Health Tourism Legislation

Purpose

Article 1 – (1) The purpose of this Regulation is to determine the minimum service delivery standards of health services offered at international level within the scope of international health tourism and tourists’ health, to authorize health institutions and intermediary institutions that will operate in international health tourism services, and to regulate the procedures and principles regarding the supervision of these activities.

Scope

Article 2 – (1) This Regulation is not covered by the Social Insurance and General Health Insurance Law No. 5510 and dated 31/5/2006 and international bilateral reciprocity agreements, but; It covers those who come to our country to receive health services from abroad and those who need health care while they are in our country as tourists, and public, university and private health institutions and organizations and intermediary institutions that provide health services to these people.

(2) The following situations are not covered by this regulation:

a) In cases of war, disaster, hunger and similar extraordinary situations, foreign patients and injured persons who receive health services during their stay in Turkey from countries determined by the Council of Ministers, the Prime Ministry or the relevant Ministry, or who are brought for treatment by non-governmental organizations from these countries and paid for treatment.

b) Patients brought from the Balkans and Turkic Republics to our country for treatment by non-governmental organizations deemed appropriate by our Ministry or the Turkish Cooperation and Coordination Agency (TIKA) or the Prime Ministry Presidency for Turks Abroad and Related Communities.

c) Patients brought by the Turkish Cooperation and Coordination Agency (TIKA).

ç) Citizens of countries entitled to receive health assistance within the scope of Social Security Agreements in accordance with the international agreement signed by the Republic of Turkey, and citizens of the Republic of Turkey and those who come to our country for treatment within the scope of an international bilateral cooperation agreement in the field of health.

d) Persons who come to our country for education, training and courses and their dependents during their education.

e) Temporary protected persons, refugees, asylum seekers and asylum seekers, asylum seekers, stateless persons, victims of human trafficking.

f) Those who are within the scope of Article 28 and 44 of the Turkish Citizenship Law dated 29/5/2009 and numbered 5901.

g) Foreigners of Turkish ancestry who present a document showing that they are of Turkish ancestry.

ğ) Foreigners who receive emergency health care by being brought by law enforcement within the scope of judicial cases.

(3) Persons in the second paragraph can receive international health tourism services within the scope of this Regulation, if they undertake to pay fees within the scope of international health tourism voluntarily.

Basis

Article 3 – (1) This Regulation is based on subparagraph (c) of Article 9 of the Health Services Basic Law No. 3359 and dated 7/5/1987, and the Decree-Law on the Organization and Duties of the Ministry of Health and its Affiliates, dated 11/10/2011 and numbered 663. It has been prepared based on subparagraphs (a) and (i) of the first paragraph of article 8 and article 40.

Definitions

Article 4 – (1) In this Regulation;

a) Ministry: The Ministry of Health,

b) General Directorate: General Directorate of Health Services,

c) Directorate: Provincial / District Health Directorates,

ç) SATURK: The Health Tourism Coordination Board established with the Prime Ministry Circular No. 2015/3,

d) International health tourism: All kinds of health services and related support services received by real persons who come to our country temporarily from abroad for health purposes, who are not citizens of the Republic of Turkey or who are citizens of the Republic of Turkey but reside abroad,

e) Tourist health: Foreigners who are temporarily in our country for any reason receive health care services in case of sudden diseases and emergencies while they are in our country,

f) International health tourist: The patient who receives health services within the scope of international health tourism and tourist health,

g) International health tourism intermediary institution: A business license in accordance with the Travel Agencies and Travel Agencies Union Law No. 1618 dated 14/9/1972, authorized by the Ministry to carry out the activities of providing accommodation, transportation and transfer services to the international health tourist, accompanying person and other relatives. Group A travel agencies,

ğ) International health tourism health facility: Public, university and private health institutions and organizations that have a health facility license and have been given an international health tourism authorization certificate by the Ministry,

h) Foreign: Person who does not have citizenship bond with the Republic of Turkey,

ı)Authorization certificate: International health tourism authorization certificate,means.

General Terms

Article 5 – (1) In order to operate within the scope of international health tourism; It is obligatory for the health facility and the intermediary institution to obtain an international health tourism authorization certificate. The international health tourism activities of those who do not receive a certificate of authorization are suspended by the Ministry.

(2) In international health tourism health facilities, diagnosis, treatment and rehabilitative health services and traditional and complementary medicine practices can be offered in accordance with the criteria in this Regulation.

(3) An international health tourism health facility may accept international health tourists who apply directly to it. However, if there is a need for intermediary institution activities, it is obligatory to make a protocol with the international health tourism intermediary institution authorized by the Ministry. A copy of the signed protocol is sent to the General Directorate through the Directorate.

(4) It is the responsibility of the international health tourism health facility to provide other services that the international health tourist will need in addition to the health care they will receive in the health facility until they are discharged. For the provision of these services, it can make a contract with the international health tourism intermediary institution, as well as with other institutions and organizations.

(5) It is obligatory for the international health tourism health facility to register the persons who are provided with health services within the scope of this Regulation in the web-based system created by the Ministry.

(6) Personal health data recorded by the international health tourism health facility is processed in accordance with the Law on Protection of Personal Data No. 6698 dated 24/3/2016 and transferred to the central health data system in accordance with the procedures and principles determined by the Ministry.

(7) International health tourism health facility and international health tourism intermediary institution are obliged to send the information and documents requested by the Ministry.

International Health Tourism Unit

Article 6 – (1) In the international health tourism health facility, an international health tourism unit is established, which is responsible for the coordination of the works and transactions related to the acceptance, registration, diagnosis, treatment, billing, discharge, translation and intermediary institutions of the international health tourist.

(2) In the international health tourism unit, a doctor/specialist doctor is assigned as the head of the international health tourism unit and notified to the Directorate. According to the international health tourist potential, a health professional can be appointed as the assistant responsible for the international health tourism unit. Those who will be appointed as the international health tourism officer and the international health tourism unit assistant responsible must have the following qualifications:

a) To graduate to do his art in Turkey.

b) To have knowledge of a foreign language at the proficiency specified in the fourth paragraph of this article.

c) To have a document or documents showing that he has been practicing his profession for at least five years, two years in public or private health institutions in Turkey.

(3) In the international health tourism unit, at least 2 personnel, including the responsible person, who speak a foreign language are employed. One of the foreign language must be English.

(4) For foreign language proficiency, it is necessary to have at least one of the following documents.

a) To have obtained at least sixty-five points out of one hundred in the English language or the language of the international health tourist to be served, in the exam made or made by the Council of Higher Education, or in the Foreign Language Proficiency Exam conducted by the Measurement, Selection and Placement Center Presidency, or equivalent to this score by OSYM. To have a document with international validity that is accepted.

b) To have a document showing the B2 language level in the European Language Portfolio in English or in the language of the international health tourist to be served.

c) Those with dual citizenship identity must have a Turkish language document showing the B2 language level in the European Language Portfolio.

ç) To have a certificate proving that he graduated from the department of translation and interpreting at the undergraduate level.

(5) In the international health tourism unit, guidance and guidance services are also provided to those who come to our country to receive health services pursuant to the international social security agreement and international bilateral cooperation agreements in the field of health.

Competence Criteria

Article 7 – (1) In order to issue an International Health Tourism Authorization Certificate by the Ministry in the field of international health tourism:

a) The health facility must meet the criteria specified in the International Health Tourism Health Facility Competency Criteria in Rider-1.

b) The intermediary institution must meet the criteria specified in the International Health Tourism Intermediary Institution Competency Criteria in Rider-2.

Licence of Authorization

Article 8 – (1) In order to obtain a certificate of authorization, the application form for the authorization certificate in Rider-3 related to the field of activity it serves is filled by the health facility/intermediary institution, the application documents specified in the same annex are attached to the form and an application is made to the Directorate with them.

(2) The directorate examines on the file whether it meets the competency criteria in the rider of this Regulation. If a deficiency in the application documents or non-compliance with the criteria is detected as a result of the examination, the health facility/intermediary institution is notified within seven working days.

(3) The health facility/intermediary institution, which is found to have no deficiencies or non-compliance with the criteria in the application documents, is examined on-site by the examination team formed by the Directorate. Applications that are determined to be suitable in terms of competency criteria as a result of on-site inspection are sent to the Ministry within fifteen working days. If deemed appropriate by the Ministry, an International Health Tourism Authorization Certificate included in Rider-4/A and intermediary institution in Rider-4/B is issued to the healthcare facility.

Services within the scope of tourist health

Article 9 – (1) Foreigners who stay in our country for a period of time for meeting, congress, commercial or tourism purposes can benefit from the health services offered in public, university or private health institutions in case of diseases and emergencies that develop during their stay in our country.

(2) Emergency health services and emergency patient transfers are offered against a fee. However, 112 emergency health services are provided free of charge to citizens of the Republic of Turkey who live abroad and do not have any social security. The income obtained from the ambulance service provided by the public and from the emergency patient transport is invested in the revolving fund of the directorate that first responds to the patient.

(3) It is obligatory to accept the foreign patients who apply to the health facility to receive emergency health services and to make the necessary medical intervention unconditionally and without delay. Procedures related to the collection of the service fee are made after the emergency response and maintenance is provided.

(4) The cost of health services to be provided as a result of traffic accidents, regardless of the nationality of Turkish citizens and foreign nationals and whether they have social security or not, is collected from the Social Security Institution as per the relevant law. In traffic accidents, the treatment fee cannot be demanded from the person himself. However, if the person receiving emergency health care due to a traffic accident has optional additional travel insurance, this insurance is invoiced and the payment is collected under the policy.

Pricing

Article 10 – (1) The cost of the health service provided within the scope of international health tourism to be offered within the scope of this Regulation is determined by the Ministry by taking the opinion of SATURK.

(2) International health tourism health facilities are obliged to comply with the procedures and principles determined in the health tourism price tariff determined by the Ministry.

Invoicing and documents to be submitted

Article 11 – (1) According to the relevant legislation, it is obligatory to issue a sales receipt or invoice for those who receive services within the scope of health tourism by international health tourism health facilities. A document showing the detailed breakdown of the health service provided to the patient and the unit prices is prepared in the attachment of the sales receipt or invoice. In addition, when requested by service recipients, the following documents must be provided free of charge:

a) By the international health tourism facility;

1) A list showing the types and amounts of drugs and consumables used in the international health tourism health facility and taken from the patient.

2) Laboratory examination and analysis results and x-ray films made in the health facility or outside and paid for by the patient, provided that the originals of the forensic cases are not given.

3) Prescriptions for drugs and materials purchased from outside.

b) By the international health tourism intermediary institution;

1) A detailed breakdown of the fees requested for services such as accommodation, transportation and transfer, translation and consultancy provided to the international health tourist, accompanying person and other relatives.

Information and promotion

Article 12 – (1) Information and promotion cannot be made by health facilities and intermediary institutions that are not authorized within the framework of this Regulation regarding international health tourism.

(2) It is obligatory to carry out promotional activities within the scope of international health tourism as follows:

a) Promotion in Turkish language cannot be made in a way that will create demand within the borders of Turkey. Promotions can be made in the languages ​​of the countries to be promoted and/or in English.

b) Information on the services to be provided within the scope of health tourism and detailed transportation information are published on the websites by the international health tourism health facility and international health tourism intermediary institutions, specifying the last update date.

c) Information about health services that are not authorized and not registered in the license and activity permit of the health facility, information that is contrary to professional and ethical rules, that are false, misleading and that create a demand for domestic citizens cannot be included in promotions.

ç) Health-related information on the website and other promotional tools and equipment is made by legally authorized healthcare professionals who have knowledge and experience in their field.

d) In promotions; Stories of patients receiving treatment can be included, provided that patient privacy is respected, patient rights are respected, and the patient’s consent is documented in this regard.

e) Medical procedures and practices that are prohibited or not allowed to be applied in our country according to the current legislation cannot be included in promotions.

Training

Article 13 – (1) Certification and vocational training in the field of international health tourism are carried out within the framework of cooperation with the Ministry and the Council of Higher Education.

Audit

Article 14 – (1) International health tourism health facility and international health tourism intermediary institution are inspected by the Directorate at least once a year in terms of compliance with this Regulation, excluding complaints or investigations. In addition to the general provisions of this Regulation, the competency criteria and sanction form in the Rider of the Regulation are used in audits.

(2) The necessary registration and notification system shall be established by the Ministry for the assessment of complaints regarding disputes that may arise during the practice of international health tourism and tourist health. Regarding the complaint procedure, foreigners are informed by the international health tourism health facility prior to the provision of health services.

(3) The health facility and its intermediary institution, whose health tourism activities are stopped because they do not comply with the procedures and principles specified in this Regulation, are notified by the Ministry to the Ministry of Economy.

Sanctions

Article 15 – (1) For those who do not comply with the procedures and principles specified in this Regulation, the administrative sanctions in Rider-5 and Rider-6 and other legislative provisions are applied.

Current Status of Those Carrying out International Health Tourism Activities

Temporary Article 1 – (1) Health facilities and intermediary institutions carrying out international health tourism activities before the date of entry into force of this Regulation must comply with the competency criteria in this Regulation and obtain a certificate of authorization from the Ministry within 1 (one) year from the effective date. Those who have not obtained an International Health Tourism Authorization Certificate at the end of the period shall be suspended from their activities within the scope of this Regulation.

Force

Article 16 – (1) This Regulation enters into force on the date of its publication.

Executive

Article 17 – (1) The provisions of this Regulation are executed by the Minister of Health