site.btaCourt Invalidates Provisions of Agreement for Medical Activities between Health Insurance Fund and Medics

The Supreme Administrative Court (SAC) invalidated provisions of the National Framework Agreement for Medical Activities between the National Health Insurance Fund (NHIF) and the Bulgarian Medical Association for 2023–2025, SAC reported here on Wednesday.

The Court held that the invalidated provisions regulate a prohibition for the NHIF to pay for hospital medical care rendered by medical institutions, when the volumes and values specified in their contracts with the regional health insurance funds are exceeded. These provisions restricted the ability of hospital care facilities to be paid in full for inpatient hospital care activities, when the monthly values get exceeded.

The Court reasoned that medical establishments have an obligation to provide medical care to insured patients. Timely and accessible medical care provided on equal terms and with equal opportunities for treatment is a fundamental right of insured persons. The contested provisions would therefore restrict, impede and delay the provision of medical care, including potentially denying patients treatment at the facility of their choice

The invalidation can be appealed within seven days.