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Hospitals and Health Maintenance Organisations Accounting Law for the Years 2026 to 2030 (Accounting for Health Services in General Public Hospitals), 5786-2026

חוק התחשבנות בין בתי חולים לקופות חולים לשנים 2026 עד 2030 (התחשבנות בעד שירותי בריאות בבתי חולים ציבוריים כלליים), תשפ"ו-2026

Published: 2026-03-31Consolidated Hebrew text as of 2026-04-19 · Last amended 2026-03-31✓ Amendment status checked against the Knesset legislation record on 2026-09-28
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Unofficial English translation — for reference only. It may contain errors or omissions and cannot be relied on as a legal text. Only the Hebrew text published in Reshumot is legally binding.More

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The Hebrew text as published in Reshumot (ספר החוקים) and on the Knesset website is the sole authoritative and legally binding version. In any discrepancy, the Hebrew text prevails.

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Definitions§

1.

In this Law –

"general public hospital" – a general hospital, and in respect of a general government hospital or a general hospital in the ownership of a local authority – including a health corporation operating within its framework, all provided that all of the following conditions are met in relation to it:

(1)the total payments made by all health maintenance organisations to the hospital for health services in 2025 exceeds 0.25% of the total payments made by all health maintenance organisations to general hospitals for health services in 2025;
(2)its registration certificate under the Public Health Ordinance includes positions for urgent medicine (emergency rooms);
(3)it conducts medical student training activity on behalf of an institution of higher education within the meaning of the Council for Higher Education Law, 5718-1958, or medical intern training activity in accordance with regulations made under section 17 of the Physicians Ordinance [New Version], 5737-1976, at a recognised institution within the meaning of those regulations;

"accounting scope" – the total payments that a health maintenance organisation is required to pay to a general public hospital for the consumption of health services;

"volume discount" – a discount for a health service consumed by a health maintenance organisation at a general government hospital or at a general hospital in the ownership of a local authority, as set by the Director in an administrative directive published on the website of the Ministry of Health;

"tariff discount" – a discount for a specific health service consumed by a health maintenance organisation at a general public hospital, beyond the volume discount and any other discount that is not for a specific health service;

"National Health Insurance Law" – the National Health Insurance Law, 5754-1994;

"Accounting Law 2021" – the Hospitals and Health Maintenance Organisations Accounting Law for the Years 2021 to 2025 (Accounting for Health Services in General Public Hospitals), 5782-2021;

"Budget Foundations Law" – the Budget Foundations Law, 5745-1985;

"Supervision Law" – the Commodities and Services Price Supervision Law, 5756-1996;

"insured person" – as defined in the National Health Insurance Law;

"full price" – the maximum price of a health service, as it appears in the Ministry of Health fee schedule;

"patient designated for transfer" – one of the following:

(1)a person hospitalised in a general public hospital in whom all of the following conditions are met:
(a)the person is on prolonged ventilation and has been hospitalised in a general public hospital for more than 30 consecutive days, or is defined in accordance with an administrative directive set by the Director or the head of the medical division of the Ministry of Health and published on the website of the Ministry of Health, as a complex nursing patient or sub-acute patient or as a geriatric rehabilitation patient;
(b)a decision has been made that the person may be transferred out of the general public hospital in accordance with an administrative directive as referred to in sub-paragraph (a), taking into account the need to maintain continuity of care;
(c)the health maintenance organisation has not offered, in the manner prescribed in an administrative directive as referred to in sub-paragraph (a), another place to which the person may be transferred that meets the provisions of the National Health Insurance Law, including the requirements of section 3(d) of that Law;
(2)a person hospitalised in a general public hospital in whom the conditions referred to in paragraph (1) are not met, but in whom other conditions set by the Ministers by Order are met;

"patient registered under a special arrangement" – a person who has been registered under a special arrangement set pursuant to section 56(a)(1)(d) of the National Health Insurance Law;

"the Director" – the Director General of the Ministry of Health;

"weighted number of insured persons" – as defined in section 17(a) of the National Health Insurance Law;

"reduced amount" – an amount paid for consumption that exceeds a consumption ceiling for a differential service or for another health service;

"Public Health Ordinance" – the Public Health Ordinance, 1940;

"consumption", of health services by a health maintenance organisation at a general public hospital – excluding consumption of health services by a health maintenance organisation at a general public hospital in its ownership that is not a separate corporation from it, and excluding home hospitalisation services;

"health maintenance organisation" – as defined in the National Health Insurance Law;

"consumption floor" – as its meaning in section 7, including consumption floors that have been consolidated as referred to in section 10;

"update rate" – the rate of update of the price of a hospitalisation day as set by the Ministers, by Order, pursuant to the Supervision Law;

"advancement rate" – a rate as set out below, as the case may be:

(1)for a differential service – 5.3%;
(2)for another health service – 2.7%;

"capitation rate", of a health maintenance organisation – the rate of a health maintenance organisation's share of the amount for distribution set by the National Insurance Institute pursuant to the provisions of sections 17 and 18 of the National Health Insurance Law;

"home hospitalisation service" – a medical treatment service provided at the patient's home as a substitute for hospitalisation in a general public hospital, pursuant to an administrative directive set by the Director and published on the website of the Ministry of Health;

"internal medicine hospitalisation service" – hospitalisation services in departments whose code in the Ministry of Health fee schedule is: G00M1, G00M2, G00M3, G00M4, G00M5, G00M6, or another code or an additional code set by the Ministers pursuant to section 3(b);

"health service" – a health service of the type of internal medicine hospitalisation service, differential service or other health service;

"other health service" – a health service that is not an internal medicine hospitalisation service and is not a differential service;

"differential service" – a health service for which an individual price has been set that includes the performance of the medical procedure, days of hospitalisation and other medical services provided within its framework, as published in the Ministry of Health fee schedule;

"health corporation" – as defined in section 21 of the Budget Foundations Law, including a health corporation operating within the framework of a general hospital in the ownership of a local authority;

"multi-year bed plan" – the plan for the addition of general hospitalisation beds for the years 2023 to 2028, published on the website of the Ministry of Health, and any future plan for the allocation of beds agreed upon by the Ministers and published on the website of the Ministry of Health;

"real addition" – an addition for each of the years 2026 to 2030, in accordance with the rates set out below, as the case may be, to be distributed among general public hospitals in accordance with the provisions of section 5 or 6:

(1)for an internal medicine hospitalisation service – 0.5%;
(2)for a differential service – the rate of population growth in the previous year compared to the year preceding it, as published by the Central Bureau of Statistics, plus 0.209%;
(3)for another health service – 77.5% of the sum of the rate of population growth in the previous year compared to the year preceding it, as published by the Central Bureau of Statistics, and 0.209%;
(4)in 2029 a rate of 0.2% shall be added to each addition as set out in paragraphs (2) and (3), as the case may be, and in 2030 – 0.4%;

"Ministry of Health fee schedule" – the list of hospitalisation tariffs and ambulatory and differential services published by the Ministry of Health on its website, reflecting the tariffs as updated from time to time pursuant to Orders made under section 12 of the Supervision Law;

"consumption ceiling" – as its meaning in section 2 in respect of a differential service and another health service, and as its meaning in section 3 in respect of an internal medicine hospitalisation service, all including consumption ceilings that have been consolidated as referred to in section 10;

"the Ministers" – the Minister of Health and the Minister of Finance.

Calculation of consumption ceiling for a differential service and another health service§

2.
(a)The consumption ceiling for a differential service and the consumption ceiling for another health service, for each of the health maintenance organisations at each general public hospital, in each of the years 2026 to 2030, shall be calculated as set out below:
(1)in 2026 – the product of a health maintenance organisation's proportionate share at the hospital of the total accounting scope by the overall consumption ceiling for the type of health service, plus the update rate and a real addition;
(2)in the years 2027 to 2030 – the consumption ceiling in the previous year plus the update rate and the real addition;
(3)in respect of a health maintenance organisation providing health services to patients registered under a special arrangement pursuant to the National Health Insurance (Arrangements regarding Registration with a Health Maintenance Organisation and the Provision of Health Services to Persons in Israel Who Are Not Insured under the Law) Regulations, 5784-2024 – the following amount shall be added to the consumption ceiling referred to in paragraphs (1) and (2), as the case may be, as the case may be (in this section – the addition for patients registered under a special arrangement):
(a)in 2026 – the total payments that the health maintenance organisation was required to pay to the general public hospital in 2025 for the consumption of health services provided to patients as aforesaid, plus the update rate;
(b)in the years 2027 to 2030 – the addition for patients registered under a special arrangement in the previous year, plus the update rate.
(b)In addition to what is stated in subsection (a) –
(1)in 2026 –
(a)if the individual growth rate in respect of a specific general public hospital, other than a new hospital, exceeded the determining growth rate, the positive difference between the individual growth rate and the determining growth rate shall be deducted from the consumption ceiling amounts calculated for 2026 pursuant to subsection (a)(1) in respect of that hospital;
(b)the amount deducted as referred to in sub-paragraph (a) shall be added to the consumption ceilings of general public hospitals for those types of services, other than a general public hospital from which the amount was deducted as aforesaid or a new hospital, in accordance with their proportionate share of the overall consumption ceiling;
(c)the consumption ceiling of the health maintenance organisation at the general public hospital referred to in subsection (a) shall increase or decrease, as the case may be, in accordance with the change in the capitation rate of the health maintenance organisation compared to 2023, and in respect of a consumption ceiling at a hospital on a confrontation line – compared to 2022;
(2)in each of the years 2027 to 2030, the consumption ceiling of the health maintenance organisation at the general public hospital referred to in subsection (a) shall increase or decrease, as the case may be, in accordance with the change in the capitation rate of the health maintenance organisation compared to the preceding year, provided that the total consumption ceilings of all health maintenance organisations at the general public hospital shall not change as a result of the changes referred to in this paragraph.
(c)In this section –

"new hospital" – a general public hospital that received its registration certificate under the Public Health Ordinance for the first time after the 19th day of Tevet 5776 (31 December 2015), other than a hospital as aforesaid that received its registration certificate for the first time as a result of a consolidation as referred to in section 10;

"hospital on a confrontation line" – a general public hospital whose accounting scope with all health maintenance organisations in the last quarter of 2023 decreased by at least 15% from the average accounting scope with all health maintenance organisations in the first three quarters of that same year;

"accounting scope for 2023" – the accounting scope of a health maintenance organisation with a general public hospital, other than a hospital on a confrontation line, in 2023, for a differential service or another health service, as the case may be;

"accounting scope of a health maintenance organisation with a hospital on a confrontation line" – the accounting scope of a health maintenance organisation with a hospital on a confrontation line, in 2022, for a differential service or another health service, as the case may be, plus 3% for a differential service, or plus 4% for another health service;

"2022 differential" – the ratio between the total consumption of health services that are not internal medicine hospitalisation services by all health maintenance organisations at a general public hospital in 2022 and the gross consumption ceiling of all health maintenance organisations at that hospital for health services that are not internal medicine hospitalisation services for 2022, and in respect of a general public hospital for which that ratio was less than 100% – 100%;

"2024 differential" – the ratio between the total consumption of health services that are not internal medicine hospitalisation services by all health maintenance organisations at a general public hospital in 2024 and the gross consumption ceiling of all health maintenance organisations at that hospital for health services that are not internal medicine hospitalisation services for 2024;

"proportionate share of a health maintenance organisation at the hospital of the total accounting scope" – one of the following, as the case may be:

(1)in respect of a general public hospital, other than a hospital on a confrontation line, by type of health service – the ratio between the following two:
(a)the accounting scope for 2023 for that type of health service;
(b)the accounting scope for 2023 for that type of health service of all health maintenance organisations with all hospitals, plus all accounting scopes of all health maintenance organisations with all hospitals on a confrontation line;
(2)in respect of a hospital on a confrontation line, by type of health service – the ratio between the following two:
(a)the accounting scope of a health maintenance organisation with a hospital on a confrontation line for that type of health service;
(b)the accounting scope for 2023 for that type of health service of all health maintenance organisations at all public hospitals, plus all accounting scopes of all health maintenance organisations with all hospitals on a confrontation line;

"individual growth rate" – the gap by which the 2024 differential exceeded the 2022 differential for each general public hospital separately;

"determining growth rate" – the average gap by which the 2024 differential for all health maintenance organisations and general public hospitals exceeded the 2022 differential for all health maintenance organisations and general public hospitals, plus 1.2%;

"gross consumption ceiling" and "net consumption ceiling" – as their meaning under the Accounting Law 2021;

"overall consumption ceiling", in respect of a differential service or in respect of another health service – the sum of all net consumption ceilings, for 2025, of all health maintenance organisations at general public hospitals, for a differential service or for another health service, as the case may be, plus the advancement rate.

Calculation of consumption ceiling for an internal medicine hospitalisation service§

3.
(a)The consumption ceiling for an internal medicine hospitalisation service at a general public hospital, in each of the years 2026 to 2030, shall be calculated as set out below:
(1)in 2026 – the ratio between the number of hospitalisation days consumed by a health maintenance organisation in the internal medicine departments of that hospital in 2025 and the total hospitalisation days consumed by all health maintenance organisations in the internal medicine departments of that hospital in 2025, multiplied by the total amount that all health maintenance organisations were required to pay to that hospital in 2025 pursuant to section 15(a)(2) of the Accounting Law 2021 and by 99%, plus the update rate and a real addition;
(2)in the years 2027 to 2030 – the ratio between the number of hospitalisation days consumed by a health maintenance organisation in the internal medicine departments of that hospital and the total number of hospitalisation days consumed by all health maintenance organisations in the internal medicine departments of that hospital, in the previous year, multiplied by the total consumption ceilings for internal medicine hospitalisation services of all health maintenance organisations of that hospital in the previous year, plus the update rate for that year and a real addition.
(b)The Ministers may, by Order, set an additional code beyond the codes listed in the definition of "internal medicine hospitalisation service" or another code to replace the code listed in that definition.
(c)The Director shall notify, once per quarter commencing on the 16th day of Tammuz 5786 (1 July 2026), each health maintenance organisation of the ratio between the number of hospitalisation days consumed by the health maintenance organisation in the internal medicine departments of each hospital and the total number of hospitalisation days consumed by all health maintenance organisations in the internal medicine departments of each such hospital, in the preceding quarter.
(d)In this section, "number of hospitalisation days consumed by a health maintenance organisation in the internal medicine departments of a hospital" – the number of hospitalisation days consumed by a health maintenance organisation in the internal medicine departments of a general public hospital less the home hospitalisation service days consumed by the health maintenance organisation at the hospital.

Additional Payment Distributed according to a Service Improvement Index in respect of Inpatient Service in Internal Medicine Departments§

4.
(a)In addition to the amounts paid by a health maintenance organisation pursuant to section 12(c), in each of the years 2026 to 2030, all health maintenance organisations shall pay to all general public hospitals a total amount of NIS 90 million, each in accordance with its capitation rate, for inpatient service in internal medicine departments, in accordance with the provisions of subsection (f) and as directed by the Director (in this section – the additional payment for internal medicine departments), no later than 60 days from the date on which they received the said direction.
(b)The Director, with the consent of the Budget Commissioner of the Ministry of Finance and after affording general public hospitals an opportunity to present their arguments, shall determine the service improvement index for internal medicine departments in general public hospitals in accordance with the principles set out in subsection (c) and shall publish it in an administrative directive on the website of the Ministry of Health (in this section – the service improvement index).
(c)The service improvement index for internal medicine departments shall include indices according to which the internal medicine departments of all general public hospitals shall be measured and ranked, and shall be based on a mix as detailed below:
(1)half of the index shall be composed of clinical indices as directed by the Director, including indices relating to the quality of treatment in internal medicine departments;
(2)half of the index shall be composed of service quality indices as directed by the Director and the Budget Commissioner of the Ministry of Finance, including indices relating to patient satisfaction with hospitalisation in internal medicine departments.
(d)The Director and the Budget Commissioner of the Ministry of Finance may decide on a different mix of indices from the mix set out in paragraphs (1) and (2) of subsection (c), provided that a decision on a mix that differs by more than 10% from the allocation fixed between those paragraphs shall require the approval of the Health Committee of the Knesset.
(e)
(1)The Director shall direct the reports and data that each general public hospital must submit for the purpose of examining its compliance with the service improvement index and the dates for their submission, provided that with respect to personal information as defined in the Privacy Protection Law, 5741-1981, a report shall be required only on the following detailed information:
(a)data regarding a patient discharged from hospitalisation in an internal medicine department for the purpose of conducting a patient service experience survey, in accordance with the breakdowns directed by the Director according to age groups, dates of discharge from hospitalisation and the minimum hospitalisation duration to be included in the survey; the data to be transferred pursuant to this sub-paragraph shall be the first name, telephone number, code of the general public hospital and code of the hospitalisation department;
(b)data regarding the treating staff in the internal medicine department and their qualifications: full name, identity number, scope of employment at the hospital, number of months of employment in that year and qualifications;
(2)personal information received from a report pursuant to paragraph (1) shall be stored in a database as defined in the Privacy Protection Law, 5741-1981;
(3)data referred to in paragraph (1)(a) shall be used solely for the purpose of conducting the patient service experience survey, and data regarding the first name and telephone number shall be deleted immediately upon completion of the survey in its entirety, or within three months of the date of receipt of the data, whichever is earlier;
(4)for the purpose of conducting the patient service experience survey, the Director shall notify, before conducting the survey, a patient whose details were transferred pursuant to paragraph (1)(a), in a simple and convenient manner by a written personal message, and where it is not possible to receive such a message – by means of a personal voice message, of the transfer of the details and the purpose of their use, and shall afford the patient a reasonable opportunity to respond by the same means if the patient does not wish to be contacted for the purpose of conducting the survey; where a patient gives such notice, the patient's details shall be deleted immediately and no use whatsoever shall be made of them;
(5)notwithstanding the provisions of paragraph (4), for the purpose of conducting a survey as referred to in that paragraph in 2026, the Director shall notify, including through the hospital, before conducting the survey, a patient hospitalised in the internal medicine department, by personal message in such manner as the Director directs, of the transfer of the details and the purpose of their use and of the patient's option to contact and give notice that the patient does not wish to be contacted for the purpose of conducting the survey, in a simple and convenient manner to be provided in the notice and within a deadline to be provided therein, provided that the manner and deadline shall ensure that the patient is afforded a reasonable opportunity to give notice; the text of the message directed by the Director shall also be published on the website of the hospital and of the Ministry of Health; where a patient gives such notice, the patient's details shall be deleted immediately and no use whatsoever shall be made of them.
(f)The additional payment for internal medicine departments shall be distributed among the general public hospitals in accordance with the service improvement index scores of which the Director shall notify the general public hospitals by 31 March of each year in respect of the preceding year, and in 2026 – within one month of the date of publication of this Law.
(g)The Minister of Finance may, by Order, prescribe, in place of the amount fixed in subsection (a), an amount exceeding it.

Distribution of the Real Addition§

5.
(a)For the purpose of calculating the consumption ceilings referred to in section 2 in respect of each general public hospital, the total real addition of all general public hospitals (in this section – the total real addition) for a differential service and for another health service, as the case may be, shall be distributed among all general public hospitals in accordance with the following provisions:
(1)half of the total real addition for a given year shall be distributed in accordance with the multi-year bed plan, such that 70% of that half shall be distributed for hospitalisation beds allocated within the framework of the plan and 30% of that half shall be distributed for hospitalisation beds for which an approval has been granted pursuant to the Public Health Ordinance and which have actually been opened;
(2)half of the total real addition for a given year shall be distributed in accordance with the proportional share of the consumption ceilings of each general public hospital out of the total consumption ceilings of all general public hospitals.
(b)For the purpose of calculating the consumption ceilings referred to in section 2 in respect of each general public hospital, the real addition for inpatient service in internal medicine departments shall be distributed among the general public hospitals, having regard to the multi-year bed plan or to additional considerations determined by the Ministers.

Different Calculation in respect of Consumption Ceilings, the Advancement Rate and the Real Addition§

6.
(a)Notwithstanding the provisions of the definitions of "advancement rate" and "real addition" and of sections 2 and 5, the Ministers may, by a reasoned written decision, calculate, in respect of a specific health maintenance organisation and a specific general public hospital, an advancement rate and a real addition that differ from the advancement rate and the real addition, having regard, inter alia, to one or more of the considerations set out below:
(1)additional medical devices approved for the hospital pursuant to any law and the manner of implementation of the approval; for this purpose, "medical device" – a medical device in respect of which it has been determined that its purchase or use requires a licence pursuant to section 65b(3) of the Public Health Ordinance;
(2)a change in the weighted number of insured persons, including such a change in a specific area;
(3)the multi-year bed plan and the manner of its implementation.
(b)The calculation referred to in subsection (a) shall be carried out in such a manner that the total consumption ceilings, the total advancement rate and the total real addition relative to the total consumption ceilings for health services and for all general public hospitals and health maintenance organisations in a given year shall not change as a result of the change pursuant to that subsection.

Calculation of Consumption Floor§

7.

The consumption floor for each health maintenance organisation at each general public hospital, in each of the years 2026 to 2030, shall be calculated as detailed below, as the case may be:

(1)for a differential service and another health service –
(a)in 2026 – 95% of the consumption ceiling for that year;
(b)in 2027 – the consumption floor in 2026, plus the update rate and plus a rate of 1%;
(c)in 2028 – as detailed below, as the case may be:
(1)if the averages ratio was up to 97% – 97% of the consumption floor for 2027, plus the update rate and plus a rate of 1%;
(2)if the averages ratio exceeded 97% and did not exceed 100% – the product of the averages ratio and the consumption floor for 2027, plus the update rate and plus a rate of 1%;
(3)if the averages ratio exceeded 100% – the consumption floor in 2027, plus the update rate and plus a rate of 1%;

in this paragraph, "averages ratio" – the ratio between the average accounting scope of the health maintenance organisation at the general public hospital in 2026 and 2027 and the average consumption floor of the health maintenance organisation at the general public hospital for those years, for the same type of health service;

(d)in 2029 and 2030 – the consumption floor in the preceding year, plus the update rate and plus a rate of 1%;
(2)notwithstanding the provisions of paragraph (1), where the Ministers find in a given year that the ratio between the extended accounting scope of the health maintenance organisation at that hospital and the extended accounting scope of all health maintenance organisations at that hospital in the preceding year does not exceed 12%, the following provisions shall apply, as the case may be:
(a)the consumption floor in respect of another health service of the health maintenance organisation at that hospital in that year shall be at a rate of 95% of the consumption floor in respect of another health service that would have been calculated pursuant to paragraph (1), provided that the capitation rate of the health maintenance organisation does not exceed 20%;
(b)the Ministers may calculate, in respect of a specific health maintenance organisation at a specific general public hospital, a consumption floor for a health service as detailed below, as the case may be, that is lower than that set out in paragraph (1), provided that it is not less than 95% of the consumption floor for that year pursuant to that paragraph, after affording the parties an opportunity to present their arguments and having considered the financial situation of the hospital and the effect of the health maintenance organisation on the number of its insured persons receiving services at that hospital, if one of the following conditions is met:
(1)in respect of a differential service – if the capitation rate of the health maintenance organisation does not exceed 20%;
(2)in respect of a differential service and in respect of another health service – if the capitation rate of the health maintenance organisation in the sub-district in which the hospital is located does not exceed 20%; for this purpose, "sub-district" – as its meaning in the notice on the division of the territory of the State into districts and sub-districts and the descriptions of their boundaries, pursuant to section 3 of the Law and Administration Ordinance, 5708-1948;

in this paragraph, "extended accounting scope" – the total payments that a health maintenance organisation is required to pay to a general public hospital for health services, including a payment by a health maintenance organisation to a general public hospital in its ownership that is not a separate corporation from it;

(3)for inpatient service in internal medicine departments – 100% of the consumption ceiling for that year.

Modification of Consumption Ceilings and Consumption Floors§

8.
(a)Where the Government has decided to increase the cost of the basket of health services within its meaning in section 9 of the National Health Insurance Law for the purpose of consuming health services at general public hospitals, the Ministers may, by Order, prescribe consumption ceilings higher than the ceilings calculated pursuant to sections 2 and 3, or consumption floors higher than the floors calculated pursuant to section 7, in accordance with criteria to be prescribed in such an Order, provided that the total additional expenditure for the health maintenance organisations by reason of such prescription shall equal the amount added to the cost of the basket of health services for the said purpose.
(b)The Ministers may, by Order, prescribe consumption ceilings different from the consumption ceilings calculated pursuant to sections 2 or 3, in accordance with criteria to be prescribed in such an Order, if they find that the prescription is required by reason of a change in the prices of that type of health service, as published in the Ministry of Health fee schedule, provided that the total consumption ceilings shall not change as a result of such prescription.

Notice of Consumption Ceiling and Consumption Floor§

9.

The Ministers, or a person whom they have authorised from among the employees of their ministries, shall notify each general public hospital and each health maintenance organisation –

(1)by the 15th of Sivan 5786 (31 May 2026) – of the consumption ceiling and consumption floor for health services for 2026;
(2)by 1 March of each of the years 2027 to 2030 – of the consumption ceiling and consumption floor for health services for that year.

Merger of Hospitals§

10.

Where two or more general public hospitals are merged into a single general public hospital holding a single registration certificate pursuant to the Public Health Ordinance, their consumption ceilings and consumption floors shall be merged in accordance with the sum of the said ceilings and floors.

Home Hospitalisation Service§

11.
(a)A health maintenance organisation shall pay for a differential home hospitalisation service consumed from a general public hospital, provided through the hospital and its physicians, in accordance with the payment it would have made pursuant to the provisions of this Law for a differential service.
(b)For the development of an internal home hospitalisation service and another home hospitalisation service, payments shall be made to a general public hospital as follows, from the amount to be allocated as referred to in subsection (c), in respect of insured persons whom the general public hospital has notified the health maintenance organisation that it is referring to a home hospitalisation service:
(1)for an internal home hospitalisation service or another home hospitalisation service that the health maintenance organisation provides otherwise than through the hospital – the Ministry of Health shall transfer to the general public hospital a monetary amount for each insured person so referred;
(2)for an internal home hospitalisation service or another home hospitalisation service provided by the general public hospital through the hospital and its physicians, where the health maintenance organisation has not notified the hospital of its intention to provide such service as referred to in paragraph (1), or where in accordance with the administrative directive referred to in subsection (e) its notice is not required – the Ministry of Health shall transfer to the general public hospital a monetary amount for the said home hospitalisation service.
(c)Notwithstanding the provisions of section 3a of the Budget Foundations Law, the Ministry of Health shall allocate a budget as follows for the purpose of transferring the monetary amounts as detailed in subsection (b):
(1)in 2026 – NIS 30 million;
(2)in 2027 – NIS 40 million;
(3)in each of the years 2028 to 2030 – NIS 50 million.
(d)Notwithstanding the provisions of subsection (b), a general public hospital may notify the Director, by 1 December of a given year, that in lieu of the payments referred to in that subsection it chooses the alternative of converting beds in its registration certificate for the provision of an internal home hospitalisation service and another home hospitalisation service to be provided through the hospital and its physicians, provided that the Director has published an administrative directive as referred to in subsection (e) on or after the commencement date of this Law; where the hospital gives such notice, the following provisions shall apply from the year following the giving of the notice:
(1)the Director or a person authorised by the Director from among the employees of the Ministry of Health shall convert beds in the registration certificate of the general public hospital from beds for the provision of inpatient service in internal medicine departments or from beds for the provision of another health service, to beds for the provision of a home hospitalisation service; such conversion shall be carried out in accordance with the number of beds for the provision of a home hospitalisation service requested by the hospital and approved for it, and having regard to the ratio between the prices of the health services provided in connection with the beds to be converted and the prices of home hospitalisation services, pursuant to the Ministry of Health fee schedule, as the case may be;
(2)the consumption ceiling of the health maintenance organisation in respect of inpatient service in internal medicine departments or another health service at the general public hospital shall be reduced proportionally to the number of beds converted to beds for the provision of a home hospitalisation service as referred to in paragraph (1);
(3)a health maintenance organisation shall pay to the general public hospital an amount not exceeding the full price for that type of service for an internal home hospitalisation service and for another home hospitalisation service provided through the hospital and its physicians, provided that the hospital has notified the health maintenance organisation that it is referring the insured person to a home hospitalisation service and the health maintenance organisation has not given notice of its intention to provide the home hospitalisation service to the insured person;
(4)notwithstanding the provisions of paragraph (3), the total payment that the health maintenance organisation shall pay to the general public hospital for an internal home hospitalisation service or another home hospitalisation service, as the case may be, shall not exceed 110% of the amount deducted from the consumption ceiling as referred to in paragraph (2).
(e)The Director shall publish on the website of the Ministry of Health an administrative directive regarding home hospitalisation service, including criteria for service quality and regarding home hospitalisation service provided through a hospital and its physicians, including provisions on the following matters:
(1)the general public hospital's notice to the health maintenance organisation that it is referring an insured person to home hospitalisation;
(2)the health maintenance organisation's notice of its intention to provide the home hospitalisation service to the insured person, the manner of its delivery and its dates, the manner and date of provision of the service, and the types of another home hospitalisation service in respect of which receipt of such a notice shall not be required;
(3)criteria for the calculation of the monetary amount pursuant to subsection (b)(1) or (2), as the case may be.
(f)In this section –

"another home hospitalisation service" – a home hospitalisation service provided as part of the provision of another health service;

"differential home hospitalisation service" – a home hospitalisation service provided as part of the provision of a differential service;

"internal home hospitalisation service" – a home hospitalisation service provided as part of the provision of inpatient service in internal medicine departments.

Payment for Health Services§

12.
(a)A health maintenance organisation shall pay for a differential service or another health service that it consumed at each general public hospital, in each of the years 2026 to 2030, amounts as detailed below, as the case may be:
(1)if the health maintenance organisation consumed differential services or other health services up to the consumption floor, as the case may be – the consumption floor for that year; however, if the Ministers, or employees of their ministries whom they have authorised for this purpose, found that the general public hospital did not agree to provide the health maintenance organisation, in that year, upon its request, with health services similar in their financial scope, availability and mix to the differential services or other health services that the hospital provided to the health maintenance organisation in the preceding year, the full price shall be paid for the differential services or other health services consumed;
(2)if the health maintenance organisation consumed differential services or other health services, as the case may be, beyond the consumption floor and up to the consumption ceiling – an amount not exceeding the full price for the differential services or other health services consumed;
(3)if the health maintenance organisation consumed differential services or other health services, as the case may be, beyond the consumption ceiling – the consumption ceiling plus a reduced amount as detailed below, as the case may be:
(a)for consumption of a differential service beyond the consumption ceiling set for such service – not more than 63.5% of the full price of the service;
(b)for consumption of another health service beyond the consumption ceiling set for such service – not more than 41% of the full price of the service.
(b)Notwithstanding the provisions of subsection (a), where a health maintenance organisation consumed from a general public hospital, in each of the years 2026 to 2030 –
(1)differential services in an amount lower than the consumption ceiling set for those services, there shall be added, for the purpose of calculating the payment as referred to in subsection (a), the difference between the consumption ceiling and the actual consumption of those services to the consumption ceiling of another health service;
(2)other health services in an amount lower than the consumption ceiling set for those services, there shall be added, for the purpose of calculating the payment as referred to in subsection (a), the difference between the consumption ceiling and the actual consumption of those services to the consumption ceiling of a differential service.
(c)A health maintenance organisation shall pay for an inpatient service in internal medicine wards, in each of the years 2026 to 2030, the amount of the consumption floor as referred to in section 7(3).

Date of Payment for Health Services§

13.
(a)A health maintenance organisation shall transfer to a general public hospital, no later than 60 days from the 1st of the month in which it received a monthly charge notice from the hospital, the higher of the following amounts:
(1)8.33% of the consumption floor for that year set for the health maintenance organisation at that general public hospital, unless the health maintenance organisation received approval from the Ministers or from employees of their ministries whom they have authorised for this purpose, to pay only the full price for the health services consumed, on account of the hospital's failure to agree to provide the health maintenance organisation with health services similar to the health services it provided it in the preceding year as referred to in section 12(a)(1);
(2)the undisputed amount in the charge notice;
(3)97% of the net amount required pursuant to the charge notice in respect of health services taken into account within the consumption ceiling, urgent medicine (emergency room) services and home hospitalisation services, unless the health maintenance organisation appealed against the charge notice in accordance with a clarification mechanism pursuant to an administrative directive set by the Director and published on the website of the Ministry of Health, and the hospital did not respond to that appeal in accordance with the said administrative directive.
(b)Where a health maintenance organisation has not transferred to a general public hospital the payment amount required under subsection (a), or the amount of the additional payment to internal medicine wards in accordance with the provisions of section 4(a), the following provisions shall apply:
(1)to the amount not transferred as aforesaid, the Accountant General's interest shall be added from the last date for payment as referred to in subsection (a) until the date of its actual transfer to the general public hospital;
(2)the Director, after having given the health maintenance organisation and the hospital an opportunity to state their arguments, may set off the amount not transferred as aforesaid from the health services funding sources within the meaning of section 13(a) of the National Health Insurance Law and from the support funds transferred to the health maintenance organisation pursuant to section 3a of the Budget Foundations Law, and transfer it to the general public hospital.
(c)Excess amounts paid by a health maintenance organisation to a general public hospital by reason of the provisions of subsection (a), or amounts that a health maintenance organisation was required to pay to a general public hospital and were not paid by reason of the provisions of the said subsection, shall be refunded or paid, as the case may be, with the addition of the Accountant General's interest, from the date on which the health maintenance organisation paid excess amounts as aforesaid, or from the last date for payment as referred to in subsection (a), as the case may be, within 30 days of the conclusion of the clarification process pursuant to the administrative directive referred to in subsection (a)(3).
(d)Nothing in the provisions of subsection (a) shall derogate from the obligation of a health maintenance organisation to pay a general public hospital any other payment it owes.
(e)In this section, "Accountant General's interest" – as its meaning in the notice regarding the Accountant General's interest rates as published from time to time in Reshumot (Official Gazette).

Patient Designated for Transfer§

14.

A health maintenance organisation shall pay a general public hospital for an inpatient service for a patient designated for transfer, as detailed below:

(1)from the first day on which the person is considered a patient designated for transfer (in this section – the designated transfer date) until the fourth day from the designated transfer date – full price;
(2)from the fifth day from the designated transfer date until the 28th day from the designated transfer date – 120% of the full price;
(3)from the 29th day from the designated transfer date – full price.

Payment for Urgent Medicine (Emergency Room) Services§

15.

Notwithstanding the provisions of section 20(a)(7), a health maintenance organisation shall pay a general public hospital for urgent medicine (emergency room) services the full price of the service.

Payment for a Health Service Provided Outside the Premises of a General Public Hospital§

16.
(a)Without derogating from the provisions of any law, a health maintenance organisation shall not pay a general public hospital for a health service provided outside the premises of a general public hospital (in this section – an off-premises health service), unless one of the following conditions is met:
(1)the health service was provided pursuant to a contract between the health maintenance organisation and the hospital as aforesaid;
(2)the health service is a home hospitalisation service as referred to in section 11;
(3)the Director approved the hospital, with public participation and after giving the health maintenance organisations an opportunity to state their arguments, in a reasoned written decision, to provide the health service outside the hospital premises, taking into account the distribution of health services and the needs of residents for health services at an adequate level, quality and availability as required by the provisions of the National Health Insurance Law, and the geographical connection of the services to the existing activity of the hospital, provided that the service is provided in accordance with the conditions of the approval as aforesaid.
(b)A copy of a contract concluded as referred to in subsection (a)(1) shall be transmitted to the Director no later than seven days from the date on which the contract was signed; if the Director considers that, in view of the considerations set out in subsection (a)(3), there is no justification for the contract and that the contract significantly prejudices the other health maintenance organisations, the Director may, after giving the parties to the contract an opportunity to state their arguments, cancel the contract by a reasoned written decision to be delivered to the parties.
(c)Where a general public hospital provided a health maintenance organisation with an off-premises health service before the commencement of this Law, the general public hospital shall be deemed to have been granted approval as referred to in subsection (a)(3) in respect of that health service at that location, provided that the general public hospital notified the Director by the 15th of Tammuz 5786 (30 June 2026) of the off-premises health service provided as aforesaid with details thereof, in the manner directed by the Director and published on the website of the Ministry of Health; nothing in the provisions of this subsection shall derogate from the provisions of any law regarding approval for the provision of the service.

Payment for Remote Health Services§

17.

A health maintenance organisation shall not pay for a remote health service provided by a general public hospital, unless one of the following conditions is met:

(1)the service was provided pursuant to a contract between the hospital and the health maintenance organisation;
(2)the service was provided pursuant to a referral from the health maintenance organisation;
(3)the service was provided in continuation of medical treatment given at the hospital;
(4)the service is of a type of health services in respect of which the Director directed in an administrative directive that payment is to be made, even if the conditions in paragraphs (1) to (3) are not met.

Accounting between a Hospital and a Health Corporation§

18.

In a general government hospital or in a general hospital in the ownership of a local authority within the framework of which a health corporation operates, the scope of the accounts for which a reduced amount as referred to in section 12(a)(3) is paid that is attributed to the health corporation shall not be less than an amount equal to 48.67% of all the accounts for which a reduced amount as aforesaid is paid for a differential service and for another health service; the Ministers may prescribe, by Order, in respect of such a hospital and in respect of a health corporation operating within its framework, for each of the years 2027 to 2030, a different rate of all the accounts for which a reduced amount as aforesaid is paid, after having given the hospital and the corporation an opportunity to state their arguments.

Contract between a Health Maintenance Organisation and a General Public Hospital regarding the Accounting Method between Them§

19.
(a)Notwithstanding the provisions of this Law, a general public hospital and a health maintenance organisation may determine in a written contract between them an alternative arrangement for accounting in respect of the consumption of health services at the hospital (in this section – the contract), provided that all of the following conditions are met:
(1)the contract shall stipulate that services shall be provided to the insured persons of the health maintenance organisation at an adequate level and with the quality and availability required by the provisions of the National Health Insurance Law, and the terms of the contract shall enable the provision of services at an adequate level and with the quality and availability as aforesaid;
(2)the contract shall include the accounting components between the hospital and the health maintenance organisation, including details of the changes compared to the arrangement set in this Law, tariff discounts and provisions from previous contracts that continue to apply;
(3)if the total scope of consumption of health services by the health maintenance organisation at the hospital, in a particular year of the contract years, exceeds the consumption ceiling set for that year by more than 6%, the parties to the contract shall notify the Ministers thereof, and the Ministers may notify the parties that the contract is void; where the Ministers so notified, the accounting between the parties in the following year shall be conducted in accordance with the provisions of this Law;
(4)the period of the contract shall not extend beyond the 5th of Tevet 5791 (31 December 2030);
(5)within the framework of the contract, the hospital shall be entitled to grant the health maintenance organisation discounts on the tariff of health services constituting not more than half of the accounting turnover between the hospital and the health maintenance organisation; for this purpose, "accounting turnover" – the total financial scope of the health services taken into account within the consumption ceiling, purchased by the health maintenance organisation from the hospital pursuant to the contract;
(6)the contract shall stipulate that the total payment that the health maintenance organisation shall pay the hospital for the consumption of health services, in each year, shall not be less than the consumption floor as referred to in section 7;
(7)the contract shall include the provisions of sections 3, 13, 14 and 15 and shall not derogate from those provisions.
(b)A copy of a contract concluded as referred to in subsection (a), including amendments to and additions to the contract made during the contract period, shall be transmitted to the Ministers or to those authorised by them from among the employees of their ministries, no later than seven days from the date on which the contract, the amendment to the contract or the addition to the contract, as the case may be, was signed.
(c)If the Ministers consider that the contract does not comply with the provisions of this section, they shall notify the health maintenance organisation and the hospital thereof within 60 days of the date on which the contract was transmitted to them, and the Ministers may, after having given the parties to the contract an opportunity to state their arguments, cancel the contract in its entirety by a reasoned written decision to be delivered to the parties.

Non-Application to Certain Health Services§

20.
(a)The provisions of this Law shall not apply to the following services, and they shall not be considered a health service for the purposes of this Law:
(1)a health service provided to a victim as defined in the Victims of Hostile Action (Pensions) Law, 5730-1970;
(2)a health service provided to a foreign worker as defined in the Foreign Workers Law, 5751-1991, included within the framework of the basket of services set by the Minister of Health pursuant to section 1d of that Law, but excluding a service provided to a foreign worker residing in Israel pursuant to a visa and temporary residence permit of type A/1, as referred to in regulation 6(a) of the Entry into Israel Regulations, 5734-1974;
(3)a health service provided to a soldier pursuant to a contract between a health maintenance organisation and the Israel Defence Forces; for this purpose, "soldier" – a soldier in compulsory service within the meaning of paragraph (1) of the definition of "soldier" in the Military Justice Law, 5715-1955, excluding a soldier in compulsory service during a period of service without pay, as referred to in section 55 of the National Health Insurance Law;
(4)a health service provided to a patient pursuant to a contract between a health maintenance organisation and another body responsible for providing the service to the patient, by law, agreement or insurance contract;
(5)a health service provided to a person who is not an insured person as defined in section 2 of the National Health Insurance Law;
(6)a service from among the mental health services listed in item 22a of the Second Schedule to the National Health Insurance Law;
(7)urgent medicine (emergency room) services, subject to the provisions of sections 15 and 19(a)(7);
(8)an additional health service set by the Ministers in the Arrangement of the State Economy Order (Determination of Excluded Services and Determination of Reductions), 5773-2013;
(9)a health service listed in the Schedule;
(10)a laboratory test service performed on a sample taken at the health maintenance organisation and sent by it to the hospital.
(b)The Ministers may, by Order, amend the Schedule.

Extension of Application to Persons Present in Israel Who Are Not Insured§

21.

Notwithstanding the provisions of section 20(a)(5), the provisions of this Law shall also apply to health services provided to a patient registered under a special arrangement, as if the patient were an insured person.

Limitation on the Application of Section 9 of the Supervision Law§

22.

The provisions of this Law shall apply notwithstanding the provisions of section 9 of the Supervision Law.

Publication of the List of General Public Hospitals§

23.

The Director shall publish on the website of the Ministry of Health, by the 22nd of Nisan 5786 (9 April 2026), the list of hospitals in respect of which the conditions set out in the definition of "general public hospital" are met.

Reporting to the Knesset§

24.

The Ministers shall report to the Health Committee of the Knesset, by 31 March of each year, on all of the following, in respect of the preceding year:

(1)the number of patients designated for transfer in that year at each hospital, broken down by health maintenance organisation and district, and by the number of their hospitalisation days in the internal medicine wards of the hospital after the designated transfer date within the meaning of section 14;
(2)the number of beds in frameworks designated to receive patients designated for transfer that were actually opened in that year, broken down by type of framework and by the entity operating it;
(3)a comparison between the total number of patients designated for transfer as referred to in paragraph (1) and the total available beds in frameworks designated to receive patients designated for transfer;
(4)the number of patients designated for transfer for whom an amount as referred to in section 14(2) was paid at each hospital, broken down by health maintenance organisation and district;
(5)the manner of distribution of the amount pursuant to the service improvement index under section 4;
(6)home hospitalisations by type of various home hospitalisation services, broken down by hospitals, health maintenance organisations and districts;
(7)the payments made pursuant to the provisions of section 11(b)(1) and (2) to the hospitals, broken down by health maintenance organisations.

Amendment of the Accounting Law 2021 – No. 2§

25.

In the Hospitals and Health Maintenance Organisations Accounting Law for the Years 2021 to 2025 (Accounting for Health Services in General Public Hospitals), 5782-2021 –

(1)in the name of the Law, instead of "between hospitals and health maintenance organisations for the years 2021 to 2025 (Accounting for Health Services in General Public Hospitals)" there shall come "between general public hospitals and health maintenance organisations (national budgeting)";
(2)in section 9, after subsection (f) there shall come:

"(g) In this subsection, 'general public hospital' – as defined in the Hospitals and Health Maintenance Organisations Accounting Law for the Years 2026 to 2030 (Accounting for Health Services in General Public Hospitals), 5786-2026.".

Amendment of the Hospitals and Health Maintenance Organisations Accounting Law (Mental Health)§

26.

In the Hospitals and Health Maintenance Organisations Accounting Law (Mental Health), 5785-2025, in section 1, in the definition of "general public hospital", instead of "2021 to 2025" there shall come "2026 to 2030" and instead of "5782-2021" there shall come "5786-2026".

Implementation and Regulations§

27.
(a)The Ministers are charged with the implementation of this Law and may make Regulations on any matter relating to its implementation.
(b)The Minister of Health may make Regulations regarding the reporting obligation of general public hospitals to the Ministry of Health and to the Ministry of Finance, on any matter relating to the costs of providing health services.

Commencement and Application§

28.

This Law shall commence on the 12th of Tevet 5786 (1 January 2026) (hereinafter – the commencement date), and its provisions shall apply to health services consumed by a health maintenance organisation at a general public hospital until the 5th of Tevet 5791 (31 December 2030).

Commencement of Changes to the Ministry of Health Fee Schedule – Temporary Provision§

29.
(a)Notwithstanding the provisions of section 23(a) of the Supervision Law, where changes to the Ministry of Health fee schedule in respect of health services consumed by a health maintenance organisation at a general public hospital, other than changes to the update rate of the price of a hospitalisation day, were published on the website of the Ministry of Health during the period from the commencement date until the 15th of Tammuz 5786 (30 June 2026), their commencement shall be the commencement date; however, for the purposes of an offence under the Supervision Law, the commencement of such changes to the Ministry of Health fee schedule shall be in accordance with the provisions of the said section 23(a).
(b)Where no changes to the Ministry of Health fee schedule as referred to in subsection (a) were made by the 15th of Tammuz 5786 (30 June 2026), the following amendments shall apply to the provisions of this Law in respect of health services consumed by a health maintenance organisation at a general public hospital in 2026:
(1)in section 12(a) –
(a)in paragraph (2), instead of "and up to the consumption ceiling – an amount not exceeding the full price" it shall read "and up to the consumption ceiling multiplied by 122.88% – an amount not exceeding the full price multiplied by 81.38%";
(b)in paragraph (3) –
(1)in the opening passage, instead of "beyond the consumption ceiling" it shall read "beyond the consumption ceiling multiplied by 122.88%";
(2)in sub-paragraph (a), instead of "beyond the consumption ceiling" it shall read "beyond the consumption ceiling multiplied by 122.88%" and instead of "63.5%" it shall read "51.7%";
(3)in sub-paragraph (b), instead of "beyond the consumption ceiling" it shall read "beyond the consumption ceiling multiplied by 122.88%" and instead of "41%" it shall read "33.4%";
(2)in section 15, at its end it shall read "multiplied by 81.5%".

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LawAdministrative LawHealth

חוק התחשבנות בין בתי חולים לקופות חולים לשנים 2026 עד 2030 (התחשבנות בעד שירותי בריאות בבתי חולים ציבוריים כלליים), תשפ"ו-2026

hospitals health maintenance organizations accounting law 2026

HMO hospital accounting law 2026-2030

public hospitals accounting law Israel

takshivnut bein batei cholim

hospital accounting law 2026

health services public hospitals accounting

hospitals kuppot cholim accounting

public hospital billing law Israel

health maintenance organisation hospital billing

takshivnut baadom shurutei briyut