Regulation on Private Health Institutions Providing Outpatient Diagnosis and Treatment

The Regulation on Private Health Institutions Providing Outpatient Diagnosis and Treatment Services (“Regulation“) was published in the Official Gazette on 19 April 2025. With the Regulation coming into force, the Regulation on Private Health Institutions Providing Outpatient Diagnosis and Treatment Services published in the Official Gazette on 15 February 2008 (“Previous Regulation”) has been abolished. It should be noted that not all provisions of the Regulation entered into force upon its publication, and certain provisions are subject to transitional periods.

The Regulation brings forth significant changes in relation to the provision of private healthcare services:

The scope has been changed. While the Previous Regulation included provisions relating to medical centres, polyclinics (Type A and Type B), laboratories, healthcare facilities, and private practices, laboratories have now been excluded from the scope, whereas physical therapy and rehabilitation facilities have been included within the scope of the Regulation. Additionally, the distinction between different types of polyclinics has been abolished, and all polyclinics are now defined under one single category. Accordingly, the Regulation governs medical centres, polyclinics, physical therapy facilities, and private practices providing outpatient diagnosis and treatment services.

Staffing requirements for specialist physicians have been changed. Under the Previous Regulation, the minimum number of specialist physicians required for medical centres was set at ten. The Regulation stipulates that medical centres must employ at least five specialist physicians across a minimum of two different specialties. As for polyclinics, while the Previous Regulation required a minimum of two physicians, the Regulation sets this number between a minimum of two and a maximum of four physicians.

An accreditation requirement has been introduced for medical centres. Under the Regulation, medical centres are required to obtain an accreditation certificate from the Turkish Institute for Quality and Accreditation in Healthcare Services (“TÜSKA”) within three years from the date of licensing. Medical centres that fail to obtain this certificate are obliged to display a notice informing patients of this status. Additionally, medical centres without a TÜSKA accreditation certificate shall be reported to the Social Security Institution by the Ministry of Health (“Ministry”) every January. Medical centres licensed and operational under the previous Regulation are also subject to this requirement, and must obtain the TÜSKA accreditation certificate within three years from the date of publication of the Regulation.

Criteria for emergency units have been further specified. Pursuant to the Regulation, emergency units may only be established within medical centres that operate on a 24-hour basis without interruption, that have a minimum indoor area of 3,000 square meters, and that employ at least ten specialist physicians.

Novelties regarding the procurement of services have been brought. As per the Regulation, laboratory and imaging services may be procured from public or private sector providers. In this context, both service procuring and providing parties shall bear joint liability for the performance and outcomes of such services. Furthermore, requests for examinations and the results related to these services shall be managed through an electronic system and shall be integrated into the system of the procuring healthcare institution.

New provisions have been introduced regarding delivery units within medical centres. The Regulation sets forth detailed criteria for delivery units operating within medical centres where natural deliveries are performed. Medical centres with delivery units that do not meet the requirements stipulated under the Regulation are obliged to comply with these standards by 31 December 2025. Otherwise, the delivery units of such medical centres shall be closed down. Furthermore, performing planned caesarean sections within medical centres is now prohibited, and medical centres without operating rooms shall not be permitted to establish delivery units.

A provision regarding the issuance of a planning conformity certificate has been introduced. Under the Regulation, a planning conformity certificate shall be issued in accordance with the planning determined by the Ministry. Within this framework, the specialties and staffing numbers of healthcare institutions shall be planned by the Ministry, and the corresponding planning conformity certificate shall be issued accordingly. The certificate is not transferable. Moreover, if a preliminary permit is not obtained within one year for polyclinics and within two years for medical centres following the issuance of the certificate, the certificate shall become invalid.

Licensing timelines in the event of relocation of healthcare institutions have been changed. According to the Previous Regulation, in case of relocation of medical centres, it was mandatory to obtain a preliminary permit within two years, and to complete the licensing process within three years from the date of the preliminary permit, thereby finalizing the relocation process within a total period of five years. Pursuant to the Regulation, medical centres are required to obtain a preliminary permit within two years and to complete the licensing process within two years from the date of the preliminary permit, finalizing the whole relocation process in four years. In the event of relocation of polyclinics and healthcare facilities, it is now mandatory to obtain a preliminary permit within one year and to complete the licensing process within two years from the date of the preliminary permit, finalizing the relocation process within a total period of three years.

Procedures for suspension and revocation of licenses have been further detailed. The Regulation elaborates on the processes for suspension and revocation of licenses, and expands the provisions regarding the supervision of medical indications and practices. Within the framework of the criteria set forth under the Regulation, in cases where deficiencies are identified, such deficiencies must be remedied within the prescribed timeframes. Until these deficiencies are rectified, the operations in the healthcare institution may be partially or completely suspended on a temporary basis. If the deficiencies and/or non-compliances are not remedied within six months from the date of suspension of operations, the institution’s license shall be suspended, and an additional grace period of six-month period shall be granted. Should the institution fail to remedy the deficiencies/non-compliances and resume operations within this grace period, its license shall be revoked by the Ministry. Furthermore, if a healthcare institution continues to admit patients despite the partial suspension of its operations on temporary basis, the institution’s operations shall be fully suspended for a period that is twice the originally suspended period. In the event that a healthcare institution continues to admit patients despite the full suspension of its operations, its license shall be revoked by the Ministry.

Provisions regarding the working arrangements of private practice physicians within medical centres have been introduced. As per the Regulation, physicians operating in private practices may enter into agreements with medical centres subject to certain conditions, thereby allowing them to treat their patients within such centres. In this context, both the private practice physician and the medical centre shall be jointly liable for the diagnosis and treatment services provided to the patient during the course of treatment at the medical centre.