The new Health Protection Act (Zakon o zdravstvenoj zaštiti “Official Gazette of RS“, no. 25/2019) and Health Insurance Act (Zakon o zdravstvenom osiguranju “Official Gazette of RS“, no. 25/2019) have come into force on 11 April 2019.
Status of health institutions
According to the Health Protection Act, the general legislation on corporates will apply also to the issues of governance, status changes, changes of legal form and liquidation of private health institutions.
The list of health institutions that cannot be privately owned (emergency medical assistance, provision of blood and blood products, harvesting, preservation and transplantation of human organs and parts of human bodies, production of serums and vaccines, and pathoanatomy and autopsy) is expanded to include health institutions providing forensic medicine service.
Health organisations can now be established also under the law on public-private partnership.
A new unique Register of Health Institutions should be established by the Serbian Agency for Business Registers before 11 October 2020. This Register will replace the current system where there is no unique register but health institutions are established by registration with competent commercial courts.
The Health Protection Act provides that a health care professional can enter into an agreement on supplementary work with his employer or with at most three other employers for maximally one third of full-time working hours. This is an exception to the general regime under the Employment Act, which permits supplementary work only with one other employer.
Health institutions will be able to enter into agreements to share resources (e.g. blood and blood components, diagnostics etc.) and health care professionals, with more flexible conditions for operating health institutions.
The Health Protection Act introduces the obligation to submit to targeted preventive examinations, i.e. screenings. An individual who fails to undergo a mandatory screening without justification will have to contribute towards maximum 35% of the total cost of health services if diagnosed before the next screening cycle begins.
In the current system, every health institution has its own waiting list. This will be replaced by a unique waiting list for all health institutions.
When the general practitioner refers a patient to a specialist, the specialist can further refer the patient for hospitalization or to another specialist, without the need for the patient to go back to the GP for those further referrals.
Healthcare professionals may not accept money or gifts, except for small non-monetary gifts in the individual value below 5% of average monthly net salary in Serbia or in the aggregate value not exceeding one average monthly net salary. It remains unclear whether the aggregate value of permitted gifts is calculated in relation to a single gift provider and/or single gift occasion, or in relation to all gifts received in a particular period (the reference period, if relevant at all, is not specified).
Sick child leave. In cases of serious medical condition of a child that is a minor, due to a traumatic damage of brain structure, malignant illness or other serious deterioration of child’s health condition, the second instance medical commission can extend the paid leave period every six months if necessary for the care of the child, for as long as the child does not turn 18. Until now, parents have been entitled to only four months of paid leave.
Sick leave. Sick leave can be approved by the employee’s chosen doctor for a period of up to 60 days, instead of 30 days so far. Sick leave beyond 60 days can be approved by a first-instance medical commission.
The new basis for calculating salary reimbursement in case of sick leave is the average salary that the employee has been receiving in the reference period of 12 (instead of three) months prior to the commencement of sick leave. For those who did not work for the entire 12-month period prior to the leave the basis will be an average calculated on the basis of their salary in those months they did work and the statutory minimum wage in those months they did not work.
Work-related injuries. The Health Insurance Act expands the notion of work-related injury to encompass injuries suffered while traveling to or from workplace. This means that individuals who are not covered by the compulsory health insurance but are merely covered with insurance against work-related injuries (volunteers, temporary workers, persons engaged via youth cooperatives, interns etc) will now be covered also against injuries suffered while commuting to and from work and enjoy the benefits of the compulsory health insurance.