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Bulgarian Health Act, part 1
Last update: 2008-08-22 01:26:02

Bulgarian Health Act, part 1

Chapter One
NATIONAL HEALTHCARE SYSTEM


Section I
General Provisions
Article 1
This Act shall regulate the social relations concerning the protection of the citizens' health.
Article 2
The protection of the citizens' health as a condition of full physical, mental and social wellbeing is a national priority and it shall be guaranteed by the government through the application of the following principles:
1. equality in the use of health services;
2. ensuring accessible and high-quality healthcare, giving priority to children, pregnant women and mothers of children aged up to one year;
3. priority of health promotion and the integrated disease prevention;
4. prevention and reduction of the health risk to citizens as a result of adverse effects of environmental factors;
5. special health protection of children, pregnant women, mothers of children aged up to one year and people with physical and mental disabilities;
6. participation of the government in the financing of activities aimed at protecting the health of citizens.
Article 3
(1) The government health policy shall be guided and implemented by the Council of Ministers.
(2) The Council of Ministers, at the proposal of the Minister of Health, shall approve the National Health Strategy to be adopted by the National Assembly.
(3) The Council of Ministers, at the proposal of the Minister of Health, shall adopt national health programmes.
(4) The National Health Strategy and the national health programmes shall build on an assessment of the health condition and health needs of the citizens, the health and demographic trends, as well as the resource capacities of the national healthcare system.
(5) National health programmes shall be financed from the central government budget as separate expenditures from the budget of the Ministry of Health and may be supported by other financial sources.
Article 4
(Amended, SG No. 31/2007)
The national healthcare system shall include the medical establishments under the Medical Treatment Facilities Act, the healthcare establishments under this Act and the Medicinal Products in Human Medicine Act, as well as the central, local and non-governmental bodies and institutions for organisation, management and control of health-protection and building activities.

Section II
Managing Bodies of the National Healthcare System
Article 5
(1) The Minister of Health shall guide the national healthcare system and exercise control over the activities related to:
1. the protection of the citizens' health and the state health control;
2. the provision of urgent medical aid, transfusion haematology, psychiatric aid at specialised facilities, medical and social care for children aged up to three years, transplantations and health information;
3. the provision and sustainable development of health activities at medical and healthcare establishments;
4. medical expert activities.
(2) The Minister of Health shall submit to the National Assembly an annual report on the condition of the citizens' health and the implementation of the National Health Strategy within three months before the beginning of the fiscal year.
(3) The Minister of Health shall approve the allocation of the central government budget transfers for the activities under this Act by programmes, except for the activities under Paragraph 1, Items 1 and 2.
(4) (Amended, SG No. 88/2005) The Minister of Health shall provide methodological guidance and control of the medical activities of the medical establishments set up at the Council of Ministers, the Ministry of Defence, the Ministry of Interior, the Ministry of Justice and the Ministry of Transport.
(5) The Minister of Health shall exercise also other powers prescribed by law or a secondary legislative act of the Council of Ministers.
Article 6
(1) The Supreme Medical Council shall be set up at the Minister of Health.
(2) (Supplemented, SG No. 46/2005, SG No. 75/2006) The Supreme Medical Council shall include five representatives designated by the Minister of Health, five representatives of the Bulgarian Doctors' Union, three representatives of the Union of Dentists in Bulgaria, three representatives of the Union of Pharmacists in Bulgaria, three representatives of the National Health Insurance Fund (NHIF), one representative of the Bulgarian Association of Health Care Professionals and a representative of the National Association of Municipalities, each higher medical school and the Bulgarian Red Cross each. The Minister of Health shall serve as the Chairperson of the Council in a non-voting capacity.
(3) The Supreme Medical Council shall be an advisory body, discussing and giving opinions on:
1. the priorities of the National Health Strategy;
2. ethical issues of medicine and biomedicine;
3. bills and drafts of secondary legislative acts of the Council of Ministers in the field of healthcare and within the competence of the Minister of Health;
4. the report of the Minister of Health under Article 5, Paragraph 2;
5. the draft of the annual health budget;
6. the research priorities in the field of medicine and dental medicine;
7. the annual admission of students and postgraduates in the professional area of health and the criteria for selecting facilities to conduct undergraduate and postgraduate training under Arts. 91 and 92 of the Medical Treatment Facilities Act;
8. the types of specialties in the professional area of health.
(4) The organisation and activities of the Supreme Medical Council shall be regulated in Rules drafted by the Supreme Medical Council and approved by the Minister of Health.
Article 7
(1) The government health policy within the territory of administrative regions shall be implemented and organised by the Regional Healthcare Centre (RHC) and the Regional Inspectorate for Public Health Protection and Control (RIPHPC).
(2) For the purposes of organising healthcare within municipalities, the respective municipal council may set up a healthcare service within the framework of the municipal administration. The service shall operate under the methodological guidance of the regional healthcare centre.
Article 8
(1) Regional healthcare centres shall be budget-supported legal entities - secondary spending units at the Minister of Health seated in the community which is the administrative centre of the region.
(2) Regional healthcare centres shall be opened, re-organised and closed by the Council of Ministers.
Article 9
(1) A regional healthcare centre shall be managed and represented by a director appointed on the basis of a competition announced by the Minister of Health.
(2) A RHC director may be a person with three years length of service in medicine or dental medicine.
(3) The RHC director shall be subject to evaluation by a commission appointed by the Minister of Health once in three years. The evaluation procedure shall be laid down in the regulations under Article 10, Paragraph 3.
(4) The Minister of Health may terminate the employment contract of a RHC director who has received a negative evaluation with a notice pursuant to Article 328, Paragraph 1, Item 5 of the Labour Code.
Article 10
(1) Regional healthcare centres shall carry out activities related to:
1. the control of the registration and healthcare activities provided by the medical establishments and health offices within the territory of the respective region;
2. the control over the application of the medical standards approved pursuant to Article 6, Paragraph 1 of the Medical Treatment Facilities Act and over the quality assurance arrangements with regard to medical activities at healthcare and medical establishments;
3. the introduction of information technologies in the field of healthcare;
4. the collection, registration, processing, storage, analysis and provision of health information for the needs of the national healthcare system;
5. the planning, organisation, guidance and supervision of medical expert activities within the territory of the respective region;
6. the planning and organisation of healthcare activities in the event of natural calamities, accidents or disasters within the territory of the respective region;
7. the verification of complaints and reports of citizens concerning medical services;
8. the coordination of the activities for implementation of national and regional health programmes.
(2) Regional healthcare centres, together with the professional organisations, shall examine the needs for physicians, doctors of dental medicine, pharmacists and other medical and non medical specialists with higher education in the region and propose to the Minister of Health the number of postgraduates in basic and profile specialties.
(3) The RHC structure and activities shall be set out in regulations issued by the Minister of Health.

Section III
State Health Control
Article 11
With a view to protecting the health of citizens within the territory of the Republic of Bulgaria, state health control shall be exercised to check the observance and implementation of the statutory health requirements with regard to facilities for public use, products, goods and activities of importance for human health and the environmental factors.
Article 12
(1) The state health control authorities are the Chief State Health Inspector of the Republic of Bulgaria, Regional inspectorates for public health protection and control (RIPHPC) and the National Centre for Radiobiology and Radiation Protection (NCRRP).
(2) (Amended, SG No. 59/2006) State health control shall be performed by state health inspectors at the Ministry of Health, RIPHPC and NCRRP. The state health inspectors at the Ministry of Health and RIPHPC shall be civil servants.
(3) State health inspectors may not engage in any form of activity which is subject to state health control.
Article 13
(1) The Chief State Health Inspector shall be appointed by the Prime Minister at the proposal of the Minister of Health.
(2) The powers of the Chief State Health Inspector in his/her absence from the country or during his/her legitimate leave shall be exercised by a deputy appointed in each individual case by the Minister of Health with an order in writing from among the employees in the administration of the Ministry of Health.
(3) The activities of the Chief State Health Inspector shall be supported by the administration of the Ministry of Health.
Article 14
(1) The Chief State Health Inspector shall organise and guide:
1. the state health control;
2. the activities related to health promotion and the integrated disease prevention;
3. the infectious diseases control;
4. the measures to protect the population against the effect of ionising radiation;
5. preventive and anti-epidemic activities in the event of natural calamities, accidents and disasters.
(2) The Chief State Health Inspector shall provide methodological guidance and supervision of the institutional health control units at the Ministry of Defence and the Ministry of Interior.
Article 15
(1) The government policy for public health protection and the state health control within the territory of administrative regions shall be implemented by RIPHPC.
(2) The state health control for the observance of the requirements to protect people against the effect of ionizing radiation shall be implemented by RIPHPC designated by the Minster of Health and by NCRRP.
(3) Regional inspectorates for public health protection and control shall be budget-supported legal entities - secondary spending units at the Minister of Health seated in the community which is the administrative centre of the region.
(4) Regional inspectorates for public health protection and control shall be opened, re-organised and closed by the Council of Ministers.
Article 16
(1) A regional inspectorate for public health protection and control shall be managed and represented by a director appointed on the basis of a competition announced by the Minister of Health.
(2) A RIPHPC director may be a person holding a master's degree in medicine and recognised specialty and five years length of service in the respective specialty.
(3) The RIPHPC director shall be subject to evaluation by a commission appointed by the Minister of Health once in three years. The evaluation procedure shall be laid down in the regulations under Article 17, Paragraph 2.
(4) The Minister of Health may terminate the employment contract of a RIPHPC director who has received a negative evaluation with a notice pursuant to Article 328, Paragraph 1, Item 5 of the Labour Code.
Article 17
(1) Regional inspectorates for public health protection and control shall carry out activities related to:
1. the control of the observance and implementation of the statutory health requirements with regard to facilities for public use, products, goods and activities of importance for human health and the environmental factors.
2. the infectious diseases control;
3. the control of the health condition of people in contact with contagious patients, infection carriers and those suspected of being contagious patients, the persons under Article 34, Paragraph 3, as well as other people for epidemic indications;
4. the health promotion and the integrated disease prevention;
5. the laboratory control of the environmental factors and the analysis and assessment of their impact on the health of citizens;
6. the monitoring, assessment and control of noise in urban territories and public buildings, of pollutants in foods, and of potable water;
7. the methodological, advisory and expert assistance in the field of the protection of public health;
8. the development and implementation of regional programmes and projects in the field of the protection of public health;
9. the implementation of national programmes and projects in the field of the protection of public health;
10. the postgraduate training in the field of the protection of public health.
(2) The RIPHPC structure and activities shall be set out in regulations issued by the Minister of Health.
Article 18
(1) The revenues of RIPHPC shall be generated from:
1. central government budget transfers;
2. other budget revenues from:
(a) fees from the documents issued within the framework of the state health control;
(b) paid services requested by individuals or legal entities defined in an ordinance of the Minister of Health.
(2) The resources under Paragraph 1, Item 2(a) shall be credited to the budget of the respective RIPHPC and allocated for operational support.
(3) The resources under Paragraph 1, Item 2(b) shall be credited to the Ministry of Health, included in the RIPHPC budgets, and allocated as follows:
1. at least 60 percent - for financing of regional health programmes and acquisition of assets for the respective RIPHPC;
2. up to 40 percent - for material incentives to the staff of the respective RIPHPC.
Article 19
(1) The state health control shall be performed systematically without any prior notice and especially on the occasion of reports from citizens, central and local government bodies and organisations, or where other information on the occurrence of accidents is available.
(2) In the course of the implementation of the state health control, state health inspectors shall be entitled to:
1. free access to the facilities, products, goods, activities and persons subject to control;
2. demand information and documents and receive copies thereof on paper and/or electronic carrier;
3. take samples for laboratory analysis in the quantities needed for the testing;
4. commission examinations and tests for assess the health condition of the persons under Article 34, Paragraph 3;
5. prescribe the removal from work of persons who are ill or carriers of an infection and constitute a threat to the health of the people around them;
6. prescribe mandatory hygienic and anti-epidemic measures, specifying time limits for their implementation;
7. place certification signs in the cases under Arts. 38 and 39;
8. draw up statements of findings in the cases of administrative violations;
9. propose coercive administrative measures as provided by law.
(3) The coercive administrative measures shall be imposed at an order of the RIPHPC director.
(4) The terms and conditions for exercising state health control shall be set out in an ordinance issued by the Minister of Health.
Article 20
(1) The proceeds from fines and penalties imposed with penalty orders by the state health control authorities shall be transferred to the budget of the Ministry of Health and used for financing of national programmes in the field of the protection of public health.
(2) The voluntary payment of debt as a result of enforceable penalty orders issued by the state health control authorities may be effected also at the Ministry of Health and the respective RIPHPC.
(3) The Minister of Health shall administer the proceeds from fines and penalties at penalty orders issued under this Act under terms and conditions set out in an ordinance issued by the Minister of Health and the Minister of Finance.

Section IV
Healthcare Establishments
Article 21
(1) Healthcare establishments shall be structures of the national healthcare system, where medical and non-medical specialists exercise activities for the protection and promotion of the health of citizens.
(2) Within the meaning of this Act, healthcare establishments shall be:
1. the national centres for public health affairs;
2. the National Expert Medical Commission (NEMC);
3. health offices under Article 26.
4. (new, SG No. 81/2006) the opticians' shops referred to in Article 26a.
(3) (Amended, SG No. 31/2007) Pharmacies shall be healthcare establishments with status and activities set out in the Medicinal Products in Human Medicine Act.
Article 22
(1) National centres for public health affairs shall be budget supported legal entities - secondary spending units at the Minister of Health, which shall be opened, re-organised and closed by the Council of Ministers at the proposal of the Minister of Health.
(2) National centres for public health affairs shall be managed and represented by a director appointed on the basis of a competition announced by the Minister of Health.
(3) The directors of the national centres for public health affairs shall be subject to evaluation by a commission appointed by the Minister of Health once in three years. The evaluation procedure shall be laid down in the regulations for the structure and activity of the respective national centre for public health affairs.
(4) The Minister of Health may terminate the employment contract of a director of a national centre for public health affairs who has received a negative evaluation with a notice pursuant to Article 328, Paragraph 1, Item 5 of the Labour Code.
Article 23
(1) National centres for public health affairs shall carry out activities related to:
1. the preparation of studies, assessments, expert opinions and reports, analyses and forecasts in the field of the protection of public health;
2. the prevention, reduction and liquidation of epidemics of infectious diseases;
3. the organisation, management and coordination of medical aid in the event of natural calamities, accidents and disasters within the territory of the Republic of Bulgaria;
4. the assessment of the risk and adverse effect of environmental factors on the individual, family and public health;
5. laboratory tests and expert reports;
6. protection of people against the effects of ionizing radiation;
7. the health promotion and the integrated disease prevention;
8. the expert and advisory support to RIPHPC;
9. the expert, advisory and methodological support to medical and healthcare establishments;
10. the planning and conduct of basic and applied research;
11. the state health control in the cases provided by law;
12. educational activities.
(2) The structure and activities of individual national centres for public health affairs shall be set out in regulations issued by the Minister of Health.
Article 24
(1) The revenues of national centres for public health affairs shall be generated from:
1. central government budget transfers;
2. gifts and inheritance;
3. other budget revenues from:
(a) paid services requested by individuals or legal entities defined in an ordinance of the Minister of Health;
(b) research and expert activities;
(c) postgraduate tuition fees.
(2) The resources under Paragraph 1, Item 3 shall be credited to the Ministry of Health, included in the budgets of the national centres, and allocated as follows:
1. at least 60 percent - for financing of regional health programmes and acquisition of assets for the respective national centre;
2. up to 40 percent - for material incentives to the staff of the respective national centre.
Article 25
(1) The National Expert Medical Commission shall be a budget supported legal person - a secondary spending unit at the Minister of Health seated in Sofia.
(2) The National Expert Medical Commission shall be managed and represented by a director appointed on the basis of a competition announced by the Minister of Health.
(3) The National Expert Medical Commission shall perform expert, controlling, methodological and advisory activities in the expert assessment of the ability to work.
Article 26
(1) Health and dental medicine offices may be established at:
1. kindergartens and schools;
2. (repealed, SG No. 95/2007);
3. (supplemented, SG No. 95/2007) specialised social welfare institutions - homes for children, homes for aged people with disabilities, social welfare vocational schools, homes for aged people, orphanages and homes for temporary accommodation.
(2) (Amended, SG No. 103/2005, SG No. 95/2007) The requirements to the structure and activities of health and dental medicine offices, the procedure for opening those, and the documentation which they shall keep, shall be set out in regulations issued by the Minister of Health in consultation with the Minister of Finance, the Minister of Labour and Social Policy and the chairman of the State Agency for Youth and Sport.
(3) (Amended, SG No. 95/2007) The State Budget of the Republic of Bulgaria Act shall specify, on an annual basis, the financing by the central and local governments of the health activities for children and pupils, of the equipment and consumables for, and the performance of the activities for the respective year at the health and dental medicine offices opened under this act.
(4) (New, SG No. 95/2007) The regulations under Paragraph (2) shall also specify the minimum number of children or pupils needed for the health and dental medicine offices under Paragraph (1) to be opened, as well as the requirements for the equipment and consumables therein.
Article 26a
(New, SG No. 81/2006)
(1) Opticians' shops shall carry out activities on:
1. health consultations on sight problems;
2. undertaking measures for sight correction prescribed by a doctor;
3. manufacture and sale of optical glasses and ophthalmic optics materials.
(2) Opticians' shops shall be managed by persons who have acquired higher education with the educational qualification degree of "Master" in the occupational division of "Medicine" with acknowledged specialty in ophthalmic diseases, or by persons with the professional qualification in the occupations of "optical technician" or "optometrist (ophthalmic optician)" and with at least one year experience in this specialty.
(3) The manufacture and sale of optical glasses and ophthalmic optics materials shall be carried out by persons with professional qualification in the occupations of "optical technician" or "optometrist (ophthalmic optician)".
Article 26b
(New, SG No. 81/2006)
(1) Persons who open opticians' shops shall register with the respective RHC, submitting an application and presenting the following documents:
1. data about the applicant and about the persons who shall manage the opticians' shop - name, passport data, standard public registry number, address and/or data about the registration in court, registered office and address of the place of management;
2. documents attesting to the respective education and specialty or professional qualification of the persons who shall manage, respectively work at the opticians' shop;
3. hygienic conclusion of the site prepared by the RIPHPC authorities.
(2) In the case of deficiencies of the submitted documents referred to in Paragraph (1) the director of the RHC shall notify within 14 days in writing the relevant person of the deficiencies allowed and shall set a time limit for their eradication thereof.
(3) Within 14 days following the submission of the documents referred to in Paragraph (1) or from eradication of the deficiencies referred to in Paragraph (2) the director of the RHC shall issue a certificate for the registration of the optician's shop.
(4) The persons referred to in Paragraph (1) shall be obligated to notify RHC within seven days from the onset of the change of circumstances referred to in Paragraph (1).
(5) The Regional Healthcare Centre shall keep a register of opticians' shops under the procedure provided by an ordinance of the Minister of Health.
(6) The registration of an optician's shop shall be expunged:
1. at the request of the person who has registered the optician's shop;
2. upon the death of the natural person or at the termination of the activity of the legal person that has registered the optician's shop;
3. in the case of activity in violation of the registration made.
(7) The requirements about the organisation and activity of opticians' shops shall be determined by an ordinance of the Minister of Health.

Section V
Health Information and Documentation
Article 27
(1) Health information shall include the personal data related to the health condition, the physical and mental development of individuals, as well as any other information contained in medical prescriptions, instructions, protocols, certificates and other medical documentation.
(2) Medical and healthcare establishments, RHC, RIPHPC, medical doctors, doctors of dental medicine, pharmacists and other medical specialists, as well as non-medical specialists with higher non-medical education working in the national healthcare system shall collect, process, use and store health information.
(3) The form and content and the terms and procedures for the processing, use and storage of medical documentation and for the exchange of medical statistical information shall be set out in regulations
Article 28
(1) Health information may be disclosed to this parties in any of the following cases:
1. the treatment of the person continues at another medical establishment;
2. there exists a threat to the health or life of other persons;
3. it is necessary for identifying a human corpse of for establishing the reasons for the death;
4. it is necessary for the needs of the state health control to prevent epidemics or the spread of infectious diseases;
5. it is necessary for the needs of medical expert activities and the social security scheme;
6. it is necessary for the needs of medical statistics or medical research, having deleted the data identifying the patient;
7. it is necessary for the needs of the Ministry of Health, the National Health Information Centre, NHIF, RHC, RIPHPC, and the National Statistical Institute.
(2) In the cases under Paragraph 1, Item 2, the information shall be disclosed upon notification of the person concerned.
(3) The persons under Article 27, Paragraph 2 shall ensure the protection of the health information they keep against unauthorised access.

Chapter Two
HEALTH PROTECTION ACTIVITIES

Section I
General Provisions
Article 29
Government bodies and institutions shall plan, develop and implement a policy aimed at protecting the citizens' health by ensuring a healthy environment, training for healthy life style and health prevention.
Article 30
(1) Medical establishments shall carry out preventive checks and dispensary registration for the purposes of protecting the citizens' health and ability to work.
(2) Persons of higher health risk or diseases shall be subject t to dispensary registration.
(3) The terms and conditions and the financing of preventive checks and the dispensary registration, as well as the list of diseases for which dispensary registration is required shall be set out in regulations issued by the Minister of Health.
Section II
Ensuring a Healthy Environment
Article 31
(1) The central and local governments, legal entities and individuals shall carry out their activities by ensuring the protection of the environment against biological, chemical, physical and social factors which are harmful to the human health.
(2) In the course of their activities, legal entities and individuals shall observe the existing health requirements.
Article 32
(1) The Minister of Health shall lead the national system for analysis, assessment and control of noise in urban areas and public buildings and of pollutants in foods and drinking water.
(2) The Minister of Health shall analyze and assess the environment factors at the national level in the annual report under Article 5, Paragraph 2 and propose measures to limit their harmful impact on the health of citizens.
(3) Regional inspectorates for public health protection and control shall monitor, analyse and assess the factors of the environment within the territory of the region and propose measures to limit their harmful impact on the health of citizens.
(4) The government bodies performing analysis, assessment and control of the parameters of the environment shall provide the Ministry of Health with the data needed for the health risk assessment.
Article 33
(1) The Council of Ministers shall identify the areas with higher health risk in the country at the proposal of the Minister of Health and the Minister of the Environment and Water once in three years.
(2) The Council of Ministers shall adopt programmes to organise control tests and examinations and activities related to the protection, strengthening and recovery of the health of citizens living in the areas with higher health risk.
Article 34
(1) The health requirements to the design and construction of facilities for public use shall be set out in regulations issued by the Minister of Health and the Minister of Regional Development and Public Works.
(2) The health requirements to facilities for public use, products, goods and activities of importance to human health, as well as the maximum allowed levels of factors of the environment shall be set out in regulations issued by the Minister of Health, unless another law provides otherwise.
(3) The health requirements to persons working at childcare establishments, specialised institutions for children and aged people, water supply facilities, enterprises producing or trading in foods, barbers' shops, hairdressers' shops and beauty salons shall be set out in regulations issued by the Minister of Health.
Article 35
The state health control authorities shall take part in the membership of the expert boards for physical planning and development, coordinate development schemes and plans, if necessary, participate in the assessment of the compliance of investment projects, where the latter is subject to approval by an expert board of the approving administration or requested by individuals or legal entities, and give opinion on the preparedness of construction works to be set into operation under the Spatial Development Act.
Article 36
(1) (Amended, SG No. 34/2006) Any person opening a facility for public use shall advise the respective RIPHPC at the location of the facility thereof within seven days of the start of its operation, specifying the address of the facility, the types of activities performed there, as well as the name and permanent address of the person performing the activities or, in case that person is a trader - shall submit a relevant attestation to entry into the Register of Commercial Corporations.
(2) Within three months of the notice, the territorial bodies of the state health control shall check the observance of health requirement in the facility.
(3) Regional inspectorates for public health protection and control shall establish and maintain a public register of facilities for public use under terms and conditions set out in an ordinance issued by the Minister of Health.
(4) (Supplemented, SG No. 81/2006) Paragraph (1) shall not apply to medical establishments, enterprises for production of and wholesale trade in medicines, pharmacies, drugstores and opticians' shops, enterprises for production, storage and trade in foods and public catering outlets.
Article 37
(1) At the request of the parties concerned, the Chief State Health Inspector shall issue a health certificate for the export of products and goods of importance to human health to certify the observance of the statutory requirements to the manufacturing of the products and goods of importance to human health.
(2) The Minister of Health shall issue regulations to set out the terms and conditions for the issuance of health certificates for the export of products and goods of importance to human health.
(3) Where any doubts exist as to the safety of products and goods of importance to human health, the customs authorities shall be entitled not to let them into the territory of the Republic of Bulgaria. Such products and goods shall be imported upon receipt of a RIPHPC opinion on their safety.
Article 38
(1) (Amended, SG No. 59/2006) Where health requirements are not observed in facilities for public use, as regards products, goods or in the course of activities of importance to human health and of the maximum permissible levels of environmental factors, state health inspectors shall issue mandatory instructions and shall specify the deadline for the elimination of the violations.
(2) In the event of failure to fulfil the mandatory instructions within the prescribed time limits, the RIPHPC director or the NCRRP director respectively shall issue an order to stop the operation of the facility or parts thereof or to discontinue the respective activity pending the elimination of the violations.
(3) Where an immediate threat exists to human life or health or for the spread of infectious diseases or for the occurrence of poisoning, state health inspectors shall stop the operation of the facility or parts thereof or to discontinue the respective activity immediately, specify the remedies and advise the RIPHPC director forthwith.
(4) Within 24 hours of the stop or discontinuation, the RIPHPC director or the NCRRP director respectively shall issue an order to confirm or revoke the instruction to stop the operation of the facility or to discontinue the respective activity.
(5) Upon the fulfilment of the mandatory instructions and measures, the body which has issued the order shall allow the recovery of the activity or the operation of the facility by issuing an order.
Article 39
(1) Where any doubts exist as to the safety of products and goods of importance to human health, the State Health Inspector shall:
1. issue instructions in writing to stop the sales of the goods of importance to human health and deliver them to the party concerned or its representative with a signed receipt;
2. take samples for laboratory tests and for expert opinion and report in the presence of the party concerned or its representative and provide them to the RIPHPC laboratory.
(2) The State Health Inspector shall advise the party concerned of the results of the laboratory tests and the expert opinion and report within three days of their reception.
(3) Where the results of the laboratory tests and the expert opinion and report are contested, repeated tests shall be made at the request of the party concerned given in writing to the Chief State Health Inspector through the RIPHPC Director within three days of reception of the results from the initial tests.
(4) In the cases under Paragraph 3, the repeated tests shall be conducted by another RIPHPC designated by the Chief State Health Inspector.
(5) The results of the tests conducted under Paragraph 4 shall not be subject to contesting.
Article 40
Where the products and goods are obviously unfit for use and the party concerned submits no objections in writing to this conclusion to the state health inspector, no laboratory tests and expert opinions and reports shall be made.
Article 41
(1) Where the results of the laboratory tests and the expert opinion and report confirm the compliance of the products and goods with the health requirements, the state health inspector shall check them for any changes occurred during the stop and revoke in writing the instruction to stop the sale within three days of receipt of the results.
(2) Where the results of the laboratory tests and the expert opinion and report show that the products and goods do not comply with the health requirements, the state health inspector shall propose the issuance of an order to process or to use in a processed or unprocessed form for other purposes or to destroy the products and goods of importance to human health.
Article 42
(1) The order to process or to use in a processed or unprocessed form for other purposes or to destroy the products and goods of importance to human health shall be issued by the RIPHPC or NCRRP director for products and goods worth up to BGN 100,000 and by the Chief State Health Inspector for products and goods worth more than BGN 100,000.
(2) Within seven days of the effective date of the order under Paragraph 1, the products and goods shall be delivered for processing, use for other purposes or destruction always in the presence of a state health inspector for which a protocol shall be drawn up. The protocol shall be attached to the order under Paragraph 1.
Article 43
(1) The terms and conditions for taking samples and conducting the laboratory tests, analyses and expert opinions and reports needed for the purposes of the state health control shall be set out in regulations issued by the Minister of Health.
(2) The costs of the laboratory tests for the needs of the state health control shall be borne by RIPHPC.
Article 44
Individuals and legal entities shall fulfil the mandatory instructions of state health inspectors and the order of the state health control authorities.
Article 45
(1) The enforceable administrative measures under this Section shall be subject to appeal pursuant to the Administrative Procedure Code. The enforceable administrative measures shall be executed immediately.
(2) The enforceable administrative measures under this Section shall be subject to administrative appeal as follows:
1. those issued by a state health inspector - before the RIPHPC director and the NCRRP director;
2. those issued by the RIPHPC director and the NCRRP director - before the Chief State Health Inspector;
3. those issued by the Chief State Health Inspector - before the Minister of Health.
Article 46
Fees established by the Council of Ministers shall be paid for the issuance of documents by the state health control authorities.
Article 47
The facts and circumstances which become known to the officials exercising state health control in the discharge of their duties shall constitute an official secret, except for the cases of an existing threat to the health and life of citizens.
Article 48
The bodies of the Ministry of Interior, the other central and local government authorities and the heads of institutions and organisations shall provide the necessary support and assistance to state health inspectors in the exercise of their powers.

Section III
Health Requirements to Cosmetic Products
Article 49
(1) Cosmetic products offered on the market shall not cause any damage to human health, when applied in accordance with their purpose, the instructions for use and destruction and all other instructions provided by the manufacturer or the importer.
(2) The requirements to the production, packaging, labelling, promotion, launch and sale of cosmetic products on the market shall be set out in regulations issued by the Minister of Health in consultation with the Minister of the Economy.
Article 50
Manufacturers and importers shall be entitled, with the permission of the Chief State Health Inspector, not to specify one or more ingredients of a cosmetic product in the labelling for a five-year period with a view to protecting the commercial secret.
Article 51
(1) In order to receive permission, the parties concerned shall submit an application to the Chief State Health Inspector of the Republic of Bulgaria, enclosing evidence of the safety of the ingredient as prescribed in the regulations under Article 49, Paragraph 2.
(2) The Chief State Health Inspector shall issue permission or refusal with reasons thereof within two months of the submission of the documents under Paragraph 1. The refusal shall be subject to appeal pursuant to the Administrative Procedure Code.
(3) Where important reasons exist, the parties concerned may request renewal of the permission for up to three years in accordance with the provisions of Paragraphs (1) and (2).
Article 52
(1) The manufacturer or importer of the cosmetic product shall advise the Chief State Health Inspector in due course of any change in the circumstances under which the permission under Article 50 was issued.
(2) Where the name of the cosmetic product with an undeclared ingredient is changed, the manufacturer or importer of the cosmetic product shall advise the Chief State Health Inspector not later than 15 days prior to the launch of the product on the market.
(3) In the case of non-compliance with the safety requirements for the health of consumers or research or empirical reports on a health risk related to the undeclared ingredient, the Chief State Health Inspector shall evoke the permission.

Section IV
Activities to Impact Health Risk Factors
Article 53
(1) The Minister of Health and other competent government authorities, together with non-governmental organisations, shall create conditions to restrict smoking and the abuse of alcohol and to prevent the use of narcotic drugs by:
1. carrying out promotional and preventive activities;
2. ensuring access to medical assistance and social protection of the persons affected.
(2) The activities under Paragraph 1 shall be carried out through national programmes to restrict smoking and the abuse of alcohol and to prevent the use of narcotic drugs.
(3) One percent of the revenues to the central government budget from excise taxes on tobacco products and spirits shall be used to finance national programmes to restrict smoking and the abuse of alcohol and to prevent the use of narcotic drugs.
(4) Local governments shall adopt and implement regional programmes to restrict smoking and the abuse of alcohol and to prevent the use of narcotic drugs.
Article 54
There shall be prohibited the sale of alcoholic beverages:
1. to persons below the age of 18;
2. to persons in a drunken state;
3. within the territory of kindergartens, schools, pupil boarding houses and medical establishments;
4. at sports events;
5. at public events organised for children and pupils.
Article 55
(1) The direct advertising of spirits shall be prohibited.
(2) The indirect advertising of spirits and the advertising of wine and beer may not:
1. be targeted to persons below the age of 18 or broadcast in programmes or published in the press for them;
2. use persons below the age of 18 as participants;
3. relate the use of alcoholic beverages to sports and physical achievements or driving;
4. contain untrue assertions as to health benefits and social or sexual wellbeing or present abstinence or moderation in negative light.
(3) The indirect advertising of spirits may not be broadcast on the radio and television earlier than 10 o'clock p. m.
Article 56
(1) Smoking in indoor public places, including the public transport and indoor work premises, shall be prohibited.
(2) The Council of Ministers shall issue regulations on the terms and conditions to allow smoking, by way of exception, in special areas at the places under Paragraph 1.

Section V
Control of Infectious Diseases
Article 57
(1) Border health control shall be exercised, if needed, to protect the country against the spread of particularly dangerous infectious diseases.
(2) The terms and conditions for the border health control shall be set out in regulations issued by the Council of Ministers.
Article 58
(1) Mandatory immunization shall be performed to protect citizens against infectious diseases.
(2) The Minister of Health shall issue regulations to specify the persons subject to immunization, as well as the terms and conditions for the performance of:
1. mandatory planned immunization and re-immunization included in the immunization calendar of the Republic of Bulgaria;
2. special immunization and re-immunization performed at specific indications;
3. recommended immunization.
(3) The regulations under Paragraph 2 shall set out also the specific requirements to and the application of individual serums, immunoglobulins and other bio products for preventive purposes.
Article 59
Where an emergency epidemic situation occurs or a tangible decline is observed in the immunization coverage, the Minister of Health may issue instructions in:
1. mandatory immunization and re-immunization of certain groups of the population other than those included in the immunization calendar;
2. mandatory immunization and re-immunization with substances other than those included in the immunization calendar;
3. immunization and re-immunization in ways other than those included in the immunization calendar;
4. the organisation of immunization campaigns, the opening of temporary immunization offices, the establishment of teams for on-site immunization and other emergency measures.
Article 60
(1) Patients with infectious diseases, persons in contact with them and infection carriers shall be subject to registration, mandatory notification and reporting.
(2) The Minister of Health shall issue regulations to specify the diseases under Paragraph 1 and the terms and conditions for registration, notification and reporting.
(3) The Minister of Health shall also specify in the regulations under Paragraph 2 the terms and conditions for supervision, early warning and undertaking of measures in the event of bioterrorism or emergence of new unknown infectious diseases.
(4) The organisation of prevention and the control of internal hospital infections shall be s et out in regulations issued by the Minister of Health.
(5) (Amended, SG No. 59/2006) The Minister of Health shall issue ordinances to specify the terms and conditions for diagnostics, prevention and control of certain infectious diseases.
(6) The terms and conditions for testing, notification and reporting of infection with the virus of the acquired immune deficiency syndrome shall be set out in regulations issued by the Minister of Health.
Article 61
(1) Subject to mandatory isolation and hospital treatment shall be persons who are patients or infection carriers of cholera, plague, smallpox, yellow fever, viral hemorrhagic fever, diphtheria, typhoid fever, poliomyelitis, brucellosis, anthrax, malaria, severe acute respiratory syndrome and tuberculosis with bacilli spread.
(2) Where a threat to the health of citizens exists, the Minister of Health may issue instructions on the mandatory isolation of infection carriers and patients of diseases other than those laid down in Paragraph 1.
(3) The mandatory isolation and the treatment of the persons under Paragraphs (1) and (2) shall be carried out at an order issued by the head of the respective medical establishment at the proposal of the physician in charge of the treatment.
(4) The isolation and treatment of patients of infectious diseases other than those under Paragraph 1 may be carried out at home upon the assessment of the existing epidemic risk by an epidemiologist and a specialist in infectious diseases.
Article 62
(1) Individuals and legal entities performing disinfection, disinfection and deratization shall advise the Ministry of Health thereof within 14 days of the beginning of their activities.
(2) The terms and conditions for the activities under Paragraph 1 shall be set out in regulations issued by the Minister of Health.
Article 63
(1) Where an emergency epidemic situation occurs, the Minister of Health shall introduce anti-epidemic measures within the territory of the whole country or a specific region.
(2) The measures under Paragraph 1 within the territory of a specific municipality may be introduced also by the mayor at the proposal of the director of the respective RIPHPC.
(3) Central and local government authorities shall create the necessary conditions for the implementation of the measures under Paragraph 1, while the resources for their implementation shall be provided from the central government budget or the municipal budgets respectively.
(4) In the event of a threat of occurrence and epidemic spread of infectious diseases, central and local government authorities, individuals and legal entities shall provide all the necessary assistance to the state health control authorities.

Section VI
Protection against the Impact of Ionizing Radiation
Article 64
(1) The protection of persons against the impact of ionizing radiation shall be carried out, while observing the principles of radiation protection pursuant to this Act and the Safe Use of Nuclear Energy Act.
(2) The protection under Paragraph 1 shall include:
1. control of the factors of the working and living environment in order to identify and reduce the exposure of persons to sources of ionizing radiation;
2. medical treatment of persons working with sources of ionizing radiation;
3. dissymmetric control to establish the internal and external exposure of persons working with sources of ionizing radiation;
4. assessment of the exposure and the radiation risk of the population as a whole or groups thereof;
5. medical monitoring of persons exposed to sources of ionizing radiation in the course of medical tests or treatment;
6. medical assistance to the community, individual groups thereof or persons working with sources of ionizing radiation in the event of radiation accident.
Article 65
(1) The Minister of Health shall issue regulations to specify:
1. the terms and conditions for medical assistance and health norms to protect persons in the event of radiation accident;
2. the terms and conditions for ensuring protection of persons in the case of medical radiation;
3. the terms and conditions for the performance of individual dissymmetric control of persons working with sources of ionizing radiation;
4. the health norms and requirements to work in an ionizing radiation environment;
5. the requirements to the protection of persons exposed to recurrent radiation as a result of the production of, trade in or use of raw materials, objects and goods with increased radionuclide content.
(2) Persons who fall ill as a result of radiation accident or radiation fallout in the environment shall be subject to monitoring and treatment under terms and conditions set out in regulations issued by the Minister of Health.
Article 66
(1) Medical ionizing radiation shall be allowed in any of the following cases:
1. diagnostics or treatment of patients;
2. health screening;
3. implementation of medical research programmes with the participation of volunteers.
(2) Medical ionizing radiation shall be allowed with regard to persons who consciously and voluntarily help other persons in the course of medical radiation without having any professional duty to do so.
(3) The medical radiation under Paragraph 1 shall be prescribed and conducted by medical doctors or doctors of dental medicine.
(4) The exposure of children to ionizing radiation within the framework of a health screening programme and the radiation involving high doses for the patient shall be conducted only by specialists who have undergone further specialised training.
(5) In the cases under Paragraph 1, the persons to whom medical radiation is applied shall be entitled to refuse diagnostics and treatment related to ionizing radiation at any point of time.
Article 67
(1) Medical ionizing radiation shall be allowed in the implementation of forensic procedures for persons held criminally liable.
(2) The instruction on the medical radiation under Paragraph 1 shall be issued by the competent government authority upon a medical conclusion that the person has no medical counter indications to apply it.
(3) The terms and conditions for the medical radiation of persons under Paragraph 1 shall be set out in regulations issued by the Minister of Health, the Minister of Finance and the Minister of Justice.
Article 68
(1) No medical ionizing radiation shall be applied to pregnant women, unless there exists a serious threat to their life or health. In the case of medical ionizing radiation of a woman in fertile age, medical specialists shall ask her whether she is pregnant or not.
(2) Where emergency aid is provided and the possibility for pregnancy cannot be ruled out, measures shall be taken to protect the health of the pregnant woman and the foetus.
(3) Medical radiation of a breast-feeding woman for diagnostics and/or treatment with the methods of nuclear medicine shall be allowed only in case there exists a serious threat to her life or health.
Article 69
(1) Where the patient is at home after treatment or diagnostics with radioactive substances, the medical specialist in charge of the treatment of diagnostics shall provide the patient with instructions in writing on how to limit the exposure of the family members or the persons taking care of the patient directly.
(2) The instructions shall be provided to the parent or the trustee of a patient who is a minor or put under full legal incapacity or to the parent or guardian of a patient who is under age or put under partial legal incapacity.
Article 70
(1) The state health control authorities may allow, by way of exception, the performance of activities by volunteers at higher levels of exposure in order to save human life or prevent greater exposure in the event of a radiation accident. The effective dose per person shall not exceed 50 millivert in any year or a total of 200 millivert for ten years.
(2) The persons under Paragraph 1 shall be subject to immediate medical testing and monitoring.
Article 71
(1) The Ministry of Health shall establish and maintain a register of the persons working or having worked in an environment of ionizing radiation.
(2) The terms and conditions for the registration, processing and storage of the data under Paragraph 1 shall be set out in regulations issued by the Minister of Health
Article 72
(1) Individuals and legal entities performing activities with sources of ionizing radiation shall:
1. allow staff from external organisations to work upon the presentation of a medical conclusion on the fitness of the employee to work in an ionizing radiation environment;
2. perform radiation monitoring and provide medical supervision of these persons during their work on the site;
3. submit the results of the radiation monitoring to the employer of the external organisation.
(2) The persons under Paragraph 1 shall advise the Ministry of Health of any deviations in the course of normal operation of the facilities, which may lead to exposure of citizens.
(3) The government authorities which perform monitoring of the radiation parameters of the environment shall provide the Minister of Health, from time to time, with data needed for health risk assessment purposes.

Section VII
Protection of the Health of Citizens in the Performance of Works with Asbestos and Asbestos-containing Materials
Article 73
(1) (Amended, SG No. 59/2006, effective 21.07.2006) The works related to the demolition or removal of asbestos and/or asbestos-containing materials of buildings, structures, enterprises, installations or vessels shall be carried out upon reception of permission from the RIPHPC director on the territory of which they are carried out.
(2) (Amended, SG No. 59/2006, effective 21.07.2006) For the purposes of obtaining permission, the party concerned shall submit an application to RIPHPC.
1. application for issuance of permit;
2. a work plan, featuring concrete measures for providing the health and safety of workers and employees at work;
3. a list of workers and employees engaged;
4. attestation of training of workers and employees.
(3) (Amended, SG No. 59/2006, effective 21.07.2006) The work plan shall specify:
1. the type and expected duration of activities;
2. the location of activities;
3. the methods applied at activities involving asbestos or asbestos-containing materials;
4. the personal protection kits provided where necessary;
5. the characteristics of the equipment used for protection of:
(a) the workers and employees and for eradication of pollution with asbestos;
(b) other persons on location of or in proximity to the work done;
6. the planned activities for protection of the environment;
7. the procedure and means of proving the lack of risk from exposure to asbestos at work after completion of the works on demolition or removal of asbestos or asbestos-containing materials.
(4) (Amended, SG No. 59/2006, effective 21.07.2006) The work plan shall be developed in abidance by the requirement for removal of asbestos and/or asbestos-containing materials prior to the application of techniques for demolition, with the exception of the cases where works on said removal cause a greater risk for workers and employees than non-removal of the asbestos or asbestos-containing materials.
(5) (New, SG No. 59/2006, effective 21.07.2006) The training of workers and employees shall be conducted under conditions and by a procedure established by the ordinance referred to in Item 2 of Article 36 of the Health and Safety at Work Act .
(6) (Renumbered from Paragraph (5), SG No. 59/2006, effective 21.07.2006) No permission shall be required for emergency and rescue operations.
Article 74
(1) (Amended, SG No. 59/2006, effective 21.07.2006) Within ten days of the date of the application, the RIPHPC director shall send the documents under Article 73 (2) in an administrative procedure to the Regional Inspectorate for the Environment and Water on the territory of which the site for demolishing or removal of asbestos or asbestos-containing materials is located.
(2) The Regional Inspectorate for the Environment and Water shall give its opinion within 14 days of the date of receipt of the documents. Where no opinion is received by RIPHPC within the prescribed time limits, the Regional Inspectorate for the Environment and Water shall be presumed to have given its consent with the documents without any reservations.
(3) The RIPHPC director shall advise the applicant with regard to the recommendations of RIPHPC and/or the Regional Inspectorate for the Environment and Water to change the work plan. In accordance with the recommendations and within a month of the notification, the applicant shall submit the work plan adjusted in conformity with the recommendations.
(4) (Amended, SG No. 59/2006, effective 21.07.2006) The permission for demolishing or removal of asbestos and/or asbestos-containing materials shall be issued by the RIPHPC director within five days of the date of receipt of a positive opinion of the Regional Inspectorate for the Environment and Water or the adjusted work plan.
(5) In the event of failure to fulfil the recommendations, the RIPHPC director shall issue a refusal to give permissions with reasons thereof.

Section VIII
Resort Resources and Resorts
Article 75
(1) Resort resources are mineral waters, curative pelloids, the beach strip and the areas with favourable bio-climatic conditions for preventive medicine, treatment and rehabilitation.
(2) Curative pelloids are slime from firths and lagoons, slime from water sources, peat and bentonite clay.
Article 76
(1) Territories with categorized resort resources and opportunities for construction and operation of sites and facilities for preventive medicine, treatment, rehabilitation, recreation and tourism of the population shall be declared resorts.
(2) The boundaries and conditions for the development of the resort shall be established at a decision of the Council of Ministers which is promulgated in The State Gazette.
Article 77
(Amended, SG No. 94/2005)
The Minister of Health, jointly with the Minister of Regional Development and Public Works, the Minister of the Environment and Water and the Chairman of the State Tourism Agency, shall issue regulations specifying the conditions and procedure for:
1. the use and protection of mineral waters, curative pelloids, the beach strip and the areas with favourable bio climatic conditions for preventive medicine, treatment and rehabilitation, as well as specifying the capacity of the beach strip and the areas with favourable bio-climatic conditions for preventive medicine, treatment and rehabilitation;
2. the approval of protective zones and arrangements for the protection on of the deposits of curative pelloids, the beach strip and the areas with favourable bio-climatic conditions for preventive medicine, treatment and rehabilitation;
3. the approval of the operational stock and use of curative mud deposits;
4. the operation of beaches along the Black Sea coast.
Article 78
(1) Medical establishments shall use mineral waters and curative mud for their medical activities, including the cases in which these resort resources are subject to the provisions of the Concessions Act.
(2) The quantities of mineral waters and curative mud under Paragraph 1 shall be established on an annual basis in a decision of the Council of Ministers at the proposal of the Minister of Health.

Chapter Three
MEDICAL SERVICES

Section I
Accessibility and Quality of Medical Aid
Article 79
Medical aid in the Republic of Bulgaria shall be provided by applying methods and technologies approved by medical science and practice.
Article 80
The quality of medical aid shall be based on medical standards approved pursuant to Article 6, Paragraph 1 of the Medical Treatment Facilities Act and the Rules of Good Medical Practice adopted and approved pursuant to Article 5, Item 4 of the Doctors' and Doctors of Dental Medicine Professional Organisations Act.
Article 81
(1) Each Bulgarian citizen shall be entitled to accessible medical aid under the terms and conditions of this Act and the Health Insurance Act.
(2) The right to accessible medical aid shall be exercised, while applying the following principles:
1. timeliness, sufficiency and quality of medical aid;
2. equality in the provision of medical aid with priority given to children, pregnant women and mothers of children aged below one year;
3. cooperation, consistency and coordination of the activities of medical establishments;
4. respect for the patient's rights.
(3) The terms and conditions for the exercise of the right of access to medical aid under Paragraph 1 shall be set out in regulations issued by the Council of Ministers.
Article 82
(1) Beyond the scope of the mandatory health insurance of Bulgarian citizens, medical services shall be provided in relation to:
1. medical aid in emergency cases;
2. (new, SG No. 59/2006) obstetric aid for all women without health insurance, regardless of the manner of birth, within the scope and by a procedure determined by an ordinance of the Minister of Health;
3. (renumbered from Item 2, SG No. 59/2006) psychiatric hospital aid;
4. (renumbered from Item 3, SG No. 59/2006) the provision of blood and blood products;
5. (renumbered from Item 4, SG No. 59/2006) the transplantation of organs, tissues and cells;
6. (renumbered from Item 5, SG No. 59/2006) the mandatory treatment and/or mandatory isolation;
7. (renumbered from Item 6, SG No. 59/2006) expert opinions and reports on the degree of disability and long-term loss of the ability to work;
8. (renumbered from Item 7, SG No. 59/2006) the payment for the treatment of diseases under terms and conditions set out by the Minister of Health;
9. (renumbered from Item 8, SG No. 59/2006) medical transport under terms and conditions set out by the Minister of Health.
(2) Each Bulgarian citizen shall use:
1. vaccines for mandatory immunization and re-immunization, vaccines for specific indications and in emergency situations, specific serums, immunoglobulins and other bio products related to the prevention of infectious diseases, as well as the technical means for their application;
2. the full range of anti-epidemic activities;
3. access to healthcare activities within the framework of national, regional and municipal health programmes.
(3) Children below the age of 16 shall be entitled to medical aid beyond the scope of the mandatory health insurance.
(4) Children accommodated at medical establishments under Article 5, Paragraph 1 of the Medical Treatment Facilities Act shall be entitled to medical and social care free of charge.
(5) The activities under Paragraphs (1), (2), (3), and (4) shall be financed from the central and local government budgets and used under terms and conditions set out in regulations issued by the Minister of Health.
Article 83
(Amended and supplemented, SG No. 18/2006, amended, SG No. 95/2006)
(1) Foreigners allowed long-term stay in the Republic of Bulgaria shall use the medical aid under Articles 81 and 82 on equal terms with the Bulgarian citizens.
(2) The procedures for access to medical aid of the persons under Paragraph (1) shall be set out by the regulations under Article 81 (3).
(3) Foreign graduate students and PhD students, admitted for education in establishments of higher education and research in this country under the procedure of Decree of the Council of Ministers No.103/1993 regarding carrying out of education activities among Bulgarians abroad (promulgated, SG, No.48/1993; corrected, No.52/1993, amended, No. 54/1995, No. 20/1996, Nos. 38 and 73/1999, No. 101/2002, No. 89/2004) and Decree of the Council of Ministers, No. 228/1997 on admission of citizens of the Republic of Macedonia as graduate students in public higher educational establishments in the Republic of Bulgaria (promulgated, SG No. 42/1997, amended, No. 71/1999, No. 101/2002), shall enjoy access to medical assistance under Article 81 and 82 on equal terms with Bulgarian citizens.
(4) Foreigners residing in the Republic of Bulgaria on a long or short- term basis or passing transit shall pay the value of the medical aid rendered to them at the prices set out by the medical establishment under the terms and conditions set out by the regulations of the Minister of Health, the Minister of Foreign Affairs and the Minister of Justice.
(5) Foreigners residing in the Republic of Bulgaria on a short-term basis or passing transit shall have health insurance or policy covering the costs of treatment and hospitalization during their stay in the country, unless ruled otherwise in an international agreement to which the Republic of Bulgaria is a party.
(6) Where the mandatory insurance under Paragraph (5) is made upon the entry into the country, the general terms and conditions, the minimum insurance amount, the minimum insurance premium and the procedure shall be set out in regulations issued by the Council of Ministers.
(7) The regulations of Paragraphs (4) - (6) shall not apply to foreigners residing in the Republic of Bulgaria on a long or short term basis to whom shall apply the regulations for coordination of the social security systems within the meaning of § 1, Item 1 of the Additional Provision of the Health Insurance Act.
(8) The procedures for access to medical aid in the Republic of Bulgaria of the persons under Paragraph (7) shall be set out by the regulations under Article 81 (3).
Section II
Patient's Rights and Obligations
Article 84
(1) Patient is any person who has sought or who is receiving medical aid.
(2) Persons shall be registered as patients with their informed consent, except for the cases prescribed by law.
Article 85
The assessment of the health condition of the patient may not be based on race, gender, age, ethnic community, origin, religion, education, cultural level, convictions, political affiliation, sexual orientation, personal and social status or property.
Article 86
(1) In the capacity of a patient, every person shall be entitled to:
1. respect for his/her civil, political, economic, social, cultural and religious rights;
2. care from the community in which he/she lives;
3. accessible and high-quality medical aid;
4. more than one medical opinion on the diagnosis, treatment and prognosis of the disease;
5. protection of the data related to his/her health condition;
6. remuneration for the work he/she performs equal to the one he/she would receive if healthy;
7. becoming aware of his/her rights and obligations in a language comprehensible to him/her;
8. clear and accessible information on his/her health condition and the methods of the possible treatment.
(2) In the case of hospitalisation, patients shall be entitled to:
1. visits by the family doctor and the specialists who has issued the hospitalisation instruction;
2. receive or refuse to receive visitors;
3. the services of a psychotherapist, a lawyer and a priest;
4. education and access to activities meeting their social, religious and cultural needs;
5. information on the price of each medical service, manipulation, treatment and medicine in the primary and hospital aid.
(3) The patient's rights shall be exercises, while observing the rules for the structure, activities and internal order of the medical establishment.
Article 87
(1) Medical activities shall be performed upon the informed consent expressed by the patient.
(2) Where the patient is under age or put under partial legal incapacity, his/her informed consent shall be given together with the consent of a parent or a custodian.
(3) Where the patient is a minor or put under full legal incapacity, the informed consent shall be given by a parent or a trustee, unless prescribed otherwise by law.
(4) Where persons have mental disorders and are incapable of giving informed consent, the latter shall be expressed by the persons under Article 162, Paragraph 3.
Article 88
(1) In order to obtain the informed consent, the physician (doctor of dental medicine) in charge of the treatment shall inform the patient or the parent, custodian or trustee respectively, as well as the persons under Article 162, Paragraph 3 about:
1. the diagnosis and nature of the disease;
2. the description of the goals and the nature of the treatment, the reasonable alternatives, the expected outcome and the prognosis;
3. the potential risks related to the proposed methods of diagnostics and treatment, including the side effects and undesired pharmaceutical reactions, pain and other discomfort;
4. the likelihood of a favourable impact, and the health risk in the application of other methods of treatment or in the refusal to take treatment.
(2) The medical information under Paragraph 1 shall be provided to the patient or the parent, custodian or trustee respectively, as well as the persons under Article 162, Paragraph 3 in a timely manner and in an appropriate amount and format to ensure the freedom of choice of a treatment.
Article 89
(1) In the event of surgical intervention, general anaesthetics, invasive and other diagnostic and therapeutic methods leading to higher risk the patient's life of health or temporary change of the mind, the information under Article 88 and the informed consent shall be given in writing.
(2) The activities under Paragraph 1 may be performed to the benefit of the patient's health without any informed consent given in writing only if there is an immediate threat to the patient's life and:
1. his/her physical or mental condition prevent him/her from expressing an informed consent;
2. it is impossible to obtain the consent of the parent, custodian, trustee or the person under Article 162, Paragraph 3 in a timely manner, where such a consent is required by law.
(3) With regard to persons have mental disorders and are incapable of giving informed consent, the activities under Paragraph 1 may be performed only with the permission of the commission for medical ethics and upon obtaining the consent of their legitimate representatives or the head of the medical establishment, where no such commission exists.
Article 90
(1) The patient or the parent, custodian or trustee respectively, as well as the persons under Article 162, Paragraph 3 may refuse the medical aid offered or continuation of medical activities that have started at any point of time.
(2) The refusal under Paragraph 1 shall be certified in the medical documentation with signatures of the person.
(3) Where the patient or the parent, custodian or trustee respectively, or the person under Article 162, Paragraph 3 in not in a position or refuses to certify the refusal under Paragraph 1 in writing, this fact shall be certified with the signature of the physician in charge of the treatment and a witness.
(4) Where the parent, custodian or trustee has given the refusal under Paragraph 1 and the patient's life is threatened, the head of the medical establishment may decide to apply life saving treatment.
Article 91
Medical aid may be provided to the patient against his/her will only in cases prescribed by law.
Article 92
(1) The physician in charge of the treatment shall inform the patient about:
1. his/her health condition and the need for treatment;
2. the disease in connection with which the patient has sought medical aid, and its prognosis;
3. the planned preventive, diagnostic, therapeutic and rehabilitation activities, as well as the related risks;
4. the diagnostic and therapeutic alternatives;
5. the name, position and specialty of the persons involved in the diagnostic and therapeutic process.
(2) The patient's access to the health information under Paragraph 1, Items 2 and 3 may be restricted in the case of his/her refusal given in writing.
(3) The decision under Paragraph 2 shall be reflected in writing in the patient's medical documentation.
Article 93
(1) The patient or the parent, trustee or custodian respectively or a person authorised by the patient may submit complaints and reports to RHC in the case of violation of the patient's rights under this Act or disputes related to medical services.
(2) The Regional Healthcare Centre shall check the complaint or reports in an administrative procedure within seven days.
(3) Where an administrative violation is observed, the inspecting officer of RHC shall draw up a statement of findings, while the RHC director shall issue a penalty order under the Administrative Violations and Sanctions Act.
(4) Where the established violations are punishable under the Doctors' and Doctors of Dental Medicine Professional Organisations Act and the Health Insurance Act, RHC shall inform and send the complaint to the regional chapters of the Bulgarian Doctors' Union and the Union of Dentists in Bulgaria and the Regional Health Insurance Fund.
(5) Within three days of the end of the check, RHC shall advise the patient of the results thereof and the action undertaken.
Article 94
The patient shall:
1. take care of his/her own health;
2. not harm the health of others;
3. assist the providers of medical aid in the performance of the activities related to the improvement and recovery of his/her health;
4. observe the order established at healthcare and medical establishments.
Article 95
(1) In the case of incurable diseases with unfavourable prognosis, the patient shall be entitled to palliative medical care.
(2) The objective of palliative medical care shall be to maintain the quality of life through reduction or elimination of some immediate signs of the diseases, as well as the related adverse psychological and social effects.
Article 96
(1) Palliative medical care shall include:
1. medical observation;
2. healthcare aimed at providing care to the patient, removing pain and the psychological and emotional effects of the disease;
3. moral support to the patient and his/her relatives.
(2) Palliative medical care shall be provided by the family doctor, by medical establishments for outpatient and hospital care, by dispensaries and hospices.
(3) The requirements to the provision of palliative medical care shall be set out in regulations issued by the Minister of Health.
Article 97
No euthanasia shall be applied within the territory of Bulgaria.
Article 98
(1) Persons who died at a medical establishment shall be subject to post-mortem upon notification of a parent, adult child, spouse or sibling.
(2) Post-mortem of persons who dies outside a medical establishment may be performed at the request of the medical doctor who reported the death or at the explicit request of the relatives of the deceased person.
(3) No post-mortem shall be performed where the corpse is subject to forensic medical expert opinion and report.
(4) Post-mortem shall not be performed when the corpse is subject to forensic expertise.

Section III
Medical Aid in Emergency
Article 99
(1) The government shall organise and finance a system for emergency medical aid.
(2) Emergency is an acute or sudden change of human health, which requires urgent medical aid.
(3) Medical aid in emergency shall be aimed at preventing:
1. death;
2. severe or irreversible morphological and functional damage to vital organs and systems;
3. complications in women at childbirth, which threaten the health and life of the mother or the foetus.
Article 100
(1) Each person on the site of the accident shall inform the nearest emergency medical aid centre, another medical establishment or police department.
(2) Each medical establishment shall provide the possible volume of medical activities to a patent in emergency, regardless of his/her citizenship, address or health insurance status.
(3) Where it is impossible to provide the necessary volume of activities, the patient shall be accommodated at the nearest medical establishment which has the requisite conditions, provided that the condition of the patient allows to do so.
(4) In the case of relocation of a patient from one medical establishment to another, all medical documents on the diagnostic, consultative and therapeutic activities shall be attached in the summarized form of an epicrisis.
(5) A patient shall not be transported if the transportation or the related circumstances lead to unjustified high risk for his/her health and life.

Section IV
Medical Expert Activities
Article 101
(1) Medical expert opinions and reports shall be given to establish the extent of loss of the ability to work and to confirm an occupational disease.
(2) Medical expert activities shall be organised and guided by the Minister of Health and RHC.
(3) The extent of the long-term loss of the ability to work and the extent of the reduced capability of social adaptation of children below the age of 16 shall be expressed in percentage of the capabilities of a healthy person.
(4) The extent of the long-term loss of the ability to work of persons aged 65 or above shall be established for life. Re assessment of these persons may be performed at their request or at the request of the medical expert control authorities.
(5) The principles and criteria for medical expert activities and the procedures for establishment of the extent of loss of the ability to work and for confirmation of an occupational disease shall be set out in regulations issued by the Council of Ministers.
Article 102
(1) The National Medical Expert Board shall be established at Council of Ministers with the following powers:
1. to prepare and submit to the Council of Ministers opinions on the national health policy in connection with medical expert activities;
2. to ensure the coordination of government authorities in connection with medical expert activities;
3. to analyse the information on the performance, development and condition of medical expert activities in this country;
4. to draft and submit for adoption to the Council of Ministers new and amending bills related to medical expert activities;
5. to develop a methodology for financing and control of medical expert bodies, which shall be adopted by the Council of Ministers.
(2) The National Medical Expert Board shall have the following membership: a Deputy Prime Minister who will serve as the chairperson of the Board, the Minister of Health, the Minister of Labour and Social Policy, the Minister of Finance, the head of the National Social Security Institute (NSSI), the NHIF director, and the NEMC director.
(3) The structure and activities of the Board under Paragraph 1 shall be set out in regulations issued by the Council of Ministers.
Article 103
(1) The medical expert opinion and report on the ability to work shall include an opinion and report on the temporary loss of the ability to work and an opinion and report on the long term loss of the ability to work.
(2) The medical expert opinions and reports on the temporary loss of the ability to work shall be given by the physician in charge of the treatment, physician consultative commissions (PCC), territorial physician expert commissions (TPEC) and NEMC.
(3) The medical expert opinions and reports on the long-term loss of the ability to work and occupational diseases shall be given by TPEC and NEMC.
(4) The medical expert opinions and reports on the reduced capability of social adaptation of children below the age of 16 shall be given by TPEC with the participation of paediatricians and social workers.
Article 104
(1) Physician consultative commissions shall be opened and closed down with an order of RHC directors at medical establishments for outpatient and hospital care at the proposal of the head of the respective medical establishment.
(2) At the medical establishments under Article 5, Paragraph 1 of the Medical Treatment Facilities Act and at university hospitals, the PCC membership shall be set out in an order of the head of the respective medical establishment.
(3) Physician consultative commissions shall be general and specialised. The PCC membership shall include at least two permanent members who are medical doctors with recognised specialty, including a chairperson.
Article 105
(1) Territorial physician expert commissions shall be opened and closed down with an order of RHC directors, in consultation with the Minister of Health, at state-owned and municipal medical establishments for hospital care and dispensaries.
(2) Territorial physician expert commissions shall be structural units of the medical establishments at which they are opened.
(3) The membership of each TPEC shall include: a medical doctor representing the respective territorial subdivision of NSSI designated at an order of the head of the respective territorial subdivision of NSSI, and a representative of the Regional Social Welfare Directorate designated at an order of the director of the respective Regional Social Welfare Directorate.
Article 106
(1) The membership of TPEC and NEMC shall include medical doctors with recognised specialty and at least 10 years of service in the respective profile.
(2) The membership of specialised NEMC divisions shall include a medical doctor representing the NSSI designated at an order of the head of the NSSI.
(3) TPEC and NEMC members may not engage in activities subject to their control or consultative activities related to medical expert opinions and reports on temporary or long-term loss of the ability to work.
Article 107
(1) The director of the medical establishment shall sign a funding agreement for the activities of TPEC with the Minister of Health.
(2) Highly specialised and costly medical and diagnostic tests related to the process of medical expert opinions and reports on the ability to work, which are performed at the request of TPEC and NEMC, shall be financed by the NHIF within the framework of its annual budget.
Article 108
(1) The activities related to the registration, processing and storage of health information for persons assessed by TPEC and NEMC shall be carried out by regional medical expert record offices (RMERO).
(2) The regional medical expert record offices shall be structural units of RHC.
(3) The medical documentation of persons assessed by TPEC and NEMC with recognised percentage of long-term loss of the ability to work shall be stored for 40 years of the date of the latest TPEC (NEMC) decision, and that of all other persons shall be stored for five years.
(4) Copies of the TPEC and NEMC decisions shall be sent to the National Health Information Centre.
Article 109
The structure and activities of the medical expert bodies under Article 103 and of RMERO shall be set out in regulations issued by the Council of Ministers
Article 110
Medical expert activities shall be subject to control by the National Medical Expert Board, the Minister of Health, the Minister of Labour and Social Policy, NHIF, NSSI, the regional boards under Article 111 and RHC.
Article 111
(1) For the purposes of exercising control over the acts issued by medical expert bodies with regard to the temporary loss of the ability to work, a regional board shall be set up at an order of the respective RHC director, including representatives of RHC, the NSSI territorial subdivision and RHIF. The regional board shall perform also inspections ex officio of at least two percent of the decisions on the temporary loss of the ability to work made within the territory of the respective region, which shall be subject to random choice.
(2) The regional board shall review and control medical expert activities with regard to the temporary loss of the ability to work, which are carried out by physicians in charge of the treatment, PCC and TPEC. The organisation of the activities of the board shall be set out in regulations issued by the Minister of Health together with the NSSI head.
(3) Regional boards shall check the observance of the requirements for the issuance of decisions on the temporary loss of the ability to work by physicians in charge of the treatment and TPEC at the proposal of the parties and organisations concerned (assessed persons, insurers, NSSI and NHIF territorial subdivisions).
(4) Where a violation is observed in the issuance of expert decisions on the temporary loss of the ability to work, the regional board shall advise in writing the higher-standing medical expert body and the parties and organisations concerned (assessed persons, insurers, NSSI and NHIF territorial subdivisions).
Article 112
(1) The appeals and objections on part of the parties and organisations concerned (assessed persons, insurers, NSSI, the Social Welfare Agency, the Rehabilitation and Social Integration Fund and the medical expert bodies assessing the ability to work) shall be served:
1. against the decisions of the physician in charge of the treatment within 14 days of their reception before the physician consultative commission;
2. against PCC decisions within 14 days of their reception before TPEC;
3. against TPEC decisions within 14 days of their reception before NEMC;
4. (amended, SG No. 30/2006) against NEMC decisions before the Sofia City Administrative Court pursuant to the Administrative Procedure Code.
(2) The parties and organisations concerned (assessed persons, insurers, NSSI and NHIF territorial subdivisions) may appeal, within 14 days, against PCC decisions violating the requirements and procedure for the issuance of expert decisions on the temporary loss of the ability to work also before the regional board under Article 111.
(3) The regional board shall rule on the appeals within ten days of the repeated medical expert opinion and report on the temporary loss of the ability to work, which shall be performed by a specialised PCC designated by the board, depending on the type of disease.
(4) Where a violation is observed in the issuance of the appealed expert decision, the regional board shall revoke it and the ability to work shall be established in the repeated medical expert decision.
(5) The decision of the regional board to revoke the medical expert decision and the decision to give a repeated medical expert opinion and report shall be sent to the parties concerned (assessed persons, insurers and NSSI) and RHIF.
(6) An appeal against a PCC decision under Paragraph 2 shall be an obstacle to appealing against it under Paragraph 1, Item 2.
(7) The decision of the regional board not to grant the appeal shall not prevent the appeal against the PCC decision before TPEC under Paragraph 1, Item 2. In these cases, time limits shall start on the date of receipt of the decision of the regional board.
(8) The decision to give a repeated medical expert opinion and report shall be subject to appeal under Paragraph 1, Item 2.
Article 113
(1) Medical expert bodies may also act on their own initiative to revoke or alter wrong decisions of lower-standing bodies or refer their decisions back for removal of errors or incompleteness within three months of the date of these decisions.
(2) The head of NEMC may give instructions to review wrong or contradictory decisions of NEMC divisions within three months of the date of these decisions.
(3) The decisions of medical expert bodies, which have not been appealed against or all the remedies in connection with which have already been exhausted, shall be binding on all persons, bodies and organisations in this country.

Section V
Medical Care in Natural Calamities, Accidents and Disasters
Article 114
(1) The management, organisation and provision of resources for medical care in natural calamities, accidents and disasters shall be performed by the Minister of Health, RHC directors, state health control authorities, medical and healthcare establishments.
(2) (Amended, SG No. 102/2006) The authorities under Paragraph (1) shall carry out the medical care activities in natural calamities, accidents and disasters in close cooperation with the central and local government authorities, the Ministry of State Policy for Disasters and Accidents, non- governmental organisations and the Bulgarian Red Cross Society.
Article 115
(1) The Minister of Health shall develop plans for medical care in natural calamities, accidents and disasters, which shall be subject to approval by the Council of Ministers.
(2) On the basis of the action plans in natural calamities, accidents and disasters as approved by the Council of Ministers, the authorities under Paragraph 1 shall:
1. create the necessary conditions for medical sorting, primary processing, treatment, rehabilitation and medical expert activities for the victims;
2. set up and train management bodies and medical teams;
3. ensure the protection of hospitalised patients and medical staff against external factors;
4. organise and carry out anti-epidemic and sanitary activities and control in the affected areas;
5. establish resource stock for medical activities;
6. organise the continuous training of medical specialists and the population in the field of medical care in natural calamities, accidents and disasters.
(3) Healthcare in natural calamities, accidents and disasters shall be financed from the central government budget.
Article 116
(1) A board for medical care in natural calamities, accidents and disasters at the RHC director shall be set up to provide medical care in natural calamities, accidents and disasters.
(2) The board under Paragraph 1 shall include the directors of RIPHPC, medical establishments for hospital care, the emergency medical aid centre and representatives of the regional administration and municipalities in the respective region.
(3) The board under Paragraph 1 shall adopt the regional action plans and the training programmes for medical teams operating in natural calamities, accidents and disasters.

Chapter Four
HEALTH PROTECTION OF SPECIFIC GROUPS OF THE POPULATION

Section I
Health Protection of Children
Article 117
Central and local government authorities, individuals and legal entities shall create conditions to ensure a healthy environment and normal physical and mental development of children.
Article 118
(1) Creches and kitchens for children shall be set up to support families in raising children up to the age of three and to ensure their normal physical and mental development.
(2) Creches shall be organisationally distinct structures, where medical and other specialists raise, educate and train children aged from three months to three years.
(3) Kitchens for children shall be organisationally distinct structures, where medical and other specialists prepare, keep and provide food for children aged up to three years.
(4) The requirements to the structure and activities of crèches and kitchens for children, as well as the norms for healthy nutrition of children aged up to three years shall be set out in regulations issued by the Minister of Health.
Article 119
(1) Crèches and kitchens for children may be set up by local governments, individuals and legal entities.
(2) The support of children at municipal crèches and the operation of municipal kitchens for children shall be supported from the respective municipal budget.
(3) Parents and trustees shall pay fees for raising children at municipal crèches and for receiving food from municipal kitchens for children in amounts specified by the Municipal Council pursuant to the Local Taxes and Fees Act.
Article 120
(Amended, SG No. 95/2007)
(1) Health offices at kindergartens, schools and specialised institutions providing social services for children under Article 26, Paragraph (1), Item 3, shall carry out the following activities:
1. medical services for the provision of first medical aid to the children and pupils and medical services until the arrival of a specialized urgent medical aid team;
2. promotion and prevention with regard to the children's and pupils' health;
3. organising and carrying out activities to prevent outbreaks and limit the spreading of infectious and parasitical diseases at the kindergartens, schools and specialised institutions providing social services for children;
4. participation in the preparation, conducting and control of the various forms of recreation, tourism and sports activities for the children and pupils;
5. organisation and implementation of health education programs for the children and pupils, of special healthy diet programs, of programs to prevent deviations in diet habits, to prevent the use of narcotic and psychotropic substances, to prevent the use of tobacco products and alcoholic drinks, and to cultivate a sexual culture;
6. consultation on the weekly schedule of classes with the headmaster of the kindergarten, the school, and of the specialised institutions providing social services for children.
(2) The activities under Paragraph (1) shall be carried out periodically and by university graduates of medicine with the vocational qualification of doctor and by other medical specialists with a bachelor's degree under Article 42, Paragraph (1), Item 1 of the Higher Education Act, in accordance with standards specified by the regulations under Article 26, Paragraph (2). The regulations shall also specify the powers, duties and responsibilities of the doctors and medical specialists working in the medical offices under Paragraph (1).
(3) The doctors shall keep accounting and reporting records as per sample forms and systematise the information from the doctor of dental medicine on the process of prevention and treatment regarding the dental status of the children and pupils at the kindergartens, schools, and specialised institutions providing social services for children under Paragraph (1), in cases where no dental medicine offices have been opened therein.
(4) The doctors and medical specialists under Paragraph (2) shall work under a contract with the mayor of the municipality on whose territory the kindergartens, schools, and specialised institutions providing social services for children are located, or with the person who has obtained a permit, or respectively a license, to open a private kindergarten, a private school, or a private specialised institution providing social services for children.
(5) The activities of the medical offices opened in state-owned kindergartens, schools, and homes for children under Article 26, Paragraph (1), Item 3, shall be financed by the central government budget, while the activities of the medical offices opened in municipal kindergartens, schools, and homes for children shall be financed by the municipal budgets. The activities of the medical offices opened in private kindergartens, schools, and specialised institutions providing social services for children, shall be financed by their owners.
(6) The activities performed by the medical offices shall be controlled by the respective RHC.
Article 121
In the event of a detected disease or deviation in the development of a child, the specialists at health offices shall inform the parents, trustees or custodians and the general practitioner of the child.
Article 122
(1) The approved curriculum shall provide pupils with training in:
1. personal hygiene;
2. healthy nutrition;
3. healthy environment;
4. healthy life style;
5. prevention of infectious diseases;
6. health risks related to smoking, use of alcohol and narcotic drugs;
7. sexual behaviour, prevention of sexually transmitted diseases and AIDS and prevention of undesired pregnancy;
8. first aid to victims.
(2) The training of trainers in the issues under Paragraph 1 shall be organised by the Minister of Education and Science in accordance with training programmes consulted with the Minister of Health.
(3) School boards of trustees shall organise events to inform parents on children health issues.
Article 123
(1) For the purposes of ensuring preventive medical and dental aid to children and pupils at crèches, kindergartens, schools, orphanages and specialised child institutions, documents on examinations conducted shall be required or preventive medical and dental examinations shall be carried out.
(2) The terms and conditions for carrying out the preventive examinations under Paragraph 1 shall be s et out in regulations issued by the Minister of Health.
(3) The activities under Paragraph 1 shall be financed by NHIF.
Article 124
(1) The preventive medical aid to children at medical and social care homes for children shall be provided by the medical doctors working at the medical establishment.
(2) The dental treatment beyond the scope of the National Framework Agreement of children at specialised child institutions opened by the Ministry of Health, the Ministry of Education and Science, the Ministry of Labour and Social Policy, the Ministry of Interior and the Ministry of Justice, as well as at specialised child institutions run by local governments shall be paid by the respective institutions.
Article 125
An agreement with a medical establishment for outpatient care may be signed to provide additional or specialised medical services to children at the institutions under Article 123, Paragraph 1.

Section II
Reproductive Health
Article 126
(1) The government shall provide health protection of the reproductive health of citizens by means of:
1. promotion and consultations for protection of the reproductive health of children and persons in reproductive age;
2. ensuring access to specialised consultative aid on issues of reproductive health and family planning;
3. prevention and treatment of sterility;
4. specialised information, consultations, prevention and treatment of sexually transmitted diseases and AIDS;
5. prevention, treatment and dispensary monitoring of persons with malignant diseases of the reproductive system.
(2) Every person shall be entitled to information and freedom of choice with regard to his/her reproductive health.
Article 127
(1) For the purposes of ensuring risk-free maternity, every woman shall have access to health activities aimed at ensuring optimal health condition of the woman and the foetus from the beginning of the pregnancy to the 42nd day of the child.
(2) The health activities under Paragraph 1 shall include:
1. promotion aimed at protecting the health of the woman and the foetus;
2. prevention of the threat of abortion and premature childbirth;
3. training in the feeding and care of infants;
4. active medical monitoring of pregnancy on the basis of the dispensary principle at medical establishments for primary and specialised outpatient aid;
5. pre-natal diagnostics and prevention of genetic and other diseases under terms and conditions set out in regulations issued by the Minister of Health;
6. ensuring optimal living environment for mothers and infants;
7. dispensary monitoring and healthcare for mothers and infants;
8. free access of pregnant women or mothers of infants to medical establishments for specialised outpatient aid;
9. free access of pregnant women to medical establishments for specialised outpatient and hospital care in conditions threatening the pregnancy;
10. the freedom of choice of a medical establishment for hospital aid at childbirth by pregnant women.
Article 128
(1) The terms and conditions for performing artificial abortions and the foetus viability criteria shall be set out in regulations issued by the Minister of Health.
(2) The regulations under Paragraph 1 shall specify also the obligations of medical specialists in the case of suspected abortions carried out beyond the terms and conditions set out in this Act.
(3) The lasting removal of the ability to reproduce shall be carried out under terms and conditions set out in regulations issued by the Minister of Health.


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