Quota for the operation how long to wait. When and to whom a quota is issued for a free eye cataract surgery - all stages of obtaining a quota. Can they charge a fee for a free quota operation

Document

• FULL NAME.

  patient, date of birth, registration address;

The directions are accompanied by:

• a copy of the CHI policy;

Step 3

Urology:

Gynecology:

Abdominal surgery:

Colorectal surgery:

Thoracic surgery:

Head and neck:

Obtaining a quota for high-tech medical care

Prior to the Federal Law On the basics of protecting the health of citizens in the Russian Federation» The procedure for referring patients to the provision of high-tech medical care (issuing quotas for high-tech medical care) was approved every year by the Ministry of Health and Social Development. In 2012, a new order was released, which will operate indefinitely.

Last year, in order to obtain a quota for a VMP, a citizen had to apply directly to the regional health authority (department, committee, ministry), having an extract from the medical documentation, including recommendations for obtaining a VMP, and a number of other documents (copies of a passport, policy Compulsory medical insurance and pension certificate). The structure of the healthcare authority provided for the relevant commission of the constituent entity of the Russian Federation for the selection of patients for the provision of HTMC, which made a decision within 10 working days from the date of application.

Now, in accordance with the procedure approved by the Order of the Ministry of Health and Social Development of December 28, 2011 No. 1689n, the procedure has been partially changed.

Quotas for high-tech medical care

Let's take a closer look at the procedure for obtaining a quota.

The decision to grant a quota is made by the Commission of the healthcare authority of the constituent entity of the Russian Federation for the selection of patients for the provision of HTMC.

However, now the selection of patients and their referral to this commission is carried out by the medical commissions of those medical organizations in which patients undergo treatment and observation, on the recommendation of the attending physician on the basis of an extract from the patient's medical records.

An extract from the patient's medical records, drawn up by the attending physician, must contain a diagnosis of the disease (condition), an ICD diagnosis code, information about the patient's health status, diagnostics and treatment, recommendations on the need for VMP. It is accompanied by the results of laboratory, instrumental and other types of studies on the profile of the patient's disease, confirming the established diagnosis.

The medical commission, within three working days from the date of receipt of the extract, considers it and makes a decision on sending or refusing to send the patient's documents to the Commission of the subject of the Russian Federation to decide on the need to provide him with VMP. The decision of the Medical Commission is documented in a protocol.

The criterion for making a decision by the medical commission is the presence of medical indications for the provision of VMP in accordance with the list of types of VMP.

If the medical commission decides to send the patient's documents to the Commission of the constituent entity of the Russian Federation, within three working days, it forms and sends a set of documents to the healthcare authorities. At the same time, the patient has the right to receive a protocol of the decision of the medical commission and an extract from the medical documentation in his hands in order to independently take the documents to the health authorities.

If the medical commission decides to refuse, then the protocol of the decision is issued to the patient, indicating the reasons for the refusal and an extract from the medical documentation.

The set of documents sent to the Commission of the constituent entity of the Russian Federation must contain:

1. An extract from the protocol of the decision of the Medical Commission.
2. Written statement of the patient (his legal representative, authorized representative), containing the following information about the patient:

1. residence data,

1. passport of a citizen of the Russian Federation,
2. patient's birth certificate (for children under the age of 14),
3. patient's compulsory medical insurance policy (if any),
4. certificate of compulsory pension insurance of the patient (if any),
5. an extract from the patient's medical records signed by the head of the medical organization at the place of treatment and observation of the patient,
6. results of laboratory, instrumental and other types of studies confirming the established diagnosis.

In the case of a request on behalf of the patient by the patient's legal representative (authorized representative):

1. The written application shall additionally indicate information about the legal representative (trustee):

1. surname, name, patronymic (if any),
2. residence data,
3. details of the document proving identity and citizenship,
4. mailing address for sending written responses and notifications,
5. contact phone number (if available),
6. email address (if available).

1. a copy of the passport of the patient's legal representative (the patient's trustee),
2. a copy of a document confirming the authority of the patient's legal representative, or a power of attorney certified in accordance with the procedure established by the legislation of the Russian Federation in the name of the patient's authorized representative.

The commission of the constituent entity of the Russian Federation resolves the issue no later than 10 working days from the date of receipt of the documents. Based on the results of consideration of documents, one of the following decisions is made:

1. On the presence of medical indications for referring the patient to a medical organization for the provision of HTMC. In this case, the chairman of the commission ensures the issuance of a voucher for the provision of VMP (form N 025 / y-VMP) to the patient within 3 working days, as well as the coordination of the expected date of hospitalization with the medical organization to which the quota is requested. After that, the patient is sent for treatment.
2. On the absence of medical indications for referring the patient to a medical organization for the provision of HTMC.
3. On the presence of medical indications for referring the patient to a medical organization for the purpose of conducting an additional examination. In this case, the health authority ensures that the patient is referred for the necessary examinations.
4. On the presence of medical indications for referring the patient to a medical organization for the provision of specialized medical care. In this case, the health authority also ensures that the patient is referred for treatment to the appropriate medical organization.

In addition to local health authorities, a quota can be obtained by submitting a written application to the Ministry of Health and Social Development of Russia, but this is allowed only if:

1. the patient does not live in the territory of the Russian Federation;
2. the patient is not registered at the place of residence;
3. the healthcare authority of the constituent entity of the Russian Federation did not ensure the referral of the patient to medical organizations for the provision of HTMC.

Hospitalization is carried out by decision of the commission of the medical organization providing high-tech medical care. This decision is made no later than 10 working days on the basis of a voucher for the provision of HCW with the electronic attachment of documents from the list above.

By phone All-Russian free round-the-clock hotline for cancer patients and their relatives 8-800 100-0191 you can get legal advice on issues related to obtaining medical care, including the procedure for obtaining quotas for HTMC.

Anton Radus, legal adviser of the Clear Morning Project

Regulations:

On approval of the procedure for sending citizens of the Russian Federation to provide high-tech medical care at the expense of budgetary allocations provided for in the federal budget to the Ministry of Health and Social Development of the Russian Federation, using a specialized information system
Order of the Ministry of Health and Social Development of the Russian Federation of December 28, 2011 No. 1689n

On approval of the list of types of high-tech medical care
Order of the Ministry of Health of the Russian Federation dated December 29, 2012 No. 1629n

How to get a VMP quota?

The discovery of a disease that requires high-tech surgical intervention is a common story. Such an intervention can be performed using the method of minimally invasive surgery using the da Vinci robotic platform. The basis of the method is surgery using point punctures in tissues or through natural physiological openings, which avoids large postoperative traces.

It may seem to you that it is extremely difficult to get funding from the budget for high-tech assistance, nevertheless, there is a chance, and the number of operations performed under the quota is growing every year. According to official data, the cost of VMP is growing annually by 20%, and the number of transactions completed over the past 10 years has increased 15 times.

Speaking at SPIEF-2018, Minister of Health Veronika Skvortsova announced the increase in the availability of high-tech medical care (HTMC): “We have significantly increased the volume of high-tech medical care, starting from 60 patients 10 years ago, and now it is more than 1 million according to the results of last year,” - said the Minister

Surgery using the da Vinci robotic platform is expensive, but any patient in need is eligible to receive a government quota for such an operation.

We bring to your attention answers to questions that arise from applicants.

Who is eligible for a free high-tech operation?

Any needy citizen of the Russian Federation can take advantage of free medical care. This is stated in Decree of the Government of the Russian Federation of December 8, 2017 N 1492 "On the Program of State Guarantees of Free Medical Care for Citizens for 2018 and for the planning period of 2019 and 2020." This document is adopted annually.

Document

Order of the Ministry of Health and Social Development No. 1248n dated December 31, 2010 regulates the procedure for providing high-tech medical care (HMC) to citizens of the Russian Federation at public expense. According to this order, every ordinary citizen of the Russian Federation has the right to receive funding for the operation from the state if necessary.

Which institutions deal with the issue of quotas?

All issues of obtaining funding for High-Technological Medical Assistance (HMP) from the federal budget are regulated by the Ministry of Health.

What diseases fall under the quota program?

The list of diseases in the presence of which the patient can count on state support is annually approved by order of the Ministry of Health of the Russian Federation.

The types of assistance that can be provided using the da Vinci robot can be viewed here.

Which institutions are eligible to provide High-Tech Medical Care (HICH)?

A medical institution providing high-tech medical care under state quotas must have an appropriate license. All the clinics on our list that have the da Vinci robotic system in their arsenal have such a document.

Is there an age limit for the patient?

There are no age restrictions for minimally invasive surgery using the da Vinci robot.

What steps need to be taken in the process of obtaining a quota for an operation corresponding to the gold standard of surgery?

Step 1. Appeal to the attending physician.

First of all, the patient should contact the attending physician to obtain a referral for hospitalization, draw up the necessary documents and send them for consideration to the competent organization. The attending physician of the medical organization in which the patient is being diagnosed and treated determines the presence of medical indications for the provision of HTMC and, if there are medical indications, issues a referral for hospitalization. The presence of medical indications is confirmed by the decision of the medical commission of the medical organization, which is drawn up in a protocol and entered into the patient's medical documentation. If there are medical indications, the attending physician issues a referral for hospitalization.

Requirements for issuing a referral for hospitalization:

The referral must be completed on the letterhead of the referring medical organization legibly by hand or in hard copy, certified by the personal signatures of the attending physician and the head of the medical organization, as well as the seals of the attending physician and the medical organization, and contain the following information:

• CHI policy number and the name of the medical insurance organization;
• insurance certificate of compulsory pension insurance;
• code of diagnosis of the underlying disease in accordance with the international classification of diseases;
• profile and name of the type of VMP;
• the name of the medical organization to which the patient is referred;
• FULL NAME. and the position of the attending physician, if available, his phone number and e-mail address.

The directions are accompanied by:

• an extract from medical records indicating the diagnosis of the disease, the disease code according to the international classification of diseases, information about the state of health, the results of special medical studies. The extract must be certified by the personal signatures of the attending physician and the head of the medical organization;
• a copy of the patient's identity document or a copy of the birth certificate (for children under 14 years of age);
• a copy of the CHI policy;
• a copy of the insurance certificate of compulsory pension insurance (if any);
• consent to the processing of personal data.

The head of the sending medical organization or another employee of the medical organization authorized by the head of the organization sends a referral for hospitalization:

- to the receiving medical organization, if the VMP is included in the basic CHI program (clause 15.1 of the Procedure);

- to the executive authority of the constituent entity of the Russian Federation in the field of healthcare (OHZ), if the VMP is not included in the basic CHI program.

Important: The patient or his legal representative has the right to submit the completed package of documents on his own. This will speed up the collection and submission of the documentation required to obtain the VMP.

Step 2. It is necessary to wait for the registration of the coupon for the VMP.

There are 2 ticketing options:

• If the patient is referred for the provision of HTMC included in the basic compulsory medical insurance program, then the receipt of the coupon with the attachment of the set of documents specified in step 1 is provided by the receiving medical organization.
• If a patient is referred for the provision of HTMC not included in the basic CHI program, the issuance of a coupon and the conclusion of the commission of the executive authority of the constituent entity of the Russian Federation in the field of healthcare for the selection of patients for the provision of HTMC (commission of the HMO) is provided by the HMO.

The HMO Commission decides on the presence or absence of indications for referring the patient to the receiving medical organization within 10 working days from the date of receipt of the full package of documents.

How to get a quota for surgery and treatment in 2018

The decision of the HMO commission is drawn up in a protocol, which should contain a conclusion on the indications for referral to the VMP or on the need for additional examination.

Note: An extract from the protocol of the decision of the HMO commission is sent to the sending medical organization, and is also handed over to the patient (his legal representative) upon a written application or sent to the patient (his legal representative) via postal and (or) electronic communication.

Step 3It is necessary to wait for the decision of the commission of the medical organization providing HTMC.

The Commission makes a decision on the presence (absence) of medical indications or the presence of medical contraindications for hospitalization of the patient within seven working days from the date of issue of the coupon for the provision of HTMC.

The decision is drawn up in a protocol containing a conclusion on the presence of medical indications and the planned date of hospitalization of the patient, on the absence of medical indications for hospitalization, on the need for an additional examination, on the presence of medical indications for referring the patient to a medical organization for specialized medical care, on the presence of medical contraindications for hospitalization of a patient in a medical organization providing HTMC.

Step 4. After completing the HCMC, get recommendations.

Based on the results of the provision of HTMC, medical organizations make recommendations for further monitoring and (or) treatment and medical rehabilitation with the relevant records in the patient's medical records.

Note: In case of dissatisfaction with the quality of HTMC, the patient has the right to contact local health authorities or territorial bodies of Roszdravnadzor.

What should applicants for a quota for da Vinci robotic surgery have to consider?

The number of quotas is incommensurably less than the number of patients requiring surgery. The classical direct way of obtaining quotas is usually stretched over time.

Where can I find out if there are quotas for High-Tech Medical Care?

The Ministry of Health annually approves the number of quotas for HTMC and other types of treatment. All quotas are distributed among medical institutions licensed to provide such care. Information about how many quotas are left can be obtained from two sources. One of them is the Department of Health, the other is the clinic where you want to get a VMP.

In any clinic that provides treatment under government quotas, there must be a person responsible for quotas, or there may even be a whole quota department. It is there that you need to contact for questions about the availability of quotas.

How many high-tech operations with the help of the da Vinci robot are performed per year, is there any chance of getting help?

In 2017, a total of 2421 operations were performed using a robotic system. Of these, only 5% was paid by private individuals, the rest was financed by quotas.

If the medical center is equipped with the da Vinci system, does this mean that all types of operations can be performed at the medical center?

The use of a robotic system allows for the most complex interventions in urology, general surgery, gynecology, thoracic surgery, colorectal surgery and on the organs of the head and neck. Although the list of operations is quite wide, 70% of all interventions take place in Urology, and robot-assisted prostatectomy is the gold standard in the world in the treatment of prostate cancer. It is important to understand that each clinic develops separate directions. There are multidisciplinary centers where surgical interventions using da Vinci are carried out in different directions, and there are centers specializing in one thing. For example, GBUZ MO "MONIIAG" specializes in gynecology, and all operations are carried out only in this area.

Which medical institutions in Russia provide HTMC with the help of the da Vinci robot?

The list of medical institutions that perform surgery using the da Vinci robot is presented on our website, in the "Clinics" section. There you can find the address and phone number of the registry of each medical center.

List of operations that are carried out using the da Vinci robot-assisted system in Russia:

Urology: Radical prostatectomy, Adenomectomy, Kidney resection; autotransplantation; allotransplantation, Nephrectomy, Adrenalectomy, Cystectomy, Bladder resection, LMS plasty, Ureteroanastomosis; Ureterocystoanastamosis, Abdominal testicular resection, Pyelolithotomy, Varicocelectomy.

Gynecology: Hysterectomy, Extirpation of the uterus with appendages; Extirpation of the uterus with tubes, Extirpation with lymphadenectomy, Oophorectomy, Panhysterectomy, Myoimectomy, Curettage, Resection of endometriosis, Transposition of the ovaries, Sacrocolpopexy, Retropubic colpo-urethrosuspension (Burch operation), Salpingectomy.

Abdominal surgery: Hepatectomy, Liver resection, Pancreatectomy, Fundoplication, Cardiomyotomy, Adrenalectomy, PDR (Pancreatoduodenal resection), Cholecystectomy, Selective arterial embolization or partial pancreaticoduodenectomy, Gastrectomy, Nissen fundoplication, Tupe fundoplication, Gastro-polypectomy, Abdominal prosthesis, Splenectomy.

Colorectal surgery: Rectal resection (anterior and low anterior), BAR (Abdominal-anal resection), Hemicolectomy (left-sided, right-sided), Sigmoidectomy, Colectomy.

Thoracic surgery: Segmentectomy, Lobectomy, Bilobectomy, Marginal resection, Mediastinal resection.

Head and neck: Glossectomy, Thymectomy, Theriodectomy, Hemithyroidectomy, Resection of the isthmus of the thyroid gland.

How to get a VMP quota?

The discovery of a disease that requires high-tech surgical intervention is a common story. Such an intervention can be performed using the method of minimally invasive surgery using the da Vinci robotic platform. The basis of the method is surgery using point punctures in tissues or through natural physiological openings, which avoids large postoperative traces.

It may seem to you that it is extremely difficult to get funding from the budget for high-tech assistance, nevertheless, there is a chance, and the number of operations performed under the quota is growing every year. According to official data, the cost of VMP is growing annually by 20%, and the number of transactions completed over the past 10 years has increased 15 times.

Speaking at SPIEF-2018, Minister of Health Veronika Skvortsova announced the increase in the availability of high-tech medical care (HTMC): “We have significantly increased the volume of high-tech medical care, starting from 60 patients 10 years ago, and now it is more than 1 million according to the results of last year,” - said the Minister

Surgery using the da Vinci robotic platform is expensive, but any patient in need is eligible to receive a government quota for such an operation.

We bring to your attention answers to questions that arise from applicants.

Who is eligible for a free high-tech operation?

Any needy citizen of the Russian Federation can take advantage of free medical care. This is stated in Decree of the Government of the Russian Federation of December 8, 2017 N 1492 "On the Program of State Guarantees of Free Medical Care for Citizens for 2018 and for the planning period of 2019 and 2020." This document is adopted annually.

Document

Order of the Ministry of Health and Social Development No. 1248n dated December 31, 2010 regulates the procedure for providing high-tech medical care (HMC) to citizens of the Russian Federation at public expense. According to this order, every ordinary citizen of the Russian Federation has the right to receive funding for the operation from the state if necessary.

Which institutions deal with the issue of quotas?

All issues of obtaining funding for High-Technological Medical Assistance (HMP) from the federal budget are regulated by the Ministry of Health.

What diseases fall under the quota program?

The list of diseases in the presence of which the patient can count on state support is annually approved by order of the Ministry of Health of the Russian Federation.

The types of assistance that can be provided using the da Vinci robot can be viewed here.

Which institutions are eligible to provide High-Tech Medical Care (HICH)?

A medical institution providing high-tech medical care under state quotas must have an appropriate license. All the clinics on our list that have the da Vinci robotic system in their arsenal have such a document.

Is there an age limit for the patient?

There are no age restrictions for minimally invasive surgery using the da Vinci robot.

What steps need to be taken in the process of obtaining a quota for an operation corresponding to the gold standard of surgery?

Step 1. Appeal to the attending physician.

First of all, the patient should contact the attending physician to obtain a referral for hospitalization, draw up the necessary documents and send them for consideration to the competent organization. The attending physician of the medical organization in which the patient is being diagnosed and treated determines the presence of medical indications for the provision of HTMC and, if there are medical indications, issues a referral for hospitalization. The presence of medical indications is confirmed by the decision of the medical commission of the medical organization, which is drawn up in a protocol and entered into the patient's medical documentation. If there are medical indications, the attending physician issues a referral for hospitalization.

Requirements for issuing a referral for hospitalization:

The referral must be completed on the letterhead of the referring medical organization legibly by hand or in hard copy, certified by the personal signatures of the attending physician and the head of the medical organization, as well as the seals of the attending physician and the medical organization, and contain the following information:

• FULL NAME. patient, date of birth, registration address;
• CHI policy number and the name of the medical insurance organization;
• insurance certificate of compulsory pension insurance;
• code of diagnosis of the underlying disease in accordance with the international classification of diseases;
• profile and name of the type of VMP;
• the name of the medical organization to which the patient is referred;
• FULL NAME. and the position of the attending physician, if available, his phone number and e-mail address.

The directions are accompanied by:

• an extract from medical records indicating the diagnosis of the disease, the disease code according to the international classification of diseases, information about the state of health, the results of special medical studies. The extract must be certified by the personal signatures of the attending physician and the head of the medical organization;
• a copy of the patient's identity document or a copy of the birth certificate (for children under 14 years of age);
• a copy of the CHI policy;
• a copy of the insurance certificate of compulsory pension insurance (if any);
• consent to the processing of personal data.

The head of the sending medical organization or another employee of the medical organization authorized by the head of the organization sends a referral for hospitalization:

- to the receiving medical organization, if the VMP is included in the basic CHI program (clause 15.1 of the Procedure);

- to the executive authority of the constituent entity of the Russian Federation in the field of healthcare (OHZ), if the VMP is not included in the basic CHI program.

Important: The patient or his legal representative has the right to submit the completed package of documents on his own. This will speed up the collection and submission of the documentation required to obtain the VMP.

Step 2

Extradition protection

It is necessary to wait for the registration of the coupon for the VMP.

There are 2 ticketing options:

• If the patient is referred for the provision of HTMC included in the basic compulsory medical insurance program, then the receipt of the coupon with the attachment of the set of documents specified in step 1 is provided by the receiving medical organization.
• If a patient is referred for the provision of HTMC not included in the basic CHI program, the issuance of a coupon and the conclusion of the commission of the executive authority of the constituent entity of the Russian Federation in the field of healthcare for the selection of patients for the provision of HTMC (commission of the HMO) is provided by the HMO.

The HMO Commission decides on the presence or absence of indications for referring the patient to the receiving medical organization within 10 working days from the date of receipt of the full package of documents. The decision of the HMO commission is drawn up in a protocol, which should contain a conclusion on the indications for referral to the VMP or on the need for additional examination.

Note: An extract from the protocol of the decision of the HMO commission is sent to the sending medical organization, and is also handed over to the patient (his legal representative) upon a written application or sent to the patient (his legal representative) via postal and (or) electronic communication.

Step 3It is necessary to wait for the decision of the commission of the medical organization providing HTMC.

The Commission makes a decision on the presence (absence) of medical indications or the presence of medical contraindications for hospitalization of the patient within seven working days from the date of issue of the coupon for the provision of HTMC.

The decision is drawn up in a protocol containing a conclusion on the presence of medical indications and the planned date of hospitalization of the patient, on the absence of medical indications for hospitalization, on the need for an additional examination, on the presence of medical indications for referring the patient to a medical organization for specialized medical care, on the presence of medical contraindications for hospitalization of a patient in a medical organization providing HTMC.

Step 4. After completing the HCMC, get recommendations.

Based on the results of the provision of HTMC, medical organizations make recommendations for further monitoring and (or) treatment and medical rehabilitation with the relevant records in the patient's medical records.

Note: In case of dissatisfaction with the quality of HTMC, the patient has the right to contact local health authorities or territorial bodies of Roszdravnadzor.

What should applicants for a quota for da Vinci robotic surgery have to consider?

The number of quotas is incommensurably less than the number of patients requiring surgery. The classical direct way of obtaining quotas is usually stretched over time.

Where can I find out if there are quotas for High-Tech Medical Care?

The Ministry of Health annually approves the number of quotas for HTMC and other types of treatment. All quotas are distributed among medical institutions licensed to provide such care. Information about how many quotas are left can be obtained from two sources. One of them is the Department of Health, the other is the clinic where you want to get a VMP.

In any clinic that provides treatment under government quotas, there must be a person responsible for quotas, or there may even be a whole quota department. It is there that you need to contact for questions about the availability of quotas.

How many high-tech operations with the help of the da Vinci robot are performed per year, is there any chance of getting help?

In 2017, a total of 2421 operations were performed using a robotic system. Of these, only 5% was paid by private individuals, the rest was financed by quotas.

If the medical center is equipped with the da Vinci system, does this mean that all types of operations can be performed at the medical center?

The use of a robotic system allows for the most complex interventions in urology, general surgery, gynecology, thoracic surgery, colorectal surgery and on the organs of the head and neck. Although the list of operations is quite wide, 70% of all interventions take place in Urology, and robot-assisted prostatectomy is the gold standard in the world in the treatment of prostate cancer. It is important to understand that each clinic develops separate directions. There are multidisciplinary centers where surgical interventions using da Vinci are carried out in different directions, and there are centers specializing in one thing. For example, GBUZ MO "MONIIAG" specializes in gynecology, and all operations are carried out only in this area.

Which medical institutions in Russia provide HTMC with the help of the da Vinci robot?

The list of medical institutions that perform surgery using the da Vinci robot is presented on our website, in the "Clinics" section. There you can find the address and phone number of the registry of each medical center.

List of operations that are carried out using the da Vinci robot-assisted system in Russia:

Urology: Radical prostatectomy, Adenomectomy, Kidney resection; autotransplantation; allotransplantation, Nephrectomy, Adrenalectomy, Cystectomy, Bladder resection, LMS plasty, Ureteroanastomosis; Ureterocystoanastamosis, Abdominal testicular resection, Pyelolithotomy, Varicocelectomy.

Gynecology: Hysterectomy, Extirpation of the uterus with appendages; Extirpation of the uterus with tubes, Extirpation with lymphadenectomy, Oophorectomy, Panhysterectomy, Myoimectomy, Curettage, Resection of endometriosis, Transposition of the ovaries, Sacrocolpopexy, Retropubic colpo-urethrosuspension (Burch operation), Salpingectomy.

Abdominal surgery: Hepatectomy, Liver resection, Pancreatectomy, Fundoplication, Cardiomyotomy, Adrenalectomy, PDR (Pancreatoduodenal resection), Cholecystectomy, Selective arterial embolization or partial pancreaticoduodenectomy, Gastrectomy, Nissen fundoplication, Tupe fundoplication, Gastro-polypectomy, Abdominal prosthesis, Splenectomy.

Colorectal surgery: Rectal resection (anterior and low anterior), BAR (Abdominal-anal resection), Hemicolectomy (left-sided, right-sided), Sigmoidectomy, Colectomy.

Thoracic surgery: Segmentectomy, Lobectomy, Bilobectomy, Marginal resection, Mediastinal resection.

Head and neck: Glossectomy, Thymectomy, Theriodectomy, Hemithyroidectomy, Resection of the isthmus of the thyroid gland.

How to get a VMP quota?

The discovery of a disease that requires high-tech surgical intervention is a common story. Such an intervention can be performed using the method of minimally invasive surgery using the da Vinci robotic platform. The basis of the method is surgery using point punctures in tissues or through natural physiological openings, which avoids large postoperative traces.

It may seem to you that it is extremely difficult to get funding from the budget for high-tech assistance, nevertheless, there is a chance, and the number of operations performed under the quota is growing every year. According to official data, the cost of VMP is growing annually by 20%, and the number of transactions completed over the past 10 years has increased 15 times.

Speaking at SPIEF-2018, Minister of Health Veronika Skvortsova announced the increase in the availability of high-tech medical care (HTMC): “We have significantly increased the volume of high-tech medical care, starting from 60 patients 10 years ago, and now it is more than 1 million according to the results of last year,” - said the Minister

Surgery using the da Vinci robotic platform is expensive, but any patient in need is eligible to receive a government quota for such an operation.

We bring to your attention answers to questions that arise from applicants.

Who is eligible for a free high-tech operation?

Any needy citizen of the Russian Federation can take advantage of free medical care. This is stated in Decree of the Government of the Russian Federation of December 8, 2017 N 1492 "On the Program of State Guarantees of Free Medical Care for Citizens for 2018 and for the planning period of 2019 and 2020." This document is adopted annually.

Document

Order of the Ministry of Health and Social Development No. 1248n dated December 31, 2010 regulates the procedure for providing high-tech medical care (HMC) to citizens of the Russian Federation at public expense. According to this order, every ordinary citizen of the Russian Federation has the right to receive funding for the operation from the state if necessary.

Which institutions deal with the issue of quotas?

All issues of obtaining funding for High-Technological Medical Assistance (HMP) from the federal budget are regulated by the Ministry of Health.

What diseases fall under the quota program?

The list of diseases in the presence of which the patient can count on state support is annually approved by order of the Ministry of Health of the Russian Federation.

The types of assistance that can be provided using the da Vinci robot can be viewed here.

Which institutions are eligible to provide High-Tech Medical Care (HICH)?

A medical institution providing high-tech medical care under state quotas must have an appropriate license. All the clinics on our list that have the da Vinci robotic system in their arsenal have such a document.

Is there an age limit for the patient?

There are no age restrictions for minimally invasive surgery using the da Vinci robot.

What steps need to be taken in the process of obtaining a quota for an operation corresponding to the gold standard of surgery?

Step 1. Appeal to the attending physician.

First of all, the patient should contact the attending physician to obtain a referral for hospitalization, draw up the necessary documents and send them for consideration to the competent organization.

How many times can I get a quota for an operation

The attending physician of the medical organization in which the patient is being diagnosed and treated determines the presence of medical indications for the provision of HTMC and, if there are medical indications, issues a referral for hospitalization. The presence of medical indications is confirmed by the decision of the medical commission of the medical organization, which is drawn up in a protocol and entered into the patient's medical documentation. If there are medical indications, the attending physician issues a referral for hospitalization.

Requirements for issuing a referral for hospitalization:

The referral must be completed on the letterhead of the referring medical organization legibly by hand or in hard copy, certified by the personal signatures of the attending physician and the head of the medical organization, as well as the seals of the attending physician and the medical organization, and contain the following information:

• FULL NAME. patient, date of birth, registration address;
• CHI policy number and the name of the medical insurance organization;
• insurance certificate of compulsory pension insurance;
• code of diagnosis of the underlying disease in accordance with the international classification of diseases;
• profile and name of the type of VMP;
• the name of the medical organization to which the patient is referred;
• FULL NAME. and the position of the attending physician, if available, his phone number and e-mail address.

The directions are accompanied by:

• an extract from medical records indicating the diagnosis of the disease, the disease code according to the international classification of diseases, information about the state of health, the results of special medical studies. The extract must be certified by the personal signatures of the attending physician and the head of the medical organization;
• a copy of the patient's identity document or a copy of the birth certificate (for children under 14 years of age);
• a copy of the CHI policy;
• a copy of the insurance certificate of compulsory pension insurance (if any);
• consent to the processing of personal data.

The head of the sending medical organization or another employee of the medical organization authorized by the head of the organization sends a referral for hospitalization:

- to the receiving medical organization, if the VMP is included in the basic CHI program (clause 15.1 of the Procedure);

- to the executive authority of the constituent entity of the Russian Federation in the field of healthcare (OHZ), if the VMP is not included in the basic CHI program.

Important: The patient or his legal representative has the right to submit the completed package of documents on his own. This will speed up the collection and submission of the documentation required to obtain the VMP.

Step 2. It is necessary to wait for the registration of the coupon for the VMP.

There are 2 ticketing options:

• If the patient is referred for the provision of HTMC included in the basic compulsory medical insurance program, then the receipt of the coupon with the attachment of the set of documents specified in step 1 is provided by the receiving medical organization.
• If a patient is referred for the provision of HTMC not included in the basic CHI program, the issuance of a coupon and the conclusion of the commission of the executive authority of the constituent entity of the Russian Federation in the field of healthcare for the selection of patients for the provision of HTMC (commission of the HMO) is provided by the HMO.

The HMO Commission decides on the presence or absence of indications for referring the patient to the receiving medical organization within 10 working days from the date of receipt of the full package of documents. The decision of the HMO commission is drawn up in a protocol, which should contain a conclusion on the indications for referral to the VMP or on the need for additional examination.

Note: An extract from the protocol of the decision of the HMO commission is sent to the sending medical organization, and is also handed over to the patient (his legal representative) upon a written application or sent to the patient (his legal representative) via postal and (or) electronic communication.

Step 3It is necessary to wait for the decision of the commission of the medical organization providing HTMC.

The Commission makes a decision on the presence (absence) of medical indications or the presence of medical contraindications for hospitalization of the patient within seven working days from the date of issue of the coupon for the provision of HTMC.

The decision is drawn up in a protocol containing a conclusion on the presence of medical indications and the planned date of hospitalization of the patient, on the absence of medical indications for hospitalization, on the need for an additional examination, on the presence of medical indications for referring the patient to a medical organization for specialized medical care, on the presence of medical contraindications for hospitalization of a patient in a medical organization providing HTMC.

Step 4. After completing the HCMC, get recommendations.

Based on the results of the provision of HTMC, medical organizations make recommendations for further monitoring and (or) treatment and medical rehabilitation with the relevant records in the patient's medical records.

Note: In case of dissatisfaction with the quality of HTMC, the patient has the right to contact local health authorities or territorial bodies of Roszdravnadzor.

What should applicants for a quota for da Vinci robotic surgery have to consider?

The number of quotas is incommensurably less than the number of patients requiring surgery. The classical direct way of obtaining quotas is usually stretched over time.

Where can I find out if there are quotas for High-Tech Medical Care?

The Ministry of Health annually approves the number of quotas for HTMC and other types of treatment. All quotas are distributed among medical institutions licensed to provide such care. Information about how many quotas are left can be obtained from two sources. One of them is the Department of Health, the other is the clinic where you want to get a VMP.

In any clinic that provides treatment under government quotas, there must be a person responsible for quotas, or there may even be a whole quota department. It is there that you need to contact for questions about the availability of quotas.

How many high-tech operations with the help of the da Vinci robot are performed per year, is there any chance of getting help?

In 2017, a total of 2421 operations were performed using a robotic system. Of these, only 5% was paid by private individuals, the rest was financed by quotas.

If the medical center is equipped with the da Vinci system, does this mean that all types of operations can be performed at the medical center?

The use of a robotic system allows for the most complex interventions in urology, general surgery, gynecology, thoracic surgery, colorectal surgery and on the organs of the head and neck. Although the list of operations is quite wide, 70% of all interventions take place in Urology, and robot-assisted prostatectomy is the gold standard in the world in the treatment of prostate cancer. It is important to understand that each clinic develops separate directions. There are multidisciplinary centers where surgical interventions using da Vinci are carried out in different directions, and there are centers specializing in one thing. For example, GBUZ MO "MONIIAG" specializes in gynecology, and all operations are carried out only in this area.

Which medical institutions in Russia provide HTMC with the help of the da Vinci robot?

The list of medical institutions that perform surgery using the da Vinci robot is presented on our website, in the "Clinics" section. There you can find the address and phone number of the registry of each medical center.

List of operations that are carried out using the da Vinci robot-assisted system in Russia:

Urology: Radical prostatectomy, Adenomectomy, Kidney resection; autotransplantation; allotransplantation, Nephrectomy, Adrenalectomy, Cystectomy, Bladder resection, LMS plasty, Ureteroanastomosis; Ureterocystoanastamosis, Abdominal testicular resection, Pyelolithotomy, Varicocelectomy.

Gynecology: Hysterectomy, Extirpation of the uterus with appendages; Extirpation of the uterus with tubes, Extirpation with lymphadenectomy, Oophorectomy, Panhysterectomy, Myoimectomy, Curettage, Resection of endometriosis, Transposition of the ovaries, Sacrocolpopexy, Retropubic colpo-urethrosuspension (Burch operation), Salpingectomy.

Abdominal surgery: Hepatectomy, Liver resection, Pancreatectomy, Fundoplication, Cardiomyotomy, Adrenalectomy, PDR (Pancreatoduodenal resection), Cholecystectomy, Selective arterial embolization or partial pancreaticoduodenectomy, Gastrectomy, Nissen fundoplication, Tupe fundoplication, Gastro-polypectomy, Abdominal prosthesis, Splenectomy.

Colorectal surgery: Rectal resection (anterior and low anterior), BAR (Abdominal-anal resection), Hemicolectomy (left-sided, right-sided), Sigmoidectomy, Colectomy.

Thoracic surgery: Segmentectomy, Lobectomy, Bilobectomy, Marginal resection, Mediastinal resection.

Head and neck: Glossectomy, Thymectomy, Theriodectomy, Hemithyroidectomy, Resection of the isthmus of the thyroid gland.

How to get a VMP quota?

The discovery of a disease that requires high-tech surgical intervention is a common story. Such an intervention can be performed using the method of minimally invasive surgery using the da Vinci robotic platform. The basis of the method is surgery using point punctures in tissues or through natural physiological openings, which avoids large postoperative traces.

It may seem to you that it is extremely difficult to get funding from the budget for high-tech assistance, nevertheless, there is a chance, and the number of operations performed under the quota is growing every year. According to official data, the cost of VMP is growing annually by 20%, and the number of transactions completed over the past 10 years has increased 15 times.

Speaking at SPIEF-2018, Minister of Health Veronika Skvortsova announced the increase in the availability of high-tech medical care (HTMC): “We have significantly increased the volume of high-tech medical care, starting from 60 patients 10 years ago, and now it is more than 1 million according to the results of last year,” - said the Minister

Surgery using the da Vinci robotic platform is expensive, but any patient in need is eligible to receive a government quota for such an operation.

We bring to your attention answers to questions that arise from applicants.

Who is eligible for a free high-tech operation?

Any needy citizen of the Russian Federation can take advantage of free medical care. This is stated in Decree of the Government of the Russian Federation of December 8, 2017 N 1492 "On the Program of State Guarantees of Free Medical Care for Citizens for 2018 and for the planning period of 2019 and 2020." This document is adopted annually.

Document

Order of the Ministry of Health and Social Development No. 1248n dated December 31, 2010 regulates the procedure for providing high-tech medical care (HMC) to citizens of the Russian Federation at public expense. According to this order, every ordinary citizen of the Russian Federation has the right to receive funding for the operation from the state if necessary.

Which institutions deal with the issue of quotas?

All issues of obtaining funding for High-Technological Medical Assistance (HMP) from the federal budget are regulated by the Ministry of Health.

What diseases fall under the quota program?

The list of diseases in the presence of which the patient can count on state support is annually approved by order of the Ministry of Health of the Russian Federation.

The types of assistance that can be provided using the da Vinci robot can be viewed here.

Which institutions are eligible to provide High-Tech Medical Care (HICH)?

A medical institution providing high-tech medical care under state quotas must have an appropriate license. All the clinics on our list that have the da Vinci robotic system in their arsenal have such a document.

Is there an age limit for the patient?

There are no age restrictions for minimally invasive surgery using the da Vinci robot.

What steps need to be taken in the process of obtaining a quota for an operation corresponding to the gold standard of surgery?

Step 1. Appeal to the attending physician.

First of all, the patient should contact the attending physician to obtain a referral for hospitalization, draw up the necessary documents and send them for consideration to the competent organization. The attending physician of the medical organization in which the patient is being diagnosed and treated determines the presence of medical indications for the provision of HTMC and, if there are medical indications, issues a referral for hospitalization.

The presence of medical indications is confirmed by the decision of the medical commission of the medical organization, which is drawn up in a protocol and entered into the patient's medical documentation. If there are medical indications, the attending physician issues a referral for hospitalization.

Requirements for issuing a referral for hospitalization:

The referral must be completed on the letterhead of the referring medical organization legibly by hand or in hard copy, certified by the personal signatures of the attending physician and the head of the medical organization, as well as the seals of the attending physician and the medical organization, and contain the following information:

• FULL NAME. patient, date of birth, registration address;
• CHI policy number and the name of the medical insurance organization;
• insurance certificate of compulsory pension insurance;
• code of diagnosis of the underlying disease in accordance with the international classification of diseases;
• profile and name of the type of VMP;
• the name of the medical organization to which the patient is referred;
• FULL NAME. and the position of the attending physician, if available, his phone number and e-mail address.

The directions are accompanied by:

• an extract from medical records indicating the diagnosis of the disease, the disease code according to the international classification of diseases, information about the state of health, the results of special medical studies. The extract must be certified by the personal signatures of the attending physician and the head of the medical organization;
• a copy of the patient's identity document or a copy of the birth certificate (for children under 14 years of age);
• a copy of the CHI policy;
• a copy of the insurance certificate of compulsory pension insurance (if any);
• consent to the processing of personal data.

The head of the sending medical organization or another employee of the medical organization authorized by the head of the organization sends a referral for hospitalization:

- to the receiving medical organization, if the VMP is included in the basic CHI program (clause 15.1 of the Procedure);

- to the executive authority of the constituent entity of the Russian Federation in the field of healthcare (OHZ), if the VMP is not included in the basic CHI program.

Important: The patient or his legal representative has the right to submit the completed package of documents on his own. This will speed up the collection and submission of the documentation required to obtain the VMP.

Step 2. It is necessary to wait for the registration of the coupon for the VMP.

There are 2 ticketing options:

• If the patient is referred for the provision of HTMC included in the basic compulsory medical insurance program, then the receipt of the coupon with the attachment of the set of documents specified in step 1 is provided by the receiving medical organization.
• If a patient is referred for the provision of HTMC not included in the basic CHI program, the issuance of a coupon and the conclusion of the commission of the executive authority of the constituent entity of the Russian Federation in the field of healthcare for the selection of patients for the provision of HTMC (commission of the HMO) is provided by the HMO.

The HMO Commission decides on the presence or absence of indications for referring the patient to the receiving medical organization within 10 working days from the date of receipt of the full package of documents. The decision of the HMO commission is drawn up in a protocol, which should contain a conclusion on the indications for referral to the VMP or on the need for additional examination.

Note: An extract from the protocol of the decision of the HMO commission is sent to the sending medical organization, and is also handed over to the patient (his legal representative) upon a written application or sent to the patient (his legal representative) via postal and (or) electronic communication.

Step 3It is necessary to wait for the decision of the commission of the medical organization providing HTMC.

The Commission makes a decision on the presence (absence) of medical indications or the presence of medical contraindications for hospitalization of the patient within seven working days from the date of issue of the coupon for the provision of HTMC.

The decision is drawn up in a protocol containing a conclusion on the presence of medical indications and the planned date of hospitalization of the patient, on the absence of medical indications for hospitalization, on the need for an additional examination, on the presence of medical indications for referring the patient to a medical organization for specialized medical care, on the presence of medical contraindications for hospitalization of a patient in a medical organization providing HTMC.

Step 4. After completing the HCMC, get recommendations.

Based on the results of the provision of HTMC, medical organizations make recommendations for further monitoring and (or) treatment and medical rehabilitation with the relevant records in the patient's medical records.

Note: In case of dissatisfaction with the quality of HTMC, the patient has the right to contact local health authorities or territorial bodies of Roszdravnadzor.

What should applicants for a quota for da Vinci robotic surgery have to consider?

The number of quotas is incommensurably less than the number of patients requiring surgery.

Operation quota (2018)

The classical direct way of obtaining quotas is usually stretched over time.

Where can I find out if there are quotas for High-Tech Medical Care?

The Ministry of Health annually approves the number of quotas for HTMC and other types of treatment. All quotas are distributed among medical institutions licensed to provide such care. Information about how many quotas are left can be obtained from two sources. One of them is the Department of Health, the other is the clinic where you want to get a VMP.

In any clinic that provides treatment under government quotas, there must be a person responsible for quotas, or there may even be a whole quota department. It is there that you need to contact for questions about the availability of quotas.

How many high-tech operations with the help of the da Vinci robot are performed per year, is there any chance of getting help?

In 2017, a total of 2421 operations were performed using a robotic system. Of these, only 5% was paid by private individuals, the rest was financed by quotas.

If the medical center is equipped with the da Vinci system, does this mean that all types of operations can be performed at the medical center?

The use of a robotic system allows for the most complex interventions in urology, general surgery, gynecology, thoracic surgery, colorectal surgery and on the organs of the head and neck. Although the list of operations is quite wide, 70% of all interventions take place in Urology, and robot-assisted prostatectomy is the gold standard in the world in the treatment of prostate cancer. It is important to understand that each clinic develops separate directions. There are multidisciplinary centers where surgical interventions using da Vinci are carried out in different directions, and there are centers specializing in one thing. For example, GBUZ MO "MONIIAG" specializes in gynecology, and all operations are carried out only in this area.

Which medical institutions in Russia provide HTMC with the help of the da Vinci robot?

The list of medical institutions that perform surgery using the da Vinci robot is presented on our website, in the "Clinics" section. There you can find the address and phone number of the registry of each medical center.

List of operations that are carried out using the da Vinci robot-assisted system in Russia:

Urology: Radical prostatectomy, Adenomectomy, Kidney resection; autotransplantation; allotransplantation, Nephrectomy, Adrenalectomy, Cystectomy, Bladder resection, LMS plasty, Ureteroanastomosis; Ureterocystoanastamosis, Abdominal testicular resection, Pyelolithotomy, Varicocelectomy.

Gynecology: Hysterectomy, Extirpation of the uterus with appendages; Extirpation of the uterus with tubes, Extirpation with lymphadenectomy, Oophorectomy, Panhysterectomy, Myoimectomy, Curettage, Resection of endometriosis, Transposition of the ovaries, Sacrocolpopexy, Retropubic colpo-urethrosuspension (Burch operation), Salpingectomy.

Abdominal surgery: Hepatectomy, Liver resection, Pancreatectomy, Fundoplication, Cardiomyotomy, Adrenalectomy, PDR (Pancreatoduodenal resection), Cholecystectomy, Selective arterial embolization or partial pancreaticoduodenectomy, Gastrectomy, Nissen fundoplication, Tupe fundoplication, Gastro-polypectomy, Abdominal prosthesis, Splenectomy.

Colorectal surgery: Rectal resection (anterior and low anterior), BAR (Abdominal-anal resection), Hemicolectomy (left-sided, right-sided), Sigmoidectomy, Colectomy.

Thoracic surgery: Segmentectomy, Lobectomy, Bilobectomy, Marginal resection, Mediastinal resection.

Head and neck: Glossectomy, Thymectomy, Theriodectomy, Hemithyroidectomy, Resection of the isthmus of the thyroid gland.

Read this article to learn how to get a quota for an operation in Moscow in 2018 and what high-tech medical care (HTMC) is.

High-tech medical care - what is it

VMP is a medical care that, due to the complexity of the disease, can only be provided in a specialized medical institution, where there are appropriate specialists and equipment.

High-tech medical care includes:

• oncology
• cardiovascular surgery
• Maxillofacial Surgery
• otorhinolaryngology
• rheumatology
• ophthalmology
• pediatrics
• thoracic surgery
• traumatology and orthopedics
• organ and tissue transplantation
• urology
• endocrinology
• abdominal surgery
• combustiology
• obstetrics and gynecology
• gastroenterology
• dermatovenereology
• hematology
• neurology
• neurosurgery

The list of diseases eligible for the quota is annually approved by order of the Ministry of Health of the Russian Federation.

What is an operation quota and how does it relate to VMP

In official documents, there is no such thing as a "quota". A synonym for "receiving a quota" can be considered a referral to receive high-tech medical care at the expense of the federal budget.

In 2018, VMP will be provided to citizens of the Russian Federation mainly at the expense of compulsory medical insurance (CHI). In practice, this may mean that the majority will be treated at the place of residence, and the decision to send the patient to another region, for example, to Moscow, will be taken only as a last resort.

How to get a quota for treatment in Moscow

For non-residents, this procedure may be somewhat more complicated, due to the need to coordinate high-tech medical care in another region. In general, the scheme consists of three stages - the passage of three medical commissions:

1. at the place of residence
2. in the regional health department
3. at the hospital where the treatment will take place

You can start registration both with an independent selection of a medical institution, and with the collection of documents and the delivery of the necessary tests at the clinic at the place of residence.

If you decide to choose a medical institution on your own, you will be better able to navigate the timing and be more confident in the quality of treatment.

A voucher for the provision of VMP must be issued at the regional department of health.

Documents for obtaining a quota for treatment

In general, the following documents will suffice:

• extracts from a medical institution, conclusions of specialists with the results of analyzes and studies
• original and photocopy of the CHI policy
• certificate of compulsory pension insurance and its photocopy
• original and photocopy of the passport
• for the child's birth certificate and its copy

Where to get a quota for a resident of Moscow

To obtain a coupon for the provision of VMP, you can contact the Department of Health of the city of Moscow, at the address: Moscow, 2nd Shemilovsky lane, house 4 "A", building 4

Some time later, after submitting the documents, an employee of the health department will inform you of the coupon number and the clinic for treatment, if you have not chosen it in advance.

The coupon is an electronic document and its status can be controlled on the website: talon.rosminzdrav.ru

How long can I get a quota for treatment?

Unfortunately, there are no clear regulations here, it all depends on the specific case. A response to the provision of VMP must be given within 10 days. After that, the waiting period for treatment can last from several days to several months.

Is quota treatment free?

Theoretically, yes, treatment should be completely free. Even the road to the place of treatment and accommodation can be paid, not to mention medicines. Unfortunately, in life, not everything goes as smoothly as we would like, so it is better to be prepared for unforeseen expenses in advance.

17 comments

Hello! We live in the city of Yakutsk. Mom received a quota in the form 057 / y-04 at the end of November 2016 to the Blokhin clinic in Moscow. She has oncology. Before the new year, she only had time to undergo an examination. For some types of research (ultrasound of the veins of the legs, revision of cytology and histology glasses, revision of CT and MRI disks, filling out our documents for a commission), they took money. Now the year 2017 has come, we have been prescribed radiation therapy, and then we will have an operation. Doctors are now telling us that our quota ended back in 2016 and no one can tell us what to do and who to contact. Until the new year, not one doctor told us anything that we had to go back for a new quota. What should we do?

Hello, I'm from Tuva I've been registered with a neurologist for 7-8 years with a diagnosis of epilepsy I can't work for health reasons Doctors said they can't help me except for pills On Malysheva's program I found out that I can be cured in Moscow And a question is asked Mother who is not working for health reasons - for a single two children with a diagnosis of epilepsy without a disability, does the state provide for free treatment in a clinic in Moscow? Thanks in advance

Good afternoon! I had a consultation at the Burdenko Research Institute with the neurosurgeon Konovalov N.A. According to all the doctor's indications, I need an operation: microsurgical decompression and stabilization at the L3-L4 level, I need a cage for the operation. According to the doctor: there are no implants and I don’t know when they will be, maybe in a month, or maybe more ... .. Tell me what I should do in such a situation. While I still walk, but every day the leg is getting worse and worse (it has completely lost sensitivity, severe lameness). They also asked me why you do not want to be operated on without a quota? Yes, I have no money - that's the whole answer. Help advice. Thank you.

Good afternoon! I am visually impaired, myopia of a high degree of -20 in both eyes and cataracts, registration in Arkhangelsk but I live in Moscow, registration was made for 5 years, I am attached to the clinic at the place of residence and am being monitored. Now I need an operation to replace the IOL, as I can i get a quote?

Hello, my child lost his hearing as a result of Meningitis. The doctors said that it was necessary to have cochlear implantation of the ears (an operation in Moscow) and they said that it was necessary to collect documents for the quota. We collected everything. The ministry said that our documents had reached and we were put on the queue when this turn comes, but the operation was said to be done urgently, because already the 4th degree of hearing loss (deafness in both ears). If anyone has encountered such a problem, please RESPOND; write how it was for you; how did you collect the quota for the operation; when you were called for surgery. Thank you

Good afternoon, my name is Vadim, I live in Yugorsk Khanty-Mansiysk Autonomous Okrug, I recently came to Moscow on February 14, 2017 due to an eye problem, I have a retinal detachment in my left eye, I was in the ophthalmology clinic of the N.I. Pirogov” of the Ministry of Health of the Russian Federation, the doctor Gilya A.P. examined me. I signed up for the queue, they said they would put me on a quota in the near future, but there are still 300 people ahead of you for the operation. When waiting for a quota for an operation, the eye sees badly. I will be grateful

Hello. My husband has non-specific ulcerative colitis, we live in Dagestan, documents were sent to Moscow at the Research Institute of Colonoprocolonoproctology on January 25, 2017, we still have not received a response, my husband is getting worse and worse, how can we speed up the receipt of a quota?

HELLO! WE ARE FROM THE KRASNODAR REGION, HAVE A DAUGHTER CALCIFIED GRANULOMA - WERE SEVERAL TIMES IN THE HOSPITAL, BUT THE SPOTS CONTINUE TO GROW ON THE LEGS AND WENT ALREADY ON THE BODY. HOW TO GET A QUOTA FOR TREATMENT IN MOSCOW AND IN KAKUB CLINIC PLEASE TELL ME VERY PLEASE - DAUGHTERS ARE ONLY 21 YEARS OLD.

Hello! I am Suraykina Tatyana Nikolaevna from Moscow. I was diagnosed with "Gonarthrosis of the 3rd stage of the right knee joint." From our regiment No. 31 of branch 107, I was given a referral to the Botkin hospital on 04/14/2016. I got an appointment with the doctor Kashcheev G.A. 05.05.2016 They gave me a referral to KEK for Endoprosthetics on 13.03. 2017 I passed the commission, they gave me an extract from the protocol and told me to wait. I am in so much pain that I can't bear it anymore. What I just don’t do and injections and ointments and folk remedies, nothing helps. I am disabled 3gr. by Parkinson. Please help me get a quota as soon as possible, I have been waiting for the second year already.

Hello! I am Tatyana Suraykina. Tell me, we are writing to you, but there is no answer. Or should it not exist?

Hello, Tatyana. This site is informational, unfortunately I cannot speed up the operation.

Try contacting the Moscow Department of Health with a complaint about the delay.

Website of the Health Department with contacts: mosgorzdrav.ru/ru-RU/department/contacts.html

An operation has already been performed to remove the hernia with the installation of a mesh for which an invoice has been issued.

The account has not yet been paid.

A patient with a Moscow residence permit was operated on in Moscow at the 13th City Clinical Hospital. She was taken to the emergency room due to a sharp exacerbation of the disease.

Does this case entitle you to a quota?

An operation has already been performed to remove an umbilical hernia with the installation of a mesh for which an invoice has been issued for payment. The bill has not yet been paid. Patient with Moscow residence, born in 1940 (does not work, retired), invalid of the 3rd group, operated in Moscow at the 13th City Clinical Hospital. Delivered to the emergency hospital due to a sharp exacerbation of the disease.

Does this case give the right to receive a quota?

Hello, I want to get a quota for bite correction (surgical) in Moscow, please tell me how to do it?

Hello Saule, I have the same problem, and I want to get a quota, how did you do it?

Hello. I live in Kaluga. Please tell me, after the accident, the bones on my foot did not grow together correctly, as a result, I was lame. Can I get a quota for an operation in Moscow? I was told that such operations are done only in Moscow and somewhere in Yakutia (if I don’t confuse anything). Thank you.

Almost every person faces serious illnesses during their lives, but not everyone has enough money to receive appropriate medical care in the best clinics in the world. Therefore, in Russia, some types of high-tech medical care (HTMC) can be obtained absolutely free of charge (at public expense).

What is the operation quota?

The Decrees of the Government of the Russian Federation and the Federal Laws speak about the VMP and the procedure for its provision, but there is nothing about quotas. Since a limited amount of money is allocated from the budget for the treatment of patients who need VMP, the concept of “quota” (in the sense of “direction to VMP”) is often used by doctors, employees of health departments, the patients themselves and their relatives. Often, this refers to a limited number of quotas or their absence.

What diseases are subject to quotas?

VMPs include:

• organ transplantation;
• open heart surgery;
• neurosurgical operations;
• joint arthroplasty;
• treatment of leukemia;
• treatment of hereditary diseases;
• treatment of severe forms of endocrine pathology;
• complex surgical procedures.

The list of types of HTMC, as well as the list of medical centers in Moscow and other cities of the Russian Federation that provide them, as well as the number of quotas allocated for each institution, are approved by order of the Ministry of Health and Social Development.

How to get a quote for an operation?

In order for a person with a serious illness to be able to receive a VMP at the state expense, he needs to go through 3 medical commissions:

• in the clinic at the place of residence;
• in the department of health of the region;
• in a medical institution where he will be sent to receive a VMP.

Where to apply?

First, the patient must go to the clinic at his place of residence. If the attending physician deems it necessary after the diagnostic examination, he will issue a referral to the regional health department. It should contain conclusions on the need to provide the VMP.

After that, the patient must apply to the health department, where, after considering his issue, the commission issues a coupon for the provision of VMP. In the medical institution where the patient will be sent, on the basis of the documents sent, it is decided whether there are indications and contraindications for his hospitalization.

Required documents

To receive a quota for treatment, you need:

• passport (for a child - a birth certificate);
• insurance policy;
• pension policy;
• an extract with a diagnosis from a medical institution;
• results of analyzes and studies made during the diagnosis of the disease.

How long to wait for a quota for an operation?

Getting a quota for an operation can take several weeks due to the need to go through 3 commissions. The commission should respond to a request for a VMP within 10 days, but after that, the patient can expect medical care from several days to several months.

What to do if the quota is denied?

The money allocated by the state is not enough to provide VMP to everyone. If the provision of VMP was denied due to the fact that the quotas are over, you can stand in line. In this case, a coupon for obtaining a VMP will be issued when it reaches you.

In addition, a refusal to refer to high-tech treatment can be issued if an incomplete package of documents is submitted to patients. They can also refuse to provide HTMC if there are no indications or there are contraindications to treatment. If the patient believes that he was refused illegally, he can always contact the territorial body of the Federal Service for Supervision of Health and Social Development.

Advice: it is best to undergo the necessary treatment for a fee in case of refusal to provide VMP. Waiting in line for a quota operation or appealing a denial can take too long, during which health can deteriorate very badly.

Frequently asked Questions

Consider frequently asked questions on the topic.

Where is it better to get a quota - in the department or in the clinic?

If the patient independently finds a clinic in which they have the opportunity to provide the necessary HTMC according to the quota and agree to do this, then an officially issued decision with a list of necessary documents is sent from this clinic to the health department. This entails great time savings, which can be vital in cancer or other serious illnesses.

Can I charge for a free quota operation?

If the quota operation is free, other related medical services and expensive medicines may be charged. Although in some cases the cost of them may be covered by the CHI policy.

How to get a quote for eye surgery?

Since there are many people in need of VMP, it is much more realistic to get a quota for eye surgery (as well as for other types of VMP) at the beginning of the year. To do this, you need to contact the medical institution at the place of residence, then to the health department, and then to the clinic, where the patient will be sent for treatment from the department.

Is it possible to expedite the receipt of a quota?

In order to speed up the receipt of a quota, you can often call the officials responsible for their provision or come to see them. But such psychological pressure can turn the official against you, and not stimulate him to speed up the resolution of your issue.

A more effective way to expedite the receipt of THC is to find a clinic that specializes in your disease and has permission to treat patients according to quotas. Usually in such clinics they meet the needs of patients who come to them on their own and take them for treatment at the expense of the state.

How can I find out about the availability of quotas?

You can find out about the availability of quotas both in the clinic itself, where they provide the type of VMP you need, and on specialized sites, as well as in the local health department.

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Every citizen of the Russian Federation (regardless of gender and age) has the right to receive a VMP at the state expense, if there are indications and there are no contraindications. But due to the large number of seriously ill people, quotas quickly run out, so in emergency cases and with rapidly progressing diseases, the patient may simply not wait for a free operation. At the same time, even when receiving HTMC at the expense of the state, the patient and his relatives have to pay many expenses out of their own pocket. Nevertheless, thanks to the allocation of quotas by the state, many citizens of the Russian Federation have the opportunity to receive HTMC and be cured or significantly extend their lives with various serious diseases.

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The procedure for obtaining a "quota" for residents of Moscow and Moscow Region

Before contacting the Department, it is advisable to familiarize yourself with the general procedure for obtaining a quota.

For residents of Moscow

Residents of Moscow apply for a "quota" to the Department of Health of the city of Moscow. Attention! You need to contact the patient personally or his representative. Phones are not answered!

Address: Moscow, 2nd Shchemilovsky lane, 4 A, building 4.

Monday-Thursday - from 9:00 to 17:30

Friday - from 9:00 to 16:30

lunch break from 13:30 to 14:30

To have with you: protocol of the quota decision, passport of the person for whom the quota is issued, compulsory medical insurance policy, pension policy - SNILS, certificate of disability (if available). Also, without fail, photocopies of all listed documents are required.

For residents of the Moscow region

Residents of the Moscow Region apply to the Ministry of Health of the Moscow Region.

Address: Moscow, st. Shchepkina, 61/2, MONIKI them. M.F. Vladimirsky, building 3, 1st floor; rooms 115,116,117.

To have with you: protocol of the quota decision, passport of the person for whom the quota is issued, compulsory medical insurance policy, pension policy - SNILS, certificate of disability (if available). Also, without fail, photocopies of all listed documents are required. An extract from the hospital is welcome.

Allocation of "quotas" for Muscovites and residents of the Moscow Region

After receiving a voucher for VMP at the Department of Health of the region, the patient can personally seek advice from a medical institution for which a “quota” has been allocated. Or the region organizes a correspondence consultation by mail or e-mail. Within 10 days from the date of receipt of the coupon (if the documents were sent by mail), a special commission decides on the possibility of providing VMP. If the patient applies personally, the terms of consideration do not exceed 3 days.

With a positive decision, the date of hospitalization of the patient is assigned, or the patient's data is entered on the waiting list (in order of priority). In case of a negative decision, when the commission considers it impossible to conduct a VMP, recommendations for further treatment are attached to the conclusion or additional studies are assigned, which can be done within the walls of the medical center.

How to get a quota for surgery and treatment in 2018

The treatment of some diseases is so complicated and costly that citizens are not able to pay for and organize it themselves. But every citizen of the Russian Federation has guarantees from the state, written in the basic law. They are provided with quotas for specialized medical services.

You just need to know how to get a quota for treatment in 2018. This is a complex process regulated by law.

What is a quota and who is entitled to it

It must be assumed that certain types of treatment (surgical intervention) are provided only by those healthcare institutions that are provided with:

• specialized equipment;
• highly professional staff.

This means that such clinics receive additional funding for development. It is allocated from the state budget so that doctors can save citizens in especially difficult situations. There aren't many hospitals like this.

If you understand this, then it will not be difficult to understand how to get a quota for an operation. All quota issues are dealt with only by state bodies. Each stage is laid down in the regulatory framework. Deviation from the implementation of the law in this case is unacceptable.

Thus, the quota is the allocation of state support to people in need of special treatment, within the framework of the Compulsory Health Insurance (CHI).

The Ministry of Health of the Russian Federation determines the lists:

• medical institutions involved in the treatment of ailments;

• diseases for which quotas are granted.

The legislative framework

A number of government documents fully describe the process of allocation and use of quotas. These should include:

• regulations guaranteeing free medical care to citizens of the country;
• Federal Law No. 323. Its Article 34 just describes the process of registration of quotas, the conditions for the implementation of this state guarantee;
• orders of the Ministry of Health of the Russian Federation specifying the quota process.

Issues of financing medical care are in the department of this ministry. Only this state body has the right to decide how many quotas will be provided to citizens in the current year, in which healthcare institutions they can be sold. Relevant resolutions are issued regularly. Download for viewing and printing

Do you need expert advice on this matter? Describe your problem and our lawyers will contact you as soon as possible.

Diseases subject to quotas

The state does not issue money to rid a citizen of any ailment. A valid reason is required to obtain a quota.

The Ministry of Health issues a document containing a list of diseases that are subject to treatment at public expense. The list is extensive, it contains up to 140 ailments.

Here is some of them:

1. Heart diseases, for getting rid of which surgery is indicated (including repeated).
2. Transplantation of internal organs.
3. Joint prosthetics, if arthroplasty is necessary.
4. Neurosurgical intervention.
5. In vitro fertilization (IVF).
6. Treatment of hereditary diseases in severe form, including leukemia.
7. Surgical intervention requiring specialized equipment, i.e. high-tech medical care (HTMC):
   • before the eyes;
   • on the spine and so on.

The Ministry of Health of the Russian Federation determines the number of quotas for each institution that has the appropriate license. This means that the respective clinic can only accept a certain number of patients for treatment at the expense of the budget.

The procedure for obtaining a preferential place in the clinic

The path to a medical facility that can cure is not easy. The patient will have to wait for a positive decision from three commissions. This procedure for obtaining a quota was established by the Ministry of Health of the Russian Federation.

There is a workaround. We will describe it a little later. Any application for a quota should begin with the attending physician.

To receive preferential treatment, you need to confirm the diagnosis. This may require paid tests and examinations. Their patient will have to do with their own savings.

The first commission - at the place of observation of the patient

The sequence for initiating a quota is as follows:

1. Contact the treating doctor and describe the intention.
2. Get a referral from him if you need to undergo an additional examination. Failure to do so will result in non-receipt of a quota.
3. The doctor draws up a certificate, which indicates the data:
   • about the diagnosis
   • about treatment;
   • on diagnostic measures;
   • about the general condition of the patient.
4. The certificate is considered by the commission dealing with quota issues, established in this medical institution.
5. This body has three days to make a decision.

The treating doctor is responsible for the "candidate" for the quota. He cannot recommend the commission of a citizen who can do without the VMP.

The decision of the first commission

If the patient needs specialized services, then the hospital commission decides to send the documents to the next body - the regional health department. At this stage, a package of documents is formed, which includes:

1. An extract from the minutes of the meeting with the rationale for the positive decision;
2. A photocopy of the passport (or birth certificate if we are talking about a child under 14 years old);
3. Application to include:
   • registration address;
   • passport data;
   • citizenship;
   • contact information;
4. A copy of the OM C policy;
5. Pension insurance policy;
6. Insurance account details (in some cases);
7. Data on examinations and analyzes (originals);
8. An extract from a medical card with a detailed diagnosis (prepared by a doctor).

It is necessary to give consent to the medical organization for the processing of personal data. For this, another statement is being written.

The second stage of decision making

The commission of the regional level includes five specialists. Its activities are supervised by the head of the relevant department. This body has ten days to decide.

In the event of a positive decision, this commission:

• determines the medical institution in which the treatment will be carried out;
• sends a package of documents there;
• informs the applicant.

It is customary to choose a clinic located near the patient's place of residence. However, not all hospitals are licensed to perform specialized operations. Consequently, a citizen may well be given a referral to another region or to a metropolitan institution.

The work of this body is recorded. The paper reflects the following data:

• the basis for the creation of a commission of a constituent entity of the Russian Federation;
• the specific composition of the sitting persons;
• information about the patient whose application is being considered;
• conclusion, which reads:
  • complete data on indications for granting a quota;
  • diagnosis, including its code;
  • grounds for referral to the clinic;
  • the need for additional testing;
  • grounds for refusal upon receipt of the VMP.

The following shall be sent to the medical institution where the patient will receive HTMC:

• coupon for the provision of VMP;
• a copy of the protocol;
• medical information about human health.

The third stage is the final

In the medical institution chosen for treatment, there is also a quota commission. After receiving the documents, she holds her own meeting, in which at least three people must take part.

1. Examines the information provided for the possibility of carrying out the necessary treatment for the patient
2. Decides to provide it.
3. Sets specific deadlines.
4. He has ten days to complete this task.

The coupon, if used, is kept at this clinic. It is the basis for budget financing of treatment.

Thus, the decision to include a person in the quota program takes at least 23 days (the time for sending the documentation should also be taken into account).

Features of quota services

Public funds provide only those medical services that are not available at the local hospital.

• surgical intervention;
• treatment.

Each of the types of assistance requires specialized equipment, appropriate training of specialists. That is, ordinary diseases are not subject to quotas.

Operation

This type of support is provided to people whose diagnosis matches the list of the Ministry of Health. They are sent to a clinic capable of performing the necessary manipulation. All treatment is provided free of charge.

Some citizens are also paid for travel to the place of assistance.

This type of service involves the use of high technology to get rid of the disease. This is an expensive procedure. All necessary expenses are covered by the budget.

However, there are necessary compelling medical grounds to provide HTMC.

Treatment

This type of state support involves the purchase of expensive drugs, which the patient himself is not able to pay for. Its procedure is determined by Federal Law No. 323 (Article 34). The Government of the Russian Federation specifies the implementation of the provisions of this regulatory act into practice by its resolutions.

Women who are diagnosed with infertility are referred for such an operation. In vitro fertilization is a costly and time-consuming procedure.

Many women are not able to feel the joy of motherhood without such an operation. But they give a referral for IVF only to patients who have passed a difficult preliminary period of examinations and treatment.

Not all types of assistance in restoring health and saving the life of a citizen of the Russian Federation are described. There are many ailments, almost all of them fall under one of the described areas of medical technology. But there are exceptions.

How to reduce the time to receive support

Often times people don't have time to wait. Help is needed urgently.

Speeding up the decision-making process of the three commissions is not easy.

In the first case, you can put "pressure" on the people responsible for allocating quotas:

• call them to find out about the progress of the issue;
• go to the reception to the leaders;
• write letters and so on.

The effectiveness of this method is doubtful. Only experienced specialists take part in the work of the commissions. These people themselves understand that the delay is unacceptable.

The second option is to go directly to the clinic that provides the services you need. For this you need:

• collect a package of documents (described above);
• bring to the hospital and write a statement on the spot.

Documents from the local hospital where the patient was initially diagnosed must be certified by:

Unfortunately, without compliance with the formalities, the quota clinic will not be able to provide assistance. This medical institution has yet to account for the use of budgetary funds.

We describe typical ways to resolve legal issues, but each case is unique and requires individual legal assistance.

For a prompt solution to your problem, we recommend contacting qualified lawyers of our site.

Changes in 2018

Our experts monitor all changes in legislation in order to provide you with reliable information.

The compulsory health insurance policy does not cover all types of treatment and the state allocates additional funds, the amount of which is limited. Read this article to learn how to get a quota for an operation in Moscow in 2019 and what high-tech medical care (HTMC) is.

High-tech medical care - what is it

VMP is a medical care that, due to the complexity of the disease, can only be provided in a specialized medical institution, where there are appropriate specialists and equipment.

High-tech medical care includes:

• oncology
• cardiovascular surgery
• Maxillofacial Surgery
• otorhinolaryngology
• rheumatology
• ophthalmology
• pediatrics
• thoracic surgery
• traumatology and orthopedics
• organ and tissue transplantation
• urology
• endocrinology
• abdominal surgery
• combustiology
• obstetrics and gynecology
• gastroenterology
• dermatovenereology
• hematology
• neurology
• neurosurgery

The list of diseases eligible for the quota is annually approved by order of the Ministry of Health of the Russian Federation.

What is an operation quota and how does it relate to VMP

In official documents, there is no such thing as a "quota". A synonym for "receiving a quota" can be considered a referral to receive high-tech medical care at the expense of the federal budget.

In 2018, VMP will be provided to citizens of the Russian Federation mainly at the expense of compulsory medical insurance (CHI). In practice, this may mean that the majority will be treated at the place of residence, and the decision to send the patient to another region, for example, to Moscow, will be taken only as a last resort.

How to get a quota for treatment in Moscow

For non-residents, this procedure may be somewhat more complicated, due to the need to coordinate high-tech medical care in another region. In general, the scheme consists of three stages - the passage of three medical commissions:

1. at the place of residence
2. in the regional health department
3. at the hospital where the treatment will take place

You can start registration both with an independent selection of a medical institution, and with the collection of documents and the delivery of the necessary tests at the clinic at the place of residence.

If you decide to choose a medical institution on your own, you will be better able to navigate the timing and be more confident in the quality of treatment.

A voucher for the provision of VMP must be issued at the regional department of health.

Documents for obtaining a quota for treatment

In general, the following documents will suffice:

• extracts from a medical institution, conclusions of specialists with the results of analyzes and studies
• original and photocopy of the CHI policy
• certificate of compulsory pension insurance and its photocopy
• original and photocopy of the passport
• for the child's birth certificate and its copy

Where to get a quota for a resident of Moscow

To obtain a coupon for the provision of VMP, you can contact the Department of Health of the city of Moscow, at the address: Moscow, 2nd Shemilovsky lane, house 4 "A", building 4

Some time later, after submitting the documents, an employee of the health department will inform you of the coupon number and the clinic for treatment, if you have not chosen it in advance.

The coupon is an electronic document and its status can be controlled on the website: talon.rosminzdrav.ru

How long can I get a quota for treatment?

Unfortunately, there are no clear regulations here, it all depends on the specific case. A response to the provision of VMP must be given within 10 days. After that, the waiting period for treatment can last from several days to several months.

Is quota treatment free?

Theoretically, yes, treatment should be completely free. Even the road to the place of treatment and accommodation can be paid, not to mention medicines. Unfortunately, in life, not everything goes as smoothly as we would like, so it is better to be prepared for unforeseen expenses in advance.