Associations of state, municipal and private hospitals fear that the National Health Insurance Fund (NHIF) is looking for other ways to limit its payments to medical institutions after the Constitutional Court overturned the limits. On Friday, they came out with a joint statement against the option of the NHIF reducing the prices of the pathways and procedures it pays hospitals for in order to fit into its budget for this year.
According to the hospital associations, contrary to the decision made by the Supreme Court, instead of taking the necessary actions to synchronize the by-laws with the decision, a new way is being sought to counter these payments to medical institutions.
“This is confirmed by the letter of the Management Board of the BLS, addressed to the NHIF, in which a mechanism is proposed to circumvent the decision of the Constitutional Court – the hospitals that have exceeded the limits should be paid at lower prices. So for one and for the same activity, some hospitals will be paid at one price, and other hospitals at another. are not sought by patients, they will benefit from it”hospital associations say.
They recall that, according to the decision of the Supreme Court, the cost of treating one patient has the same weight from the point of view of the general expenditure part of the budget of the NHIF, regardless of whether he was treated in a hospital with exhausted limits or without.
“We also draw attention to the fact that the option proposed by the union to pay lower prices to some medical facilities is not regulated and does not exist as a possibility in the National Development Plan 2023-2025. On the other hand, the adoption of such a provision would mean that the medical facilities , which have high-quality medical care and are sought after by patients because they offer a qualified service, will be penalized with a reduction in value, and those who “do not treat well” and are not sought after by patients, which also depends on the region, will be favored . Such a discriminatory and contrary to our internal and European legislation proposal would hinder the development of health care in Bulgaria and would direct our patients to seek medical help abroad”say hospital associations.
In addition, they point out that such a punitive change in prices for hospitals that have reached the limits leads to a violation of the rights of the health insured.
Therefore, the hospital associations are turning to the Supervisory Board of the NHIF and the Chairman of the Medical Union, Dr. Ivan Madzharov, with an insistence on dialogue so that a solution to the problem can be found. They also express their willingness to give ideas for improving the control of the spending of public funds.
They remind that the elimination of the limits does not leave the NHIF without the possibility of sanctions in case of violations by medical institutions. Also, the NHIF can unilaterally terminate the contract with the medical facility as a type of sanction in the event of hospitalizations for which there are no medical indications and which are not justified.
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