At today's meeting, the Government of the Slovak Republic approved the amendment of Act No. 580/2004 Coll. on Health Insurance and Act No. 95/2002 Coll. on Insurance. This responds to application practice and affects several areas. For example, it will also help vulnerable groups in poverty. The amendment will then go to parliament for discussion.
To date, the health care area has ensured access to emergency care, pregnancy care and vaccination for the prevention of infectious diseases because of poverty among at-risk population groups, i.e. debtors or homeless people, appointed Minister for Health, Zuzana Dolinková, according to which the scope of reimbursement is re-enlarged:For example, it is proposed that homeless and debtors should have access to general care and nursing care provided through ADOS or social services facilities. And after new also to treat infectious disease and diagnose chronic disease.
Next the area of establishment and termination of public health insurance. It regulates the problem of registering insured persons at an extremely old age. They are currently managed in the Central Register of policyholders, they do not receive health care, there is no registered communication with them and it is realistic to assume that they are no longer living.
Public health insurance shall be lost to the insured person in cases of:
- If he has reached the age of 105 years,
- There is no general outpatient care agreement concluded with any such provider;
- If the health insurance company has not registered the provision of healthcare to the insured person in Slovakia or abroad in the last 5 years,
- It also disappears if the insurance undertaking has not registered any communication from the insured person or if it has not changed the insurance undertaking in the last 5 years.
Redistribution area defines the terms in the exercise of reallocation (e.g. average additional costs, total additional costs, etc.), the dates for the transmission of data or the identification of records. It also introduces a new parameter - Overinsurance groupThis may eliminate too frequent changes in health insurance.
Another area is insurance reporting. This defines the exchange of data on electronic PN directly between the NCZI and the health insurance company, thus relieving employers of the notification obligation.
Field of activity of the health insurance undertaking extends the enabling provision for the issue of the so-called programme decree. The economic concepts for reporting data by the health insurance undertaking are clearly established.
Implementation of the eTourism project is solved by area of authorisation for providers; The publication of methodologies for the conversion of the DRG reimbursement mechanism ensures area of reimbursement mechanisms.
The Slovak Government has also set out in the Programme Statement for 2023 - 2027 Strengthening powers Health Care Supervisory Authority:
- The Authority's control and supervision activities for health insurance companies are increasing.
- The Authority will be able to order the health insurance undertaking to submit, for approval, a recovery plan if it shows losses, as a result of which the amount of the health insurance undertaking's equity has fallen below the minimum value of the capital pursuant to Paragraph 33 (1) (a). (a).
