Paid conditions for free treatment – Newspaper Kommersant No. 158 (7359) of 08/30/2022

The All-Russian Union of Patients turned to the Ministry of Health of the Russian Federation with a request to influence hospitals that, during planned hospitalization, require the results of a PCR test for coronavirus, but do not offer to take it free of charge under compulsory medical insurance. The Ministry of Health explained that such a requirement is classified as an unreasonable refusal to provide medical care. But the union claims that patients are still forced to do tests at their own expense and do not risk complaining to higher authorities, as they are afraid to spoil relations with health workers or even be denied hospitalization.

During the COVID-19 pandemic, the All-Russian Union of Patients (VSP) receives mass appeals from citizens who have encountered problems with planned hospitalization in hospitals of the Russian Federation under the CHI policy. In a letter (Kommersant has it) to Minister of Health Mikhail Murashko, co-chairs of the Supreme Council Yan Vlasov and Yuri Zhulev indicate that medical organizations require a PCR test for coronavirus and do not offer to take it for free. Hospitals refer to the Program of State Guarantees of Free Medical Care for Citizens for 2022, which supposedly does not include a budget for this. “As a result, the patient is forced to carry out this study at his own expense. This violates the right to receive free medical care, written in Art. 11 of the law “On the Fundamentals of Protecting the Health of Citizens in the Russian Federation,” the appeal says.

The Union of Patients notes that Russians with chronic disabling diseases suffer the most from illegal demands. They need repeated hospitalizations for long-term course treatments, so regular testing costs about 2 thousand rubles. weighs heavily on their budget. The letter to the minister emphasizes that the majority of citizens who applied to the SCJ and received a recommendation to complain to higher authorities still do not do so. People are afraid of denial of hospitalization and complications in relations with health workers. In addition, health insurance organizations that represent the interests of patients under the compulsory medical insurance program, in response to citizens’ requests, often assure that the PCR test must be taken for a fee.

The Ministry of Health of the Russian Federation promptly responded to the appeal of the Patients’ Union. The agency noted that “the temporary procedure for the admission of patients by medical organizations in the context of the spread of a new coronavirus infection” does not establish a requirement to conduct a laboratory test for the presence of COVID-19 before planned hospitalization at the pre-hospital stage. The analysis is carried out only if there are medical indications – signs of an acute cold that does not exclude coronavirus, the presence of a positive result of express testing for covid, or the coronavirus infection itself. At the same time, it is emphasized that the PCR test is done at the expense of the MHI, and the costs for this are included in the cost of the completed treatment case. These costs are included in the State Guarantee Program for 2022 and for the planned year 2023–2024. Thus, the Ministry of Health concluded that the requirement to provide the results of a coronavirus test before hospitalization is a violation, it is classified as an unreasonable refusal to provide medical assistance to insured persons under compulsory medical insurance and entails penalties for the medical organization.

At the same time, as Kommersant was convinced, hospitals continue to require patients to independently prove the absence of coronavirus. So, on the website of the Tomsk Emergency Hospital, among the list of documents for planned hospitalization, a negative PCR test for COVID-19 “at least 48 hours old” is highlighted separately. The website of the Chelyabinsk Regional Perinatal Center states that “in order to prevent the introduction and spread of coronavirus infection and in accordance with the orders of the Ministry of Health of the region, all patients during planned hospitalization must present the results of a PCR test for COVID-19.” The deadline for submitting the analysis is not earlier than seven days before hospitalization; the term of admission to the hospital – no later than a day after receiving the result. It is noted that the examination should be carried out at the place of residence, however, the possibility of taking the test under the MHI policy is not stipulated. The Telegram channel of the perinatal center of Krasnodar Regional Clinical Hospital No. 2 reported that in the event of not only planned, but also emergency hospitalization, pregnant women must provide the results of a PCR test done no later than 48 hours. The website of the Children’s Clinical Infectious Diseases Clinical Hospital No. 6 in Moscow also warns that a PCR test is still required for planned hospitalization. True, they offer to make it 24 hours before hospitalization in the admissions department of the hospital by appointment (under the insurance policy).

“The Ministry of Health directly says in its letter that money for PCR tests has been allocated to medical institutions. Thus, hospitals have the opportunity to perform various rapid tests on patients during hospitalization. Why they don’t, I can’t say. Perhaps they are saving money,” Yury Zhulev commented. “And without a PCR test, of course, the patient cannot be hospitalized so as not to create risks for other patients and staff.” Mr. Zhulev stressed that the problem has not only acquired a systemic character, but also causes social tension, and expressed the hope that the explanation of the Ministry of Health will help “change the situation for the better.”

Natalya Kostarnova