How to become a supplier? 
Map of medical care organizations 
Execution of the contract for the purchase of medical services 
Frequently Asked Questions Frequently Asked Questions
1. In which order is it stated that 50% of the planned volume should be spent on co-execution?
In the Procurement Rules, paragraph 62 specifies the volume of transferring CDR services for co-execution, where PHC entities with a population of 30,000 or more must transfer 60% of the total contract amount to district organizations and 50% to city organizations.
Source: Order of the Ministry of Health of the Republic of Kazakhstan dated December 8, 2020, No. ҚР ДСМ-242/2020 "On the approval of the Rules for the procurement of services from healthcare entities for the provision of medical care within the framework of the GOBMP and (or) the MSMI system."
Source: Order of the Ministry of Health of the Republic of Kazakhstan dated December 8, 2020, No. ҚР ДСМ-242/2020 "On the approval of the Rules for the procurement of services from healthcare entities for the provision of medical care within the framework of the GOBMP and (or) the MSMI system."
2. How is payment distributed in a day hospital? Under what conditions will the payment be covered by GOBMP, and under what conditions by MSMI?
The choice of funding source is made automatically when creating a referral for day hospital admission in the "Hospitalization Bureau" portal in accordance with regulatory legal acts.
Sources:
Government Decree of the Republic of Kazakhstan dated June 20, 2019, No. 421 "On approval of the list of medical care in the mandatory social medical insurance system,"
Government Decree of the Republic of Kazakhstan dated October 16, 2020, No. 672 "On approval of the list of guaranteed volume of free medical care and the invalidation of some decisions of the Government of the Republic of Kazakhstan,"
Order of the Ministry of Health of the Republic of Kazakhstan dated June 7, 2023, No. 106 "On approval of the standard for the provision of medical care in substitute conditions in the Republic of Kazakhstan."
Sources:
Government Decree of the Republic of Kazakhstan dated June 20, 2019, No. 421 "On approval of the list of medical care in the mandatory social medical insurance system,"
Government Decree of the Republic of Kazakhstan dated October 16, 2020, No. 672 "On approval of the list of guaranteed volume of free medical care and the invalidation of some decisions of the Government of the Republic of Kazakhstan,"
Order of the Ministry of Health of the Republic of Kazakhstan dated June 7, 2023, No. 106 "On approval of the standard for the provision of medical care in substitute conditions in the Republic of Kazakhstan."
3. How to conduct settlements with co-executors? What documents should the co-executor provide?
The Supplier and the Co-executor conclude a co-execution agreement, according to which settlements are carried out.
The Co-executor must meet all the requirements imposed on the Fund's supplier.
The Co-executor provides the supplier with the following payment documents:
Source: Order of the Ministry of Health of the Republic of Kazakhstan dated December 20, 2020, No. ҚР ДСМ-291/2020 "On the approval of payment rules for healthcare entities within the framework of the guaranteed volume of free medical care and (or) in the mandatory social medical insurance system."
The Co-executor must meet all the requirements imposed on the Fund's supplier.
The Co-executor provides the supplier with the following payment documents:
- invoice register;
- contract execution protocol;
- act of rendered services.
Source: Order of the Ministry of Health of the Republic of Kazakhstan dated December 20, 2020, No. ҚР ДСМ-291/2020 "On the approval of payment rules for healthcare entities within the framework of the guaranteed volume of free medical care and (or) in the mandatory social medical insurance system."
4. Who is eligible for advance payments under the GOBMP and MSMI?
Advance payments are received by medical organizations that have signed service procurement contracts for a period of more than six months of the current financial year, provided they have no outstanding debts to the Fund, and those that signed service procurement contracts in the previous year.
Exceptions are clinics that provide:
Source: Order of the Ministry of Health of the Republic of Kazakhstan dated December 20, 2020, No. ҚР ДСМ-291/2020 "On the approval of payment rules for healthcare entities within the framework of the guaranteed volume of free medical care and (or) in the mandatory social medical insurance system."
Exceptions are clinics that provide:
- medical care to children;
- care for pregnant women;
- care for patients with tuberculosis, oncology, mental disorders, HIV, and other socially significant diseases.
Source: Order of the Ministry of Health of the Republic of Kazakhstan dated December 20, 2020, No. ҚР ДСМ-291/2020 "On the approval of payment rules for healthcare entities within the framework of the guaranteed volume of free medical care and (or) in the mandatory social medical insurance system."
5. Questions regarding discrepancies between the Order of the Ministry of Health of the Republic of Kazakhstan No. 37 and the EPS service description?
In case discrepancies are identified between the Order of the Ministry of Health of the Republic of Kazakhstan No. 37 and the EPS service description, comments and suggestions should be sent to the Ministry of Health, the Republican Center for Electronic Health (RCEH), and the Fund.
6. What medical services are included outside the Guaranteed Volume of Free Medical Care?
Payment to providers for the provision of consultative-diagnostic assistance is made by the Fund according to the list of services defined by Order No. ҚР ДСМ-37.
7. Are healthcare providers allowed to purchase fixed assets with the funds allocated by the Fund?
Tariffs for medical services under the GOBMP and MSMI do not include the costs of updating fixed assets.
Source: Order of the Ministry of Health of the Republic of Kazakhstan dated December 21, 2020, No. ҚР ДСМ-309/2020 "On the approval of rules and methodology for forming tariffs for medical services provided under the guaranteed volume of free medical care and (or) the mandatory social medical insurance system."
Source: Order of the Ministry of Health of the Republic of Kazakhstan dated December 21, 2020, No. ҚР ДСМ-309/2020 "On the approval of rules and methodology for forming tariffs for medical services provided under the guaranteed volume of free medical care and (or) the mandatory social medical insurance system."
8. If the patient does not have an insurance status, what should be done?
1️.Check the status and periods of debt using available resources
2️.If there is a debt, then you need to pay it or eliminate it, but no more than 12 previous months (from the current month of this year to the current month of last year).
The insurance status will be assigned within 3 working days
If a person is self-employed, an independent payer, then the debt can be paid as an independent payer
If there is a debt from an individual entrepreneur (IE), owners of a peasant farm (KH), persons engaged in private practice, an employee or someone who works under a civil law contract (GPH), then you need to check the status of the payments sent, there may have been refunds, then you need to pay the debt and the penalty
If payments were mistakenly paid for another period or payment documents were incorrectly issued, then you can refund the money for these periods. To do this, you need to write an application to the NAO "State Corporation "Government for Citizens", specify the reason for the error and attach documents confirming the payment to the application
2️.If there is a debt, then you need to pay it or eliminate it, but no more than 12 previous months (from the current month of this year to the current month of last year).
The insurance status will be assigned within 3 working days
If a person is self-employed, an independent payer, then the debt can be paid as an independent payer
If there is a debt from an individual entrepreneur (IE), owners of a peasant farm (KH), persons engaged in private practice, an employee or someone who works under a civil law contract (GPH), then you need to check the status of the payments sent, there may have been refunds, then you need to pay the debt and the penalty
If payments were mistakenly paid for another period or payment documents were incorrectly issued, then you can refund the money for these periods. To do this, you need to write an application to the NAO "State Corporation "Government for Citizens", specify the reason for the error and attach documents confirming the payment to the application
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