For citizens of the Russian Federation who have been diagnosed with serious pathologies that require complex and special medical intervention, there is an opportunity to receive high-tech help.
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Quotas for such treatment are reviewed by a commission of doctors and approved by the Ministry of Health after submitting all necessary documents.
Treatment according to the VMP “quota”
High-tech medical care (HTMC) is medical care using high technologies to treat complex diseases. This includes both therapeutic and diagnostic services, which are performed in a specialized hospital. Every year, the Ministry of Health approves a list of medical institutions and a list of diseases for which VMT is provided. The program to provide medical care to Russian citizens was launched back in 1994. Then the Russian Government issued a special resolution to allocate a certain amount from the federal budget to provide high-tech medical care for each specific patient. This was called a "quota". Currently, the Russian Ministry of Health has abandoned the concept of “quotas for high-tech medical care.” Now it is customary to talk about the volume of VMP, since quotas do not sound entirely correct in relation to people with serious diseases. Previously, funding for high-tech medical care came only from the federal budget, but starting in 2014, funds began to be attracted from compulsory health insurance funds (CHI). Everything related to high-tech care is under the jurisdiction of the Russian Ministry of Health. It is this body that annually determines the number of “quotas” that each medical institution will receive. Medical institutions cannot exceed this plan and treat more patients than the Ministry of Health planned.
Absolutely every citizen of the Russian Federation has the right to receive free high-tech medical care. The main reason for receiving VMP is medical indications.
Helpful information
VMP portal - https://talon.rosminzdrav.ru/ The field for checking the coupon is in the center. At the top left is background information about all medical institutions providing medical care by region
Helpdesk: 8-800-500-74-78 Email
What is the difference between insurance companies operating under the compulsory medical insurance system?
VMP is an opportunity to save health, and in some cases, life. Thanks to the compulsory medical insurance system and the federal budget, citizens can receive complex treatment free of charge, provided they have the indications and the necessary documents.
Diseases for which you can receive high-tech medical care
At the moment, high-tech medical care is provided in more than 20 areas, which include: abdominal surgery, obstetrics and gynecology, gastroenterology, hematology, dermatovenerology, neurology, combustiology (treatment of severe burn injuries), neurosurgery, oncology, otorhinolaryngology, ophthalmology, pediatrics, rheumatology, cardiovascular surgery, thoracic surgery (surgery for diseases of the chest organs), traumatology and orthopedics, organ and tissue transplantation, urology, maxillofacial surgery, endocrinology.
At the Clinic of Coloproctology and Minimally Invasive Surgery, high-tech medical care is provided in the treatment of the following diseases:
ONCOLOGY:
- surgical treatment of rectal cancer of all stages;
- laparoscopic and open nerve-sparing operations with extended lymph node dissection;
- operations with resection of adjacent organs for locally advanced forms of cancer;
- sphincter-saving operations of any complexity;
- removal of early forms of rectal cancer without abdominal surgery through the anal canal;
- removal of the primary tumor with simultaneous resection of distant metastases for stage 4 cancer;
- surgical treatment of colon cancer of all stages;
- laparoscopic and open operations with extended lymph node dissection;
- surgical treatment of recurrent colon cancer;
- surgical treatment of extraorgan (retroperitoneal) tumors.
SURGERY:
- surgical treatment of familial adenomatous polyposis;
- surgical treatment of nonspecific ulcerative colitis;
- surgical treatment of complex rectal fistulas;
- surgical treatment of rectal prolapse, rectocele;
- surgical treatment of presacral cyst;
- surgical treatment of anal sphincter insufficiency;
- surgical treatment of recto-vaginal fistulas;
- surgical treatment of complicated diverticular disease of the colon;
- reconstructive operations for end intestinal stoma.
How to get a VMP quota?
A coupon for the provision of high-tech medical care is issued by the regional ministry or health department at the place of registration of the patient. To do this, the patient must provide a referral from his attending physician with an established diagnosis and the results of the necessary examinations. Based on these documents, a specialist from the VMP department in a ministry or department himself determines which medical institution to send the patient for treatment.
If the patient already knows which clinic he wants to undergo treatment, then he first needs to contact this clinic, provided that this clinic has been allocated “quotas” for VMP, and receive a specially drawn up conclusion that he is indicated for high-tech medical care in this medical institution. With this conclusion, the patient applies to the regional ministry or department of health, where they issue a voucher for VMP to the specified clinic.
Despite the fact that the rules stipulate the need for a patient to personally contact the regional health department, in practice this is not always required. Therefore, if a patient from a distant region, for example, from Siberia, comes to Moscow to the clinic of his choice, and the doctors give him a conclusion that he needs high-tech medical care, the patient does not need to go back to his region and take this conclusion personally. Clinic specialists themselves will send an electronic copy of the conclusion to the regional health authority and receive a response about the issuance of a coupon for the provision of VMP. Usually it takes 1-2 days.
How to check the status of a coupon
The received VMP coupon looks like a document drawn up in the form and containing an identification number, information about the organization that issued it and information about the recipient.
Using the identifier number, you can find out the number of quotas, information about the review of documents and the date of hospitalization.
In order to verify the necessary information, you need to contact your regional health department. By providing the coupon number, you can get all the information you need. It’s even easier to check the progress of the case by using the service on the RosMinistry of Health website.
The procedure for obtaining a VMP quota for treatment at the KKMH Clinic
- 1
Step 1.
Personally
The patient personally contacts us at the Clinic with the results of the examinations he has, he is advised by the Clinic’s doctor and determines that the treatment of the patient’s disease can be performed using VMP. After this, a conclusion is issued on the need and possibility of such treatment.
Remotely
The patient is in another region and has the results of tests and examinations in hand. He contacts our Clinic remotely - by phone, email, through an online registration form, and sends us copies of his examinations (electronically or by fax). Doctors at the Clinic of Coloproctology and Minimally Invasive Surgery review the received documents and make a preliminary conclusion about whether treatment using high-tech medical care is indicated for this patient. If the doctor of our clinic decides that the patient is indicated for VMP, then a conclusion is drawn up for him on the official form of the Clinic.
- 2
Step 2.
On one's own
The patient takes the resulting conclusion to the regional ministry or health department at the place of registration. The regional authority issues a voucher for VMP for treatment in our Clinic and sends it to us electronically. The process of issuing a coupon takes 1-2 days.
With the help of clinic administrators
The specialists of our Clinic forward the conclusion on the need to provide VMP to the regional department at the place of registration of the patient and in response receive a coupon for VMP, which gives the right to treat this patient.
- 3
Step 3.
Hospitalization to the Clinic.
Hospitalization is possible on the day of the patient's visit.
Features of providing assistance by medical institutions
The provision of high-tech care by medical institutions has some features:
- Provided under a compulsory medical insurance policy, which is issued to every citizen of the Russian Federation, regardless of his employment, age and other factors.
- It comes from the federal budget.
- Carried out after collecting all documents, as well as making a positive decision by the medical commission and the Ministry of Health.
Note: the medical commission decides whether the diagnosis is included in the VMP program or not.
When is VMP included in the compulsory medical insurance program?
VMP is included in the basic medical insurance program in the following profiles:
- traumatology;
- orthopedics;
- cardiovascular surgery;
- oncology;
- urology;
- hematology;
- ophthalmology;
- gynecology and so on.
In recent years, the list has expanded, and the following high-tech medical care was included in the compulsory medical insurance program:
- Treatment of extensive body burns (more than 50%).
- Endoscopic intervention.
- Reconstructive surgical operations, for example, for serious fractures or pathologies of the spine.
- Endovascular intervention for pathologies in the vessels of the brain or spinal cord.
Note: the full list of VMP included in the compulsory medical insurance program can be found on the official website of the Ministry of Health of the Russian Federation or consult your doctor.
In the case when VMP is included in the compulsory medical insurance program, then:
- The attending physician writes a referral to a medical institution that provides such care.
The referral is issued in the name of the chief physician.
- The institution to which the patient was referred conducts a detailed examination and makes a decision to provide treatment or refuse.
Note: a refusal is issued if the diagnosis is not confirmed or contraindications are identified.
What assistance is not included in the compulsory medical insurance policy?
Help not included in the compulsory medical insurance policy is approved by orders of the Ministry of Health of the Russian Federation. In the event that a patient is diagnosed with a pathology that requires therapy that is not included in the basic basic health insurance program, the attending physician:
- Refers patient to health department.
- Subsequently, a commission meets and the issue is resolved individually.
The commission examines clinics in different cities that have a special license and are ready to accept patients.
- The necessary documents are sent to the clinic, and a quota for such treatment is allocated.
Note: the clinic may refuse treatment if the patient has contraindications or the diagnosis is not confirmed.
What is included in the VMP “quota”?
The referral for the provision of high-tech medical care, which is issued to the patient, “covers” all treatment in a specialized medical center, including stay in the hospital during hospitalization, medications and consumables provided for by the standards. This is all included in the cost of providing high-tech medical care, which means it is free for the patient. The examination necessary to establish a diagnosis and prepare for surgery is usually not covered by the “quota”, since according to orders for VMP, the patient must be admitted for treatment already fully examined at the place of residence.
The legislative framework
Below are a number of government documents that fully describe the process of allocating and using quotas.
- Order of the Ministry of Health of the Russian Federation dated December 2, 2014 No. 796n “On approval of the Regulations on the organization of the provision of specialized, including high-tech, medical care”
- List of types of high-tech medical care (Appendix to the order of the Ministry of Health of the Russian Federation dated December 29, 2012 No. 1629n)
- Federal Law No. 323. Article 34 describes the process of issuing quotas, the conditions for the implementation of this state guarantee;
To receive personal advice on treatment under VMP “quotas” from the doctors of our Clinic, please make an appointment by calling +7 or using the feedback form.
If you are from another city and want to find out about the possibility of treatment in our clinic under VMP “quotas”, please send your test results and examinations to [email protected] with the subject “VMP quotas”
