Hospitals in Bulgaria's Major Cities Accused of Draining Health Fund

Hospitals in major Bulgarian cities like Sofia, Pleven, Plovdiv, and Blagoevgrad have been found to be draining funds from the National Health Insurance Fund (NHIF), according to Stanimir Mihaylov, the head of the institution. Although the names of the hospitals involved have not been disclosed, Mihaylov confirmed that disciplinary actions are underway following an internal investigation.

Upon returning to the NHIF, Mihaylov encountered an alarming excess activity in the system, which amounted to 104 million leva three months ago. To address the issue, an in-depth analysis was conducted to understand the reasons behind this overspending. The investigation revealed that between May and September 2024, the reported activity had surged by over 9.6 percent, leading to increased hospital admissions despite no significant population growth or epidemics to justify the rise.

The analysis indicated that the emergence of new medical institutions, particularly commercial ones, was driving the increase in hospital admissions. These institutions were found to be reporting more expensive medical procedures in order to receive higher reimbursements from the NHIF. As a result, the NHIF was effectively being drained.

Further scrutiny uncovered a troubling pattern where hospitals were entering non-existent hospital beds into the electronic system while reporting medical activity associated with them. Mihaylov suggested that this might have been more of a clerical oversight on the part of several regional health insurance funds rather than intentional fraud.

Sources:

• bTV
• econ.bg