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Valstybinė ligonių kasa prie Sveikatos apsaugos ministerijos Misija Vizija Vertybės |
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Jūs esate: Valstybinės ligonių kasos prie Sveikatos apsaugos ministerijos interneto svetainėje
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STATUTE OF THE STATE PATIENTS FUND AT THE MINISTRY OF HEALTH OF THE REPUBLIC OF LITHUANIAGENERAL PROVISIONS1. The State Patients Fund at the Ministry of Health (further referred to as the SPF) is a public authority of the Lithuanian Republic engaged in implementation of Compulsory Health Insurance. The SPF solves the issues ascribed to its competence and is an active participant in implementation of the Lithuanian Republic Governmental policy and that of the Ministry of Heath in the field of health insurance, organizes implementation of respective legislation instruments and is engaged in implementation of other functions foreseen by the laws of Lithuanian Republic, Governmental resolutions and orders passed by the Health Minister. 2. In its activities, the SPF follows the Constitution of the Republic of Lithuania, other laws of the country, legal acts passed by the Seimas of the Lithuanian Republic, Governmental resolutions, decrees by the Prime Minister, orders by the Minister of Health, other legal acts and the present Statute. The Law on Budgetary Institutions applies for the SPFs activities insofar as not regulated by the Law on Health Insurance. 3. The SPF shall be a legal entity, dependent on the budget of the Compulsory Health Insurance Fund, bearing its own seal with the coat of arms of the Lithuanian State pictured therein and bank accounts in the Republic of Lithuania. 4. The SPF shall be accountable for its activities to the Ministry of Health of the Lithuanian Republic, and for its financial activities to the Ministry of Finance of the Lithuanian Republic. 5. The official name of the SPF shall be the State Patients Fund at the Ministry of Health. II. TASKS AND FUNCTIONS OF THE STATE PATIENTS FUND6. The main task of the SPF shall be implementing the compulsory health insurance as provided in the legal acts and provisions in the field of the Governmental Program of the Lithuanian Republic. Carrying out the task assigned to the SPF, it shall: 6.1. in compliance with the Law on Health Insurance, guarantee the provision of personal health care services, including preventive medical aid, medical aid, medical rehabilitation, nursing, social services and maintenance prescribed as health care of a person and personal health expertise services, as well as compensation of costs incurred by such services, compensation of costs incurred for purchase of medications and medical aid measures, prosthesis of limbs, joints and organs and acquisition of ammunition for such prosthesis, to persons insured by the compulsory health insurance out of the Compulsory Health Insurance Funds budget through the territorial patients funds; 6.2. prepare the draft budget for the Compulsory Health Insurance Fund and submit it to the Ministry of Health, as well as prepare the annual accounting for implementation of such budget upon the terms provided by the Law on Health Insurance and other legal acts of the Republic of Lithuania; 6.3. upon the terms provided by respective legislation of the Republic of Lithuania, keep the register of the insured by the Compulsory Health Insurance; 6.4. implement the budget of the Compulsory Health Insurance Fund; 6.5. use the funds by the Compulsory Health Insurance Funds budget; 6.6. in coordination with the Ministry of Health, form the reserve provision out of the funds of the Compulsory Health Insurance Funds budget and use it in compliance with the terms set by the Government; 6.7. in coordination with the Ministry of Health, make operations with temporarily free funds in the Compulsory Health Insurance Funds budget; 6.8. in coordination with the Ministry of Health of the number of territorial patients funds and territorial functional areas, found territorial patients funds, approve the statutes thereof and supervise the activities; 6.9. perform audit of the territorial patients funds or in compliance with respective legal acts, make contracts with audit companies for performance of audits of the territorial patients funds; 6.10. compensate the costs for the compensated medicines and medial aid measures in compliance with the procedure established by the Ministry of Health; 6.11. compensate the costs for prosthesis of limbs, joints and organs, acquisition of prosthesis ammunition and centralized reimbursable medicines and medical aid measures in compliance with the procedure established by the Ministry of Health; 6.12. cover the costs for personal health care services in compliance with the procedure established by the Ministry of Health; 6.13. prepare the draft revision of Compulsory Health Insurance Funds budget, when the budget expenditures and/or income are less than foreseen in the approved budget for the Compulsory Health Insurance Fund, and submit it to the Ministry of Health for approval; 6.14. prepare strategic action plans (programs) for the State Patients Fund, submit them to the Ministry of Health for approval and proceed for their implementation and reporting thereof; 6.15. in coordination with the Ministry of Health and State Tax Inspection at the Ministry of Finance, fix the procedure for control and administration of payment of compulsory health insurance contributions; 6.16. submit its opinion on compulsory health insurance issues, as provided by respective legal acts; and 6.17. be engaged in performance of other functions ascribed to its competence. III. RIGHTS OF THE STATE PATIENTS FUND7. In fulfillment of its functions, the SPF shall be entitled to: 7.1. the use of funds and property of the Compulsory Health Insurance Fund budget provided thereto and legally acquired other funds and property, in compliance with the procedure provided by laws and other legal acts; 7.2. making contracts, in compliance with the procedure provided by laws and other legal acts; 7.3. acquisition of securities issued by the Government of the Republic of Lithuania and Bank of Lithuania and having them in its own disposition using the received income for the needs of compulsory health insurance; 7.4. upon the proposal by the Council of the Compulsory Health Insurance, implementation of certain measures in order to receive and use some extra income; 7.5. in compliance with the procedure provided by laws and other legal acts, obtaining information, free of any charges, from the ministries, other governmental institutions, administrators of counties, executive institutions of municipalities, territorial patients funds, state social insurance institutions, health care institutions, other enterprises, institutions and organizations, as required for performance of the functions by the State Patients Fund, including: 7.5.1. the residents register data on persons being insured or insured by the compulsory health insurance; 7.5.2. statistical data on persons insured by the State funds in accordance with each group of the insured as specified by section 4 of Article 6 of the Law on Health Insurance and insured persons specified in sections 5 and 6 of article 6 of the aforementioned law, as well as the data on any changes of residents social status; 7.5.3. statistical data on the distribution of persons insured by the compulsory heath insurance within the activity areas of the territorial patients funds; 7.5.4. personal health care services being provided or provided to insured persons, the procedure and conditions for provision of such services, compensated medicines and other medical aid measures being sold or sold (dispensed) to such persons; 7.5.5. data and information on health promotion activities, breaches of legal acts in regulation of such activities, financing provided to heath care institutions, residents health conditions and status within the administrative territorial units, cases of massive diseases, natural calamities and disasters, as well as statistical data on monitoring of populations heath conditions and other information required for performance of functions of the State Patients Fund; 7.5.6. licenses for engagement in the health care and pharmacies activities issued to personal health care institutions, pharmacies and experts in the field; 7.5.7. data on essential personal heath care services provided to persons, not insured by the compulsory health insurance; 7.6. controls on quantity and quality of personal health care services financed from the Compulsory Health Insurance Fund budget and compliance of the aforementioned services with the fixed requirements; 7.7. controls of legitimacy of prescription and dispensation of medicines and medical aid measures and the related activities of health care institutions and pharmacies; 7.8. checks upon the correctness of invoices issued by health care institutions and pharmacies and the related accounting and other documents; 7.9. performance of financial and economic analysis on the use of funds of the Compulsory Health Insurance Fund budget and trend analysis on changes of health care service structure, accessibility and quality; 7.10. According to the competence, taking part in preparation of international draft contracts; 7.11. provision of information on implementation of the Compulsory Health Insurance Fund budget to the Ministry of Health of the Republic of Lithuania, on a quarterly basis; 7.12. participation at seminars and conferences on the issues of compulsory health insurance, taking care of professional training and raising qualification of experts of the State Patients Fund structural divisions, as foreseen by the law; 7.13. cooperation with respective foreign and international institutions on the issues of health insurance; 7.14. investigate complaints raised by the insured in relation to breaches of laws and other legal acts in regulation of compulsory health insurance. 7.15. The State Patients Fund shall have other rights provided thereto by the laws of the Republic of Lithuania, Governmental resolutions, other legal acts and orders by the Health Minister. IV. ORGANIZATION OF ACTIVITIES OF THE STATE PATIENTS FUND8. The SPF shall be managed by its Director nominated to this position and discharged thereof, as well as promoted and disciplined by the Minister of Health of the Republic of Lithuania as provided by the Law on Public Service of the Republic of Lithuania. 9. The Minister of Health shall fix and approve the salary payable to the SPF Director in compliance with the procedure provided by the Law on Public Service of the Republic of Lithuania. 10. The Director of the SPF shall: 10.1. manage and organize the activities of the State Patients Fund and be personally responsible for implementation of the tasks and functions assigned to the SPF; 10.2. approve the cost estimates of the SPF and territorial patients funds and submit such approved estimates to the Health Minister; 10.3. in coordination with the Health Ministry, establish the SPF structure; 10.4. assign the functions and staff to the SPF departments and divisions; 10.5. in compliance with respective legal acts, fix the salaries of the SPF employees staying within the budget for job remuneration as provided by the law; 10.6. in compliance with the Labor Code, admit and discharge employees of the SPF, provide promotions and disciplinary sanctions thereto; 10.7. in compliance with the procedure as provided by the Law on Public Service, admit to job and discharge therefrom public servants of the SPF and directors of the territorial patients funds; 11.8. approve the job descriptions for the SPF employees, perform appraisals of public servants service activities in compliance with procedure established by respective legal acts; 11.9. according to his/her competence, issue orders and other legal acts approved by respective orders; 11.10. use the funds and property of the SPF in compliance with the approved estimate, and submit the estimate implementation report to the Ministry of Health and Ministry of Finance; 10.11. coordinate and control the activities of different departments and divisions of the SPF, as well as activities of the territorial patients funds through the heads of aforementioned institutions; 10.12. be accountable for activities of the SPF to the Health Minister in compliance with the procedure provided in respective legal acts; 10.13. represent the SPF in relations with other legal and natural persons; 10.14. according to his/her competence, participate in preparation of and making strategic action plans by the Ministry of Health to achieve the set goals and implement the measures of the strategic action plan by the Ministry of Health in the field of health insurance. V. FINANCING THE STATE PATIENT FUND11. The SPF is an institution maintained by the funds of the Compulsory Health Insurance Fund budget. The budget of the Compulsory Health Insurance Fund is an independent State-owned budget, not included into any other State and municipal budget. The rules for formation and implementation of the Compulsory Health Insurance Fund budget shall be approved by the Government. 12. Up to 2 (two) percent of the funds of the Compulsory Health Insurance Fund budget may be allocated to cover the expenses of activities by the State and territorial patients funds. 13. The funds allocated for the maintenance of the SPF shall be foreseen in the Compulsory Health Insurance Fund budget. 14. The funds allocated for the maintenance of the SPF from the Compulsory Health Insurance Fund budget shall be kept in Lithuanian banks. 15. Financial accounting and accountability of the SPF shall be managed in compliance with the procedure provided by the laws and other legal acts of the Republic of Lithuania. 16. The SPF shall be subject to payment of taxes as well as to tax exemptions also in compliance with the procedure provided by the laws and other legal acts of the Republic of Lithuania. 17. The SPF shall account for its financial activities by submitting the quarterly and annual reports on implementation of the Compulsory Health Insurance Fund budget to the Ministry of Health and Ministry of Finance. VI. REORGANIZATION AND LIQUIDATION OF THE STATE PATIENTS FUND18. The SPF shall be reorganized and liquidated in compliance with the procedure as provided by the laws of the Republic of Lithuania. |
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