the health insurance contributions belonging to the property of the social security bodies on the basis of art. 62a of the Act of 20 December 1990. on the social insurance of farmers and on the basis of art. 83d of the Act of 13 October 1998. the social security system.
Article 110. [ The complaint to the administrative court] From the decision of the President of the Fund in individual cases of health insurance, there is a complaint to the administrative court.
Article 111. [ Application of the provisions on social insurance of farmers] For the treatment of health insurance for farmers and persons subject to social insurance for farmers and farmers receiving pensions or agricultural pensions, the provisions on social insurance of farmers shall apply, with the exception of persons. subject to social insurance for farmers and for collecting structural annuities paid by a different institution than the Agricultural Social Insurance Fund.
Article 112. [ Non-connectivity of the Fund's employee function with certain other functions] 1. The employees of the Fund shall not be simultaneously:
1) healthcare providers who have entered into contracts for the provision of health care services or apply for the conclusion of such contracts;
2) the owners, employees or persons cooperating with the providers who have entered into contracts for the provision of health care services or are applying for the conclusion of such contracts;
3) the members of the bodies or employees of entities constituting within the meaning of the provisions on the activity of the medicinal
4) members of bodies or employees of local government units;
5) the members of the bodies of the insurance undertaking conducting the insurance business on the basis of the Act of 11 September 2015. about insurance and reinsurance activities (Dz. U. Entry 1844 and from 2016. items 615);
6) the owners of shares or shares in the trading companies conducting the entities referred to in point 2;
7) the owners in the commercial companies of more than 10% of shares or shares representing more than 10% of the share capital-in each of these companies, in the case of companies other than those referred to in point 6;
8. Members, Members of the European Parliament, or senators;
9) members of the Fund Board and the councils of the Fund's voivod
2. The Fund's employees may not without the consent of the President of the Fund:
1) take up employment with another employer;
2) perform business activities.
Chapter 2
Financial management of the Fund
Article 113. [ Principles of conduct of financial economy] The Fund shall conduct the financial economy on the basis of the principles set out in the
Article 114. [ Financial resources of the Fund and its banking support] 1. The financial resources of the Fund shall be public funds.
2. The bank support of the Fund shall be run by Bank Gospodarstwa Krajowego.
Article 115. [ Basic Fund and Fund Spare Fund] 1. The Fund shall be set up and the Fund's backup fund.
2. The backup fund shall be increased by the approved net profit for the financial year.
3. The reserve fund shall be reduced by the approved net loss for the financial year.
Article 116. [ Fund Revenues] 1. The Fund's arrival shall be:
(1) health insurance premiums due;
(2) interest on unpaid health insurance premiums;
3) donations and records;
4) the funds transferred to the execution of tasks commissioned within the scope set out in the Act;
5) grants, including the special-purpose grants for the financing of tasks referred to in art. 97 ust. 3 points 2a-2c, 3 and 3b;
6) the funds obtained from the claims of regressions;
(7) income from investments;
7a) (repealed)
7b) the amounts referred to in Article 4 par. 10 of the Act on refunds;
7c) the amounts referred to in Article 34 par. 6 of the Act on refunds;
7d) the amount of the penalties imposed by the Minister responsible for the health of the monetary penalties referred to in Article 3 (1) of the basic Regulation. 50-52 of the refund act;
7e) the amount of the reimbursement of the part of the refund referred to in Article 3. 11 (1) 5 point 4 of the refund act;
8) other revenue.
1a. Revenue as referred to in paragraph 1. 1, it shall be reduced by a copy of the tarification of the benefits referred to in Article 3. 31t ust. 5-8.
2. The financial resources of the Fund may also come from loans and loans.
Article 117. [ Costs incurred by the Fund] 1. The costs of the Fund shall be:
1) the costs of health care benefits for insured persons;
1a) (repealed)
2) the costs of health care benefits for the persons entitled to those benefits under the rules on coordination;
(3) the costs of the refund fixed by the refund act;
4) the cost of the task referred to in art. 97 ust. 3 points 2a, 3 and 3b;
5) the costs of tasks outsourced within the scope specified in the Act;
6) the costs of the operations of the Fund, in particular depreciation costs, costs related to the maintenance of the property, the costs of salaries together with the torches, allowances and reimbursements of travel expenses;
7) collection costs and records of contributions to health insurance;
8) the cost of the compensation payment;
9) other costs resulting from separate regulations.
2. The financial resources of the Fund may also be allocated to the repayment of loans.
Article 118. [ Financial plan of the Fund] 1. The President of the Fund shall draw up an annual financial plan of the Fund in terms of revenue and expenditure.
2. In the financial plan of the Fund the President of the Fund shall specify the
1) planned costs for the headquarters, including:
(a) the financing costs of the central business,
(b) provisions for the costs of carrying out the tasks resulting from the coordination provisions,
(c) (repealed)
(d) provisions for the costs of carrying out the tasks resulting from Article 42b,
2) the planned costs of individual branches of the Fund, including:
(a) the costs of financing the activities of individual
(b) reserves for the costs of health care benefits under the migration of insured persons,
(c) the reserve referred to in Article 3 para. 3 of the Act on refunds,
3) the total revenue and costs of the Fund.
3. Planned funds to cover the costs of financing by the provincial branches of the Health Care Benefits Fund for the insured, excluding the appropriations corresponding to the revenue mentioned in art. 125, is divided between the Provincial branches of the Fund, taking into account:
1) the number of insured persons registered in the Fund's provincial branch;
2) separated, by age and sex, group of insured persons and separate groups of health care services, including high-specialistic benefits;
3) the health risk corresponding to a given group of insured persons, within the scope of a given health care benefit group, compared with the reference group.
4. The planned costs of financing the health care benefits by a given branch of the Fund's voivodship shall not be lower than the amount of financing of the health care benefits for the given branch in the previous year, planned in the financial plan, referred to in art. 121 (1) 3 and 5 and Art. 123 3.
5. In the financial plan referred to in art. 121 (1) 3 and 5 and Art. 123 3, a general reserve of 1% of the planned revenue for the health insurance premiums is created.
6. The provisions of the paragraph. 3 and 4 do not apply as regards the funds transferred to the Fund from the state budget under the provisions of the Act of 8 September 2006. o State Medical Rescue.
Article 119. [ Delegation] The Minister for Health, in consultation with the Minister responsible for public finance, after consulting the President of the Fund, will determine, by way of regulation, the detailed modalities and criteria for the allocation of funds between headquarters and branches Voivodship Fund for the financing of health care services for the insured persons, taking into account the provisions of Article 118.
Article 120. [ Annual revenue forecast for the next 3 years] 1. The President of the Fund in agreement with the Minister responsible for public finance and the Minister of Health shall, by 1 June, draw up an annual forecast of the revenue for the following three years.
2. Directors of the Provincial branches of the Fund shall provide information on the forecast costs of the branches by 5 June on the basis of the forecast referred to in paragraph. 1.
3. The President of the Fund, in agreement with the Minister responsible for public finance and the minister competent for health, shall, by 15 June, draw up an annual cost estimate for the next 3 years on the basis of the information provided by the the directors of the Fund's provincial branches.
4. The President of the Fund shall, by 20 June, inform the directors of the provincial branches of the Fund of the anticipated costs of branches of the Fund's voivodships
5. The directors of the voivodship branches shall submit to the President of the Fund by the deadline of 25 June projects of financial plans of the Fund's branches.
(6) The forecasts referred to in paragraph 1. 1 and 3, and draft plans referred to in paragraph 1. 5, they are the basis for drawing up the draft financial plan for the following year.
7. The Social Insurance Institution, the Agricultural Social Insurance Fund, the authorities of the governmental administration, local government units, the healthcare provider and other institutions shall grant the funds necessary for the preparation of the Fund free of charge. the forecasts referred to in paragraph 1. 1 and 3.
Article 121. [ Develop a draft financial plan] 1. The President of the Fund shall draw up the draft financial plan of the Fund and present it, for an opinion, by 1 July of the year preceding the year to which this plan relates:
1. the Council of the Fund;
2) the committee responsible for public finance affairs and the committee responsible for the health of the Sejm of the Republic of Poland.
2. The non-issuing of opinions referred to in paragraph 1. 1, within 14 days from the date of receipt of the draft financial plan, shall be tantamount to giving a positive opinion.
3. The President of the Fund after considering the opinions referred to in paragraph. 1, if they have been issued, draw up the financial plan of the Fund and forward it together with those opinions by 15 July of the year preceding the year to which the plan relates, to the Minister responsible for health.
4. The Minister of Health shall, in agreement with the Minister responsible for public finance, approve the financial plan of the Fund by 31 July of the year preceding the year to which the plan relates.
5. In the event that the President of the Fund does not submit within the period referred to in paragraph. The financial plan of the Fund, the minister responsible for health, in agreement with the minister responsible for public finance, shall determine by way of order the financial plan of the Fund by 31 July of the year preceding the year to which that plan applies.
Article 122. [ Conditions of action of the Fund on the basis of a financial plan] In the case of:
1) the non-approval of the financial plan of the Fund, within the time limit referred to in art. 121 (1) 4, or
2) the failure to establish a financial plan in accordance with the procedure laid down in Article 123 3
-The Fund shall act on the basis of the financial plan referred to in Article 3. 121 (1) 3.
Article 123. [ Grounds for refusal to approve the financial plan of the Fund] 1. Where the financial plan of the Fund violates the law or leads to a failure to balance the revenue and costs of the Fund, the minister competent for health in agreement with the Minister responsible for public finance shall refuse to approve the plan the Fund's financial assistance and recommends the President of the Fund to remove irregularities, specifying a deadline for amendments of not more than 7 days.
The financial plan of the Fund shall be amended by the President of the Fund, taking account of the recommendations referred to in paragraph 2. 1, and shall immediately submit it to the Minister responsible for health for approval in accordance with the procedure referred to in Article 1. 121 (1) 4.
3. In the case of the failure of the President of the Fund to remove the irregularities referred to in paragraph. 1:
1. the Minister responsible for health, in agreement with the Minister responsible for public finance, shall amend the financial plan of the Fund and establish it by way of order of management and.
2) (repealed)
Article 124. [ Changes in the Fund's financial plan] 1. Changes to the financial plan of the Fund may be made in the event of a situation which could not have been foreseen at the time of approval or the establishment of the plan.
2. Changes to the financial plan of the Fund approved in the mode referred to in art. 121 (1) 4, the President of the Fund may be made. The provisions of Article 4 121 (1) 1-4 shall apply mutatis mutandis.
3. Changes to the financial plan of the Fund established in accordance with art. 121 (1) 5 or Art. 123 3 may make the Minister competent for health in consultation with the Minister responsible for public finance on a reasoned request of the President of the Fund. The request for amendment of the plan shall be accompanied by the opinion of the Board of the Fund, the opinions of the committee responsible for public finances and the committee responsible for health of the Sejm of the Republic of Poland.
4. The President of the Fund, after informing the Minister responsible for health and the minister responsible for public finance, may make an offset of the costs in the financial plan of the Fund's headquarters and the transfer of costs within the cost the financial plan of the Fund, as well as to amend the financial plan as regards the funds transferred to the National Health Fund from the state budget grant.
5. The director of the provincial branch of the Fund, after informing the President of the Fund, may make a transfer of costs within the costs for the provision of health care in the financial plan of the provincial branch of the Fund.
6. The President of the Fund shall decide on the activation of the general reserve after obtaining the positive opinions of the Minister responsible for health and the Minister responsible for public finance.
7. The President of the Fund shall decide on the activation of the reserve referred to in art. 118 (1) 2 point 1 (c) (b) and point 2 (b) and the reserve referred to in Article 2 (2) (b) and 3 para. 3 of the refund act, after informing the Minister responsible for health and the Minister responsible for public finance. The President of the Fund shall decide on the activation of the reserve referred to in Article 4. 118 (1) 2 point 2 (b) and the reserve referred to in Article 2 3 para. 3 of the Act on refunds, upon request of the Director of the Fund's branch office.
8. Changes to the financial plan of the Fund referred to in paragraph 1 1-3, shall be carried out in accordance with the rules laid down in the Article. 118, provided that in the event of a revision of the financial plan of the Fund providing for an increase in the planned costs of the health care benefits of the branches of the Fund, the rules set out in the art. 118 (1) 3 shall apply to the amount of the increase in these costs.
9. To the changes in the financial plan referred to in paragraph 1. 4-7, and to amend the financial plan resulting from the art. 129 (1) Articles 3 and 4 shall not apply to the provisions of Article 3. 118 (1) 3 and Art. 121.
10. (repealed)
11. (repealed)
Article 125. [ Purpose of certain revenue of the Fund] Revenue of the Fund:
1. not included in the financial plan as determined in accordance with Article 3 (1) of the 121 (1) 3, para. 5 or of art. 123 3:
(a) for surplus revenue over the cost of correcting the costs of health care benefits from previous years,
(b) in excess of the excess revenue over the costs of financial activities,
2) coming from grants intended to finance health care benefits
-in the section concerning the provincial branch of the Fund, it is intended to cover the costs of health care benefits in this branch of the Fund.
Article 126. [ Annual report on the implementation of the financial plan of the Fund's branch office] 1. The Director of the Fund's branch office shall draw up an annual report on the implementation of the financial plan of the Fund's branch office
2. The report referred to in paragraph 2. 1, shall be subject to approval by the Board of the provincial branch of the Fund after carrying out the examination of the report referred to in art. 128 (1) 4, by a certified auditor.
Article 127. [ Borrowing of loans and loans to ensure financial liquidity of the Fund] 1. The President of the Fund may borrow and loans, after obtaining the consent of the Minister responsible for public finance and the minister competent for health matters. The amount of the instalments of loans to be repaid in a given year shall not exceed the amount of the general reserve provided for in the financial plan for the year in question.
2. The provision of the paragraph. The second sentence shall not apply to measures coming from the State budget.
3. Where the financial plan of the Fund takes account of the use of financial resources from loans and loans referred to in paragraph 3. 1, or take into account the repayment of the instalments of these loans and loans, in part not included in the costs of the Fund, the rules laid down in Art. 118 (1) 1 shall not apply.
4. In the case referred to in paragraph. 3, the difference between the revenue and the costs in the financial plan of the Fund may not be higher than the difference between the amount of the funds derided from the loans and the loans and the amount of the loans to be repaid in part not to be included in the financial plan the costs of the Fund, subject to Article 129 (1) 3.
Article 128. [ Accounting Principles of the Fund] 1. The Fund shall keep accounts under the rules laid down in the Act of 29 September 1994. of accounting, excluding art. 80 par. 3 of this Act.
2. The Fund's Central Fund and branches of the Fund shall prepare their own financial statements.
3. Total financial statements of the Fund referred to in art. 51 of the Act of 29 September 1994. on accounting, shall be drawn up by the President
4. Total financial statements referred to in paragraph 3, shall be subject to examination by a statutory auditor and shall be approved by the Minister responsible for public finances after consulting the Minister responsible for health.
5. The Minister responsible for public finances or the Minister responsible for health may request additional data on the Fund's total financial statements.
Article 129. [ The purpose of net profit and net loss coverage for the year] 1. The approved net profit for a given financial year shall be allocated to:
1) coverage of losses from previous years;
(2) the backup fund.
2. The Board of the Fund shall decide on the coverage of net loss or the purpose of net profit, taking into account the priority to cover losses from previous years, shall be decided by the Fund.
3. In the period between the adoption by the Council of the Fund of the resolution referred to in paragraph. 2, in a given year and the adoption by the Council of the Fund for a resolution referred to in paragraph 1. 2, the following year, the planned costs of health care benefits in the financial plan in force during that period or drawn up during that period may be increased, with the total increase of the planned costs of health care benefits in may not be greater than the amount of the backup fund. In this case, the rule laid down in the Article shall not apply. 118 (1) 1.
4. In the case referred to in paragraph. 3, when determining the amount of funds transferred to individual branches of the Fund for the financing of health care benefits shall be taken into account in particular the financial results of branches of the Fund's branches for previous financial years.
5. (repealed)
6. When applying art. 118 (1) 4 to the financial plan for the following year, no account shall be taken of the funds transferred to the Fund's branches in accordance with the paragraph. 3 and 4.
Article 130. [ The deadline for the annual report on the implementation of the Fund's financial plan] 1. The President of the Fund, on the basis of the reports referred to in art. 126, draw up an annual report on the implementation of the financial plan of the Fund, no later than 6 months after the end of the year to which the report relates.
2. The Board of the Fund shall adopt the report referred to in paragraph 1. 1, within 15 days from the date of its receipt.
3. The report referred to in paragraph 1. 1, shall be subject to approval by the Minister responsible for public finances after consultation of the Minister responsible for health and after obtaining the opinion of the committee responsible for public finances and the committee responsible for health matters Sejm of the Republic of Poland.
4. The non-issuing of opinions referred to in paragraph 3, within 14 days from the date of receipt of the draft report is tantamount to issuing positive opinions.
Article 131. [ Periodic reports on the financial plan] 1. The Fund shall be required to draw up periodic reports on the implementation of the financial plan and to communicate them to the Minister for Public Finance and the Minister for Health.
2. The Minister responsible for public finances in agreement with the minister responsible for health shall determine, by means of the regulation, the detailed rules for conducting the financial economy of the Fund, including:
1) the types of reports referred to in paragraph. 1, the way they are created and the time limits for transmission,
2) how to create a financial plan and annual report on the implementation of the financial plan and their designs
-having regard to the need to ensure sound and fair management of public funds.
Article 131b. [ Plan of purchase of health care benefits] 1. The director of the provincial branch of the Fund shall draw up a plan to purchase health care benefits for the following year, taking into account the Regional Map and the state of availability to health care benefits in the area of the voivodship
2. The plan for the purchase of health care benefits consists of:
1) a general part containing, in particular, an indication of the priorities for financing health care services, taking into account the priorities for the regional health policy, together with the justification;
2) the detailed part specifying in particular the territorial areas for which proceedings for the conclusion of contracts for the provision of health care services are carried out, and the maximum number of contracts for the provision of health care services, which will be concluded in a given area, in a given area or type of benefit.
CHAPTER VI
Procedure for the conclusion of contracts with service providers
Article 132. [ Agreement on the provision of health care services] 1. The basis for the provision of health care benefits financed from public funds by the Fund is an agreement for the provision of health care services concluded between the provider and the Fund, subject to art. 19 (1) 4.
2. The contract for the provision of health care benefits may be concluded only with the provider, who has been selected to provide health care benefits under the conditions specified in this chapter.
3. Unable to conclude a contract for the provision of health care benefits with a doctor, nurse, midwife, another person performing a medical profession or a psychologist, if they grant health care benefits to the healthcare provider who has entered into an agreement o provision of health care benefits with the Fund.
4. The provision of health care not specified in the contract for the provision of health care benefits financed by the Fund shall be awarded to the insured persons only in the cases and under the conditions stipulated in the Act.
5. The amount of the total commitments of the Fund arising from the contracts concluded with the service providers may not exceed the amount of the costs provided for that purpose in the Fund's financial plan.
Art 132a. [ The common application for the conclusion and execution of a contract for the provision of health care services] 1. The providers may jointly apply for the conclusion and execution of a contract for the provision of health care services, the subject of which is the provision of health care benefits in not less than two of the ranges referred to in art. 15 para. 2 points 2-8, 10-13, 15 and 16.
2. In the case referred to in paragraph. 1, the healthcare providers shall establish a proxy to represent them in the proceedings for the provision of health care services and the conclusion of the contract for the provision of health care benefits.
3. The healthcare providers referred to in paragraph 3. 1, shall be jointly and severally liable for the implementation of the contract for the provision of health care services.
(4) The provisions relating to the healthcare provider shall apply mutatis mutandis to the providers referred to in paragraph 1. 1.
Article 133. [ Outsourcing of health care benefits to subcontractors] Providers may contract subcontractors to provide health care services under a health care contract concluded with the Fund if the contract so provides. Article Recipe 132 (1) 3 shall apply mutatis mutandis.
Article 134. [ The protection of equal treatment of healthcare providers applying for the conclusion of a contract for the provision of health care services] 1. The Fund shall be obliged to ensure equal treatment of all providers of applicants for the conclusion of a contract for the provision of health care services and conduct the proceedings in such a way as to ensure that fair competition is maintained.
2. All requirements, explanations and information, as well as the documents related to the proceedings concerning the conclusion of the contract for the provision of health care benefits shall be made available to the healthcare provider under the same conditions.
Article 135. [ Disclosure of tenders and contracts for the provision of health care services] 1. Offers submitted in the proceedings for the provision of health care benefits and the contract for the provision of health care services shall be made public.
2. The Fund shall implement the principle of openness:
1) agreements-by posting on its website the information on each contract concluded, taking into account the maximum amount of the Fund's obligation to the healthcare provider resulting from the concluded contract, type, number and price of the benefits purchased either the type of benefits purchased, the number of units of account (measure taken to determine the value of the healthcare provision to a particular extent or type, in particular: point, advice, or persons) expressing the value of the benefit; and the price of the unit of account, and the maximum amount of the undertaking The Fund to the healthcare provider resulting from all the contracts concluded;
2) tenders, excluding information constituting the secret of the entrepreneur, which was reserved by the provider-in particular by allowing access to these offers.
3. The information referred to in paragraph. Article 2 (1) shall be entered within 14 days from the date on which the contract for the provision of health care is concluded.
Article 136. [ Contract Content] 1. The contract for the provision of health care benefits shall specify in particular:
1) the type and scope of the health care benefits provided;
2) the conditions for the provision of health care benefits;
2a) the way of implementing the risk sharing instruments referred to in art. 11 (1) 5 of the Act on refunds concerning a given medicinal product or foodstuff for particular nutritional uses-in the case of a contract for the provision of health care services from the scope referred to in art. 15 para. 2 points 15 and 16;
3) the list of subcontractors and the requirements for them other than technical and sanitary ones, specified in separate regulations;
4. the rules of the accounts between the Fund and the providers;
5) the amount of the Fund's commitment to the healthcare provider;
6) the principle of dealing with disputed issues;
7) an order to terminate the contract, which may occur with a prior notice period of not less than 3 months, unless the parties decide otherwise;
8) the provision of a contractual penalty in the event of failure to apply the term and the mode set out in point 7.
2. In the case of a contract for the provision of health care benefits from the scope of hospital treatment or outpatient care in the part concerning oncological diagnostics or oncological treatment provided on the basis of the diagnostics card and of the oncological treatment, the amount of the obligation changes, adjusting it to the health needs in the scope of oncological diagnostics or oncological treatment and the implementation of this agreement.
Art. 136b. [ Compulsory civil liability insurance] 1. The provider:
1) being the entity performing the medical activity is subject to the obligation to insurance civil liability under the rules laid down in the provisions of the Act of 15 April 2011. of therapeutic activities;
2) being the entity referred to in art. 5 point 41 (b) b and d, shall be subject to the obligation to insure civil liability for damage caused by the provision of health care services under the health care provision contract.
2. The Minister responsible for financial institutions in agreement with the Minister of Health, after consulting the authorities of the medical professions and the Polish Chamber of Insurance, will determine, by way of regulation, the detailed scope of the of the compulsory insurance referred to in paragraph 1. Article 1 (2), the term of the insurance obligation and the minimum guarantee sum, taking into account, in particular, the specificity of the profession and the scope of the tasks to be performed.
Article 137. [ General terms and conditions of the provision of health care contracts] 1. The general terms and conditions of contracts for the provision of health care benefits include:
1) the subject of contracts for the provision of health care benefits and conditions for the provision of health care benefits;
2) how to finance health care benefits;
3) the mode of determining the amount of the obligation, in the case of contracts for the provision of health care services concluded for a period longer than a year;
4) the scope and conditions of the healthcare provider's liability for improper performance of the contract for the provision of health care services;
5. the conditions, the manner of fixing the amount and the procedure for imposing contractual penalties;
6) the conditions and the mode of termination of the contract for the provision of health care services and the conditions for its expiry.
2. The Minister of Health shall determine, by regulation, the general terms and conditions of contracts for the provision of health care services, guided by the interests of the recipients and the need to ensure the proper performance of the contracts.
Article 138. [ Exemption from the application of public procurement rules] Public procurement rules shall not be used to conclude contracts for the provision of health care.
Article 139. [ The procedure for dealing with the conclusion of a contract for the provision of health care services] 1. Containment by the Fund of contracts for the provision of health care services, subject to art. 159, shall take place after the conduct of the procedure:
(1) a competition offering, or
2. negotiations.
2. In order to proceed with the procedure for the conclusion of the contract for the provision of health care services in the mode of the contest offers the Fund shall include the notice in accordance with the provisions issued on the basis of the paragraph. 9. In order to conduct the negotiations after the announcement, the Fund shall send the invitations.
3. The notice of proceedings concerning the conclusion of the contract for the provision of health care services shall include in particular:
1) the name of the procurator and the address of his seat
2) determination of the value and object of the contract;
3) the required professional and technical qualifications of the providers, taking into account the Polish Standards introducing European standards, European technical approvals or standards of the European Union Member States introducing European standards harmonized and statistical classifications issued on the basis of public statistics;
4) an indication of the promoters invited to the negotiations-in the case of negotiations;
5) the determination of the territorial area for which the procedure for the conclusion of a contract for the provision of health care services is carried out, and an indication of the maximum number of contracts for the provision of health care services to be concluded after carrying out this procedure, in accordance with the financial plan of the provincial branch of the Fund and the plan to purchase health care benefits.
4. The director of the provincial branch of the Fund appoints and dismisses the competition commission in order to proceed with the procedure for the conclusion of the contract for the provision of health care services.
5. The member of the competition committee shall not be the person who:
1) is a provider of the applicant for the conclusion of the contract;
2) it remains with the provider referred to in point 1, in the marriage or in relation of kinship or affinity in a straight line or on the sidelines to the second degree;
3) is bound, by way of adoption, care or guardianary, with the provider referred to in point 1, his or her representative or a proxy or a member of the bodies of legal persons taking part in the proceedings;
4) it remains with the provider referred to in point 1, in such a legal or factual relationship, that it may raise reasonable doubts as to its impartiality, or in such a relation remains their spouse or the person with whom they remain in common Borrowing.
(6) The members of the competition committee after the opening of tenders shall submit, under penalty of criminal responsibility for the submission of false statements, a statement that they shall not be subject to the conditions set out in the paragraph. 5. The filing statement shall be obliged to conclude in it the clause of the following content: "I am aware of the criminal responsibility for making a false statement.". This clause replaces instructing the body of criminal responsibility for making false statements.
7. Exclusion of a member of the competition committee and appointment of a new member of the competition committee in case of the existence of the circumstances referred to in the paragraph. 5, shall make the director of the provincial branch of the Fund ex officio or at the request of a member of the competition commission or the provider of the applicant for the conclusion of the contract.
8. The procedure for the conclusion of a contract for the provision of health care benefits may be commenced before the approval of the financial plan. In such a case, the total commitments of the Fund arising from the contracts concluded with the service providers may not exceed the amount of the costs provided for that purpose in the Fund's financial plan for the current year.
9. The Minister of Health, after consulting the President of the Fund, will determine, by way of regulation, the manner of announcing the proceedings concerning the conclusion of a contract for the provision of health care services, the submission of tenders, the appointment and the dismissal of the competition committee, its tasks and the mode of operation, taking into account the need for equal treatment of the providers and of the assurance of fair competition.
10. The Minister responsible for Health may specify, by way of regulation, the way of determining the territorial areas for which the procedure for the conclusion of a contract for the provision of health care services for benefits is carried out in the different ranges and types, bearing in mind the health needs and the geographical and communication conditions.
Article 140. [ Description of subject of the contract] 1. The subject matter of the contract shall be described in a unambiguous and exhaustive manner, by means of sufficiently precise and comprehensible terms, taking into account all the requirements and circumstances which may affect the drawing up of the tender.
2. The subject of the contract may not be described:
1) in a way that would impede fair competition;
2) by the indication of trade marks, patents or provenance, unless it is justified by the specificity of the subject of the contract or the procuring cannot describe the subject of the contract by sufficiently precise terms, and the indication of such a companion the words 'or equivalent' or other synonymous words.
Article 141. [ The inclusion of Polish Standards in describing the subject of the contract] 1. The subject of the contract shall be described by means of technical and qualitative features, taking into account Polish Standards introducing European harmonized standards.
2. In the absence of the Polish Standards introducing the European harmonized standards shall be taken into account:
1) European Technical Approves;
2. common technical specifications;
3) Polish Norms introducing European standards;
4) the standards of the Member States of the European Union introducing European harmonized standards;
5) Polish Norms introducing international standards;
6. Polskie Norma;
7) Polish technical approvals.
3. You may refrain from describing the subject of the order, taking into account the Polish Standards introducing European harmonised standards, European technical approvals or common technical specifications, if:
1. they do not contain any requirements to ensure compliance with the essential requirements; or
(2) their application would impose on the contracting authority the obligation to use products which do not co-operate with the equipment already used, or
3) their application would not be appropriate due to the innovative nature of the subject of the order.
4. The description of the subject of the contract shall apply the names and codes set out in the Common Procurement Vocabulary as set out in Regulation No 2195/2002 of 5 November 2002. on the Common Procurement Vocabulary (Dz. Urz. EC L 340, 16.12.2002, p. 1 and n., with late. zm.).
Article 142. [ Contest Bids] 1. The contest of tenders shall consist of an explicit and implicit part.
2. In the part of an explicit contest of tenders, the commission in the presence of tenderers shall:
1) state the correctness of the announcement of the contest of tenders and the number of submitted tenders
2) open envelopes or parcels with offers and determine which of the tenders meet the conditions laid down in the provisions issued on the basis of art. 31d and the conditions referred to in Article 146 (1) 1 point 2;
3) adopt to the protocol the explanations or statements submitted by the bidders.
3. The certificates or explanations provided by telex, electronic mail or facsimile shall be deemed to have been submitted within the time limit, if their content reached the addressee before the deadline and has been immediately confirmed in writing by transferor.
4. The offer shall be drawn up in the Polish language, with the conduct of the written form under the rigorome of invalidity.
5. In the part of the implicit contest of tenders the commission may:
1) select an offer or a larger number of offers, the most favourable in terms of the selection criteria set out in Art. Par. 148 1;
2) do not make the choice of any offer, if it does not result from them the possibility of proper provision of health care benefits.
(6) The Commission may negotiate with tenderers for the purpose of establishing, in the part of the Classified Contest, the tenderers:
1) the number of planned to provide health care benefits;
2) the prices for the provision of health care benefits.
(7) The Commission is required to negotiate at least two bidders if more than one bidder is involved in the competition.
Article 143. [ Conclusion of a contract for the provision of health care benefits in negotiations mode] 1. The conclusion of a contract for the provision of health care services in the mode of negotiations shall take place in the cases specified in the Act.
2. By prognosis is the mode of concluding contracts for the provision of health care services, in which proceedings concerning the determination of the price and number of health care benefits and the conditions of their award with such number of providers shall be understood, which ensure the choice of the most favourable offer or more tenders and the smooth conduct of the proceedings, but not less than three, unless the specialised nature of the health care benefits or the limited availability of the benefits is fewer healthcare providers who are able to provide them.
3. The prognates shall consist of an explicit and implicit part.
4. The part of the public negotiations shall apply mutatis mutandis. 142 (1) 2.
5. The part of the implicit negotiations shall apply mutatis mutandis. 142 (1) 5.
Article 144. [ Conditions for the conduct of the proceedings in the negotiation procedure] The proceedings in the mode of negotiations may be carried out if:
1) the previously conducted proceedings in the mode of contest of tenders have been annulled and the detailed conditions of the proceedings on the conclusion of the contract for the provision of health care services are the same as in the contest of tenders or
(2) there is an urgent need to conclude a contract for the provision of health care benefits which could not have been foreseen before, or
3) there is a limited number of providers, not more than five, which may provide health care services subject to the procedure for the conclusion of contracts for the provision of health care benefits.
Article 145. [ Invitation to participate in the prognosis of the providers whose offers have not been rejected in the invalidated tender contest] 1. In the case referred to in art. 144 point 1, which is invited to participate in the claims of the providers whose offers have not been rejected in the invalidated bid contest.
2. In the cases referred to in art. 144 points 2 and 3, invites you to participate in the negotiations of healthcare providers who are able to provide health care services for the purpose of concluding contracts for the provision of health care services.
Article 146. [ Participation of the President of the Fund in the proceedings] 1. President of the Fund shall specify:
1) the subject matter of the proceedings on the conclusion of the contract for the provision of health care services
2) the detailed terms and conditions of the contracts for the provision of health care benefits, covering in particular the territorial area for which the procedure for the conclusion of contracts with the healthcare providers is carried out, taking into account the benefit tariff in the case of its findings in a given range.
2. The detailed terms of the agreements referred to in paragraph 2. Article 1 (2) may not apply to the conditions for the performance of the guaranteed benefit referred to in the Regulations issued on the basis of the Article. 31d.
3. In drawing up the specific conditions of the agreements referred to in paragraph. 1 point 2, a justification shall be drawn up and information on the effects of their acceptance, which shall indicate:
1) the problem solved;
2) the recommended solution, including the planned intervention tools, and the expected effect;
3) entities to which the terms of the agreements are affected;
4) information on the scope, duration and summary of the results of the consultations conducted under the terms of the agreements;
5) financial implications;
6) deadline for the planned implementation of the terms of contracts
7) how and when the evaluation of the effects of the adopted terms and conditions will be evaluated and the measures taken will be applied.
4. The design of the subject matter of the procedure on the conclusion of the contract for the provision of health care services and the detailed conditions of the agreements referred to in the paragraph. The President of the Fund shall present to the competent national consultants for an opinion 1 point 2. The opinion shall be forwarded to the President of the Fund within a period of time which shall be no less than 14 days. Failure to submit an opinion within this time limit shall be tantamount to giving an opinion positive.
5. Specified by the President of the Fund the subject of the proceedings concerning the conclusion of the contract for the provision of health care services and the detailed terms of the agreements referred to in the paragraph. 1 point 2, with the exception of the subject of the procedure for the conclusion of a contract for the provision of health care benefits and the detailed conditions of contracts for the benefit of the lec programs and chemotherapy specified in the provisions of the refund Act, they shall apply not earlier than 30 days from the date of their issue, unless the Minister for Health has given his consent to their earlier application.
6. To the proceedings on the conclusion of a contract for the provision of health care benefits carried out in a given year, and in the case of a contract for the provision of health care services concluded for a period longer than a year, to determine the amount of the obligation and conditions the specific conditions referred to in paragraph 1 shall apply in respect of the financial year in question. 1 point 2, published in the Public Information Bulletin of the President of the Fund, and the benefit tariff published in the Agency's Public Information Bulletin, until 30 June of the previous year.
Article 147. [ Criteria for the evaluation of tenders and terms and conditions for the services of the providers] The criteria for evaluating the tenders and the conditions required by the providers shall be open and shall not be subject to change in the course of the procedure.
Article 148. [ Comparison of tenders in the course of the procedure for the conclusion of the contract] 1. The comparison of offers in the course of proceedings on the conclusion of the contract for the provision of health care benefits shall be made according to the selection criteria:
1) quality,
2) comprehensiveness,
3) availability,
4) continuity,
5) Prices
-the provision of health care benefits.
2. When comparing offers in the course of proceedings concerning the conclusion of the contract for the provision of health care services, the following shall also be taken into account, whether the provider has:
1) the contract referred to in art. 31lc ust. 4;
2) an important positive opinion referred to in art. 95d ust. 1, or an important positive opinion on the protest.
3. The Minister responsible for health shall determine, by means of a regulation, the detailed criteria for the selection of tenders, broken down by different ranges or types of health care benefits, guided by the interests of the recipients and the need to ensure that the correct course of comparison of tenders in the course of the procedure for the conclusion of a contract for the provision of healthcare services
Article 149. [ Conditions for rejecting an offer] 1. The offer is rejected:
1) submitted by the provider after the deadline;
2) containing untrue information;
3) if the provider has not specified the object of the offer or has not provided the proposed number or the price of the health care benefits;
4) if it contains a grossly low price in relation to the subject of the contract;
5) if it is invalid on the basis of separate provisions;
6) if the provider has submitted an alternative offer;
7. if the tenderer or tender does not meet the required conditions laid down by the provisions of law and under the specific conditions of the contracts for the provision of health care benefits referred to in art. 146 (1) 1 point 2;
8) submitted by the provider, with whom in the period of 5 years preceding the announcement of the proceedings, has been terminated by a branch of the Fund's voivodship the contract for granting health care benefits in a range or type corresponding to the object notices, without giving notice of notice for reasons attributable to the healthcare provider.
2. Where the deficiencies referred to in paragraph 1 are not 1, they concern only part of the offer, the offer can be rejected in the part affected by the absence.
3. In the event that the provider has not submitted all the required documents or where the tender contains formal deficiencies, the committee shall invite the tenderer to remedy those deficiencies within the prescribed time limit under the rigorous rejection of the offer.
Article 150. [ Conditions for annulment of the procedure for the conclusion of a contract for the provision of health care services] 1. The director of the provincial branch of the Fund shall invalidate the proceedings on the conclusion of the contract for the provision of health care services, when:
1) no offer has been received;
2) one offer not subject to rejection has been received, subject to the paragraph. 2;
3) all bids have been rejected;
4) the amount of the most favourable offer exceeds the amount which the Fund has allocated to the financing of health care services in the course of the proceedings;
(5) there has been a significant change in the circumstances in which the conduct of the proceedings or the conclusion of the contract is not in the interest of the insured, which could not have been foreseen beforehand.
(2) If only one non-rejection offer has been received during the contest of tenders, the Commission may accept that offer where it is clear from the circumstances that no more tenders will be affected by the tender for the award of tenders on the same terms.
Article 151. [ Notice of Conduct] 1. If there has not been a cancellation of the procedure for the conclusion of the contract for the provision of health care services, the committee shall announce the decision to proceed.
2. On the decision of the contest of tenders shall be announced in the place and time specified in the tender notice.
3. The settlement of negotiations shall be published on the bulletin board and on the website of the competent branch of the Fund's voivodship, within 2 days of the end of the negotiations.
4. The notices referred to in paragraph. 2 and 3, they shall include the name (s) and the name and location of the business or the address of the healthcare provider who has been elected.
5. At the time of the announcement of the settlement of the proceedings on the conclusion of the contracts for the provision of health care services shall be concluded
6. Announcement of the outcome of the resolution of the proceedings The director of the provincial branch of the Fund shall submit to the Office for Official Publications of the European Communities, if the value of the subject of the contract for the provision of health care benefits The gold equivalent of EUR 130 000 according to the average euro exchange rate announced by the National Bank of Poland on the date of the resolution of the proceedings.
7. (repealed)
Article 152. [ Remedies for referers] (1) The rights of appeals whose interests are affected by the breach by the Fund of the Rules of Procedure on the conclusion of a contract for the provision of health care services shall be entitled to appeal and to the provisions of the Rules of Procedure of the Court of Justice of the European Union. referred to in art. 153 and 154.
2. The means of appeal shall not be entitled to:
1) the choice of the procedure;
2. failure to choose the healthcare provider;
3) annulment of the proceedings on the conclusion of the contract for the provision of health care benefits.
Article 153. [ Protest] 1. In the course of the proceedings on the conclusion of the contract for the provision of health care services, pending the termination of the proceedings, the tenderer may submit to the commission a motivated protest within 7 working days from the date of the action of the contested action.
2. Pending the examination of the protest, the proceedings on the conclusion of the contract for the provision of health care services shall be suspended, unless it is clear from the content of the protest that it is manifestly unfounded.
3. The Commission shall consider and resolve the protest within 7 days from the day of its receipt and shall give a written reply to the applicant. Failure to take into account the protest requires justification.
4. A protest submitted after the deadline is not subject to consideration.
5. Information on the transfer of the protest and its settlement shall be immediately placed on the bulletin board and on the website of the competent branch of the Fund's voivodship.
(6) If the protest is taken into account, the Commission shall repeat the contested action.
Article 154. [ Appeals for decision of the procedure] 1. A provider taking part in the proceedings may bring to the Director of the Fund's branch office, within 7 days from the day of the announcement of the decision of the proceedings, the appeal concerning the decision of the proceedings. The appeal before the date is not subject to consideration.
2. The appeal shall be considered within 7 days from the date of its receipt. The lodging of the appeal shall withhold the conclusion of the contract for the provision of health care until it has been examined.
3. After consideration of the appeal, the director of the provincial branch of the Fund shall issue an administrative decision taking into account or dismiss the appeal. The decision shall be posted within 2 days from the day of its issue, on the bulletin board and on the website of the competent provincial branch of the Fund.
4. From the decision of the director of the provincial branch of the Fund the healthcare provider shall have a request for reconsideration of the case.
5. An application for reconsideration of the case referred to in paragraph 1. 4, shall submit to the Director of the Fund's branch office within 7 days from the date of service of the decision referred to in the paragraph. 3.
6. The Director of the Fund's branch of the Fund shall consider a request for reconsideration of the case referred to in paragraph. 4, within 14 days from the date of its receipt and issue an administrative decision on the matter. The decision of the director of the provincial branch of the Fund issued upon reconsideration of the case shall be immediately executed.
6a. The parties to the proceedings referred to in paragraph 1. 1-6, are the provider who has lodged the appeal referred to in paragraph 1. 1, or a request for reconsideration of the case referred to in paragraph. 4, and the healthcare providers who have been selected to provide health care benefits in the given proceedings on the conclusion of a contract for the provision of health care benefits.
7. If the appeal concerning the settlement of the proceedings concerning the conclusion of the contract for the provision of health care services is taken into account, the procedures shall be carried out in the mode of negotiations with the provider, who has made the indicated appeal, unless It is clear from the description of the subject of the contract that the contract for the provision of health care benefits is provided with one healthcare provider in the area concerned. In such a case, the director of the Fund's branch office shall reconduct the procedure for conclusion of the contract.
8. From the decision referred to in paragraph. 6, the healthcare provider shall have a complaint to the administrative court.
Article 155. [ Application of provisions of the Civil Code] 1. The provisions of the Civil Code shall apply to the contracts for the provision of health care benefits, if the provisions of the Act do not provide otherwise.
2. The contract for the provision of health care benefits shall be void if it is concluded with the tenderer whose tender subject to rejection for the reasons indicated in art. 149 (1) 1 points (1) and (3) to (8), or as a result of a procedure which has been annulled.
3. The contract for the provision of health care benefits shall be invalid in part beyond the subject matter of the proceedings concerning the conclusion of this contract.
4. The contract for the provision of health care services requires the written form under the rigorous annulment.
5. If the contract for the provision of health care benefits does not provide otherwise, the transfer to a third party of the rights and obligations resulting from the contract requires the written consent of the Director of the Fund's provincial branch.
Article 156. [ The time for which the health care service contract is concluded] 1. The contract for the provision of health care benefits shall not be concluded for an indefinite period of time, subject to art. 159 par. 2a. Conclusion of a contract for the provision of health care services for more than 5 years and contracts for the provision of health care services in a type of stationary and 24-hour health care provision within the meaning of the provisions on medical activity for a longer period than 10 years, requires the consent of the President of the Fund.
(1a) Where there is a risk of failure to secure the provision of health care services, the duration of the contract for the provision of health care services may be extended, but not longer than 6 months.
1b. In the absence of the possibility of safeguarding the provision of health care in a situation where the provision of health care benefits in a given range of health care benefits was provided by one provider in a particular area, the Director the provincial branch of the Fund may amend the contract for the provision of health care services concluded with the provider in this area in the area adjacent to that area, for a period not longer than the one specified in the paragraph. 1a.
1c. Making changes to the contract for the provision of health care benefits referred to in paragraph. 1b, the director of the provincial branch of the Fund shall take into account the need to ensure equal access to health care services, the health care needs of the recipients and the communication conditions.
1d. Change of the contract for the provision of health care benefits referred to in paragraph. 1a and 1b, require the consent of the President of the Fund.
1e. The director of the provincial branch of the Fund is obliged to immediately conduct the proceedings on the conclusion of the contract for the provision of health care benefits in respect of the benefits covered by the contract, the term of which has been extended to Paragraph 1. 1a and 1b, where such a proceeding has not been initiated or terminated.
2. (repealed)
Article 157. [ Provisions not applicable to amendment of the contract] The provisions on the procedure for the conclusion of a contract for the provision of health care benefits shall not be applied to the amendment of the contract.
Article 158. [ An unimportant change to the agreement] 1. It is not important to change the concluded contract if it concerns the conditions that have been assessed in the selection of the offer, unless the necessity to introduce such changes results from the circumstances which could not have been foreseen at the time of conclusion of the contract.
2. If the changes referred to in paragraph are necessary. 1, the contract in the new wording shall apply until the time of providing the benefits on the basis of the new procedure for concluding the contract.
Article 159. [ Exclusion of the provisions of Article 136 1 point 5 and the provisions relating to the competition of tenders and negotiations] 1. Rules of the art. 136 Point 5 and the provisions relating to the tender and negotiations contest shall not apply to the conclusion of contracts with the services of:
1) providing benefits in primary health care, except for night and holiday health care;
2. carrying out supplies of medical supplies, on behalf of the authorized person;
3) to the agreements referred to in art. 41 par. 1 of the refund act.
2. In the cases referred to in paragraph. 1 points 1 and 2, there shall be an agreement with the provider meeting the conditions for the conclusion of the contract as defined by the President of the Fund.
2a. Contracts for the provision of health care benefits in the field of primary health care, with the exception of night and holiday health care, shall be included for an indeterminate period.
3. The Director of the provincial branch of the Fund shall state on the website of the competent provincial branch of the Fund and make available at the registered office of that branch information on the conditions of conclusion of the contract for the provision of health care services, of Paragraph 1. 2.
4. The Fund shall inform about the security of the health care benefits referred to in paragraph. 1, by posting the information on the website of the competent provincial branch of the Fund.
5. The Minister responsible for health shall determine, by means of a regulation, the detailed requirements to be met by the premises of the operator performing the supplies of medical supplies available on request, in particular by specifying his/her the organisation and equipment, taking into account the nature of the activities carried out and the provision of accessibility to the recipients.
Article 160. [ The complaint to the activities of the Director of the Provincial Branch of the Fund] The healthcare provider who has entered into a contract for the provision of health care benefits shall be entitled to a complaint against the activities of the Regional Director of the Fund for the implementation of the contract.
Article 161. [ Compose Mode] 1. The complaint referred to in art. 160, it shall consider, within 14 days from the date of its receipt, the President of the Fund.
2. The complaint referred to in paragraph. 1, shall be submitted together with the justification through the appropriate locality of the Fund's provincial branch within 14 days from the date of the operation by the director of the Fund's provincial branch.
2a. The President of the Fund, having regard to the complaint in part or in whole, imposes on the Director of the Fund's branch of the Fund an obligation to remove the identified irregularities, in particular by repealing the task to which the complaint relates, and notify the provider within 7 days of the taking into account of the complaint.
3. (repealed)
3a (repealed)
3b. (repealed)
3c. (repealed)
Art. 161a. [ Relevant application of the provisions] For the procedure for concluding contracts for the execution of medical rescue operations by medical rescue teams referred to in the provisions of the Act of 8 September 2006. The provisions of this Chapter shall apply mutatis mutandis to the State Medical Rescue, their conclusion and accounting.
Article 161b. [ Additional proceedings for the conclusion of contracts for the provision of health care services] 1. In the event that, as a result of the conducted proceedings in the competition mode of the tenders, will be concluded for the year of the next contract for the provision of health care services causing a reduction, in the area of the Fund's branch office, access to benefits guaranteed in a given range in relation to the current year, the director of the provincial branch of the Fund may carry out additional proceedings on the conclusion of contracts for the provision of health care benefits. The Director of the Fund shall inform the President of the Fund of the intention to carry out additional proceedings.
2. In the additional proceedings may take on the participation of the provider meeting the conditions concerning:
1) medical staff or
2) equipment for medical equipment and apparatus
-as regards the conditions required by the providers, as defined in the provisions adopted on the basis of art. 31d, and other conditions for the implementation of the guaranteed benefits, as laid down in those provisions.
3. As a result of the settlement of the additional proceedings referred to in paragraph. 1, may be concluded with the healthcare provider referred to in paragraph 1. 2, the contract for the provision of health care benefits, in the given scope of guaranteed benefits:
1) only once;
2) for a period not longer than a year.
4. The provisions of Article 4 shall apply mutatis mutandis to the additional proceedings. 139-161. Article Article 149 (1) 1 point 7, as regards the conditions relating to medical staff or the conditions for equipment and medical equipment required by the healthcare providers, as defined in the provisions adopted on the basis of art. 31d, does not apply.
5. In determining in the contract concluded with the healthcare providers referred to in paragraph. 2, the prices of healthcare provision shall take into account the extent of the underuse of those healthcare providers to the conditions referred to in the provisions issued on the basis of art. 31d. In the case of these healthcare providers, the price of the health care benefit is lower than the lowest price specified in the contract for the provision of health care services concluded by the director of the provincial branch of the Fund referred to in paragraph. 1, with a healthcare provider fulfilling the conditions laid down in the provisions issued on the basis of art. 31d, for the same type and scope of guaranteed benefits and the period of validity of the price.
SECTION VIA
Sanitary transport
Art. 161ba. [ Sanitary measures] 1. Sanitary transport is performed by specialist means of land transport, water and air transport.
2. The sanitary means of transport referred to in paragraph. 1, they must meet the technical and quality characteristics laid down in the Polish Norms moving the European harmonised standards.
Art. 161c. [ Agreement for the implementation of sanitary transport] 1. The Fund and the medicinal product shall include contracts for the implementation of sanitary transport with entities with means of transport.
2. To the agreements referred to in paragraph. The provisions of Chapter VI shall apply mutatis mutandis to the Fund.
Art. 161d. [ Activity of air ambulance transport teams] 1. The activities of air ambulance transport teams shall be financed:
1) from the budget of the State from the part of which the Minister responsible for health is at the disposal, to the extent referred to in paragraph. 4;
2) by the medicinal product subject to which the transport is carried out, to the extent referred to in paragraph. 5.
2. The tasks of the air ambulance transport team shall be performed by ambulance transport, including the transport referred to in art. 41 par. 1.
3. The financial condition referred to in paragraph 1 shall be provided for in paragraph 1. 1 point 1, is to ensure the continuous readiness of the air ambulance transport team to carry out the transport referred to in art. 41 par. 1, to the extent specified in the agreement referred to in paragraph. 6.
4. The calculation of the costs of the activities of the air ambulance teams shall be made, subject to the paragraph. 5, taking into account direct and indirect costs, in particular:
1) personnel costs;
2. operating costs;
3) administrative and economic costs;
4) depreciation, excluding depreciation made from fixed assets, to which the entity received a grant.
5. Cost of direct use of the air ambulance transport team related to the sanitary transport does not include the cost of the activities of this team. These costs include:
1) the cost of fuel;
2) the cost of en route charges and for landing.
6. The financing referred to in paragraph 1. 1 point 1 shall be made on the basis of an agreement concluded between the Minister of Health and the entity with air ambulance teams.
7. In order to conclude the agreement referred to in paragraph. 6, the prognosis is carried out.
8. The committee shall carry out the commission appointed by the Minister responsible for health.
9. The prognates concern the conditions for the implementation and financing of sanitary transport.
Art. 161e. [ Control Actions] 1. Ministries competent for health, in relation to all entities carrying out sanitary transport, and of the voivodship, in relation to entities carrying out sanitary transport, established in the area of the voivodship, shall be entitled to the carrying out of the checks to be carried out by the specific sanitary means of transport of the requirements referred to in Article 4 (1) of the basic Regulation. 161ba par. 1 and 2.
2. To carry out the control activities referred to in paragraph 2. 1, the provisions of Chapter VI of the Act of 15 April 2011 shall apply accordingly. Medical activity.
CHAPTER VII
Supervision
Article 162. [ The subject supervising the activities of the Fund] 1. The supervision of the activities of the Fund shall be exercised by the Minister responsible for health matters.
2. Under the principles provided for in the Act and the provisions of specific supervision of the financial economy of the Fund shall be exercised by the Minister responsible for the affairs of public finances, applying the criterion of legality, reliability, advisability and economic activity.
Article 163. [ Surveillance criteria] 1. The Minister of Health shall exercise supervision, applying the criterion of legality, reliability and advisability, on the activities of:
1. The Fund;
2) the providers, in the execution of contracts with the Fund;
3) the entities to whom the Fund has entrusted the performance of certain activities;
4) pharmacies, in terms of the refund of medicines.
2. The Minister of Health shall examine the resolutions adopted by the Board of the Fund and the decisions taken by the President of the Fund and shall state the invalid resolutions or decisions, in whole or in part, where:
1) violates the law or
2) lead to improper security of health care benefits, or
3) leads to the unbalance of the Fund's revenues and costs.
3. Taking the decision of the Minister responsible for health of the decision on the matters referred to in paragraph 3. 2, requires a positive opinion of the Minister responsible for public finance matters in the field referred to in paragraph. 2 point 3.
4. Resolutions of the Board of the Fund and the decisions of the President of the Fund The President of the Fund shall transmit to the Minister competent to health matters immediately, not later than within 3 working days from the day of their taking.
5. The provisions of the paragraph. 2-4 shall not apply to the proceedings concerning the approval of the financial plan, the resolutions concerning the financial statements, the reports on the implementation of the financial plan and the decisions made following an appeal in the course of the proceedings contracts for the provision of health care services, in individual cases with health insurance and in matters arising from the performance of the employer's function within the meaning of the provisions of the Labour Code.
Article 164. [ Control of decisions taken by the director of the provincial branch of the Fund and the Board of the Fund's provincial branch 1. The Minister competent for health may examine the decisions taken by the director of the Fund's branch of the Fund and resolutions adopted by the Board of the Branch of the Fund's voivodship.
2. Rules of Art. 163 (1) 2, 3 and 5 shall apply mutatis mutandis.
Article 165. [ Powers to be granted to the Minister of Health in the framework of surveillance] 1. In the framework of supervision, the Minister responsible for health shall be entitled in particular to:
1) requests made available to him by the Fund of documents relating to the activities of the Fund or copies thereof and to familiarizing themselves with their content;
2) requests for the transfer of all information and explanations, concerning the activities of the Fund, from the Fund Board, the President and the Deputy President of the Fund, the councils of the Fund's voivodships, the directors of the Fund's voivodship branches, the Fund's employees, other persons performing work on behalf of the Fund on the basis of an agreement contract, a work contract or any other contract, to which the provisions relating to the order shall apply in accordance with the Civil Code;
3) requests made available by the provider of any information, documents and explanations, concerning the implementation of the contract for the provision of health care services;
4) requests made available by the entity referred to in Article 163 (1) 1 point 3, any information, documents and explanations relating to the operations to be carried out on behalf of the Fund;
5) requests made available by the entity referred to in Article 163 (1) In accordance with Article 4 (1), all information, documents and explanations relating to the refund of medicines
2. The Minister for Health shall present the written request referred to in paragraph 1. 1, indicates the date of its implementation.
3. In the event of a statement, on the basis of the information obtained, the explanations and documents referred to in the paragraph. 1, cases of breaches of the law, the statutes of the Fund or the interest of the recipients of the minister competent for health shall notify the Fund, the provider, the entity referred to in Article. 163 (1) 1 point 3, or a pharmacy with irregularities found and issues recommendations aimed at removing the identified irregularities and adapting the activity of the notified entity to the provisions of the law, setting a time limit for the removal of the found irregularities and adaptations of the activity to the provisions of law.
4. Where a request for reconsideration of the case has been submitted, the time limit for the removal of the irregularity referred to in paragraph 1 shall be made. 3, shall count from the date of service of the decision after consideration of the application.
5. Within 3 days from the date of expiry of the time limit set for the removal of irregularities, the Fund, the provider, the entity referred to in Art. 163 (1) 1 point 3, or the pharmacy shall inform the Minister responsible for health in writing about the manner in which the irregularity was removed.
Article 167. [ Imposition of a monetary penalty] 1. In the case of a violation of the law, the statutes of the Fund or the interests of the recipients, and in the case of refusal to provide explanations and information referred to in art. 128 (1) 5 and in art. 165 par. 1 points 1 to 4, the minister competent for health may impose on the President of the Fund or the Deputy President of the Fund or the Director of the Fund's provincial branch responsible for these violations or failure to provide explanations and information, the penalty payment in up to three times the monthly salary of that person, calculated on the basis of the salary for the last three months preceding the month in which the penalty was imposed, irrespective of any other supervision measures provided for in the law.
2. In the event of a breach of the law or interests of the recipients, and in the case of refusal to provide explanations and information referred to in art. 165 par. In accordance with Article 1 (1) (5), the Minister responsible for Health may impose a monetary penalty on the pharmacy of up to three times the average salary.
Article 168. [ Request for immediate consideration] 1. The Minister competent for health may demand written immediate consideration of the case by the Board of the Fund, the President of the Fund, the Deputy Chairman of the Fund, the Board of the Fund's provincial branch or the directors of the Fund's voivodships, if that it considers it necessary for the proper supervision of the activities of the Fund.
2. In the cases referred to in paragraph. 1, the Minister responsible for Health shall take part or delegate his representative to attend the meeting of the bodies referred to in paragraph 1. 1. The Minister competent for health or his representative shall be entitled to speak on matters covered by the agendas of these entities.
3. The Minister for Health may request the written request referred to in paragraph. 1, specifying the time limit within which the meeting of the bodies referred to in paragraph 1 shall be met. 1, should take place.
4. The entities referred to in paragraph. 1, shall be obliged to inform the Minister of the competent health care of the stipulated time and place of the meeting without delay.
5. If within 7 days from the date of service of the call the date of the meeting is not set, it will be determined in violation of the time limit specified in the notice or the minister competent for health will not be informed of the fixed date and place meetings, the minister may convene the meeting of the entities referred to in paragraph 1. 1, at the expense of the Fund.
6. The powers of the minister responsible for health referred to in paragraph. 1-5 shall also be entitled to the Minister responsible for public finance. The Minister responsible for public finance and the Minister responsible for health shall inform each other of the request to convene the meeting referred to in paragraph 1. 1, and the actions taken.
Article 169. [ Powers of the Minister of Finance for the supervision of the financial economy of the Fund] 1. The powers of the minister responsible for health referred to in art. 165 shall be entitled, as appropriate, to the Minister responsible for public finance, in the field of supervision of the financial economy of the Fund.
2. The powers of the Minister responsible for health referred to in art. 167 and art. As appropriate, the Minister for Public Finance, in particular in the case of:
1) actions that result in unsustainable revenue from the Fund's costs;
2) the non-approval of the Fund's financial statements;
3) not to approve the annual report on the implementation of the Fund's financial plan;
4. the overruns of the time-limits referred to in Chapter 2 of Chapter V-excluding provisions relating to the financial plan of the Fund;
5) irregularities in the reports referred to in art. 131 (1) 1.
Article 170. [ The effects of the failure to delete within the time limit set for the irregularities found] 1. In the event of failure to delete within the prescribed period by the provider or entity referred to in art. 163 (1) In accordance with Article 1 (1) (3), the Minister responsible for Health may impose a pecuniary penalty on those entities, up to the monthly value of the agreement between those entities and the Fund to which the irregularity relates.
2. If the pharmacy is not removed by the pharmacy within the prescribed period of the irregularity, the Minister responsible for health may impose a pecuniary penalty on the pharmacy up to three times the average remuneration.
Article 171. [ Consequences of the statement of gross infringement of the interests of the recipients] 1. In the case of a statement on the basis of the information obtained, the explanations or documents referred to in Article 165 par. 1 points 1 to 4, gross violation of the law or gross violation of the interests of the recipients by the provider or entity referred to in art. 163 (1) In accordance with Article 1 (1) (3), the Minister responsible for Health may impose a pecuniary penalty on those entities up to the monthly value of the agreement between those entities and the Fund to which the irregularity relates.
2. In the case of a statement on the basis of the information obtained, the explanations or documents referred to in Article 165 par. In the case of a serious breach of the law or a flagrant violation of the interest of the recipients by the pharmacy, the Minister responsible for health may impose a pecuniary penalty on the pharmacy of up to six times the average remuneration.
Article 172. [ Grounds for the termination of the contract with the provider] In the cases referred to in Article 170 par. 1 and Art. 171 the Minister responsible for Health may apply to the Director of the Fund's Branch Office to terminate the contract with the provider or entity referred to in art. 163 (1) 1 point 3.
Article 173. [ Checks carried out by the Minister of Health] 1. The Minister competent for health may carry out at any time the following:
1) the activities and assets of the Fund, in order to verify whether the activities of the Fund are in accordance with the law, the statutes of the Fund or with the interest of the recipients;
2) providers, in terms of the conformity of their activities with the contract for the provision of health care benefits or with the interest of the recipients;
3) the entities referred to in art. 163 (1) 1 point 3, in relation to the discharge of the agreement concluded with the Fund;
4) pharmacies, in terms of the refund of medicines.
2. When carrying out the audit, the Minister responsible for Health may use the services of the entities entitled to audit the financial statements and entities entitled to the quality control and the costs of health care benefits financed by Fund. The provisions of Article 4 64 par. 3 and 4 shall apply mutatis mutandis.
3. The Minister responsible for health in the authorization to carry out the checks shall specify the subject matter and scope of the inspection and shall indicate the person authorised to carry out the inspection, hereinafter referred to as the 'controller'.
4. The controlled entity shall be obliged to submit to the controller the requested documentation and to provide any information and assistance necessary in connection with the control.
4a. Controllers, to the extent determined in the authorisation of the Minister responsible for health, shall have the right to:
1) access to all premises of the controlled entity;
2. free access to:
(a) a separate office space, intended solely for the purpose of carrying out tasks by the controller,
(b) communication means;
3) inspection of any documents of the controlled entity and the request for the preparation of copies, copies and extracts from these documents;
4) insight into the data contained in the IT system of the audited subject and the request to draw up copies or extracts from these data, including in electronic form;
5) requests of oral or written explanations from persons remaining in the employment relationship, order or other legal relationship of a similar nature with a controlled entity, including in electronic form;
6) request the transfer of necessary data or compiling the data sets, including in electronic form;
7) security of documents and other evidence.
5. The controller may not be at the same time:
1. an employee of the Fund;
2) the owner of the provider referred to in art. 5 point 41 (a), which has entered into an agreement for the provision of health care services;
3) a provider who has entered into a contract for the provision of health care services;
4. the employee of the healthcare provider referred to in point 3;
5. the person cooperating with the provider as referred to in point 3;
6) a member of the bodies or an employee of the forming entity within the meaning of the provisions on medicinal activity;
7) a member of the bodies of the insurance undertaking conducting the insurance business on the basis of the Act of 11 September 2015. on insurance and reinsurance activities.
6. The controller shall be exempted from participation in the control by the Act, if:
1) it remains with an entity controlled in such legal or factual relationship that the result of the control may affect its rights or obligations;
2. the control relates to his or her spouse and/or his/her relatives and other duties;
3. the control concerns a person associated with him for adoption, care or guardianal treatment.
7. The reasons for exclusion referred to in paragraph 1 6, they also continue after the cessation of the justifications for marriage, adoption, care and guardianment.
8. Regardless of the reasons mentioned in the paragraph. 6. the Minister responsible for health shall exclude the controller at his/her request or at the request of the controlled entity, if between him and the controlled undertaking there is a personal relationship of that type, that he could raise doubts as to impartiality controller.
9. The disabled controller should only take urgent action due to the social interest or the important interest of the controlled entity.
10. (repealed)
Article 174. [ Audit Log] 1. The results of the inspection of the controller shall be presented in the audit log
2. The control protocol shall contain a description of the facts established during the control of the operation of the controlled entity, including the established irregularities, taking into account the reasons for the uprising, the extent and effects of those irregularities and the persons for them responsible.
3. The audit protocol shall sign the controller and the manager of the controlled entity, and in the event of his/her absence, the person authorized by him.
Article 175. [ The right to raise reasoned objections as to the findings of the Protocol] 1. The manager of the controlled entity or the person of his authorized person shall have the right to notify, prior to the signature of the protocol of control, the motivated reservations as to the findings of the protocol.
2. Reservations must be made in writing within 14 days from the date of receipt of the audit protocol.
3. In the event of a declaration of objections referred to in paragraph. 1, the controller is required to carry out their analysis and, where necessary, take additional control activities and, where the validity of the reservations is determined, amend or supplement the relevant part of the control protocol.
4. In the event of disclaimer of the reservation in whole or in part, the auditor shall forward his/her position to the applicant in writing.
Article 176. [ Submission of reservations to the position of the Minister of Health by the head of the controlled entity] 1. The manager of the controlled entity or the person by him authorized may within 7 days from the date of receipt of the position referred to in art. 175 par. 4, report in writing motivated objections to the minister competent for health.
2. The Minister responsible for Health shall examine the reservations without delay and shall serve the information on their consideration, together with the reasons for the reservation.
Article 177. [ Refusal to sign the audit protocol] 1. The head of the controlled entity or the person authorized by him may refuse to sign the control protocol by filing within 7 days of receiving a written explanation of that refusal.
2. In the event of reservation of objections, the time limit to provide an explanation of the refusal to sign the protocol shall be counted from the date of receipt of the final decision on the consideration of these objections
3. The refusal to sign the control protocol and to provide an explanation of the controller makes reference to the protocol.
4. Refusal of the signature of the control protocol by the person mentioned in the paragraph. 1 shall not prevent the protocol from being signed by the controller and the implementation of the inspection arrangements.
Article 178. [ Post-control occurrence] 1. The Minister of Health shall draw up a post-control speech which shall be transmitted to the manager of the controlled entity.
2. The audit occurrence shall include an assessment of the controlled activity resulting from the findings described in the audit protocol, as well as recommendations aimed at the removal of the identified irregularities and the adjustment of the activity of the controlled entity to legal provisions.
3. The head of the controlled entity or the person authorized by him shall be obliged, within 14 days from the day of receipt of the post-control occurrence, to inform the Minister of the competent health care about the use of the comments and execution of the applications control and the actions taken or the reasons for not taking these measures.
4. In the event of failure to implement the recommendations referred to in paragraph. 2, the provisions of art. 167-171 shall apply mutatis mutandis.
Article 179. [ Reference from the assessments, observations, conclusions and recommendations contained in the post-control speech] 1. The head of the controlled entity or the person authorized by him, within 7 days from the day of receipt of the post-control occurrence, may appeal to the Minister responsible for health from the observations, observations, conclusions and observations made in the presentation of the control recommendations.
2. The Minister of Health shall consider the appeal within 14 days from the day of its receipt and takes up the position.
3. The position of the Minister responsible for health shall be final and shall, with the justification, be served by the controlled entity.
Art. 179a. [ The application of the provisions of Article 173-179] The provisions of Article 4 173-179 shall apply to the checks carried out by the Minister responsible for public finance.
Article 180. [ Delegation] The Minister responsible for Health, in consultation with the Minister responsible for public finance, will determine, by way of regulation, the detailed manner and the mode of carrying out checks, taking into account the proper implementation of the control objectives and ensuring that the its speed and effectiveness.
Article 181. [ Application of provisions of the Code of Administrative Procedure] 1. The provisions of the Code of Administrative Procedure shall apply to the proceedings before the minister competent for health surveillance, unless the Act states otherwise.
2. In the cases referred to in art. 163 (1) 2, art. 164, art. 165 par. 3, art. 167, art. 170 and 171, the minister responsible for health issues administrative decisions.
Article 182. [ Application of provisions of the Code of Administrative Procedure] 1. The provisions of the Code of Administrative Procedure shall apply to the proceedings before the Minister responsible for public finance in the field of supervision of the financial economy of the Fund, unless otherwise provided by the law.
2. In the cases referred to in art. 169, the Minister responsible for public finance issues administrative decisions.
Article 183. [ Enforcement of penalties in the enforcement proceedings in the administration] 1. The monetary penalties referred to in art. 167, 170 and 171, are subject to enforcement in the enforcement proceedings in the administration.
2. When determining the amount of the monetary penalty imposed on the basis of the provisions of the Act, the Minister responsible for Health shall take into account the nature and gravity of the irregularities found.
3. From the decision on the penalty payments, the complaint is made to the administrative court.
Article 184. [ The complaint to the administrative court] The administrative decisions referred to in this chapter shall be subject to an application to the administrative court.
Article 185. [ Information on irregularities found in the healthcare provider] The Minister for Health shall notify the creator referred to in Article. 2. 1 point 6 of the Act of 15 April 2011. of the activity of the medicinal product, of irregularities found in the healthcare provider and of decisions made in order to remove the irregularities found and to adapt the activity of the entity to which the decision relates to the law.
Article 186. [ Prohibition of the merging of certain posts with the supervision activities of the Fund] Persons performing on behalf of the Minister responsible for health or the Minister responsible for the financial affairs of the public oversight activities of the Fund may not:
1) be members of the organs of the Fund;
2) be employees of the Fund;
3) perform work on behalf of the Fund on the basis of a contract of order, a contract of work or any other contract, to which according to the Civil Code the provisions relating to the order apply;
4) be the providers with whom the Fund has entered into an agreement for the provision of health care services, or employees or persons cooperating with the providers who have entered into the contract with the Fund for the provision of health care benefits;
5) be members of the bodies or employees of the entities referred to in art. 163 (1) In accordance with the Civil Code, the provisions relating to the order shall be applied, either on the basis of a contract contract, a contract of work or any other contract to which the Civil Code applies.
Article 187. [ Annual report on the activities of the Fund] 1. The President of the Fund shall present annually to the Minister responsible for health and the Minister responsible for public finance, not later than 30 June of the following year, the annual activity report adopted by the Fund Board Fund.
2. The Minister of Health shall present to the Sejm of the Republic of Poland, no later than 31 August of the following year, the annual report of the Fund's activities referred to in paragraph. 1, following an opinion of the report by the Minister responsible for public finance, together with his position on the report.
CHAPTER VIII
Data processing and protection
Article 188. [ Processing of personal data of insured persons] 1. The Fund shall be entitled to the processing of personal data of the insured persons in order to:
1) the determination of the existence of health insurance and the right to the health care benefits financed by the Fund;
2) the issue of documents entitling to benefit from benefits financed by the Fund;
3) statements of the obligation to pay the contribution and set the amount of the contribution;
4) control of the nature, scope and causes of the benefits provided;
5) settlement with the healthcare providers;
6) settlement with other institutions or persons in terms of their obligations to the Fund;
7) the control of compliance with the principles of legality, the economy, the integrity and the advisability of the financing of health benefits provided;
8) monitoring of health status and the needs of insured persons for health benefits and medicines and medical devices;
9) identification of the contributor of contributions to health insurance;
10) to conduct and maintain an electronic monitoring system for the medicines of the left referred to in Article 188c.
1a. The Fund shall be entitled to process the personal data of persons referred to in art. 2. 1 point 2, in order to:
1) accounting with the healthcare providers;
2) the clearing of the grant referred to in art. 116 (1) 1 point 5;
3) control the observance of the principles of legality, the economy, the reliability and the advisability of the financing of the provided health care benefits;
4) control of the nature, scope and causes of health care benefits provided.
1b. The Fund shall be entitled to process the personal data of persons referred to in Art. 2. In order to account for the costs of the reimbursement of medicines, 1 points 3 and 4.
2. The Fund shall be entitled to process the personal data of persons entitled to health care benefits on the basis of the provisions on coordination and international agreements in order to:
1) confirmation of the entitlements to health care benefits;
2. accounting for the costs of health care benefits granted to persons entitled under the rules on coordination;
3) clearing with other institutions or persons in the scope of the healthcare providers and the Fund for the costs of health care services;
4) control of the nature, scope and causes of the benefits provided;
5) the control of compliance with the principles of legality, the economy, the integrity and the desirability of financing the provision of health care benefits;
6) conduct the contact point referred to in art. 97 ust. 3d.
2a. The Fund shall be entitled to obtain and process personal data related to the implementation of tasks specified in Art. 97 ust. 3 points 2 and 3a.
2b. The Fund shall be entitled to process the following data of patients from other than the Republic of Poland of the Member States of the European Union in connection with the implementation of the tasks referred to in art. 97a par. 2 and 5:
1. surname and first name (s);
2. nationality;
3) date of birth;
4) the identification number of the patient in the country of insurance;
(5) the identity document number;
6) information on health status;
7) information on the health benefits granted on the territory of the Republic of Poland;
8) information on medicines, foodstuffs intended for particular nutritional uses and medical devices purchased on the territory of the Republic of Poland.
2c. The Fund is entitled to obtain and process personal data related to the issuance of prescription to refunded drugs, foodstuffs for particular nutritional uses, medical devices and their implementation in the pharmacy.
3. The Minister of Health shall be entitled to the processing of personal data:
1) insured persons, for the purpose referred to in para. 1 points 4 to 8;
2) persons entitled to health care benefits on the basis of the rules on coordination, for the purpose set out in the mouth. 2 (2) and (3);
3) the persons referred to in art. 2. 1 points 2 to 4, for the purpose referred to in paragraph 1. 1 points 4 to 8.
4. For the implementation of the tasks referred to in paragraph. 1-3, the minister competent for health and the Fund shall have the right to process the following data:
1. surname and first name (s);
(2) the family name;
3) date of birth;
4. sex;
5. nationality;
6) (repealed)
7) PESEL number;
8) (repealed)
9) series and number of the identity card, passport or other document stating the identity-in the case of persons who do not have a PESEL number assigned;
10) address of residence;
11) the address of the temporary residence on the territory of the Republic of Poland, if the person concerned is not in the territory of the Republic of Poland of residence;
11a) the address of the check-in;
11b) address for correspondence and other data allowing to contact the person to whom the Fund is processing in the Central List of Insured Persons;
12) insurance number;
13) the degree of kinship with the cost-paying premium;
14) the degree of disability;
15) the type of authority and the number and validity of the document confirming the rights of the persons referred to in art. 43 par. 1, art. 44 par. 1, art. 45 par. 1, art. 46 (1) 1 and Art. 47, as well as persons holding on the basis of separate provisions broader entitlement to health care benefits than those resulting from the Act;
15a) the information on the entitlement referred to in Article 43a ust. 1;
16) concerning the provided health care benefits to the recipients referred to in art. 2. 1 points 3 and 4;
17) the reasons for the health care benefits provided;
18) the name of the competent institution of the person entitled to health care benefits on the basis of the rules on coordination;
19) data concerning a doctor, a feller, a nurse or a midwife who issues a prescription for the reimbursed medicines or foodstuffs for particular nutritional uses or supplies of medical devices;
20) data on the healthcare provider employing a doctor, feller, nurse or midwife, as referred to in point 19;
21) data on the prescription pharmacy for reimbursed medicines and medical devices;
22) the date of the notification to health insurance;
22a) the code of the insurance title;
22b) the date of creation of the health insurance obligation;
22c) date of filing of the notification to health insurance;
23) the date of the unenrollment from health insurance;
23a) the expiry date of the health insurance obligation;
(24) the period for which the contribution to health insurance was paid and the data relating to paid, unpaid, unpaid and due health insurance premiums, together with an indication of the period for which they relate;
25) data on the payment of the premium for health insurance;
26) the type of document entitling to health care benefits;
27) date of death;
28) data on accidents at work and occupational diseases, being in the possession of the insured, his employer or the Social Insurance Institution;
29) information, specifying the legislation appropriate in accordance with the rules on coordination, held by the insured person, his employer, the Social Insurance Institution or the Agricultural Social Insurance Fund;
30) data on the revenue from the titles of the surviving health insurance obligations;
(31) the period of entitlement of the Article. 67 par. 6 and 7;
32) information as to whether a family member stays in the common household;
33) reason code for unenrollment from health insurance.
5. The providers operating under the agreements with the Fund shall be required to collect and communicate to the Fund the data on health benefits provided.
(5a) Information and data collected in the Fund shall be made available:
1) free of charge to enforcement authorities referred to in art. 19 and art. 20 of the Act of 17 June 1966. on enforcement proceedings in the administration (Dz. U. of 2016 r. items 599, 868, 1228, 1244 and 1579),
2) paid to court bailiers
-to the extent necessary for the conduct of enforcement proceedings.
5b. The fee for the provision by the Fund to judicial bailiers of information and data concerning one employee or one contributor of contributions is 50 PLN.
5c. The amount referred to in paragraph 1. 5b, is subject to the valorisation of the forecast in the Finance Act for a given year, the average annual price index of consumer goods and services announced by the President of the Central Statistical Office on the basis of the provisions on pensions and pensions from the Fund Social Security.
5d. The court of the court shall attach to the application for information and data a copy of the proof of payment of the fee referred to in paragraph. 5b, for the account indicated by the Fund.
6. The Council of Ministers may define, by means of a regulation, the persons referred to in Article 4. 66 (1) 1 points 2 to 9, for which, in view of the need to ensure the security of the forms and methods of carrying out the tasks to be protected in accordance with the provisions on the protection of classified information, a separate processing mode of the data referred to in paragraph 1 shall apply. (4) The Regulation should, in particular, specify the personal data to be processed, the way in which they are processed and the entity entitled to collect and process them.
Art. 188a. [ Processing of personal data of persons providing benefits] In order to carry out the tasks specified in the Act, the Fund is entitled to process the following personal data of the persons issuing the prescription for refunded medications, foodstuffs for particular nutritional uses and medical devices, persons granting benefits under contracts for the provision of health care benefits and applying for the conclusion of such contracts:
1. surname and first name (s);
(2) the family name;
3) the PESEL number, and in the absence of it-the number of the document confirming the identity;
4) number of the right to pursue the profession-in the case of persons to whom this number has been given;
5) concerning professional competences relevant to the provision of health care services on the basis of a contract with the Fund;
6) information on the final judgements of the courts of conviction for the offence referred to in art. 54 para. 2, 3 or 5 of the Act on refunds or Articles 228-230, art. 286 or art. 296a of the Act of 6 June 1997. -Penal Code (Dz. U. of 2016 r. items 1137).
Art. 188b. [ Right to data processing] In order to carry out the tasks set out in the Article 97a par. 2 point 3 The Fund shall be entitled to process the following data relating to persons performing medical profession:
1. surname and first name (s);
2) information on the right to pursue the profession and the professional qualifications.
Art. 188c. [ Electronic monitoring system for programs of the left] 1. The President of the Fund shall be obliged to maintain and maintain the electronic monitoring system of the medicines referred to in the Act on refunds.
2. The electronic monitoring system of the leech programs enables the processing of data in the scope of:
(1) the fulfilment of the criteria for inclusion in the le programme by the users;
2) the qualifications of the recipients of the program to the program of the lek;
3) the treatment applied, including the method of administration and dosage of the medicine or foodstuff for particular nutritional uses;
4) monitoring the course of therapy and evaluating its effectiveness;
5) the term and reasons for the exclusion from the drug programme;
6) evaluation of the effectiveness of the drug programme.
3. [ 5] The settlement of the costs of the medicine used in the framework of the lek programme and the costs of the associated healthcare services is a condition for the transmission of the data referred to in paragraph 1. 2.
4. If you create a new LEU:
1. The President of the Fund shall adjust the system referred to in paragraph 1. 1, to the new lear programme within 4 months from the date of notification of the first notice referred to in art. 37 par. 1 of the law on refunds which contains this programme;
2) [ 6] the condition referred to in paragraph. 3, shall apply from the first day of the sixth month following the date of notification of the first notice referred to in Article 3. 37 par. 1 of the law of the refund containing that programme.
5. In the case of a change of the lear programme, the President of the Fund shall adjust the system referred to in paragraph. 1, to that change within 4 months from the date of the announcement of the notice referred to in art. 37 par. 1 of the Act of refund, containing this amendment.
6. [ 7] The Fund shall be entitled to obtain and process data for the implementation of the medicines referred to in the Act on refunds.
Art. 188d. [ Right to data processing] Local government unit, in order to carry out the tasks referred to in art. 9a and art. 9b, has the right to process data concerning:
1) persons who have been granted a benefit guaranteed under the contract referred to in art. 9b ust. 1, comprising:
(a) name and surname (s),
b) date of birth,
(c) sex,
(d) nationality,
(e) the PESEL number,
(f) the series and the number of the identity card, passport or other document stating the identity, in the case of persons who do not have a PESEL number assigned,
(g) address of residence,
(h) information on the guarantees provided under the contract referred to in Article 9b ust. 1, and the reasons for their granting;
2) persons providing guaranteed benefits provided under the contract referred to in art. 9b ust. 1, comprising:
(a) name and surname (s),
(b) the PESEL number,
(c) the series and the number of the identity card, passport or other document stating the identity, in the case of persons who do not have a PESEL number assigned,
(d) the number of the exercise of the profession, in the case of persons who have been given this number,
(e) information on the final decisions of the courts of conviction for the offence referred to in Article 228-230, art. 286 or art. 296a of the Act of 6 June 1997. -Penal Code.
Article 189. [ The obligation to collect and communicate the data to the data fund] 1. (repealed)
2. The providers, who have entered into contracts for the provision of health care services, shall be obliged to collect and communicate to the Fund the data referred to in Article. 190 par. 1 and 2.
3. (repealed)
Art. 189a. [ Collection of information on the benefits provided to the recipients residing in the voivodship] The Fund shall provide the voivodship and the marshal of the voivodship with information on the health care benefits provided to the recipients resident in the voivodship by the providers of benefits in the voivodship, necessary to carry out the tasks defined in the Act.
Article 190. [ Delegation] 1. The Minister of Health, after consulting the President of the Central Statistical Office, the President of the Fund, the Chief Medical Council and the Supreme Council of Nurses and Po³onists, will determine, by means of a regulation, the scope of the necessary information the information collected by the providers, including the calculation of the average waiting time for the provision of health care, a detailed way of recording this information and the transmission of the information to the Minister responsible for health, Fund or other body responsible for the financing of benefits from public funds, including the types of information media used and document models, taking into account the scope of the tasks carried out by those entities and taking into account the need to protect personal data.
1a. In the case of health care benefits, to which the availability, measured by the average time of waiting, is significantly impeded, the minister competent for health in the legislation issued on the basis of the mouth. 1 may determine the list of guaranteed benefits for which the waiting lists for the provision are carried out by the providers providing these benefits in the application provided by the President of the Fund.
2. The Minister of Health shall determine, by means of a regulation, the scope of the necessary information to be collected by the healthcare providers holding an agreement with the Fund to provide round-the-clock or all-day health services related to the the acquisition of medicines, foodstuffs intended for particular nutritional uses and medical devices, in particular the parties to the transaction, the invoice number, the date of invoice, the quantity of the medicinal product, the foodstuff for particular nutritional uses and the product the medical and their unit prices and the value of the invoice, as well as the rebates or discounts, taking into account the scope of the data included in the purchase documentation.
3. The Minister responsible for health shall determine, by means of a regulation:
1) the scope of the information contained in the annual and periodic reports on the activities of the Fund,
2) the model of the periodic report on the activities of the Fund and the manner and timing of its transmission of the Minister of Health to the competent health affairs,
3) the minimum scope of the aggregate information provided by the Fund to the voivodship and the marshals of voivodships on the basis of art. 189a, the manner and timing of their transmission and the model for the construction of electronic messages for the transmission of this information
-having regard to the scope of the tasks carried out by those entities and the need to ensure the uniformity of information
4. (repealed)
Article 191. [ Collection and processing by the Minister of Health of Data on Health Insurance] 1. The Minister of Health shall collect and process the health insurance data to the extent necessary for the performance of the tasks resulting from the Act.
2. The Minister of Health and the Fund shall be entitled to obtain and process the personal data of the witnesses other than the insured, in order to:
1) accounting with the healthcare providers;
2. controls:
(a) the nature, scope and reasons for the provision of health care benefits,
(b) the observance of the principles of legality, the economy, the integrity and the advisability of the financing of health care services provided;
3) to monitor the health status and the needs of the providers other than those insured for the provision of health care, medicines and medical devices.
3. In order to carry out the tasks referred to in paragraph. 1, the Minister for Health and the Fund shall have the right to process the following data:
1. surname and first name;
2) the PESEL number;
3) (repealed)
4) series and number of the ID card or passport-in the case of persons who do not have the PESEL number assigned;
5) data on the type and extent of the benefits provided to the recipients other than the insured health care services, to the extent specified in the provisions issued on the basis of art. 190 par. 1.
4. Minister of National Defence, Minister of Justice, Minister responsible for internal affairs, minister responsible for public finance and minister competent for health matters shall be entitled to obtain the information necessary for implementation the tasks resulting from the Act.
Art. 191a. [ Settlements with healthcare providers and pharmacies] Settlement with the healthcare providers and pharmacies of the Fund shall be implemented through the System of Registry of Medical Services-"RUM-NFZ", as referred to in the Act of 28 April 2011. o System of information in health care.
Article 192. [ Information to be provided by the Fund] 1. The Fund shall, at the request of the provider, inform it of:
1) held on a given day to the right to health care benefits and the basis of that right, and where the right to health care benefits results from the coverage of health insurance, also about the date of filing for health insurance, and the NIP and REGON numbers of the health insurance payer, on the basis of information processed in the Central List of Insured Persons;
2) the health care benefits provided to him and the amount of public funds spent on the financing of these benefits.
2. The Minister of Health shall, after consulting the President of the Fund, determine by way of regulation, the manner, the mode and timing of the occurrence of the Fund and the provision by the Fund of the information referred to in paragraph. 1, having regard to the extent of the information provided by the operator, the need to ensure proper identification and authentication of the provider and of a person acting in another person's name and the protection of personal data against unauthorised access or disclosure.
Art. 192a. [ Acknowledgement of benefits] In order to confirm the provision of health care benefits, the Fund may ask the provider to provide information on the health care benefits provided to him.
CHAPTER IX
Penal provisions
Art. 192b. (repealed)
Article 193. [ Liability for other acts inconsistent with the Act] Who:
1) it does not report the required provisions of the Data Act or reports untrue data affecting the dimension of the health insurance contributions, or provides untrue explanations in those cases or refuses to give them,
(1a) do not enter into health insurance or health insurance registration at the time of notification,
2) thwart or obstruct the carrying out of checks on the implementation of health insurance,
3) does not pay off within the deadline for health insurance premiums,
4) levy undue fees from the insured persons for the benefits covered by the agreement with the Fund for the provision of health care benefits,
5) prohibits or restricts the access of the healthcare provider to health care benefits in a serious way,
(5a) prohibit or restrict, to a serious extent, the possibility of being written to waiting lists,
6) being insured, does not inform the entity competent to make a notification to health insurance about the circumstances causing the need to report or unregister a member of the family,
7) state in the offer made in the proceedings concerning the conclusion of the contract for the provision of health care services financed by the Fund with inaccurate information and data
-is punished by the fine.
Article 194. [ Liability acting on behalf of a legal person or an entity without legal personality] The liability provided for in Article 193 shall also be subject to the admisation of acts specified in those provisions, acting in the name of a legal person or an organisational unit without legal personality.
Article 195. [ Application of provisions of the Code of Administrative Procedure] Adjudication on the matters referred to in Article 193 and 194, follows the provisions of the Code of Conduct on Offences Cases.
SECTION X
Amendments to the provisions in force
Article 196. (bypassed)
Article 199. (bypassed)
Article 217. (bypassed)
Article 228. (bypassed)
CHAPTER XI
Transitional provisions, adaptation and final provisions
Article 229. [ Explanatory provision] Whenever you are in the current legislation, you are talking about:
1. Act:
(a) the general insurance coverage of the National Health Fund,
(b) on general health insurance
-it shall be understood by this Act;
2. provisions:
(a) the general insurance coverage of the National Health Fund,
(b) on general health insurance
-it is understood by this Act and the provisions adopted on the basis of that law.
Article 230. [ The change in the legal basis of insurance concluded on the basis of the Law on the General Insurance of the National Health Fund] Insured persons under the Act of 23 January 2003. of the general insurance in the National Health Fund (Dz. U. Entry 391, of late. zm.) become from the date of entry into force of the Act insured under this Act.
Article 231. [ Ensuring continuity of benefits] 1. The Fund shall ensure the continuity of providing health services to the insured person.
2. Contracts for the provision of health services concluded for a period longer than until 31 December 2004. shall be terminated by law on 31 December 2004, unless, within 14 days of the entry into force of the Law on the date of entry into force of the law on which the contract has been concluded, it is to propose to the Fund that it remains bound. The declaration shall be made in writing under the action of invalidity.
3. In the event that it is not possible to conclude by 31 December 2004, contracts for 2005 providing health care services with the existing contracts concluded with the healthcare providers for the period up to 31 December 2004. may be extended for a period no longer than 31 December 2005, by way of a modification of the contract effected not later than 31 December 2004.
Article 232. [ Ribbon of the Fund in the rights and obligations of the National Health Fund] 1. The Fund shall enter into the rights and obligations of the National Health Fund set up on the basis of the Act referred to in art. 251.
2. The mass of the National Health Fund set up on the basis of the Act referred to in art. 251, becomes effective as of the date of entry into force of the Act under the law of the Fund, except that the property received from the State Treasury is included in the Fund's core fund.
3. Contracts, on the basis of which the National Health Fund set up under the Act referred to in art. 251, acquired the right to use the property, shall expire after 3 months from the date of entry into force of the Act, unless within 2 months from the date of entry into force of the Act in force the President of the Fund declares the other party to the agreement that it remains bound. The statement made by the President of the Fund shall be submitted in writing under the action of
4. Paragraph Recipe 3 does not concern agreements on the basis of which the National Health Fund set up on the basis of the Act referred to in art. 251, acquired the property or the use of perpetual property.
5. The transition of rights and property of the National Health Fund set up on the basis of the Act referred to in art. 251, the Fund shall be free of charge and shall be free of taxes and charges.
Article 233. [ The transformation of the closure balance of the National Health Fund into the opening balance of the Fund] 1. Balance of closure of the National Health Fund set up on the basis of the Act referred to in art. 251, it shall become the opening balance sheet of the Fund.
2. Financial plan for 2005 The National Health Fund set up on the basis of the Act referred to in art. 251, becomes the financial plan of the Fund. The provisions of the Act concerning the financial plan of the Fund shall apply accordingly
3. The financial report for the year 2004 of the National Health Fund set up on the basis of the Act referred to in art. 251, shall be approved in accordance with the procedure laid down in Article 4. 130 (1) 3.
Article 234. [ Disclosure in the perpetual accounts of property rights and perpetual usuals assumed by the Fund] 1. Disclosure in the books of perpetual property rights of real estate and the use of perpetual property, resulting from the acquisition by the Fund of property referred to in art. 232 par. 2, following the request of the President of the Fund, on the basis of a declaration of will, referred to in art. 239 (1) 2 point 5.
2. The proceedings concerning the entries shall be free of charge of the court.
Article 235. [ Takeover by the fund of data collections carried out by the National Health Fund] The Fund takes over the collections of data carried out by the National Health Fund set up on the basis of the Act referred to in art. 251, including sets of personal data. In the case of datasets located in the branches of the voivodship of the National Health Fund set up on the basis of the Act referred to in art. 251, these collections become the data sets of the Fund's competent branches.
Article 237. [ Transition of voivodship branches and headquarters of the National Health Fund in the organizational structure of the Fund] From the date of entry into force of the Act:
1) voivodship branches of the National Health Fund set up on the basis of the Act referred to in art. 251, shall become by virtue of the law of the Fund's voivodship;
2) the head office of the National Health Fund set up on the basis of the Act referred to in art. 251, the Fund shall become the head of the Fund.
Article 238. [ Transition of employees of the voivodship branches and the headquarters of the National Health Fund to the Fund 1. Employees of the provincial branches of the National Health Fund set up on the basis of the Act referred to in art. 251, as of the entry into force of the Act, shall become, by virtue of the law, the employees of the Fund, employed in the working positions in the competent branches of the voivodship.
2. The employees of the headquarters of the National Health Fund set up on the basis of the Act referred to in art. 251, as from the date of entry into force of the Act, shall become, by virtue of the law, the employees of the Fund employed in the positions of work at the headquarters of the Fund.
Article 239. [ The authority supervising the organisation of the Fund] 1. The Minister responsible for health shall supervising the organisation of the Fund.
2. The Minister of Health shall take the measures necessary to implement the objectives of the Act, and in particular:
1) appoints the Commission of Probes to determine the property of the National Health Fund, established on the basis of the Act referred to in art. 251, which will be transferred to the Fund, including the determination of which of the assets of the National Health Fund come from the property of the State Treasury;
2) draw up lists of property of the National Health Fund, established on the basis of the Act referred to in art. 251, and of all its organizational units, including a separate list of Treasury's property, which was taken over by the National Health Fund set up under the Act referred to in art. 251, after the liquidated casks of the sick and their organizational units;
3) prepares the acquisition by the Fund of Property of the National Health Fund, established on the basis of the Act referred to in art. 251, as well as all its organisational units, and in particular fixed assets and equipment;
4) prepares the acquisition by the Fund of the property rights and non-core National Health Fund, set up on the basis of the Act referred to in art. 251, as well as all its business units;
5) shall submit, in the form of a notarial deed, a declaration of intent to transfer to the Fund property of the State Treasury referred to in point 2.
3. The Treasury of the State Treasury referred to in paragraph. Article 2 (2), shall be counted against the Fund's core fund.
4. Until the declaration referred to in paragraph is made. 2 point 5, the Fund shall exercise the powers of the National Health Fund, established on the basis of the Act referred to in art. 251 to the extent that this fund has exercised these powers until the entry into force of the Act.
Article 240. [ Documents providing for health insurance coverage up to the time of issue of the insured health insurance card] 1. Until the issue of the insured health insurance card proof of health insurance is any document which confirms the entitlement to health care benefits, in particular the document confirming the payment of contributions to the health insurance.
2. In the case of pensioners and pensioners, the document confirming the payment of the health insurance contributions referred to in the paragraph. 1, is a document confirming the amount of the transferred pension, including in particular the transmission section or extract.
3. In the case of pensioners and pensioners, a document confirming the inclusion of health insurance may be a pensioner's ID card issued on the basis of separate provisions.
Article 241. [ Financing of health care benefits granted after the date of entry into force of the Act] The Fund finances health care provision on the basis of art. 97 ust. 3 point 3 granted after the entry into force of the Act.
Article 242. [ Height of the contribution dimension] The amount of the contribution to health insurance referred to in Article 79 par. 1, shall be:
1) from the date of entry into force of the Act until 31 December 2004. -8,25% of the base of the dimension;
2. from 1 January 2005. by 31 December 2005 -8,5% of the basis of dimension;
3. from 1 January 2006. by 31 December 2006 -8.75% of the base of the dimension.
Article 244. [ Leave in the capacity of statements regarding the choice of a doctor, nurse and midwife of primary health care] Statements of will of insured persons about the choice of a doctor, nurse and midwife of primary health care, submitted before the date of entry into force of this Act, shall remain valid.
Article 245. [ Condition of the exemption from the levy on the subject of insurance of insured persons voluntarily] Insurer shall not voluntarily pay the fee referred to in Article 68 par. 7 if they insure within 3 months from the date of entry into force of this Act.
Article 246. [ Transitional provision] The proceedings in individual cases of health insurance initiated and not completed before the entry into force of the Act are pending before the President of the Fund on the basis of the existing rules.
Article 249. [ Transitional provision] 1. Until the establishment of the bodies of the Fund referred to in art. 98 (1) 1, the bodies of the National Health Fund set up on the basis of the Act referred to in art. 251, as well as the directors of the voivodship branches of this Fund shall perform their functions on the existing basis, with the President of the Fund and the directors of the Provincial branches of the Fund shall perform its functions no more than 3 months from the date of entry into force This Act.
2. On the date of the appointment of the bodies of the Fund referred to in art. 98 (1) 1, the bodies of the National Health Fund set up on the basis of the Act referred to in art. 251, the work relations of the directors of the provincial branches of the Fund are addressed and the terms of the social councils are terminated.
Article 250. [ Delegation for the establishment of an organisational unit evaluating medical procedures] The Minister for Health shall take action, in particular, to set up an organisational unit for the evaluation of medical procedures, with particular reference to the medical procedures covered by the contracts. to provide health care benefits.
Article 251. [ Repealed provisions] The Law of 23 January 2003 is repealed. of the general insurance in the National Health Fund (Dz. U. Entry 391, of late. zm.).
Article 252. [ Entry into force] The Act shall enter into force on 1 October 2004, with the exception of:
1. 201, which shall enter into force on 1 January 2005;
2. Article 239 (1) 1 and 2, which shall enter into force on the day of the announcement of the Act.
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Annex to the Act of 27 August 2004.
(repealed)
[ 1] On the basis of art. 26 point 5 of the Act of 22 July 2014. amending the Act on health care benefits financed from public funds and certain other laws (Journal of Laws of the Law on Public Health Care). 1138; ost. 1. OJ of 2015 items 2198), art. 31lc ust. 6 will enter into force on 1 January 2020.
[ 2] The Act was repealed with effect from 1 October 2010. based on art. 6 of the Act of 30 April 2010. -Provisions implementing the law reforming the system of science (Journal of Laws of the European Union) 620), which entered into force on 1 October 2010.
[ 3] Currently, the Act of 20 April 2004. on the promotion of employment and labour market institutions (Journal of Laws of 2016 items 645; ost. zm.: Dz.U. z 2016 r. items 1579), which entered into force on 1 June 2004; on the basis of art. 145 of this Act.
[ 4] Currently, the Guaranteed Employee Benefit Fund within the meaning of the Act of 13 July 2006. on the protection of employees ' claims in the event of the insolvency of the employer (Journal of Laws of 2016 items 1256), which entered into force on 1 October 2006; on the basis of art. 48 (1) 2 of this Act.
[ 5] On the basis of art. 52 point 6 in conjunction with the Article 7 point 23 of the Act of 9 October 2015. amending the Act on the System of Information in Health Protection and certain other Laws (Journal of Laws of the 1991) art. 188c ust. 3 will be added on 1 July 2017
[ 6] On the basis of art. 52 point 6 in conjunction with the Article 7 point 23 of the Act of 9 October 2015. amending the Act on the System of Information in Health Protection and certain other Laws (Journal of Laws of the 1991) art. 188c ust. 4 point 2 will be added on 1 July 2017.
[ 7] On the basis of art. 52 point 6 in conjunction with the Article 7 point 23 of the Act of 9 October 2015. amending the Act on the System of Information in Health Protection and certain other Laws (Journal of Laws of the 1991) art. 188c ust. 6 will be added on 1 July 2017
