23 Oct NHIF: There are no problems with the refferals till the end of the year.
There are no problems with the regulatory standards provided for the last quarter of the year. This was announced by the press center of the NHIF in connection with the emerging information that the refferals for specialists have been cut by 20% and those for testing – by 40%. According to the Fund, the difference between the estimated refferals for the last quarter of 2014 and for the fourth quarter of 2013 was 2%, as shown in the table:
Forth quarter of 2013 Forth quarter of 2014
Refferals for consultations with specialist (total) 1 616 359 1 583 098
In connection with acute cases 1 197 621 1 106 306
Dispensary monitoring 418 738 476 792
In 2014, in the National Framework Contract for Medical Activities (NFC for MA 2014) the Bulgarian Medical Association and the NHIF agreed upon a price increase of the examinations, which the institution pays to the specialists for the health insured patients. To comply with the parameters of the National Health Insurance Budget Act, the increase of the funds for examinations is at the expense of the volume of the regulatory standards. The decrease of the refferals for consultations with specialists compared to last year is due to the increased in the number of dispensarised persons with mandatory consultations assigned.
The NHIF informs that the general practitioners and specialists can use an additional 10% above the set quarterly regulatory standards. There is also the possibility of exceeding the regulatory standards by an additional 15% to be compensated in the next quarter, and the unused refferals of the preceding quarter can be absorbed in the current.
There is an option the unused refferals for dispensary monitoring to be transferred for acute cases. Also defined are the reserves in the NHIF and the RHIF, out of which additional resources for general practitioners and specialists should be allocated, if they have expressed such a need.