Experts criticize demands to pay for coronavirus tests for hospital patients
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Recently, people who tell the same story have increasingly begun to contact the All-Russian Union of Patients: during planned hospitalization under the compulsory medical insurance policy, hospitals require them to undergo a mandatory PCR test for COVID-19. Everything would be fine – during a pandemic, the requirement is quite reasonable. Only now patients have to pay for the test themselves: for some reason, according to the MHI policy, they refuse to do it and send it to paid laboratories. How legitimate are these claims? What to do if you are faced with a similar situation?
As they say in the All-Russian Union of Patients (VSP), in medical institutions where patients are admitted for planned hospitalizations, they explain that it is impossible to undergo PCR testing for coronavirus free of charge under the MHI policy due to the fact that this service is not included in the State Guarantee Program for free provision of medical care to citizens for 2022, because such studies are not included in its budget.
Elena Tretyakova, deputy head of the working group of the All-Russian Union of Insurers on the organization of CHI, argues that this requirement has nothing to do with the law: “It is illegal to oblige all patients to take a test for COVID-19, even if the risk of the spread of a new coronavirus infection remains, during planned hospitalization is illegal. Especially on a paid basis.
The basic program of state guarantees involves mandatory PCR testing for COVID-19 in three cases. First: if the patient has developed symptoms of an acute cold of unknown etiology or other symptoms that do not exclude covid. Secondly, a PCR test is mandatory if the diagnosis of COVID-19 has already been established, but it is necessary to evaluate the effectiveness of the treatment. And finally, tests are carried out without fail in order to more accurately identify the pathogen in the presence of a positive test for COVID-19 obtained by the express method, as a rule, outside the walls of the medical organization where the patient is hospitalized.
In any case, emphasizes Elena Tretyakova, testing is free of charge for the patient: “Therefore, if there is no threat of the spread of coronavirus infection and the situation does not apply to one of the above cases, the patient does not need to be tested and provide test results.”
Another important document is the “Temporary procedure for admitting patients to organizations providing specialized, including high-tech, medical care in a planned form in the face of the continued risk of the spread of a new coronavirus infection COVID-19.” According to him, patients with symptoms that may indicate COVID-19 are tested for coronavirus only according to indications, and whether they exist or not, the general practitioner decides based on the results of examining the patient in the presence of respiratory manifestations.
At the same time, if the hospitalization is planned, the administrations of the hospitals where the patient is sent must themselves ensure that he receives a therapist, as well as measure body temperature and perform pulse oximetry. If there are indications, the medical institution is obliged to send a person for a plain radiography or CT scan of the lungs, as well as conduct a laboratory study of biological material for the presence of coronavirus (this can be both rapid tests and PCR). And all this is done for the patient free of charge, that is, for nothing.
According to a member of the Public Council for the Protection of Patients’ Rights under Roszdravnadzor, Professor Alexei Starchenko, if the situation is related to emergency hospitalization, testing should also be performed free of charge for the patient. Moreover, it should be done in the medical organization where the patient is hospitalized. Attention: the expert emphasizes that even in the case of a positive test result, there are no indications for refusing medical care! “A positive test in such a situation only requires taking into account the presence of concomitant COVID-19 infection, and most importantly, appropriate routing for treatment and the underlying disease (cardiovascular, diabetes, cancer, etc.) taking into account covid. Such patients should receive full medical care,” says Aleksey Starchenko. At the same time, neither the absence of a test nor its positive result can be a reason for not providing emergency medical care.
According to the expert, emergency care means not only emergency conditions, but also, for example, another course of chemotherapy or surgery for a cancer patient. “Such types of assistance cannot be classified as planned, because if they are refused, a threat to the patient’s life is created – an increase in the volume of the tumor, the appearance of metastases,” Starchenko explains. “Providing care to patients with hypertension and coronary heart disease, subcompensated diabetes mellitus is also urgent, because delay can result in decompensation of the condition and endanger life.”
So, what to do if a medical institution requires you to take a coronavirus test at your own expense? First of all, remember that this requirement is illegal, as well as refusing to be hospitalized without such a test or with a positive result for COVID-19.
If you have any difficulties with hospitalization, contact your health insurance organization (its details are on your CHI policy). The insurance representative will contact the hospital management or the local Ministry of Health to resolve your problem. If you have already paid for the text on covid from your own pocket, according to your complaint, the insurance medical organization must conduct an examination of the validity of its appointment, and then issue an order to the clinic to return the money spent on the test. By the way, in parallel, the medical organization itself will face a fine for violating the requirements for free and accessible medical care. “Usually, the HMO submits a claim to a medical organization with a proposal to resolve the conflict out of court by reimbursement to the patient of unlawfully spent money. If the medical organization does not agree (which is extremely rare), the case goes to court,” says SMO expert Mikhail Pushkov.
Newspaper headline:
goodwill test
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