The number limits applied to transplantation operations are related to the limited number of medical specialists and medical institutions performing the relevant medical services, including the material and technical base.
This was reported by the State Agency for Compulsory Medical Insurance in response to APA's request. It was noted that, in addition, due to the high rates of the mentioned services and the uncertainty of the current demand, the provision of unlimited coverage in the first year limits the prediction of the amount of insurance payments:
"This, in turn, creates a serious risk in the solvency of the compulsory health insurance fund. Taking into account the above, existing limits have been applied to the listed services."
It was reported that previously, limits were also applied to cochlear implantation and intra-articular endoprosthesis operations:
"Because the operations in question were performed only in private medical institutions. However, starting this year, these operations began to be performed in the Clinical Medical Center, Republican Clinical Hospital and New Clinic under TABIB, along with contracted medical institutions. The limits applied to cochlear implantation and intra-articular endoprosthesis operations have already been lifted. cancelled".
It should be recalled that in August 2023, 775 medical services were increased to 3315 in the 2550 Services Envelope of compulsory medical insurance. Tendon, muscle transplantation, bone marrow, kidney and liver transplantation operations have been added to the list of new services provided. An annual limit was applied only for liver, kidney and bone marrow transplantation among the operations in the Services Envelope. The limit number is 100, 150 and 20 respectively. During these transplant operations, the drug supply of the recipient (the person receiving the donor) is covered by the Service Envelope. Preparation and operation of a living donor for transplantation is included in the medical service tariff.
