This article deals with issues that are directly related to the regulatory legal regulation of the health care system in the Russian Federation. The paper analyzes the norms regulating both the provision of medical services itself and the developing activities of entrepreneurs in the field of providing medical services on a paid basis. Today, the state's policy is aimed at forming a healthy lifestyle of civil society, at making them aware of the value of life and health. in the context of the emergence of new risks and, in this regard, the introduction of new restrictions in the life of society. In this light, the development of private medical practice already has a very different meaning. The fear of people when contacting doctors in state polyclinics, the need for a long time to stay in queues for tests, leads to the desire of people to increasingly turn to private clinics, in which the appointment is made by appointment at a certain set time, and tests can be passed not according to the strictly limited two hours in state medical institutions, but choose a more suitable and convenient time. Problems of providing medical services and medical care were analyzed during data collection through interviews and interviews with patients of polyclinics and ordinary citizens who want to express their opinions. The analysis of the legislation that changed in late 2020 - early 2021 brought some information on positive and not quite innovations that are already in effect on the territory of the state. The paper analyzes the regulatory legal acts that allow the state institution of the Russian healthcare system to provide medical services on a paid basis. The problems that require legislative regulation for the foundations of the activities of private medical institutions for the provision of medical care, medical services and counseling of citizens who have applied to them are considered. The results of the study show that it is possible to make certain changes in the activities of the health care system of the Russian Federation by organizing co-financing of patients from insurance organizations, associated with the use of a progressive taxation scale, as well as the obligation of private clinics to provide certain types of services, for example, counseling, in the direction issued by a state medical institution in the absence of a narrow specialist. Consequently, the development of domestic health care, taking into account a fairly wide range of services provided under compulsory health insurance policies, can be assessed positively. To regulate the activities and development of private business in the organization and operation of medical institutions, it is necessary to introduce rules that allow you to control the tariffs for services and assistance provided, contracts and agreements offered to those who apply, as well as to introduce a system of expert assessments to facilitate the resolution of disputes arising on the work of medical institutions on a commercial basis.