In application of the provisions of Articles 19.1 of Law 28/1975, of 27 June, on Social Security of the Armed Forces, and 75.2 and 3 of its General Regulation, approved by Royal Decree 2330/1978, of 29 September, the Management of the Social Institute of the Armed Forces (ISFAS) signed a concert, dated December 30, 1986, and under the regime of successive annual extensions, with the National Institute of Social Security and the General Treasury of Security Social, so that the members and other beneficiaries of the Special Regime of Social Security of the Forces Armed services may receive the provision of health care through the health network of Social Security, in accordance with the conditions in force for the General Regime.

Under the above mentioned precepts, the ISFAS, on the basis of a public call, has also concluded a concert with various health care insurance entities, which took effect during the years 1997 and, by agreement of extension, 1998 and 1999.

In order to facilitate the choice of those ISFAS holders who may choose to receive healthcare through the Social Security Health Network or a concerted insurance entity, taking into account the (a) the provisions of Article 4 (1) of the Treaty establishing the European Union for the provision of services to the Member States of the European Parliament and of the Council of the European Parliament and of the Council of the European Parliament and of the Council of the European Parliament

of the Council

This General Address agrees:

First.-Publish, as an annex to this Resolution, the text of the undersigned agreement for the health care of the affiliates and other beneficiaries of the ISFAS during the years 1997 and, in the case of an extension agreement, 1998 and 1999, with the following insurance entities:

"Insurer Islas Canarias, Sociedad Ancionima" (ASEICA).

"Medical Assistance Collegial Extremena, Sociedad Anonima de Seguros" (AMECESA).

"Inter-provincial Health Insurance Assistance, Limited Company" (ASISA).

"Insurance and Reinsurance Health Insurance, Public Limited Liability Company".

"Caser Salud, Compañía de Seguros, Sociedad Anonima".

"Adeslas Insurance Company, Limited Company".

"Groupama Ibérica, Seguros y Reinsurance, Sociedad Anonymous".

"The Equitable of Madrid, Company of Insurance, Company Anonymous".

Second. -To make public equally that, as the only applicants, the special care modalities detailed in Annex V of the concert have been assigned to the following entities:

"Insurer Islas Canarias, Sociedad Ancionima" (ASEICA).

"Inter-provincial Health Insurance Assistance, Limited Company" (ASISA).

"Insurance and Reinsurance Health Insurance, Public Limited Liability Company".

"Adeslas Insurance Company, Limited Company".

"The Equitable of Madrid, Company of Insurance, Company Anonymous".

Third. -To determine that, during the month of January of each of the years 1997, 1998 and 1999, the holders affiliated to the ISFAS with the possibility of choice and who so wish can change the entity, through the appropriate application, by the National Institute of Social Security (Social Security Health Network) or some of those referred to in the first subparagraph or, where appropriate, second.

The change referred to will be requested in the ISFAS Delegation or Subdelegation to whose scope the holder belongs or, in the case of Madrid, in any of the delegated offices.

The month of January of each year shall be unique for changes of entity of an ordinary character, without prejudice to the extraordinary changes provided for in clause 1.5 of the Concerts.

Fourth. -Dispose that in the delegations, Subdelegations and delegated offices of the ISFAS are exposed, at the disposal of the holders who wish to consult them, the catalogues of services of the respective province corresponding to the (a) insurance institutions for concerted health care.

The final annex of the concert will also be available to the members, which, due to its specific and technical nature, is not published.

Madrid, December 18, 1996. -Director General, José A. Sánchez Velayos.

ANNEX

Social Institute of the Armed Forces Concert with insurance entities for the health care of the Institute's affiliates during the years 1997, 1998 and 1999

INDEX

Chapter I

Concert and Payee Object

1.1 Object of the concert.

1.2 Beneficiaries in general.

1.3 Maternity Beneficiaries.

1.4 Birth and extinction of beneficiaries ' rights.

1.5 Entity change.

1.6 Affiliates not attached to medical entity.

Chapter II

Entity Media

2.1 General rules.

2.2 Healthcare stations.

2.2.1 Health Care Level I.

2.2.2 Health Care Level II.

2.2.3 Health Care Level III.

2.2.4 Level IV Health Care.

2.2.5 Media accessibility guarantee.

2.2.6 Emergency care.

2.3 Complementary benefits.

2.3.1 Oxygenotherapy, ventilation and aerosoltherapy at home.

2.3.2 Orthoprosthetic Prstation.

2.3.3 Transport for Health Care.

2.3.4 Health information and documentation.

2.4 Incorporation of new means of diagnosis and treatment.

2.5 Service Catalog of the entity.

Chapter III

Using the entity media

3.1 General Rule.

3.2 Scope of the protective action.

3.3 Territorial scope.

3.4 Requirements.

3.4.1 Identification.

3.4.2 Assistance Checks.

3.4.3 Additional requirements.

3.5 Freedom of choice of optional and center.

3.6 Health care content.

3.6.1 Assistance in external query.

3.6.2 Home Assistance.

3.6.3 Urgent assistance.

3.6.4 Assistance in hospitalization.

A) Requirements.

B) Duration of hospitalization.

C) Room type.

D) Expenses covered.

E) Maternity hospitalization.

F) Hospitalization for pediatric assistance.

G) Home hospitalization.

3.7 Pharmacy.

3.8 Direct use of ambulance service.

3.9 Complementary specifications.

3.9.1 Diagnosis and treatment of sterility.

3.9.2 Stomatology and Dentistry.

3.9.3 Rehabilitation.

3.9.4 Psychiatry.

3.9.5 Plastic surgery.

3.9.6 Transplants.

3.10 Special Supposition.

Chapter IV

Using non-entity media

4.1 General Rule.

4.2 Unjustified denial of assistance.

4.3 Life-critical urgent assistance.

4.3.1 Concept.

4.3.2 Requirements.

4.3.3 Scope.

4.3.4 Effects of communication to the entity.

4.3.5 Entity obligations.

4.3.6 Claim of the beneficiary.

Chapter V

Legal framework of the concert

5.1 Nature and regime of the concert and the relationships in the building.

5.2 Nature and regime of care relations.

5.3 Mixed Commissions.

5.4 Procedure for complaints.

5.5 Estimated refund claims execution procedure.

Chapter VI

Duration, price and economic regime of the concert

6.1 Duration of the concert.

6.2 Concert Price.

6.3 Economic arrangement of the concert.

ANNEX I

Support for rural areas

ANNEX II

Additional special conditions for the islands of the Balearic and Canarian archipelagos

ANNEX III

Relationship of services of the entity that require prior authorization of the same

ANNEX IV

Life-threatening pathologies

ANNEX V

Complementary care modalities

CHAPTER FIRST

Concert and Payee Object

1.1 Concert Object

1.1.1 The purpose of the concert is to provide healthcare to ISFAS affiliates throughout the national territory. This assistance will be provided in accordance with the provisions of Law 28/1975 of 27 June on Social Security of the Armed Forces and Law 14/1986, General of Health, seeking maximum homogeneity with the benefits provided by the System National of Health. To this end, the signatory of the concert (hereinafter the entity) shall make available to the members attached to it (hereinafter the beneficiaries) all the necessary means (hereinafter the means of the entity) to provide health care (a) a comprehensive quality or, if not available, of an exceptional nature, to assume or to reintegrate the costs incurred to the beneficiaries by the use of other means necessary for such assistance (hereinafter referred to as "foreign media"). entity), all in accordance with the provisions of the terms of the concert.

1.1.2 For its part and to the same end, the ISFAS is obliged to pay the entity the amount per month and person provided for in clause 6.2, subject to the specifications and procedure contained in clause 6.3.

1.2 Beneficiaries in general

1.2.1 Without prejudice to the provisions of clause 1.3, all ISFAS health care members, determined in accordance with their own rules, who have been left, are beneficiaries for the purposes of this concert. assigned to the entity for such purposes.

Recognition of the payee condition corresponds to the ISFAS.

1.2.2 For certain purposes of management and provided that the text of the clauses itself is derived, the beneficiaries of the concert may be called the holders, if they have an ISFAS affiliation document of their own, or simply beneficiaries, when they appear in the beneficiary's Document of Beneficiaries. In any event, the beneficiaries shall be assigned to the institution as long as the holder of the entity is dependent.

1.2.3 The holders who, where appropriate, were at 31 December 1996 and do not change the entity as provided for in clause 1.5 or in accordance with the rules governing the health network of the institution, shall be attached to the institution. Social security and those who choose it in accordance with the rules of that clause or when their discharge occurs in the ISFAS.

1.3 Maternity Beneficiaries

In addition to the beneficiaries included in clause 1.2, they are also beneficiaries for maternity, for the purposes of this concert, the spouses of the holders or those who have been living with them in the same way. the relationship of affectivity to that of the spouse, even if they do not meet the status of beneficiaries included in the corresponding document, provided that they are not holders assigned to another entity that is a signatory to the present concert. In this case, the care covers the preparation for delivery and all the incidences and obstetric pathology of pregnancy, childbirth and puerperium.

1.4 Birth and extinction of beneficiaries ' rights

1.4.1 Without prejudice to the following paragraph and clause 1.6, the rights of beneficiaries start on the date on which they have been assigned to the institution by the services of the ISFAS, without any time limit. of lack for any kind of assistance.

1.4.2 To the above mentioned effects, it is presumed that the newborn is attached to the entity that caters to the mother, from the moment of delivery until one month. From then on, this right is conditional on the formalisation of the membership with the consequent economic effects.

1.4.3 The rights of the beneficiaries are extinguished, in any case, on the date when the Services of the ISFAS agree their discharge in the same or the entity.

1.5 Entity change

The holders attached to the entity may switch to another of the concerted ones in the following cases:

A) On an ordinary and general basis, during the month of January of each year, in the form established by the ISFAS.

B) With extraordinary character:

a) When a change of destination occurs for the province-based holder.

(b) Where the data subject obtains the written agreement of the two entities concerned.

c) Where, in the light of objective circumstances justifying the change of a plurality of holders affected by the same health care problem, the ISFAS Directorate-General agrees to the opening of a special period of choice of entity.

(d) In particular cases where, in the judgment of the Director-General of the ISFAS, exceptional circumstances warrant the change of entity.

1.6 Affiliates not attached to medical entity

The military career or employment officer who, without having to be assigned to the coverage of military health, has not formalized his or her attachment to one of the concerted entities or to the health network of Social Security and that, specifying health care for you or your beneficiaries, requires it in the offices of the entity, you will have the right to receive it once you credit your condition.

The entity shall provide the assistance and, within the following five working days, shall notify the ISFAS to the effect of the insurance at the institution with the effect of the fifth of the said days and the payment of the expenditure on the assistance provided up to the date of discharge.

CHAPTER II

Entity Media

2.1 General rules

2.1.1 The means of the entity may be as follows:

A) Healthcare personnel, optional and non-optional, dependent on the entity through a relationship of a working nature or linked to it by means of a civil relationship.

B) Centers, facilities or establishments owned by the entity or arranged by the entity under any legal regime.

C) Means that another entity is available and that they are assigned, by subconcert with the concerted entity, to the purposes of this concert.

Also for the purposes of this concert, the primary care and emergency services of the Public Health Network are assimilated to the entity's media, according to the provided for in Annex I.

2.1.2 The entity shall have all the means available to it in its catalogue of services.

The ISFAS may verify, when it deems appropriate, the entity's compliance with the obligation laid down in the preceding paragraph.

2.1.3 The means of the entity must comply with the requirements established in general by the current health regulations, under the supervision that, with the same character, can proceed from the health administration competent.

The qualified specialists must have the title recognized, in the terms provided for in Royal Decree 127/1984, of 11 January, for which the specialized medical training and the obtaining of the medical degree are regulated Specialist.

If the ISFAS is aware of the possible non-compliance with these general requirements, it may inform the competent health authority.

2.1.4 Within each of the levels of assistance provided for in this Chapter, the means available to the institution shall, in any event, ensure the principle of the free choice of optional, taking into account the set out in clauses 2.2.1, 2.2.2, 2.2.3 and 2.2.4.

2.1.5 The ISFAS will communicate to the signatories of this concert the way in which they will have to provide the necessary information, for the integration of the data relating to the provision of services to the beneficiaries of the ISFAS, in order to make it possible to compare the different care modalities.

2.2 Healthcare stations

A) Healthcare comprises the following modes:

a) Primary Care.

b) Specialized Attention.

c) Pharmaceutical Benefits.

(d) Complementary Benefits.

e) Health Information and Documentation Services.

B) Healthcare is structured at care levels by population sizes:

a) Health Care Level I: Localities of up to 20,000 inhabitants.

b) Level II Health Care: Municipalities of more than 20,000 and up to 75,000 inhabitants.

c) Level III Health Care: Municipalities of more than 75,000 inhabitants and provincial capitals.

d) Level IV Health Care: Autonomous Communities.

Each level of higher population size includes all services from the lower levels.

For island territories, account shall also be taken of the provisions of Annex II.

2.2.1 Health Care Level I.

A) Locations from 1,000 to 20,000 inhabitants will be provided with Primary Care, which will include health care at the outpatient, home and emergency level in charge of the general practitioner, Pediatrics, Nurse, Physiotherapist and Odontologo, taking into account:

(a) The locations of 1,000 or more inhabitants will always be provided by General Practitioner and Nurse.

(b) The localities of 5,000 or more inhabitants will also have orders, from Pediatrics, Matrona, Fiosiotherapist and Odontologo.

B) Media availability will conform to the following rules:

A general practitioner for every 1,500 inhabitants or fraction.

A Nurse for every 2,500 inhabitants or fraction.

A pediatrician for every 1,500 inhabitants under the age of 14 or fraction.

A Matron and a physiotherapist for every 20,000 inhabitants.

A Dentist for every 12,000 inhabitants.

C) Primary Care Services Portfolio. The Portfolio of Primary Care Services will include in general the same benefits as for this level establishes Royal Decree 63/1995, of January 20, on the Management of Health Benefits of the National Health System, and of It specifies the vaccinations of the child and adult, the care for patients with HIV/AIDS and the basic physiotherapeutic treatments. Also, the Primary Care of Urgency will be given to people of any age, continuously, during the twenty-four hours of the day, through the medical and nursing care, in the outpatient system or in the patient's home.

D) Extra Criterion. As a criterion for the provision of this clause, it shall be taken into account that health care at the outpatient, home or emergency level of the general practitioner, the doctor, the nurse and the Matron may be provided by the services Primary and Emergency Care for the public health network.

2.2.2 Health Care Level II.

A) In the municipalities of more than 20,000 and up to 75,000 inhabitants, in addition to the Primary Care services referred to in clause 2.2.1, the following services of Specialized Care:

Outpatient assistance specialized in consultations, including, where appropriate, the conduct of outpatient surgery.

Specialist assistance in hospitalization, including medical, surgical, obstetric and pediatric assistance. Psychiatric care, including diagnosis and clinical follow-up in outpatient settings.

Hospital and extra-hospital emergency care.

B) At this level, the entities must have at least two optional optional, increased, if appropriate, in proportion to the number of beneficiaries, according to the criteria used in the National System Health.

C) Portfolio of Health Care Level II Specialized Care Services.

External Queries/Hospitalization/Services/Functional Units/Services/Functional Units

Medical Area/Medical Area

A. Digestive.

Cardiology.

Stomatology. //Hemotherapy.

Internal Medicine//Internal Medicine

Obstetrics/Ultrasound/Obstetrics

Pediatrics. /Paediatrics.

Psychiatry.

Rehabilitation. /Logopedia. /Rehabilitation.

ICU.

Surgical Area/Surgical Area

Anesthesia and Resuscitation.

General Surgery. /General Surgery.

Gynecology. /Gynecology.

Ophthalmology. /Ophthalmology.

ORL. /ORL.

Traumatology. /Traumatology.

Central Services/Central Services

Clinical Analysis. /Clinical Analysis.

Pathological Anatomy.

Pharmacy.

Radiodiagnosis. /General Radiology. /Radiodiagnosis. /General Radiology.

Ultrasound. /Ultrasound.

Mammography. /Mammography. TAC. /TAC.

Emergency/Emergency

2.2.3 Health Care Level III.

A) In the municipalities of more than 75,000 inhabitants, in the cities of Ceuta and Melilla and in the provincial capitals, in addition to the services of Primary Care and Specialized Care provided in the clauses 2.2.1 and 2.2.2, the following:

Outpatient assistance specialized in consultations, which will include, where appropriate, the conduct of outpatient surgery.

Specialist assistance in hospitalization.

Specialist day hospital care for patients who need medical or nursing care and do not require a hospital stay.

Specialist assistance for home hospitalization.

Psychiatric care, which includes the diagnosis and clinical follow-up in outpatient treatment and hospitalization in acute processes and the resharpening of chronic processes.

Inpatient and extra-hospital emergency care.

B) At this level, institutions must have at least two optional, on a special basis, increased, where appropriate, in proportion to the number of beneficiaries, according to the criteria used in the national system. Health.

C) Health Care Level III Specialized Care Services Portfolio.

External Queries/Hospitalization/Services/Functional Units/Services/Functional Units

Medical Area/Medical Area

Allergology. /Allergology.

Digestive System. /Digestive System. /Digestive Endoscopy.

Cardiology. /Electrophysiology. /Cardiology. /Electrophysiology.

Dermatology. /Dermatology.

Endocrinology. /Endocrinology.

Stomatology.

Hematology. /Hematology. /Day Hospital.

Internal Medicine. /Internal Medicine. /Infectious Unit.

Nephrology. /Hemodialysis and Peritoneal Peritoneal Dialysis. /Nephrology. /Hemodialysis and Peritoneal Dialysis.

Pneumonia. /Pneumonia. /Resp Endoscopy.

Neurology. /Neurology.

Obstetrics. /Ultrasound. /Obstetrics.

Medical Oncology. /Medical Oncology. /Chemotherapy.

Day Hospital.

Pediatrics. /Paediatrics. /Neonatology.

Psychiatry. /Psychiatry. /Detoxification Unit.

Day Hospital.

Rehabilitation and Physiotherapy. /Rehabilitation. /Early Care Unit.

Hospice Unit.

Anesthesiology. /Awakening Unit.

Resuscitation Unit.

Pain Unit.

Angiology and C. Vascular.

General and Digestive Surgery. /General and Digestive Surgery. /laparoscopy.

Maxillofacial Surgery. /Maxillofacial Surgery.

Pediatric Surgery. /Paediatric Surgery.

Vascular Surgery.

Gynecology. /Ultrasound. /Gynecology. /IVE.

Ligature of Trompas.

Ophthalmology. /Ophthalmology.

ORL. /ORL.

Traumatology and C. Orthopaedic. /Traumatology and C. Orthopaedic.

Urology. /Urology. /Litotricia.

Vasectomy.

Endoscopy.

Intensive Care Unit. /Adults.

Paediatric.

Central Services/Central Services

Clinical-Biochemistry Analysis. /Laboratory. /Pathological Anatomy.

Biochemistry.

Pharmacology.

Hematology.

Immunology.

Microbiology.

Parasitology.

Pharmacy.

Neurophysiology. /Evoked Potentials.

EMG.

Radiodiagnosis. /General Radiology. /Radiology. /General Radiology.

Ultrasound. /Ultrasound.

Mammography. /Mammography.

TAC. /TAC.

RNM. /RNM.

Bone Densitometry. /Bone Densitometry.

Emergency/Emergency

External Queries/Hospitalization/Services/Functional Units/Services/Functional Units

Cardiology. /Cardiology. /Diagnostic Hemodynamics.

Therapeutic Hemodynamics.

Cardiovascular Surgery. /Cardiovascular Surgery.

Plastic and Repairing Surgery. /Plastic and Repairing Surgery.

thoracic Surgery. /Thoracic Surgery.

Nuclear Medicine. /Nuclear Medicine.

Neurosurgery. /Neurosurgery. /Stereotaxic Surgery.

Neurophysiology. /Sleep Unit.

High Risk Obstetrics. /Cobaltotherapy.

radioterapic Oncology. /Radiumtherapy and Isotopes.

Radiac. /Brachytherapy.

Linear Accelerator.

Family Planning. /Genetic Advice.

Assisted Reproduction Unit. /FIV.

Artificial Insemination.

Bank of Semen.

Transplants. /Heart.

Cornea.

Liver.

Bone Marrow.

Pancreas.

Lung.

Kidney.

Burns Unit.

Medular Injured Unit.

Lab. /Genetics.

Cytogenetics.

Molecular Genetics.

Nuclear Medicine.

Radiology. /Digital Angiography.

Gammacamara.

Interventional Radiology.

2.2.5 Guarantee of accessibility to the media. -In case of not having the means that in each level of care demands the Portfolio of Services of the present concert, and whenever this is due to the lack of sanitary resources (a) the institution must provide such means in the locations of the highest immediate level in which they exist, or if it is impossible for the public health network to agree with the public health network. In any case, the appropriate emergency health care shall be ensured at each level.

2.2.6 Urgency. -The Emergency Care will be provided in accordance with the provisions of Clauses 2.2.1, 2.2.2 and 2.2.3 of this concert and according to the following specifications:

(a) Health Care Level I: Primary Emergency Care will be provided, on an ongoing basis, during the twenty-four hours of the day, to people of any age, through medical and nursing care. Outpatient and home.

b) Levels II and III of Health Care: In addition to the Emergency Care established for the level I of health care, the institution must have the services of hospital emergency and extra-hospital emergency services. in clauses 2.2.2 and 2.2.3, as appropriate. Such services may be provided by the beneficiaries at all times and shall be provided with the required medical practitioners and the personal and material resources necessary for their function.

2.2.7 The entity will facilitate access to the centres and services included in the Service Portfolio, so that the ISFAS can check the adequacy of the means with respect to the offer of services.

2.3 Complementary Benefits

2.3.1 Oxygenotherapy, ventilation and aerosoltherapy at home. -It requires a prescription from the specialist of the institution and presentation to it for authorization.

2.3.2 Orthoprosthetic Prstation. -Fixed surgical prostheses will be carried out by the entity, with such medical devices requiring internal implantation in the patient, through a certain act. surgical. Also included are the materials used to perform osteosynthesis techniques.

Oosteintegrated implants for dental prostheses are excluded.

2.3.3 Transport for healthcare.

A) Transport type:

It is understood by means of sanitary transport that, for the care provided in the concert, it is carried out in the following means:

(a) Ordinary transport: Car, bus, railway, boat and plane. Such transfers shall always be valued at their cost, in a normal or tourist class, on regular bus or rail transport lines or, if they are treated as island provinces or the cities of Ceuta and Melilla, by boat or plane.

b) Extraordinary transport: Ambulance, medicalized ambulance, mobile UVI, medicalized aircraft and helicopter and taxi. This transport shall be used in the event that the patient's pathology prevents him from travelling in ordinary means, which is accredited by the written prescription of the optional, stating the need for the transfer in those means.

B) Derived benefits:

The beneficiary of the ISFAS shall be entitled to health transport by the institution, provided that it is carried out to the nearest locality in which it has the means, in the following cases:

a) In ordinary means of transport:

In order to receive regular treatments, from the locality in which it resides, on a temporary or permanent basis, to the nearest locality in which the entity has the means, provided that said locality has more than 25 kilometers.

To services of the level IV of Health Care, provided that it is outside the locality of residence.

Between different levels of health care, in the event of not having the means required in each of them, provided that the distance between the locality in which it resides and the one in which the assistance is provided more than 25 kilometres.

b) In extraordinary means of transport:

For reasons of urgency, from the place in which it occurs, for its entry into the center of the entity. In such cases, the prior written prescription, stating the need for the transfer in such means, may be from the non-member to the entity that has provided the initial assistance.

To receive regular treatments, such as hemodialysis, radiation therapy, rehabilitation, or other treatments, from the place where you reside on a temporary or permanent basis.

Between different levels of healthcare.

To services located outside a location in level III of Health Care, in the event that the entity does not have the means required at this level.

C) General conditions:

(a) All displacements require prior authorisation of the entity, except for those that occur for reasons of urgency and in cases of use of ordinary means to move between levels of healthcare in the assumption of not having the means required in each of them.

(b) Travel in extraordinary means of transport always requires a written prescription from the optional person stating the need for the transfer in those means.

(c) Journeys made by less than 15 years of age shall entitle the passenger to the transport costs. Residents of the cities of Ceuta and Melilla are exempt from the above age requirement, which, in any case, must provide written prescription of the optional.

2.3.4 Health information and documentation. -Entity's faculty are required to:

(a) Inform the patient and his or her family members or relatives of their rights and duties, in particular for the proper provision of informed consent and the use of health services.

b) Meet and deliver the discharge report at the end of the stay in a hospital institution or the external consultation report for specialized care.

c) Communicate or deliver, at the request of the person concerned, a copy of his or her medical history or certain data contained therein, without prejudice to the obligation of his or her conservation in the health centre.

(d) To comply with the medical reports on sickness, accident, pregnancy and maternity, both for the initial discharge and for the continuity of the work.

e) Facilitating the medical records and reports provided for in the fifth paragraph of the Resolution of the Secretariat of State for Public Administration of 29 December 1995, and other relevant rules, for the processing of the retirement procedures of civil servants for permanent incapacity for service.

f) Issue the medical reports required by the ISFAS to its beneficiaries for certain or complementary health benefits.

g) Issue the medical documentation or certification of birth, death and other extremes for the Civil Registry, and other reports or certificates on the health status required by law or regulation.

2.4 Incorporation of new diagnostic and treatment media

Any new diagnostic or treatment technique that appears after the signature of the concert will be a mandatory means for the entity when it is implemented in the public health network. In case of doubt, the provisions of Royal Decree 63/1995 of 20 January on the Management of Health Benefits of the National Health System will be available.

2.5 Entity Services Catalog

2.5.1 The catalogue of services of the entity contains the detailed relationship of the means of the entity and its purpose is to enable the use of these means by the beneficiaries.

2.5.2 Services Catalogues will be provincial-level and will include:

A) Portfolio of services by levels of health care, broken down by external consultation and hospitalization, as provided for in Clauses 2.2.1, 2.2.2, 2.2.3 and 2.2.4, ordered in descending order.

B) Relation of emergency services, hospital centers, physicians, groups of specialties, ambulance service and information service of the entity, with addresses, telephones and operating hours.

C) A comprehensive list of the means of the entity requiring prior authorisation of the institution and which shall be in accordance with Annex III.

D) In addition to the above points, it shall contain the relation of the Information, Emergency and Ambulance services for the other provinces in order to facilitate their use in the event of displacement of the beneficiaries.

2.5.3 The entity shall draw up under its responsibility its Service Catalogue and, on the first working day of the beginning of the concert, make available to the Territorial Delegations of the ISFAS the necessary number of copies for delivery to persons who request them. Where appropriate, they shall be updated at least once a year, making available to ISFAS on 31 December 1997 and 1998 the necessary number of modified copies or 'addenda' to the Catalogs.

2.5.4 If there is any reduction in the service catalogues, the entity is obliged to guarantee patients in the treatment of serious pathological processes, the continuity of service delivery with the same optional or until 31 December of the year in which the discharge had been made, provided that there was agreement of the optional or centre.

The casualties will be brought to the attention of the relevant ISFAS delegations within 15 working days and, if they reduce a catalogue of services in such a way as to meet the minimum requirements set out in the This Chapter shall be completed simultaneously by the institution, and shall also communicate to ISFAS the services, centres or facultives to replace the casualties produced. In addition, if the reduction or changes affect more than 25% of the initial content of the catalogue, the entity is obliged to take the necessary measures to ensure that the holders attached to it are able to dispose of the new catalogues.

In the event that the entity does not comply with the above paragraph, it is required to assume the costs arising from the use by the beneficiaries of the services provided by the institutions and the optional in the last catalog in force.

CHAPTER III

Using the entity media

3.1 General Rule

For the purposes set out in Articles 19.1 of the Law on Social Security of the Armed Forces and 75.2 of its General Regulation, it is considered that the means of the entity are the services assigned to the health care of the the beneficiaries attached to it.

The use of the means of the entity will always be carried out according to the current health regulations.

3.2 Scope of the protective action

Beneficiaries will be able to use the means of the entity in cases of common or professional illness, in those of injuries arising from accidents, whatever the cause, even if it is an act of terrorism, and by pregnancy, childbirth and puerperium, as well as in the preventive actions collected at the concert.

3.3 Territorial Scope

The right to the use of the means of the entity may be exercised throughout the national territory, regardless of whether they are themselves, agreed or subconcerted.

3.4 Requirements

3.4.1 Identification.-The condition of the beneficiary must be credited in advance, displaying the corresponding document of affiliation to the ISFAS and, where applicable, the beneficiary. One and the other may be replaced by the Individual Health Care Document, issued by the ISFAS in accordance with its own rules.

In the case of maternity assistance to the beneficiaries referred to in clause 1.3 not included in the document of beneficiaries of the insured person, the link or situation shall be credited by displaying the Family Book or any other means of proof admitted in law.

In cases where, for reasons of urgency, it is not possible to provide in the act the above documentation, the beneficiary must identify with his or her national identity document or other document that accredits his/her personality and/or present the documentation within the maximum period of forty-eight hours.

3.4.2 Assistance checks.-The checkouts of the assistance checks shall be made by the institution and made available to the beneficiaries at no cost to the beneficiaries, in the offices of the institution.

The payee must deliver the corresponding attendance check when it comes to the entity's media. The use of these checks shall be carried out exclusively, due to their non-transferable nature, by the holder to which they correspond and by the beneficiaries included in their beneficiary's document, the data being correctly completed The same is true.

The entity, after communication to the ISFAS, may completely or partially delete the requirement for checks. In this case, after agreement with the ISFAS, it may replace in whole or in part the system of checks by any other established on magnetic or analog supports.

3.4.3 Additional requirements. The entity may require, in the cases expressly stated in this concert, any additional requirements, such as a prescription and prior authorization. Annex III contains a comprehensive list of the assumptions for the use of the means of the institution which require prior authorisation of the institution.

3.5 Optional and Center Choice Freedom

The beneficiaries will be able to choose freely optional and center from among those listed in the service catalogues of the entity throughout the national territory.

3.6 Healthcare Content

3.6.1 Assistance in external consultation.-The beneficiary will be directly directed to the optional Primary and Specialized Care option to receive the assistance that he needs, without further requirement to prove his/her condition and to deliver the corresponding assistance cheque or, in the case provided for in the final paragraph of clause 3.4.2, present the appropriate magnetic support.

3.6.2 Home Care.-In Primary Care, home care will be provided by primary healthcare professionals at the patient's home, when the patient cannot travel, due to his or her disease, to the external query.

In Specialized Care, home care by an optional specialist requires the prior written prescription of the Primary Care physician. In any case, the specialist will inform the doctor who requested the interconsultation on the diagnostic and therapeutic orientation of the case.

3.6.3 Urgent assistance. The urgent assistance may be obtained from the general medical, pediatric and nursing physicians of the entity and, outside of the hours of consultation and in any case, of the Emergency Services of Primary and Specialized Care of the entity.

3.6.4 Assistance in hospitalization. -It will be provided in the institutions of the institution although, at the request of the beneficiary, the entity, in his capacity, may authorize the entrance in a military hospital.

A) Requirements. Admission to a hospital will require:

(a) The prescription of the same by the institution's physician, with indication of the center.

b) The authorization of the "flyer" of prescription by the entity.

c) The presentation of the authorized "flyer" in the center.

B) Duration of hospitalization. The hospitalization will persist while, in the opinion of the physician responsible for the care of the patient, there is a need for it, without any reason for this social type.

C) Room type. The hospitalization shall be carried out in a single room with bath or shower and a companion bed, and must be provided by the higher level entity when it has not been available of the indicated type. In no case may rooms which are part of the accommodation capacity of the centre be excluded.

By way of exception, the ISFAS may authorise the institution to have in its Services Portfolio of hospital facilities that do not comply with the requirement of the previous paragraph.

D) Expenses covered. The entity covers all expenses incurred during the hospitalization of the patient, from admission to hospital discharge, including:

The performance of the examinations and diagnostic tests, and the application of the therapeutic treatments or procedures that the patient requires, both for the pathology treated and for any other intercurrant other than the the main process that prompted the entry.

The treatment of possible complications that may occur throughout the care process.

Additional treatments that the patient may require, such as: Dialysis, rehabilitation, etc.

Drug treatment, medicinal gases, fungible material, and sanitary products that are accurate.

Cures.

Diet according to prescribed diet.

parenteral and enteral nutrition.

Assistance by specialized medical equipment, nursing and auxiliary health personnel.

Stays in single room, including basic hotel services directly related to the hospitalization itself.

ICU stays.

E) Maternity hospitalization. In the event of circumstances that prevent the presentation of the "steering wheel" authorized by the entity at the time of entry, it must be provided as soon as possible and, in any case, before the hospital discharge.

For the purpose of the newborn care, the provisions of clause 1.4.2 shall be taken into account.

If the practice of the tubal ligation is decided at the same time of delivery without having indicated in the "steering wheel" of income, the expenses caused by this concept will also be borne by the entity.

F) Hospitalization for pediatric assistance. Children will be given zero to fourteen years inclusive. In any case, the person accompanying the child shall be entitled to a bed and a companion pension.

When the companion resides in a location other than that of the health center and the characteristics of the nursing units of the center do not permit its lodging, the entity will pay a compensatory amount of 4,500 pesetas per year. day.

G) Home hospitalization. The home hospitalization may be carried out in cases where the condition of the patient permits and makes it advisable. The indication must be made in writing by the doctor of the entity who comes to him, in the appropriate steering wheel or document. This document will be presented to the institution, so that it will authorize this hospitalization regime and assign the health care team to take care of the assistance.

In all cases of home hospitalization, including hemodialysis at home, the entity is obliged to provide adequate material and human means, including oxygen therapy, and the patient is also responsible for medication until the medical discharge or the pass to the situation of ordinary care home.

3.7 Pharmacy

3.7.1 The facultative of the institution shall prescribe the medicinal products and other pharmaceutical products in the terms laid down in Royal Decree 83/1993 of 22 January, which regulates the selection of medicinal products for the purposes of their funding by the National Health System, and further developments. The prescriptions must be made in the official prescriptions of the ISFAS which, in talonaries, will make the headlines.

The acquisition will be made by the beneficiaries at the Pharmacy Offices, in accordance with the rules established by the ISFAS for their pharmaceutical delivery.

If, as a result of the analysis by the ISFAS of the data corresponding to the requirements, certain measures are considered appropriate in relation to the same, the Directorate-General of the ISFAS, prior to the Commission's report The National Mixed Party may agree that it should be implemented and enforced by the entity.

3.7.2 Medicines qualified as hospital use in the standards of PROSEREME 5 of the Directorate General of Pharmacy and Health Products of the Ministry of Health and Consumer Affairs, will be provided by the Pharmacy Services Hospital in charge of the entity.

3.7.3 The precise means, elements or pharmaceutical products for the performance of diagnostic techniques, such as contrast media or other, intrauterine devices (IUD) and insulin syringes, will always be position of the institution.

3.8 Direct use of ambulance service

In cases of urgency where it has not been possible to communicate with the Emergency and/or ambulance services of the entity and no alternative is appropriate, the beneficiary may request directly from the Ambulances existing in the locality the transfer to the Emergency Service of the entity to which it is attached and the entity must assume or reintegrate the expenses of the shipment.

3.9 Complementary Specifications

3.9.1 Diagnosis and treatment of sterility. -The entity is obliged to assume the necessary expenses to obtain the diagnosis of sterility, which will be extended, where appropriate, to the couple. However, the treatment of the cause of sterility will only reach the spouse if it is a beneficiary included in the corresponding document.

3.9.2 Stomatology and Dentistry.

A) You will understand the treatment of stomatological conditions in general, including any kind of extractions, cleaning of the mouth once a year or prior to the justification of the optional specialist, and the periodontics.

B) They are excluded, both in terms of their cost and their placement, the fillings, the endodontics, the dental prostheses, the osteointegrated implants and the orthodontics.

(C) However, when an accident of service or occupational disease is measured, all treatments and performances, including the necessary dental prostheses, as well as their placement, shall be carried out by the institution.

D) For periodontics and mouth cleaning, as well as, in case of accident of service or occupational disease, for dental prostheses, it will be necessary to prescribe the prescription of the optional specialist, together with budget in the case of prostheses, for authorisation by the institution.

3.9.3 Rehabilitation.

A) The rehabilitation plan must be made by the entity's rehabilitator physician, and must contain:

a) Valuation of the patient's functional status and the evolution of the process.

b) Exercise program.

c) Professionals responsible for the exercise program: Fiotherapist, foniatra, logopeda.

d) The number of sessions calculated to end the plan.

B) The rehabilitation plan must be submitted to the entity for authorization.

C) The rehabilitator physician will, in any case, supervise the patient's evolution and the plan's fulfillment by the assigned professionals, until the moment of discharge.

(D) The entity's obligation shall end when the functional recovery has been achieved fully or as much as possible because it has entered the process into an unsurpassed stabilisation state, or when it becomes maintenance and occupational therapy, except in the case of a process of resharpening.

3.9.4 Psychiatry.

A) Psychiatric assistance is covered, including diagnosis, clinical follow-up, and psychopharmacotherapy. Psychoanalysis, hypnosis, ambulatory narcolepsy and psychological tests are excluded.

B) Also, hospitalization is covered in the cases of patients affected by acute or chronic acute processes. If the revenue is produced in a non-concerted centre, the institution shall assume the assistance in accordance with the scale set out as the final annex.

C) Once the acute or chronic psychiatric processes in charge of the institution have been overcome, the beneficiary may obtain from the ISFAS, where appropriate, the financial assistance that is appropriate in accordance with its specific regulations.

(D) However, in cases of mental illness arising from an accident of service or occupational disease, the institution shall bear the total amount of the costs of hospitalization, including chronic and uncapped processes. temporary.

3.9.5 Plastic surgery. -Excluded cosmetic surgery that does not have a relationship with accident, disease or congenital malformation. In the case of an accident of service or occupational disease, it shall be carried out in all its amplitude, including, if necessary, cosmetic surgery in cases where, even if the lesions have been cured, deformations or mutilations shall be left that cause physical appearance or make the patient's total recovery difficult.

3.9.6 Transplants. Transplants of all kinds, as well as bone grafts, are included in the coverage. Organ procurement and transplantation shall be performed in accordance with the current health legislation, corresponding to the entity assuming all the costs of obtaining and transplantation of the organ or tissue.

3.10 Special Subposition

(A) Where, by a decision of its own nature and for a given intervention, a beneficiary chooses a doctor outside the institution, he may request that he take charge of the detention at a centre of the institution, provided that the request is based on the continuity of care in serious pathological processes or on the doctor's family, including the concept of family up to the fifth degree of kinship, both by consanguinity and by affinity.

B) The entity must authorize the detention, in his capacity, if one of these circumstances is present and if, in addition, the physician fulfils the conditions required by the center to act professionally in the same.

C) Interment will be authorized by the period of

time which is normally considered sufficient for the intervention concerned, without prejudice to its extension in the case of a medical cause which justifies it.

D) The entity shall cover the costs of the internment in the terms of clause 3.6.4, D) with the exception of the doctors ' fees and, in the case of childbirth, Matrona, which shall be on behalf of the beneficiary.

CHAPTER IV

Using non-entity media

4.1 General Rule

Pursuant to Articles 19, 3, the Armed Forces Social Security Act, and 76 of its General Regulation, in connection with clause 3.1 of this concert, when a beneficiary, by own decision or of his or her family members, use means outside the institution, pay, without right to reimbursement, the costs that may be incurred, except in cases of unjustified refusal of assistance and in the cases of urgent assistance of a nature vital.

4.2 Unjustified denial of assistance

4.2.1 For the purposes provided for in Article 76 of the General Regulation on Social Security of the Armed Forces, an unjustified refusal of assistance shall be deemed to occur:

A) When the beneficiary does not obtain from the means of the entity an assistance requested subject to the conditions and requirements of this concert and, communicated in writing such circumstance to the entity, it does not offer him, also in writing and before the end of the third working day following the communication, the aid solution at the appropriate level.

In this case, the beneficiary shall have the right to have the entity reintegrate the expenses incurred by the assistance received from the existing non-existent media at the level concerned. The refund shall be made within 10 working days of the date on which the beneficiary submits to the institution the appropriate written complaint, accompanying the supporting documents for such expenditure.

B) When the media availability requirements of clauses 2.2.1, 2.2.2, 2.2.3, 2.2.4 and 2.2.5 of this concert are not met.

In this case, the beneficiary may refer to the faculty or centers that exist at the appropriate level and, without the need to communicate to the entity the beginning of the assistance received, will have the right to the entity reintegrate the costs incurred. The refund shall be made within 10 working days of the date on which the beneficiary submits to the institution the appropriate written complaint, accompanying the supporting documents for such expenditure.

(C) Where an individual of the institution prescribes in writing, with exposure of the medical reasons, the need to refer to an optional or other person's office and, presented by the beneficiary, the prescription in the entity, is, before the end of the tenth working day following the presentation, does not authorize the referral to the optional or non-medical center or does not offer a care alternative with its means.

In this case of refusal, the beneficiary who uses the other means specified in the prescription presented to the entity shall have the right to the same reintegrate the expenses incurred, equally without the need of inform you of the start of healthcare. The refund shall be made within 10 working days of the date on which the beneficiary submits to the institution the appropriate written complaint, accompanying the supporting documents for such expenditure.

If the entity approves the referral to an optional or foreign institution, it must authorize and assume the expenses incurred during the entire care process, without exclusions. If you offer your own means, you must ensure that they are in attendance and can carry out the prescribed diagnostic or therapeutic technique.

(D) Where in a centre of the institution, in which a beneficiary is entered or who has come to receive assistance, the appropriate means are not available or are not available, according to the discretion of the institution or the the centre of the assistance, which is implicitly expressed in the referral of the beneficiary to a foreign institution.

In this case of refusal, the beneficiary shall have the right to have the costs incurred directly by the entity, including those for the shipment. It is not necessary for the beneficiary to inform the entity of his/her income in the foreign centre, since the refusal has originated in a centre of the entity itself.

4.2.2 The beneficiary may lodge a complaint with the relevant ISFAS delegation when the institution incurs any of the alleged unjustified refusal of assistance provided for in the previous paragraph or does not the reimbursement of the costs incurred within the time limits referred to in that paragraph.

4.2.3 The acceptance by the entity or, where appropriate, the statement by the ISFAS that there is an unjustified refusal of assistance, does not imply acceptance or declaration, respectively, that there has been a refusal for assistance to other civil or criminal purposes, for which, where appropriate, the beneficiary will have to go to the appropriate ordinary court.

4.3 Vital character urgent assistance

4.3.1 Concept. -For the purposes also provided for in Article 76 of the General Regulation of the Social Security of the Armed Forces, it is considered a situation of urgency of a vital nature in the fact that there has been a pathology, the nature and symptoms of which make it possible to present an imminent or very imminent vital risk or irreparable damage to the physical integrity of the person, without immediate therapeutic action. To assess the concurrency of this circumstance, account shall be taken of the provisions set out in Annex IV.

4.3.2 Requirements.-In order for the beneficiary to be entitled to the reimbursement of expenses for the use of means other than the entity in a situation of vital urgency, the following requirements must be met:

A) That the optional or non-member of the patient to whom the patient is directed is reasonably chosen, taking into account the circumstances of the place and the time when the pathology has occurred, as well as the capacity of the patient the decision of the patient and, where appropriate, of the persons who have provided the first aid.

B) That the beneficiary or other person on his behalf communicates to the entity, by any means that permits the communication, the assistance received or, where appropriate, the hospital admission.

4.3.3 Scope. The emergency situation of a vital nature extends from the entrance to the patient's discharge, except in the following two cases:

A) When the entity, with the compliance of the physician who is providing the assistance, decides to transfer the patient to an appropriate appropriate center and the patient or his or her family members responsible refuse to do so.

B) When the patient is transferred to a second foreign center and there are no causes to prevent his transfer to a center of the entity.

4.3.4 Effects of the communication to the entity. -If the communication to the entity of the assistance received with other means is carried out within the period of the fifteen working days following the beginning of the assistance, the beneficiary shall be entitled to the full coverage of the costs incurred.

If this is done after the deadline, but before five years have elapsed since the beginning of the assistance, the beneficiary will be entitled to the reimbursement of the expenses according to the scale shown as the final annex. The entity shall complete the refund within 10 working days of the date on which the beneficiary submits the supporting documents for such expenditure.

The clinical state of unconsciousness of the person concerned, not having relatives close to him, or any other similar circumstance, will interrupt the computation of the fifteen days foreseen for the communication to the entity.

4.3.5 Obligations of the entity. -When the entity receives the communication from the beneficiary, it must answer in writing, within 15 days of receipt of the communication, if it accepts the situation of urgency (a) vital and, therefore, the direct payment or the remover, or, on the other hand, if it is not deemed to be compulsory for payment, because it has not been a vital emergency situation.

The absence of an answer within the prescribed period shall in any event entail the obligation of the total drawback entity or by scale, as appropriate.

4.3.6 Claim by the beneficiary. The beneficiary may lodge a complaint with the corresponding territorial delegation of the ISFAS when the institution fails to comply with the obligations set out in clause 4.3.5 and in case of discrepancy. with the criteria of the entity.

CHAPTER V

Legal framework of the concert

5.1 Nature and regime of the concert and relationships in the building

5.1.1 This concert, carried out in accordance with the provisions of Articles 19, one, of Law 28/1975 of 27 June on Social Security of the Armed Forces, and 75, two and three, of its General Regulation, approved by Decree 2330/1978, of 29 September, is excluded from the system laid down in Law 13/1995 of 18 May 1995 on the contracts of general government, in accordance with the provisions of Article 3.1 (d) thereof, without prejudice to the application of the principles contained therein to resolve any doubts and gaps that may arise, as referred to in Article 3.2 thereof.

5.1.2 They are concert-based relationships:

A) The relations between the ISFAS and the entity, in order to comply with the rights and obligations which, according to clause 1.1, constitute the respective objects of the concert.

B) The relationship between the beneficiaries and the entity, in order to comply with the obligations set out in the preceding paragraph.

5.1.3 Issues arising in the field of the relations listed in paragraph B) of the above clause shall be of an administrative nature and shall be resolved by the ISFAS body which has the jurisdiction conferred upon it. the procedure, if appropriate, which is determined in this chapter. Against any of the agreements which are to be made, the Minister of Defence shall have an ordinary appeal in accordance with Article 4 (c) of Royal Decree 1728/1994. The competent court shall, where appropriate, always be the administrative dispute.

5.1.4 It is for the General Directorate of the ISFAS, with the limits, requirements and effects mentioned in Law 13/1995, the ability to interpret the concert, to resolve the doubts that offer its fulfillment, to modify it by reasons of public interest, to agree to its resolution for non-compliance with the entity and to determine the effects of the entity, and the procedures provided for in Article 60 of the said Law should be followed.

The agreements thus dictated will put an end to the administrative route and will be immediately executive, proceeding against them the judicial-administrative appeal, in accordance with the provisions of the Law regulating the jurisdiction.

5.2 Nature and regimen of care relationships

5.2.1 The present concert does not imply or cause any relationship between the ISFAS and the faculty or institutions of the entity providing the assistance. The relationships between the entity and the faculty or centers are in any case alien to the concert.

5.2.2 Consequently, they are also alien to the set of rights and obligations that determine the purpose of the concert and are configured as autonomous relationships between the parties:

A) The relations of the beneficiaries with the faculty of the entity because it affects or relates to the scope of the professional exercise of such facultative.

B) The relations of the beneficiaries with the institutions of the institution, due to the care activity of those means or the operation of their facilities or for reasons affecting or referring to the scope of the exercise professional of the facultative who, under any title, develop activity in such centers.

Both the relations of paragraph A and B) of this clause shall continue to be alien to the purposes of the concert even if, by virtue of the links between the faculty and the institutions, they may be generate direct or subsidiary effects on these.

5.2.3 The relationships mentioned in the preceding clause will have the nature that, according to the law, corresponds to its content, and the knowledge and decision of the questions that may arise in the same will be competition of the ordinary civil jurisdiction or, where appropriate, the criminal jurisdiction.

5.2.4 Notwithstanding the provisions of this clause 5.2, the institution is obliged to provide ISFAS with the data and checks it requests on the various services that have been provided to the beneficiaries with their (a) a system of information enabling the number and type of services provided to be known.

5.3 Mixed Commissions

5.3.1 The Joint Committees, with joint membership, are responsible for monitoring and, where appropriate, evaluating the performance of the present concert, in which the framework of the Joint Committees will meet the complaints they may have. be made by the beneficiaries in accordance with the provisions of this Chapter.

5.3.2 The operating system of the Joint Commissions will be regulated in the following clauses and, as not provided for in them, the rules of the Law of the Legal Regime of Public and Public Administrations will apply. Common Administrative Procedure on the functioning of the collegiate bodies.

5.3.3 The functions mentioned in clause 5.3.1 will be performed by the Provincial Mixed Commissions when they refer to the provincial level and the National Joint Commission when they affect the entire national territory.

If these are claims the distribution of functions will be accommodated as provided in clause 5.4.

5.3.4 The Provincial Joint Committees shall be composed, by the ISFAS, by the corresponding territorial delegate, who shall preside over them, and by an official of the Delegation who shall act, in addition, as Secretary; and of the institution, by one or two representatives of the entity with sufficient decision-making powers. The Medical Adviser of the Delegation may attend the meetings.

5.3.5 The operation of the Provincial Mixed Commissions will be in accordance with the following rules:

A) Whenever there are issues to be dealt with, the Commission will hold regular meetings within the first ten days of each month. They shall be convened at the request of one of the parties.

B) In the event of an appearance at a meeting of the representatives of the entity, the actions will be forwarded to the National Joint Commission for the study of the complaints and issues on the agenda.

C) In the event that the representatives of the entity do not attend the meetings for three consecutive sessions, it is understood that the entity accepts the agreements that the ISFAS adopts in relation to the matters that should have been examined at the third hearing and in subsequent sessions in which he does not appear.

D) Minutes of each session shall be lifted by the Secretary, whose project, with his signature, shall be sent immediately to the entity for his/her knowledge, conformity and return once signed by the representative of the same, at which time shall be understood as approved. If there are differences in the content of the minutes, they shall be resolved by means of appropriate arrangements between the two parties and, in any case, at the following meeting.

5.3.6 The National Joint Commission will be composed of three representatives of the ISFAS and three of the entity. The President shall be the Deputy Director of Prstations or the official in whom he delegates and as Secretary shall act an official of the ISFAS, with a voice but without a vote.

5.3.7 The operation of the National Joint Commission shall be in accordance with the same rules as set out in clause 5.3.5 for the Provincial Commissions, except those contained in paragraph B).

5.4 Claims Procedure

5.4.1 The beneficiaries will be able to claim from the ISFAS that, as provided for in clause 5.1, the entity agrees to the origin of any action by the institution:

A) When the entity refuses any of the authorisations specifically referred to in the concert or when it does not respond to the request of the same and, in addition, a positive effect is not foreseen for that absence of reply.

B) When the institution is required to directly assume some expenditure or to reintegrate its amount and, upon request of the beneficiary, do not do so.

C) When the entity fails to comply with any other obligations under the terms of the concert.

This administrative route will not be used for complaints on issues concerning the relationships mentioned in clause 5.2. In the event of a question, the person concerned will be replied that, due to the lack of competence of the ISFAS, it is not possible to resolve the merits of the complaint, with the indication that it may be made, if appropriate, in relation to the optional institutions. or, where appropriate, the institution itself, in the ordinary court which corresponds according to the nature of the facts.

5.4.2 The complaints will be made in writing to the corresponding territorial delegation of the ISFAS, accompanying how many documents can justify the same.

5.4.3 If the complaint concerns an urgent matter, the Delegation may immediately take the necessary steps to obtain the satisfaction of the entity, in which case it will be closed without further delay. procedures with annotation of the solution adopted.

5.4.4 In case of non-successful or urgent complaints, the delegation will formalize the appropriate file, will include it on the agenda of the immediate meeting of the Provincial Joint Commission. and, under study, the corresponding record shall be lifted in which the positions of the ISFAS and the entity on the claim raised shall necessarily be recorded.

5.4.5 In the cases in which the positions of the parties that make up the Provincial Joint Committee are consistent and favorable to the estimation of the complaint, agreement will be made by the ISFAS Delegate in this regard.

5.4.6 If the assumption provided for in the preceding clause is not produced, the file will be raised for study by the National Joint Commission and will be included on the agenda of the first meeting to be held. It will be studied by the General Directorate of the ISFAS.

5.4.7 The resolutions of the complaints referred to in the preceding headings must be resolved within a maximum period of nine months, as provided for in Article 3.2 of Royal Decree 1728/1994 of 29 July 1994.

5.4.8 The resolutions issued by the Delegates and the General Directorate of the ISFAS will be notified to the entity and to the stakeholders. It may be brought against them by ordinary appeal to the Minister of Defence, in accordance with Articles 107 to 114 of the Law on the Legal Regime of Public Administrations and the Common Administrative Procedure, in respect of Article 4 (c) of that Royal Decree 1728/1994 of 29 July 1994.

5.5 Refund Claims Execution Procedure

estimated

5.5.1 In the refund claims positively resolved by the Delegates, the execution procedure will be as follows:

(A) The entity shall, within one month of the notification of the Resolution, proceed to the full or scale reimbursement of the costs claimed, upon presentation, where appropriate, of the appropriate supporting documents, which, that end and if it has been filed, they shall be returned to the claimant.

B) Within the deadline, the institution shall report to the ISFAS Delegation:

a) That you made the credit, or

(b) The payment has not been made because the data subject has not been submitted, because the payment has not been made for the same reasons or because the payment has not been accepted.

C) If the ISFAS had not received this communication within the indicated time limit or if, exceeded this period, it was aware that the payment was refused to the person concerned, under any reason, the Delegate, without further formalities and provided that it is in force, it shall issue certification of the adopted agreement and subsequent events and shall forward it to the ISFAS Subdirection of Prstations. It shall also, without further requirements, propose the appropriate agreement to the Directorate-General and shall be deducted from the immediate payment to the institution and shall be paid directly to the person concerned, on behalf of the person concerned, the amount included in the the certification, with an increase of 20 per 100 in terms of penalty to the entity and of reciprocal compensation to the holder for the delay in the refund.

5.5.2 In the event of claims for reimbursement positively resolved by the General Directorate of the ISFAS, prior to the study of the National Joint Commission, the payment of the amount that in each case corresponds will be carried out directly by the ISFAS to the person concerned on behalf of the entity, deducting the amount of the monthly fees to pay to the same and facilitating to this the document that the payment has been made on its own.

5.5.3 Administrative resolutions or judgments that resolve actions brought against ISFAS acts in respect of reimbursement of expenses subject to this Concert shall be executed, if appropriate, in accordance with the procedure set out in clause 5.5.2.

CHAPTER VI

Duration, Price and Economic Regime of the Concert

6.1 Concert Duration

6.1.1 The effects of this Concert will be started at zero hours on 1 January 1997 and will be extended to 24 hours on 31 December 1997, without prejudice to what is set out in the clauses. next.

6.1.2 For 1998 and 1999 this Concert may be extended, year by year, by mutual agreement of the parties, expressed in writing in the month of October of the year preceding that of the extension. The calculation of the start and end of the extension period, referred to in the year in question, shall be done in the same manner as that laid down in clause 6.1.1.

6.1.3 If there is no agreement to extend the Concert by 1998, the entity will continue to be bound by the content of this agreement in 1997, for the collective that was assigned to 31 December of that year, until 31 January of this year. 1998 or, in cases where an attendance was provided on the date of hospitalization or maternity care when the delivery was scheduled for the month of February, until the day on which the birth of the child was or the end of maternity care.

The entity will be entitled to receive, for the month of January 1998 and for the collective assigned to 31 December 1997, the price per person/month to be established for the entities that subscribe to the extension of the Concert for 1998. However, the amount to be paid for that month by the ISFAS shall be 10 per 100 until 31 December 1998, with the sole purpose of dealing, on behalf of the institution, with the reimbursement of expenses that are agreed upon during the said year. amparo del presente Concerto. If the estimated quantity is exhausted or the reimbursements are agreed after the date indicated, the entity is obliged to satisfy them directly and immediately.

The affected collective will have to choose a new entity within the time limit set by the ISFAS and the choice will have effect at zero hours on 1 February 1998, without prejudice, in any case, to the provision of hospital admissions and maternity in the first paragraph of this clause.

6.1.4 How much is available in clause 6.1.3 will be of full application in the case that, extended the Concerto for 1998, does not extend, however, for 1999, understanding that the references of dates in that contained is moving the following year, and the appointment of the entities to sign the 1998 Concert extensions corresponds to that of the entities that subscribe to the new Concert for the year 2000.

6.2 Concert Price

6.2.1 The price that ISFAS will pay to the institution for its obligations under this Concert in 1997 shall be, provided that it is within the limits of the price set by MUFACE ± 3.5 per 100 next:

TSS x PTSS

Pesetas per person/month =/-PR

CSS

For the application of the preceding formula:

By TSS, the number of ISFAS holders who, at zero hours of January 1, 1997, are attached to the Health Network of Social Security.

By PTSS, the price in pesetas per holder/month that the ISFAS must pay to the Social Security in 1997, under the Convention signed with it, for the health care equivalent to that of the present Concert, that is, by the Full health care, without the provision of pharmacy, plus the amount corresponding to the contingency of accidents at work and occupational diseases. As long as the price is fixed for 1997, the PTSS used in 1996 increased in the CPI for that year, which, for the purposes of the definitive calculation, will be considered minimum.

By CSS, the ISFAS collective (more beneficial owners) than also at zero hours of January 1, 1997, are assigned to the Health Network of Social Security.

By PR, the average expenditure for ISFAS, in pesetas per person per month, by the orthopedic and orthotics prostheses paid in 1996 to the total collective assigned to all the entities that signed the Concert in that year, with an increase This is the same as the figure for 1995.

In the event that the provisional or definitive price so calculated exceeded the price of MUFACE + 3,5 per 100 or was less than the price of MUFACE-3,5 per 100, the price shall be taken as that quantity or is, as appropriate.

6.2.2 In case of extension of the Concert, the price for 1998 and 1999 will be that of the previous year, increased in the percentage of increase that will apply MUFACE to its price in each of those years. The same percentage of increase shall apply to the scale of the final annex.

6.3 Economic Regime of the Concert

6.3.1 Without prejudice to the birth and extinction for beneficiaries of rights deriving from the Concert in the terms provided for in the relevant clauses, the high level will cause economic effects at zero hours of day 1 of the month following the month in which they were produced and the casualties within 24 hours of the last day of the month in which they took place. Accordingly, each monthly payment shall take into account the number of holders and beneficiaries existing at zero hours of the day one of the month in question and shall be effected by the ISFAS, by name or bank transfer, within the the first 15 days of the following month, prior to the holding or the discounts which come in accordance with the decision of the convocation and the Concert, with its annexes.

6.3.2 THE ISFAS, by the delivery of the members themselves, shall provide the provincial representation of the institution, before the 16th of the month following that in which they occur, a diligent copy of the applications for discharge of the and of beneficiaries, as well as a relation of the casualties of each other and of the variations produced. It will also deliver the ISFAS, with the liquidation of each month, magnetic tape or relation with the data of all the ups, downs and variations in the previous month, communicating the figure of the total collective attached to the entity, referred to the zero hours of the first day of the month that is liquid.

6.3.3 The tape or relationship may be checked by the entity together with the information provided directly by the ISFAS Delegations, so that, if it considers that there are differences, it may make the following claims:

(a) Those relating to the holders, including those affecting their beneficiaries, if they exist.

b) Those relating to beneficiaries exclusively.

6.3.4 The entity shall present claims separately, in accordance with the above classification, and shall accompany magnetic tape or relation of the same technical characteristics as that provided by the ISFAS, containing the information on which the claim is based. Complaints must be submitted within three months of the monthly communication of the status of the collective and the relationship of incidents, after which no claim has been made the entity's compliance with the payment made on the basis of that collective. The complaints submitted shall be resolved by the ISFAS within three months of the date of submission of the complaints.

6.3.5 All taxes, arbitrations, fees and charges that are taxed in this Concert or the acts that are derived from it shall be of account of the entity.

6.3.6 In the case of health care for injuries caused or a disease caused by or aggravated by accidents covered by any form of compulsory insurance or when the cost of the healthcare provided must be the entity, without prejudice to the provision of assistance, may be subrogated to the rights and actions of the beneficiaries in respect of the benefit of the institution, or by public bodies other than the ISFAS or by private entities. (a) the amount of expenditure arising from such health care, taking into account the necessary steps to be reintegrated into the cost of the project. The beneficiaries, for their part, shall be obliged to provide the entity with the data necessary for this purpose.

6.3.7 Whenever there is a firm court judgment in which the ISFAS is ordered to pay compensation, arising from direct or subsidiary liability for assistance actions included in the object of the Concert, the ISFAS, without prejudice to the execution of the judgment, shall have an impact on the amount paid to the relevant concerted entity, in accordance with the procedure under heading 5.5.2 of this Agreement.

By the ISFAS,/By the entity,

CONCERT ATTACHMENTS

ANNEX I

Support for rural areas

According to this Concert, the entity must have certain means of health care throughout the national territory, but in rural areas there is a circumstance that, in general, there are no means (a) private persons who are able to carry out such assistance under the authority of the institution, since only the National Institute of Health and the Management Bodies of the Health Care of the Autonomous Communities are provided with transfers in this area of competence.

In accordance with the provisions of the General Health Law, such public bodies may provide urgent health care or may not be carried out by other means to any person, even if they are not a beneficiary of the General system of social security, reintegrating, where appropriate, the third party obliged to pay the cost of the assistance provided, so that, in order to enable the provision of such health services to the mutualists and other beneficiaries attached to the entity:

First. -The ISFAS may agree with the National Institute of Health and the Management Agencies of the Health Care of the Autonomous Communities to provide the following services to the holders and others. beneficiaries that the entity has attached to:

A) Primary healthcare services in populations that do not have sufficient private means.

B) Emergency services in populations of up to 20,000 inhabitants.

The entity grants its express and total authorization to ISFAS for that purpose.

Second. -Conventions may be common to all entities that are signatories to the Concert and their amount, known and accepted by the entity, will be charged to the entity according to the collective affected and satisfied with the price The ISFAS, once established and released, must be paid by the ISFAS for the present Health Care Concert, with the payment on behalf of the entity being understood.

Third. -The ISFAS will make each monthly payment charged to the amount of the same month that the entity must pay for the Concert, transferring the corresponding justification.

Fourth.-The authorization of the ISFAS contained in the first point must be understood as ampara also the extension of the Conventions subscribed to the same purpose before 1 January 1997.

ANNEX II

Additional special conditions for the islands of the Balearic and Canarian archipelagos

1. The entity shall count on the islands of the Balearic and Canary Islands with sufficient and stable means to provide health care.

In non-capital islands with a population of less than 75,000 inhabitants, the service catalogue of the institution shall include the services provided for in Chapter II of this Concert for levels I and II of assistance health. In the absence of such means, the entity shall ensure assistance on the nearest island in which it has the same, and shall bear the costs of posting.

2. Level IV health care, if not available in the relevant Autonomous Community, shall be provided in that Community which is closer to the time of travel.

3. The institution shall bear the costs of posting the beneficiary to the services of level III and IV of health care and in the absence of means provided for in point 1.1 above, in the means specified in clause 2.3.3, (a) or (b), as the case may be, upon written prescription of the institution's optional.

For such purposes, the institution shall immediately pay, upon presentation by the beneficiary of the report of the optional providing the assistance, with an indication of the assistance given and the date on which it was carried out. or, in case of detention, of the initial and final dates, and the invoice of expenditure.

4. In the event that the patient needs accompanying, the travel expenses of the companion will be borne by the entity. To this end, the institution's report should be provided to the institution which provided the assistance in which the need is justified.

ANNEX III

Relationship of services of the entity that require prior authorization of the same

1. Hospitalizations and outpatient surgery:

a) Hospitalization.

b) Home hospitalization.

c) Outpatient surgery.

2. Diagnostic techniques, treatments and surgical techniques:

a) Odontostomatology: Tartrectomy (mouth cleaning) and periodontics.

b) Rehabilitation: All techniques.

c) Oxygenotherapy, ventilation and aerosoltherapy at home.

d) Peritoneal dialysis and hemodialysis treatments.

e) Oncology: Immunotherapy, chemotherapy.

f) Diagnosis by image: Computed Axial Tomography, MRI, orthopantomography, mammography.

g) Treatment in pain unit.

h) Treatment in sleep unit.

i) All services corresponding to level IV of health care.

j) Renal Litotricia.

3. Transport for healthcare:

a) Transportation in extraordinary means.

b) Transport in ordinary media:

For periodic treatments.

A level IV health care services outside the locality of residence.

ANNEX IV

Life-threatening pathologies

A purely indicative and non-exhaustive title, in the following cases it will be understood that there is an imminent or very near risk of not obtaining an immediate therapeutic action, so that, if the requirements under clause 4.3.2, the total or scale of the costs incurred in the event of the use of means other than the entity being used:

1. Acute intracranial or intracerebral bleeding, genital, digestive, respiratory, renal or rupture of blood vessels in general, with significant loss of blood or internal bleeding.

2. Complete or incomplete abortions. Uterine rupture or the complication of extra-uterine pregnancy. Gravidic toxicosis.

3. "Shocks" cardiac, renal, hepatic, circulatory, traumatic, toxic, metabolic or bacterial. Commas. Allergic reactions with involvement of the general state.

4. Acute respiratory, renal or cardiac failure.

5. Acute abdomen, formulated as a diagnosis, prior or presumption. Acute abdominal pain.

6. Lesions with external tears with affectation of viscera.

7. Hip fractures or the head of the femur.

8. Cerebrovascular accidents.

9. Acute poisonings. Acute sepsis.

10. Anuria. Acute urine retention.

11. Diphtheria. Botulism. Meningitis. Meningoencephalitis. Acute form of ulcerative colitis. Acute gastroenteritis with involvement of the general state.

12. Obstruction of the upper respiratory tract. Pulmonary embolism. Pleural effusion. Spontaneous pneumothorax. Acute lung oedema. Dyspnea. Bronchial asthma crisis.

13. Myocardial infarction. Hypertensive crisis of urgency. Peripheral arterial embolism. Asistolia. Paroxysmal tachycardia.

14. Diabetic coma. Hypoglycaemia.

15. Seizures. Childhood seizures. Toxicosis of the infant.

16. Acute adrenal insufficiency. Acute failure of peripheral circulation. Changes in electrolytic metabolism.

Note: The assistance specified by the holders of the ISFAS belonging to any Army or Corps of the Civil Guard, in the event of injuries or bodily harm suffered in the exercise of the functions proper to their activity or as a result or in the event of acts committed by persons integrated into organised and armed bands or groups, it shall be deemed to have initially met the characteristics set out in clause 4.3.1 and that the assistance received, if used outside means, it also initially has the requirement laid down in the clause 4.3.2, A). The beneficiary or other person on his behalf must comply with the requirement set out in clause 4.3.2, B), and the remainder of clause 4.3.

ANNEX V

Complementary care modalities

In accordance with the provisions of Article 75 of the General Regulation of the Social Security of the Armed Forces, the ISFAS maintains a system of concerted collaboration with the military sanities, which includes the coverage of specialized assistance and Hospitalization, through the Military Hospitals of Barcelona, Burgos, Cartagena, Ceuta, El Ferrol, La Coruña, Las Palmas, Madrid, Melilla, San Fernando, Seville, Tenerife, Valencia, Valladolid and Zaragoza, as stated in the Instruction No. 140/1994 of 23 December 1994 of the Secretary of State for Military Administration, with the assistance corresponding to the primary step and the emergency aid, which can therefore be provided by entities. who subscribe to this Institute, provided that they are chosen by the interested parties.

On the other hand, the closure of the Military Hospitals of La Coruña, Granada, Tenerife and Valladolid, as well as, presumably, the one in Barcelona, makes it necessary that the medical-surgical assistance of specialties in outpatient If the group decides to continue receiving the primary care in the ISFAS Consultoires, it must also be covered by the same entities, also in the event that they are chosen for this by those affected.

For this reason, it is necessary to define two complementary care modalities: Primary Care modality and the form of Assistance of Specialties and Hospitalization, which may be assigned members and beneficiaries in accordance with the conditions set out below.

Primary Care Mode (C mode)

First. -They may be assigned to the entity, for the exclusive coverage of Primary Care and Emergency Care, the holders and beneficiaries of the Special Regime of Social Security of the Armed Forces who, having set their residence in any of the localities mentioned in the fifth paragraph, receive specialized assistance and hospitalization through military hospitals, in accordance with the regime of collaboration with the military healings in force in each time.

The above mentioned list of locations may be modified at any time by Resolution of the Director General of the ISFAS.

Second. -A) The health services to be provided by the entity to the Primary Care and Emergency Care collective will be limited to those of:

(a) General or Family Medicine, Paediatrics and DUE/ATS or Practitioner, either on an outpatient, home or emergency basis.

b) Emergency health services (without hospitalization).

B) In general, it will be taken into account that when a beneficiary receives emergency assistance in any of the localities reflected in the fifth paragraph, if the initial assessment of the need arises, the The emergency department will send the patient to the appropriate military hospital, managing if the transfer is necessary by ambulance. In the rest of the national territory the beneficiary must be admitted to hospitals of the INHEALTH or the Health Services of the Autonomous Communities.

C) Only the beneficiary's income in the agreed centre may be managed with the institution which has provided the emergency assistance, when its clinical status does not allow the transfer to the hospital (a) the costs arising from this detention shall not be borne by the institution.

D) Furthermore, any optional entity, due to urgent and immediate assistance to be provided by the entity, may prescribe the income of a beneficiary in a military hospital.

(E) The corresponding physicians of the institution shall make the prescription of medicinal products and other pharmaceutical products in the official prescriptions of the ISFAS, formalize the reports of Temporary Incapacity (I.T.) in the official models and the prescription of tests or means of diagnosis on the corresponding flyers. Recipe and I.T. talonaries will be presented to the entity's faculty by the beneficiaries of the ISFAS when they are needed.

F) In no case shall the pharmaceutical provision or the ambulance transfers which may be specified be covered.

Third. -The health services referred to in the preceding paragraph shall be provided throughout the national territory with the same extension and under the same conditions laid down in this Convention for the members and beneficiaries with full assistance from the institution, considering the application of the clauses relating to such services.

Fourth.-The price to be paid for the care services corresponding to the Primary and Emergency Care Mode will be the one that is currently in force in the Convention for Health Care in the Rural Environment signed between ISFAS and INHEALTH on 23 December 1992.

Fifth. -Only the insured and beneficiaries who have their usual residence in some of the following locations will be eligible for Primary Care and Emergency.

Barcelona

Badalona.

Barbera del Valles.

Barcelona.

Castelldefels.

Cerdanyola del Valles.

Cornella de Llobregat.

Esplugues de Llobregat.

Gava.

Granollers.

Hospitalet de Llobregat.

Matched.

Manresa.

Masnou.

Mataro.

Molins de Rei.

Mollet del Valles.

Moncada i Reixac.

Prat del Llobregat (El).

Rubi.

Sabadell.

Sant Adria del Besos.

Sant Boi de Llobregat.

Sant Celoni.

Sant Cugat del Valles.

Sant Feliu de Llobregat.

Santa Coloma de Gramanet.

Tarrasa.

Burgos

Aranda de Duero.

Briviesca.

Burgos.

Lerma.

Medina de Pomar.

Miranda de Ebro.

Villarfell.

Cadiz

Alcala de los Gazules.

Alcala del Valle.

Algar.

Algeciras.

cotton.

Arcos de la Frontera.

Barbate.

Barrios (Los).

Cadiz.

Conil.

Chiclana.

Chipiona.

Jerez de la Frontera.

Jimena de la Frontera.

Line of the Conception (La).

Medina Sidonia.

Olvera.

Puerto de Santa Maria (El).

Puerto Real.

Broken.

San Fernando.

San Roque.

Sanlúcar de Barrameda.

Rate.

Ubrique.

Veger de la Frontera.

Villamartin.

Las Palmas

Arucas.

Galdar.

Ingenuity.

Las Palmas.

Telde.

Madrid

Alcala de Henares.

Alcobendas.

Alcorcon.

Aranjuez.

Arganda.

Boadilla del Monte.

Ciemos.

Old Hive.

Villalba Collado.

Coslada.

Fuenlabrada.

Galpower.

Getafe.

Leganes.

Madrid (including Aravaca and El Pardo).

Majadahonda.

Mostoles.

Parla.

Pinto.

Pozuelo de Alarcón.

Rozas (Las).

San Fernando de Henares.

San Sebastian de los Reyes.

Torrejón de Ardoz.

Three Chants.

Valdemoro.

Villaviciosa de Odon.

Murcia

Abaran.

Eagles.

Sewer.

Alguazas.

Alhama de Murcia.

Archena.

Caravaca de la Cruz.

Cartagena.

Cehegin.

Ceuta.

Cieza.

Jumilla.

Lorca.

Mazarron.

Molina de Segura.

Mule.

Murcia.

San Javier.

Torre Pacheco.

Totana.

Union (La).

Yecla.

Seville

Alcala de Guadaira.

Algaba (La).

Arahal.

Beds.

Carmona.

Coria del Rio.

Two Sisters.

Ecija.

Lebrija.

Mairena de Aljarafe.

Marchena.

Moron de la Frontera.

Osuna.

Palacios and Villafranca (Los).

Rinconada (La).

San Juan de Aznalfarache.

Sevilla.

Utrera.

Valencia

Alaquas.

Albal.

Alboraya.

Alfafar.

Algemesi.

Alzira.

Betera.

Burjassot.

Carcaixent.

Catsheds.

Cullera.

Gandia.

lliria.

Manises.

Massamagrell.

Miscan.

Moncada.

Oliva.

1st.

Paterna.

Pincaya.

Pucol.

Quart de Poblet.

Requena.

Sagunto.

Chair.

Swedish.

Tabernes de la Valldiga.

Torrent.

Valencia.

Xativa.

Xirivella.

Zaragoza

Calatayud.

Egea of the Knights.

Tarazona.

Zaragoza.

Ceuta

Melilla

Specialty and hospitalization assistance mode

(mode B)

First. -The holders and beneficiaries of the Special Social Security Regime of the Armed Forces who have chosen to receive Primary Care (General or Family Medicine, or the General Health System) will be eligible for this assistance. Pediatrics and Nursing, ATS or DUE) through the ISFAS Consultoires, and have their usual residence in the localities of Barcelona, La Coruña, Granada, Santa Cruz de Tenerife and Valladolid. In the event of the closure of some Military Hospital in the future, the collective resident in the locality where it will be located will also be able to benefit from this assistance modality.

Second.-The Health Services to be provided by the Entity to the collective assigned to this care modality will be:

(a) All those collected in this Concert, except for Primary Care (General or Family Medicine, Pediatrics and Nursing, ATS or DUE) in the localities of Barcelona, La Coruña, Granada, Santa Cruz de Tenerife and Valladolid;

b) Primary care, in case of displacement, in the rest of the national territory.

Third. -The health services mentioned in the preceding paragraph shall be provided with the same extension and under the same conditions as set out in this Concert, for the members and beneficiaries, with complete assistance by the Entity.

Fourth.-The price per beneficiary and month, which the ISFAS will pay to the Entity for the services corresponding to the modality of assistance of specialties and hospitalization, will be the one fixed for complete assistance in each year of validity of the Convention, minus the price of the Convention for health care in rural areas, signed between ISFAS and INHEALTH on 23 December 1992, plus an amount equal to one twelfth of the said price of the Convention with INHEALTH, in order to compensate for the cost of primary care that a beneficiary may specify when it is found moved out of your place of residence.