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Courts: branches of Moscow clinics in the regions can work at the capital's compulsory medical insurance rates

Courts: branches of Moscow clinics in the regions can work at the capital's compulsory medical insurance rates

The TFOMS of the Saratov Region has already tried to collect 10.1 million rubles in three instances - the Moscow Arbitration Court, the Ninth Arbitration Appeal Court and the Moscow District Arbitration Court, but without success. Now the complaint has been filed with the Supreme Court of the Russian Federation.

These funds will pay for 59,509 cases of medical care at the branch of the Center for Space Medicine and Biology of the Federal Medical and Biological Agency in 2022–2024.

The defendant, MGFOMS, is confident that all formalities for paying the bills were observed. The patients, residents of the Saratov region, were treated at a branch of the capital's clinic, so the bills for payment went directly to the Moscow fund, and then re-issued to Saratov using inter-territorial settlements.

The regional fund tried to prove that these cases do not fall under inter-territorial calculations, since they were provided by a clinic from the Saratov region for residents of this region.

The courts agreed with the capital fund, specifying that the funds carried out the procedure of payment for medical care and verification, and at the stage of mutual settlements, the TFOMS of the Saratov Region did not challenge the payment for medical care. The arguments of the Saratov fund were not accepted.

In parallel, in June 2025, the Saratov fund filed a lawsuit to declare the conclusion based on the results of medical and economic examinations regarding the accounts involved in the dispute illegal. The trial is still ongoing.

In early 2025, the Supreme Court and other courts completed consideration of another protracted case on inter-territorial settlements in compulsory medical insurance – the capital's IVF center AltraVita versus the Moscow City Compulsory Medical Insurance Fund. The fund managed to recover from the clinic about 45 million rubles, previously allocated from the capital's compulsory medical insurance budget, but spent on medical care for patients from other regions. Auditors and courts considered that the clinic sent targeted funds from the Moscow City Compulsory Medical Insurance Fund for expenses that, by law, should have been compensated by other territorial funds.

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