site.btaDoctors Disagree with Health Insurer about Penalizing Hospitals

The Bulgarian Medical Association (BMA) and the National Health Insurance Fund (NHIF) failed to reach agreement on an annex to the National Framework Agreement 2023-2025, which is why another meeting will be held at the end of the week, BMA President Ivan Madzharov told journalists on Wednesday, emerging from talks between the BMA Management Board and the NHIF Supervisory Board.

The point of contention is the penalties which, according to the draft of the annex, should be imposed on hospitals which have not reached the base wage rates set in the collective agreement: BGN 910 per month for an orderly, BGN 1,500 for a nurse, and BGN 2,000 for a non-specialist doctor.

Asked about his take on the NHIF's misgivings, Madzharov speculated that there is probably an analysis which shows that the introduction of such penalties would jeopardize the existence of some hospitals.

According to him, the proposed penalties are a relatively acceptable way to make hospitals raise staff wages. Another way, used in the past, was by cutting down on the funding for clinical pathways, he recalled. "We are caught in a vicious circle in trying to ensure high staff remuneration in hospitals which have been hard up financially for years," he commented.

NHIF Supervisory Board Chair and Deputy Health Minister Mihail Okoliiski predicted that the penalties will not be abandoned, but the annex will probably provide for a grace period. "We have no problems with the BMA, but we need to sort out these details," Okoliiski said. He did not specify the likely duration of the grace period.

The BMA will hold a convention on February 17. The delegates to the convention are expected to discuss the draft annex to the National Framework Agreement and give the green light to its signing.