27-06-2024

The National Health Insurance Fund will be able to protect patients’ interests more effectively

Iliustracija

Seimas approved amendments to the Law on Health Insurance, which will allow merging the National Health Insurance Fund under the Ministry of Health (NHIF) and the five territorial health insurance funds into a single legal entity from 1 July 2025. The amendments also give the Director of the NHIF the right to impose minimum sanctions on medical establishments, pharmacies and other economic operators who have violated the legislation.      

“The amendments to the Law on Health Insurance adopted by the Seimas will allow the National Health Insurance Fund to have stronger legal instruments to achieve stronger protection of patients and more efficient use of the Compulsory Health Insurance Fund. We hope that the new regulation will help, first of all, to prevent institutions from illegally prescribing services and receiving payment for them, profiting from patients by charging premiums and charging for services that have already been paid for, as well as to ensure a simpler and smoother recovery of illegally used funds for both patients and the Fund,” says Gytis Bendorius, Director of the NHIF.

Amendments to the Law on Health Insurance, which will enter into force in July next year, will allow the head of the NHIF to issue a written instruction to a medical institution, pharmacy or other entity for breaches of laws and regulations and to order the return of illegally received funds of the Compulsory Health Insurance Fund. And in cases where the right of a patient covered by compulsory health insurance to free healthcare services, medicines, medical aids or medical devices is violated, to return the illegally collected fee to the patient.

“We trust our contract partners and want to underline that the vast majority of them provide their services with integrity and strive to work on a level playing field. Thus, the amendments to the law introduce only minimal impact measures to encourage all institutions to behave fairly, to discourage abuse of the Compulsory Health Insurance Fund, and to allow the NHIF to protect the right of patients to receive taxpayer-funded and state-guaranteed healthcare services. Minor infringements or infringements caused by human error will not be subject to the impact measures”, notes G. Bendorius.

Decisions of the NHIF Director can be appealed against in accordance with the Law on Administrative Procedure, but it is recalled that an appeal does not suspend the execution of the decision. 

(NHIF photo)

The NHIF invites you:

Last updated: 11-07-2024

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