​Several organizations of employers of family doctors claim that health insurance companies do not comply with the contractual deadline for full payment of primary care services in October: “Partial payment, in the proportion of 60-70%, is unacceptable, this clause is not included in the intended bilateral contract,” they say. representatives of the family doctors, indicating that if no action is taken within two days, the family doctors will suspend all scheduled medical activities.

Due to the insufficient budget and the lack of budget adjustment, the NSHU has been without money since the beginning of autumn, and in recent months has accumulated debts to providers of medical services – hospitals, medical offices, pharmacies and analytical laboratories.

The President of the National Health Insurance Fund, Andrey Bachiu, said a week ago that CNAS requested 4.2 billion lei and received only 1.7 billion from the government’s reserve fund, money that will be allocated, first of all, for the salaries of employees, the rest will be evenly distributed among the sectors medical assistance.

In a press release, the employers’ organizations of family doctors draw the attention of the district houses of health insurance and CNAS that the contractual deadline for full payment of primary care services provided in October 2023 is not being met.

“This fact is a unilateral violation of the terms of the contract on the provision of medical services, which can cause damages – interest. We believe that compliance with the terms of the contract should be the responsibility of all parties who sign the contract, not just healthcare providers. Partial payment, in the proportion of 60-70%, is inadmissible, since this clause is not contained in the intended bilateral contract. You will have to quickly provide public explanations to the legal entities that we represent and whose fiscal forecasts you have upset, regarding the repeated non-fulfillment of contractual provisions by medical centers,” said the organizations of family doctors, quoted by News.ro.

According to them, this is not an isolated case, previously there was a delay in payment of about 14 days: “We publicly state that patients who cannot use their own health insurance are strictly your responsibility. We suggest explaining to your insured what consequences failure to provide medical services in primary medicine can lead to. We urge CNAS and CJAS to look into this issue and find immediate solutions to ensure correct and timely payment of health care services provided by family doctors so as not to create financial hardship for professionals in the field. It is extremely important to avoid any negative impact on patients’ access to high-quality primary medical care,” representatives of family doctors also note.

They add that within two days, in the absence of measures to eliminate the specified problems, they will suspend all programmatic medical activities.

The Communiqué was signed by the Bihor Employers’ Organization of Family Physicians, Bistrita-Năsăud Association of Family Physicians, Bucharest-Ilfov Family Physician Association, Cluj Family Physician Association, Dâmboviţa Family Physician Association, Dolj Family Physician Association, Galac Family, Gorj Family Physician Association, Family Physician Association Iasi, Association of Family Doctors of Mures, Association of Family Doctors of Sibiu, Association of Family Doctors of Timișoara, Association of Family Doctors of Vilca, Association of Family Doctors of Vranca.

Rafila says that the budget of CNAS will be repeatedly replenished

Minister of Health Alexandru Rafila stated that the budget of CNAS will be repeatedly supplemented in order to ensure the necessary financing of medical services by the end of the year.

At the same time, he stated on Monday for B1Tv that the budget of the National Health Insurance Fund was supplemented by 1.7 billion lei, although CNAS requested 4.2 billion, as this was the availability of the state budget at the time. in accordance.

“From the discussions I have had at the government level – I have also discussed with the President of CNAS, Dr. Bachu, I understand that these additions will be consistent, repeated, so that by the end of the year they will fully fund the service, both in hospitals and reimbursed and free drugs and health programs. Of course, you can make decisions on replenishing the budget from the reserve fund available to the Government or from other sources, repeatedly; even if these allowances will be more frequent and the end result will be the same in terms of covering the required amounts, then I think everything will go on the normal course,” said Rafila, as quoted by Agerpres.

The Minister of Health also stated that CNAS finances hospitals on the basis of concluded contracts, and the allocation of 1.7 billion lei will reach the medical units these days. He noted that he had discussions with the Ministry of Finance and CNAS and expressed his belief that the budget adjustment will continue to prevent the “impossibility of providing” medical services. At the same time, he admitted that the costs of medical materials, medicines and utilities have increased significantly recently.

“We have to understand that even if hospitals fulfill their indicators, i.e. perform all the consultations for which they are ordered, the amounts they receive are not enough. We are trying to develop a concrete proposal so that, together with CNAS, we can propose some solutions for implementation in the next period, on the one hand. And on the other hand, the way of financing medical services next year should change and reflect reality. Because if I receive an income of 100 lei, and my expenses to receive this income amount to 120 lei, then it is clear that there is no financial sustainability. This difference must be covered by changes in hospital funding. “Probably, medical services, which have not changed in terms of value for eight years – only this year they have changed by 13.2%, the level of inflation – should be reassessed, and for this a time interval is needed,” Rafila clarified.

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