Headline:
Bulgaria’s National Health Insurance Fund (NHIF) CEO Reveals Worrying Trends in Hospitalization Rates and Costs
Subhead:
Stanimir Mihaylov, reinstated as NHIF CEO by the Constitutional Court, speaks out about mismanagement, fraud.html” title=”Handling Insurance Billing Fraud Complaints: Licensee … – JustAnswer”>inflated bills, and possible fraud in Bulgarian hospitals.
Article:
Bulgaria’s National Health Insurance Fund (NHIF) CEO, Stanimir Mihaylov, has shed light on troubling trends in the country’s healthcare system after his recent reinstatement to the post. In an interview with bTV, Mihaylov disclosed that upon his return, he found a significant excess of medical activities, amounting to 104 million BGN (around 52 million EUR).
Mihaylov revealed that a spike in reported medical activities, especially hospitalizations, occurred during the period from May to September 2024, with no apparent increase in population or health emergencies to justify the surge. "In essence, this means that we’ve seen an increase in hospitalizations while the population size and health crisis situation have remained stable," he explained.
A taskforce has identified two primary causes for this increase: newly opened medical facilities and an expanded scope of services at existing partners, leading to a higher volume of reported activities and costs. According to Mihaylov, these commercial entities are motivated to bill NHIF for more expensive treatments to secure larger payouts.
The final report submitted to the NHIF indicates a high likelihood of manipulated pathology records, suggesting that certain clinical pathways are being overcharged. "Practically, this means that NHIF is being drained of funds," Mihaylov concluded.
Mihaylov disclosed that over 24.965 million BGN (around 12.5 million EUR) had been paid out in 2024, with the possibility of this amount increasing following the conclusion of ongoing investigations. He also addressed the issue of non-existent hospital beds being billed for medical services, attributing this to errors made by several regional NHIF offices rather than deliberate misuse.
Mihaylov refused to name any specific hospitals involved in wrongdoing, citing ongoing investigations. However, he confirmed that they are located in major cities like Sofia, Pleven, Pловdiv, and Blagoevgrad. He reaffirmed that disciplinary proceedings have been initiated, and those responsible will face consequences.
The NHIF CEO’s revelations underscore the urgent need for transparency and accountability in Bulgaria’s healthcare system, with potential mismanagement and fraud costing the fund and, ultimately, Bulgarian taxpayers, millions of euros.
Image Credits:
-.Main Image: BTA
- In-article images: Provided by Dnes.dir.bg
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