site.btaSupreme Administrative Court Invalidates Methodology for Valuation of Medical Services

Supreme Administrative Court Invalidates Methodology for Valuation of Medical Services

Sofia, May 15 (BTA) - The Supreme Administrative Court (SAC)
issued a ruling invalidating texts of Ordinance No. 57 of the
Council of Ministers of 2014 regarding the methodology for
valuation and payment for medical services. The ruling is
published on the SAC webpage. The case has been instituted based
on appeals by the Bulgarian Patient Forum Federation, the
National Association of Private Hospitals and the Centre for the
Protection of Rights in Healthcare.

The report of judge Svetlana Boirissova says that the appeals
are justified. It points out that the Ordinance at issue will
cause pecuniary damage on the medical establishments as they
will have to bear the costs for the medical services provided,
while the damage for the patients will involve restricted access
to timely and high-quality services.

However, the court's decision is not final and can be appealed
by the Council of Ministers within seven days before a
five-member panel of SAC. If the latter confirms the decision of
the lower-instance panel, the National Health Insurance Fund
will have to pay the full value of the services, reported by
hospitals. Yet, the next hearing of the court is scheduled for
March 2016, when the Regulation will be no longer in force.

Nevertheless, the appealing organizations have asked to halt
certain provisions of the Regulation until the final decision of
SAC and the court has granted their request.

This has not been the first time that the court invalidates
hospitals' limits. The new methodology has drawn serious
criticism on the part of medical establishments because of the
financial restrictions imposed.

Already in the first months of the year NHIF has incurred a
deficit due to its payments to hospitals which will grow
considerably if the Fund is forced to reimburse the full value
of the medical services provided by these facilities.