{"id":3227,"date":"2014-04-18T06:34:54","date_gmt":"2014-04-18T03:34:54","guid":{"rendered":"http:\/\/www.ced.org.tr\/?p=3227"},"modified":"2014-05-19T22:20:42","modified_gmt":"2014-05-19T19:20:42","slug":"genel-saglik-sigortasi-uygulamalari-yonetmeligi-yayimlandi","status":"publish","type":"post","link":"http:\/\/www.ced.org.tr\/?p=3227","title":{"rendered":"Genel Sa\u011fl\u0131k Sigortas\u0131 Uygulamalar\u0131 Y\u00f6netmeli\u011fi yay\u0131mland\u0131"},"content":{"rendered":"

Genel Sa\u011fl\u0131k Sigortas\u0131 Uygulamalar\u0131 Y\u00f6netmeli\u011fi 18.04.2014 tarih ve 28976 say\u0131l\u0131 Resmi Gazete\u2019de yay\u0131mland\u0131. <\/span><\/p>\n

Bu Y\u00f6netmeli\u011fin;<\/span><\/p>\n

a) 32 ve 33 \u00fcnc\u00fc maddeleri 1\/1\/2014 tarihinden ge\u00e7erli olmak \u00fczere yay\u0131m\u0131 tarihinde,<\/span><\/p>\n

b) Di\u011fer maddeleri ise yay\u0131m\u0131 tarihinde,<\/span><\/p>\n

y\u00fcr\u00fcrl\u00fc\u011fe girer.<\/span><\/p>\n

<\/p>\n

http:\/\/www.resmigazete.gov.tr\/eskiler\/2014\/04\/20140418-16.htm<\/a><\/span><\/p>\n

GENEL SA\u011eLIK S\u0130GORTASI UYGULAMALARI Y\u00d6NETMEL\u0130\u011e\u0130<\/p>\n

B\u0130R\u0130NC\u0130\u00a0B\u00d6L\u00dcM<\/p>\n

Ama\u00e7, Kapsam, Dayanak, Tan\u0131mlar ve Genel\u00a0\u0130lkeler<\/p>\n

Ama<\/b>\u00e7<\/b><\/b><\/p>\n

MADDE 1\u00a0<\/b>\u2013<\/b>\u00a0(1) Bu Y\u00f6netmeli\u011fin amac\u0131, 31\/5\/2006 tarihli ve 5510 say\u0131l\u0131\u00a0Sosyal Sigortalar ve Genel Sa\u011fl\u0131k Sigortas\u0131\u00a0Kanununun genel sa\u011fl\u0131k sigortas\u0131\u00a0uygulamalar\u0131na ili\u015fkin usul ve esaslar\u0131n\u0131\u00a0d\u00fczenlemektir.<\/p>\n

Kapsam<\/b><\/p>\n

MADDE 2\u00a0<\/b>\u2013<\/b>\u00a0(1) Bu Y\u00f6netmelik; genel sa\u011fl\u0131k sigortas\u0131ndan yararland\u0131r\u0131lacak ki\u015fileri, i\u015fverenleri, sa\u011fl\u0131k hizmeti sunucular\u0131n\u0131, ger\u00e7ek ki\u015fileri, her t\u00fcrl\u00fc\u00a0kamu ve\u00a0\u00f6zel hukuk t\u00fczel ki\u015fileri ile bunlar\u0131n t\u00fczel ki\u015fili\u011fi olmayan\u015fubelerini kapsar.<\/p>\n

Dayanak<\/b><\/p>\n

MADDE 3\u00a0<\/b>\u2013<\/b>\u00a0(1) Bu Y\u00f6netmelik, 5510 say\u0131l\u0131\u00a0Kanunun 107 nci maddesi h\u00fckm\u00fcne dayan\u0131larak haz\u0131rlanm\u0131\u015ft\u0131r.<\/p>\n

Tan<\/b>\u0131<\/b>mlar<\/b><\/p>\n

MADDE 4\u00a0<\/b>\u2013<\/b>\u00a0(1) Bu Y\u00f6netmelikte ge\u00e7en;<\/p>\n

a) Aile hekimi: Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u00a0taraf\u0131ndan aile hekimi olarak yetkilendirilen ve\/veya Kurum ile s\u00f6zle\u015fme yapm\u0131\u015f\u00a0hekimleri,<\/p>\n

b) Asgari\u00a0\u00fccret: 22\/5\/2003 tarihli ve 4857 say\u0131l\u0131\u00a0\u0130\u015f\u00a0Kanununun 39 uncu maddesi gere\u011fi\u00a0\u00c7al\u0131\u015fma ve Sosyal G\u00fcvenlik Bakanl\u0131\u011f\u0131nca Asgari\u00a0\u00dccret Tespit Komisyonu arac\u0131l\u0131\u011f\u0131\u00a0ile i\u015f\u00e7iler i\u00e7in belirlenen bir ayl\u0131k br\u00fct\u00a0\u00fccreti,<\/p>\n

c) Ayakta tedavi: Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin, sa\u011fl\u0131k hizmeti sunucular\u0131nda yat\u0131r\u0131lmaks\u0131z\u0131n ayakta sa\u011flanan sa\u011fl\u0131k hizmetlerini,<\/p>\n

\u00e7) Ayl\u0131k: Malull\u00fck, ya\u015fl\u0131l\u0131k ve\u00a0\u00f6l\u00fcm sigortalar\u0131\u00a0ile vazife malull\u00fc\u011f\u00fc\u00a0h\u00e2linde yap\u0131lan s\u00fcrekli\u00a0\u00f6demeyi,<\/p>\n

d) Bakanl\u0131k:\u00a0\u00c7al\u0131\u015fma ve Sosyal G\u00fcvenlik Bakanl\u0131\u011f\u0131n\u0131,<\/p>\n

e) Bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015fi: 5510 say\u0131l\u0131\u00a0Kanunun 5 inci maddesinin birinci f\u0131kras\u0131n\u0131n (b) bendi ile 60\u0131nc\u0131\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (c) bendinin (1), (2) ve (7) numaral\u0131\u00a0alt bentleri ile yedinci ve sekizinci f\u0131kralar\u0131d\u0131\u015f\u0131nda kalan genel sa\u011fl\u0131k sigortal\u0131s\u0131n\u0131n, sigortal\u0131\u00a0say\u0131lmayan veya iste\u011fe ba\u011fl\u0131\u00a0sigortal\u0131\u00a0olmayan, kendi sigortal\u0131l\u0131\u011f\u0131nedeniyle gelir veya ayl\u0131k ba\u011flanmam\u0131\u015f\u00a0olan;<\/p>\n

1) E\u015fini,<\/p>\n

2) 18 ya\u015f\u0131n\u0131, lise ve dengi\u00a0\u00f6\u011frenim veya 5\/6\/1986 tarihli ve 3308 say\u0131l\u0131\u00a0Meslek\u00ee\u00a0E\u011fitim Kanununda belirtilen aday\u00a0\u00e7\u0131rakl\u0131k ve\u00a0\u00e7\u0131rakl\u0131k e\u011fitimi ile i\u015fletmelerde meslek\u00ee\u00a0e\u011fitim g\u00f6rmesi h\u00e2linde 20 ya\u015f\u0131n\u0131, y\u00fcksek\u00a0\u00f6\u011frenim g\u00f6rmesi h\u00e2linde 25 ya\u015f\u0131n\u0131\u00a0doldurmam\u0131\u015f\u00a0ve evli olmayan\u00a0\u00e7ocuklar\u0131\u00a0ile ya\u015f\u0131na bak\u0131lmaks\u0131z\u0131n bu Kanuna g\u00f6re malul oldu\u011fu tespit edilen evli olmayan\u00a0\u00e7ocuklar\u0131n\u0131,<\/p>\n

3) Ge\u00e7imi genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0taraf\u0131ndan sa\u011flanan, Genel Sa\u011fl\u0131k Sigortas\u0131\u00a0Kapsam\u0131nda Gelir Tespiti, Tescil ve\u00a0\u0130zleme S\u00fcrecine\u00a0\u0130li\u015fkin Usul ve Esaslar Hakk\u0131nda Y\u00f6netmelik uyar\u0131nca yap\u0131lan gelir testi sonucunda 5510 say\u0131l\u0131\u00a0Kanunun 60\u00a0\u0131nc\u0131\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (c) bendinin 1 numaral\u0131\u00a0alt bendi ve ayn\u0131\u00a0f\u0131kran\u0131n (g) bendi kapsam\u0131nda olup da aile i\u00e7inde fert ba\u015f\u0131na d\u00fc\u015fen gelir miktar\u0131\u00a0asgari\u00a0\u00fccrete kadar oldu\u011fu tespit edilen ve di\u011fer\u00e7ocuklar\u0131ndan sa\u011fl\u0131k yard\u0131m\u0131\u00a0almayan ana ve babas\u0131n\u0131,<\/p>\n

f) Fatura: Sa\u011fl\u0131k hizmeti sunucusu taraf\u0131ndan sunulan sa\u011fl\u0131k hizmeti sonucunda, 4\/1\/1961 tarihli ve 213 say\u0131l\u0131Vergi Usul Kanunu h\u00fck\u00fcmleri uyar\u0131nca d\u00fczenlenen fatura, serbest meslek makbuzu, bilet, perakende sat\u0131\u015f\u00a0fi\u015fi ile kamu idarelerinin ilgili mevzuat\u0131na g\u00f6re d\u00fczenledikleri belgeleri,<\/p>\n

g) Fatura d\u00f6nemi: Her ay\u0131n birinci ve son g\u00fcn\u00fcn\u00fc\u00a0kapsayan d\u00f6nemi,<\/p>\n

\u011f) Fatura teslim s\u00fcresi: Fatura d\u00f6nemini takip eden ay\u0131n birinci g\u00fcn\u00fcnden onbe\u015finci g\u00fcn\u00fcne (onbe\u015finci g\u00fcn d\u00e2hil) onbe\u015finci g\u00fcn resm\u00ee\u00a0tatil ise takip eden ilk i\u015f\u00a0g\u00fcn\u00fcne kadarki s\u00fcreyi,<\/p>\n

h) Fatura teslim tarihi: Fatura teslim s\u00fcresi i\u00e7inde teslim edilen faturalar i\u00e7in teslim edildi\u011fi ay\u0131n onbe\u015finci g\u00fcn\u00fcn\u00fc, fatura teslim s\u00fcresi i\u00e7inde teslim edilmeyen faturalar i\u00e7in teslim edildi\u011fi ay\u0131\u00a0takip eden ay\u0131n onbe\u015finci g\u00fcn\u00fcn\u00fc,<\/p>\n

\u0131) Gelir:\u00a0\u0130\u015f\u00a0kazas\u0131\u00a0veya meslek hastal\u0131\u011f\u0131\u00a0h\u00e2linde sigortal\u0131ya veya sigortal\u0131n\u0131n\u00a0\u00f6l\u00fcm\u00fc\u00a0h\u00e2linde hak sahiplerine yap\u0131lan s\u00fcrekli\u00a0\u00f6demeyi,<\/p>\n

i) Genel M\u00fcd\u00fcrl\u00fck: Sosyal G\u00fcvenlik Kurumu Genel Sa\u011fl\u0131k Sigortas\u0131\u00a0Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fcn\u00fc,<\/p>\n

j)\u00a0\u00a0Genel sa\u011fl\u0131k sigortal\u0131s\u0131: 5510 say\u0131l\u0131\u00a0Kanunun 60\u00a0\u0131nc\u0131\u00a0maddesinde say\u0131lan ki\u015fileri,<\/p>\n

k) Genel sa\u011fl\u0131k sigortas\u0131: Ki\u015filerin\u00a0\u00f6ncelikle sa\u011fl\u0131klar\u0131n\u0131n korunmas\u0131n\u0131, sa\u011fl\u0131k riskleri ile kar\u015f\u0131la\u015fmalar\u0131h\u00e2linde ise olu\u015fan harcamalar\u0131n finansman\u0131n\u0131\u00a0sa\u011flayan sigortay\u0131,<\/p>\n

l) Genel sa\u011fl\u0131k sigortas\u0131\u00a0primi: Genel sa\u011fl\u0131k sigortas\u0131ndan yararlanabilmek i\u00e7in prim\u00a0\u00f6deme y\u00fck\u00fcml\u00fcs\u00fctaraf\u0131ndan\u00a0\u00f6denecek olan ve prime esas kazan\u00e7\u00a0\u00fczerinden Kanunda belirtilen oranlarda belirlenen tutar\u0131,<\/p>\n

m) Hizmet akdi: 11\/1\/2011 tarihli ve 6098 say\u0131l\u0131\u00a0T\u00fcrk Bor\u00e7lar Kanununda tan\u0131mlanan hizmet akdini ve i\u015fmevzuat\u0131nda tan\u0131mlanan i\u015f\u00a0s\u00f6zle\u015fmesini veya hizmet akdini,<\/p>\n

n)\u00a0\u0130ste\u011fe ba\u011fl\u0131\u00a0sigorta: Ki\u015filerin iste\u011fe ba\u011fl\u0131\u00a0olarak prim\u00a0\u00f6demek suretiyle uzun vadeli sigorta kollar\u0131na ve genel sa\u011fl\u0131k sigortas\u0131na tabi olmalar\u0131n\u0131\u00a0sa\u011flayan sigorta kolunu,<\/p>\n

o)\u00a0\u0130\u015fveren: Kanunun 4\u00a0\u00fcnc\u00fc\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (a) ve (c) bentlerine g\u00f6re sigortal\u0131\u00a0say\u0131lan ki\u015fileri\u00e7al\u0131\u015ft\u0131ran ger\u00e7ek veya t\u00fczel ki\u015filer ile t\u00fczel ki\u015fili\u011fi olmayan kurum ve kurulu\u015flar\u0131,<\/p>\n

\u00f6)\u00a0\u0130yile\u015ftirme ara\u00e7\u00a0ve gere\u00e7leri: Protez ve ortez tan\u0131m\u0131na girmeyen, tek ba\u015f\u0131na iyile\u015ftirme\u00a0\u00f6zelli\u011fi olan iyile\u015ftirici nitelikteki t\u0131bb\u00ee\u00a0cihazlar\u0131,<\/p>\n

p) Kamu idareleri: 10\/12\/2003 tarihli ve 5018 say\u0131l\u0131\u00a0Kamu Mal\u00ee\u00a0Y\u00f6netimi ve Kontrol Kanununun 3\u00a0\u00fcnc\u00fcmaddesinin birinci f\u0131kras\u0131n\u0131n (a) bendinde belirtilen kamu idareleri ve kamu iktisadi te\u015febb\u00fcsleri ile bunlar\u0131n ba\u011fl\u0131idare, ortakl\u0131k, m\u00fcessese ve i\u015fletmeleri ve yukar\u0131da belirtilenlerin\u00a0\u00f6denmi\u015f\u00a0sermayesinin % 50\u2019sinden fazlas\u0131na sahip olduklar\u0131\u00a0ortakl\u0131k ve i\u015fletmelerden T\u00fcrk Ticaret Kanununa tabi olmayanlarla\u00a0\u00f6zel kanunlar\u0131na g\u00f6re personel\u00a0\u00e7al\u0131\u015ft\u0131ran di\u011fer kamu kurumlar\u0131n\u0131,<\/p>\n

r) Kanun: 5510 say\u0131l\u0131\u00a0Sosyal Sigortalar ve Genel Sa\u011fl\u0131k Sigortas\u0131\u00a0Kanununu,<\/p>\n

s) Kat\u0131l\u0131m pay\u0131: Sa\u011fl\u0131k hizmetlerinden yararlanabilmek i\u00e7in, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0veya bakmakla y\u00fck\u00fcml\u00fcoldu\u011fu ki\u015filer taraf\u0131ndan\u00a0\u00f6denecek tutar\u0131,<\/p>\n

\u015f) K\u0131sa vadeli sigorta kollar\u0131:\u00a0\u0130\u015f\u00a0kazas\u0131\u00a0ve meslek hastal\u0131\u011f\u0131, hastal\u0131k ve anal\u0131k sigortas\u0131\u00a0kollar\u0131n\u0131,<\/p>\n

t) Ki\u015fiye y\u00f6nelik koruyucu sa\u011fl\u0131k hizmeti: Ki\u015filerin, hastal\u0131ktan korunmas\u0131\u00a0veya sa\u011fl\u0131kl\u0131\u00a0olma h\u00e2linin s\u00fcrd\u00fcr\u00fclmesi amac\u0131yla ki\u015fiye y\u00f6nelik olarak finansman\u0131\u00a0sa\u011flanacak sa\u011fl\u0131k hizmetlerini,<\/p>\n

u) Kurum: Sosyal G\u00fcvenlik Kurumunu,<\/p>\n

\u00fc) Kurum Sa\u011fl\u0131k Kurulu: Kurumca yetkilendirilen sa\u011fl\u0131k hizmeti sunucular\u0131n\u0131n sa\u011fl\u0131k kurullar\u0131nca d\u00fczenlenecek raporlardaki te\u015fhis ve bu te\u015fhise dayanak te\u015fkil eden belgeleri incelemek suretiyle,\u00a0\u00e7al\u0131\u015fma g\u00fcc\u00fc\u00a0kayb\u0131ve meslekte kazanma g\u00fcc\u00fc\u00a0kayb\u0131\u00a0oranlar\u0131n\u0131, erken ya\u015flanma h\u00e2lini, vazifelerini yapamayacak\u00a0\u015fekilde meslekte kazanma g\u00fcc\u00fc\u00a0kayb\u0131n\u0131\u00a0ve malull\u00fck derecelerini belirlemeye yetkili hekimlerden ve\/veya di\u015f\u00a0hekimlerinden olu\u015fan kurullar\u0131n\u0131,<\/p>\n

v) Misyon\u00a0\u015fefli\u011fi: Genel sa\u011fl\u0131k sigortal\u0131s\u0131n\u0131n ge\u00e7ici veya s\u00fcrekli g\u00f6revle bulundu\u011fu, tetkikin\/ tedavinin yap\u0131ld\u0131\u011f\u0131\u00a0\u00fclkedeki b\u00fcy\u00fckel\u00e7ilik, daimi temsilcilik, ba\u015fkonsolosluk ve konsolosluk\u00a0\u015fubesi olarak, ayn\u0131\u00a0\u00fclkede veya\u015fehirde birden fazla temsilcilik bulunmas\u0131\u00a0h\u00e2linde ise b\u00fcy\u00fckel\u00e7ilik taraf\u0131ndan bu i\u015fle yetkili k\u0131l\u0131nan temsilci\u011fi ile\u00e7al\u0131\u015fma ata\u015felikleri ve m\u00fc\u015favirlikleri,<\/p>\n

y) Mutat ta\u015f\u0131t:\u00a0\u0130ki mahal aras\u0131nda gidip gelmeye en uygun, kullan\u0131lmas\u0131\u00a0mutat ve ekonomik olan ta\u015f\u0131tlar\u0131,<\/p>\n

z) Ortez: Do\u011fu\u015ftan veya sonradan herhangi bir nedenle bir organda olu\u015fan fonksiyon kayb\u0131n\u0131\u00a0veya yetersizli\u011fini\u00a0\u00f6nlemek ya da v\u00fccut par\u00e7alar\u0131ndan birini desteklemek veya korumak amac\u0131yla kullan\u0131lan t\u0131bb\u00ee\u00a0cihazlar\u0131,<\/p>\n

aa) Otelcilik hizmeti: Yatarak tedavilerde hasta ve refakat\u00e7isine Kurumca belirlenen standartlar\u0131n\u00a0\u00fczerinde sunulan yatak, yemek, temizlik vb. hizmetleri,<\/p>\n

bb)\u00a0\u00d6deme d\u00f6nemi: Sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0faturalar\u0131n\u0131n teslim tarihinden itibaren inceleme ve\u00a0\u00f6demenin ger\u00e7ekle\u015ftirildi\u011fi doksan g\u00fcnl\u00fck s\u00fcreyi,<\/p>\n

cc)\u00a0\u00d6deme Komisyonu: Be\u015feri t\u0131bbi\u00a0\u00fcr\u00fcnlerin\/be\u015feri ila\u00e7lar\u0131n\u00a0\u00f6deme usul ve esaslar\u0131n\u0131n belirlenmesi hususunda, Sosyal G\u00fcvenlik Kurumu Ba\u015fkanl\u0131\u011f\u0131n\u0131n koordinat\u00f6rl\u00fc\u011f\u00fcnde Maliye Bakanl\u0131\u011f\u0131, Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131, Kalk\u0131nma Bakanl\u0131\u011f\u0131\u00a0ve Hazine M\u00fcste\u015farl\u0131\u011f\u0131\u00a0temsilcilerinin kat\u0131l\u0131m\u0131yla olu\u015fturulan komisyonu,<\/p>\n

\u00e7\u00e7) Protez: Do\u011fu\u015ftan ya da sonradan herhangi bir nedenle v\u00fccut organlar\u0131ndan bir veya bir ka\u00e7\u0131n\u0131n tam veya k\u0131smi kayb\u0131nda, o organ veya organlar\u0131n fonksiyonlar\u0131n\u0131\u00a0yerine getirmek ve\/veya g\u00f6rsel olarak v\u00fccut b\u00fct\u00fcnl\u00fc\u011f\u00fcn\u00fcsa\u011flamaya y\u00f6nelik t\u0131bb\u00ee\u00a0cihazlar\u0131,<\/p>\n

dd) Sa\u011fl\u0131k hizmeti: Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filere Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesi gere\u011fi finansman\u0131\u00a0sa\u011flanacak t\u0131bb\u00ee\u00a0\u00fcr\u00fcn ve hizmetleri,<\/p>\n

ee) Sa\u011fl\u0131k hizmeti sunucusu: Sa\u011fl\u0131k hizmetini sunan ve\/veya\u00a0\u00fcreten; ger\u00e7ek ki\u015filer ile kamu ve\u00a0\u00f6zel hukuk t\u00fczel ki\u015filerini ve bunlar\u0131n t\u00fczel ki\u015fili\u011fi olmayan\u00a0\u015fubelerini,<\/p>\n

ff) Sa\u011fl\u0131k Hizmetleri Fiyatland\u0131rma Komisyonu: Kurumca finansman\u0131\u00a0sa\u011flanan sa\u011fl\u0131k hizmetleri ile yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri i\u00e7in Kurumca\u00a0\u00f6denecek bedelleri belirleyen komisyonu,<\/p>\n

gg) Sa\u011fl\u0131k raporu: Uzman hekim raporunu\/sa\u011fl\u0131k kurulu raporunu,<\/p>\n

\u011f\u011f) Uzman hekim raporu:\u00a0\u0130lgili tek uzman hekim taraf\u0131ndan d\u00fczenlenen ba\u015fhekimlik m\u00fchr\u00fc\u00a0ve\u00a0\u0131slak imza onay\u0131\u00a0bulunan sa\u011fl\u0131k raporunu veya elektronik ortamda d\u00fczenlenen e-raporunu,<\/p>\n

hh) Sa\u011fl\u0131k kurulu raporu:\u00a0\u0130lgili daldan\u00a0\u00fc\u00e7\u00a0uzman hekimin kat\u0131l\u0131m\u0131yla, ayn\u0131\u00a0daldan\u00a0\u00fc\u00e7\u00a0uzman hekim bulunmamas\u0131\u00a0h\u00e2linde ise ilgili dal uzman\u0131\u00a0ile birlikte\u00a0\u00f6ncelikle bu uzmanl\u0131k dal\u0131na en yak\u0131n uzmanl\u0131k dal\u0131ndan olmak\u00fczere ba\u015fhekimin se\u00e7ece\u011fi di\u011fer dallardan uzman hekimlerin kat\u0131l\u0131m\u0131\u00a0ile en az\u00a0\u00fc\u00e7\u00a0uzman hekimden olu\u015fan sa\u011fl\u0131k kurullar\u0131nca d\u00fczenlenen, ba\u015fhekimlik m\u00fchr\u00fc\u00a0ve\u00a0\u0131slak imza onay\u0131\u00a0bulunan sa\u011fl\u0131k raporunu veya elektronik ortamda d\u00fczenlenen e-raporunu,<\/p>\n

\u0131\u0131) S\u0131\u011f\u0131nmac\u0131\u00a0ve vatans\u0131z:\u00a0\u0130\u00e7i\u015fleri Bakanl\u0131\u011f\u0131\u00a0taraf\u0131ndan s\u0131\u011f\u0131nmac\u0131\u00a0veya vatans\u0131z olarak kabul edilen ki\u015fileri,<\/p>\n

ii) Sigortal\u0131: K\u0131sa ve\/veya uzun vadeli sigorta kollar\u0131\u00a0bak\u0131m\u0131ndan ad\u0131na prim\u00a0\u00f6denmesi gereken veya kendi ad\u0131na prim\u00a0\u00f6demesi gereken ki\u015fiyi,<\/p>\n

jj) Sosyal sigortalar: Kanunda tan\u0131mlanan k\u0131sa ve uzun vadeli sigorta kollar\u0131n\u0131,<\/p>\n

kk) Tebli\u011f: Kanunun genel sa\u011fl\u0131k sigortas\u0131na ili\u015fkin h\u00fck\u00fcmlerinin uygulanmas\u0131n\u0131\u00a0i\u00e7eren Sosyal G\u00fcvenlik Kurumu Sa\u011fl\u0131k Uygulama Tebli\u011fini,<\/p>\n

ll) T\u0131bben ba\u015fkas\u0131n\u0131n bak\u0131m\u0131na muhta\u00e7\u00a0ki\u015filer: Engellilik\u00a0\u00d6l\u00e7\u00fct\u00fc, S\u0131n\u0131fland\u0131r\u0131lmas\u0131\u00a0ve Engellilere Verilecek Sa\u011fl\u0131k Kurulu Raporlar\u0131\u00a0Hakk\u0131nda Y\u00f6netmelik kapsam\u0131nda, yetkilendirilmi\u015f\u00a0engelli sa\u011fl\u0131k kurulu raporu vermeye yetkili sa\u011fl\u0131k kurulu\u015flar\u0131nca, a\u011f\u0131r engelli oldu\u011fu engelli sa\u011fl\u0131k kurulu raporu ile belgelendirilen ki\u015fileri,<\/p>\n

mm) T\u0131bb\u00ee\u00a0cihaz: 7\/6\/2011 tarihli ve 27957 say\u0131l\u0131\u00a0Resm\u00ee\u00a0Gazete\u2019de yay\u0131mlanan T\u0131bb\u00ee\u00a0Cihaz Y\u00f6netmeli\u011finde tan\u0131mlanan her t\u00fcrl\u00fc\u00a0ara\u00e7, gere\u00e7, alet, cihaz, ki\u015fi kullan\u0131m\u0131na mahsus cihaz, aksesuar veya di\u011fer malzemeleri,<\/p>\n

nn) T\u0131bb\u00ee\u00a0sarf malzemesi: Protez ve ortez tan\u0131m\u0131na girmeyen, iyile\u015ftirmeyi tek ba\u015f\u0131na sa\u011flamayan, te\u015fhis, tedavi ve bak\u0131m ama\u00e7l\u0131\u00a0i\u015flemlerin yap\u0131lmas\u0131\u00a0esnas\u0131nda tek sefer ya da s\u0131n\u0131rl\u0131\u00a0say\u0131da kullan\u0131lmaya mahsus t\u0131bb\u00eemalzemeleri,<\/p>\n

oo) Uluslararas\u0131\u00a0sosyal g\u00fcvenlik s\u00f6zle\u015fmeleri:\u00a0\u00dclkemizin taraf oldu\u011fu sosyal g\u00fcvenlik s\u00f6zle\u015fmelerini,<\/p>\n

\u00f6\u00f6) Uzun vadeli sigorta kollar\u0131: Malull\u00fck, ya\u015fl\u0131l\u0131k ve\u00a0\u00f6l\u00fcm sigortas\u0131\u00a0kollar\u0131n\u0131,<\/p>\n

pp)\u00a0\u00dccret: Kanunun 4\u00a0\u00fcnc\u00fc\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (a) ve (c) bendi kapsam\u0131nda sigortal\u0131\u00a0say\u0131lanlara saatlik, g\u00fcnl\u00fck, haftal\u0131k, ayl\u0131k veya y\u0131ll\u0131k olarak para ile\u00a0\u00f6denen ve s\u00fcreklilik niteli\u011fi ta\u015f\u0131yan br\u00fct tutar\u0131,<\/p>\n

rr)\u00a0\u00dcnite: Sosyal g\u00fcvenlik il m\u00fcd\u00fcrl\u00fckleri ile sosyal g\u00fcvenlik merkez m\u00fcd\u00fcrl\u00fcklerini ve sa\u011fl\u0131k sosyal g\u00fcvenlik merkez m\u00fcd\u00fcrl\u00fcklerini,<\/p>\n

ss) Vazife malull\u00fc\u011f\u00fc: Kanunun 47 nci maddesinde tarif edilen vazife ve\/veya harp malull\u00fc\u011f\u00fc\u00a0h\u00e2llerini,<\/p>\n

\u015f\u015f) Yatarak tedavi: Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin, sa\u011fl\u0131k hizmeti sunucusunda yat\u0131r\u0131larak sa\u011flanan sa\u011fl\u0131k hizmetlerini,<\/p>\n

tt) Yerle\u015fim yeri: Belediye\/b\u00fcy\u00fck\u015fehir belediye m\u00fccavir alan\u0131n\u0131,<\/p>\n

ifade eder.<\/p>\n

Genel ilkeler<\/b><\/p>\n

MADDE 5\u00a0<\/b>\u2013<\/b>\u00a0(1) Kanunun 60\u00a0\u0131nc\u0131\u00a0maddesinde say\u0131lan ki\u015filerin genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0olmas\u0131\u00a0zorunludur. Genel sa\u011fl\u0131k sigortas\u0131\u00a0hak ve y\u00fck\u00fcml\u00fcl\u00fcklerini ortadan kald\u0131rmak, azaltmak veya ba\u015fkas\u0131na devretmek i\u00e7in s\u00f6zle\u015fmelere konulan h\u00fck\u00fcmler ge\u00e7ersizdir.<\/p>\n

(2) Genel sa\u011fl\u0131k sigortas\u0131\u00a0kapsam\u0131nda finansman\u0131\u00a0sa\u011flanan sa\u011fl\u0131k hizmetleri ile yol gideri, g\u00fcndelik ve refakat\u00e7i haklar\u0131ndan, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer yararland\u0131r\u0131l\u0131r.<\/p>\n

(3) Genel sa\u011fl\u0131k sigortas\u0131\u00a0kapsam\u0131nda finansman\u0131\u00a0sa\u011flanan sa\u011fl\u0131k hizmetleri ile yol gideri, g\u00fcndelik ve refakat\u00e7i haklar\u0131ndan yararlanmak, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer i\u00e7in bir hak, bu Y\u00f6netmelikte belirtilen usul ve esaslara g\u00f6re bu hizmet ve haklar\u0131n finansman\u0131n\u0131n sa\u011flanmas\u0131\u00a0Kurum i\u00e7in bir y\u00fck\u00fcml\u00fcl\u00fckt\u00fcr. Genel sa\u011fl\u0131k sigortas\u0131\u00a0kapsam\u0131nda finansman\u0131\u00a0sa\u011flanan sa\u011fl\u0131k hizmetleri ile yol gideri, g\u00fcndelik ve refakat\u00e7i haklar\u0131nda, ki\u015filerden al\u0131nan primlerin tutar\u0131na g\u00f6re herhangi bir farkl\u0131la\u015ft\u0131rma yap\u0131lamaz.<\/p>\n

\u0130K\u0130NC\u0130\u00a0B\u00d6L\u00dcM<\/p>\n

Sa\u011fl\u0131k Kart\u0131<\/p>\n

Sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k kart<\/b>\u0131<\/b>\u00a0d<\/b>\u00fc<\/b>zenlenmesi<\/b><\/p>\n

MADDE 6\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurum, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin muayene ve tedavileri i\u00e7in sa\u011fl\u0131k hizmeti sunucular\u0131na ba\u015fvurular\u0131nda g\u00f6sterilmek\u00a0\u00fczere sa\u011fl\u0131k kart\u0131\u00a0d\u00fczenleyebilir.<\/p>\n

(2) Kurum, sa\u011fl\u0131k kart\u0131n\u0131n\u00a0\u015feklini, bu kart\u0131n kullan\u0131m\u0131na ili\u015fkin usul ve esaslar\u0131\u00a0belirler.<\/p>\n

\u00dc\u00c7\u00dcNC\u00dc\u00a0B\u00d6L\u00dcM<\/p>\n

Finansman\u0131\u00a0Sa\u011flanan Sa\u011fl\u0131k Hizmetlerinin Belirlenmesi ve Sa\u011flanma Y\u00f6ntemleri,<\/p>\n

Yol Gideri, G\u00fcndelik ve Refakat\u00e7i Giderleri<\/p>\n

Finansman<\/b>\u0131<\/b>\u00a0sa<\/b>\u011f<\/b>lanan sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetlerinin amac<\/b>\u0131<\/b>\u00a0ve kapsam<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 7\u00a0<\/b>\u2013<\/b>\u00a0(1) Genel sa\u011fl\u0131k sigortal\u0131s\u0131n\u0131n ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin sa\u011fl\u0131kl\u0131\u00a0kalmalar\u0131; hastalanmalar\u0131\u00a0h\u00e2linde sa\u011fl\u0131klar\u0131n\u0131\u00a0kazanmalar\u0131; i\u015f\u00a0kazas\u0131\u00a0ile meslek hastal\u0131\u011f\u0131, hastal\u0131k ve anal\u0131k sonucu t\u0131bben gerekli g\u00f6r\u00fclen sa\u011fl\u0131k hizmetlerinin kar\u015f\u0131lanmas\u0131, i\u015f\u00a0g\u00f6remezlik h\u00e2llerinin ortadan kald\u0131r\u0131lmas\u0131\u00a0veya azalt\u0131lmas\u0131, i\u015f\u00a0kazas\u0131\u00a0ve meslek hastal\u0131\u011f\u0131na, kazaya, hastal\u0131klara veya konjenital (do\u011fu\u015ftan) nedenlere ba\u011fl\u0131\u00a0olarak ortaya\u00a0\u00e7\u0131kan durumlarda v\u00fccut b\u00fct\u00fcnl\u00fc\u011f\u00fcn\u00fcn sa\u011flanmas\u0131\u00a0amac\u0131yla Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (a), (b), (c), (d), (e) ve (f) bentlerinde say\u0131lan sa\u011fl\u0131k hizmetlerinin finansman\u0131\u00a0Kurumca sa\u011flan\u0131r.<\/p>\n

Finansman<\/b>\u0131<\/b>\u00a0sa<\/b>\u011f<\/b>lanan sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetlerinin belirlenmesi<\/b><\/p>\n

MADDE 8\u00a0<\/b>\u2013<\/b>\u00a0(1) Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (a), (b), (c), (d) ve (e) bentleri gere\u011fi finansman\u0131\u00a0sa\u011flanacak sa\u011fl\u0131k hizmetleri, Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca t\u0131bben sa\u011fl\u0131k hizmeti olarak kabul edilen sa\u011fl\u0131k hizmetleri esas al\u0131narak Kurumca belirlenir.<\/p>\n

(2)\u00a0\u0130nsan sa\u011fl\u0131\u011f\u0131na zararl\u0131\u00a0madde ba\u011f\u0131ml\u0131l\u0131\u011f\u0131n\u0131\u00a0\u00f6nlemeye y\u00f6nelik koruyucu sa\u011fl\u0131k hizmetleri, Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131n\u0131n g\u00f6r\u00fc\u015f\u00fc\u00a0al\u0131narak Kurumca belirlenir.<\/p>\n

Finansman<\/b>\u0131<\/b>\u00a0sa<\/b>\u011f<\/b>lanan di<\/b>\u011f<\/b>er sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetlerinin belirlenmesi<\/b><\/p>\n

MADDE 9\u00a0<\/b>\u2013<\/b>\u00a0(1) Bu Y\u00f6netmeli\u011fin 8 inci maddesi do\u011frultusunda sa\u011flanacak sa\u011fl\u0131k hizmetleri ile ilgili te\u015fhis ve tedavileri i\u00e7in gerekli olabilecek kan ve kan\u00a0\u00fcr\u00fcnleri, kemik ili\u011fi, a\u015f\u0131, ila\u00e7\u00a0ve t\u0131bbi malzemelerin sa\u011flanmas\u0131, tak\u0131lmas\u0131, garanti s\u00fcresi sonras\u0131\u00a0bak\u0131m\u0131, onar\u0131lmas\u0131\u00a0ve yenilenmesi hizmetlerinin, t\u00fcrleri, miktarlar\u0131\u00a0ve kullan\u0131m s\u00fcreleri,\u00a0\u00f6deme usul ve esaslar\u0131, Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131n\u0131n g\u00f6r\u00fc\u015f\u00fc\u00a0al\u0131narak Kurumca belirlenir.<\/p>\n

Finansman<\/b>\u0131<\/b>\u00a0sa<\/b>\u011f<\/b>lanan ila<\/b>\u00e7<\/b>lar<\/b>\u0131<\/b>n temin esaslar<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 10\u00a0<\/b>\u2013<\/b>\u00a0(1) Yatarak tedavilerde sa\u011fl\u0131k hizmeti sunucular\u0131nda kullan\u0131lacak ila\u00e7lar\u0131n tedavinin yap\u0131ld\u0131\u011f\u0131sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0taraf\u0131ndan temin edilir. Ancak Kurum, yatarak tedavilerde tedavinin yap\u0131ld\u0131\u011f\u0131\u00a0sa\u011fl\u0131k hizmeti sunucusunca temin zorunlulu\u011fu olmayan istisnai durumlara ili\u015fkin usul ve esaslar ile temini zorunlu ila\u00e7lar\u0131n sa\u011fl\u0131k hizmeti sunucular\u0131nca temin edilmeyerek hastaya ald\u0131r\u0131lmas\u0131\u00a0halinde y\u00fcr\u00fct\u00fclecek i\u015flemlere ili\u015fkin usul ve esaslar\u0131belirler.<\/p>\n

(2) Kurumca finansman\u0131\u00a0sa\u011flanan ve ayaktan tedavilerde gerekli g\u00f6r\u00fclen ila\u00e7lar, Kurumla s\u00f6zle\u015fmeli eczanelerden temin edilir. Ancak, acil h\u00e2ller nedeniyle genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin s\u00f6zle\u015fmesiz eczanelerden re\u00e7ete kar\u015f\u0131l\u0131\u011f\u0131\u00a0temin etti\u011fi ila\u00e7lar\u0131n bedelleri, acil h\u00e2lin Kurumca kabul olunmas\u0131\u00a0kayd\u0131yla Tebli\u011f\u00a0esaslar\u0131na g\u00f6re ki\u015filere\u00a0\u00f6denir.<\/p>\n

(3) Kurum, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ile bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin tedavisi i\u00e7in gerekli g\u00f6r\u00fclen ancak,\u00fclkemizde ruhsatl\u0131\u00a0olmayan veya ruhsatl\u0131\u00a0oldu\u011fu h\u00e2lde\u00a0\u00e7e\u015fitli nedenlerle\u00a0\u00fcretilmeyen veya ithalat\u0131\u00a0yap\u0131lmayan ila\u00e7lar\u0131n yurt d\u0131\u015f\u0131ndan teminine ili\u015fkin usul ve esaslar\u0131, Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131n\u0131n g\u00f6r\u00fc\u015f\u00fcn\u00fc\u00a0alarak belirler.<\/p>\n

Finansman<\/b>\u0131<\/b>\u00a0sa<\/b>\u011f<\/b>lanan t<\/b>\u0131<\/b>bb<\/b>\u00ee<\/b>\u00a0malzemelerin temin esaslar<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 11\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurum t\u0131bbi malzemeleri sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0ile s\u00f6zle\u015fme yapmak suretiyle sa\u011flar. Ancak acil hallerde s\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmeti sunucular\u0131ndan ki\u015filerce sat\u0131n al\u0131nan t\u0131bbi malzeme bedelleri Kurumca belirlenen usul ve esaslara g\u00f6re kar\u015f\u0131lan\u0131r.<\/p>\n

(2) Yatarak tedavilerde sa\u011fl\u0131k hizmeti sunucular\u0131nda kullan\u0131lacak t\u0131bbi malzemeler sa\u011fl\u0131k hizmeti sunucular\u0131taraf\u0131ndan temin edilir. Kurum, temini zorunlu t\u0131bbi malzemelerin sa\u011fl\u0131k hizmeti sunucular\u0131nca temin edilmeyerek hastaya ald\u0131r\u0131lmas\u0131\u00a0halinde t\u0131bbi malzemelerin\u00a0\u00f6denmesine ili\u015fkin usul ve esaslar\u0131\u00a0belirler.<\/p>\n

(3) Kurumca bedeli kar\u015f\u0131lanan t\u0131bbi malzemelerin, Kurumca belirlenen istisnalar hari\u00e7\u00a0olmak\u00a0\u00fczere T\u00fcrkiye\u0130la\u00e7\u00a0ve T\u0131bbi Cihaz Ulusal Bilgi Bankas\u0131na (T\u0130TUBB) kay\u0131t\/bildirim i\u015flemi tamamlanm\u0131\u015f\u00a0olmal\u0131d\u0131r.\u00a0\u00a0T\u0130TUBB kay\u0131t\/bildirim i\u015flemi tamamlanmam\u0131\u015f\u00a0t\u0131bbi malzeme bedelleri Kurumca kar\u015f\u0131lanmaz. Ancak 7\/6\/2011 tarihli ve 27957 say\u0131l\u0131\u00a0Resm\u00ee\u00a0Gazete\u2019de yay\u0131mlanan T\u0131bbi Cihaz Y\u00f6netmeli\u011fi kapsam\u0131nda yer almayan t\u0131bbi malzeme bedellerinin\u00f6denmesinde; T\u0130TUBB kay\u0131t\/bildirim i\u015flemi tamamlanm\u0131\u015f\u00a0olma\u00a0\u015fart\u0131\u00a0aranmaz.<\/p>\n

(4) Kurum, finansman\u0131\u00a0sa\u011flanan t\u0131bb\u00ee\u00a0malzemeleri Kurumca belirlenen usullerle temin etmeye yetkilidir.<\/p>\n

(5) 12\/4\/1991 tarihli ve 3713 say\u0131l\u0131\u00a0Ter\u00f6rle M\u00fccadele Kanuna g\u00f6re ayl\u0131k ba\u011flanm\u0131\u015f\u00a0malullerin, 8\/6\/1949 tarihli ve 5434 say\u0131l\u0131\u00a0Kanunun 56 nc\u0131\u00a0maddesi veya 3\/11\/1980 tarihli ve 2330 say\u0131l\u0131\u00a0Kanunun 2 nci maddesinin birinci f\u0131kras\u0131n\u0131n (e) ve (f) bentlerinde say\u0131lanlardan 3713 say\u0131l\u0131\u00a0Kanun kapsam\u0131na giren olaylar sebebiyle malul kal\u0131p da ayl\u0131k ba\u011flananlar\u0131n ve 3713 say\u0131l\u0131\u00a0Kanun kapsam\u0131na girmese dahi ba\u015fkas\u0131n\u0131n yard\u0131m\u0131\u00a0ve deste\u011fi olmaks\u0131z\u0131n ya\u015famak i\u00e7in gereken hareketleri yapamayacak derecede malul olan vazife ve harp malullerinin; sa\u011fl\u0131k kurulu raporuyla kullanmalar\u0131\u00a0gerekli g\u00f6r\u00fclen her t\u00fcrl\u00fc\u00a0ortez\/protez ve di\u011fer iyile\u015ftirici ara\u00e7\u00a0ve gere\u00e7ler, herhangi bir k\u0131s\u0131tlama getirilmeksizin Kurumca kar\u015f\u0131lan\u0131r. Kanunun 72 nci maddesinde belirtilen usullere g\u00f6re bedelleri kar\u015f\u0131lanacak olan bu kapsamdaki\u00a0\u00fcr\u00fcnler veya ayn\u0131\u00a0amaca y\u00f6nelik yeni\u00a0\u00fcr\u00fcn talepleri Kurum taraf\u0131ndan belirlenen usul ve esaslara g\u00f6re kar\u015f\u0131lan\u0131r. Bu f\u0131kra h\u00fck\u00fcmleri, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ile bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerden, 3713 say\u0131l\u0131\u00a0Kanunun 21 inci maddesinde say\u0131lan olaylara maruz kalmalar\u0131\u00a0nedeniyle yaralananlar\u0131n, tedavileri sonu\u00e7lan\u0131ncaya veya maluliyetleri kesinle\u015finceye kadar ge\u00e7en s\u00fcre i\u00e7erisinde de uygulan\u0131r.<\/p>\n

Di<\/b>\u011f<\/b>er sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetlerinin temin esaslar<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 12\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurum sa\u011fl\u0131k hizmetlerini, Kanunun 3\u00a0\u00fcnc\u00fc\u00a0maddesinin 25 inci bendinde ve Kanunun 63\u00fcnc\u00fc\u00a0maddesinin (f) bendinde tan\u0131mlanan yurt i\u00e7i ve yurt d\u0131\u015f\u0131\u00a0sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0ile Kanunun 73 maddesine g\u00f6re s\u00f6zle\u015fme yap\u0131l\u0131ncaya kadar Kurum taraf\u0131ndan belirlenmi\u015f\u00a0olan usul ve esaslar ge\u00e7erlidir. Ancak acil hallerde s\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmeti sunucular\u0131ndan ki\u015filerce sat\u0131n al\u0131nan sa\u011fl\u0131k hizmeti bedelleri Kurumca belirlenen usul ve esaslara g\u00f6re kar\u015f\u0131lan\u0131r.<\/p>\n

(2) Kurum, kamu idarelerince verilecek sa\u011fl\u0131k hizmetlerini g\u00f6t\u00fcr\u00fc\u00a0bedel\u00a0\u00fczerinden hizmet al\u0131m s\u00f6zle\u015fmesiyle de sa\u011flar. Kamu idaresi sa\u011fl\u0131k hizmeti sunucular\u0131, s\u00f6zle\u015fmede belirtilen g\u00f6t\u00fcr\u00fc\u00a0bedel kar\u015f\u0131l\u0131\u011f\u0131nda genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filere s\u00f6zle\u015fme kapsam\u0131nda verilmesi gereken her t\u00fcrl\u00fc\u00a0sa\u011fl\u0131k hizmetini sunar. S\u00f6z konusu sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0s\u00f6zle\u015fmede belirtilen g\u00f6t\u00fcr\u00fc\u00a0bedel d\u0131\u015f\u0131nda Kurumdan veya genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerden ilave\u00a0\u00fccret al\u0131nabilecek hizmetler ve kat\u0131l\u0131m paylar\u0131\u00a0d\u0131\u015f\u0131nda ayr\u0131ca bir bedel talep edemez. G\u00f6t\u00fcr\u00fc\u00a0bedele ili\u015fkin usul ve esaslar Kurum ve ilgili kamu idareleri ile m\u00fc\u015ftereken belirlenir.<\/p>\n

Yard<\/b>\u0131<\/b>mc<\/b>\u0131<\/b>\u00a0<\/b>\u00fc<\/b>reme y<\/b>\u00f6<\/b>ntemi tedavileri<\/b><\/p>\n

MADDE 13\u00a0<\/b>\u2013<\/b>\u00a0(1)\u00a0\u0130nvitro fertilizasyon (IVF) i\u015flemi, Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesinde tan\u0131mlanan\u00a0\u201cyard\u0131mc\u0131\u00fcreme y\u00f6ntemi\u201d\u00a0olarak kabul edilir. Ovulasyon ind\u00fcksiyonu (OI) ile intrauterin inseminasyonu (IUI) i\u015flemi bu kapsamda de\u011ferlendirilmez.<\/p>\n

(2) Kurumca;<\/p>\n

a) Evli olmakla birlikte\u00a0\u00e7ocuk sahibi olmayan genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0kad\u0131n ise kendisinin, erkek ise kar\u0131s\u0131n\u0131n;<\/p>\n

1) Yap\u0131lan t\u0131bb\u00ee\u00a0tedavileri sonras\u0131nda normal t\u0131bb\u00ee\u00a0y\u00f6ntemlerle\u00a0\u00e7ocuk sahibi olamad\u0131\u011f\u0131n\u0131n ve ancak IVF i\u015flemi ile\u00a0\u00e7ocuk sahibi olabilece\u011fine dair Kurumca yetkilendirilen sa\u011fl\u0131k hizmet sunucular\u0131nca sa\u011fl\u0131k kurulu raporu d\u00fczenlenmi\u015f\u00a0olmas\u0131,<\/p>\n

2) 23 ya\u015f\u0131ndan b\u00fcy\u00fck, 39 ya\u015f\u0131ndan k\u00fc\u00e7\u00fck olmas\u0131,<\/p>\n

3) Kurumca belirlenen istisnalar hari\u00e7\u00a0olmak\u00a0\u00fczere son\u00a0\u00fc\u00e7\u00a0y\u0131l i\u00e7inde OI ve\/veya IUI i\u015fleminden sonu\u00e7al\u0131namam\u0131\u015f\u00a0oldu\u011funun Kurumla s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmet sunucusunun sa\u011fl\u0131k kurullar\u0131\u00a0taraf\u0131ndan belgelenmesi,<\/p>\n

4) Uygulaman\u0131n yap\u0131ld\u0131\u011f\u0131\u00a0merkezin Kurum ile s\u00f6zle\u015fmeli olmas\u0131,<\/p>\n

5) En az be\u015f\u00a0y\u0131ld\u0131r genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0veya bakmakla y\u00fck\u00fcml\u00fc\u00a0olunan ki\u015fi olup, 900 g\u00fcn genel sa\u011fl\u0131k sigortas\u0131\u00a0prim g\u00fcn say\u0131s\u0131n\u0131n olmas\u0131\u00a0veya halen genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0olan kad\u0131n\u0131n bu bentteki ko\u015fullar\u0131\u00a0ta\u015f\u0131mamas\u0131halinde e\u015finin gerekli ko\u015fullar\u0131\u00a0sa\u011flamas\u0131,<\/p>\n

\u015fartlar\u0131n\u0131n birlikte ger\u00e7ekle\u015fmesi h\u00e2linde en fazla Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesinde belirtilen deneme say\u0131s\u0131\u00a0ile s\u0131n\u0131rl\u0131\u00a0olmak\u00a0\u00fczere IVF i\u015fleminin,<\/p>\n

b) Bir hastal\u0131\u011f\u0131n tedavisinin ba\u015fka t\u0131bb\u00ee\u00a0bir y\u00f6ntemle m\u00fcmk\u00fcn olmamas\u0131\u00a0ve Kurumca yetkilendirilen sa\u011fl\u0131k hizmet sunucular\u0131\u00a0sa\u011fl\u0131k kurullar\u0131\u00a0taraf\u0131ndan t\u0131bben zorunlu g\u00f6r\u00fclmesi h\u00e2linde IVF i\u015fleminin,<\/p>\n

finansman\u0131\u00a0sa\u011flan\u0131r.<\/p>\n

(3) Kanunun y\u00fcr\u00fcrl\u00fc\u011fe girdi\u011fi tarihten\u00a0\u00f6nce yap\u0131lan ve bedelleri sosyal g\u00fcvenlik kurumlar\u0131nca\u00a0\u00f6denen IVF i\u015flemleri, i\u015flem adedinin hesaplanmas\u0131nda dikkate al\u0131n\u0131r.<\/p>\n

(4) IVF i\u015flemine, 38 ya\u015f\u0131n\u0131\u00a0doldurmadan\u00a0\u00f6nce ba\u015flanan kad\u0131n\u0131n deneme\u00a0\u00f6ncesi 38 ya\u015f\u0131n\u0131\u00a0doldurmu\u015f\u00a0olmas\u0131durumunda, IVF i\u015flemine ait bedeller Kurumca kar\u015f\u0131lan\u0131r.<\/p>\n

(5) IVF i\u015fleminde kullan\u0131lan ila\u00e7lardan kat\u0131l\u0131m pay\u0131\u00a0tahsil edilir.<\/p>\n

Finansman<\/b>\u0131<\/b>\u00a0sa<\/b>\u011f<\/b>lanmayan sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetleri<\/b><\/p>\n

MADDE 14\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurumca;<\/p>\n

a) V\u00fccut b\u00fct\u00fcnl\u00fc\u011f\u00fcn\u00fc\u00a0sa\u011flamak amac\u0131na y\u00f6nelik protezler ile fonksiyon kayb\u0131n\u0131\u00a0gidermeye y\u00f6nelik yap\u0131lan ve i\u015f\u00a0kazas\u0131\u00a0ile meslek hastal\u0131\u011f\u0131na, kazaya, hastal\u0131klara veya konjenital nedenlere ba\u011fl\u0131\u00a0olarak ortaya\u00a0\u00e7\u0131kan durumlarda yap\u0131lacak sa\u011fl\u0131k hizmetleri d\u0131\u015f\u0131nda estetik ama\u00e7l\u0131\u00a0yap\u0131lan her t\u00fcrl\u00fc\u00a0sa\u011fl\u0131k hizmeti ile estetik ama\u00e7l\u0131ortodontik di\u015f\u00a0tedavilerinin,<\/p>\n

b) Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca insan sa\u011fl\u0131\u011f\u0131\u00a0bak\u0131m\u0131ndan kullan\u0131lmas\u0131na veya uygulanmas\u0131na izin veya ruhsat verilmeyen sa\u011fl\u0131k hizmetlerinin,<\/p>\n

c) Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca t\u0131bben sa\u011fl\u0131k hizmeti oldu\u011fu kabul edilmeyen sa\u011fl\u0131k hizmetlerinin,<\/p>\n

\u00e7) Kanunun 60\u00a0\u0131nc\u0131\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (d) ve (g) bentleri kapsam\u0131na giren yabanc\u0131\u00a0\u00fclke vatanda\u015flar\u0131n\u0131n genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0veya genel sa\u011fl\u0131k sigortal\u0131s\u0131n\u0131n bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015fi say\u0131ld\u0131\u011f\u0131tarihten\u00a0\u00f6nce var olan kronik hastal\u0131\u011fa ili\u015fkin sa\u011fl\u0131k hizmetlerinin,<\/p>\n

d) Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesine g\u00f6re y\u00f6ntem, t\u00fcr, miktar ve kullan\u0131m s\u00fcrelerinin belirlenmesi sonucunda Kurumca finansman\u0131\u00a0sa\u011flanacak sa\u011fl\u0131k hizmetlerinin kapsam\u0131\u00a0d\u0131\u015f\u0131nda b\u0131rak\u0131lan sa\u011fl\u0131k hizmetlerinin,<\/p>\n

finansman\u0131\u00a0sa\u011flanmaz.<\/p>\n

Komisyonlar<\/b><\/p>\n

MADDE 15\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurum, finansman\u0131\u00a0sa\u011flanan sa\u011fl\u0131k hizmetlerinin te\u015fhis ve tedavi y\u00f6ntemleri ile te\u015fhis ve tedavileri i\u00e7in gerekli olabilecek kan ve kan\u00a0\u00fcr\u00fcnleri, kemik ili\u011fi, a\u015f\u0131, ila\u00e7, ortez, protez, t\u0131bb\u00ee\u00a0ara\u00e7\u00a0ve gere\u00e7, ki\u015fi kullan\u0131m\u0131na mahsus t\u0131bb\u00ee\u00a0cihaz, t\u0131bb\u00ee\u00a0sarf, iyile\u015ftirici nitelikteki t\u0131bb\u00ee\u00a0sarf malzemelerinin sa\u011flanmas\u0131, tak\u0131lmas\u0131, garanti s\u00fcresi sonras\u0131\u00a0bak\u0131m\u0131, onar\u0131lmas\u0131\u00a0ve yenilenmesi hizmetlerinin t\u00fcrlerinin, miktarlar\u0131n\u0131n ve kullan\u0131m s\u00fcrelerinin,\u00a0\u00f6deme usul ve esaslar\u0131n\u0131n belirlenmesine y\u00f6nelik olarak komisyonlar kurabilir,\u00a0\u00fcniversiteler, ulusal ve uluslararas\u0131\u00a0t\u00fczel ki\u015filerle i\u015fbirli\u011fi yapabilir.<\/p>\n

(2) Komisyonlar\u0131n g\u00f6rev ve yetkileri ile\u00a0\u00e7al\u0131\u015fma usul ve esaslar\u0131\u00a0Maliye Bakanl\u0131\u011f\u0131\u00a0ile Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131n\u0131n g\u00f6r\u00fc\u015f\u00fc\u00a0al\u0131narak Kurumca belirlenir.<\/p>\n

Yol gideri, g<\/b>\u00fc<\/b>ndelik ve refakat<\/b>\u00e7<\/b>i giderleri<\/b><\/p>\n

MADDE 16\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurumca finansman\u0131\u00a0sa\u011flanan sa\u011fl\u0131k hizmetlerine ili\u015fkin yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri i\u00e7in\u00a0\u00f6denecek tutarlar Sa\u011fl\u0131k Hizmetleri Fiyatland\u0131rma Komisyonu taraf\u0131ndan belirlenir.<\/p>\n

(2) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin yatarak tedavileri s\u0131ras\u0131nda hekimin veya di\u015f\u00a0hekiminin t\u0131bben g\u00f6rece\u011fi l\u00fczum\u00a0\u00fczerine yan\u0131nda kalan refakat\u00e7inin yatak ve yemek giderleri, bir ki\u015fi ile s\u0131n\u0131rl\u0131olmak\u00a0\u00fczere Kurumca kar\u015f\u0131lan\u0131r. 18 ya\u015f\u0131n\u0131\u00a0doldurmam\u0131\u015f\u00a0\u00e7ocuklar i\u00e7in refakat\u00e7i kal\u0131nmas\u0131n\u0131n t\u0131bben l\u00fczum g\u00f6r\u00fclmesi\u015fart\u0131\u00a0aranmaz.<\/p>\n

(3) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin, m\u00fcracaat ettikleri s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucusunda yap\u0131lan hekim veya di\u015f\u00a0hekiminin muayenesi veya tedavisi sonras\u0131nda, t\u0131bb\u00ee\u00a0veya zorunlu nedenlerle yerle\u015fim yeri d\u0131\u015f\u0131na yap\u0131lan sevklere ili\u015fkin yol ve g\u00fcndelik gideri;<\/p>\n

a) Sevkin Kurumca istenilen bilgi ve onaylar\u0131n yer ald\u0131\u011f\u0131\u00a0belge ile veya elektronik ortamda yap\u0131lm\u0131\u015f\u00a0olmas\u0131,<\/p>\n

b) Sevkin Kurumca belirlenecek istisnalar hari\u00e7\u00a0olmak\u00a0\u00fczere ikinci veya\u00a0\u00fc\u00e7\u00fcnc\u00fc\u00a0basamak sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0taraf\u0131ndan yap\u0131lm\u0131\u015f\u00a0olmas\u0131,<\/p>\n

c) Sevk tarihi itibariyle be\u015f\u00a0i\u015f\u00a0g\u00fcn\u00fc\u00a0i\u00e7inde sevk edilen sa\u011fl\u0131k hizmeti sunucusuna m\u00fcracaat edilmi\u015f\u00a0olunmas\u0131,<\/p>\n

halinde Kurumca kar\u015f\u0131lan\u0131r.<\/p>\n

(4)\u00a0\u00dc\u00e7\u00fcnc\u00fc\u00a0f\u0131krada belirtilen esaslara uygun olarak yerle\u015fim yeri d\u0131\u015f\u0131na yap\u0131lan sevklere ili\u015fkin yol gideri; sa\u011fl\u0131k hizmetinin sa\u011flanabildi\u011fi en yak\u0131n sa\u011fl\u0131k hizmeti sunucusunun bulundu\u011fu yerle\u015fim yeri esas al\u0131narak\u00a0\u00f6denir. Ki\u015finin daha uzak bir yerle\u015fim yerindeki sa\u011fl\u0131k hizmeti sunucusuna gitmesi h\u00e2linde olu\u015facak yol gideri fark\u0131Kurumca kar\u015f\u0131lanmaz. Ancak Kurumca belirlenecek baz\u0131\u00a0\u00f6zel durum ve hastal\u0131klar i\u00e7in sevk edilen yerle\u015fim yerine g\u00f6re\u00a0\u00f6deme yap\u0131l\u0131r.<\/p>\n

(5) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0veya bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filere refakat eden kimselere bir ki\u015fiyle s\u0131n\u0131rl\u0131olmak\u00a0\u00fczere yol ve g\u00fcndelik gideri, sevki d\u00fczenleyen sa\u011fl\u0131k hizmeti sunucusu hekimi veya di\u015f\u00a0hekimi taraf\u0131ndan refakatin t\u0131bben l\u00fczumlu veya gerekli g\u00f6r\u00fclmesi ve sevk ile m\u00fcracaat edilen sa\u011fl\u0131k hizmeti sunucusuna refakat\u00e7i e\u015fli\u011finde gelindi\u011finin ve\/veya kal\u0131nd\u0131\u011f\u0131n\u0131n belirtilmi\u015f\u00a0olmas\u0131\u00a0halinde\u00a0\u00f6denir. Ancak 18 ya\u015f\u0131n\u0131\u00a0doldurmam\u0131\u015f\u00e7ocuklar\u0131n sevklerinde refakat\u00e7i e\u015fli\u011finde g\u00f6nderilmesinin t\u0131bben l\u00fczumlu veya gerekli g\u00f6r\u00fclme\u00a0\u015fart\u0131\u00a0aranmaz.<\/p>\n

(6) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0veya bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin\u00a0\u00fc\u00e7\u00fcnc\u00fc\u00a0f\u0131krada belirtilen esaslara uygun olarak yerle\u015fim yeri d\u0131\u015f\u0131na yap\u0131lan sevklerinde;<\/p>\n

a) Ayakta tedavilerde, hasta ve refakat\u00e7isine gidi\u015f\u00a0ve d\u00f6n\u00fc\u015f\u00a0tarihleri i\u00e7in yol gideri, sevk edildikleri sa\u011fl\u0131k hizmeti sunucusuna m\u00fcracaat tarihi ile tedavinin sona erdi\u011fi tarihler aras\u0131nda istirahatli olunan s\u00fcreler hari\u00e7\u00a0olmak\u00fczere g\u00fcndelikleri,<\/p>\n

b) Yatarak tedavilerde, kendisinin ve refakat\u00e7isinin gidi\u015f\u00a0ve d\u00f6n\u00fc\u015f\u00a0tarihleri i\u00e7in g\u00fcndelikleri ile yol gideri,<\/p>\n

Kurumca kar\u015f\u0131lan\u0131r.<\/p>\n

c) Yatarak tedavilerde, hasta ve bir ki\u015fi ile s\u0131n\u0131rl\u0131\u00a0olmak\u00a0\u00fczere hastaya refakati t\u0131bben uygun g\u00f6r\u00fclen refakat\u00e7inin yatak ve yemek gideri sa\u011fl\u0131k hizmeti sunucusu taraf\u0131ndan faturaland\u0131r\u0131ld\u0131\u011f\u0131ndan ayr\u0131ca\u00a0\u015fahsa\u00a0\u00f6deme yap\u0131lmaz.<\/p>\n

(7) Kemoterapi, radyoterapi, diyaliz gibi belli bir program\u00a0\u00e7er\u00e7evesinde tedavi g\u00f6ren genel sa\u011fl\u0131k sigortal\u0131s\u0131ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin bu tedavileri i\u00e7in d\u00fczenlenen ilk sevk belgesine istinaden tedavilerinin devam\u0131niteli\u011findeki di\u011fer m\u00fcracaatlar\u0131\u00a0nedeniyle yol gideri, g\u00fcndelik ve refakat\u00e7i giderlerinin\u00a0\u00f6denmesinde her gidi\u015fleri i\u00e7in sevk belgesi aranmaz.\u00a0\u00d6deme i\u015flemleri, ilk sevk belgesine istinaden di\u011fer m\u00fcracaatlara ili\u015fkin tedavi g\u00f6rd\u00fc\u011f\u00fctarihleri belirtir m\u00fcracaat edilen sa\u011fl\u0131k hizmeti sunucusunca d\u00fczenlenecek belge do\u011frultusunda y\u00fcr\u00fct\u00fcl\u00fcr. Belli bir program\u00a0\u00e7er\u00e7evesinde yer alacak di\u011fer hastal\u0131klar Kurum taraf\u0131ndan belirlenir.<\/p>\n

(8) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0veya bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin yerle\u015fim yeri d\u0131\u015f\u0131ndaki sa\u011fl\u0131k hizmeti sunucusuna yap\u0131lan sevklerinde;<\/p>\n

a) Sevk belgesinde sevk vas\u0131tas\u0131\u00a0belirtilmemi\u015f\u00a0ise mutat ta\u015f\u0131t\u00a0\u00fccreti\u00a0\u00f6denir.<\/p>\n

b) Ki\u015filerin\u00a0\u00f6zel ara\u00e7lar\u0131\u00a0ile sa\u011fl\u0131k hizmeti sunucusuna gidi\u015f\u00a0ve d\u00f6n\u00fc\u015fleri i\u00e7in mutat ta\u015f\u0131t\u00a0\u00fccreti\u00a0\u00f6denir.<\/p>\n

c) Yerle\u015fim yeri d\u0131\u015f\u0131ndaki sa\u011fl\u0131k hizmeti sunucusuna mutat ta\u015f\u0131t d\u0131\u015f\u0131ndaki ta\u015f\u0131tla nakline ili\u015fkin bedellerin\u00f6denebilmesi i\u00e7in bu durumun gereklili\u011finin sa\u011fl\u0131k kurulu raporu ile belgelenmesi ve raporda ta\u015f\u0131t tipinin belirtilmesi gerekir.<\/p>\n

\u00e7) Mutat ta\u015f\u0131t d\u0131\u015f\u0131\u00a0ara\u00e7lar\u00a0\u00a0(tarifeli u\u00e7ak, taksi, ambulans vb.) ile nakile ili\u015fkin yol gideri\u00a0\u00f6demelerinde bilet veya fatura ibraz\u0131\u00a0\u015fartt\u0131r. Bilet veya fatura ibraz edilememesi halinde yol gideri mutat ta\u015f\u0131t bedeli\u00a0\u00fczerinden\u00a0\u00f6denir.<\/p>\n

d) Kurum veya Kurumun ta\u015fra birimleri, yerle\u015fim yeri d\u0131\u015f\u0131ndan Kurumca belirlenen hastal\u0131klar\u0131n tedavileri i\u00e7in gidip gelen ve yol gideri kar\u015f\u0131lanan ki\u015filerin ula\u015f\u0131m hizmetlerini gerekli g\u00f6rd\u00fc\u011f\u00fc\u00a0hallerde Kurum yarar\u0131do\u011frultusunda hizmet sat\u0131n alma ve kiralama gibi usullerle temin etmeye yetkilidir.<\/p>\n

(9) Yerle\u015fim yeri d\u0131\u015f\u0131ndaki sa\u011fl\u0131k hizmeti sunucusuna sevk edilen, ancak yap\u0131lan tedavilere ra\u011fmen vefat eden genel sa\u011fl\u0131k sigortal\u0131lar\u0131n\u0131n cenaze nakline ili\u015fkin giderler;<\/p>\n

a) Sevkin d\u00fczenlendi\u011fi sa\u011fl\u0131k hizmeti sunucusunun bulundu\u011fu yerle\u015fim yeri mesafesini a\u015fmamak\u00a0\u00fczere nakledilen yerle\u015fim yeri esas al\u0131narak\u00a0\u00f6denir.<\/p>\n

b) Sevk edilmeksizin m\u00fcracaat edilen sa\u011fl\u0131k hizmeti sunucusunda vefat eden ki\u015filerin cenaze nakline ili\u015fkin giderler Kurumca kar\u015f\u0131lanmaz.<\/p>\n

c) Cenaze nakline ili\u015fkin giderleri, 23\/7\/1965 tarihli ve 657 say\u0131l\u0131\u00a0Devlet Memurlar\u0131\u00a0Kanununun 210 uncu maddesi gere\u011fi ilgili kamu idaresince kar\u015f\u0131lanmas\u0131\u00a0gereken ki\u015filere, cenaze nakli i\u00e7in Kurumca\u00a0\u00f6deme yap\u0131lmaz.<\/p>\n

(10) Kurum taraf\u0131ndan s\u00fcrekli i\u015f\u00a0g\u00f6remezlik veya malull\u00fck durumlar\u0131n\u0131n tespiti ve\/veya kontrol\u00fc\u00a0ile Kanunun 94\u00a0\u00fcnc\u00fc\u00a0maddesi gere\u011fince gerekli g\u00f6r\u00fclen kontrol muayeneleri i\u00e7in ki\u015filerin yerle\u015fim yeri d\u0131\u015f\u0131ndaki sa\u011fl\u0131k hizmeti sunucular\u0131na yap\u0131lan sevklere ili\u015fkin yol, g\u00fcndelik ve refakat\u00e7i giderleri Kurumca kar\u015f\u0131lan\u0131r. Ayr\u0131ca bu sevkler i\u00e7in\u00fc\u00e7\u00fcnc\u00fc\u00a0f\u0131krada yer alan m\u00fcracaat s\u00fcreleri uygulanmaz.<\/p>\n

(11) Uzun ve k\u0131sa vadeli sigorta kollar\u0131\u00a0bak\u0131m\u0131ndan s\u00fcrekli i\u015f\u00a0g\u00f6remezlik, malull\u00fck,\u00a0\u00e7al\u0131\u015fma g\u00fcc\u00fc\u00a0kayb\u0131h\u00e2llerinin tespiti veya bu ama\u00e7la yap\u0131lan kontroller nedeniyle olu\u015fan sa\u011fl\u0131k hizmeti giderleri ile sa\u011fl\u0131k hizmeti sunucusuna yap\u0131lan sevkler nedeniyle\u00a0\u00f6denecek yol, g\u00fcndelik ve refakat\u00e7i giderleri, k\u0131sa ve uzun vadeli sigorta kollar\u0131\u00a0prim gelirlerinden kar\u015f\u0131lan\u0131r.<\/p>\n

(12) Kanunun 66 nc\u0131\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (c) bendi ile ikinci f\u0131kras\u0131\u00a0kapsam\u0131nda yurtd\u0131\u015f\u0131na tetkik veya tedavi amac\u0131yla yap\u0131lacak sevklerde yol, g\u00fcndelik ve refakat\u00e7i giderlerinin\u00a0\u00f6denmesinde bu madde h\u00fck\u00fcmleri uygulan\u0131r. Bu ki\u015filerin tedavisi s\u0131ras\u0131nda\u00a0\u00f6l\u00fcm\u00fc\u00a0halinde, cenazesinin nakil gideri ile varsa refakat\u00e7isinin yurda d\u00f6n\u00fc\u015fyol giderleri de Kurumca kar\u015f\u0131lan\u0131r.<\/p>\n

(13) S\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmeti sunucusu taraf\u0131ndan yap\u0131lan sevklere ili\u015fkin yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri, sevkin acil hal nedeniyle yap\u0131lm\u0131\u015f\u00a0olmas\u0131\u00a0ve Kurumca kabul edilmesi halinde\u00a0\u00f6denir.<\/p>\n

(14) Sevk yap\u0131lmaks\u0131z\u0131n yerle\u015fim yeri d\u0131\u015f\u0131ndaki bir sa\u011fl\u0131k hizmeti sunucusundan sa\u011fl\u0131k hizmeti al\u0131nmas\u0131h\u00e2linde yol gideri ve g\u00fcndelik\u00a0\u00f6denmez.<\/p>\n

(15) Sevk edilen yerde, sa\u011fl\u0131k hizmeti sunucusunda yatarak tedavi edilmesi gerekli g\u00f6r\u00fclmesine ra\u011fmen, yatak bulunmamas\u0131\u00a0nedeniyle sa\u011fl\u0131k hizmeti sunucusuna yat\u0131r\u0131lmaks\u0131z\u0131n ge\u00e7en g\u00fcnler i\u00e7in bu durumun sa\u011fl\u0131k hizmeti sunucunca belgelenmesi\u00a0\u015fart\u0131yla be\u015f\u00a0g\u00fcn\u00fc\u00a0ge\u00e7memek\u00a0\u00fczere g\u00fcndelik\u00a0\u00f6denir.<\/p>\n

(16)\u00a0\u00a0Organ, doku ve k\u00f6k h\u00fccre nakline ili\u015fkin yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri ile bu maddenin uygulanmas\u0131na ili\u015fkin usul ve esaslar Kurumca belirlenir.<\/p>\n

D\u00d6RD\u00dcNC\u00dc\u00a0B\u00d6L\u00dcM<\/p>\n

Kat\u0131l\u0131m Pay\u0131, Sevk Zinciri, Acil H\u00e2ller,\u00a0\u0130stisnai Sa\u011fl\u0131k Hizmetleri ve\u00a0\u0130lave\u00a0\u00dccret<\/p>\n

Ayakta tedavide hekim ve di<\/b>\u015f<\/b>\u00a0hekimi muayenesi kat<\/b>\u0131<\/b>l<\/b>\u0131<\/b>m pay<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 17\u00a0<\/b>\u2013<\/b>\u00a0(1) Kat\u0131l\u0131m pay\u0131, ayakta tedavide her bir hekim ve di\u015f\u00a0hekimi muayenesi i\u00e7in 2 T\u00fcrk Liras\u0131olarak uygulan\u0131r. Kurum, ayakta tedavide hekim ve di\u015f\u00a0hekimi muayenesi kat\u0131l\u0131m pay\u0131\u00a0tutar\u0131n\u0131, her y\u0131l bir\u00a0\u00f6nceki y\u0131la ili\u015fkin olarak 213 say\u0131l\u0131\u00a0Vergi Usul Kanunu uyar\u0131nca belirlenen yeniden de\u011ferleme oran\u0131nda art\u0131rmaya ve yeniden de\u011ferleme oran\u0131\u00a0kadar art\u0131r\u0131lmas\u0131\u00a0h\u00e2linde\u00a0\u00e7\u0131kan kuru\u015f\u00a0kesirlerini tama ibla\u011f\u00a0etmeye yetkilidir.<\/p>\n

(2) Ayakta tedavide hekim ve di\u015f\u00a0hekimi muayenesi kat\u0131l\u0131m pay\u0131n\u0131; birinci basamak sa\u011fl\u0131k hizmeti sunucular\u0131nda yap\u0131lan muayenelerde almamaya ya da daha d\u00fc\u015f\u00fck tutarlarda belirlemeye veya tekrar birinci f\u0131krada belirlenen tutara getirmeye, ikinci ve\u00a0\u00fc\u00e7\u00fcnc\u00fc\u00a0basamak sa\u011fl\u0131k hizmet sunucular\u0131nda yap\u0131lan muayenelerde ise m\u00fcracaat edilen sa\u011fl\u0131k hizmeti sunucusunun yer ald\u0131\u011f\u0131\u00a0basamak, sa\u011fl\u0131k hizmeti sunucusunun resmi ve\u00a0\u00f6zel sa\u011fl\u0131k hizmeti sunucusu niteli\u011finde olup olmamas\u0131,\u00a0\u00f6nceki basamaklardan sevkli olarak ba\u015fvurulup ba\u015fvurulmad\u0131\u011f\u0131\u00a0gibi hususlar\u0131\u00a0g\u00f6z\u00a0\u00f6n\u00fcnde bulundurarak on kat\u0131na kadar art\u0131rmaya ve sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0i\u00e7in farkl\u0131\u00a0belirlemeye Kurum yetkilidir.<\/p>\n

V<\/b>\u00fc<\/b>cut d<\/b>\u0131\u015f\u0131<\/b>\u00a0kullan<\/b>\u0131<\/b>lan (eksternal) protez ve ortez kat<\/b>\u0131<\/b>l<\/b>\u0131<\/b>m pay<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 18\u00a0<\/b>\u2013<\/b>\u00a0(1) V\u00fccut d\u0131\u015f\u0131\u00a0protez ve ortezler i\u00e7in Kurumca\u00a0\u00f6denen bedeller\u00a0\u00fczerinden, Kurumdan gelir veya ayl\u0131k alan genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer i\u00e7in %10, kapsamdaki di\u011fer genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer i\u00e7in %20 oran\u0131nda kat\u0131l\u0131m pay\u0131\u00a0al\u0131n\u0131r. Kat\u0131l\u0131m pay\u0131n\u0131\u00a0% 1\u2019e kadar indirmeye, Kurumun teklifi\u00a0\u00fczerine\u00a0\u00c7al\u0131\u015fma ve Sosyal G\u00fcvenlik Bakan\u0131\u00a0yetkilidir.<\/p>\n

(2) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin v\u00fccut d\u0131\u015f\u0131\u00a0ortez ve protezler i\u00e7in\u00f6deyecekleri kat\u0131l\u0131m pay\u0131n\u0131n tutar\u0131, sa\u011fl\u0131k hizmetinin al\u0131nd\u0131\u011f\u0131\u00a0tarihteki asgari\u00a0\u00fccretin y\u00fczde yetmi\u015fbe\u015fini ge\u00e7emez. Y\u00fczde yetmi\u015fbe\u015flik\u00a0\u00fcst s\u0131n\u0131r\u0131n hesaplanmas\u0131nda her bir ortez ve protez, ba\u011f\u0131ms\u0131z olarak de\u011ferlendirilir.<\/p>\n

Ayakta tedavide sa<\/b>\u011f<\/b>lanan ila<\/b>\u00e7<\/b>lar i<\/b>\u00e7<\/b>in kat<\/b>\u0131<\/b>l<\/b>\u0131<\/b>m pay<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 19\u00a0<\/b>\u2013<\/b>\u00a0(1) Ayakta tedavide sa\u011flanan ila\u00e7lar i\u00e7in kat\u0131l\u0131m pay\u0131, Kurumdan gelir veya ayl\u0131k alan genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer i\u00e7in % 10, kapsamdaki di\u011fer genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer i\u00e7in % 20 olarak uygulan\u0131r.\u00a0\u0130la\u00e7\u00a0kat\u0131l\u0131m pay\u0131n\u0131\u00a0% 1\u2019e kadar indirmeye, Kurumun teklifi\u00a0\u00fczerine\u00a0\u00c7al\u0131\u015fma ve Sosyal G\u00fcvenlik Bakan\u0131\u00a0yetkilidir.<\/p>\n

(2) Kurum, aile hekimlerince yaz\u0131lan re\u00e7eteler d\u00e2hil olmak\u00a0\u00fczere re\u00e7etede yer alan\u00a0\u00fc\u00e7\u00a0kaleme yada\u00a0\u00fc\u00e7\u00a0kutuya kadar ila\u00e7\/ila\u00e7lar i\u00e7in 3 T\u00fcrk Liras\u0131, ilave her bir kalem yada kutu ila\u00e7\u00a0i\u00e7in 1 T\u00fcrk Liras\u0131\u00a0olmak\u00a0\u00fczere kat\u0131l\u0131m pay\u0131uygulamaya yetkilidir. Kat\u0131l\u0131m pay\u0131na ili\u015fkin kutu hesab\u0131nda enjektable formlar, serum ve beslenme\u00a0\u00fcr\u00fcnleri ile Kurum taraf\u0131ndan belirlenecek ila\u00e7lar dikkate al\u0131nmaz. Kurum, bu f\u0131krada belirtilen 1 T\u00fcrk Liras\u0131\u00a0ve 3 T\u00fcrk Liras\u0131n\u0131, 213 say\u0131l\u0131\u00a0Vergi Usul Kanunu uyar\u0131nca belirlenen yeniden de\u011ferleme oran\u0131nda her y\u0131l art\u0131rmaya yetkilidir.<\/p>\n

Yatarak tedavide kat<\/b>\u0131<\/b>l<\/b>\u0131<\/b>m pay<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 20\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurumca belirlenecek hastal\u0131k gruplar\u0131na g\u00f6re yatarak tedavide finansman\u0131\u00a0sa\u011flanan sa\u011fl\u0131k hizmetleri bedelinin y\u00fczde birine kadar kat\u0131l\u0131m pay\u0131\u00a0al\u0131nabilir. Y\u00fczde birine kadar tespit edilen kat\u0131l\u0131m pay\u0131n\u0131almamaya, yar\u0131s\u0131na kadar indirmeye veya bir kat\u0131na kadar art\u0131rmaya, gerekti\u011finde bu tutarlar\u0131\u00a0kanuni tutarlar\u0131na getirmeye veya indirmeye Kurum yetkilidir. Yatarak tedavide kat\u0131l\u0131m pay\u0131\u00a0tutar\u0131, bir takvim y\u0131l\u0131nda asgari\u00a0\u00fccret tutar\u0131n\u0131\u00a0ge\u00e7memek kayd\u0131yla her bir yatarak tedavi i\u00e7in asgari\u00a0\u00fccretin d\u00f6rtte birini ge\u00e7emez.<\/p>\n

Yard<\/b>\u0131<\/b>mc<\/b>\u0131<\/b>\u00a0<\/b>\u00fc<\/b>reme y<\/b>\u00f6<\/b>ntemi tedavilerinde kat<\/b>\u0131<\/b>l<\/b>\u0131<\/b>m pay<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 21\u00a0<\/b>\u2013<\/b>\u00a0(1) Yard\u0131mc\u0131\u00a0\u00fcreme y\u00f6ntemi tedavisinde kullan\u0131lan ila\u00e7lar i\u00e7in kat\u0131l\u0131m pay\u0131, Kurumdan gelir ve ayl\u0131k alan genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bunlar\u0131n bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer i\u00e7in y\u00fczde on, kapsamdaki di\u011fer genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bunlar\u0131n bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer i\u00e7in y\u00fczde yirmi olarak uygulan\u0131r.<\/p>\n

(2) Yard\u0131mc\u0131\u00a0\u00fcreme y\u00f6ntemleri i\u015flem\u00a0\u00fccretleri i\u00e7in al\u0131nacak kat\u0131l\u0131m pay\u0131, Sa\u011fl\u0131k Hizmetleri Fiyatland\u0131rma Komisyonunca belirlenen i\u015flem\u00a0\u00fccretleri\u00a0\u00fczerinden ilk denemede y\u00fczde otuz, sonraki denemeler i\u00e7in Kanunla belirlenen oranda uygulan\u0131r.<\/p>\n

(3) Yard\u0131mc\u0131\u00a0\u00fcreme y\u00f6ntemleri i\u015flem\u00a0\u00fccretleri i\u00e7in\u00a0\u00f6denecek kat\u0131l\u0131m pay\u0131nda bu Y\u00f6netmeli\u011fin 29 uncu maddesinde belirtilen\u00a0\u00fcst limit uygulanmaz.<\/p>\n

Kat<\/b>\u0131<\/b>l<\/b>\u0131<\/b>m pay<\/b>\u0131<\/b>\u00a0tahsili<\/b><\/p>\n

MADDE 22\u00a0<\/b>\u2013<\/b>\u00a0(1) Kat\u0131l\u0131m paylar\u0131n\u0131n tahsilat\u0131na ili\u015fkin usul ve esaslar Kurumca belirlenir.<\/p>\n

(2) Kurum, kat\u0131l\u0131m paylar\u0131n\u0131, gelir veya ayl\u0131k alan ki\u015filerin gelir veya ayl\u0131klar\u0131ndan,\u00a0\u00e7al\u0131\u015fanlar\u0131n\u00a0\u00fccret veya maa\u015flar\u0131ndan mahsup edilmek suretiyle veya eczaneler ile di\u011fer kurum ve kurulu\u015flar arac\u0131l\u0131\u011f\u0131\u00a0ile tahsile yetkilidir. S\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131na, tahsil ettikleri kat\u0131l\u0131m pay\u0131\u00a0d\u00fc\u015f\u00fcld\u00fckten sonra kalan tutar\u00a0\u00f6denir.<\/p>\n

Kat<\/b>\u0131<\/b>l<\/b>\u0131<\/b>m pay<\/b>\u0131<\/b>\u00a0iadesi<\/b><\/p>\n

MADDE 23\u00a0<\/b>\u2013<\/b>\u00a0(1) Harcamalar\u0131, ta\u015f\u0131n\u0131r ve ta\u015f\u0131nmazlar\u0131\u00a0ile bunlardan do\u011fan haklar\u0131\u00a0da dikkate al\u0131narak, Kurumca belirlenecek test y\u00f6ntemleri ve veriler kullan\u0131larak tespit edilecek aile i\u00e7indeki geliri ki\u015fi ba\u015f\u0131na d\u00fc\u015fen ayl\u0131k tutar\u0131\u00a0asgari\u00a0\u00fccretin\u00a0\u00fc\u00e7te birinden az olan vatanda\u015flar ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer, vatans\u0131zlar ve s\u0131\u011f\u0131nmac\u0131lar, 1\/7\/1976 tarihli ve 2022 say\u0131l\u0131\u00a065 Ya\u015f\u0131n\u0131\u00a0Doldurmu\u015f\u00a0Muhta\u00e7, G\u00fc\u00e7s\u00fcz ve Kimsesiz T\u00fcrk Vatanda\u015flar\u0131na Ayl\u0131k Ba\u011flanmas\u0131\u00a0Hakk\u0131nda Kanun h\u00fck\u00fcmlerine g\u00f6re ayl\u0131k alan ki\u015filer ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin\u00f6demi\u015f\u00a0olduklar\u0131\u00a0kat\u0131l\u0131m paylar\u0131, talepleri h\u00e2linde, 29\/5\/1986 tarihli ve 3294 say\u0131l\u0131\u00a0Sosyal Yard\u0131mla\u015fma ve Dayan\u0131\u015fmay\u0131\u00a0Te\u015fvik Kanunu h\u00fck\u00fcmlerine g\u00f6re Sosyal Yard\u0131mla\u015fma ve Dayan\u0131\u015fma Vak\u0131flar\u0131nca kendilerine geri\u00f6denir.<\/p>\n

Kat<\/b>\u0131<\/b>l<\/b>\u0131<\/b>m pay<\/b>\u0131<\/b>\u00a0al<\/b>\u0131<\/b>nmayacak h<\/b>\u00e2<\/b>ller, sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetleri ve ki<\/b>\u015f<\/b>iler<\/b><\/p>\n

MADDE 24\u00a0<\/b>\u2013<\/b>\u00a0(1) Kat\u0131l\u0131m pay\u0131\u00a0al\u0131nmayacak h\u00e2ller, sa\u011fl\u0131k hizmetleri ve ki\u015filer\u00a0\u015funlard\u0131r;<\/p>\n

a)\u00a0\u0130\u015f\u00a0kazas\u0131na u\u011frayan veya meslek hastal\u0131\u011f\u0131na tutulan genel sa\u011fl\u0131k sigortal\u0131s\u0131ndan, bu durumlar\u0131\u00a0nedeniyle sa\u011flanan sa\u011fl\u0131k hizmetleri i\u00e7in bu Y\u00f6netmeli\u011fin 17, 18, 19 ve 20 nci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

b) Asker\u00ee\u00a0tatbikat ve manevralarda sa\u011flanan sa\u011fl\u0131k hizmetleri i\u00e7in bu Y\u00f6netmeli\u011fin 17, 18, 19 ve 20 nci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

c) Kanunun 75 inci maddesinde yer alan afet ve sava\u015f\u00a0h\u00e2li nedeniyle sa\u011flanan sa\u011fl\u0131k hizmetleri i\u00e7in bu Y\u00f6netmeli\u011fin 17, 18, 19 ve 20 nci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

\u00e7) Aile hekimi muayenelerinde bu Y\u00f6netmeli\u011fin 17 nci maddesinde belirtilen kat\u0131l\u0131m pay\u0131\u00a0al\u0131nmaz.<\/p>\n

d) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ya da bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filere sa\u011flanan ki\u015fiye y\u00f6nelik koruyucu sa\u011fl\u0131k hizmetleri i\u00e7in bu Y\u00f6netmeli\u011fin 17, 18, 19 ve 20 nci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

e) Kurumca yetkilendirilen sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0taraf\u0131ndan sa\u011fl\u0131k raporu ile belgelendirilmek\u00a0\u015fart\u0131yla; Kurumca belirlenen kronik hastal\u0131klarda bu Y\u00f6netmeli\u011fin 17, 18, 19 ve 20 nci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131al\u0131nmaz. Kurum, ayakta tedavide hekim ve di\u015f\u00a0hekimi muayenesi, yatarak tedavi, v\u00fccut d\u0131\u015f\u0131\u00a0ortez ve protezler ile ayakta tedavide sa\u011flanan ila\u00e7lar bak\u0131m\u0131ndan, kat\u0131l\u0131m pay\u0131\u00a0al\u0131nmayacak kronik hastal\u0131klar\u0131\u00a0ayr\u0131\u00a0ayr\u0131\u00a0belirleyebilir.<\/p>\n

f) Kurumca yetkilendirilen sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0taraf\u0131ndan sa\u011fl\u0131k raporu ile belgelendirilmek\u00a0\u015fart\u0131yla; Kurumca belirlenen hayati\u00a0\u00f6neme haiz v\u00fccut d\u0131\u015f\u0131\u00a0protez ve ortezlerden kat\u0131l\u0131m pay\u0131\u00a0al\u0131nmaz.<\/p>\n

g) Kurumca yetkilendirilen sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0taraf\u0131ndan sa\u011fl\u0131k raporu ile belgelendirilmek\u00a0\u015fart\u0131yla; organ, doku ve k\u00f6k h\u00fccre nakline ili\u015fkin sa\u011fl\u0131k hizmetleri i\u00e7in bu Y\u00f6netmeli\u011fin 17, 18, 19 ve 20 nci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

\u011f) Kurumca y\u00fcr\u00fct\u00fclen soru\u015fturma kapsam\u0131yla s\u0131n\u0131rl\u0131\u00a0olmak\u00a0\u00fczere;<\/p>\n

1) Sa\u011fl\u0131k hizmeti alan genel sa\u011fl\u0131k sigortal\u0131s\u0131ndan veya bunlar\u0131n bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerden, sa\u011fl\u0131k hizmetinin ger\u00e7ekten al\u0131n\u0131p al\u0131nmad\u0131\u011f\u0131n\u0131n tespitine y\u00f6nelik,<\/p>\n

2) Sigortal\u0131\u00a0ile hak sahiplerinin malull\u00fck, i\u015f\u00a0g\u00f6remezlik raporlar\u0131nda belirtilen rahats\u0131zl\u0131klar\u0131n\u0131n mevcut olup olmad\u0131\u011f\u0131n\u0131n tespitine y\u00f6nelik,<\/p>\n

Kurumca yap\u0131lan sevkler nedeniyle yap\u0131lan kontrol muayenelerinde bu Y\u00f6netmeli\u011fin 17 nci maddesinde belirtilen kat\u0131l\u0131m pay\u0131\u00a0al\u0131nmaz.<\/p>\n

h) 24\/2\/1968 tarihli ve 1005 say\u0131l\u0131\u00a0\u0130stiklal Madalyas\u0131\u00a0Verilmi\u015f\u00a0Bulunanlara Vatani Hizmet Tertibinden\u00a0\u015eeref Ayl\u0131\u011f\u0131\u00a0Ba\u011flanmas\u0131\u00a0Hakk\u0131nda Kanun h\u00fck\u00fcmlerine g\u00f6re\u00a0\u015feref ayl\u0131\u011f\u0131\u00a0alan ki\u015filer ile bunlar\u0131n e\u015flerinden bu Y\u00f6netmeli\u011fin 17, 18, 19, 20 ve 21 inci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

\u0131) 28\/5\/1986 tarihli ve 3292 say\u0131l\u0131\u00a0Vatani Hizmet Tertibi Ayl\u0131klar\u0131n\u0131n Ba\u011flanmas\u0131\u00a0Hakk\u0131nda Kanun h\u00fck\u00fcmlerine g\u00f6re ayl\u0131k alan ki\u015filerden bu Y\u00f6netmeli\u011fin 17, 18, 19 ve 20 nci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131al\u0131nmaz.<\/p>\n

i) 2330 say\u0131l\u0131\u00a0Nakdi Tazminat ve Ayl\u0131k Ba\u011flanmas\u0131\u00a0Hakk\u0131nda Kanun h\u00fck\u00fcmlerine g\u00f6re ayl\u0131k alanlar ile bunlar\u0131n bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerden bu Y\u00f6netmeli\u011fin 17, 18, 19, 20 ve 21 inci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

j) 24\/5\/1983 tarihli ve 2828 say\u0131l\u0131\u00a0Sosyal Hizmetler Kanunu h\u00fck\u00fcmlerine g\u00f6re korunma, bak\u0131m ve rehabilitasyon hizmetlerinden\u00a0\u00fccretsiz faydalanan ki\u015filerden bu Y\u00f6netmeli\u011fin 17, 18, 19 ve 20 nci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

k) Harp malull\u00fc\u011f\u00fc\u00a0ayl\u0131\u011f\u0131\u00a0alanlar ile 3713 say\u0131l\u0131\u00a0Ter\u00f6rle M\u00fccadele Kanunu kapsam\u0131nda ayl\u0131k alanlardan ve bunlar\u0131n bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerden bu Y\u00f6netmeli\u011fin 17, 18, 19, 20 ve 21 inci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

l) Vazife malullerinden bu Y\u00f6netmeli\u011fin 17, 18, 19 , 20 ve 21 inci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131al\u0131nmaz.<\/p>\n

m) Harp okullar\u0131\u00a0ile fak\u00fclte ve y\u00fcksek okullarda, T\u00fcrk Silahl\u0131\u00a0Kuvvetleri hesab\u0131na okuyan veya kendi hesab\u0131na okumakta iken asker\u00ee\u00a0\u00f6\u011frenci olanlar ile astsubay meslek y\u00fcksek okullar\u0131\u00a0ve astsubay naspedilmek\u00a0\u00fczere temel askerlik e\u011fitimine tabi tutulan adaylardan bu Y\u00f6netmeli\u011fin 17, 18, 19 ve 20 nci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

n) Polis Akademisi ile fak\u00fclte ve y\u00fcksekokullarda, Emniyet Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc\u00a0hesab\u0131na okuyan veya kendi hesab\u0131na okumakta iken Emniyet Genel M\u00fcd\u00fcrl\u00fc\u011f\u00fc\u00a0hesab\u0131na okumaya devam eden\u00a0\u00f6\u011frencilerden bu Y\u00f6netmeli\u011fin 17, 18, 19 ve 20 nci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

o) 3713 say\u0131l\u0131\u00a0Kanunun\u00a0\u00a021 inci maddesinde say\u0131lan olaylara maruz kalmalar\u0131\u00a0nedeniyle yaralananlar\u0131n tedavileri sonu\u00e7lan\u0131ncaya veya maluliyetleri kesinle\u015finceye kadar sa\u011flanacak sa\u011fl\u0131k hizmetlerinden bu Y\u00f6netmeli\u011fin 17, 18, 19, 20 ve 21 inci maddelerinde belirtilen kat\u0131l\u0131m paylar\u0131\u00a0al\u0131nmaz.<\/p>\n

\u00f6) Harp mal\u00fbll\u00fc\u011f\u00fc, vazife mal\u00fbll\u00fc\u011f\u00fc, mal\u00fbll\u00fck ayl\u0131\u011f\u0131\u00a0veya s\u00fcrekli i\u015f\u00a0g\u00f6remezlik geliri ba\u011flanm\u0131\u015f\u00a0sigortal\u0131lar ile ayl\u0131k veya gelir ba\u011flanan ve\u00a0\u00e7al\u0131\u015fma g\u00fcc\u00fcn\u00fcn en az % 60\u2019\u0131n\u0131\u00a0yitiren mal\u00fbl\u00a0\u00e7ocuklar\u0131n kontrol muayenelerinde bu Y\u00f6netmeli\u011fin 17 nci maddesinde belirtilen kat\u0131l\u0131m pay\u0131\u00a0al\u0131nmaz.<\/p>\n

(2) Birinci f\u0131kran\u0131n (c) bendinde kat\u0131l\u0131m pay\u0131\u00a0al\u0131nmayaca\u011f\u0131\u00a0belirtilen 15\/5\/1959 tarihli ve 7269 say\u0131l\u0131\u00a0Umumi Hayata M\u00fcessir Afetler Dolay\u0131s\u0131yla Al\u0131nacak Tedbirlerle Yap\u0131lacak Yard\u0131mlara Dair Kanun kapsam\u0131ndaki genel hayata etkili afet h\u00e2li nedeniyle sa\u011flanan sa\u011fl\u0131k hizmetleri i\u00e7in kat\u0131l\u0131m pay\u0131\u00a0al\u0131nmayacak s\u00fcre Ba\u015fbakanl\u0131k Afet ve Acil Durum Y\u00f6netimi Ba\u015fkanl\u0131\u011f\u0131n\u0131n g\u00f6r\u00fc\u015f\u00fc\u00a0al\u0131narak Kurumca belirlenir.<\/p>\n

(3) Bu madde gere\u011fince kat\u0131l\u0131m pay\u0131\u00a0al\u0131nmayacak sa\u011fl\u0131k hizmetleri Kurumca tespit edilir.<\/p>\n

Hizmet basamaklar<\/b>\u0131<\/b>, sevk zinciri ve yapt<\/b>\u0131<\/b>r<\/b>\u0131<\/b>m<\/b><\/p>\n

MADDE 25\u00a0<\/b>\u2013<\/b>\u00a0(1) Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n sadece (f) bendindeki sa\u011fl\u0131k hizmetlerini sunanlar veya\u00a0\u00fcretenler hari\u00e7\u00a0olmak\u00a0\u00fczere sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u00a0taraf\u0131ndan birinci, ikinci ve\u00fc\u00e7\u00fcnc\u00fc\u00a0basamak olarak s\u0131n\u0131fland\u0131r\u0131l\u0131r. Bu s\u0131n\u0131fland\u0131rmada aile hekimleri birinci basamak sa\u011fl\u0131k hizmeti sunucusu olarak yer al\u0131r.<\/p>\n

(2) Kurum, Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131n\u0131n g\u00f6r\u00fc\u015f\u00fcn\u00fc\u00a0alarak, bu basamaklar ve sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0aras\u0131nda sevk zincirini; tan\u0131,\u00a0\u00f6n tan\u0131, hekimlerin ve di\u015f\u00a0hekimlerinin uzmanl\u0131klar\u0131n\u0131\u00a0dikkate almak suretiyle t\u00fcm yurtta veya il ya da il\u00e7e baz\u0131nda belirlemeye yetkilidir. Kanunun 60\u00a0\u0131nc\u0131\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (c) bendinin (1), (3) ve (9) numaral\u0131\u00a0alt bentlerinde say\u0131lanlar\u0131n, Kurumla s\u00f6zle\u015fmeli\u00a0\u00fcniversite ve istisnai hallerde\u00a0\u00f6zel sa\u011fl\u0131k hizmeti sunucular\u0131na m\u00fcracaat edebilme ko\u015fullar\u0131\u00a0ile uygulamaya ili\u015fkin usul ve esaslar Kurum taraf\u0131ndan belirlenir.<\/p>\n

(3) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer, Kanunda, bu Y\u00f6netmelikte ve ilgili mevzuatta belirtilen istisnalar d\u0131\u015f\u0131nda sa\u011fl\u0131k hizmetlerini istedi\u011fi il ya da il\u00e7ede s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucusundan alma hakk\u0131na sahiptir.<\/p>\n

(4) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin Kurumca belirlenen sevk zincirine uymalar\u0131\u00a0zorunludur. Sevk zincirine uyulmamas\u0131\u00a0h\u00e2linde sa\u011fl\u0131k hizmetleri bedelleri ve yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri Kurumca kar\u015f\u0131lanmaz.<\/p>\n

(5) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer i\u00e7in sevk zinciri kurallar\u0131n\u0131n il ya da il\u00e7e baz\u0131nda farkl\u0131\u00a0belirlenmesi h\u00e2linde, ki\u015finin sa\u011fl\u0131k hizmeti sunucusuna ba\u015fvurdu\u011fu ildeki sevk zinciri kurallar\u0131ge\u00e7erlidir.<\/p>\n

Kimlik tespiti<\/b><\/p>\n

MADDE 26\u00a0<\/b>\u2013<\/b>\u00a0(1) S\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucusu, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerden acil h\u00e2ller hari\u00e7\u00a0olmak\u00a0\u00fczere (acil h\u00e2llerde ise acil h\u00e2lin sona ermesinden sonra) biyometrik y\u00f6ntemlerle kimlik do\u011frulamas\u0131n\u0131\u00a0yapar ve\/veya n\u00fcfus c\u00fczdan\u0131, s\u00fcr\u00fcc\u00fc\u00a0belgesi, evlenme c\u00fczdan\u0131, pasaport veya Kurum taraf\u0131ndan verilen resimli sa\u011fl\u0131k kart\u0131\u00a0belgelerinden birinin ibraz\u0131n\u0131\u00a0istemek ve bu belgelerin ba\u015fvuran ki\u015fiye ait olup olmad\u0131\u011f\u0131n\u0131kontrol eder.<\/p>\n

(2) 2828 say\u0131l\u0131\u00a0Kanunla sa\u011flanan yard\u0131mlardan\u00a0\u00fccretsiz faydalananlardan\u00a0\u00e7ocuk, engelli, kad\u0131n ve ya\u015fl\u0131lar\u0131n sa\u011fl\u0131k hizmeti sunucular\u0131na birinci f\u0131krada belirtilen belgelerle ba\u015fvurmalar\u0131\u00a0h\u00e2linde Sosyal Hizmetler ve\u00a0\u00c7ocuk Esirgeme Kurumu kapsam\u0131nda bulunduklar\u0131n\u0131\u00a0g\u00f6sterir belgeye g\u00f6re gerekli i\u015flemler y\u00fcr\u00fct\u00fclerek sonras\u0131nda s\u00f6z konusu belgelerin ibraz\u0131\u00a0an\u0131lan Kurumdan istenir.<\/p>\n

(3) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin kendi ad\u0131na bir ba\u015fkas\u0131n\u0131n sa\u011fl\u0131k hizmeti almas\u0131n\u0131\u00a0veya Kurumdan haks\u0131z bir menfaat temin etmesini sa\u011flamas\u0131\u00a0yasakt\u0131r. Bu fiilleri i\u015fleyenlerden Kurumun u\u011frad\u0131\u011f\u0131\u00a0zarar\u0131n iki kat\u0131\u00a0kanun\u00ee\u00a0faiziyle birlikte m\u00fc\u015ftereken ve m\u00fcteselsilen tahsil edilir ve ilgililer hakk\u0131nda 26\/9\/2004 tarihli ve 5237 say\u0131l\u0131\u00a0T\u00fcrk Ceza Kanunu h\u00fck\u00fcmleri uygulan\u0131r.<\/p>\n

(4) Kimlik tespiti y\u00fck\u00fcml\u00fcl\u00fc\u011f\u00fcn\u00fc\u00a0yapmayan ve bu nedenle bir ba\u015fka ki\u015fiye sa\u011fl\u0131k hizmeti sunulmas\u0131nedeniyle Kurumun zarara u\u011framas\u0131na sebebiyet veren sa\u011fl\u0131k hizmeti sunucular\u0131ndan yap\u0131lan yersiz\u00a0\u00f6demeler geri al\u0131n\u0131r.<\/p>\n

Acil h<\/b>\u00e2<\/b>ller ve acil sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetleri<\/b><\/p>\n

MADDE 27\u00a0<\/b>\u2013<\/b>\u00a0(1) Acil h\u00e2ller; ani geli\u015fen hastal\u0131k, kaza, yaralanma ve benzeri durumlarda olay\u0131n meydana gelmesini takip eden ilk 24 saat i\u00e7inde t\u0131bb\u00ee\u00a0m\u00fcdahale gerektiren durumlar ile ivedilikle t\u0131bb\u00ee\u00a0m\u00fcdahale yap\u0131lmad\u0131\u011f\u0131veya ba\u015fka bir sa\u011fl\u0131k kurulu\u015funa nakli h\u00e2linde hayat\u0131n ve\/veya sa\u011fl\u0131k b\u00fct\u00fcnl\u00fc\u011f\u00fcn\u00fcn kaybedilme riskinin do\u011faca\u011f\u0131kabul edilen durumlard\u0131r. Bu nedenle sa\u011flanan sa\u011fl\u0131k hizmetleri acil sa\u011fl\u0131k hizmeti olarak kabul edilir.<\/p>\n

\u0130<\/b>stisnai sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetleri<\/b><\/p>\n

MADDE 28\u00a0<\/b>\u2013<\/b>\u00a0(1) Bir sa\u011fl\u0131k hizmetinin istisnai sa\u011fl\u0131k hizmeti olarak de\u011ferlendirilebilmesi i\u00e7in hayati\u00a0\u00f6neme haiz olmamas\u0131\u00a0ve alternatif tedavi y\u00f6nteminin bulunmas\u0131\u00a0gibi hususlar g\u00f6z\u00a0\u00f6n\u00fcne al\u0131n\u0131r.<\/p>\n

(2) Kurumca finansman\u0131\u00a0sa\u011flanan sa\u011fl\u0131k hizmetlerinden istisnai sa\u011fl\u0131k hizmeti olarak kabul edilecek sa\u011fl\u0131k hizmetleri Sa\u011fl\u0131k Hizmetleri Fiyatland\u0131rma Komisyonu taraf\u0131ndan belirlenir.<\/p>\n

(3) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0olduklar\u0131\u00a0ki\u015filerin talepleri do\u011frultusunda sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0taraf\u0131ndan, Kurumca istisnai sa\u011fl\u0131k hizmeti olarak kabul edilen sa\u011fl\u0131k hizmetinin sunulmas\u0131\u00a0durumunda, bu hizmetler i\u00e7in bedeli en d\u00fc\u015f\u00fck alternatifi\u00a0\u00fczerinden\u00a0\u00f6deme yap\u0131l\u0131r.<\/p>\n

S<\/b>\u00f6<\/b>zle<\/b>\u015f<\/b>meli sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmeti sunucular<\/b>\u0131<\/b>n<\/b>\u0131<\/b>n alabilece<\/b>\u011f<\/b>i ilave\u00a0<\/b>\u00fc<\/b>cretler<\/b><\/p>\n

MADDE 29\u00a0<\/b>\u2013<\/b>\u00a0(1) Kamu idaresi sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0d\u0131\u015f\u0131ndaki vak\u0131f\u00a0\u00fcniversiteleri d\u00e2hil s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131nca, Sa\u011fl\u0131k Hizmetleri Fiyatland\u0131rma Komisyonunca belirlenen sa\u011fl\u0131k hizmetleri bedeline ek olarak, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0olduklar\u0131\u00a0ki\u015filerden sa\u011fl\u0131k hizmeti sunucular\u0131n\u0131n giderleri ve\u00fcrettikleri sa\u011fl\u0131k hizmetlerinin maliyetleri, yap\u0131lan s\u00fcbvansiyonlar gibi kriterler dikkate al\u0131narak bu bedellerin Kanunun 73\u00a0\u00fcnc\u00fc\u00a0maddesinin 2 nci f\u0131kras\u0131nda belirtilen oran kadar al\u0131nabilecek ilave\u00a0\u00fccretin tavan\u0131\u00a0Bakanlar Kurulunca belirlenir. Bu tavan d\u00e2hilinde al\u0131nabilecek ilave\u00a0\u00fccret oranlar\u0131\u00a0Kurumca belirlenir. Ancak 1005 say\u0131l\u0131\u0130stiklal Madalyas\u0131\u00a0Verilmi\u015f\u00a0Bulunanlara Vatani Hizmet Tertibinden\u00a0\u015eeref Ayl\u0131\u011f\u0131\u00a0Ba\u011flanmas\u0131\u00a0Hakk\u0131nda Kanun h\u00fck\u00fcmlerine g\u00f6re\u00a0\u015feref ayl\u0131\u011f\u0131\u00a0alan ki\u015filer, 2330 say\u0131l\u0131\u00a0Nakdi Tazminat ve Ayl\u0131k Ba\u011flanmas\u0131\u00a0Hakk\u0131nda Kanun h\u00fck\u00fcmlerine g\u00f6re ayl\u0131k alan ki\u015filer, Harp malull\u00fc\u011f\u00fc\u00a0ayl\u0131\u011f\u0131\u00a0alanlar ile Ter\u00f6rle M\u00fccadele Kanunu kapsam\u0131nda ayl\u0131k alanlar, tedavileri sonu\u00e7lan\u0131ncaya veya maluliyetleri kesinle\u015finceye kadar 3713 say\u0131l\u0131\u00a0Kanunun 21 inci maddesinde say\u0131lan olaylara maruz kalmalar\u0131\u00a0nedeniyle yaralananlar ile bunlar\u0131n bakmakla y\u00fck\u00fcml\u00fc\u00a0olduklar\u0131\u00a0ki\u015filerden ilave\u00fccret al\u0131namaz. E\u015fde\u011fer ila\u00e7lar\u0131n azami fiyat\u0131\u00a0ile genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin talep etti\u011fi e\u015fde\u011fer ilac\u0131n fiyat\u0131\u00a0aras\u0131nda olu\u015facak fark ve optik i\u00e7in tavan uygulanmaz ve bu f\u0131kra kapsam\u0131nda de\u011ferlendirilmez.<\/p>\n

(2) Kamu idaresi sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0ise otelcilik hizmeti ile istisnai sa\u011fl\u0131k hizmetleri d\u0131\u015f\u0131nda, sa\u011flad\u0131klar\u0131\u00a0sa\u011fl\u0131k hizmetleri i\u00e7in genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerden ilave\u00a0\u00fccret talep edemez. Ancak y\u00fcksek\u00f6\u011fretim kurumlar\u0131na ait sa\u011fl\u0131k hizmeti sunucular\u0131nda\u00a0\u00f6\u011fretim\u00a0\u00fcyeleri taraf\u0131ndan mesai saatleri d\u0131\u015f\u0131nda bizzat verilen sa\u011fl\u0131k hizmetleri i\u00e7in Kurumca belirlenmi\u015f\u00a0sa\u011fl\u0131k hizmetleri bedelinin, poliklinik muayenelerinde ve di\u011fer hizmetlerde Kanunun 73\u00a0\u00fcnc\u00fc\u00a0maddesinin 3\u00a0\u00fcnc\u00fc\u00a0f\u0131kras\u0131nda belirtilen oran\u0131\u00a0ge\u00e7memek\u00fczere,\u00a0\u00fcniversite y\u00f6netim kurulu karar\u0131yla\u00a0\u00f6\u011fretim\u00a0\u00fcyelerinin unvanlar\u0131\u00a0itibar\u0131yla belirlenen miktarda ilave\u00a0\u00fccret al\u0131nabilir. Ancak, al\u0131nacak ilave\u00a0\u00fccret bir defada asgari\u00a0\u00fccretin iki kat\u0131n\u0131\u00a0ge\u00e7emez. Bu f\u0131kra kapsam\u0131nda ilave\u00a0\u00fccret al\u0131namayacak sa\u011fl\u0131k hizmetleri Kurumca belirlenir.<\/p>\n

(3) Acil h\u00e2llerde s\u00f6zle\u015fmeli ve s\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0ki\u015filerden ilave\u00a0\u00fccret talep edemez.<\/p>\n

(4) Sa\u011fl\u0131k hizmeti sunucular\u0131, otelcilik hizmetleri ile istisnai sa\u011fl\u0131k hizmetleri i\u00e7in, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerden Sa\u011fl\u0131k Hizmetleri Fiyatland\u0131rma Komisyonu taraf\u0131ndan belirlenen sa\u011fl\u0131k hizmeti fiyatlar\u0131n\u0131n\u00a0\u00fc\u00e7\u00a0kat\u0131n\u0131\u00a0ge\u00e7memek\u00a0\u00fczere ilave\u00a0\u00fccret alabilir.<\/p>\n

(5) Kurum, ilave\u00a0\u00fccret al\u0131nmayacak sa\u011fl\u0131k hizmetlerini belirlemeye yetkilidir.<\/p>\n

BE\u015e\u0130NC\u0130\u00a0B\u00d6L\u00dcM<\/p>\n

Yurt D\u0131\u015f\u0131nda Tedavi ve\u00a0\u0130\u015fverenin Y\u00fck\u00fcml\u00fcl\u00fc\u011f\u00fc<\/p>\n

Yurt d<\/b>\u0131\u015f\u0131<\/b>nda ge<\/b>\u00e7<\/b>ici veya s<\/b>\u00fc<\/b>rekli g<\/b>\u00f6<\/b>revle g<\/b>\u00f6<\/b>nderilme h<\/b>\u00e2<\/b>linde sa<\/b>\u011f<\/b>lanacak sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetleri<\/b><\/p>\n

MADDE 30\u00a0<\/b>\u2013<\/b>\u00a0(1) Kanunun 60\u00a0\u0131nc\u0131\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (a) bendinin (1) numaral\u0131\u00a0alt bendinde say\u0131lan genel sa\u011fl\u0131k sigortal\u0131lar\u0131ndan, i\u015fverenleri taraf\u0131ndan Kurumca belirlenen usule uygun olarak veya kamu idareleri i\u00e7in\u00a0\u00f6zel mevzuatlar\u0131nda belirtilen usule uygun olarak;<\/p>\n

a) Ge\u00e7ici g\u00f6revle yurt d\u0131\u015f\u0131na g\u00f6nderilenlerin Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesinde say\u0131lan sa\u011fl\u0131k hizmetleri acil h\u00e2llerde,<\/p>\n

b) S\u00fcrekli g\u00f6revle g\u00f6nderilenler ile bunlar\u0131n yurt d\u0131\u015f\u0131nda birlikte ya\u015fad\u0131klar\u0131\u00a0bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesinde say\u0131lan sa\u011fl\u0131k hizmetleri acil hal olup olmad\u0131\u011f\u0131na bak\u0131lmaks\u0131z\u0131n,<\/p>\n

yurt d\u0131\u015f\u0131nda sa\u011flan\u0131r.<\/p>\n

(2) Kanunun 4\u00a0\u00fcnc\u00fc\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (a) veya (c) bendi kapsam\u0131nda sigortal\u0131\u00a0say\u0131lmas\u0131\u00a0nedeniyle genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0say\u0131lanlar\u0131n daimi olarak alt\u0131\u00a0aydan fazla s\u00fcreyle yurt d\u0131\u015f\u0131nda g\u00f6revlendirilmeleri durumu, bu Y\u00f6netmeli\u011fin uygulanmas\u0131nda s\u00fcrekli g\u00f6revle yurt d\u0131\u015f\u0131na g\u00f6nderilme say\u0131l\u0131r. Bu ki\u015filerin g\u00f6revlendirilmesine ili\u015fkin usul, g\u00f6revlendirilen\u00a0\u00fclke ile ikili sosyal g\u00fcvenlik s\u00f6zle\u015fmesi olmas\u0131\u00a0h\u00e2linde s\u00f6zle\u015fme h\u00fck\u00fcmlerine g\u00f6re y\u00fcr\u00fct\u00fcl\u00fcr. Ge\u00e7ici veya s\u00fcrekli g\u00f6revle yurt d\u0131\u015f\u0131na g\u00f6nderilenlerin Kuruma bildirimi, tedavi giderleri olu\u015fmas\u0131\u00a0h\u00e2linde bu giderin talep edildi\u011fi s\u0131rada da yap\u0131labilir.<\/p>\n

(3) Kanunun 4\u00a0\u00fcnc\u00fc\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (c) bendi kapsam\u0131nda sigortal\u0131\u00a0say\u0131lmas\u0131\u00a0nedeniyle genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0say\u0131lanlar\u0131n, i\u015fverenleri taraf\u0131ndan ge\u00e7ici ya da s\u00fcrekli g\u00f6revle yurt d\u0131\u015f\u0131na g\u00f6nderilmeleri, kamu idarelerinin\u00a0\u00f6zel mevzuatlar\u0131nda belirtilen usule g\u00f6re yap\u0131l\u0131r.<\/p>\n

(4) Birinci f\u0131kra kapsam\u0131nda yurt d\u0131\u015f\u0131nda tedavi g\u00f6ren ki\u015filer ile Bakanlar Kurulu karar\u0131yla asker\u00ee\u00a0birlik h\u00e2linde ya da kamu idarelerinin yetkili makamlar\u0131nca yurt d\u0131\u015f\u0131na asker\u00ee\u00a0veya g\u00fcvenlik ama\u00e7l\u0131\u00a0g\u00f6revlendirilenlerin sa\u011fl\u0131k hizmeti giderleri,\u00a0\u00f6ncelikle i\u015fverenleri taraf\u0131ndan\u00a0\u00f6dendikten sonra, yurt d\u0131\u015f\u0131nda g\u00f6revli olduklar\u0131na dair belge ile birlikte mahalli konsolosluktan tasdikli rapor ve sair belgelere dayan\u0131larak Kurumdan talep edilir. Kurumca kar\u015f\u0131lanacak tutar, yurt i\u00e7inde s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131na tedavinin yap\u0131ld\u0131\u011f\u0131\u00a0tarihte\u00a0\u00f6denen en y\u00fcksek tutar\u0131\u00a0ge\u00e7emez. A\u015fan k\u0131sm\u0131, i\u015fverenlerince\/ g\u00f6revle g\u00f6nderen kurumlar\u0131nca kar\u015f\u0131lan\u0131r. Kurumca\u00a0\u00f6demeler,\u00a0\u00f6deme tarihindeki T\u00fcrkiye Cumhuriyet Merkez Bankas\u0131\u00a0d\u00f6viz sat\u0131\u015f\u00a0kuru esas al\u0131narak T\u00fcrk Liras\u0131\u00a0\u00fczerinden yap\u0131l\u0131r. Ancak, Bakanlar Kurulu karar\u0131yla asker\u00ee\u00a0birlik h\u00e2linde ya da kamu idarelerinin yetkili makamlar\u0131nca yurt d\u0131\u015f\u0131na asker\u00ee\u00a0veya g\u00fcvenlik ama\u00e7l\u0131\u00a0g\u00f6revlendirilenlerin yabanc\u0131\u00a0\u00fclke askeri sa\u011fl\u0131k tesislerinden sa\u011flam\u0131\u015f\u00a0olduklar\u0131\u00a0sa\u011fl\u0131k hizmetine ait i\u015flem bedellerinin (tetkik, muayene, ila\u00e7, yatak\u00a0\u00fccreti, m\u00fcdahele, vb) ayr\u0131nt\u0131l\u0131\u00a0belirtilemedi\u011fi durumlarda, fatura bedelinin y\u00fczde ellisi Kurumca, kalan y\u00fczde ellisi ise kendi kurumlar\u0131nca kar\u015f\u0131lan\u0131r.<\/p>\n

(5) Kurum, birinci f\u0131kra kapsam\u0131ndaki ki\u015filerin sa\u011fl\u0131k hizmetlerini, bu ki\u015filerin ge\u00e7ici veya s\u00fcrekli g\u00f6rev s\u00fcresince genel sa\u011fl\u0131k sigortas\u0131\u00a0i\u00e7in Kuruma\u00a0\u00f6denen prim tutar\u0131n\u0131\u00a0ge\u00e7memek kayd\u0131yla, ilgili\u00a0\u00fclkede sa\u011fl\u0131k sigortas\u0131yapt\u0131rmak suretiyle sa\u011flayabilir. Sigortalamaya ili\u015fkin esaslar Kurumca belirlenir. Bu durumda Kurumca sa\u011fl\u0131k hizmeti giderleri ile yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri\u00a0\u00f6denmez.<\/p>\n

(6) Ge\u00e7ici ya da s\u00fcrekli g\u00f6revle g\u00f6nderilen\u00a0\u00fclke ile T\u00fcrkiye aras\u0131nda sa\u011fl\u0131k yard\u0131mlar\u0131n\u0131\u00a0kapsayan sosyal g\u00fcvenlik s\u00f6zle\u015fmesi olmas\u0131\u00a0h\u00e2linde, sa\u011fl\u0131k hizmetleri giderleri ile yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri bu s\u00f6zle\u015fme h\u00fck\u00fcmlerine g\u00f6re\u00a0\u00f6denir.<\/p>\n

(7) Yurt d\u0131\u015f\u0131na ge\u00e7ici veya s\u00fcrekli g\u00f6revle g\u00f6nderilen ki\u015filer ile bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer i\u00e7in yol gideri, g\u00fcndelik, refakat\u00e7i ve cenaze giderleri Kurumca kar\u015f\u0131lanmaz.<\/p>\n

(8) Yurt d\u0131\u015f\u0131nda ge\u00e7ici veya s\u00fcrekli g\u00f6revle g\u00f6nderilenlerin sa\u011fl\u0131k hizmeti giderlerinin\u00a0\u00f6denmesinde misyon\u015feflikleri ile gerekti\u011finde i\u015fbirli\u011fi yap\u0131labilir.<\/p>\n

(9) Yurt d\u0131\u015f\u0131na ge\u00e7ici veya s\u00fcrekli g\u00f6revle g\u00f6nderilenlerin bulundu\u011fu\u00a0\u00fclkede s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucusu bulunmas\u0131\u00a0halinde tedavi giderleri, Kanunun 66 nc\u0131\u00a0maddesi ile sa\u011flanm\u0131\u015f\u00a0olan di\u011fer haklar\u0131\u00a0sakl\u0131\u00a0kalmak kayd\u0131yla, s\u00f6zle\u015fme h\u00fck\u00fcmlerine g\u00f6re\u00a0\u00f6denir.<\/p>\n

Ge<\/b>\u00e7<\/b>ici ya da s<\/b>\u00fc<\/b>rekli g<\/b>\u00f6<\/b>revle g<\/b>\u00f6<\/b>nderilme d<\/b>\u0131\u015f\u0131<\/b>nda yurt d<\/b>\u0131\u015f\u0131<\/b>nda bulunma h<\/b>\u00e2<\/b>linde sa<\/b>\u011f<\/b>lanacak sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetleri<\/b><\/p>\n

MADDE 31\u00a0<\/b>\u2013<\/b>\u00a0(1) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0veya bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin yurt d\u0131\u015f\u0131nda bulunduklar\u0131s\u0131rada sa\u011flanan sa\u011fl\u0131k hizmetlerine ili\u015fkin bedellerin\u00a0\u00f6denmesinde, bulunduklar\u0131\u00a0\u00fclke ile T\u00fcrkiye aras\u0131nda sa\u011fl\u0131k yard\u0131mlar\u0131n\u0131\u00a0kapsayan sosyal g\u00fcvenlik s\u00f6zle\u015fmesi olmas\u0131\u00a0h\u00e2linde s\u00f6zle\u015fme h\u00fck\u00fcmleri uygulan\u0131r. Sa\u011fl\u0131k yard\u0131mlar\u0131n\u0131kapsayan sosyal g\u00fcvenlik s\u00f6zle\u015fmesinin olmamas\u0131\u00a0h\u00e2linde, sa\u011fl\u0131k hizmetleri giderleri ile yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri Kurumca\u00a0\u00f6denmez.<\/p>\n

(2) T\u00fcrk vatanda\u015f\u0131\u00a0olan genel sa\u011fl\u0131k sigortal\u0131lar\u0131n\u0131n ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin Kuzey K\u0131br\u0131s T\u00fcrk Cumhuriyetinde bulunduklar\u0131\u00a0s\u0131rada sa\u011flanan sa\u011fl\u0131k hizmeti bedelleri, yurt i\u00e7inde s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131na\u00a0\u00f6denen en y\u00fcksek tutar\u0131\u00a0ge\u00e7memek\u00a0\u00fczere Kurumca kar\u015f\u0131lan\u0131r. Bu\u00a0\u00fclkede Kurumla s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucusu bulunmas\u0131\u00a0halinde s\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmet sunucusunda yap\u0131lacak tedavi giderleri s\u00f6zle\u015fme h\u00fck\u00fcmlerine g\u00f6re kar\u015f\u0131lan\u0131r. Bu f\u0131kra kapsam\u0131nda olan ki\u015filere ayr\u0131ca yol ve g\u00fcndelik gideri\u00a0\u00f6denmez.<\/p>\n

T<\/b>\u00fc<\/b>rkiye<\/b>\u2019<\/b>de tahlil, tetkik ve tedavinin m<\/b>\u00fc<\/b>mk<\/b>\u00fc<\/b>n olmamas<\/b>\u0131<\/b>\u00a0nedeniyle yurt d<\/b>\u0131\u015f\u0131<\/b>nda sa<\/b>\u011f<\/b>lanacak sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetleri<\/b><\/p>\n

MADDE 32\u00a0<\/b>\u2013<\/b>\u00a0(1) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin Kurumca yetkili k\u0131l\u0131nan sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0taraf\u0131ndan d\u00fczenlenen sa\u011fl\u0131k kurulu raporlar\u0131n\u0131n Kurumca belirlenecek sa\u011fl\u0131k hizmeti sunucusu sa\u011fl\u0131k kurulu taraf\u0131ndan teyit edildikten sonra yurt i\u00e7inde tedavisinin yap\u0131lamad\u0131\u011f\u0131n\u0131n Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca onaylanmas\u0131\u00a0h\u00e2linde, bu hastal\u0131\u011f\u0131n tedavisine ili\u015fkin yurt d\u0131\u015f\u0131nda yap\u0131lacak sa\u011fl\u0131k hizmeti giderleri Kurumca\u00a0\u00f6denir.<\/p>\n

(2) Yurt d\u0131\u015f\u0131nda tedavi edilecek ki\u015fi,\u00a0\u00f6ncelikle sevke konu tedaviye ili\u015fkin yurt d\u0131\u015f\u0131ndaki s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucusuna sevk edilir. Yurt d\u0131\u015f\u0131nda s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucusunun olmamas\u0131\u00a0h\u00e2linde ise sevk edilen sa\u011fl\u0131k hizmeti sunucusuna g\u00f6nderilir.<\/p>\n

(3) Ki\u015filerin T\u00fcrkiye ile sosyal g\u00fcvenlik s\u00f6zle\u015fmesi olan bir\u00a0\u00fclkeye g\u00f6nderilmesi h\u00e2linde; o\u00a0\u00fclke ile yap\u0131lan sosyal g\u00fcvenlik s\u00f6zle\u015fmesinde tedavi uygulamas\u0131\u00a0\u00f6ng\u00f6r\u00fclm\u00fc\u015f\u00a0ve tedavi amac\u0131yla g\u00f6nderilen sigortal\u0131\u00a0da sosyal g\u00fcvenlik s\u00f6zle\u015fmesinin kapsam\u0131nda bulunuyor ise bunlar hakk\u0131nda sosyal g\u00fcvenlik s\u00f6zle\u015fmesi h\u00fck\u00fcmleri uygulan\u0131r.<\/p>\n

(4) Kurumca hastan\u0131n veya tetkikin yurt d\u0131\u015f\u0131na g\u00f6nderilmesi, tetkik ve tedavi i\u015flemleri, yurda d\u00f6n\u00fc\u015f\u00a0i\u015flemleri ile tedavi giderlerinin\u00a0\u00f6denmesinde, misyon\u00a0\u015feflikleri ile gerekti\u011finde i\u015fbirli\u011fi yap\u0131labilir.<\/p>\n

(5) Yurt d\u0131\u015f\u0131ndaki tedavi s\u00fcresi, alt\u0131\u00a0ay\u0131\u00a0ge\u00e7memek kayd\u0131\u00a0ile sa\u011fl\u0131k kurulu raporunda belirtilir. Tedavi s\u00fcresi raporda belirtilen s\u00fcreyi ge\u00e7emez. T\u0131bb\u00ee\u00a0nedenlerle yurt d\u0131\u015f\u0131nda tedavinin uzamas\u0131\u00a0h\u00e2linde, t\u0131bb\u00ee\u00a0gerek\u00e7eleri misyon\u015feflikleri vas\u0131tas\u0131yla Kuruma g\u00f6nderilir. Sevke esas sa\u011fl\u0131k kurulu raporunu teyit eden sa\u011fl\u0131k hizmeti sunucusunun g\u00f6r\u00fc\u015f\u00fc\u00a0ve Kurumun onay\u0131\u00a0ile bu s\u00fcre alt\u0131\u00a0ay\u0131\u00a0ge\u00e7meyen d\u00f6nemler halinde uzat\u0131labilir. Belirlenen ya da uzat\u0131lan s\u00fcrenin a\u015f\u0131lmas\u0131\u00a0h\u00e2linde a\u015f\u0131lan s\u00fcreye ait tedavi giderleri ile g\u00fcndelik ve refakat\u00e7i giderleri\u00a0\u00f6denmez.<\/p>\n

(6) Sa\u011fl\u0131k kurulu raporu ile belgelendirilmek ve Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca onaylanmak ko\u015fuluyla yurt i\u00e7inde yap\u0131lamayan tetkikler, numunenin veya gerek\u00e7eleri ile belirtilmek kayd\u0131yla hastan\u0131n g\u00f6nderilmesi suretiyle yurt d\u0131\u015f\u0131sa\u011fl\u0131k hizmeti sunucular\u0131nda yapt\u0131r\u0131l\u0131r.<\/p>\n

(7) Yurt d\u0131\u015f\u0131\u00a0tedaviye ili\u015fkin raporlar\u0131n Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca onaylanmas\u0131ndan itibaren\u00a0\u00fc\u00e7\u00a0ay i\u00e7inde yurt d\u0131\u015f\u0131na\u00e7\u0131k\u0131lmamas\u0131\u00a0nedeniyle i\u015flem yap\u0131lmayan raporlar\u0131n yenilenmesi gerekir.<\/p>\n

(8) Yurt i\u00e7inde sa\u011flanamayan organ nakli i\u00e7in yurt d\u0131\u015f\u0131nda bekleme s\u00fcresi ile bu s\u00fcrenin uzat\u0131m\u0131na ili\u015fkin usul ve esaslar Kurumca belirlenir.<\/p>\n

(9) Yurt d\u0131\u015f\u0131\u00a0tetkik ve tedavi i\u00e7in sevklere esas te\u015fkil edecek sa\u011fl\u0131k kurulu raporlar\u0131n\u0131n d\u00fczenlenmesi, onay i\u015flemleri, yurt d\u0131\u015f\u0131na g\u00f6nderilme ve\u00a0\u00f6demelere ili\u015fkin di\u011fer usul ve esaslar Kurumca belirlenir.<\/p>\n

Yurt d<\/b>\u0131\u015f\u0131<\/b>\u00a0tahlil, tetkik ve tedaviye ili<\/b>\u015f<\/b>kin\u00a0<\/b>\u00f6<\/b>demeler ve belgelerin onaylanmas<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 33\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurumca, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin yurt d\u0131\u015f\u0131nda yap\u0131lacak tedavileri ile tetkik i\u015flemleri i\u00e7in yap\u0131lacak giderlere mahsuben ki\u015filere veya sa\u011fl\u0131k hizmeti sunucusuna avans\u00a0\u00f6denebilir. Misyon\u00a0\u015fefli\u011fi arac\u0131l\u0131\u011f\u0131yla da avans\u00a0\u00f6demesi yap\u0131labilir.<\/p>\n

(2) Kurum, avans\u00a0\u00f6demeleri i\u00e7in, yurt d\u0131\u015f\u0131ndaki sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0taraf\u0131ndan d\u00fczenlenen belgelerin ve raporlar\u0131n misyon\u00a0\u015feflikleri taraf\u0131ndan terc\u00fcme edilmesini ve onaylanmas\u0131n\u0131\u00a0isteyebilir. Ayr\u0131ca, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer taraf\u0131ndan belge ve raporlar\u0131n yetkili terc\u00fcmanlar taraf\u0131ndan yap\u0131lm\u0131\u015fterc\u00fcmelerini de kabul edebilir.<\/p>\n

(3) Yurt d\u0131\u015f\u0131na tedavi amac\u0131yla g\u00f6nderilen hasta ile raporda\u00a0\u00f6ng\u00f6r\u00fclmesi halinde bir ki\u015fiyle s\u0131n\u0131rl\u0131\u00a0olmak\u00fczere refakat\u00e7isinin\u00a0\u00a0yol gideri, belirlenen ula\u015f\u0131m arac\u0131na g\u00f6re fatura\/bilet tutar\u0131\u00a0\u00fczerinden Kurumca kar\u015f\u0131lan\u0131r. 18 ya\u015f\u0131n\u0131\u00a0doldurmam\u0131\u015f\u00a0ki\u015filer i\u00e7in refakat\u00e7i\u00a0\u00f6ng\u00f6r\u00fclme\u00a0\u015fart\u0131\u00a0aranmaz.<\/p>\n

(4) Yurt d\u0131\u015f\u0131na tedavi amac\u0131yla g\u00f6nderilen hasta ve refakat\u00e7isine ayaktan tedavinin sa\u011fland\u0131\u011f\u0131\u00a0g\u00fcnler i\u00e7in g\u00fcndelik, yatarak tedavide ise yatarak tedavi s\u00fcresi ile s\u0131n\u0131rl\u0131\u00a0olmak\u00a0\u00fczere sa\u011fl\u0131k hizmeti sunucusunda kal\u0131nmayan g\u00fcnler i\u00e7in refakat\u00e7isine yemek ve yatak gideri, g\u00fcndelik tutar\u0131n\u0131\u00a0a\u015fmamak\u00a0\u00fczere\u00a0\u00f6denir. Ayr\u0131ca Kurumca yurt d\u0131\u015f\u0131na organ nakli i\u00e7in g\u00f6nderilen hastan\u0131n, uygun organ teminine kadar ge\u00e7ecek s\u00fcreyi naklin yap\u0131laca\u011f\u0131\u00a0\u00fclkede beklemesine onay verilen hasta ve refakat\u00e7isine Kurumca belirlenen s\u00fcre i\u00e7in g\u00fcndelik\u00a0\u00f6denir.<\/p>\n

(5) Yurt d\u0131\u015f\u0131na tedavi amac\u0131yla g\u00f6nderilenlerin tedavi giderleri, Kurum taraf\u0131ndan yurt d\u0131\u015f\u0131\u00a0sa\u011fl\u0131k hizmeti sunucusunun banka hesab\u0131na havale edilmesi veya ki\u015filerce\u00a0\u00f6denen tutar\u0131n belge kar\u015f\u0131l\u0131\u011f\u0131\u00a0kendilerine\u00a0\u00f6denmesi suretiyle kar\u015f\u0131lan\u0131r.<\/p>\n

(6) Yurt d\u0131\u015f\u0131\u00a0s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucusuna g\u00f6nderilen hastan\u0131n sevke konu tetkik\/tedavi giderleri s\u00f6zle\u015fme h\u00fck\u00fcmlerine g\u00f6re\u00a0\u00f6denir. Kurumla s\u00f6zle\u015fmesi olmayan yurt d\u0131\u015f\u0131\u00a0sa\u011fl\u0131k hizmeti sunucusunda yap\u0131lan tetkik\/tedavi giderlerinin tamam\u0131\u00a0Kurumca kar\u015f\u0131lan\u0131r. Ki\u015finin tercihi do\u011frultusunda Kurumun yurt d\u0131\u015f\u0131nda s\u00f6zle\u015fmeli oldu\u011fu sa\u011fl\u0131k hizmeti sunucusuna gitmemesi h\u00e2linde s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucusuna\u00a0\u00f6denebilecek tutar\u0131ge\u00e7memek\u00a0\u00fczere tetkik\/tedavi giderleri Kurumca\u00a0\u00f6denir.<\/p>\n

(7) Yurt d\u0131\u015f\u0131na tedavi amac\u0131yla g\u00f6nderilen hastan\u0131n sevke konu hastal\u0131\u011f\u0131na ba\u011fl\u0131\u00a0olarak geli\u015fen komplikasyon, ili\u015fkili tedaviler ve acil h\u00e2ller d\u0131\u015f\u0131ndaki sa\u011fl\u0131k hizmetleri Kurumca\u00a0\u00f6denmez.<\/p>\n

(8) Yurt d\u0131\u015f\u0131nda hastaya uygulanan ba\u015fka bir tedavinin bu madde kapsam\u0131nda olup olmad\u0131\u011f\u0131n\u0131n tespit edilemedi\u011fi durumlarda yurt d\u0131\u015f\u0131\u00a0tedavi raporunu teyit eden hastanenin de g\u00f6r\u00fc\u015f\u00fc\u00a0al\u0131nmak suretiyle Kurumca karar verilerek i\u015flem yap\u0131l\u0131r.<\/p>\n

(9) Yurt d\u0131\u015f\u0131na belirli bir tedavi i\u00e7in g\u00f6nderilen hastaya ilgili sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0taraf\u0131ndan farkl\u0131\u00a0bir tedavi uygulamas\u0131\u00a0\u00f6ng\u00f6r\u00fclm\u00fc\u015f\u00a0ise, 32 nci maddenin birinci f\u0131kras\u0131nda belirtilen rapor ve onaylar\u0131n yeni tedavi i\u00e7in de al\u0131nm\u0131\u015f\u00a0olmas\u0131\u00a0halinde tedavi giderleri kar\u015f\u0131lan\u0131r.<\/p>\n

(10) Tedavi\/ tetkik i\u00e7in yurt d\u0131\u015f\u0131na g\u00f6nderilen hastan\u0131n\u00a0\u00f6l\u00fcm\u00fc\u00a0h\u00e2linde cenazesinin nakil gideri ile varsa refakat\u00e7isinin yurda d\u00f6n\u00fc\u015f\u00a0yol giderleri Kurumca kar\u015f\u0131lan\u0131r.<\/p>\n

(11) Yurt i\u00e7inde yap\u0131lamayan tetkiklere ait\u00a0\u00fccretler, tetkiki yapan sa\u011fl\u0131k hizmeti sunucusunca d\u00fczenlenen faturada\/ fatura yerine ge\u00e7en belgede belirtilen tutar\u00a0\u00fczerinden kar\u015f\u0131lan\u0131r. Hastan\u0131n g\u00f6nderilmesi suretiyle yapt\u0131r\u0131lan tetkiklere ili\u015fkin yol ve g\u00fcndelik giderleri Kurumca ayr\u0131ca kar\u015f\u0131lan\u0131r.<\/p>\n

ALTINCI B\u00d6L\u00dcM<\/p>\n

Sa\u011fl\u0131k Hizmetleri ile Yol Gideri, G\u00fcndelik ve Refakat\u00e7i Giderlerinin<\/p>\n

Kurumca\u00a0\u00d6denecek Tutarlar\u0131n\u0131n Belirlenmesi,<\/p>\n

Fatura\u00a0\u0130ncelenmesi ve\u00a0\u00d6deme\u00a0\u0130\u015flemleri<\/p>\n

Sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmetleri ile yol gideri, g<\/b>\u00fc<\/b>ndelik ve refakat<\/b>\u00e7<\/b>i giderlerinin Kurumca\u00a0<\/b>\u00f6<\/b>denecek tutarlar<\/b>\u0131<\/b>n<\/b>\u0131<\/b>n belirlenmesi<\/b><\/p>\n

MADDE 34\u00a0<\/b>\u2013<\/b>\u00a0(1) Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesi gere\u011fi Kurumca tespit edilen finansman\u0131\u00a0sa\u011flanacak sa\u011fl\u0131k hizmetlerinin ve yol gideri, g\u00fcndelik ve refakat\u00e7i giderlerinin Kurumca\u00a0\u00f6denecek tutarlar\u0131; sa\u011fl\u0131k hizmetinin sunuldu\u011fu il ve basamak, sa\u011fl\u0131k hizmetlerinin maliyeti, Devletin do\u011frudan veya dolayl\u0131\u00a0olarak sa\u011flam\u0131\u015f\u00a0oldu\u011fu s\u00fcbvansiyonlar, sa\u011fl\u0131k hizmetinin niteli\u011fi itibar\u0131yla hayati\u00a0\u00f6neme sahip olup olmamas\u0131, kan\u0131ta dayal\u0131\u00a0t\u0131p uygulamalar\u0131, te\u015fhis ve tedavi maliyetini esas alan maliyet-etkililik\u00a0\u00f6l\u00e7\u00fctleri ve genel sa\u011fl\u0131k sigortas\u0131\u00a0b\u00fct\u00e7esi dikkate al\u0131nmak suretiyle, her s\u0131n\u0131f i\u00e7in tek tek veya grupland\u0131r\u0131larak Sa\u011fl\u0131k Hizmetleri Fiyatland\u0131rma Komisyonu taraf\u0131ndan belirlenir.<\/p>\n

(2) Kurumca finansman\u0131\u00a0sa\u011flanan sa\u011fl\u0131k hizmetlerinin bedeli, Sa\u011fl\u0131k Hizmetleri Fiyatland\u0131rma Komisyonu taraf\u0131ndan belirlenen tutar\u00a0\u00fczerinden\u00a0\u00f6denir.<\/p>\n

S<\/b>\u00f6<\/b>zle<\/b>\u015f<\/b>meli sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmeti sunucular<\/b>\u0131<\/b>\u00a0faturalar<\/b>\u0131<\/b>n<\/b>\u0131<\/b>n incelenmesi ve\u00a0<\/b>\u00f6<\/b>deme i<\/b>\u015f<\/b>lemleri<\/b><\/p>\n

MADDE 35\u00a0<\/b>\u2013<\/b>\u00a0(1) S\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0taraf\u0131ndan Kuruma g\u00f6nderilen faturalar, genel sonu\u00e7lar verecek\u00a0\u015fekilde Kanunla belirlenen oran\u0131nda\u00a0\u00f6rnekleme metodu ile incelenir. Bu inceleme sonucunda sa\u011fl\u0131k hizmeti sunan ger\u00e7ek veya t\u00fczel ki\u015filer ile kamu idarelerine ait d\u00f6ner sermayeli i\u015fletmelerin incelenen d\u00f6neme ait b\u00fct\u00fcn faturalar\u0131na uygulanmak suretiyle\u00a0\u00f6denecek tutar tespit edilir ve buna g\u00f6re\u00a0\u00f6deme yap\u0131l\u0131r. Kurum ihtiya\u00e7duydu\u011fu h\u00e2llerde faturalar\u0131n tamam\u0131n\u0131\u00a0incelemeye yetkilidir.<\/p>\n

(2)\u00a0\u00d6rnekleme yap\u0131larak fatura incelemesi y\u00f6ntemini kabul etmeyen sa\u011fl\u0131k hizmeti sunucular\u0131, bu tercihlerini hizmet vermeye ba\u015flamadan\u00a0\u00f6nce Kuruma yaz\u0131l\u0131\u00a0olarak bildirir. Bildirimde bulunulmamas\u0131\u00a0h\u00e2linde\u00a0\u00f6rnekleme y\u00f6ntemi kabul edilmi\u015f\u00a0say\u0131l\u0131r.<\/p>\n

(3) G\u00f6t\u00fcr\u00fc\u00a0bedel\u00a0\u00fczerinden hizmet al\u0131m s\u00f6zle\u015fmesiyle temin edilen hizmetler i\u00e7in Kuruma ayr\u0131ca fatura ve dayana\u011f\u0131\u00a0belge g\u00f6nderilmez.<\/p>\n

(4) Sa\u011fl\u0131k harcamalar\u0131na esas fatura ve re\u00e7ete incelemeleri, Kurumun ta\u015fra birimlerinde ve Genel M\u00fcd\u00fcrl\u00fck b\u00fcnyesinde, fatura\/re\u00e7ete inceleme ile g\u00f6revlendirilen personel taraf\u0131ndan yap\u0131l\u0131r. Genel M\u00fcd\u00fcrl\u00fck b\u00fcnyesinde sa\u011fl\u0131k harcamalar\u0131na esas hangi fatura ve re\u00e7etelerin incelenece\u011fi ve inceleme usul ve esaslar\u0131\u00a0Genel M\u00fcd\u00fcrl\u00fck\u00e7e belirlenir.\u0130l m\u00fcd\u00fcrl\u00fcklerinde yap\u0131lan kesintilere ili\u015fkin itirazlar\u0131n de\u011ferlendirilmesine y\u00f6nelik olarak yap\u0131lan fatura inceleme i\u015flemleri, sa\u011fl\u0131k harcamalar\u0131na esas fatura ve re\u00e7ete inceleme i\u015flemi kapsam\u0131nda de\u011ferlendirilir.<\/p>\n

(5) Kurum,\u00a0\u00f6rnekleme y\u00f6ntemiyle yap\u0131lacak inceleme ve kontrol i\u00e7in Kurum d\u0131\u015f\u0131ndan tabip ve eczac\u0131g\u00f6revlendirilebilir.\u00a0\u0130htiya\u00e7\u00a0halinde inceleme ve kontrol i\u015flemleri, 1\/6\/1989 tarihli ve 3568 say\u0131l\u0131\u00a0Serbest Muhasebecilik, Serbest Muhasebeci Mali M\u00fc\u015favirlik ve Yeminli Mali M\u00fc\u015favirlik Kanununa t\u00e2bi meslek mensuplar\u0131ile ba\u011f\u0131ms\u0131z denetim kurulu\u015flar\u0131na da yapt\u0131r\u0131labilir. Bunlara yapt\u0131r\u0131lacak inceleme ve kontrole ili\u015fkin us\u00fbl ve esaslar Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u00a0ve Maliye Bakanl\u0131\u011f\u0131n\u0131n g\u00f6r\u00fc\u015fleri al\u0131narak belirlenir.<\/p>\n

(6) Sa\u011fl\u0131k hizmeti sunucular\u0131, bir fatura d\u00f6neminde sunmu\u015f\u00a0olduklar\u0131\u00a0hizmetlere ili\u015fkin fatura ve eki belgeleri fatura teslim s\u00fcresi i\u00e7inde Kuruma teslim ederler. Kuruma teslim edilen fatura bedelinin tamam\u0131, fatura teslim tarihinden itibaren, altm\u0131\u015f\u00a0g\u00fcn i\u00e7inde, sa\u011fl\u0131k hizmet sunucular\u0131na avans olarak\u00a0\u00f6denir.\u00a0\u00a0Fatura ve eki belgeler, fatura teslim tarihinden itibaren\u00a0\u00fc\u00e7\u00a0ay i\u00e7inde incelenerek avans hesab\u0131\u00a0kapat\u0131l\u0131r.\u00a0\u0130nceleme sonucu fazla\u00a0\u00f6deme yap\u0131ld\u0131\u011f\u0131n\u0131n tespiti h\u00e2linde; yap\u0131lan fazla\u00a0\u00f6deme sa\u011fl\u0131k hizmeti sunucusunun varsa Kurumdan alaca\u011f\u0131ndan mahsup edilir. Alaca\u011f\u0131n\u0131n bu miktar\u0131\u00a0kar\u015f\u0131lamamas\u0131\u00a0veya alaca\u011f\u0131n\u0131n bulunmamas\u0131\u00a0durumunda genel h\u00fck\u00fcmlere g\u00f6re tahsil edilir.\u0130nceleme s\u00fcresinin takip eden mali y\u0131la sirayet etmesi durumunda, avans art\u0131klar\u0131\u00a0hakk\u0131nda 5018 say\u0131l\u0131\u00a0Kanununun 35 inci maddesindeki akreditiflere ili\u015fkin h\u00fck\u00fcmler uygulan\u0131r.<\/p>\n

S<\/b>\u00f6<\/b>zle<\/b>\u015f<\/b>mesiz sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmeti sunucular<\/b>\u0131<\/b>ndan al<\/b>\u0131<\/b>nan sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmeti giderlerinin\u00a0<\/b>\u00f6<\/b>denmesi<\/b><\/p>\n

MADDE 36\u00a0<\/b>\u2013<\/b>\u00a0(1) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin s\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmeti sunucular\u0131ndan acil h\u00e2ller hari\u00e7\u00a0olmak\u00a0\u00fczere ald\u0131\u011f\u0131\u00a0sa\u011fl\u0131k hizmeti giderleri\u00a0\u00f6denmez.<\/p>\n

(2) S\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filere acil h\u00e2llerde sunduklar\u0131\u00a0sa\u011fl\u0131k hizmetlerini, Kanunun 72 nci maddesi gere\u011fi s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0i\u00e7in belirlenen tutar esas al\u0131narak ki\u015filere fatura eder. Kurumca yap\u0131lacak inceleme sonras\u0131nda belirlenen tutarlar, fatura kar\u015f\u0131l\u0131\u011f\u0131\u00a0ki\u015filere\u00a0\u00f6denir. S\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0acil h\u00e2llerde, Kanunun 72 nci maddesi gere\u011fi belirlenen tutarlar d\u0131\u015f\u0131nda genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerden veya Kurumdan herhangi bir fark talep edemez.<\/p>\n

Genel sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k sigortal<\/b>\u0131<\/b>s<\/b>\u0131<\/b>\u00a0ile bakmakla y<\/b>\u00fc<\/b>k<\/b>\u00fc<\/b>ml<\/b>\u00fc<\/b>\u00a0oldu<\/b>\u011f<\/b>u ki<\/b>\u015f<\/b>ilere yap<\/b>\u0131<\/b>lacak\u00a0<\/b>\u00f6<\/b>demeler<\/b><\/p>\n

MADDE 37\u00a0<\/b>\u2013<\/b>\u00a0(1) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ile bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer i\u00e7in yap\u0131lacak\u00a0\u00f6demeler, 27\/6\/2007 tarihli ve 26565 say\u0131l\u0131\u00a0Resm\u00ee\u00a0Gazete\u2019de yay\u0131mlanan Sosyal G\u00fcvenlik Kurumlar\u0131\u00a0Harcama Belgeleri Y\u00f6netmeli\u011finde belirtilen ki\u015filere yap\u0131l\u0131r.<\/p>\n

YED\u0130NC\u0130\u00a0B\u00d6L\u00dcM<\/p>\n

Genel Sa\u011fl\u0131k Sigortas\u0131\u00a0Bak\u0131m\u0131ndan R\u00fccu ve Yersiz\u00a0\u00d6demelerin Geri Al\u0131nmas\u0131<\/p>\n

\u0130\u015f<\/b>verenin i<\/b>\u015f<\/b>\u00a0kazas<\/b>\u0131<\/b>\u00a0ve meslek hastal<\/b>\u0131\u011f\u0131<\/b>\u00a0h<\/b>\u00e2<\/b>linde sorumlulu<\/b>\u011f<\/b>u ve r<\/b>\u00fc<\/b>cu<\/b><\/p>\n

MADDE 38\u00a0<\/b>\u2013<\/b>\u00a0(1)\u00a0\u0130\u015fveren, i\u015f\u00a0kazas\u0131na u\u011frayan veya meslek hastal\u0131\u011f\u0131na tutulan genel sa\u011fl\u0131k sigortal\u0131s\u0131na, sa\u011fl\u0131k durumunun gerektirdi\u011fi sa\u011fl\u0131k hizmetlerini derhal sa\u011flamakla y\u00fck\u00fcml\u00fcd\u00fcr. Bu ama\u00e7la i\u015fveren taraf\u0131ndan yap\u0131lan ve belgelere dayanan sa\u011fl\u0131k hizmeti giderleri ve yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri, Sa\u011fl\u0131k Hizmetleri Fiyatland\u0131rma Komisyonu taraf\u0131ndan belirlenen tutar\u0131\u00a0ge\u00e7memek\u00a0\u00fczere Kurum taraf\u0131ndan kar\u015f\u0131lan\u0131r.<\/p>\n

(2) Birinci f\u0131krada belirtilen y\u00fck\u00fcml\u00fcl\u00fcklerin yerine getirilmesindeki ihmalinden veya gecikmesinden dolay\u0131, genel sa\u011fl\u0131k sigortal\u0131s\u0131n\u0131n tedavi s\u00fcresinin uzamas\u0131na veya malul kalmas\u0131na veya malull\u00fck derecesinin artmas\u0131na sebep olan i\u015fveren, Kurumun bu nedenle yapt\u0131\u011f\u0131\u00a0her t\u00fcrl\u00fc\u00a0sa\u011fl\u0131k hizmeti giderini\u00a0\u00f6der.<\/p>\n

(3)\u00a0\u0130\u015f\u00a0kazas\u0131\u00a0ile meslek hastal\u0131\u011f\u0131, i\u015fverenin kast\u0131\u00a0veya sigortal\u0131n\u0131n i\u015f\u00a0sa\u011fl\u0131\u011f\u0131n\u0131\u00a0koruma ve i\u015f\u00a0g\u00fcvenli\u011fi ile ilgili mevzuat h\u00fck\u00fcmlerine ayk\u0131r\u0131\u00a0hareketi sonucu olmu\u015fsa, Kurumca yap\u0131lan veya yap\u0131lacak i\u015f\u00a0kazas\u0131na ve meslek hastal\u0131\u011f\u0131na y\u00f6nelik sa\u011fl\u0131k hizmetine ili\u015fkin giderler ile yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri i\u015fverene tazmin ettirilir.\u00a0\u0130\u015fverenin sorumlulu\u011funun tespitinde ka\u00e7\u0131n\u0131lmazl\u0131k ilkesi dikkate al\u0131n\u0131r.<\/p>\n

(4)\u00a0\u0130\u015fverenin bu maddenin uygulanmas\u0131na ili\u015fkin sorumluluklar\u0131, yurt d\u0131\u015f\u0131nda ge\u00e7ici ya da s\u00fcrekli g\u00f6revlendirme h\u00e2linde de devam eder.<\/p>\n

Sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k raporu olmaks<\/b>\u0131<\/b>z<\/b>\u0131<\/b>n\u00a0<\/b>\u00e7<\/b>al<\/b>\u0131\u015f<\/b>t<\/b>\u0131<\/b>rma h<\/b>\u00e2<\/b>linde r<\/b>\u00fc<\/b>cu<\/b><\/p>\n

MADDE 39\u00a0<\/b>\u2013<\/b>\u00a0(1)\u00a0\u0130lgili kanunlar\u0131\u00a0gere\u011fince\u00a0\u00e7al\u0131\u015faca\u011f\u0131\u00a0i\u015f\u00a0i\u00e7in sa\u011fl\u0131k raporu al\u0131nmas\u0131\u00a0gerekti\u011fi h\u00e2lde, sa\u011fl\u0131k raporuna dayanmaks\u0131z\u0131n veya al\u0131nan raporlarda\u00a0\u00e7al\u0131\u015ft\u0131\u011f\u0131\u00a0i\u015fte t\u0131bb\u00ee\u00a0y\u00f6nden\u00a0\u00e7al\u0131\u015fmas\u0131n\u0131n elveri\u015fli olmad\u0131\u011f\u0131\u00a0belirtildi\u011fi h\u00e2lde, genel sa\u011fl\u0131k sigortal\u0131s\u0131n\u0131\u00a0\u00e7al\u0131\u015ft\u0131ran i\u015fverenlere, bu nedenlerle Kurumca yap\u0131lan sa\u011fl\u0131k hizmetine ili\u015fkin giderler ile yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri tazmin ettirilir.<\/p>\n

(2) Kanunun 4\u00a0\u00fcnc\u00fc\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (a) ve (c) bentleri kapsam\u0131ndaki ki\u015filer, hekim veya di\u015fhekimi sa\u011fl\u0131k raporu ile\u00a0\u00e7al\u0131\u015famayaca\u011f\u0131\u00a0belgelenen i\u015flerde\u00a0\u00e7al\u0131\u015ft\u0131r\u0131lamaz. Bu ki\u015fileri\u00a0\u00e7al\u0131\u015ft\u0131ran i\u015fverenler, genel sa\u011fl\u0131k sigortal\u0131s\u0131n\u0131n ayn\u0131\u00a0hastal\u0131\u011f\u0131\u00a0ve illiyet ba\u011f\u0131\u00a0kurulan hastal\u0131klar\u0131\u00a0sebebiyle Kurumca yap\u0131lan masraflar\u0131n\u0131\u00a0\u00f6demekle y\u00fck\u00fcml\u00fcd\u00fcr. Tedavinin sona erdi\u011fine ve\u00a0\u00e7al\u0131\u015f\u0131labilir durumda oldu\u011funa dair Kurumca yetkilendirilen hekim veya sa\u011fl\u0131k kurullar\u0131ndan belge almaks\u0131z\u0131n ba\u015fka i\u015fte\u00a0\u00e7al\u0131\u015fan genel sa\u011fl\u0131k sigortal\u0131s\u0131n\u0131n ayn\u0131\u00a0hastal\u0131\u011f\u0131\u00a0ve illiyet ba\u011f\u0131kurulan hastal\u0131klar\u0131\u00a0sebebiyle do\u011facak masraflardan kendisi ve bu durumu bilerek\u00a0\u00e7al\u0131\u015ft\u0131ran i\u015fveren Kuruma kar\u015f\u0131m\u00fc\u015ftereken ve m\u00fcteselsilen sorumludur.<\/p>\n

\u00dc\u00e7\u00fc<\/b>nc<\/b>\u00fc<\/b>\u00a0ki<\/b>\u015f<\/b>ilere r<\/b>\u00fc<\/b>cu<\/b><\/p>\n

MADDE 40\u00a0<\/b>\u2013<\/b>\u00a0(1) Genel sa\u011fl\u0131k sigortal\u0131s\u0131na ve bunlar\u0131n bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filere kast\u0131\u00a0veya su\u00e7say\u0131l\u0131r bir hareketi veya ilgili kanunlarla verilmi\u015f\u00a0bir g\u00f6revi yapmamas\u0131\u00a0ya da ihmali nedeniyle Kurumun sa\u011fl\u0131k hizmeti sa\u011flamas\u0131na veya bu ki\u015filerin tedavi s\u00fcresinin uzamas\u0131na sebep oldu\u011fu mahkeme karar\u0131yla tespit edilen\u00fc\u00e7\u00fcnc\u00fc\u00a0ki\u015filere, Kurumun bu nedenlerle yapt\u0131\u011f\u0131\u00a0sa\u011fl\u0131k hizmeti giderleri tazmin ettirilir. A\u00e7\u0131lacak r\u00fccuan tazminat davalar\u0131nda, kusur oranlar\u0131\u00a0da dikkate al\u0131n\u0131r.<\/p>\n

(2) Kurumun di\u011fer mevzuat h\u00fck\u00fcmlerine dayanan r\u00fccu veya halefiyet hakk\u0131\u00a0sakl\u0131d\u0131r.<\/p>\n

Yersiz\u00a0<\/b>\u00f6<\/b>demelerin geri al<\/b>\u0131<\/b>nmas<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 41\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurumca genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer ile sa\u011fl\u0131k hizmeti sunucular\u0131na, fazla veya yersiz olarak yap\u0131ld\u0131\u011f\u0131\u00a0tespit edilen Kanun kapsam\u0131ndaki her t\u00fcrl\u00fc\u00a0\u00f6demeler, Kurum taraf\u0131ndan belirlenen usul ve esaslara g\u00f6re geri al\u0131n\u0131r.<\/p>\n

SEK\u0130Z\u0130NC\u0130\u00a0B\u00d6L\u00dcM<\/p>\n

Denetim Yetkisi,\u00a0\u0130dari Para Cezalar\u0131,\u00a0\u0130dari Yapt\u0131r\u0131mlar ve S\u00f6zle\u015fme Feshi<\/p>\n

Sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmeti sunucular<\/b>\u0131<\/b>na ili<\/b>\u015f<\/b>kin Kurumun denetleme ve kontrol yetkisi<\/b><\/p>\n

MADDE 42\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurum, genel sa\u011fl\u0131k sigortas\u0131\u00a0h\u00fck\u00fcmlerinin uygulanmas\u0131yla ilgili olarak i\u015fverenler, s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0ile di\u011fer sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0ve di\u011fer ger\u00e7ek ve t\u00fczel ki\u015filer nezdindeki defter, belge ve bilgileri, hasta mahremiyetini ihlal etmeyecek\u00a0\u015fekilde, ibraz\u0131n\u0131\u00a0isteyebilir.<\/p>\n

(2) Kurum, Kanunda belirtilen g\u00f6revleriyle ilgili olarak s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0ile di\u011fer sa\u011fl\u0131k hizmeti sunucular\u0131n\u0131n y\u00fcr\u00fctt\u00fc\u011f\u00fc\u00a0hizmet ve i\u015flemleri kontrol yetkisine sahiptir. Kurum, bu yetkisini g\u00f6revlendirdi\u011fi personeli vas\u0131tas\u0131yla veya kamu kurumlar\u0131\u00a0ve\u00a0\u00f6zel kurumlardan hizmet sat\u0131n almak suretiyle kullanabilir.<\/p>\n

(3) Kurum, genel sa\u011fl\u0131k sigortas\u0131\u00a0h\u00fck\u00fcmlerinin uygulanmas\u0131\u00a0bak\u0131m\u0131ndan, gerekti\u011finde g\u00f6revlendirece\u011fi personeli vas\u0131tas\u0131yla Kanunun 59 uncu maddesinin yedinci f\u0131kras\u0131nda tan\u0131nan yetkileri kullanabilir.<\/p>\n

(4) Kurum, genel sa\u011fl\u0131k sigortas\u0131\u00a0h\u00fck\u00fcmlerinin, s\u00f6zle\u015fme h\u00fck\u00fcmlerinin ve kapsamdaki ki\u015filer taraf\u0131ndan al\u0131nan sa\u011fl\u0131k hizmetlerinin denetlenmesini; sa\u011fl\u0131k hizmeti sunucular\u0131nda kuraca\u011f\u0131\u00a0provizyon merkezleri arac\u0131l\u0131\u011f\u0131yla yapabilece\u011fi gibi, elektronik ve yaz\u0131l\u0131\u00a0belgelerin\u00a0\u00fczerinde veya sa\u011fl\u0131k hizmeti sunucusu b\u00fcnyesinde yapaca\u011f\u0131denetlemelerle de y\u00fcr\u00fctme yetkisine sahiptir. Kurum bu denetimleri ihbar veya\u00a0\u015fik\u00e2yete ba\u011fl\u0131\u00a0olarak, gerek\u00e7eli olarak, periyodik olarak veya benzeri nedenlerle yapabilir.<\/p>\n

(5) S\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0denetleme amac\u0131yla yap\u0131lacak\u00a0\u00e7al\u0131\u015fmalar i\u00e7in Kurum taraf\u0131ndan g\u00f6revlendirilen personele denetim s\u00fcresince, b\u00fcnyesinde konumlar\u0131na uygun bir\u00a0\u00e7al\u0131\u015fma ortam\u0131\u00a0sa\u011flamak ve g\u00f6revlerinin ifas\u0131\u00a0s\u0131ras\u0131nda gereken her t\u00fcrl\u00fc\u00a0kolayl\u0131\u011f\u0131\u00a0ve yard\u0131m\u0131\u00a0sa\u011flamak zorundad\u0131rlar.<\/p>\n

(6) Kurumun denetim ve kontrolle g\u00f6revlendirilmi\u015f\u00a0memurlar\u0131n\u0131n, Kanunun uygulanmas\u0131ndan do\u011fan inceleme ve soru\u015fturma g\u00f6revlerini yerine getirmeleri s\u0131ras\u0131nda i\u015fverenler, sigortal\u0131lar i\u015fyeri sahipleri ve bu i\u015fle ilgili di\u011fer ki\u015filer g\u00f6revlerini yapmas\u0131na engel olamazlar; engel olanlar hakk\u0131nda eylemleri ba\u015fka bir su\u00e7\u00a0olu\u015ftursa dahi, asgari\u00a0\u00fccretin be\u015f\u00a0kat\u0131\u00a0tutar\u0131nda idari para cezas\u0131\u00a0uygulan\u0131r. Denetim esnas\u0131nda sa\u011fl\u0131k hizmet sunucular\u0131\u00a0sahipleri ve bu i\u015fle ilgili di\u011fer ki\u015filer denetleme ekibinin g\u00f6revine engel olamazlar.<\/p>\n

(7) Sa\u011fl\u0131k hizmet sunucusu yetkilileri, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer ad\u0131na d\u00fczenledikleri veya tutmak zorunda olduklar\u0131\u00a0her t\u00fcrl\u00fc\u00a0kay\u0131t, fatura ve eki belgeler ile denetim ekibi taraf\u0131ndan haz\u0131rlanmas\u0131\u00a0istenilen tablo ve raporlar\u0131\u00a0denetim s\u00fcresi i\u00e7erisinde denetim ekibine g\u00f6stermek, vermek ve incelenmesine yard\u0131mc\u0131\u00a0olmak zorundad\u0131r.<\/p>\n

(8) Sa\u011fl\u0131k hizmeti sunucular\u0131n\u0131n denetlenmesi ve denetime al\u0131nma usul esaslar\u0131\u00a0Kurum taraf\u0131ndan belirlenir.<\/p>\n

Sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmeti sunucular<\/b>\u0131<\/b>na uygulanacak idar<\/b>\u00ee<\/b>\u00a0yapt<\/b>\u0131<\/b>r<\/b>\u0131<\/b>mlar ve fesih<\/b><\/p>\n

MADDE 43\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurumca yap\u0131lan inceleme neticesinde;<\/p>\n

a) Sa\u011fl\u0131k hizmeti sunulmad\u0131\u011f\u0131\u00a0h\u00e2lde sa\u011fl\u0131k hizmetini fatura etti\u011fi,<\/p>\n

b) Faturay\u0131\u00a0veya faturaya dayanak olu\u015fturan belgeleri, ger\u00e7e\u011fe ayk\u0131r\u0131\u00a0olarak d\u00fczenledi\u011fi,<\/p>\n

c) Kapsam d\u0131\u015f\u0131\u00a0tutulan sa\u011fl\u0131k hizmetlerini, kapsam i\u00e7inde olan sa\u011fl\u0131k hizmetleri gibi g\u00f6sterdi\u011fi,<\/p>\n

\u00e7) Sa\u011fl\u0131k hizmetlerine hak kazanmayan ki\u015filere, sa\u011fl\u0131k hizmeti sunarak Kuruma fatura etti\u011fi,<\/p>\n

d) Kurumca belirlenen tavan\u0131n\u00a0\u00fczerinde ilave\u00a0\u00fccret ald\u0131\u011f\u0131,<\/p>\n

e) Sa\u011fl\u0131k hizmeti sat\u0131n al\u0131nmas\u0131na y\u00f6nelik s\u00f6zle\u015fme h\u00fck\u00fcmlerine ayk\u0131r\u0131\u00a0davrand\u0131\u011f\u0131,<\/p>\n

tespit edilen s\u00f6zle\u015fmeli veya di\u011fer sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0hakk\u0131nda genel h\u00fck\u00fcmlere g\u00f6re takip yap\u0131l\u0131r.<\/p>\n

(2) Bu fiiller nedeniyle Kurumun yersiz\u00a0\u00f6dedi\u011fi tutar Kanunun 96 nc\u0131\u00a0maddesine g\u00f6re geri al\u0131n\u0131r. Ayr\u0131ca bu fiilleri i\u015fleyen s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucusunun Kurum ile yapt\u0131klar\u0131\u00a0s\u00f6zle\u015fmeler feshedilebilir. Kanunda say\u0131lan fiiller ve bu fiiller i\u00e7in getirilen yapt\u0131r\u0131mlar d\u0131\u015f\u0131nda, fesih gerektirecek fiiller ve s\u00fcreler belirleyebilir. Sa\u011fl\u0131k hizmeti sunucusunun uyar\u0131lmas\u0131n\u0131\u00a0veya s\u00f6zle\u015fmenin feshini gerektiren fiiller ile s\u00f6zle\u015fmenin feshedilmesi h\u00e2linde sa\u011fl\u0131k hizmet sunucusu ile s\u00f6zle\u015fme yap\u0131lmayacak s\u00fcreler, Kurum ile sa\u011fl\u0131k hizmeti sunucusunun yapt\u0131\u011f\u0131s\u00f6zle\u015fmelerde belirtilir. Bu s\u00fcreler sonunda sa\u011fl\u0131k hizmeti sunucusunun ba\u015fvurusu h\u00e2linde gerekli\u00a0\u015fartlar\u0131\u00a0ta\u015f\u0131yanlarla s\u00f6zle\u015fme yap\u0131l\u0131r.<\/p>\n

(3) S\u00f6zle\u015fmesi feshedilmi\u015f\u00a0sa\u011fl\u0131k hizmet sunucusunun, aktif ve pasifleri ile birlikte veya sadece ruhsat\u0131n\u0131n devredilmesi halinde her t\u00fcrl\u00fc\u00a0devir i\u015flemi devralan ger\u00e7ek ve\/veya t\u00fczel ki\u015filerle, devreden sa\u011fl\u0131k hizmeti sunucusuna s\u00f6zle\u015fmeden dolay\u0131\u00a0tahakkuk ettirilmi\u015f\u00a0Kurum zarar\u0131\u00a0tahsil edilmeden, yeni bir s\u00f6zle\u015fme yap\u0131lmaz.<\/p>\n

Di<\/b>\u011f<\/b>er yapt<\/b>\u0131<\/b>r<\/b>\u0131<\/b>mlar<\/b><\/p>\n

MADDE 44\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurum, sa\u011fl\u0131k hizmeti alan genel sa\u011fl\u0131k sigortal\u0131s\u0131ndan veya bunlar\u0131n bakmakla y\u00fck\u00fcml\u00fcoldu\u011fu ki\u015filerden, sa\u011fl\u0131k hizmetinin ger\u00e7ekten al\u0131n\u0131p al\u0131nmad\u0131\u011f\u0131n\u0131\u00a0tespit amac\u0131yla kontrol muayenesi ve tetkik yapt\u0131r\u0131lmas\u0131n\u0131\u00a0talep edebilir.<\/p>\n

(2) Genel sa\u011fl\u0131k sigortas\u0131\u00a0ve s\u00f6zle\u015fme h\u00fck\u00fcmlerine ayk\u0131r\u0131\u00a0uygulama nedeniyle Kurumun zarara u\u011framas\u0131na sebebiyet veren s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131ndan u\u011fran\u0131lan zarar geri al\u0131n\u0131r. Kurum ayr\u0131ca bu fiilleri i\u015fleyen sa\u011fl\u0131k hizmeti sunucular\u0131na s\u00f6zle\u015fme h\u00fck\u00fcmleri do\u011frultusunda cezai yapt\u0131r\u0131m uygulayabilir.<\/p>\n

DOKUZUNCU B\u00d6L\u00dcM<\/p>\n

\u00c7e\u015fitli ve Mal\u00ee\u00a0H\u00fck\u00fcmler<\/p>\n

Sosyal G<\/b>\u00fc<\/b>venlik Kurumu Sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k Uygulama Tebli<\/b>\u011f<\/b>i<\/b><\/p>\n

MADDE 45\u00a0<\/b>\u2013<\/b>\u00a0(1) Sosyal G\u00fcvenlik Kurumu Sa\u011fl\u0131k Uygulama Tebli\u011fi,<\/p>\n

a) Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (a), (b), (c), (d) ve (e) bentlerine g\u00f6re Kurumca finansman\u0131sa\u011flanan sa\u011fl\u0131k hizmetlerinin neler oldu\u011fu,<\/p>\n

b) Kurumca finansman\u0131\u00a0sa\u011flanan sa\u011fl\u0131k hizmetlerinin te\u015fhis ve tedavi y\u00f6ntemleri ile\u00a0\u00f6deme usul ve esaslar\u0131n\u0131,<\/p>\n

c) Kanunun 63\u00a0\u00fcnc\u00fc\u00a0maddesinin birinci f\u0131kras\u0131n\u0131n (f) bendine g\u00f6re sa\u011flanacak sa\u011fl\u0131k hizmetlerinin t\u00fcrlerini, miktarlar\u0131n\u0131\u00a0ve kullan\u0131m s\u00fcrelerini, Kurumca finansman\u0131n\u0131n sa\u011flanmas\u0131na ve\u00a0\u00f6denmesine ili\u015fkin usul ve esaslar\u0131n\u0131,<\/p>\n

\u00e7) Kanunun 65 inci maddesi gere\u011fi\u00a0\u00f6denecek yol gideri, g\u00fcndelik ve refakat\u00e7i giderlerinin kar\u015f\u0131lanmas\u0131na ili\u015fkin usul ve esaslar\u0131n\u0131,<\/p>\n

d) Sa\u011fl\u0131k Hizmetleri Fiyatland\u0131rma Komisyonu kararlar\u0131n\u0131,<\/p>\n

e) Kurumca uygun g\u00f6r\u00fclen di\u011fer hususlar\u0131,<\/p>\n

kapsar.<\/p>\n

Do<\/b>\u011f<\/b>al afetler veya sava<\/b>\u015f<\/b>\u00a0h<\/b>\u00e2<\/b>li<\/b><\/p>\n

MADDE 46\u00a0<\/b>\u2013<\/b>\u00a0(1) 7269 say\u0131l\u0131\u00a0Kanun kapsam\u0131ndaki afetler ile 4\/11\/1983 tarihli ve 2941 say\u0131l\u0131\u00a0Seferberlik ve Sava\u015f\u00a0Hali Kanunu gere\u011fince ilan edilen sava\u015f\u00a0h\u00e2linde, genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin sa\u011fl\u0131k hizmetlerinin finansman\u0131, genel sa\u011fl\u0131k sigortas\u0131\u00a0h\u00fck\u00fcmlerine g\u00f6re Kurum taraf\u0131ndan sa\u011flanmaya devam edilir. Ancak, afet veya sava\u015f\u00a0h\u00e2llerine ba\u011fl\u0131\u00a0nedenlerden dolay\u0131\u00a0Kurumca yap\u0131lan sa\u011fl\u0131k hizmetine ili\u015fkin giderler ile yol gideri, g\u00fcndelik ve refakat\u00e7i giderleri, giderlerin\u00a0\u00f6dendi\u011fi takvim y\u0131l\u0131\u00a0sonu esas al\u0131narak genel b\u00fct\u00e7eden Kuruma bir y\u0131l i\u00e7inde transfer edilir.<\/p>\n

Sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmeti sunucular<\/b>\u0131<\/b>n<\/b>\u0131<\/b>n duyurulmas<\/b>\u0131<\/b>\u00a0ve sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmeti sunucusunu se<\/b>\u00e7<\/b>me serbestisi<\/b><\/p>\n

MADDE 47\u00a0<\/b>\u2013<\/b>\u00a0(1) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin sa\u011fl\u0131k hizmetinden yararlanmak i\u00e7in ba\u015fvuracaklar\u0131\u00a0yurt i\u00e7inde veya yurt d\u0131\u015f\u0131ndaki s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131n\u0131n unvan, isim ve adresleri Kurumca elektronik veya internet ortam\u0131nda veya di\u011fer y\u00f6ntemlerle duyurulur.<\/p>\n

(2) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer, s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131aras\u0131ndan, genel sa\u011fl\u0131k sigortas\u0131yla ilgili 5510 say\u0131l\u0131\u00a0Kanunun di\u011fer madde h\u00fck\u00fcmlerine uymak\u00a0\u015fart\u0131yla istedi\u011fini se\u00e7me hakk\u0131na sahiptir.<\/p>\n

Sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k hizmeti sunucular<\/b>\u0131<\/b>n<\/b>\u0131<\/b>n kay<\/b>\u0131<\/b>t ve bildirim zorunlulu<\/b>\u011f<\/b>u ve sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k bilgilerinin gizlili<\/b>\u011f<\/b>i<\/b><\/p>\n

MADDE 48\u00a0<\/b>\u2013\u00a0(1) Kurum ile s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131, sa\u011fl\u0131k hizmeti sundu\u011fu ki\u015filere Kurumun bildirilmesini istedi\u011fi bilgileri, belirlenen y\u00f6ntemlere ve s\u00fcreye uygun bi\u00e7imde elektronik ortamda veya yaz\u0131l\u0131\u00a0olarak Kuruma g\u00f6ndermek zorundad\u0131r. Bu bilgiler g\u00f6nderilmeksizin genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filere ait talep edilen sa\u011fl\u0131k hizmeti giderleri, bilgiler g\u00f6nderilinceye kadar\u00a0\u00f6denmez.<\/p>\n

(2) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer ile bildirimi yap\u0131lan di\u011fer ki\u015filere ait sa\u011fl\u0131k bilgilerinin gizlili\u011fi esast\u0131r.<\/p>\n

(3) Kuruma ve s\u00f6zle\u015fmeli sa\u011fl\u0131k hizmet sunucular\u0131na ait bilgi i\u015flem veri taban\u0131ndaki sa\u011fl\u0131k verilerinin korunmas\u0131\u00a0ile g\u00fcvenli\u011finin sa\u011flanmas\u0131\u00a0ve payla\u015f\u0131lmas\u0131na ili\u015fkin i\u015flemler, 11\/7\/2012 tarihli ve 28350 say\u0131l\u0131\u00a0Resm\u00eeGazete\u2019de yay\u0131mlanan Genel Sa\u011fl\u0131k Sigortas\u0131\u00a0Verilerinin G\u00fcvenli\u011fi ve Payla\u015f\u0131m\u0131na\u00a0\u0130li\u015fkin Y\u00f6netmelik do\u011frultusunda y\u00fcr\u00fct\u00fcl\u00fcr.<\/p>\n

Devir, temlik ve Kurum alacaklar<\/b>\u0131<\/b>nda zamana<\/b>\u015f\u0131<\/b>m<\/b>\u0131<\/b><\/b><\/p>\n

MADDE 49\u00a0<\/b>\u2013<\/b>\u00a0(1) Kanun gere\u011fince, sa\u011fl\u0131k hizmeti sunucular\u0131n\u0131n genel sa\u011fl\u0131k sigortas\u0131\u00a0h\u00fck\u00fcmlerinin uygulanmas\u0131\u00a0sonucu Kurum nezdinde do\u011fan alacaklar\u0131\u00a0devir ve temlik edilemez.<\/p>\n

(2) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filer, s\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmeti sunucular\u0131ndan ald\u0131klar\u0131\u00a0sa\u011fl\u0131k hizmeti nedeniyle Kurumdan do\u011fan alacaklar\u0131n\u0131\u00a0s\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmeti sunucular\u0131na, sigorta\u015firketlerine veya\u00a0\u00fc\u00e7\u00fcnc\u00fc\u00a0ki\u015filere devir ve temlik edebilir.<\/p>\n

(3) Kurumun genel sa\u011fl\u0131k sigortas\u0131\u00a0primi ve di\u011fer alacaklar\u0131,\u00a0\u00f6deme s\u00fcresinin doldu\u011fu tarihi takip eden takvim y\u0131l\u0131\u00a0ba\u015f\u0131ndan ba\u015flayarak on y\u0131ll\u0131k zamana\u015f\u0131m\u0131na tabidir.<\/p>\n

(4) Kanunun ve bu Y\u00f6netmeli\u011fin genel sa\u011fl\u0131k sigortas\u0131\u00a0h\u00fck\u00fcmlerine dayan\u0131larak Kurumca a\u00e7\u0131lacak tazminat ve r\u00fccu davalar\u0131, on y\u0131ll\u0131k zamana\u015f\u0131m\u0131na tabidir. Zamana\u015f\u0131m\u0131\u00a0tarihi; r\u00fccu konusu masraf ve\u00a0\u00f6demeler bak\u0131m\u0131ndan, masraf veya\u00a0\u00f6deme tarihinden itibaren ba\u015flar.<\/p>\n

Zamana<\/b>\u015f\u0131<\/b>m<\/b>\u0131<\/b>, hakk<\/b>\u0131<\/b>n d<\/b>\u00fc\u015f<\/b>mesi ve avans<\/b><\/p>\n

MADDE 50\u00a0<\/b>\u2013<\/b>\u00a0(1) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin alacaklar\u0131, hakk\u0131\u00a0do\u011furan olay\u0131n\u00a0\u00f6\u011frenildi\u011fi tarihten itibaren iki y\u0131l i\u00e7inde istenmezse zamana\u015f\u0131m\u0131na u\u011frar, hakk\u0131\u00a0do\u011furan olay tarihinden itibaren ise be\u015f\u00a0y\u0131l sonunda d\u00fc\u015fer.<\/p>\n

(2) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin, Kanunun uygulanmas\u0131\u00a0bak\u0131m\u0131ndan hak ettikleri alacaklar\u0131n\u0131n s\u00fcresi i\u00e7inde\u00a0\u00f6denememesi h\u00e2linde, avans verilmesine Kurum yetkilidir.<\/p>\n

(3) Genel sa\u011fl\u0131k sigortal\u0131s\u0131n\u0131n yarg\u0131\u00a0karar\u0131yla gaipli\u011fine karar verilmesi h\u00e2linde genel sa\u011fl\u0131k sigortas\u0131na ait alacaklar\u0131n zaman a\u015f\u0131m\u0131\u00a0s\u00fcresi, gaipli\u011fe ili\u015fkin karar\u0131n kesinle\u015fti\u011fi tarihte ba\u015flar.<\/p>\n

Bilgi ve belge isteme hakk<\/b>\u0131<\/b>, bilgi ve belgelerin Kuruma verilme usul<\/b>\u00fc<\/b><\/b><\/p>\n

MADDE 51\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurum, genel sa\u011fl\u0131k sigortas\u0131\u00a0h\u00fck\u00fcmlerine ili\u015fkin yap\u0131lan soru\u015fturmalar hakk\u0131nda Cumhuriyet Savc\u0131l\u0131klar\u0131ndan, s\u00f6zle\u015fmeli ve s\u00f6zle\u015fmesiz sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0ile di\u011fer sa\u011fl\u0131k hizmeti sunucular\u0131ndan, kamu ve\u00a0\u00f6zel hukuk t\u00fczel ki\u015fileri ile ger\u00e7ek ki\u015filerden bilgi ve belge isteyebilir.<\/p>\n

(2) Kurum, genel sa\u011fl\u0131k sigortas\u0131\u00a0h\u00fck\u00fcmlerinin uygulanmas\u0131\u00a0gere\u011fi verilecek her t\u00fcrl\u00fc\u00a0belge veya bilginin internet, elektronik ve benzeri ortamda g\u00f6nderilmesi hususunda, ger\u00e7ek ve t\u00fczel ki\u015fileri zorunlu tutmaya yetkilidir.<\/p>\n

(3) Kurumca\u00a0\u00f6ng\u00f6r\u00fclen s\u00fcrede internet, elektronik ve benzeri ortamda belge veya bilgi g\u00f6ndermekle zorunlu tutulan ancak Kurumun bilgi i\u015flem sistemlerinin herhangi bir nedenle hizmet d\u0131\u015f\u0131\u00a0kalmas\u0131\u00a0sonucu g\u00f6nderemeyen sa\u011fl\u0131k hizmeti sunucular\u0131, Kurum bilgi i\u015flem sistemindeki sorunlar\u0131n ortadan kalkt\u0131\u011f\u0131\u00a0tarihi takip eden\u00a0\u00fc\u00e7\u00fcnc\u00fci\u015fg\u00fcn\u00fcn\u00fcn sonuna kadar istenilen belge ve bilgileri internet, elektronik ve benzeri ortamda g\u00f6ndermeleri h\u00e2linde Kurumca\u00a0\u00f6ng\u00f6r\u00fclen s\u00fcrede g\u00f6nderilmi\u015f\u00a0kabul edilir.<\/p>\n

Ya<\/b>\u015f<\/b>\u00a0tashihi<\/b><\/p>\n

MADDE 52\u00a0<\/b>\u2013<\/b>\u00a0<\/b>(1) Kanunun 60\u00a0\u0131nc\u0131\u00a0maddesi gere\u011fince genel sa\u011fl\u0131k sigortas\u0131\u00a0kapsam\u0131na girenler i\u00e7in tescil tarihinden sonra yap\u0131lacak ya\u015f\u00a0tashihleri genel sa\u011fl\u0131k sigortas\u0131\u00a0uygulamalar\u0131nda dikkate al\u0131nmaz.<\/p>\n

D<\/b>\u00fc<\/b>zenleme yetkisi<\/b><\/p>\n

MADDE 53\u00a0<\/b>\u2013<\/b>\u00a0(1) Kurum, bu Y\u00f6netmeli\u011fin uygulanmas\u0131na ili\u015fkin usul ve esaslar\u0131\u00a0d\u00fczenler.<\/p>\n

ONUNCU B\u00d6L\u00dcM<\/p>\n

Ge\u00e7ici ve Son H\u00fck\u00fcmler<\/p>\n

Genel sa<\/b>\u011f<\/b>l<\/b>\u0131<\/b>k sigortas<\/b>\u0131<\/b>\u00a0ge<\/b>\u00e7<\/b>i<\/b>\u015f<\/b>\u00a0h<\/b>\u00fc<\/b>k<\/b>\u00fc<\/b>mleri<\/b><\/p>\n

GE<\/b>\u00c7\u0130<\/b>C<\/b>\u0130<\/b>\u00a0MADDE 1\u00a0<\/b>\u2013<\/b>\u00a0(1) S\u00f6zle\u015fmeli sa\u011fl\u0131k hizmeti sunucular\u0131n\u0131n sigortal\u0131l\u0131k kontrol\u00fc\u00a0ve di\u011fer provizyon i\u015flemlerini elektronik ortamda yapmaya ba\u015flamas\u0131\u00a0i\u00e7in Kurumdaki gerekli bilgi i\u015flem altyap\u0131s\u0131n\u0131n kurulmas\u0131na kadar, mevcut uygulamalara devam edilir ve ki\u015filerin tedavi olmalar\u0131\u00a0i\u00e7in aranan sa\u011fl\u0131k belgelerinin veya sa\u011fl\u0131k karnelerinin kullan\u0131lmas\u0131na veya Kurumca verilmesine devam edilir.<\/p>\n

(2)\u00a0\u00a0Kurumca finansman\u0131\u00a0sa\u011flanacak sa\u011fl\u0131k hizmetleri ile g\u00fcndelik, yol, yatak ve yemek giderlerinin Kurumca\u00a0\u00f6denecek bedelleri tespit edilip yay\u0131mlan\u0131ncaya, sa\u011fl\u0131k hizmeti sunucular\u0131\u00a0ile s\u00f6zle\u015fmeler yap\u0131l\u0131ncaya kadar, bu Y\u00f6netmeli\u011fin 11 inci ve 12 nci maddelerinin birinci f\u0131kra h\u00fck\u00fcmleri sakl\u0131\u00a0kalmak kayd\u0131yla Kurum taraf\u0131ndan belirlenmi\u015f\u00a0olan usul ve esaslar, sa\u011fl\u0131k hizmeti bedelleri ile protokol ve s\u00f6zle\u015fmeler ge\u00e7erlidir.<\/p>\n

(3) Genel sa\u011fl\u0131k sigortal\u0131s\u0131\u00a0ve bakmakla y\u00fck\u00fcml\u00fc\u00a0oldu\u011fu ki\u015filerin, Kanunun y\u00fcr\u00fcrl\u00fc\u011fe girdi\u011fi tarihten\u00a0\u00f6nce ba\u015flayan ancak, Kanunun y\u00fcr\u00fcrl\u00fc\u011fe girdi\u011fi tarihten sonra da devam eden sa\u011fl\u0131k hizmetlerine ait faturaland\u0131r\u0131lan tedavi giderleri Kurum taraf\u0131ndan kar\u015f\u0131lan\u0131r.<\/p>\n

(4) Kanunun 70 inci maddesinin birinci f\u0131kras\u0131\u00a0gere\u011fi yap\u0131lacak sa\u011fl\u0131k hizmeti sunucular\u0131n\u0131n birinci, ikinci ve\u00fc\u00e7\u00fcnc\u00fc\u00a0basamak olarak s\u0131n\u0131fland\u0131r\u0131lmas\u0131na ili\u015fkin i\u015flemler Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca, sevk zincirine ili\u015fkin belirlemeler ise Kurumca, Kanunun y\u00fcr\u00fcrl\u00fc\u011fe girdi\u011fi tarihten itibaren en ge\u00e7\u00a0bir y\u0131l i\u00e7inde tamamlan\u0131r. Bir y\u0131ll\u0131k s\u00fcre i\u00e7inde Kanunun 70 inci maddesinin ikinci ve\u00a0\u00fc\u00e7\u00fcnc\u00fc\u00a0f\u0131kralar\u0131n\u0131n uygulanmas\u0131n\u0131\u00a0il ve il\u00e7e baz\u0131nda ertelemeye Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131\u00a0yetkilidir.<\/p>\n

(5) Aile hekimleri taraf\u0131ndan ba\u015flat\u0131lan sevk zincirine uygun olarak al\u0131nan sa\u011fl\u0131k hizmetlerinde ayaktan tedavide hekim ve di\u015f\u00a0hekimi muayenesi kat\u0131l\u0131m paylar\u0131,\u00a0\u00fc\u00e7\u00a0y\u0131l s\u00fcreyle % 50 oran\u0131nda azalt\u0131larak uygulanabilir.<\/p>\n

(6) Kurumca aile hekimleri ile s\u00f6zle\u015fmeler yap\u0131l\u0131ncaya kadar Sa\u011fl\u0131k Bakanl\u0131\u011f\u0131nca yap\u0131lan aile hekimli\u011fi s\u00f6zle\u015fmeleri ge\u00e7erli kabul edilir.<\/p>\n

Y<\/b>\u00fc<\/b>r<\/b>\u00fc<\/b>rl<\/b>\u00fc<\/b>k<\/b><\/p>\n

MADDE 54\u00a0<\/b>\u2013<\/b>\u00a0(1) Bu Y\u00f6netmeli\u011fin;<\/p>\n

a) 32 ve 33\u00a0\u00fcnc\u00fc\u00a0maddeleri 1\/1\/2014 tarihinden ge\u00e7erli olmak\u00a0\u00fczere yay\u0131m\u0131\u00a0tarihinde,<\/p>\n

b) Di\u011fer maddeleri ise yay\u0131m\u0131\u00a0tarihinde,<\/p>\n

y\u00fcr\u00fcrl\u00fc\u011fe girer.<\/p>\n

Y<\/b>\u00fc<\/b>r<\/b>\u00fc<\/b>tme<\/b><\/p>\n

MADDE 55\u00a0<\/b>\u2013<\/b>\u00a0(1) Bu Y\u00f6netmelik h\u00fck\u00fcmlerini Sosyal G\u00fcvenlik Kurumu Ba\u015fkan\u0131\u00a0y\u00fcr\u00fct\u00fcr.<\/p>\n

\u00a0<\/span><\/b><\/p>\n","protected":false},"excerpt":{"rendered":"

Genel Sa\u011fl\u0131k Sigortas\u0131 Uygulamalar\u0131 Y\u00f6netmeli\u011fi 18.04.2014 tarih ve 28976 say\u0131l\u0131 Resmi Gazete\u2019de yay\u0131mland\u0131. Bu Y\u00f6netmeli\u011fin; a) 32 ve 33 \u00fcnc\u00fc...<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_monsterinsights_skip_tracking":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[64],"tags":[],"class_list":["post-3227","post","type-post","status-publish","format-standard","hentry","category-mevzuat"],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\n\t\t\n\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t\n\t\t