Distributed volumes of health care provision as a criterion for the legality of its provision in the CHI system

Abstract

The article is devoted to the assessment of changes in the legislation on compulsory health insurance in 2021. Among them are the improvement of methods of distribution and payment of medical care, contractual relations of participants in the insurance system. The author critically assesses the subject of the updated contract for the provision and payment of medical care under compulsory medical insurance, which limits the obligations of a medical organization to insured persons to the standards for the volume of medical care established by the decision of the commission for the development of the territorial compulsory medical insurance program. Exceeding the required volumes, as a rule, excludes for a medical organization payment from targeted funds for actually rendered medical services. Thus, a basis is being created for the transition of the CHI system from state guarantees of free provision of medical care to the execution of its distributed volumes. The danger is that this «proper performance of the contract» can be achieved due to the availability of medical care for the insured.