Since more and more often certain healthcare facilities are requesting that clients of our insurance company pay regulatory fees, it is necessary to remind ourselves of the following important information.
Our clients are mostly drawn from countries outside the European Union
With effect as of 1 January 2008 the Czech Ministry of Health issued its Methodological Instructions for Healthcare Facilities, Medical Treatment Facilities and Health Insurance Companies, in which it clearly established certain principles for the application of the amendment to Act 48/1997 Coll., on public health insurance, as amended, in the sphere of regulatory fees and additional charges for drugs or foodstuffs for special medical purposes.
The Ministry of Health drew attention to the fact that under the terms of Act 261/2007 Coll., on the stabilisation of public budgets, which amended Act 48/1997 Coll., on public health insurance, certain provisions of Act 48/1997 Coll. (hereinafter the “Act”) were amended and supplemented. A fundamental change impacting on the activities of healthcare facilities, including medical treatment facilities and health insurance companies, is the introduction of regulatory fees and a limit to regulatory fees and additional payments for drugs or foodstuffs for special medical purposes.
The methodological instructions specify who WILL pay the regulatory fees and who WILL NOT.
In point IV paragraphs 2 and 3 and point V paragraph 2 it states that fees will not be paid by “a person who is not a beneficiary under the Act, i.e. does not have permanent residence in the Czech Republic and is not employed by an employer which has its registered office or permanent residence in the Czech republic and is not a beneficiary of another EU state or to whom healthcare is not provided which is paid on the basis of an international treaty from the state budget (and not from public health insurance). This means that fees are not paid by a person who pays for healthcare from their own resources or from commercial insurance or other sources.1)
What this means is that if persons insured with Pojišťovna VZP, a.s., are charged regulatory fees by healthcare facilities, this is at variance with the Methodological Instructions of the Ministry of Health. We cannot subsequently pay regulatory fees which have been unjustifiably charged to clients by healthcare facilities, but we refer them back to the facilities which billed them. We also warn the client of the illegitimacy of the fees and inform them as to how they may demand a refund of the already paid fees. Since Pojišťovna VZP, a.s., is not a health insurance company financed from public resources, but a commercial company, there is no reason for healthcare facilities to report regulatory fees in their accounts submitted for healthcare provided.
1) Methodological Instruction of the Ministry of Health of the Czech Republic of 1 January 2008, page 6