Health Insurance Fund – a public health insurance institution, in capacity of a legal entity with special rights, obligations, responsibilities and authorizations for implementation of this Law on behalf of the insured persons, including effective collection of financial means for provision of health care services by health care institutions in all types of ownership.
Duties of the Fund
Applies policies for improvement of the health care status and financial risk protection of population established by the Ministry of Health;
Ensures realization of the rights of insured persons in compliance with the Law;
Organizes professional administration which enables efficient and effective application of rights and obligations for mandatory health insurance;
Proposes premiums, co-payments, co-insurance, deductibles, and other financial means for mandatory health insurance for approval to the Government;
Ensures collection of financial means for mandatory health insurance in an efficient and transparent method, in compliance with this Law;
Determines terms of contracts with healthcare institutions for basic healthcare services including quality standards that should be fulfilled;
Negotiates and concludes contracts for provision of basic healthcare services, including conditions for provision and compensation of quality health care services leading to increased productivity and higher performance;
Implements effective and timely compensation of basic health care services provided by health care institutions, based on contracts;
Reviews and proposes to the Steering Board, the pricelist of basic healthcare services;
Supervises the application of all contracts concluded by the Fund and reports on them; The Steering Board reports to the Director of the Fund regarding the implementation of all contracts for health service;
Organizes and implements the information system for mandatory health insurance within the unique health information system;
Requests and uses professional evaluation of the work of the health institutions by authorized institutions;
Regulates other issues related to healthcare insurance, in compliance with the legal acts into force;
Requests external financial audit of healthcare institutions that are in contractual relations with the Fund.
Supervision
The Government supervises activities of the Fund and reports at the Assembly at least once a year.