NHIF: Automatic Reporting for Pharmacies to the Fund Is Now a Reality

From the beginning of 2026, pharmacies in the country will transition to fully automatic reporting of dispensed prescriptions for medicinal products that are partially or fully covered by the National Health Insurance Fund. With the introduction of the new process, the current requirement for pharmacies to submit reporting documents to the NHIF every two weeks will be eliminated. This was announced by the Governor of the NHIF, Assoc. Prof. Petko Stefanovski, during a working meeting with experts from the Fund and Information Services JSC.

The change became possible following the introduction of real-time electronic validation of prescriptions, which has been integrated with the National Health Information System since January 1, 2026. In this way, the NHIF works directly with primary medical documents submitted through the NHIS, without the need for pharmacies to resubmit data.

According to Assoc. Prof. Stefanovski, the digitalization of the process aims to limit reporting errors and represents another step toward fulfilling the commitments made to the National Assembly upon his election as Governor of the NHIF.

Integration with the NHIS allows prescriptions to be checked in real time against all NHIF payment rules at the very stage of issuance. The system automatically confirms the correctness of the prescription or returns information regarding an error, which can be rectified immediately. The same principle of real-time control is applied when dispensing medications in pharmacies, where the pharmacist receives confirmation that the dispensing will be reimbursed by the Fund.

The new model for dispensing medications in outpatient care is part of the strategy for the development of e-health in Bulgaria and builds upon the real-time control mechanisms introduced by the NHIF in 2025. The expected effect is a significant reduction in administrative errors, faster and higher-quality work for the Fund’s contracted partners, and greater convenience for patients, who will no longer need to travel back and forth between the doctor’s office and the pharmacy if a prescription correction is required.

The elimination of bi-weekly reporting procedures will allow NHIF employees to direct more resources toward expert control activities.

Real-time controls have been agreed upon with the Bulgarian Pharmaceutical Union and the Bulgarian Medical Association, ensuring process transparency and eliminating the subjective factor in reporting. The NHIF leadership expressed a commitment to expanding electronic controls to other activities funded by the Fund in the coming months.