Problems of legal regulation of payment for medical care in the field of compulsory medical insurance provided in excess of the allocated volume from the perspective of the patient and the medical organization (literature review).
Authors:   Kabardino-Balkarian State University named after Kh. M. Berbekov» Ministry of Education and Science of Russia, Akhokhova A. V. ,   Limited Liability Company Firm «SEM», Pshukova A. A. ,   Kabardino-Balkarian State University named after Kh. M. Berbekov» Ministry of Education and Science of Russia, Gazaeva A. М. ,   Kabardino-Balkarian State University named after Kh. M. Berbekov» Ministry of Education and Science of Russia, Nalchikova M. T. ,   Kabardino-Balkarian State University named after Kh. M. Berbekov» Ministry of Education and Science of Russia, Sabanchieva Kh.A. ,   Kabardino-Balkarian State University named after Kh. M. Berbekov» Ministry of Education and Science of Russia, Betuganova A. T. ,   GBU State Scientific Center FMBC named after. A. I. Burnazyan FMBA of Russia, Tlupova M. V. ,   Kabardino-Balkarian State University named after Kh. M. Berbekov» Ministry of Education and Science of Russia, Zalikhanova Z. M. ,   Kabardino-Balkarian State University named after Kh. M. Berbekov» Ministry of Education and Science of Russia, Gergova D. A. ,   Kabardino-Balkarian State University named after Kh. M. Berbekov» Ministry of Education and Science of Russia, Medalieva А.А. ,   RUDN University: Peoples' Friendship University of Russia
Published: February 2025

The article is devoted to a current topic – the study of issues of legal regulation of payment for medical services to medical organizations that implement them in accordance with the federal and territorial programs of state guarantees of free provision of medical care to citizens in excess of the allocated volume.
The purpose of this article is to analyze decisions and legal assessment of the current judicial practice on the issues of collection of funds for medical services provided in excess of the allocated volume from the perspective of the patient and the medical organization operating
in the field of compulsory medical insurance.
Materials and methods. The materials for the study were the works of Russian scientists devoted to the consideration of the grounds that served as the reason for the refusal to pay for medical care in excess of the allocated volume to medical organizations included in the unified register of medical organizations operating in the field of compulsory health insurance. The selection of research works and articles was carried out from electronic databases of the Scientific electronic library eLIBRARY.RU, the information and communication network «Internet» and the reference and legal system for the legislation of the Russian Federation LLC NPP «Garant-Service-University» for
the period of time since 2000 Until now. The research methods were: system analysis, comparison, systemic and integrated approaches, as well as the method of problem modeling.
Results. The authors analyzed decisions of judicial authorities on the issues of payment for medical care provided in excess of the allocated volume, including from the position of the Constitutional Court of the Russian Federation.An attempt has been made to summarize the current situation and formulate the point of view of a medical organization within the framework of the current legal regulation, taking into account the Review of judicial practice in cases related to the application of legislation on compulsory health insurance.
Conclusions. The analysis is intended to help resolve a conflict in which punishment for a medical organization is inevitable: from penalties in circumstances where the volume of medical care exceeds the planned level, to criminal liability in the event of refusal to provide it to patients. The emerging unfavorable trend for patients and medical organizations requires legal regulation, since the prospects of the impossibility of receiving medical care within the framework of the state guarantee program may become real.