32 lawsuits filed by hospitals are currently pending against the National Health Insurance Fund for over-the-limit activities. The total value of these cases is BGN 5,437,594, the NHIF reported.
The money will be paid to the medical facilities, if the cases are won, the Health Fund specifies.
The issue of limits came back on the agenda after the Constitutional Court on April 11 declared unconstitutional the provision of the Health Insurance Act (HILA), which as of 2019 prohibits hospitals from paying for over-limit activity.
This made it difficult for patients to access medical care if the medical facility they chose to be treated at exceeded their monthly financial limit set by the NHIF.
After the decision of the Constitutional Court enters into force, the treasury will have no reason to deny hospitals payment of the full amount of the performed medical activity, and patients will not be returned due to exhaustion of the limits, writes bTV.
Meanwhile, for years now, a number of medical facilities have been filing lawsuits against the NHIF for reimbursement of costs incurred due to over-the-limit activity. As for the cases that are currently being conducted, the Health Fund has the financial resources from its budget for this year to pay BGN 5,437,594 if the cases are won.
“In the event that there is a shortage of funds for payment in 2024, the NHIF takes the necessary measures to provide for it in the next budget at the latest”, specified the NHIF.
