site.btaBulgarian Parliament Moves to Close Loophole Allowing Private Hospitals to Bypass Medicine Procurement Rules

The Bulgarian Parliament is moving towards closing a loophole that allows private hospitals to bypass strict medicine procurement rules. A bill to amend and supplement the Public Procurement Act was adopted at first reading on Wednesday, requiring of private hospitals to purchase medicines through public procurement procedures - just like public hospitals. The amendments were introduced by the Continue the Change - Democratic Bulgaria (CC-DB) parliamentary group.

Now state hospitals are required to follow strict public procurement procedures for the purchase of medicines while private hospitals can purchase them after direct negotiation with traders.

Initially rejected, the bill was adopted with 98 votes in favor, 6 against, and 81 abstentions after a re-vote prompted by MP Bozhidar Bozhanov. The amendment was supported by MPs from Vazrazhdane, BSP-United Left, Democracy, Rights and Freedoms (DRF), MECh, and Velichie. MPs from GERB–UDF and There Is Such a People (TISP) abstained.

The bill’s sponsor, Nadezhda Yordanova, explained that the goal is "to correct a flaw" in the Public Procurement Act. Currently, medicines purchased by private hospitals using funds from the National Health Insurance Fund (NHIF) are excluded from public procurement rules and competitive bidding is not required.

Yordanova cited investigative journalism reports showing that the same medicinal product can cost up to 26 times more in a private hospital compared to a public or municipal one that followed the procurement process, which leads to misuse of NHIF funds, diverting money away from its intended purpose. She estimated that over BGN 100 million (approx. EUR 51 million) is improperly spent annually due to this loophole.

Yordanova added that 116 out of Bulgaria’s 341 hospitals (34%) are private, and that current European public procurement legislation does not allow for such exemptions.

Private hospitals were exempted from the requirement for holding a competitive procedure to purchase medicines by amendments in the law adopted in 2016. CC-DB has been trying to change that since 2024. In May 2024, the European Commission announced opening infringement procedures against Bulgaria for the long-term violation of internal market rules and illegal procedures allowing private hospitals to avoid tendering for medicines.