Federal Compulsory Medical Insurance Fund FFOMS

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Main article: compulsory medical insurance (Compulsory health insurance)

• How to choose or change a clinic for compulsory medical insurance
• High-tech medical care for compulsory medical insurance

Number of insured

In Russia, as of May 2019, 146.4 million people were insured under the compulsory medical insurance program.

Compulsory medical insurance policy on vacation in Russia

Main article: Compulsory medical insurance policy on vacation in Russia

History

2024: The government has updated the composition of the MHIF board. List

On August 1, 2024, the Government of the Russian Federation amended the composition of the Board of the Federal Compulsory Health Insurance Fund (MHIF). Former President of the All-Russian Union of Insurers (ARIA) Sergei Kuznetsov and member of the Federation Council Committee on Budget and Financial Markets Diana Oyun were excluded from it.

source = Website of the Government of the Russian Federation

It is reported that the board of the MHIF, as before, is headed by the Minister of Health Mikhail Murashko. The collegial executive body that determines the main activities of the fund and controls its work includes ten members, including the chairman of the MHIF Ilya Balanin, representatives of the Ministry of Finance, members of the State Duma and the Federation Council, trade unions, the Russian Union of Industrialists and Entrepreneurs. In general, the composition of the board of the MHIF is as follows:

· Bashankaev B.N. - Chairman of the State Duma Committee on Health Protection (as agreed);

· Gashkina S. A. - Director of the Department of Budgetary Policy in the Social Sphere and Science of the Ministry of Finance of Russia;

· Goritsky D. Yu. - Member of the Federation Council Committee on Budget and Financial Markets (as agreed);

· A. Domnikov - Chairman of the Professional Union of Healthcare Workers of the Russian Federation (as agreed);

· Krishtal D. M. - Deputy Chairman of the All-Russian Union "Federation of Independent Trade Unions of Russia" (as agreed);

· Perminova E.A. - Chairman of the Federation Council Committee on Social Policy (by agreement);

· Ufimtsev E.V. - President of the All-Russian Union of Insurers (as agreed);

· Khor G. Ya. - First Deputy Chairman of the State Duma Committee on Budget and Taxes (as agreed);

· Cherepov B. M. - Vice President of the All-Russian public organization "Russian Union of Industrialists and Entrepreneurs" for social policy and labor relations (as agreed).^[1]

2023

The second deputy chairman left the MHIF in six months. Foundation left Alexander Ryzhikov

In August 2023, Prime Minister Mikhail Mishustin signed a decree that dismissed Alexander Ryzhikov, deputy chairman of the Federal Compulsory Medical Insurance Fund (MHIF). The reason for the resignation is the request of the official himself, follows from the document. Read more here.

2022: Ilya Balanin - the new head of the FFOMS

On April 26, 2022, Ilya Balanin was appointed to the post of chairman of the Federal Compulsory Health Insurance Fund (MHIF). In this position, he replaced Elena Chernyakova. The decree on the change of the head of the FFOMS was signed by Prime Minister Mikhail Mishustin. Read more here.

2021: FFOMS revenues increased by 9.9%, to 2.6 trillion rubles

Revenues of the Federal Compulsory Health Insurance Fund (MHIF) in 2021 reached 2.6 trillion rubles, which is 9.9% more than a year ago. This is stated in the analytical note of the Accounts Chamber published on February 22, 2022 on the progress of the execution of the federal budget and the budgets of state extra-budgetary funds of the Russian Federation.

According to TASS with reference to this document, the revenue part of the MHIF budget in 2021 was executed in excess of the projected volume by 3.9%, or 97.59 billion rubles. The bulk of the proceeds (88.1%) to the fund were insurance premiums for compulsory health insurance.

FFOMS revenues increased by 9.9%, to 2.6 trillion rubles

The MHIF expenses in 2021 were executed by 100.9% (2.57 trillion rubles), which is 1.2% higher than the level of execution in 2020 expenses (99.7%). The main share of unfulfilled funds accounted for the costs of manufacturing compulsory medical insurance policies, the normalized insurance reserve of the MHIF budget, the costs of measures to modernize the compulsory medical insurance GIS, payment to medical experts for conducting a quality assessment, and organizing information interaction with the Uniform State Health Information System.

The Accounts Chamber also calculated spending on medical care due to COVID-19. Thus, the cost of providing medical care to Russians with coronavirus or suspicion of it for 12 months of 2021 amounted to 557.1 billion rubles. The report also cites figures on the cost of providing high-tech medical care (VMP). In 2021, they amounted to 32.93 billion rubles, or 24.8% of the total amount of expenses on the WMP under the basic compulsory medical insurance program in the country as a whole (132.6 billion rubles). At the same time, the specialists of the joint venture note that the analysis of data on the provision of specialized assistance "may indicate that the planning of the volume of medical care is carried out without taking into account the actual need of medical organizations."^[2]

2020

Federal clinics will be funded through the MHIF

On November 18, 2020, the State Duma adopted a bill according to which clinics subordinate to federal executive bodies will be financed through the Compulsory Health Insurance Fund (MHIF), without the participation of insurance medical organizations. Read more Here.

250 million rubles were stolen from the compulsory medical insurance fund in Kuzbass

On June 19, 2020, it became known about the detention of two heads of a network of private medical centers in Kemerovo and Novokuznetsk, who are suspected of embezzling more than 250 million rubles from the territorial compulsory health insurance fund (compulsory medical insurance) by reimbursing the costs of actually not provided services. It is reported by GU MINISTRY OF INTERNAL AFFAIRS Russia in the Kemerovo region.

According to the investigation, since 2016, the suspects have created a network of private medical centers in Kemerovo and Novokuznetsk, which actually did not provide services to citizens, but received payments under the compulsory medical insurance system. More than 70% of medical services, for which these organizations in the period from 2019 to April 2020, the territorial insurance fund reimbursed the costs, were actually not provided to citizens. 

In the Kemerovo region, suspects in embezzlement of funds from the compulsory health insurance fund were detained

For fictitious reports, forged documents were used. According to preliminary estimates, the amount of damage caused amounted to more than 250 million rubles. The name of the network of clinics that appear in the case is not reported.

Investigators of the Main Investigation Department of the regional police headquarters and employees of the Kuzbass FSB department worked to expose the criminal scheme and detain the suspects. As a result of the joint operation, the commercial director and manager of several medical organizations were detained.

The Main Directorate of the Ministry of Internal Affairs of Russia for the Kemerovo Region opened a case of especially large-scale fraud (part 4 of article 159). The operatives searched the places of residence of the suspects, as well as in the medical centers they created in Kemerovo and Novokuznetsk, seizing documentation and office equipment. During the investigation, both defendants were placed under house arrest. According to the Criminal Code of the Russian Federation, they face up to ten years in prison. The suspects will be charged in the near future, according to the message of the Main Directorate of the Ministry of Internal Affairs of the Russian Federation for the Kemerovo Region of June 19, 2020.^[3]

New Chairman - Elena Chernyakova

On March 13, Prime Minister Mikhail Mishustin signed an order appointing Elena Chernyakova to the post of chairman of the Federal Compulsory Health Insurance Fund (MHIF). Read more here.

2016: High-tech medical care disconnected from the federal budget

On March 17, 2016, it became known that high-tech medical care would not be funded from the state budget. Only the Federal Compulsory Health Insurance Fund (FFOMS) will remain the manager of funds.

The main areas of medical care using high technologies include neurosurgery, oncology, cardiovascular surgery and traumatology (more than 1 thousand areas in total). All of them were initially financed both from the federal budget and from the funds of the FFOMS, but in 2010 they decided to gradually transfer funding to the fund.

Financing of high-tech medical care transferred to FFOMS

As Kommersant reports with reference to the amendments of the Ministry of Health to the Budget Code, the Law "On Compulsory Medical Insurance in the Russian Federation" and other legislative acts, since 2017, money for high-tech medical care in Russia will not be allocated from the state budget.^[4]

The Ministry of Health believes that this step will not leave high-tech medicine without money, but will only streamline the process of their allocation and spending. In 2015, more than 700 thousand Russians received high-tech medical care.

Budget injections into the treatment of socially significant diseases (HIV, hepatitis, mental disorders, etc.) will remain. At the same time, according to the publication, the so-called innovative medicine, which does not have confirmed methods and uses experimental medical technologies, can switch to federal funds.

On March 18, 2016, information appeared on the website of the Government of the Russian Federation on the allocation of 5.4 billion rubles to 65 Russian regions for high-tech medical care. 27 billion rubles will be allocated from regional budgets for these purposes.^[5]

MHIF Budget

2024: MHIF spending in 2025 will exceed ₽4 trillion for the first time

The Federal Compulsory Health Insurance Fund (MHIF) plans to significantly increase the cost of providing the compulsory medical insurance system in 2025. For the first time in the history of Russia, this amount will exceed ₽4 trillion, reaching an indicator of ₽4,5 trillion. This became known on September 30, 2024 from the draft budget of the MHIF for the next three years.

According to Medvestnik, the growth of MHIF expenses in 2025 will amount to 15.4% compared to the current year. More than 80% of these funds will be sent in the form of subventions to the regions. The amount of subventions to the budgets of territorial compulsory medical insurance funds for financing the provision of medical care under the compulsory medical insurance program in 2025 will reach ₽3,64 trillion.

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Freepik

The planned size of the subvention will provide a per capita standard for financial support of the basic compulsory medical insurance program for 2025 in the amount of ₽21080,3 per person. These funds will also be used to fulfill the indicators of the May decrees on the salaries of medical workers and increase the wages of junior medical staff. ��141,2 billion is planned for the provision of high-tech medical care not included in the basic compulsory medical insurance program in the fund's budget for 2025. To financially provide specialized medical care provided by federal medical organizations, ₽250,9 billion are provided.

In the budget of the MHIF, it is also planned to reserve funds of the standardized insurance stock for 2025 in the amount of ₽425,5 billion. This money will be used to co-finance the costs of paying medical personnel, incentive payments and special social payments to certain categories of health workers.

Olga Obukhova, Deputy Director for Health Economics of the Central Research Institute for Organization and Informatization of Health Care of the Ministry of Health, noted that in the past three years, the average growth rate of financial cost standards for certain types of medical care in the compulsory medical insurance system was lower than the inflation rate, while the increase in funding from compulsory medical insurance sources was higher compared to the budget. ^[6]

2023

The annual budget of the MHIF is executed with a surplus of 104.77 billion rubles

The Government of the Russian Federation submitted on June 3, 2024 to the State Duma a bill approving the execution of the budget of the Federal Compulsory Health Insurance Fund (MHIF) for 2023 with a surplus of 104.77 billion rubles. According to the report, the fund's revenues for the past year amounted to 3 trillion 290.686 billion rubles, and expenses - 3.19 trillion rubles.

Despite difficult economic conditions and increased sanctions pressure, the actual revenues of the MHIF significantly exceeded the projected volume, which made it possible to fulfill all social obligations planned for 2023. The explanatory note to the bill emphasizes that the fund's revenues in 2023 increased by 371.27 billion rubles, or 12.7% compared to 2022, while expenses increased by 388.85 billion rubles, which is 13.9%.

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Freepik

According to the report, in 2023, interbudgetary transfers in the amount of 428.928 billion rubles were provided from the federal budget to the MHIF budget, which is 99.9% of the approved volume. In addition, the MHIF transferred to the budget of the Pension and Social Insurance Fund of the Russian Federation interbudgetary transfers to pay for birth certificates and special social payments to medical workers in the amount of 87.651 billion rubles.

The document also emphasizes that the excess of income over expenses provided stable funding for all planned activities and support for the medical industry in the face of economic challenges. This confirms the effectiveness of managing the fund's financial resources and allows us to hope for further sustainable development of the compulsory health insurance system in Russia.

The report noted that additional measures taken to ensure the stable functioning of the compulsory health insurance system include improving cost controls and streamlining the process of providing health services. In particular, in 2023, new technologies and techniques were introduced aimed at increasing the efficiency of the use of budget funds and improving the quality of medical care.^[7]

Surplus - 104.7 billion rubles

The budget of the Federal Compulsory Health Insurance Fund (FFOMS) for 2023 was executed with a surplus of 104.7 billion rubles. Such data are contained in the bill of the Ministry of Health of the Russian Federation on the execution of the fund's budget.

As Parlamentskaya Gazeta writes with reference to the explanatory note to this document, despite the difficult economic situation and the increased sanctions pressure, the actual budget revenues of the FFOMS were received in excess of the projected volume, which ensured the fulfillment of all social obligations adopted for 2023.

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Unsplash

In general, the cash execution of the FFOMS budget amounted to 3.185 trillion rubles in 2023 in terms of expenses and 3.29 trillion rubles in terms of income. Compared to 2022, revenues increased by 12.7% - due to an increase in insurance premiums for the working and non-working population, as well as through interbudgetary transfers of the Government of the Russian Federation.

More than 119 billion rubles in 2023 was allocated for the provision of high-tech medical care outside the compulsory medical insurance. Private medical organizations providing such assistance received 1.87 billion rubles, the vast majority - 117.9 billion rubles - was transferred to state medical organizations. More than 2.7 trillion rubles were spent on subventions to the budgets of territorial funds to provide medical care for compulsory medical insurance.

The federal budget sponsored the FFOMS for 429 billion rubles - this is 13% of all income. Of this amount, 140 billion rubles traditionally went to pay for chemotherapy under the Fedproject "Fight against Cancer."

The main source of income was insurance premiums for compulsory medical insurance: in 2023, their share in the total budget expenditures amounted to 85.7%. In 2023, employers, individual entrepreneurs and executive authorities in the constituent entities of the Russian Federation paid about 2.82 trillion rubles to the budget of the FFOMS.^[8]

Budget for 2024 determined

At the end of November 2023, the president Russia Vladimir Putin signed the law on the budget Federal Compulsory Health Insurance Fund (MHIF) for 2024 and the planning period 2025-2026. In addition, the head states approved the Federal Health Care in budget 2024. More. here

2022: Surplus - 122.36 billion rubles

On July 11, 2023, the State Duma of the Russian Federation voted to approve the report on the execution of the budget of the Federal Compulsory Health Insurance Fund (MHIF) for 2022. From this document it became known that the annual surplus of the MHIF amounted to about 122.36 billion rubles.

The MHIF budget for 2022 received over 2.9 trillion rubles, which is 5.1% more than approved in the law on the budget of the Compulsory Health Insurance Fund. Spent 2.797 trillion. This is 99.4% of the total planned values.

The annual surplus of the MHIF amounted to about 122.36 billion rubles

In Russia, they began to allocate more money for compulsory medical insurance of some categories of citizens. 140 billion rubles were allocated from the federal budget in 2022 for medical care for cancer patients. Almost 110 billion rubles were spent on providing high-tech assistance that is not part of the compulsory medical insurance program. This is 1.7% more than a year earlier.

In 2022, the amount of funds transferred by the MHIF from the federal budget to compensate for the shortfall in budget revenues of the fund in connection with the establishment of reduced rates of payment of insurance premiums for compulsory medical insurance for certain categories of insurers amounted to 47.5 billion rubles, which is 33.9% more compared to the previous reporting period. In addition, 148.21 billion rubles were transferred from the federal budget to compensate for lost income due to a change in the timing of payment of insurance premiums in 2022.

The interbudgetary transfer to the fund's budget for financial support of certain non-insurance expenses amounted to 121.33 billion rubles, which is 3.2% more than in the previous year. In 2022, subventions in the amount of 2.46 trillion rubles were allocated to the budgets of territorial funds from the MHIF for financial support of the organization of compulsory medical insurance in the territories of the constituent entities of the Russian Federation, which is 8.1% more than in 2021.^[9]

2019: MHIF revenues rise 12% in 2019

The MHIF budget was executed on revenues in the amount of 2 trillion 123 billion 987.9 million rubles, which is 1.2% more than the previously approved volume (2 trillion 098 billion 27 million rubles). The fund's expenses amounted to 2 trillion 186 billion 737.8 million rubles, which is 0.2% less than the approved size (2 trillion 190 billion 183 million rubles).

The revenues of the Federal Compulsory Health Insurance Fund in 2019 amounted to 2.124 trillion rubles, which is 12% higher than in 2018, the minister said in May 2020. health care Russia Mikhail Murashko

"The revenues of the federal fund amounted to 2 trillion 124 billion rubles, which is 1.2% higher than the approved volume. Compared to 2018, revenues increased by 12%, "Murashko said at a government meeting.

According to him, about 14 billion rubles were transferred in 2019 to pay for generic certificates. "According to the applications of the Social Insurance Fund, 14 billion rubles were transferred to pay for generic certificates. The budget has been fulfilled in full, "Murashko said.

Notes