On February 7, 2019, in Moscow, Russian Deputy Minister of Health Dmitry Kostenikov and de facto Minister of Health of the Tskhinvali Region Giorgi Totchiev signed a protocol on financing medical insurance agreement between the Tskhinvali Region and the Russian Federation.

The agreement was signed on November 14, 2017, and ensures medical insurance for Russian citizens permanently residing in the Tskhinvali Region. According to de facto Ministry of Health of the Tskhinvali Region, more than 45,000 Russian citizens live in the region.