NHIF: Expenditures for Medications Outside Health Insurance Are Conducted According to Strictly Regulated Procedures

The National Health Insurance Fund has issued a position regarding questions raised in the public domain concerning the pricing and financing of medicinal products, including pediatric therapies paid for outside the scope of compulsory health insurance.

The institution clarifies that the treatment of individuals under 18 years of age in these cases is financed through targeted transfers from the Ministry of Health to the NHIF. The mechanism for expenditure is fully regulated, with the Fund’s role limited to administration and payment in compliance with current legislation.

The position emphasizes that the NHIF does not have the authority to determine policies or change the conditions for the approval and payment of these therapies. Furthermore, the Fund has no competence to control pricing or price negotiation procedures for medicinal products, especially regarding medications that are not authorized or registered in the country.

Payment for treatment is made directly to healthcare facilities upon submission of the necessary documentation and provision of the relevant funding by the Ministry of Health. The hospitals administering these therapies are state structures under the jurisdiction of the Ministry of Health, which has a direct commitment to the control and tracking of expenditures.

The NHIF further states that it regularly reports expended funds to the Ministry according to established procedures and through approved forms. At the same time, the institution has submitted requests to the competent authorities for audits of medication pricing and declares its readiness to continue assisting in increasing transparency and efficiency in the expenditure of public resources.

The Health Insurance Fund states that it remains committed to ensuring access to necessary treatment while adhering to the principles of legality, transparency, and accountability.