Emergency Ordinance (OUG) no. 74/2021 for the amendment and completion of OUG no. 158/2005 regarding the holidays and indemnities of social health insurance, for the modification of articol 299 paragraph (4) of Law no. 95/2006 on the reform in the field of health, as well as for the establishment of some measures regarding the granting of medical leave was published in the Official Gazette (Part I) no. 645 of June 30, 2021, with applicability from August 1, 2021.
Thus, starting with August 1, there will be several changes regarding medical leave, including one that provides that people on sick leave for temporary incapacity for work (for common illnesses) will be monitored by doctors, through a plan to follow the evolution of the disease.
In addition, from August 1, changes will also come into force for people who are optionally insured for sick leave.
In order to make fully applicable the changes related to the medical leave, the National Health Insurance House (CNAS) recently put in public debate a draft order that modifies the norms of application of the legislation in the field and establishes the structure of the follow-up plan and the evolution of the disease.
According to the document (draft order), the plan for monitoring the evolution of the disease will contain two stages of evaluation.
In the first stage, the initial evaluation is made, the medical indications are established (medical prescription, if a diet is needed and the training regarding the therapeutic and prophylactic measures is done), referral tickets are issued for various investigations or even hospitalization, it is established the duration of the initial medical leave and the appointment is made for the subsequent evaluation.
In the second stage, which means, in fact, the follow-up of the disease that determined the temporary incapacity for work, will be noted in the follow-up plan data related to the clinical re-evaluation, the medical indications in this phase, the extension of medical leave and the justification for this measure. The model of the plan for monitoring the evolution of the disease can be downloaded from the end of the article.
We mention that, according to the draft order, in the first phase, medical leave will be granted for a maximum of three calendar days.
“In case of maintaining the temporary incapacity for work, found based on the evaluation of the response to the initial treatment and/or the result of laboratory analyzes, recommended functional and/or imaging investigations, the family doctor or, as the case may be, the outpatient specialist, who monitors the condition can still issue the medical leave certificate (…) ”, according to the document.
The project does not concretely establish the maximum duration of extended medical leave. Probably the maximum duration will be set later.
During the medical leave, depending on the changes, the plan for monitoring the evolution of the disease can be modified by the doctor.
We specify that, according to OUG 74/2021, the attending physicians who will not draw up the plan for following the evolution of the disease, once a medical leave certificate is issued, will be able to be sanctioned with a fine between 5,000 and 10,000 lei.
Moreover, the draft order provides for the modification of the norms for the application of OUG no. the state will pay only five days of quarantine medical leave.
The document also establishes the introduction of sanctions for those who work for several employers and who, during the same period, carry medical leave certificates only to one of them, continuing to work for the other employer or employees.
According to the ordinance, from August, those who will do so will risk fines of up to 2,000 lei. At the same time, this ordinance also increases the fines received by doctors who do not comply with the law when it comes to granting medical leave. Specifically, these fines will reach up to 11,000 lei.
Changes concerning persons providing optional health leave:
Specifically, the maximum monthly calculation basis for social insurance benefits, in the case of those without income from salaries, who want to be insured optionally, will be established as an average of gross monthly income in the last six months of the 12 months of the internship. insurance, up to three gross minimum wages per country.
Exempted from this rule are persons who are optionally insured to benefit from maternity leave and allowances, for which the maximum monthly calculation base of allowances is determined as the average of the insured income from the last six months of the 12 months from which the internship is constituted. insurance, up to the monthly value limit of 12 minimum gross salaries per country.
Currently, “the calculation basis of the indemnities (…) is determined as an average of the insured incomes, registered in the insurance contract, from the last 6 months of the 12 months from which the contribution period is constituted, up to the limit of 12 salaries gross minimums per country per month “, according to OUG 158/2005 regarding the holidays and the indemnities of social health insurances.
OUG 74/2021 specifies that those insurance contracts for holidays and social health insurance benefits concluded with health insurance houses by the persons provided in article 1 paragraph (2) of OUG 158/2005 – individuals without income from salaries, take effect until August 31, 2021.
The monthly income registered in the previously provided contracts, the monthly contribution calculated and paid on this income, for the period until August 31, 2021, does not change.
The rights representing the social health insurance indemnities related to the medical leave certificates issued until August 31, 2021, are granted until the cessation of the situation that determined the necessity of issuing the respective medical certificates.
Last but not least, the leave and the allowance for the care of the seriously ill child will be accessible to the parents until he reaches the age of 18.
In fact, through the ordinance, a decision of the Romanian Constitutional Court (CCR) in this regard, published in May, is transposed into the legislation on holidays.
Specifically, CCR declared, in May, unconstitutional the provision that established that this type of leave is granted to parents only if that seriously ill child was at most 16 years old, which means that that leave must be granted now until 18 years old.
- Legal basis:
- – OUG 74/2021 for the amendment and completion of the Government Emergency Ordinance no. 158/2005 on leave and social health insurance benefits, for amending article 299 paragraph (4) of Law no. 95/2006 on health care reform, as well as for establishing measures regarding the granting of medical leave;
- http://cnas.ro/wp-content/uploads/2021/07/16.07.2021-Proiect-ordin-modif.-O-15-cf.-OUG-74-2021-15.07.2021-1.pdf .