Article 20. Rights and obligations of the Foundation of the Law on Compulsory Social Health Insurance

Home / RLA / Article 20. Rights and obligations of the Foundation of the Law on Compulsory Social Health Insurance

1. The Foundation has the right to:

1) receive a commission from the fund's assets for carrying out its own activities;

2) request and receive information and documentation from participants in the compulsory social health insurance system necessary to monitor the fulfillment of the terms of the service purchase agreement;

3) monitor the fulfillment of the terms of the contract for the purchase of services by visiting the healthcare entity providing medical care;

3-1) in case of revealing the facts of carrying out medical activities without permits (licenses, appendices to the license), apply a penalty to the healthcare entity with which the contract for the purchase of services has been concluded in the amount of 10 percent of the amount of the concluded contract for the purchase of services.;

4) establish branches and representative offices in the territory of the Republic of Kazakhstan in accordance with the procedure established by the legislation of the Republic of Kazakhstan;

5) to develop proposals on the formation of a list of medical care in the system of compulsory social health insurance and the size of tariffs for medical services provided as part of medical care in the system of compulsory social health insurance;

6) to carry out consultative and explanatory work among the population and healthcare organizations on issues of compulsory social health insurance;

7) exercise other rights provided for by the legislation of the Republic of Kazakhstan.

2. The Foundation is obliged to:

1) to accumulate deductions and contributions for compulsory social health insurance;

2) ensure timely payment for the services of healthcare entities under the terms of the service purchase agreement;

3) to place temporarily available funds of the fund in financial instruments through the National Bank of the Republic of Kazakhstan;

4) ensure that an annual independent audit is conducted;

5) to refund excessively (erroneously) paid amounts of deductions, contributions and (or) penalties for late and (or) incomplete payment of deductions and (or) contributions;

6) to form a reserve to cover unforeseen expenses in accordance with the procedure determined by the Government of the Republic of Kazakhstan;

7) plan the costs of medical care in the compulsory social health insurance system;

8) monitor the fulfillment by healthcare entities of contractual obligations on the quality and volume of medical care provided to consumers of medical services;

9) consider complaints and appeals from citizens and healthcare organizations regarding the provision of medical care in the compulsory social health insurance system;

9-1) to form a monthly need and send to the local executive bodies of regions, cities of republican significance and the capital applications for the need for funds from the local budget for state contributions to compulsory social health insurance for persons specified in subparagraph 2) paragraph 1 of Article 26-1 of this Law;

9-2) publish quarterly on its official Internet resource:

the amount of funds received during the reporting period;

information on funds allocated for types of medical care within the guaranteed volume of free medical care and medical care in the compulsory social health insurance system, indicating the amounts;

information about funds paid to medical organizations for services rendered;

information about the administrative expenses of the fund;

9-3) take measures to refund funds from healthcare entities in case of non-fulfillment or improper fulfillment of obligations under the contract for the purchase of services;

10) perform other duties in accordance with the laws of the Republic of Kazakhstan.

3. The Foundation is not entitled to:

1) dispose of the fund's assets, except as provided by this Law;

2) engage in entrepreneurial and other activities not provided for by the laws of the Republic of Kazakhstan.

The Law of the Republic of Kazakhstan dated November 16, 2015 No. 405-V SAM.

This Law regulates public relations arising in the system of compulsory social health insurance in order to implement the constitutional right of citizens to health protection.

President

Republic of Kazakhstan

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