A newspaper titled News reports on new rules governing paid medical care, which take effect on September 1 and run through 2026. The changes aim to streamline existing norms and make them clearer for ordinary citizens. In early August, some outlets suggested that ambulance arrivals could incur charges when there is no immediate life threat, but that claim is inaccurate.
Lawyers and experts reviewed the work rules and the roster of paid services that may apply under the new framework.
According to a government decree dated May 11, 2023 and numbered 736, information emerged that from September 1 ambulance doctors would bill for emergency care if there is no direct danger to the patient’s life. The document itself states that medical facilities operating under the compulsory medical insurance system have the right to offer paid services when patients request medical care beyond what is covered, except in cases mandated by Russian health law. Importantly, emergency services are not included in the paid services list.
The Ministry of Health of the Russian Federation has denied rumors about introducing paid medical care. All medical care and medications provided under the state guarantees program remain free of charge, and no changes to this policy are planned.
Lawyers and medical professionals caution that federal state guarantees secured by national law cannot be canceled by this decree. However, the rules may affect foreign nationals in some situations.
Previously, legislation regulating paid health services barred paid emergency and urgent care. The new decree removes that prohibition for paid emergency services, but emergency care itself becomes billable. As a result, budget medical organizations could charge foreign citizens for emergency assistance when appropriate.
Experts highlight several aims behind the new rules described in the decree. One objective is to relieve some of the burden on doctors, while another is to broaden access to additional services. The changes are framed as part of a broader shift in the health system, which includes telemedicine expansion and the introduction of new clinical guidelines.
The regulation on paid healthcare was updated after more than a decade, reflecting significant changes in practical care. The new document requires paid medical care to be provided in line with clinical guidelines approved by the Ministry of Health, a move that may influence diagnostic accuracy and the quality of treatment. It also clarifies longstanding legal disputes and adds important explanations.
Under the decree, medical institutions may charge for services in several scenarios. First, charges may apply when a patient requests a nonessential drug not funded from the budget and not indicated by vital signs. Second, paid services may cover medical products or specialized nutrition not included in government guarantees. In certain cases, charges may also be applied for individual nursing care that is not medically required.
Some experts voice concerns about the new framework. They point out that patients could be asked to pay for drugs not stocked by the facility and that refusing to disclose personal information might lead to payment for care. The department has not publicly disclosed the full need for a new regulation or answered all outstanding questions yet.
In previous statements, a physician has suggested that certain practices can help reduce risks associated with diabetes, though those comments are not linked to a formal policy update.