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Order 502n on the medical commission. Order on the procedure for the creation and activities of the medical commission of a medical organization - Rossiyskaya Gazeta

Order of the Ministry of Health and Social Development of the Russian Federation of May 5, 2012 N 502n "On approval of the procedure for the creation and activities of the medical commission of a medical organization"

Order of the Ministry of Health and social development RF dated May 5, 2012 N 502n
"On approval of the procedure for the creation and activities of the medical commission medical organization»

With changes and additions from:

In accordance with the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in Russian Federation”(Collected Legislation of the Russian Federation, 2011, N 48, Art. 6724) I order:

1. Approve the procedure for the creation and activities of the medical commission of a medical organization in accordance with the appendix.

Order of the Ministry of Health and Social Development of the Russian Federation of May 22, 2009 N 269n “On Amendments to the Procedure for Organizing the Activities of the Medical Commission of a Medical Organization, approved by Order of the Ministry of Health and Social Development of the Russian Federation of September 24, 2008 N 513n “On the Organization of Activities medical commission of a medical organization” (registered by the Ministry of Justice of the Russian Federation on July 6, 2009 N 14233).

Approved new order creation and activities of the medical commission of a medical organization.

The Commission makes decisions on issues of prevention, diagnosis, treatment, medical rehabilitation and sanatorium treatment of citizens in the most difficult and conflict situations. It also determines the working capacity of individuals, prolongs sick leave, conducts examinations of the professional suitability of certain categories of employees.

The commission is created on the basis of the order of the head of the medical organization. It consists of the chairman, his deputies, the secretary and members of the commission.

Meetings of the medical commission are held at least once a week in accordance with the schedule. Unscheduled meetings may be convened if necessary.

The decision is considered adopted if it is supported by 2/3 of the members of the medical commission.

The chairman of the commission submits a written report on its work to the head of the medical organization on a quarterly basis, as well as at the end of the year.

The old order is no longer valid.

Order of the Ministry of Health and Social Development of the Russian Federation of May 5, 2012 N 502n "On approval of the procedure for the creation and activities of the medical commission of a medical organization"

Registration N 24516

This Order shall enter into force 10 days after the date of its official publication.

This document has been modified by the following documents:

Order of the Ministry of Health of the Russian Federation of December 2, 2013 N 886n “On Amendments to the Procedure for the Creation and Activities of the Medical Commission of a Medical Organization, approved by Order of the Ministry of Health and Social Development of the Russian Federation of May 5, 2012 N 502n, and to the Procedure for Appointment and Discharge medicinal products, approved by order of the Ministry of Health of the Russian Federation dated December 20, 2012 N 1175n "

Order of the Ministry of Health of the Russian Federation of December 2, 2013 N 886n
“On Amendments to the Procedure for the Creation and Operation of a Medical Commission of a Medical Organization, approved by Order of the Ministry of Health and Social Development of the Russian Federation of May 5, 2012 N 502n, and to the Procedure for Prescribing and Prescribing Medicines, approved by Order of the Ministry of Health of the Russian Federation of December 20 2012 N 1175n "

1. Amend the Procedure for the creation and operation of the medical commission of a medical organization, approved by order of the Ministry of Health and Social Development of the Russian Federation of May 5, 2012 N 502n (registered by the Ministry of Justice of the Russian Federation on June 9, 2012, registration N 24516), and in The procedure for prescribing and prescribing drugs, approved by order of the Ministry of Health of the Russian Federation of December 20, 2012 N 1175n (registered by the Ministry of Justice of the Russian Federation on June 25, 2013, registration N 28883), according to the Appendix.

The procedure for prescribing and prescribing drugs has been adjusted.

It was clarified that in the presence of medical indications (individual intolerance, vital indications), medications that are not included in the standards of medical care can be prescribed and prescribed. Also, in these cases, it is possible to prescribe drugs by trade names, and not by INN.

The decision to prescribe and prescribe drugs by trade names or not included in the standards is made by the medical commission of the medical organization.

The named commission is obliged to report to Roszdravnadzor about the identified side effects that are not listed in the instructions for use of the medicine. Also, the medical commission must inform the Service about serious or unexpected adverse reactions when using drugs, including those that led to the prescription of drugs by trade names or not included in the standards.

Registration N 30714

Order of the Ministry of Health and Social Development of the Russian Federation (Ministry of Health and Social Development of Russia) dated May 5, 2012 N 502n Moscow "On approval of the procedure for the creation and activities of a medical commission of a medical organization"

Registration N 24516

In accordance with the Federal Law of November 21, 2011 N 323-FZ "On the basics of protecting the health of citizens in the Russian Federation" (Collected Legislation of the Russian Federation, 2011, N 48, art. 6724) I order:

2. Recognize as invalid:

order of the Ministry of Health and Social Development of the Russian Federation of September 24, 2008 N 513n "On the organization of the activities of the medical commission of a medical organization" (registered by the Ministry of Justice of the Russian Federation on December 25, 2008 N 12993);

Minister T. Golikova

The procedure for the creation and activities of the medical commission of a medical organization

I. General provisions

1. The procedure for the creation and operation of the medical commission of a medical organization (hereinafter referred to as the Procedure) determines the goals of creation, the rules of operation and the functions of the medical commission of a medical organization.

2. The medical commission of a medical organization (hereinafter referred to as the medical commission) is created in a medical organization in order to improve the organization of the provision of medical care citizens.

3. In its activities, the medical commission is guided by the Constitution of the Russian Federation, federal laws, decrees and orders of the President of the Russian Federation, decrees and orders of the Government of the Russian Federation, regulatory legal acts of federal executive authorities, including the Procedure, laws and other regulatory legal acts of the constituent entities of the Russian Federation.

II. Functions of the medical commission

4. The medical commission performs the following functions:

4.1. making decisions on issues of prevention, diagnosis, treatment, medical rehabilitation and sanatorium treatment of citizens in the most difficult and conflict situations requiring commission consideration;

4.2. determination of the working capacity of citizens;

4.3. extension of disability certificates in cases established by the legislation of the Russian Federation;

4.4. making a decision on the issue of sending a patient for a medical and social examination in accordance with the legislation of the Russian Federation;

4.5. examination of the professional suitability of certain categories of employees;

4.6. assessment of the quality, validity and effectiveness of therapeutic and diagnostic measures, including the prescription of drugs;

4.7. assessment of compliance in the medical organization with the established procedure for maintaining medical records;

4.8. development of measures to eliminate and prevent violations in the process of diagnosing and treating patients;

4.9. study of each case of death of a patient in order to identify the cause of death, as well as to develop measures to eliminate violations in the activities of a medical organization and medical workers in the event that such violations led to the death of the patient;

4.10. making decisions on the appointment and correction of treatment in order to take into account patient data while ensuring medicines in accordance with the legislation of the Russian Federation;

4.11. making decisions on the prescription of medicinal products in cases and in the manner established by the regulatory legal acts of the Russian Federation and the constituent entities of the Russian Federation that establish the procedure for prescribing and prescribing medicinal products, including narcotic medicinal products and psychotropic medicinal products, as well as medicinal products that are provided in in accordance with the standards of medical care by prescription of a doctor (paramedic) when providing state social assistance in the form of a set of social services;

4.12. selection of patients, formation and submission of a set of documents to the Commission of the executive authority of the constituent entity of the Russian Federation in the field of healthcare for the selection of patients for the provision of high-tech medical care in accordance with the Procedure for sending citizens of the Russian Federation for the provision of high-tech medical care at the expense of budgetary appropriations provided for in the federal budget Ministry of Health and Social Development of the Russian Federation, through the use of a specialized information system, approved by order of the Ministry of Health and Social Development of the Russian Federation of December 28, 2011 N 1689n (registered by the Ministry of Justice of the Russian Federation on February 8, 2012 N 23164);

4.13. issuance of a medical opinion on the presence (absence) of medical indications and medical contraindications for medical rehabilitation and sanatorium treatment of citizens in cases provided for by the regulatory legal acts of the Russian Federation and the constituent entities of the Russian Federation that establish the procedure for sending citizens to medical rehabilitation and sanatorium treatment;

4.14. issuance of a conclusion on the veteran's need for provision with prostheses (except for dentures), prosthetic and orthopedic products in accordance with the Rules for the Provision of Disabled Persons technical means rehabilitation and certain categories of citizens from among veterans with prostheses (except for dentures), prosthetic and orthopedic products approved by Decree of the Government of the Russian Federation of April 7, 2008 N 240 (Collected Legislation of the Russian Federation, 2008, N 15, Art. 1550; N 23 , item 2713; 2009, N 2, item 244; N 3, item 378; N 33, item 4083; N 43, item 5064; N 45, item 5350; 2010, N 4, item 394 ; N 11, item 1225; N25, item 3167; 2011, N 2, item 339);

4.15. conducting a medical examination of suspects or accused of crimes, in respect of which a measure of restraint in the form of detention has been chosen, for the presence of a serious illness included in the list of serious diseases that prevent the detention of suspects or accused of committing crimes, approved by a government decree of the Russian Federation dated January 14, 2011 N 3 (Collected Legislation of the Russian Federation, 2011, N 4, art. 608);

4.16. conducting mandatory preliminary and periodic medical examinations(surveys) of workers employed in hard work and at work with harmful and (or) hazardous conditions labor;

4.17. issuance of a certificate of the absence of medical contraindications for work using information constituting a state secret;

4.18. issuance of a medical opinion that the removal of organs and tissues for transplantation (transplantation) from a living donor will not cause significant harm to his health;

4.19. analysis of morbidity, including mothers and newborns, nosocomial infections, development and implementation of measures to prevent the incidence of nosocomial infections;

4.20. organization and holding internal control quality and safety of medical activities (by decision of the head of the medical organization);

4.21. interaction in work on issues related to the competence of the medical commission, with the territorial funds of compulsory medical insurance, regional offices of the Fund social insurance Russian Federation, territorial bodies Federal Service on supervision in the field of health care and social development and the Federal Service for Supervision of Consumer Rights Protection and Human Welfare, federal agencies medical and social expertise, with insurance medical organizations, other bodies and organizations;

4.22. consideration of appeals (complaints) on issues related to the provision of medical care to citizens in a medical organization;

4.23. other functions provided for by federal laws, regulatory legal acts of the President of the Russian Federation, the Government of the Russian Federation, federal executive authorities and bodies state power subjects of the Russian Federation.

III. The procedure for the creation and operation of the medical commission

5. The medical commission is created on the basis of the order of the head of the medical organization.

6. Depending on the tasks set, the specifics of the activities of the medical organization, by decision of the head of the medical organization, subcommittees may be formed as part of the medical commission.

7. The regulation on the medical commission (subcommittee of the medical commission), which regulates the goals, tasks and functions of the medical commission (its subcommittees), the procedure for work, accounting and reporting on the results of activities, and the composition of the medical commission (its subcommittees) are approved by the head of the medical organization.

8. The medical commission (subcommittee of the medical commission) consists of a chairman, one or two deputy chairmen, a secretary and members of the commission.

9. The head of the medical organization or the deputy head (head of the structural unit) of the medical organization is appointed as the chairman of the medical commission, in official duties which includes resolving issues within the competence of the commission.

10. The chairmen of the subcommittees of the medical commission are appointed deputy heads (heads of structural divisions) of the medical organization, whose duties include resolving issues within the competence of the subcommittees.

11. The chairman of the medical commission (subcommittee of the medical commission) is responsible for the activities of the medical commission (subcommission), the timeliness, validity and objectivity of the decisions made by the medical commission (subcommission).

12. The composition of the medical commission and its subcommittees includes heads structural divisions medical organization, medical specialists from among the employees of a medical organization.

13. The secretary of the medical commission (subcommittee of the medical commission) performs the following functions:

13.1. drawing up scheduling of meetings of the medical commission (its subcommittee);

13.2. preparation of materials for the meeting of the medical commission (its subcommittee);

13.3. notification of members of the medical commission (its subcommittee) on the date and time of the meeting of the medical commission (its subcommittee);

13.4. registration of decisions of the medical commission (its subcommittee) and maintenance of a special journal, which takes into account the decisions of the medical commission (its subcommittee) (hereinafter referred to as the journal);

13.5. organization of storage of materials of the work of the medical commission (its subcommittee).

14. Meetings of the medical commission (subcommittee of the medical commission) are held at least once a week on the basis of schedules approved by the head of the medical organization.

If necessary, by decision of the head of the medical organization, unscheduled meetings of the medical commission (subcommittee of the medical commission) may be held.

15. The decision of the medical commission (subcommittee of the medical commission) is considered adopted if it is supported by two thirds of the members of the medical commission (subcommittee).

16. The decision of the medical commission (subcommittee of the medical commission) is drawn up in the form of a protocol that contains the following information:

16.1. date of the meeting of the medical commission (its subcommittee);

16.2. a list of members of the medical commission (its subcommittee) who were present at the meeting;

16.3. list of issues discussed;

16.4. decisions of the medical commission (its subcommittee) and its justification.

17. The secretary of the medical commission (subcommittee of the medical commission) enters the decision into the patient's medical records, as well as into the journal.

18. An extract from the protocol of the decision of the medical commission is issued to the patient or his legal representative on the basis of a written application.

19. Protocols of decisions of the medical commission (subcommittee of the medical commission) shall be kept for 10 years.

20. The chairman of the medical commission quarterly, as well as at the end of the year, submits to the head of the medical organization a written report on the work of the medical commission and its subcommittees.

21. Control over the activities of the medical commission and its subcommittees is carried out by the head of the medical organization.

Order of the Ministry of Health of the Russian Federation (Ministry of Health of Russia) dated May 5, 2016 N 282n Moscow "On approval of the Procedure for conducting an examination of professional suitability and the form of a medical report on suitability or unsuitability for certain types of work"

Registration N 42397

In accordance with Part 3 of Article 63 of the Federal Law of November 21, 2011 N 323-FZ “On the Basics of Protecting the Health of Citizens in the Russian Federation” (Sobraniye Zakonodatelstva Rossiyskoy Federatsii, 2011, N 48, Art. 6724; 2012, N 26, Art. 3442, 3446; 2013, N 27, items 3459, 3477; N 30, item 4038; N 39, item 4883; N 48, item 6165; N 52, item 6951; 2014, N 23, item 2930; N 30, items 4106, 4244, 4247, 4257; N 43, item 5798; N 49, items 6927, 6928; 2015, N 1, items 72, 85; N 10, item 1403, 1425; N 14, item 2018; N 27, item 3951; N 29, item 4339, 4356, 4359, 4397; N 51, item 7245; 2016, N 1, item 9, 28), subclause 5.2 .81 Regulations on the Ministry of Health of the Russian Federation, approved by Decree of the Government of the Russian Federation of June 19, 2012 N 608 (Collected Legislation of the Russian Federation, 2012, N 26, Art. 3526; 2013, N 16, Art. 1970; N 20, Art. 2477; N 22, item 2812; N 33, item 4386; N 45, item 5822; 2014, N 12, item 1296; N 26, item 3577; N 30, item 4307; N 37, 4969; 2015, N 2, item 491; N 12, Art. 1763; No. 23, art. 3333; 2016, N 2, art. 325), I order:

The procedure for conducting an examination of professional suitability in accordance with Appendix No. 1;

form of medical report on suitability or unfitness for performance certain types works according to Appendix N 2.

Minister V. Skvortsova

The procedure for the examination of professional suitability

1. This procedure defines the rules for conducting an examination of professional suitability in order to determine whether the state of health of an employee (a person entering a job) (hereinafter referred to as an employee) is appropriate for him to perform certain types of work.

2. An examination of professional suitability is carried out based on the results of preliminary medical examinations and periodic medical examinations (hereinafter referred to as the mandatory medical examination) in relation to employees who, during the mandatory medical examination, have medical contraindications to certain types of work.

3. The examination of professional suitability is carried out in a medical organization or a structural unit of a medical organization or other organization, regardless of the organizational and legal form, which has a license to carry out medical activities for the examination of professional suitability1 (hereinafter referred to as the medical organization).

4. To conduct an examination of professional suitability in a medical organization, a permanent medical commission is formed2.

5. The head of the medical organization (deputy head of the medical organization, head of the structural unit of the medical organization), corresponding to the Qualification requirements to medical pharmaceutical workers with higher education in the direction of training "Health care and medical sciences", approved by order of the Ministry of Health of the Russian Federation of October 8, 2015 N 707n (registered by the Ministry of Justice of the Russian Federation on October 23, 2015, registration N 39438) in the specialty "occupational pathology".

6. For the examination of professional suitability, the employee submits to the medical organization:

identity document;

a referral issued by a medical organization that conducted a mandatory medical examination, during which medical contraindications to the implementation of certain types of work were identified;

a medical report based on the results of a mandatory medical examination issued to an employee.

7. The medical commission, within 10 working days from the date of receipt by the medical organization of the documents specified in paragraph 6 of this Procedure, considers these documents.

8. The medical commission of a medical organization, based on the results of a mandatory medical examination, makes one of the following decisions on the recognition of an employee:

fit for health reasons to perform certain types of work;

temporarily unfit for health reasons to perform certain types of work;

permanently unfit for health reasons to perform certain types of work.

In the case of a decision on temporary unsuitability for health reasons to perform certain types of work, the justification is indicated this decision and terms of temporary unsuitability with recommendations for additional studies (laboratory, instrumental studies) and (or) appropriate treatment.

The final decision is made by the commission after the presentation of the results of the studies and (or) treatment.

9. The decision of the medical commission is drawn up in the form of a protocol.

10. If it is impossible, on the basis of the documents specified in paragraph 6 of this Procedure, to determine the compliance of the employee’s health condition with the possibility of performing certain types of work by him, the medical commission makes a decision on the appointment of examinations by specialist doctors (research) for the employee.

11. In the event that during the examination of professional suitability by the medical commission, examinations by specialist doctors (research) are scheduled, the time of which exceeds the period specified in paragraph 7 of this Procedure, the period for the examination of professional suitability is extended until the results of these examinations (research) are received. but not more than 30 business days.

This decision of the medical commission, containing a reasoned justification, is reflected in the minutes of the medical commission.

12. Based on the protocol of the medical commission, a medical worker authorized by the head of the medical organization draws up a medical report on the suitability or unsuitability for certain types of work (hereinafter referred to as the Medical Report) in the form provided for in Appendix No. 2 to this order.

13. A medical report is issued within 3 working days from the date of issuance of one of the decisions of the medical commission specified in paragraph 8 of this Procedure.

14. The medical report is issued in two copies, one of which:

issued to the employee for presentation to the employer, about which the employee signs in the Medical Reports registration log;

is pasted into the medical documentation of the employee, issued in a medical organization, and stored for 50 years.

1 Decree of the Government of the Russian Federation of April 16, 2012 N 291 “On licensing medical activities (with the exception of the specified activities carried out by medical organizations and other organizations that are part of the private healthcare system on the territory of the Skolkovo innovation center)” (Collection of Legislation of the Russian Federation, 2012, N 17, item 1965; N 37, item 5002; 2013, N 3, item 207; N 16, item 1970).

2 Order of the Ministry of Health and Social Development of the Russian Federation of May 5, 2012 N 502n “On approval of the procedure for the creation and activities of the medical commission of a medical organization” (registered by the Ministry of Justice of the Russian Federation on June 9, 2012, registration N 24516) as amended by the order Ministry of Health of the Russian Federation dated December 2, 2013 N 886n (registered by the Ministry of Justice of the Russian Federation on December 23, 2013, registration N 30714).

Order of the Ministry of Health and Social Development of Russia No. 323 dated May 10, 2007

In accordance with the List of works (services) in the implementation of medical activities, attached to the Regulation on the licensing of medical activities, approved by Decree of the Government of the Russian Federation of January 22, 2007 N 30 (Collected Legislation of the Russian Federation, 2007, N 5, Art. 656), I order:

1. Approve the attached Procedure for the organization of work (services) performed in the implementation of pre-medical, outpatient and polyclinic (including primary health care, medical care for women during pregnancy, during and after childbirth, specialized medical care), inpatient (including primary health care, medical care for women during pregnancy, during and after childbirth, specialized medical care), emergency and ambulance specialized (sanitary-aviation), high-tech, sanatorium-and-spa medical care.

Order of the Ministry of Health of the Russian Federation of July 26, 2002 N 238 "On the organization of licensing of medical activities" (registered with the Ministry of Justice of Russia on October 11, 2002 N 3856);

Order of the Ministry of Health of the Russian Federation dated October 22, 2003 N 502 "On the introduction of amendments and additions to the Order of the Ministry of Health of Russia dated July 26, 2002 N 238" (registered with the Ministry of Justice of Russia on November 13, 2003 N 5225);

Order of the Ministry of Health and Social Development of the Russian Federation of March 10, 2006 N 141 "On Amendments to the Order of the Ministry of Health of the Russian Federation of July 26, 2002 N 238" (registered with the Ministry of Justice of Russia on March 29, 2006 N 7642).

Acting Minister
IN AND. Starodubov

Approved
by order
Ministry of Health
and social development
Russian Federation
dated May 10, 2007 N 323

The procedure for organizing work (services) performed in the implementation of pre-medical, outpatient and polyclinic (including primary health care, medical care for women during pregnancy, during and after childbirth, specialized medical care), inpatient (including primary health care -sanitary care, medical care for women during pregnancy, during and after childbirth, specialized medical care), ambulance and emergency specialized (sanitary-aviation), high-tech, sanatorium-resort medical care

The list of works (services) performed in the implementation of first-aid, outpatient and vicinelines (including primary health care, medical care for women during pregnancy, during and after childbirth, specialized medical care), stationary (including primary medical and medical HEALTH CARE, MEDICAL CARE FOR WOMEN DURING PREGNANCY, DURING AND AFTER BIRTH, SPECIALIZED MEDICAL CARE), AMBULANCE AND EMERGENCY SPECIALIZED (HEALTH AND AVIATION), HIGH-TECH, SANATORIUM MEDICAL CARE

Works (services) performed:

1) in the implementation of pre-medical care for:

obstetrics;

histology;

dietetics;

laboratory diagnostics;

laboratory work;

medical examinations (pre-flight, post-flight);

medical examinations (pre-trip, post-trip);

medical optics;

medical statistics;

medical massage;

general practice;

operational business;

nursing organizations;

For reference: including for feldsher-obstetric stations.

nursing in pediatrics;

preventive dentistry;

emergency medical care;

management of nursing activities;

2) in the implementation of outpatient medical care, including:

restorative medicine;

pediatric cardiology;

cardiology;

quality control of medical care;

clinical laboratory diagnostics;

nephrology;

general medical practice (family medicine);

pediatrics;

endoscopy;

b) in the provision of medical care to women during pregnancy, during and after childbirth for:

medical flight examination;

genetics;

pediatric surgery;

diabetology;

collection, storage of donor sperm;

coloproctology;

cosmetology (therapeutic);

laboratory genetics;

medical examinations (preliminary, periodic);

otorhinolaryngology;

ophthalmology;

application of traditional medicine methods;

psychiatry-narcology;

psychotherapy;

radiology;

sexology;

dentistry;

surgical dentistry;

forensic medical examination of physical evidence and the study of biological objects, including:

biochemical;

medical forensic;

forensic biological;

forensic-histological;

forensic chemical;

forensic medical examination and examination of victims,

defendants and other persons;

homogeneous outpatient forensic psychiatric examination;

complex outpatient forensic psychiatric examination;

audiology-otorhinolaryngology;

transportation of donor sperm;

phthisiology;

functional diagnostics;

examination for the right to possess weapons;

aptitude examination;

examination of the connection of the disease with the profession;

endocrinology;

3) when providing inpatient medical care, including:

a) in the implementation of primary health care for:

in) in the provision of specialized medical care for:

4) in the implementation of emergency and emergency specialized (sanitary and aviation) medical care, including:

a) in the implementation of emergency medical care for:

anesthesiology and resuscitation;
infectious diseases;
transportation of donor blood and its components;
transportation of human organs and tissues for transplantation;

b) in the implementation of emergency specialized (sanitary-aviation) medical care:

obstetrics and gynecology;
psychiatry;
toxicology;

5) in the implementation of high-tech medical care for:

abdominal surgery;
pediatric urology-andrology;
pediatric endocrinology;
medical genetics;
application of cellular technologies;
transport of hematopoietic stem cells;
surgery (combustiology);
surgery (transplantation of organs and tissues);
storage of hematopoietic stem cells;
maxillofacial surgery;

6) in the implementation of sanatorium care for:

gastroenterology;
hematology;
geriatrics;
pediatric oncology;
physical therapy and sports medicine;
manual therapy;
neurology;
public health and healthcare organization;
orthodontics;
reflexology;
pediatric dentistry;
therapy;
urology;
endoscopy.

Appendix. The procedure for the creation and activities of the medical commission of a medical organization

Order of the Ministry of Health and Social Development of the Russian Federation of May 5, 2012 N 502n
"On approval of the procedure for the creation and activities of the medical commission of a medical organization"

With changes and additions from:

2. Recognize as invalid:

Order of the Ministry of Health and Social Development of the Russian Federation of May 22, 2009 N 269n "On Amendments to the Procedure for Organizing the Activities of the Medical Commission of a Medical Organization, approved by Order of the Ministry of Health and Social Development of the Russian Federation of September 24, 2008 N 513n" On the Organization of Activities medical commission of a medical organization" (registered by the Ministry of Justice of the Russian Federation on July 6, 2009 N 14233).

Registration N 24516

A new procedure for the creation and operation of the medical commission of a medical organization has been approved.

The Commission makes decisions on issues of prevention, diagnosis, treatment, medical rehabilitation and sanatorium treatment of citizens in the most difficult and conflict situations. It also determines the ability of individuals to work, extends sick leave, and conducts examinations of the professional suitability of certain categories of workers.

The commission is created on the basis of the order of the head of the medical organization. It consists of the chairman, his deputies, the secretary and members of the commission.

Meetings of the medical commission are held at least once a week in accordance with the schedule. Unscheduled meetings may be convened if necessary.

The medical commission should be in any medical organization, regardless of the legal form, types of activities and scope of services. The purpose of its creation and operation is to improve the quality of medical care.

As practice shows, often medical commissions are either not created at all, or are created formally: the rules of work of the commission are not studied, commission meetings are not held, and the necessary documentation is not drawn up. Mostly this situation develops in small private clinics with one type of activity and a minimum number of doctors.

For this reason, I would like to immediately stop and draw attention to the responsibility for the absence of a medical commission in the organization.

The fact is that the medical commission, the procedure for its creation and work, the documentation drawn up, are the subject of state control. Violations in this area are fraught with serious fines.

Yes, in administrative regulations on conducting inspections of organizations and departmental control of the quality and safety of medical activities, approved. By order of the Ministry of Health of Russia No. 13n dated January 23, 2015, it is said (paragraph 38, subparagraph 1 of the Administrative Regulations):

“When conducting an inspection of bodies, organizations of state, municipal and private systems health care, carrying out internal control of the quality and safety of medical activities, the following activities are carried out:

1) consideration:

b) documents and materials characterizing the activities of the medical commission of a medical organization: the order of the head of the medical organization on the establishment of a medical commission, the regulations on the medical commission and the schedule approved by the head of the medical organization, protocols of the medical commission, journals of the medical commission (including registers clinical expert work medical institution), etc.;

d) compliance with the Procedure for the creation and operation of a medical commission of a medical organization, approved by order of the Ministry of Health and Social Development of the Russian Federation dated May 5, 2012 No. 502n.

In addition, the presence of internal quality control and safety of medical activities is one of the licensing requirements for a medical organization (clause 4 subparagraph "i"; paragraph 5 subparagraph "b" of the Regulations on Licensing Medical Activities, approved by Government Decree No. 291 dated April 16, 2012).

The implementation of medical activities with a gross violation of licensing requirements entails administrative liability.

In this case, a gross violation is understood as a failure by the licensee to comply with the requirements provided for in paragraph 4 and subpara. «a» and «b» p. 5 of the Regulations, entailing the consequences established by Part 11 of Art. 19 of the Federal Law "On Licensing Certain Types of Activities".

In law enforcement practice, liability for this violation occurs under Part 4 of Art. 14.1 of the Code of Administrative Offenses of the Russian Federation. The disposition of this article sounds like “Carrying out business activities with a gross violation of the requirements and conditions provided for by a special permit (license)”. An administrative fine or administrative suspension of activity is applied to the violator. The maximum fine is set for a medical organization - from one hundred thousand to two hundred thousand rubles.

The correctness of this approach is confirmed by judicial acts of arbitration courts.

for example

The Fifteenth Arbitration Court of Appeal, in its Resolution dated October 22, 2013 in Case No. 15AP-14448/2013, qualified the absence of a medical commission in the organization as a gross violation of licensing requirements:

“In violation of Part 2 of Art. 48 of the Federal Law No. 323-FZ and paragraph 2 of the Procedure for the Creation and Operation of a Medical Commission of a Medical Organization, approved by Order of the Ministry of Health and Social Development of Russia dated 05.05.2012 No. 502n, the company does not have a medical commission for the implementation of the goals listed in the specified legislation.

Thus, the court of first instance made the correct conclusion that the company violated paragraph.n. "b" clause 5 of the Decree of April 16, 2012 No. 291, which, by virtue of clause 6, indicates gross violation licensing requirements and entails liability under Part 4 of Art. 14.1 of the Code of Administrative Offenses of the Russian Federation.

Similar conclusions were made in the Resolution of the Fifteenth Arbitration Court of Appeal in Case No. 15AP-2224/2013 dated March 15, 2013.

The decision of the Seventeenth Arbitration Court of Appeal dated 03.12.2013 No. 17AP-12136/2013-AK also confirmed the validity of bringing to responsibility under Part 4 of Art. 14.1 of the Code of Administrative Offenses of the Russian Federation for the absence of a permanent medical commission in the organization.

Here is an excerpt from the document:

“In the course of the audit, it was revealed that the Company carried out medical activities with violations of licensing requirements and conditions, namely:

... there is no permanent medical commission (violation of subparagraph "b" of paragraph 5 of the Regulations on the licensing of medical care, part 2 of article 48, article 90 of the Federal Law of November 21, 2011 No. Federation”, Order of the Ministry of Health and Social Development of the Russian Federation of 05.05.2012 No. 502n “On approval of the procedure for the creation and activities of the medical commission of a medical organization”).

.... the presence in the actions (inaction) of BioDent LLC of an administrative offense under Part 4 of Art. 14.1 of the Code of Administrative Offenses of the Russian Federation, is proven.

Regulatory requirements for the creation and operation of the medical commission.

The requirements for the creation and operation of a medical commission include:

in federal law No. 323-FZ of November 21, 2011 “On the fundamentals of protecting the health of citizens in the Russian Federation”;

in the Order of the Ministry of Health and Social Development of Russia No. 502n dated May 5, 2012 (as amended on December 2, 2013) “On approval of the procedure for the creation and activities of the medical commission of a medical organization” (Registered in the Ministry of Justice of Russia No. 24516 dated June 9, 2012).

This is a list of the main regulations. Additional provisions on the work of the medical commission are contained in regulations governing certain areas of medical care.

Regulations on the medical commission.

In a medical organization, the main document regulating the work of the commission is the Regulation on the medical commission, approved by the head.

The regulation on the medical commission is a detailed regulation of its work. Order of the Ministry of Health and Social Development of Russia No. 502n dated May 5, 2012 establishes only General requirements to the content of the document, additional details of the document are developed by the organization independently, taking into account the specifics of the activity.

Like any work regulation, the regulation on the medical commission should disclose:

legal grounds for activity;

goals and objectives;

order of creation;

structure and strength;

activity rules;

functions (range of issues to be resolved);

decision-making procedure;

the procedure for replacing absent members;

the procedure for accounting and reporting on the results of activities;

other important issues for the organization.

The medical commission and its functions.

Functions of the medical commission.

The general list of functions of the medical commission is disclosed in Law No. 323-FZ of November 21, 2011 and Order of the Ministry of Health and Social Development of Russia No. 502n of May 5, 2012.

Law No. 323-FZ of November 21, 2011 identifies four main goals for creating a medical commission:

improving the organization of medical care;

making decisions in the most complex and conflict cases on issues of prevention, diagnosis, treatment and medical rehabilitation, determining the working capacity of citizens and the professional suitability of certain categories of workers;

assessing the quality, validity and effectiveness of medical and diagnostic measures, including prescribing drugs, ensuring the appointment and correction of treatment in order to take into account patient data when providing drugs, transplantation (transplantation) of human organs and tissues, medical rehabilitation;

and making decisions on other medical issues.

Order of the Ministry of Health and Social Development of Russia No. 502n of 05/05/2012 identifies twenty-five functions of the medical commission.

However, the medical commission of a particular medical organization should not and cannot duplicate all the powers provided for it by law. The range of issues of the medical commission of a particular medical organization is determined taking into account the requirements of the legislation and the specifics of its activities. In addition, the work of the medical commission must comply with the license that the organization has received for medical activities.

The Supreme Court of the Russian Federation in its Decision dated February 12, 2013 in Case No. AKPI12-1765 stated: “The powers of the medical commission of a medical organization are limited to the list of works (services) that make up the medical activities of the specified medical organization, for which this medical organization in in due course received."

Medical commission and subcommittees.

Subcommittees may be formed within the medical commission. As follows from the Order of the Ministry of Health and Social Development of Russia No. 502n dated May 5, 2012, subcommittees are formed "depending on the tasks set, the characteristics of the activities of a medical organization." Additional cases for the creation of subcommittees are not disclosed in the legislation.

As a rule, subcommittees are created in large multidisciplinary medical organizations that solve a large number of diverse tasks. In such a situation, subcommittees may be formed to resolve issues in certain areas of activity. The number of subcommittees is not limited by law.

The work of the subcommittee can be regulated both by the relevant additional sections of the Regulations on the medical commission of the organization, and by a specially developed local act– Regulations on the subcommittee for a specific area of activity. These Regulations, in turn, can be drawn up as annexes to the Regulations on the medical commission.

Meetings of the medical commission (subcommittee) and its decisions.

Meetings of the medical commission (subcommittee) are held at least once a week on the basis of schedules approved by the head of the medical organization. If necessary, by decision of the head of the medical organization, unscheduled meetings of the medical commission (subcommittee) may be held.

The decision of the medical commission (subcommittee) is considered adopted if it is supported by two thirds of the members of the medical commission (subcommittee).

Decisions of the medical commission are drawn up in a protocol in the form approved by law. The organization has the right to supplement the form of the protocol with other necessary details and approve it as an annex to the Regulations on the medical commission.

Decisions of the medical commission (subcommittee) are recorded in a special register. The log book is kept in both written and electronic form.

The composition of the medical commission.

In accordance with the requirements of the order of the Ministry of Health and Social Development of Russia No. 502N dated May 05, 2012, the medical commission includes the following persons:

chairman;

Vice President (one or two);

secretary;

members of the commission.

The specific composition of the medical commission, as a rule, is approved by order of the head of the medical organization.

Members of the medical commission, secretary.

Only doctors can be members of the medical commission, since special knowledge is needed to solve the tasks assigned to it. The secretary of the medical commission may be elected from among non-medical employees of the organization.

The number of members of the commission is not established by law.

However, in our opinion, the commission should not consist of less than four specialists, not counting the secretary.

Heads of structural subdivisions of the medical organization, as well as medical specialists from among the employees of the medical organization may be appointed members of the medical commission. If the medical organization is small, then only doctors-specialists will be members of the commission.

At present, the Order of the Ministry of Health and Social Development of Russia No. 502n dated May 5, 2012 does not establish specific requirements regarding the experience or qualifications of members of the medical commission. However, such requirements can be established by a medical organization independently in local acts.

In general, it can be said that doctors - specialists who are members of the commission, of course, must meet the requirements that are established for the implementation of specific medical activities: at least have a diploma of education, a valid specialist certificate.

Let's turn to jurisprudence.

The Supreme Court, in its Ruling dated March 1, 2016, in Case No. APL16-26, considered the administrative claim of Yu.N. Mironov. on invalidating clause 12 of the Order of the Ministry of Health and Social Development of Russia No. 502n of 05.05.2012

In the administrative claim Mironov Yew.N. referred to the fact that the composition of medical commissions should include specialist doctors who have undergone special training in conducting an examination of temporary disability. In his opinion, the content of clause 12 of the Procedure allows the creation of medical commissions only on the basis of such criteria as the position and discretion of the chief physician.

The Supreme Court of the Russian Federation rejected these requirements, while indicating: “paragraph 12 ... defines the general requirements for the formation of the composition of the medical commission and its subcommittees.

Based on the variety of types of work (services) of medical activity, medical specialists included in the medical commission of a medical organization must meet the requirements that are established for the implementation of the corresponding type of medical activity. In each case, set special requirements to the members and the procedure for the work of the relevant medical commission.

Chairman of the medical commission (subcommittee).

The head of the medical commission (subcommittee) is the Chairman.

The head of the medical organization or the deputy head (head of the structural subdivision) may be appointed as the chairman of the medical commission.

The chairmen of the subcommittees of the medical commission are appointed deputy heads (heads of structural divisions) of the medical organization.

The resolution of issues within the competence of the commission should be recorded in job description the indicated persons.

The chairman of the medical commission (subcommittee) is responsible for the activities of the medical commission (subcommittee), the timeliness, validity and objectivity of the decisions made.

Summing up, we list the documents that are drawn up for the work of the medical commission:

Order on the establishment of a medical commission and approval of its composition;

Order on approval of the Regulations on the medical commission (subcommittees);

Regulations on the medical commission (subcommittees);

Order on approval of the schedule of meetings of the medical commission (subcommittees).

Schedule of meetings of the medical commission (subcommittees);

Order on approval of the register of decisions of the medical commission (subcommittees);

Protocols of the medical commission;

Journal of records of decisions of the medical commission (subcommittees);

CREATION AND ACTIVITIES OF THE MEDICAL COMMISSION

MEDICAL ORGANIZATION

Judicial practice and legislation - Order of the Ministry of Health and Social Development of Russia dated May 5, 2012 N 502n (as amended on December 2, 2013) On approval of the procedure for the creation and activities of a medical commission of a medical organization

In accordance with the orders of the Ministry of Health and Social Development of Russia of April 12, 2011 N 302n and of May 5, 2012 N 502n, as well as the letter of the Department of Medical Education and Personnel Policy of the Ministry of Health of the Russian Federation of November 11, 2013 N 16-2 / 2106701 to the medical commission for the mandatory preliminary and periodic medical examinations of workers employed in hard work and in work with harmful and (or) dangerous working conditions, included an occupational pathologist and specialist doctors who have undergone advanced training in the specialty "Occupational pathology" in the prescribed manner or have a valid certificate in the specialty "Professional Pathology".

1. Approve the procedure for the creation and activities of the medical commission of a medical organization in accordance with the appendix.

CREATION AND ACTIVITIES OF THE MEDICAL COMMISSION

MEDICAL ORGANIZATION

5. The medical commission is created on the basis of the order of the head of the medical organization.

8. The medical commission (subcommittee of the medical commission) consists of a chairman, one or two deputy chairmen, a secretary and members of the commission.

9. The head of the medical organization or the deputy head (head of the structural unit) of the medical organization is appointed as the chairman of the medical commission, whose duties include resolving issues within the competence of the commission.

12. The composition of the medical commission and its subcommittees includes heads of structural divisions of the medical organization, medical specialists from among the employees of the medical organization.