The regulator will change the procedure for providing medical care for pediatric surgery.

The first group includes primary specialized healthcare organizations that include a pediatric surgeon's office. The second group, according to the draft, includes institutions with a pediatric surgical department and day hospital, as well as an anesthesiology and intensive care unit, a functional and ultrasound diagnostics department or room, X-ray and endoscopy rooms, and a clinical diagnostic laboratory. In addition, the institution must be able to conduct consultations using telemedicine technologies.

The third type of medical organizations is divided into groups A and B. Group A includes institutions with a pediatric surgical department and day hospital, an anesthesiology and intensive care center, a functional and ultrasound diagnostics department, endoscopic and X-ray departments, a clinical diagnostic laboratory (levels 2 and 3), and the ability to conduct consultations using telemedicine technology. The establishment of a regional consultative and diagnostic center is also envisaged.

According to the draft, institutions in Group B are under the jurisdiction of federal executive bodies. In addition to the facilities specified in Group A, they must provide medical genetic consultations, a microbiology laboratory, a simulation training center, and the ability to conduct consultations using telemedicine technology.

All medical facilities in the third group are required to establish an anesthesiology and resuscitation center. This center, among other things, includes one or more mobile teams.

The document adds primary care for children in remote communities through mobile teams. In facilities providing specialized, high-tech care, the medical examination and treatment plan should be determined not only by a pediatric surgeon, but also by a panel of physicians and other specialists.

The section on emergency care, including specialized care, has also been expanded. The need to evacuate a child to a Group A medical facility should be decided upon in consultation with the head of the pediatric surgical department and the anesthesiologist/resuscitator at the appropriate center, including through the use of telemedicine technologies. Following this, the severity of the child's condition and the diagnostic and treatment capabilities of the facility where the child is located are taken into account. Next, air ambulance or medical evacuation is carried out. If there are contraindications to evacuation, a mobile anesthesiology/resuscitation team with a pediatric surgeon may be dispatched.

The draft also states that when providing care outside a clinic requiring emergency surgical intervention and a life-threatening situation, the child is evacuated to the nearest medical facility with an anesthesiology and intensive care unit, an operating room, an X-ray department or room, a transfusion room, and a clinical diagnostic laboratory. After the life-threatening condition has been treated, the child should be transported to a facility with a pediatric surgical unit.

If a child has a condition requiring specialized care in areas such as thoracic surgery, pediatric oncology, pediatric urology-andrology, or surgery (combustiology), then, according to the draft, care is provided in the pediatric surgical department by specialists in the relevant field or pediatric surgeons. Furthermore, the document stipulates the need for a preliminary consultation, including the use of telemedicine technologies. This is done in the absence of specialized pediatric departments in the region and if evacuation to a specialized department is not possible due to the child's severe condition or external factors.

The draft has been supplemented with a clause on providing specialized high-tech medical care to newborns, including those with congenital defects of organs and systems. These newborns will receive care in Group A and B medical facilities with neonatal intensive care units.

A provision has been added for children with surgical conditions who live significantly away from Group A medical facilities or in communities with poor transportation access. In such cases, the necessary care is provided by a surgeon. A telemedicine consultation with the head of the pediatric surgical department and an anesthesiologist-resuscitator is recommended to determine the treatment strategy.

If establishing a definitive diagnosis is difficult, a consultation with pediatric surgeons from a Group B institution is recommended. Waiting periods for specialized care are specified: they should not exceed the timeframes established in the state-guaranteed program for free medical care to citizens. After receiving specialized, high-tech inpatient care, a discharge summary is issued containing the results of the medical examination and treatment, recommendations for further treatment, and outpatient follow-up.

In September 2025, the Ministry of Health updated the Procedure for Providing Medical Care for Infectious Diseases. The new document replaced the regulations in effect since 2012 and takes into account the specifics of organizing medical processes during the coronavirus pandemic. Among the innovations are the possibility of providing high-tech care to patients with infectious diseases, treating patients in day hospital settings, and reducing the number of mandatory positions in outpatient offices.