20 May 2021

What will the amendments to the Health Insurance Act bring?

The current Health Insurance Act (the “Act”) came into force in 2019.  However, earlier this year the National Assembly of the Republic of Serbia passed the Draft on Amendments to the Health Insurance Act (the “Draft“) was passed, and it was in public debate until the end of February.  Only the Draft that was at the public debate is publicly available, so we are waiting for the version of the text that will be sent to the Government, and then in the parliamentary procedure.

Reasons for introducing amendments

One of the reasons for the adoption of the Draft is certainly the intention to improve the electronic system in the field of health insurance.  It should be reminded that the Act contains provisions related to electronic registration and cancellation of registration, as well as changes in the registry records of the Republic Health Insurance Fund (RHIF).  However, the Draft also introduces an electronic system when it comes to exercising the right to salary compensation due to temporary incapacity for work due to illness or injury, which will be explained in more detail below.  In addition, these amendments bring the harmonization with the Program for Rare Diseases in the Republic of Serbia for the period 2020-2022 (the “Program“).  Finally, “certain valid provisions are defined in a more precise way, which enables the unambiguous application of certain legal solutions“.

Mainly, the Draft introduces innovations concerning sick leave certificates, rare diseases, health insurance for pregnant women and other innovations, and therefore represents a significant step in the improvement of health insurance in Serbia.

Sick leave certificates and establishing the loss of working ability

Namely, the Draft stipulates that the article referring to sick leave certificates should be changed in the Act.  Instead of the previous solution, which implies that the insured person, i.e., a member of his family in case of serious illness, submits a certificate of temporary incapacity for work to the employer, from now on this information is electronically submitted by the selected doctor to the employer.

The significance of this change is that it also leads to the fact that some provisions of the Labor Act cease to apply. Namely, in this case, the provisions of the Labor Act relating to the submission of a certificate of temporary incapacity for work and violation of work discipline if this obligation is not fulfilled shall cease to apply.

A similar change in the procedure is introduced by the Draft in case of determining the loss of working capacity.  Namely, the request will be submitted to the disability commission in the case of the necessary assessment of working ability, by the selected doctor electronically, but with the consent of the insured person.

Basis and method of calculating compensation

Employers need to know that the basis for calculating compensation is also changing. Namely, the previous solution envisaged as a basis the average salary that the employee earned in the previous 12 months. The Draft stipulates that the basis for calculation is salary and compensation earned in the previous 12 months.

Also, another change refers to the way the salary compensation is calculated.  Before the Draft, the obligation of calculation belonged to the employer, while the RHIF performed the control of calculation.  However, the Draft envisages that in the future, the RHIF itself will calculate the salary compensation on the basis of information received from the Tax Administration officially.  In that sense, the Draft envisages a relatively short period of only 15 days from the calculation in which the RHIF should pay the employer the salary compensation.

A more favorable solution for pregnant women

Namely, until now, the Act stipulated that female insured persons can only exercise the right to health care and reimbursement of transportation costs in connection with the use of health care in case of temporary incapacity for work due to illness or complications related to pregnancy when unpaid health insurance contributions.  However, the Draft envisages a more favorable solution according to which pregnant women in these cases exercise the rights from the obligatory health insurance, including the right to salary compensation.

Definition of rare diseases

The Draft defines rare diseases as “those diseases that affect less than five people per 10,000 inhabitants”.  This clear definition of rare diseases is in line with the Program.  Namely, the idea is to clearly define in the Draft what rare diseases are and for such a definition to be the basis for establishing a register of patients with rare diseases.

It can be concluded that the Draft brought changes that are significant for both employers and employees.  It remains to be seen whether the implementation of the Draft will lead to any doubts in practice.

Author: Mina Kuzminac