2. člen BAUZZV

2. člen

Sporazum in administrativni dogovor se v izvirniku v slovenskem in angleškem jeziku glasita:

S P O R A Z U M <br /> o zagotavljanju zdravstvenega varstva med Vlado Republike Slovenije in Vlado Avstralije

Vlada Republike Slovenije in Vlada Avstralije (v nadaljevanju pogodbenici) sta se v želji, da bi uredili zdravstveno varstvo upravičenih oseb ene pogodbenice, ko so na ozemlju druge pogodbenice, sporazumeli, kot sledi:

1. člen

POMEN IZRAZOV

(1)

Izrazi v tem sporazumu pomenijo:

zdravstvene storitve«

za Republiko Slovenijo zdravstvene storitve, zagotovljene po Zakonu o zdravstvenem varstvu in zdravstvenem zavarovanju,1992, in ii) za Avstralijo zdravila, ki se državnemu pacientu zagotovijo po Zakonu o varovanju zdravja, 1953, zagotovljene zdravstvene in bolnišnične storitve ali tiste, za katere se izplača dajatev, po Zakonu o zdravstvenem zavarovanju, 1973, ali Zakonu o varovanju zdravja, 1953, in vseh sporazumih ali odločitvah po Zakonu o zdravstvenem zavarovanju, 1973, v zvezi z zagotavljanjem storitev javnih bolnišnic in drugih zdravstvenih storitev v državah in na ozemljih Avstralije;

»zavarovana oseba« za Republiko Slovenijo oseba, ki je obvezno zdravstveno zavarovana po Zakonu o zdravstvenem varstvu in zdravstvenem zavarovanju, 1992;

»prebivalec« za Avstralijo oseba, ki je prebivalec Avstralije po Zakonu o zdravstvenem zavarovanju, 1973;

»ozemlje«

za Republiko Slovenijo ozemlje Republike Slovenije in ii) za Avstralijo ozemlje Avstralije za namen uporabe Zakona o zdravstvenem zavarovanju, 1973;

»začasno bivanje« zakonito, vendar ne stalno prebivanje na ozemlju pogodbenic;

»pristojni organ«

za Republiko Slovenijo Ministrstvo za zdravje in ii) za Avstralijo Ministrstvo za zdravje in vprašanja staranja;

»pristojni nosilec«

za Republiko Slovenijo Zavod za zdravstveno zavarovanje Slovenije in ii) za Avstralijo Ministrstvo za zdravje in vprašanja staranja ali nosilec, ki ga za to pooblasti ministrstvo.

(2)

V tem sporazumu imajo drugi izrazi in besede, razen če ni drugače razvidno iz besedila sporazuma, pomen, kot izhaja iz zakonodaje pogodbenic, opredeljene v točki a prvega odstavka tega člena.

(3)

Ta sporazum se nanaša tudi na zakonodajo, ki nadomešča, spreminja, dopolnjuje ali povzema zakonodajo, opredeljeno v točki a prvega odstavka tega člena.

2. člen

OSEBE, ZA KATERE SE UPORABLJA SPORAZUM

(1)

Ta sporazum se uporablja za osebe ene pogodbenice, ki so začasno na ozemlju druge pogodbenice, in so:

za Republiko Slovenijo osebe, ki so obvezno zdravstveno zavarovane po Zakonu o zdravstvenem varstvu in zdravstvenem zavarovanju, 1992, in

za Avstralijo prebivalci po Zakonu o zdravstvenem zavarovanju, 1973.

(2)

Ta sporazum se uporablja tudi za osebe, ki so člani diplomatskega predstavništva ali konzulata, ki ga je na ozemlju ene pogodbenice odprla druga pogodbenica, ter za njihove družinske člane, ki živijo z njimi v skupnem gospodinjstvu.

(3)

Ta sporazum se ne uporablja za osebo, za katero veljajo pogoji iz prvega odstavka tega člena, kadar ta oseba vstopi na ozemlje druge pogodbenice zaradi zdravljenja, razen če je ta oseba član posadke ali potnik na ladji, plovilu ali letalu, ki prihaja na ozemlje druge pogodbenice, odhaja z njega ali se je znašlo na njem, in se je potreba po zdravljenju pojavila med potovanjem ali poletom.

3. člen

ZDRAVSTVENE STORITVE

(1)

Osebi, za katero veljajo pogoji iz prvega odstavka 2. člena, ki na ozemlju druge pogodbenice potrebuje nujno zdravljenje zaradi slabega zdravstvenega stanja, ki zahteva nujno zdravstveno oskrbo, se pod enakimi pogoji kot zavarovanim osebam, kadar je na ozemlju Republike Slovenije, ali prebivalcem, kadar je na ozemlju Avstralije, zagotovijo take zdravstvene storitve, ki so potrebne za klinično ugotavljanje bolezni, zdravljenje ali oskrbo tega stanja.

(2)

Oseba, za katero veljajo pogoji iz drugega odstavka 2. člena, je upravičena do zdravstvenih storitev ves čas, ko prebiva na ozemlju druge pogodbenice, v enakem obsegu in pod enakimi pogoji kot zavarovane osebe, kadar je na ozemlju Republike Slovenije, oziroma kot prebivalci, kadar je ta oseba na ozemlju Avstralije.

4. člen

FINANČNE DOLOČBE

V skladu s tem sporazumom nobena pogodbenica ni dolžna povrniti stroškov za opravljene zdravstvene storitve drugi pogodbenici.

5. člen

PRISTOJNA ORGANA IN NOSILCA

(1)

Pristojna organa pogodbenic sta se dolžna čim prej obveščati o vseh spremembah svoje zakonodaje, ki velja na njunih ozemljih in bi lahko bistveno vplivala na naravo in obseg zdravstvenih storitev, predvidenih po tem sporazumu.

(2)

Zadeve v zvezi z razlago tega sporazuma se rešujejo s posvetovanjem pristojnih organov pogodbenic.

(3)

Zadeve v zvezi z izvajanjem tega sporazuma se rešujejo s posvetovanjem pristojnih nosilcev pogodbenic.

(4)

Pristojna nosilca pogodbenic lahko po potrebi skleneta dogovore o izvajanju tega sporazuma.

6. člen

DOKUMENTI

Za uveljavljanje zdravstvenih storitev po tem sporazumu mora oseba, za katero veljajo pogoji iz prvega ali drugega odstavka 2. člena, predložiti veljaven potni list in dokazilo o upravičenosti do:

obveznega zdravstvenega zavarovanja v Republiki Sloveniji oziroma

prebivanja po Zakonu o zdravstvenem zavarovanju, 1973.

7. člen

KONČNE DOLOČBE

(1)

Ta sporazum začne veljati z dnem, ko se pogodbenici po diplomatski poti pisno obvestita, da so izpolnjene vse notranjepravne zahteve za začetek njegove veljavnosti.

(2)

Sporazum se sklene za nedoločen čas ali do poteka 12 mesecev od dne, ko ena pogodbenica po diplomatski poti prejme pisno obvestilo druge pogodbenice o njeni nameri, da odpoveduje sporazum.

(3)

Ob odpovedi tega sporazuma v skladu z drugim odstavkom tega člena se sporazum še naprej uporablja, če se je zdravljenje začelo pred potekom ali ob poteku odpovednega roka, navedenega v tem odstavku.

Da bi to potrdila, sta podpisana, ki sta ju njuni vladi za to pravilno pooblastili, podpisala ta sporazum.

Sestavljeno v dveh izvodih v Canberri dne 11. marca 2009 v slovenskem in angleškim jeziku, pri čemer sta besedili enako verodostojni.

Za Vado Republike Sovenije Gregor Kozovinc l.r. Za Vlado Avstralije Nicola Roxon l.r.

V skladu s 5. členom Sporazuma o zagotavljanju zdravstvenega varstva med Vlado Republike Slovenije in Vlado Avstralije (v nadaljevanju sporazum) pristojna nosilca
Zavod za zdravstveno zavarovanje Slovenije
in
Ministrstvo za zdravje in vprašanja staranja Avstralije (ali nosilec, ki ga za to pooblasti ministrstvo)
sklepata

D O G O V O R <br /> o izvajanju sporazuma o zagotavljanju zdravstvenega varstva med Vlado Republike Slovenije in Vlado Avstralije

1. člen

Pomen izrazov

V tem dogovoru se izrazi iz 1. člena sporazuma uporabljajo v enakem pomenu kot v navedenem členu.

2. člen

Naloge pristojnih nosilcev

(1)

Naloge pristojnih nosilcev so določene s sporazumom in s tem dogovorom.

(2)

Pri izvajanju dogovora pristojna nosilca sodelujeta, lahko pa se tudi neposredno obračata na pristojne organe in osebe, za katere se dogovor uporablja. Pristojna nosilca si pri izvajanju dogovora izmenjavata potrebne informacije ter pomagata drug drugemu.

(3)

Pristojna nosilca se dogovorita tudi o obliki in vsebini listin, potrebnih za izvajanje sporazuma in uporabo tega dogovora.

3. člen

Odobritev zdravstvenih storitev

(1)

Za uporabo 2. do 6. člena sporazuma morajo zavarovane osebe ali prebivalci predložiti veljavni potni list ter ustrezno listino, ki jo izdata njihova pristojna nosilca kot dokazilo o pravici.

(2)

Izvajalec zdravstvenih storitev v javni zdravstveni mreži ene pogodbenice mora ob predhodni predložitvi navedenih dokumentov zagotoviti zavarovanim osebam oziroma prebivalcem druge pogodbenice zdravstvene storitve na način in pod pogoji, ki veljajo na ozemlju prve pogodbenice.

4. člen

Povračilo stroškov

(1)

Pri odstopanju od predvidenega postopka mora pristojni nosilec ene pogodbenice obvestiti pristojnega nosilca druge pogodbenice o višini stroškov opravljenih storitev.

(2)

Pristojni nosilec ene pogodbenice povrne stroške osebam, ki so jim bile zagotovljene zdravstvene storitve na ozemlju te pogodbenice.

5. člen

Listine za uveljavljanje zdravstvenih storitev

(1)

Z evropsko kartico zdravstvenega zavarovanja, ki jo izda Zavod za zdravstveno zavarovanje Slovenije, imajo zavarovane osebe Republike Slovenije pravico do nujnega zdravljenja med začasnim bivanjem na ozemlju Avstralije.

(2)

S kartico Medicare, ki jo izda Medicare Avstralija, imajo prebivalci Avstralije pravico do nujnega zdravljenja med začasnim bivanjem v Republiki Sloveniji.

6. člen

Izmenjava podatkov

Pristojna nosilca si za vsako koledarsko leto izmenjata ustrezne statistične podatke, za katere se dogovorita.

7. člen

Končna določba

Ta dogovor začne veljati isti dan kot sporazum.

Sestavljeno v dveh izvodih v slovenskem in angleškem jeziku, pri čemer sta besedili enako verodostojni.

Za Zavod za zdravstveno zavarovanje Slovenije Samo Fakin l.r.

Ljubljana, 30. 8. 2010

Za Ministrstvo za zdravje in vprašanja staranja Avstralije Jane Halton l.r.

Canberra, 13. 11. 2010

A G R E E M E N T <br /> concerning the provision of health care between the Government of the Republic of Slovenia and the Government of Australia

The Government of the Republic of Slovenia and the Government of Australia (“the Parties”), desirous of mutually regulating the field of health care of eligible persons of one Party during their presence in the territory of the other Party, have agreed as follows:

Article 1

DEFINITIONS

(1) Terms in this Agreement mean:

(a) “medical services”

i) in relation to the Republic of Slovenia, medical services provided under the Health Care and Health Insurance Act 1992; and

ii) in relation to Australia, pharmaceutical benefits provided to a general patient as defined under the National Health Act 1953, professional and hospital services provided, or in respect of which a benefit is payable, under the Health Insurance Act 1973 or the National Health Act 1953 and any agreements or determinations made under the Health Insurance Act 1973 in relation to provision in the States and Territories of Australia of public hospital services and other health services.

(b) “insured person”

in relation to the Republic of Slovenia, a person covered by compulsory health insurance under the Health Care and Health Insurance Act 1992.

in relation to Australia, a person who is an Australia resident under the Health Insurance Act 1973.

(d) “territory”

i) in relation to the Republic of Slovenia, the territory of the Republic of Slovenia; and

ii) in relation to Australia, the territory of Australia for the purposes of the Health Insurance Act 1973.

(e) “temporary stay”

lawful presence but not permanent residence in the territory of the Parties.

(f) “competent authority”

i) in relation to the Republic of Slovenia, the Ministry of Health; and

ii) in relation to Australia, the Department of Health and Ageing.

(g) “competent institution”

i) in relation to the Republic of Slovenia, the Health Insurance Institute of Slovenia; and

ii) in relation to Australia, the Department of Health and Ageing or an institution authorised by the Department for this purpose.

(2) For the purposes of this Agreement, unless the context otherwise requires, other terms and words shall have the meanings assigned to them by the respective legislations of the Parties as defined in paragraph (1) (a) of this Article.

(3) This Agreement shall also apply to any legislation which replaces, amends, supplements, or consolidates the legislation referred to in paragraph (1) (a) of this Article.

Article 2

PERSONS COVERED

(1) This Agreement shall apply to persons of one Party who are temporarily staying in the territory of the other Party and who are:

(a) in relation to the Republic of Slovenia, persons covered by compulsory health insurance under the Health Care and Health Insurance Act 1992; and

(b) in relation to Australia, residents under the Health Insurance Act 1973.

(2) This Agreement shall also apply to persons who are members of a diplomatic mission or consular post established by one Party in the territory of the other, and their family members living with them in the same household.

(3) This Agreement does not apply to a person who falls within the terms of paragraph (1) of this Article, where that person enters the territory of the other Party for the purpose of treatment unless that person is a member of the crew or passenger on any ship, vessel or aircraft travelling to, leaving from, or diverted to the territory of the other Party and the need for the treatment arose during the voyage or flight.

Article 3

MEDICAL SERVICES

(1) A person who falls within the terms of paragraph (1) of Article 2, while in the territory of the other Party, who needs necessary medical treatment for ill health which requires immediate medical attention, shall be provided with such medical services as are clinically necessary for the diagnosis, treatment or care of the condition on the same terms as would apply to insured persons when present in the territory of the Republic of Slovenia or residents when present in the territory of Australia.

(2) A person who falls within the terms of paragraph (2) of Article 2 shall be eligible for medical services at all times during that person’s stay in the territory of the other Party to the same extent and under the same conditions as insured persons when present in the territory of the Republic of Slovenia or residents when present in the territory of Australia.

Article 4

FINANCIAL PROVISIONS

In accordance with this Agreement neither Party shall be liable to reimburse the other Party the costs of medical services provided.

Article 5

COMPETENT AUTHORITIES AND INSTITUTIONS

(1) The competent authorities of the Parties must inform each other as soon as possible of any changes in their legislation which are applicable in their territories and may significantly affect the nature and scope of medical services envisaged under this Agreement.

(2) Matters relating to the interpretation of this Agreement shall be resolved by consultation between the competent authorities of the Parties.

(3) Matters relating to the application of this Agreement shall be resolved by consultation between the competent institutions of the Parties.

(4) The competent institutions of the Parties shall make whatever administrative arrangements are necessary to implement this Agreement.

Article 6

DOCUMENTS

In order to receive medical services under this Agreement, a person who falls within the terms of paragraph (1) or paragraph (2) of Article 2 must submit a valid passport and evidence of eligibility for:

(a) compulsory health insurance in the Republic of Slovenia; or

(b) residence under the Health Insurance Act 1973.

Article 7

FINAL PROVISIONS

(1) This Agreement shall enter into force on the date that the Parties notify each other in writing, through the diplomatic channels, that all their respective requirements for its entry into force have been fulfilled.

(2) This Agreement shall remain in force until the expiration of 12 months from the date on which either Party receives from the other, written notice through the diplomatic channel of its intention to terminate this Agreement.

(3) In the event this Agreement is terminated in accordance with paragraph (2) of this Article, the Agreement shall continue to have effect in relation to medical treatment which was being provided prior to or at the expiry of the period of notice referred to in that paragraph.

In witness whereof the undersigned, duly authorised thereto by their respective Governments, have signed this Agreement.

Done in duplicate at Canberra on 11 March 2009 in the Slovene and English languages, both texts being equally authoritative.

For the Government
of the Republic of Slovenia
Gregor Kozovinc (s)
For the Government
of Avstralia
Nicola Roxon (s)

Pursuant to Article 5 of the Agreement concerning the provision of health care between the Government of the Republic of Slovenia and the Government of Australia (hereinafter: the Agreement) the competent institutions

Health Insurance Institute of Slovenia

and

Department of Health and Ageing of Australia (or any other institution duly authorised by the Department)

have concluded the following

A R R A N G E M E N T <br /> on implementation of the Agreement concerning the provision of health care between the Government of the Republic of Slovenia and the Government of Australia

Article 1

Definitions of terms

The terms under Article 1 of the Agreement shall in this Arrangement be used as having the same meaning as in the aforementioned Article.

Article 2

Tasks of competent institutions

(1) The tasks of the competent institutions shall be subject to the Agreement and this Arrangement.

(2) In implementing the Arrangement, the competent institutions shall cooperate, and may also directly appeal to competent authorities and persons to which the Arrangement applies. In implementing the Arrangement, the competent institutions shall mutually exchange all necessary information and assist each other.

(3) The competent institutions shall agree on the form and content of documents required for implementation of the Agreement and the application of this Arrangement.

Article 3

Approval of medical services

(1) For the purposes of applying Articles 2 to 6 of the Agreement, insured persons or residents shall submit a valid passport and an adequate document issued by their competent institutions as the certificate of entitlement to the right.

(2) Healthcare provider operating in the public health network shall, upon the preliminary submission of the above documents by one Party, provide to insured persons or residents of the other Party medical services in a manner and under conditions which apply to the territory of the first Party.

Article 4

Reimbursement of expenses

(1) In derogating from the procedures laid down, the competent institution of one Party shall notify the competent institution of the other Party of the amount of expenses for services rendered.

(2) The competent institution of one Party shall reimburse the expenses to persons who have been provided with medical services on the territory of this Party.

Article 5

Documents for asserting the right to medical services

(1) Pursuant to the European Health Insurance Card issued by the Health Insurance Institute of Slovenia, insured persons of the Republic of Slovenia shall have the right to immediate medical treatment during their temporary stay in the Australian territory.

(2) Pursuant to the Medicare card issued by Medicare Australia, Australian residents shall have the right to immediate medical treatment during their temporary stay in the Republic of Slovenia.

Article 6

Exchange of information

The competent institutions shall for each calendar year exchange the appropriate statistical information agreed upon.

Article 7

Final provision

This Arrangement shall enter into force on the same day as the Agreement.

Done in duplicate in the Slovene and English languages, both texts being equally authoritative.

For the Health Insurance
of Slovenia
Samo Fakin (s)

Ljubljana, 30. 8. 2010

For the Department of Health and
Ageing of Australia
Jane Halton (s)

Canberra, 13. 11. 2010

Zakon o ratifikaciji Sporazuma o zagotavljanju zdravstvenega varstva med Vlado Republike Slovenije in Vlado Avstralije ter Administrativnega dogovora o izvajanju Sporazuma o zagotavljanju zdravstvenega varstva med Vlado Republike Slovenije in Vlado Avstralije (BAUZZV)