FSSH steps up checks at health institutions to combat unjustified patient charges

The Health Insurance Fund will step up its oversight of contracted health institutions to verify that rules on fees for medical services are consistently followed and to detect unjustified charges demanded from patients.

Special attention will be paid to possible cases of double charging for a service: an institution receives funding from the Fund while also asking an insured patient to pay for the same service.

According to the State Fund’s clarification, patients are not required to pay extra for services covered by compulsory health insurance. The only exception is the legally prescribed co-payment, where it applies to the service in question. This applies at all three levels of health care: primary, secondary and tertiary.

During the checks, officials will examine whether services for which payment was requested were actually provided and whether they were billed correctly. They will also check whether the amounts requested from patients match the prescribed co-payment.

The Fund reminds health institutions that they must display co-payment fees in an accessible location and provide valid proof for every payment. Patients, meanwhile, have the right to be informed about the services covered by their insurance and any possible obligation to pay extra.

Citizens who suspect they have paid for a service that should have been funded by the Fund can report the case to the FSSH Control Sector.

If violations are identified, the FSSH says it will take measures in accordance with contractual obligations and the regulations in force.