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Italy (Bolzano) / Health / Legislative Decreen n.299/99: Norms for the rationalization of the national health service

IT25_IT0_Legislative Decreen n.299_99 Norms for the rationalization of the national health service_1999

Name of the country Italy (Bolzano)
Sector Health
Name of the document (original) Decreto Legislativo n. 299/99: Norme per la razionalizzazione del serivzio sanitario nazionale
Name of the document (English) Legislative Decreen n.299/99: Norms for the rationalization of the national health service
Administrative level National
Type of the document Legislation
Year of adoption 1999
Foreseen duration Unlimited
Sector Health
Territorial unit (NUTS/LAU) IT0
Authority President of the Council of Ministers
Availability in English No
Legally binding Legally binding
SGI coverage SSGI
Integration as a concept Yes
Integration elements
Adm. levels
Fin. sources
Description Collaboration between the autonomous Provinces, Region, State, Ministry of health, Agency of regional health services in developing the regional health plan Financial resources allocated to the National Health Service financing of the local health unit, on the basis of a correct capitation in relation to the characteristics of the resident population The social benefits of health are the responsibility of municipalities that provide their funding in the areas covered by the regional law
Major objectives Protection of health as a fundamental right and interest of the community and guaranteed, respecting the dignity and freedom of the human person, through the National Health Service
Short Summary It describes the standards for the rationalization of the National Health Service. Regions draw up proposals for the establishment of the National Health Plan, regarding to the needs of the territorial level concerned and the interregional functions to ensure priority.
The protection of health as a fundamental right and interest of the community is guaranteed, while respecting the dignity and freedom of the human person, through the National Health Service, with the functions and the welfare activities of the regional health services and other functions and activities of the institutions of national importance.
The National Health Service provides, through public resources, and consistent with the principles and objectives of Articles 1 and 2 of Law 23 December 1978, n.833, the essential and uniform levels of service defined by the National Health Plan in accordance with the principles of human dignity, the need for health, equity in access to care, the quality of care and its appropriateness with regard to the specific needs as well as economic efficiency in the use of resources (Art. 1/2). The health services include the essential levels of assistance free of charge or with participation in spending, in the form and according to the procedures under the law (Art. 1/3).
The regions, individually or through accordance, draw up proposals for the establishment of the National Health Plan, with reference to the needs of the territorial level concerned and the interregional functions to ensure priority, also based on the indications of the current Plan and the essential levels of care identified therein or in the acts which constitute implementation. The regions transmit the report to the Minister of Health by March 31 of each year (Art. 1/4).
The Regional Health Plan is the strategic plan of action for the health objectives and operation of services to meet the specific needs of the regional population in reference to the National Health Plan. The regions, within one hundred and fifty days from the date of entry into force of the National Health Plan, adopt or adapt regional health plans, providing for forms of participation (Art. 1/13).
The regions and autonomous provinces shall forward to the Minister of health related schemes or health plan projects to obtain the opinion of the same with regard to the consistency with the national health plan (Art. 1/14).
The regions, with their degree of autonomy, define the criteria and operational mode for the coordination of health facilities operating in metropolitan areas (Art. 2/2-quarter)
The regional law governing foresees local health districts. It provides primary care services as well as the coordination of the social care activities with that of departments and corporate services, including hospitals. The program of territorial activities, based on the principle of intersectoral interventions which combine the different operating units includes the determination of the resources for the socio-health integration and the quotas paid by the unit 'Local health and municipalities respectively, as well as' the location of principals for the territory of competence (Art. 3-quater).
The law foresees further the implementation of a department for prevention (Art. 7-bis).
It also entails the coordination with regional environmental agencies. The Minister for Health 'and the Minister for the Environment, in agreement with the Permanent Conference for relations between the state, regions and the autonomous provinces of Trento and Bolzano, stipulate, within their respective competences, a framework agreement for the coordination and integration of measures for the protection of health and environment which identifies areas of joint action and the related programs operating. The regions identify the modalities and levels of integration between health and environment policies policies (7-quinquies).
The relationship between the National Health Service, the general practitioners and pediatricians is regulated by specific three-year agreements which comply with the national collective agreements. The general practitioners receive a fixed fee for each person registered to the list (Art. 8).
The facilities that provide care in the National Health Service are funded according to a predefined total amount indicated in the contractual arrangements referred to in Article 8-d and determined on the basis of welfare functions and activities carried out under and account of the network of referral services. For the purposes of determining the overall funding of the individual departments, charitable functions referred to in paragraph 2 shall be remunerated on a cost production of the standard assistance program, while activity referred to in paragraph 4 are remunerated on the basis of default rates to performance.
In order to facilitate the provision of forms of integrative health care compared to those provided by the national health service, funds can be instituted aimed at enhancing the delivery of treatments and services not included in the uniform levels and essential assistance referred to in Art. 1 and National Health Plan (Art. 9).
Art. 19-bis foresees the establishment of the National Commission for Accreditation and Quality of health services.
The Minister for Health reports annually on the progress of health care expenditure, with particular reference to the financial impact, in terms of higher costs and greater economies of the measures covered by this decree (Art. 19-quintes).
Centralised/decentralised Decentralised
Governance model
Public services
Public-private partnership
Comments private bodies
Measures ambulatory secialist care/ activities and services for the prevention and treatment of addiction/ activities and consultation service for health of children, women and family/ activities or services aimed at disabled and elderly, services of integrated home care/
Type of finance
No sources available.
Sources of finance
Stakeholders' list
Federal/national State Ministry of Health National Commission for Accreditation and quality of health services
State/provincial/departmental CEOs of health units and hospitals Board of Auditors Department of Prevention
Regional Regions Agency for Regional Health Services Regional environmental agencies
Local Municipalities
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