The government criticized the idea of ​​reducing the income of medical insurance organizations

A response signed by Deputy Prime Minister of the Russian Federation and Chief of Staff of the Government Dmitry Grigorenko appeared in the bill card today, May 7. The letter states that the reduction in insurers' income "creates risks of reducing the effectiveness of the system of control over the provision of medical care" and "may lead to inefficient use of compulsory medical insurance funds and a decrease in the quality and availability of medical care."

The document also states that the procedure for monitoring the quality of treatment is “sufficiently regulated” in Federal Law No. 326-FZ “On Compulsory Medical Insurance,” and the New People bill does not contain evidence that existing legal norms are insufficient for effective auditing of the quality and timing of medical care.

The legal department of the State Duma of the Russian Federation also expressed its opinion on the draft law. They noted that the reduction in the income of the SMO will ultimately lead to a reduction in the income of the clinics themselves. The Accounts Chamber of the Russian Federation also pointed out the shortcomings of the draft law.

The draft amendments to Federal Law No. 326-FZ "On Compulsory Medical Insurance" were submitted by "New People" in February 2025. The main line of the initiative is to redirect the income of the insurance medical organizations from fines and sanctions imposed on clinics after the quality assessment of medical care (QAMC) and medical-economic assessment (MEA) to the standardized insurance reserves of the TFOMS. According to the Federal Law, insurance companies receive 15% of the unreasonably presented invoices from clinics after QAMC, the same amount after MEA, and 25% of the amount of fines that medical organizations pay for failure to provide, untimely provision, or provision of poor quality medical care.

Deputies believe that due to the current system, insurance medical organizations are interested in finding more violations, which, as stated in the explanatory note, is confirmed by the data of the Federal Compulsory Medical Insurance Fund. According to deputies, possible bias of insurance medical organizations reduces the budgetary efficiency of using compulsory medical insurance funds, and on the other hand, creates conditions for a decrease in the quality of medical care due to the financial burden on clinics.

The State Duma is currently considering another bill aimed at reforming the system of payment for medical care in the compulsory medical insurance. Deputies from the Legislative Assembly of Krasnoyarsk Krai have proposed including some types of outpatient (mainly tablet) drug therapy for malignant neoplasms in the compulsory medical insurance – currently, the bulk of such drug provision falls on the shoulders of regional and federal budgets, whose capacity, according to the initiators, is insufficient.