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Hospitals allegedly drained nearly half a million BGN from the Health Insurance Fund

Inspection finds 760 phantom beds in NHIS system

болници източили близо половин милиона лева здравната каса
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от БНТ
16:21, 18.12.2024
Чете се за: 03:35 мин.
EN

Approximately 500,000 BGN may have been siphoned off from the National Health Insurance Fund (NHIF) through the use of non-existent hospital beds. A check revealed that employees of regional health insurance offices entered hundreds of "phantom" beds into the fund's system. Some hospitals claimed and received payments from the NHIF for services related to these non-existent beds.

The final results of the Health Fund's audit showed that officials from different districts of the country had entered not 671 but 760 non-existent beds into its information system.

NHIF Director, Stanimir Mihaylov, stated: "Where necessary, there are disciplinary proceedings, but that is not the most important thing. In some cases, mistakes were made, and in others, there is a need to investigate whether there was any intent. The main issue lies in errors accumulated over the years."

These errors allowed hospitals to receive payments from the NHIF for fictitious services. The fund will attempt to recover some of the money.

Mihaylov confirmed that, so far, 143,000 BGN of such claims have been confirmed, with the total amount potentially reaching around 500,000 BGN.

In the course of the audit, it turned out that Sofia had a record number of hospital admissions. One patient in Sofia was hospitalized 37 times in the same facility since the beginning of the year, raising further concerns about misuse of the system.

Stanimir Mihaylov - manager of the NHIF: "There were people with 20, there were people with 15. We took more than 4 hospitalizations within this year. The maximum number was 39, of which 37 in one medical facility."

The health fund suspects other abuses in hospitals.

Mihaylov noted that some hospitals may also have reported services under more expensive clinical pathways than necessary, although this will need to be proven.

More than 3 billion BGN have been earmarked for hospitals this year, which turned out to be insufficient.

From next year's budget, the hospitals will have to be paid 146 million BGN reported this year.

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