How to become a supplier? 
Map of medical care organizations 
Execution of the contract for the purchase of medical services 
Frequently Asked Questions 1. For which types of assistance is the linear scale applied?
According to the Payment Rules, the linear scale is not applied to the following services:
- Emergency medical care,
- PHC,
- Screening of rural residents,
- Trauma centers,
- School medicine,
- Antenatal care and preventive examinations of target groups,
- Hemodialysis and peritoneal dialysis,
- Rural hospitals under the GOBMP,
- HTMP (high-tech medical services),
- Palliative care,
- Pathological diagnostics,
- Preparation of blood products,
- Treatment of patients with HIV infection, tuberculosis, oncology, oncohematology, mental, and infectious diseases,
- Regional and city-level maternity organizations for services provided in inpatient and outpatient settings,
- Inpatient facilities, including national healthcare organizations, providing services to children under 1 year old and maternity services with a combined share of 45% or more of treated cases involving children under 1 year old and maternity 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."
2. How is school medicine financed?
The amount of payment for the provision of medical care in secondary education organizations (excluding boarding schools) for the reporting period is determined by multiplying the per capita monthly norm for a student by the number of students assigned to the PHC subject based on the order of the Health Department.
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."
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."
3. Is it possible to remove the linear scale?
The payment rules are approved by the Ministry of Health of the Republic of Kazakhstan. If you have any suggestions, you can send them to the Ministry of Health of the Republic of Kazakhstan.
4. How can the source of funding be changed?
The choice of funding source is made automatically when creating a referral for hospitalization or a consultative-diagnostic service. Which package the service falls under is determined by the Government Decree of the Republic of Kazakhstan (GOBMP or MSMI).
The mechanisms are implemented in the information systems of the Ministry of Health of the Republic of Kazakhstan.
It is necessary to correctly code the disease or surgery.
5. 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."
6. 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."
7. 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."
8. 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.
9. 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.
10. 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."
