Health Systems in Transition - Hungary - World Health Organization ...

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244 Health systems in transition Hungary ● liberalizes the retail market of pharmaceuticals, eliminates most of the restrictions on ownership (no limitations regarding the type of business entity, no minimum share of pharmacists stipulated, manufacturers and wholesalers not excluded, pharmacy chains not prohibited (Articles 74–75)), relaxes the criteria on the establishment of new pharmacies (Article 49, section (3)) ● bases taxation of companies and pharmacies on the reimbursed value of their sales and the number of employed marketing agents (Article 36, section 1–4) ● defines the various types of pharmacies (Articles 3, 49–52) ● Further defines the process and responsibilities for deciding whether certain pharmaceuticals are to be included in or excluded from the benefits package (Article 22–35) – before these were regulated by Government Decree No. 91/2004 (IV.6) ● further defines reimbursement categories and the reimbursement application process for pharmaceuticals (Articles 24–30) ● sets the rules for exclude products from the positive list administered by the NHIFA (Article 31) ● permits the retail sale of certain OTC drugs outside of pharmacies (Articles 67–72) ● authorizes the Minster of Health to develop and approve an IT tool that will support cost-effective prescription and to determine the date after which utilization of said tool becomes mandatory as well as the related accreditation rules (Articles 77 and 87) 9. Act CXV of 2006 on the Amendment of Certain Health Care Related Acts in Connection with the Reform of the Health Care System (promulgated: 18/12/2006) ● Curtails the social health insurance funded benefit package by introducing (1) financing protocols, whereby extra costs associated with any patient-requested deviation from the system have to be covered by the patient (Articles 1, 8), (2) co-payments for the utilization of family doctor services, outpatient specialist care (together the so-called “visit fee”) and inpatient care (the so-called “hospital per diem”) (Articles 3,7,17,18,19,40,42), (3) co-insurance for free choice of doctor and (without a valid referral) hospital (Articles 8, 11,13), and (4) the exclusion of certain services, such as health services for accidents due to extreme sports, health services connected to professional sporting (Article 7) and sex change operations (Article 11) ● introduces the so-called “declaration of services provided”, which has to be printed and signed by the patient (Articles 6,18,43) ● provides detailed new regulations for the administration of waiting lists (Articles 9,10) 10. Act CXVI of 2006 on the authority supervision of health insurance (promulgated: 18/12/2006) ● defines the tasks of the Health Insurance Supervisory Authority regarding quality evaluation (Article 8 Section b and c) 11. Act CXXI of 2006 on the Amendment of Certain Act for the Establishment of the Budget of 2007 of the Republic of Hungary (promulgated: 19/12/2006) ● suspends conditional capital grants for 2007–2008 (Article 3, section (2), Article 34) ● abolishes the system of “target-type decentralized grants” (Article 29, section (3) point a)) 12. Act CXXXII of 2006 on the Development of the Health Care Delivery System (promulgated on 22/12/2006) ● defines the quantity of publicly funded specialist capacities in the Hungarian health care system (Article 2, section (1), Annex 1 and 2)
Health systems in transition Hungary 245 ● classifies capacities according to a new typology: priority capacity, capacity for special purposes, normal capacity (Article 3) ● separates the special national institutes of health and the priority hospitals (while determining their number of beds, Annex 1) from the rest of the hospitals, whose inpatient care capacities are determined only in total at the regional level (Annex 2).The actual distribution of hospital beds among these non-priority hospitals is determined annually (Article 3 and 7) ● designates the regional health councils as the primary decision-makers for the distribution of capacities and the designation of service delivery catchment areas under territorial supply obligation (Article 2, section (2), Article 4, section (3)), but in both cases, the approval of the owners are required (Article 2, section (2), Article 4, section (4)) ● determines the process of decision-making regarding the distribution and the decrease or increase of capacities (Article 4–11) ● Assigns the minister of health as the final decision-maker If there is no consensus on the distribution of capacities (Article 4, section (6)) 13. Government Decree No. 274/2006. (XII. 23.) Korm. on the Establishment and Operation of the Central Agricultural Office ● establishes the Central Agricultural Office by merging independent agricultural authorities dealing with e.g. plant and soil protection, animal health, hunting, fishing, forestry ● transfers the responsibility for food safety from the NPHMOS to the Central Agricultural Office as of 1 October 2007 14. Government Decree No. 287/2006. (XII. 23.) on the detailed regulation of health services provided based on waiting lists ● appoints the National Blood Supply Institute (NBSI) as the managing institute of professional commissions for organ transplantation (Article 6–13) ● stipulates that the Health Insurance Supervisory Authority is to be informed on waiting and reception lists by the 15th of a given month (Article 13/B) 15. Government Decree No. 295/2006. (XII. 23.) Korm. on the Hungarian Labour Inspectorate ● transfers the responsibility for occupational health from the NPHMOS to the Hungarian Labour Inspectorate as of 1 January 2007 (Article 2, section (5), Article 5, section (1)) 16. Government Decree No. 317/2006. (XII. 23.) on the National Health Insurance Fund ● defines the NHIF as a government office (Article 1) to be supervised by the Minister responsible for social health insurance (Article 2) 17. Government Decree No. 320/2006. (XII. 23.) Korm. on the Amendment of Government Decree No. 284/1997. (XII.23.) Korm. on the Fees of Certain Health Services, which can be Utilised with User Fees Only ● defines the amount of user fees ● sets the maximum amount of co-insurance for the free choice of physician and the utilization of specialist providers without a valid referral at HUF 100 000 (about €394) (Article 1, section (2)) 18. Government Decree No. 322/2006. (XII.23.) Korm on the National Emergency Ambulance Service
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Health Systems in Transition Vol. 1
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Health Systems in Transition Péter
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Contents Preface
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Preface The Health Systems in Trans
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Acknowledgements The Health System
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Health systems in transition Hungar
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Abstract Hungary has achieved a suc
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Executive summary Introduction Hung
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1. Introduction 1.1 Geography and s
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18 NATIONAL/CENTRAL LEVEL REGIONAL
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3. Financing 3.1 Health expenditure
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4. Physical and human resources 4.1
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5.0 4.5 4.0 3.5 3.0 2.5 2.0 Health
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5. Provision of services Health car
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6. Principal health reforms 6.1 Ana
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