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28-03-2022

More than 2 million EUR returned to CHIF budget

Iliustracija

Last year, Compulsory Health Insurance Fund (CHIF) received a compensation of the damages of 2.2 million EUR, caused by illegal resident activities, reported the National Health Insurance Fund under the Ministry of Health (NHIF).

‘NHIF recovers the damages to CHIF, caused by crimes or offenses against human life, health, public order, and traffic safety, as in all of these cases, injured CHI-covered patients are treated from the CHIF funds. Damages are also recovered in cases of illegal use of the European Health Insurance Card (EHIC) or when patients illegally use CHIF-covered healthcare services in Lithuania and abroad without being covered by CHI.’ says Tomas Ragauskas, Head of NHIF Law Division.

He stated that the number violations against CHIF committed by natural persons last year was 9 thousand. That is 1 thousand fewer cases than in 2020.

Based on the procedures, currently in force, the damage recovery is conducted by Territorial Health Insurance Funds (THIF). THIF receives data on victims and treated persons from police commissariats, prosecutor’s offices, while bailiffs help recover costs, spent on the treatment of victims, and return them to the CHIF.

The most cases of damage – 8873 – involve criminal offenses, traffic accidents and illegal use of healthcare services. For example, if a drunk driver causes a car accident, resulting in three CHI-covered injured persons, their healthcare costs (medical aid, medicine, etc.) will be covered from the CHIF funds. Then health insurance funds can recover the damage done to the fund from the perpetrator and, if he or she is a minor – from their parents. The total amount returned to CHIF for violations of this type, was more than 1.3 million Eur.  

Last year, there was also a number of cases (180) of illegal use of EHIC. These include situations, when travellers with no CHI coverage in Lithuania temporarily visiting any European country, provide the card and receive the necessary medical assistance at local medical facilities. In these cases, violators must compensate the costs of their treatment to the CHIF. The amount last year was nearly 25 thousand EUR.

According to NHIF, the smallest CHIF damage, recovered in 2021, was 20 EUR, while the largest exceeded 22 thousand EUR. The latter amount was paid for a long treatment of a patient, who has experienced domestic violence.

‘It should be noted that in case of damage to CHIF, there is a possibility to compensate it before the claim is submitted to court. In such case, criminal cases provide an opportunity of reconciliation and terminate the proceedings. If reconciliation is impossible, the court sees the voluntary compensation of damages as a circumstance, mitigating the perpetrator's liability.’ says Ragauskas.

He also says that upon receiving a notice, urging to compensate the damage to the fund in good faith, the debtor may choose to remunerate the entire amount immediately or come to THIF and sign an agreement regarding repayment of the damage in instalments. However, the latter option is available only for a repayment period that does not exceed 5 years and only if the amount of the damage exceeds 300 EUR.

Health insurance funds would like to remind that, in all cases, the amount of the damage depends on the type, cost and amount of the healthcare services that were covered from the CHIF funds.

(Piktochart photo)

The NHIF invites you:

Your questions are welcome by email [email protected] or phone: local (8 5) 232 2222, international +370 5 232 222

Last updated: 06-04-2022

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