Parliament has once again rejected the proposal for electronic patient notifications.

For the second time, the National Assembly failed to support the bill amending the Health Insurance Act, introduced by PP-DB. The bill proposed mandatory electronic notifications for health-insured individuals regarding medical services provided to them. Although the project received support from “Vazrazhdane,” it failed to secure enough votes during the first reading, as reported by Zdrave.net.

The proposal envisioned that notifications would be sent via the National Health Information System (NHIS), with the Governor of the National Health Insurance Fund (NHIF) and the Minister of Electronic Governance jointly collecting telephone and email data for insured individuals. To achieve this, information from the Bulgarian identity documents register, the National Revenue Agency (NRA), the toll system, and the unified e-government portal was to be utilized.

Speaking from the parliamentary rostrum, the bill’s sponsor, Bozhidar Bozhanov, argued that the measure would strengthen oversight of public spending by involving patients directly. “Every hospitalized individual will receive a notification. This is a swift and cost-effective measure that could pay for itself by preventing fraud,” he stated. Dr. Alexander Simidchiev noted that over 500,000 people already use the “eHealth” app, adding that such notifications could be sent at no extra cost. According to Assoc. Prof. Vasil Pandov, expanding the existing mechanism used for protocol-based medications is a logical step toward more effective control.

In their official statements, the relevant institutions and organizations expressed support in principle for the idea but raised several questions regarding its implementation. The Bulgarian Medical Union called for real-time preliminary electronic patient verification—similar to two-factor authentication in banking—as a prerequisite for reporting and reimbursing medical activities.

The Bulgarian Association of Healthcare Professionals supports the project without further recommendations. The Association of University Hospitals welcomed the measures to curb irregular spending, while emphasizing the need to ensure equal access to services regardless of social status or place of residence.

The Bulgarian Industrial Association also identified digitalization as a necessary step toward improved accountability and fraud prevention. However, they called for a thorough impact assessment to ensure that individuals without access to electronic channels are not excluded.

The NHIF expressed reservations regarding the practical feasibility of the proposal. According to Governor Assoc. Prof. Petko Stefanovski, the notification system would duplicate existing electronic services and require significant technical preparation, given the potential for millions of messages monthly. Concerns were also raised regarding data protection and the fact that not all citizens have access to email or mobile phones.

Similar concerns were voiced by the “Medical Supervision” Executive Agency, which highlighted the risks associated with changing phone numbers or email addresses, unauthorized access, and scenarios where citizens have not provided contact information.

Thus, despite the stated political will for stricter oversight of NHIF spending, the proposal failed to gain the necessary support and will not be reconsidered by the current parliament.