IAMN Strengthens Control Against Illegal Additional Payments in Hospitals

Limiting unregulated payments and additional fees from health-insured patients will be a leading priority in the control activities of the Executive Agency “Medical Supervision” (IAMN). This was reported by the institution. They emphasize that the goal will be achieved through a combination of increased control, greater transparency, and the imposition of sanctions.

As part of the measures, an in-depth analysis will be conducted on healthcare facilities where violations and improperly collected funds have already been identified. Based on this, periodic audits will be planned for structures with increased risk. Expansion of joint inspections with the National Health Insurance Fund (NHIF), regional health inspectorates, and the economic police is also planned. Furthermore, there will be a more active exchange of information with the prosecutor’s office in cases of suspected financial crimes and fraud.

The agency reminds that legitimate payments within the healthcare system are clearly regulated and are rather the exception, as the main package of activities is covered by the NHIF. Lawful additional payments include the co-payment fee for examinations and hospital stays. Additionally: payment for the choice of a doctor or team—only upon explicit request and signed informed consent—as well as additional payments for more expensive medical devices or supplies outside the scope of the Fund. Payments for additional services, such as improved living conditions and activities not covered by the NHIF, including certain medications, are also permissible.

At the same time, the IAMN reports a number of frequent violations. These include the fictitious “choice of team” where no real alternative exists, the mandatory imposition of “additional service” packages, and requests for additional payment for supplies that should be included in the clinical pathway. Practices such as requiring “donations” linked to treatment, as well as forcing patients to pay for better conditions without providing a free alternative, are also classified as illegal.

The agency calls on patients to be proactive in protecting their rights—to request information on whether a particular service is covered by the NHIF, whether payment is mandatory or voluntary, and to always insist on a payment document. The importance of carefully reading informed consent forms before signing is also emphasized.

In case of suspicion regarding an unlawful payment request, citizens can submit reports to the IAMN and the NHIF. In addition, the institution plans information campaigns to clarify which activities are free for health-insured individuals and to publish clear lists of services not covered by public funding.

The IAMN emphasizes that through stricter control and transparency, they will seek a real reduction in illegal practices and the protection of patients’ economic rights.