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JUDr. Ivan Humeník, PhD.
| 21.12.2017Články
ÚDZS: Platobná schopnosť zdravotných poisťovní
| 13.6.2014 | komentárov: 307
Úrad pre dohľad nad zdravotnou starostlivosťou ustanovil vo svojom Vestníku č. 8/2014 podmienky preukázania platobnej schopnosti zdravotných poisťovní za apríl 2014 v súlade so zákonom 581/2004 Z. z. o zdravotných poisťovniach, dohľade nad zdravotnou starostlivosťou a o zmene a doplnení niektorých zákonov.
Na to aby zdravotná poisťovňa nebola považovaná za platobne neschopnú, bude povinná preukázať splnenie jej záväzkov voči poskytovateľom zdravotnej starostlivosti „v lehote, ktorá nepresiahne 30 kalendárnych dní odo dňa zmluvne dohodnutej lehoty splatnosti záväzkov voči poskytovateľom.“
Ak zdravotná poisťovňa neeviduje záväzky voči poskytovateľom zdravotnej starostlivosti, ktoré sú viac ako 30 dní po dátume ich splatnosti v objeme prevyšujúcom 0,2% objemu všetkých záväzkov počas troch po sebe nasledujúcich kalendárnych mesiacov, považuje sa platobná schopnosť zdravotnej poisťovne za zabezpečenú. Záväzky neuhradené z právne uznateľných dôvodov (skutočnosti ustanovené osobitnými právnymi predpismi, na základe ktorých zdravotná poisťovňa nemôže uhradiť v lehote splatnosti svoje záväzky voči poskytovateľom zdravotnej starostlivosti, a to preto, lebo záväzok má byť uhradený tretej osobe alebo zdravotná poisťovňa nepozná výšku záväzku, alebo subjekt, ktorému má byť uhradený) sa však nezohľadňujú.
Spracovala: Ľudmila MOĽOVÁ
Zdroj: http://www.udzs-sk.sk/buxus/docs/vestniky/rocnik_2014/VE_8_2014.pdf
Obrázok: thefreedigitalphotos.net
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