site.btaHealth Insurance Legislation Fails to Ensure Representation of All Stakeholders - Regulator

Sofia, July 29 (BTA) - The Commission for the Protection of Competition Tuesday said that the Health Insurance Act fails to ensure the representation of all stakeholders in the preparation of statutory acts which determine the scope of, and prices in, the universal health insurance system.

The Commission made this conclusion after checking for compliance with the competition regulations the said law and the bylaws regulating the opportunities for the participation of the Bulgarian Medical Association, the Bulgarian Dentists'' Union and the Bulgarian Pharmaceutical Union in the preparation and adoption of administrative acts determining the scope and prices applicable in mandatory health insurance.  

The check found that despite the powers that the said three organizations have, they do not qualify as competent state bodies that could be involved in the preparation and adoption of statutory acts.

The Commission for the Protection of Competition states that all parties in respect of which the contracting with the National Health Insurance Fund has legal consequences - which means all providers of medical and dental services - need to be involved in the contracting of the scope of, and prices in, mandatory health insurance. Also, as the Pharmaceutical Union does not represent retailers who are not master pharmacists, pharmacies, too, need to have their interests represented in the negotiations with the National Health Insurance Fund.  

The Commission for the Protection of Competition further said that health-insured people are the main source of financial resources for the health insurance system and end-user of all health services and pharmaceutical products funded by the health insurance system - and yet they are excluded from the process of decision-making when the scope of health services and their prices are being contracted. This needs to change and the participation of the insured must be broadened, the Commission concluded.