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Guaranteed Volume of Free Medical Care

On the Approval of the List of Guaranteed Volume of Free Medical Care

Resolution No. 2136 of the Government of the Republic of Kazakhstan dated December 15, 2009

In accordance with Subparagraph 7) Article 6 and Paragraph 1 Article 34 of the Code of the Republic of Kazakhstan dated September 18, 2009 “About Health of the People and Health Care System”, the Government of the Republic of Kazakhstan DECIDES the following:

1. to approve the enclosed list of the guaranteed volume of free medical care.

2. The Ministry of Healthcare of the Republic of Kazakhstan, mayors of regions, Astana and Almaty are required to take the necessary action resulting from this Resolution.

3. To recognize the Resolution No. 853 of the Government of the Republic of Kazakhstan dated September 28, 2007 "On Approval of the List of Guaranteed Volume of Free Medical Care for 2008-2009" (Collection of Acts of the President of the Republic of Kazakhstan and the Government of the Republic of Kazakhstan, 2007, No. 35, Art. 397).

4. This Resolution comes into effect on January 1, 2010 and is subject to official publication.

Prime Minister of the Republic of Kazakhstan K. Massimov

Annex to the Resolution No. 2136 of

the Government of

the Republic of Kazakhstan

dated December 15, 2009

List of the Guaranteed Volume of Free Medical Care

Note: The List is as in force of the Resolution No. 29 of the Government of the Republic of Kazakhstan dated 27.01.2014.

1. General Provisions

1. The guaranteed volume of free medical care (hereinafter - GVoFMC) is provided to citizens of the Republic of Kazakhstan and repatriates (oralmans) at the expense of budget funds and includes preventive, diagnostic and therapeutic medical services with the greatest proven efficacy.

2. The GVoFMC includes the following:

1) ambulance and sanitary aviation;

2) outpatient polyclinical care, including:

primary medical care (hereinafter - PMC);

advisory and diagnostic assistance (further - ADA) in the direction of a specialist of primary medical care and specialized professionals;

3) inpatient care in the direction of a specialist or PMC professionals within the planned volumes, determined by the authorized body in the field of healthcare (hereinafter - the authorized body), on emergency indications - regardless of direction;

4) hospital-replacing medical care in the direction of a PMC professional or specialized professionals;

5) recovery treatment and medical rehabilitation;

6) palliative care and nursing care for the population categories, as determined by the Government of the Republic of Kazakhstan.

2. List of the GVoFMC

3. Ambulance under the GVoFMC includes:

1) provision of medical care in emergency indications;

2) delivery of patients to medical institutions for emergency indications;

3) health care events (social, mass cultural, sports, etc.) of district, regional, republican significance in coordination with the authorized body in the field of healthcare or the local executive body.

4. Air ambulances within the GVoFMC includes:

1) provision of emergency medical care to the population in case of impossibility of providing the appropriate level of care because of the lack of resources in the medical organization at the place of the patient's residence;

2) delivery of qualified specialists to the destination or the patient's transportation to the appropriate medical organization by air transport and motor transport means.

5. Outpatient polyclinical care under the GVoFMC includes PMC, ADA and is available in the volume according to the appendix to this list of the GVoFMC.

6. Medical care with highly specialized and new technologies is provided in the direction of a specialist of the outpatient polycnilical organization (hereinafter - APO) in accordance with the list approved by the authorized body in the field of healthcare (hereinafter - the authorized body).

7. Inpatient care under the GVoFMC is carried out without provision of additional services (TV, telephone, customized meals, etc.) in rooms determined by the authorized body of the standard.

8. The GVoFMC provided in the form of inpatient care, according to the types and volumes, approved by the authorized body, includes:

1) examinations, specialist consultations, including with the use of telemedicine communications;

2) laboratory and instrumental tests in accordance with the healthcare standards;

3) medical services (except for paid ones), provision of medicines in accordance with medical forms for medical indications;

4) provision of blood products and its components based on medical indications;

5) provision of the opportunity for mother (father) or other person directly involved in caring for a child aged up to three years, as well as seriously ill elder children, who need additional care based on the decision of doctors to stay in the medical organization along with the issuance of a temporary disability statement;

6) provision of free meals in a medical institution for the whole period of childcare to the nursing mother of a child under one;

7) early and continued medical rehabilitation according to the medical care provision arrangement standards (hereinafter – the standard) approved by the competent authority, including the late one, for children and socially vulnerable categories of citizens;

8) creation of necessary conditions for games, recreation and educational work in children's inpatient healthcare organizations;

9) palliative care and nursing care for the population categories established by the Government of the Republic of Kazakhstan.

9. Hospital-replacing medical care within the GVoFMC includes:

1) examinations, consultations with specialists;

2) medical services (except paid ones), provision of medicines, according to the medicine forms based on medical indications;

3) early and continued medical rehabilitation for all categories of citizens according to indications, including physiotherapy and exercise therapy, according to the standards.

10. Pathologicoanatomic bureaus (departments) services within the GVoFMC include the following:

1) autopsy;

2) histological examination of biopsy and operational material;

3) cytology.

11. List of the GVoFMC includes treatment of citizens of the Republic of Kazakhstan abroad when indicated and in accordance with the procedures established by the Government of the Republic of Kazakhstan.

12. Provision of medicine to provide GVoFMC is carried out in accordance with the medicine forms approved by medical organizations and agreed in the prescribed manner by the authorized body in the delivery of the following:

1) ambulance / urgent / emergency medical assistance;

2) rabies assistance in epidemiological indications at risk of infection;

3) sanitary and preventive and sanitary and anti-epidemic aid based on indications;

4) immunization / vaccination;

5) inpatient and hospital-replacing care.13. Medicine provision at outpatient level under the GVoFMC is carried out in accordance with the list of medicine and medical items, approved by the authorized body, for the free supply of certain categories of citizens with certain medical conditions (states) and specialized medical products based on indications and prescription of the PMC specialist.

14. Medical assistance under the GVoFMC also includes therapeutic and diagnostic services using minimally invasive technologies.

Annex

to the List of the Guaranteed Volume

of Free Medical Care

Outpatient Polyclinical Assistance within the Guaranteed Volume of Free Medical Care

1. Primary Medical and Sanitary Care

Activities	Services	Periodicity of Services Provision
1	2	3
Admission and advice	Admission, advice (PMC specialists - general practitioner, local physician / pediatrician, health nurses / general practitioner nurse, medical assistant, obstetrician	Upon request
Provision of services at home by PMC specialists	Based on indications
Prevention	Advice on health protection and strengthening, healthy lifestyle formation, rational and healthy meals	Upon request and referral of specialists
Advice on family planning	Upon request and referral of specialists
Introduction / removal of IUD, contraceptive injection	Upon request and referral of specialists
Preventive medical examinations (screening tests) for target groups of population	With periodicity according to the procedure approved by the body authorized in healthcare (hereinafter – authorized body)
Sanitary-epidemiological (preventive) measures in the outbreak of infectious diseases	Based on indications
	Immunization	According to the established periodicity under the National Calendar of Vaccinations and Epidemiological Indications
Training in preventive offices, health improvement schools	Upon request and referral of specialists
Teaching patients and their families to have self-control, self-help and mutual assistance in accordance with the chronic disease management programs	Upon request and referral of specialists
Counseling persons with chronic diseases on the phone	Upon request and referral of specialists
Medico-social and psychological services	Based on indications
Patronage of children, including newborns	According to the periodicity established by the authorized body and based on indications
Patronage of pregnant women	According to the periodicity established by the authorized body and based on indications
Secondary prevention of diseases and its complications through dynamic follow-up of patients with chronic diseases	At intervals, in accordance with the standards approved by the authorized body
Teaching children to have sanitary and hygienic skills in regard to the care of teeth and oral mucosa	Once per year with preventive purpose
Preventive examinations of oral cavity in children at preschool educational institutions, students of secondary educational institutions, women who are on the record for pregnancy	Once per year with preventive purpose
Diagnostics	Measurement of acuity of hearing and vision	With preventive purpose, according to the established periodicity; in other cases – based on indications
Measurement of intraocular pressure	With preventive purpose, according to the established periodicity; in other cases – based on indications
Complete blood count with leukoformula, hemoglobin, erythrocytes, color index, leukocytes, ESR, platelets. Urinalysis with the determination of protein and glucose	1 time per year when addressing with preventive purpose; in other cases – based on indications
Time of blood coagulation, blood for malaria parasites, urine analysis based on Nechiporenko method, bile pigments in the urine	Based on indications
Microreaction	1 time per year at request; in other cases – based on indications
Stool test	1 time per year at request; in other cases – based on indications
Sputum sampling for TB detection	Based on indications
Material sampling for microbiological studies	Based on indications
Blood sampling for HIV infection and Wasserman Reaction (RW)	In voluntary anonymous and (or) confidential medical examination at request; in other cases – based on indications
	Sampling and biochemical analyses: cholesterol, triglycerides, blood glucose, including rapid methods using test systems	With preventive purpose, according to the periodicity established by the authorized body; in other cases – based on indications
Sampling and biochemical analyses: glutamyl pyruvic transaminase, serum glutamic oxalacetic transaminase, total bilirubin, urea, creatinine	Based on indications
Tissue sampling for other analyses	Based on indications
Microscopy of vaginal smear and vaginal sanation	Once per year with preventive purpose at request; in other cases – based on indications
Immunochemical assay (Hemoccult Test by rapid method)	With preventive purpose, according to the periodicity established by the authorized body; in other cases – based on indications
Malaria parasite blood test	Based on indications
Electrocardiogram	With preventive purpose, according to the periodicity established by the authorized body; in other cases – based on indications
Mantoux test with 2 TE PPD-L for children from “at risk” groups (including for the purpose of BCG additional vaccination and revaccination) and in cases of suspected tuberculosis in children	With preventive purpose, according to the periodicity established by the authorized body; in other cases – based on indications
	Fluorography for the age above 15	Once per year with preventive purpose at request; in other cases – based on indications
Treatment, manipulations and procedures	Providing emergency medical care	Based on indications
Immobilization (application of curing gauze bandages, splints)	Based on indications
Prescription of medical treatment	Based on indications
Conducting intravenous, intramuscular, subcutaneous injections	Based on indications
Provision of hospital-replacing care, including at-home care	Based on indications
Physiotherapy for children under 18 and massage for children under 1	Based on indications

2. Advisory and Diagnostics Care

Activities	Services	Periodicity of Services Provision
1	2	3
Admission and advice	Admission and advice provided by relevant experts, including using telemedicine communications, as well as consultation at home: based on the appointment of primary care specialist; based on the appointment of a relevant specialist for differential diagnosis, in case of any complications involving other organs and determination of further tactics of patient treatment	Based on indications
Medical and genetic counseling of pregnant women and children under 18 based on the appointment of a specialist	Based on indications
Diagnostics	Screening of target groups of population in accordance with the procedure established by the authorized body	In accordance with periodicity set by the authorized body
	Laboratory and instrumental methods of analysis	Based on prescriptions of PMC specialists and relevant experts
General clinical tests	Based on indications and prescriptions of PMC specialists and relevant experts
Blood tests for HIV and Wasserman Reaction (RW)	Voluntary anonymous and (or) confidential medical examination at request; in other cases – based on indications
Hormonal examination based on the prescription of a specialist	Based on indications
Determination of immunno-suppressive drugs concentration in blood of patients after organs transplantation	Based on indications
Biochemical analyses	Based on indications and prescriptions of PMC specialists and relevant experts
Blood group and Rh factor for persons subject to admission to the hospital’s inpatient department for surgery	Based on indications
Microbiological analyses of the tissue (bacterial swab test)	Based on indications
Ultrasound, X-ray, fibrogastroduodenoscopy, sigmoidoscopy, duodenal intubation, colonoscopy, methods of functional diagnostics and other types of endoscopy with sampling of tissue for biopsy based on the prescription of the primary medical care specialists and relevant experts	Based on indications and when addressing with preventive purpose, not more frequently than once per year
	Screening tests (enzyme immunoassay, polymerase chain reaction) for the diagnosis of viral hepatitis B and C: children with blood diseases, malignant neoplasms, hemodialysis, those having surgeries, transfusion of blood and its components in their medical history; adults with with blood diseases, malignant neoplasms, hemodialysis, those having surgeries, transfusion of blood and its components in their medical history, as well as medical workers with increased risk of infection with viral hepatitis B and C	In accordance with periodicity set by the authorized body
Medical examination on the subject of the use of psychoactive substances	In appointment of law enforcement authorities, investigation and inquiry bodies
Forensic drug testing	Based on the decision of judicial bodies
Forensic psychiatric examination	Based on the decision of judicial bodies
Expensive types of diagnostic tests for the socially vulnerable categories of the population (children under 18; pregnant women; participants of the Great Patriotic War, I, II, III groups disabled, mothers with many children awarded with "Altyn Alka", "Kumis Alka" pendants; recipients of targeted social assistance; senior pensioners; patients with infectious, socially significant diseases, as well as diseases dangerous to others) based on the prescription of a specialist:	Based on indications
1. Polymerase chain reaction	Based on indications
2. Immunophenotyping	Based on indications
3. Medico-genetic examination of pregnant (ultrasound screening assessment of fetal anatomy, invasive prenatal procedures, biochemical screening cytogenetic study) in the amount and terms set by the body authorized in the field of healthcare	Based on indications
4. Computed tomography	Based on indications
5. Magnetic resonance imaging	Based on indications
6. Positron emission tomography	Based on indications
	7. Single photon emission computed tomography	Based on indications
8. Angiography	Based on indications
Treatment, manipulations and procedures	Surgical, gynecological, ENT, urology, ophthalmology and other outpatient procedures, including using medical items and medicine, at the expense of the patient or within voluntary medical insurance	Based on indications, based on prescription of PMC specialists and relevant experts
In Vitro Fertilization in accordance with the procedure approved by the authorized body	Based on indications, but not more than 2 cycles of IVF
Emergency dental care (acute pain) to socially vulnerable categories of the population: pain relief, preparation and tooth filling made of composite materials of chemical curing, extraction of a tooth with anesthesia, periostotomiya, abscesses opening	Based on indications
Routine dental care for children and pregnant women (except orthodontic and orthopedic) based on the prescription of a specialist, including extraction of teeth with anesthesia, preparation and tooth filling made of chemical curing composite materials	Based on indications
Orthodontic care for children with congenital pathology of maxillofacial part using an apparatus for removing dentoalveolar anomalies (orthodontic plate)	Based on indications
Early and continuous medical rehabilitation of socially vulnerable group of population according to the standards approved by the body authorized in healthcare	Based on indications