Bulgarian healthcare undergoes oversight and payment reforms

Bulgaria is undergoing significant shifts in its healthcare oversight and financial management. The 28 Regional Health Inspectorates (RZI) have issued a joint position opposing the Ministry of Health’s plans to restructure the agencies and remove their status as independent legal entities. While supporting modernization and digitalization, the RZIs are calling for a comprehensive organizational and financial analysis to ensure that such changes do not compromise the quality of state health control or regional responsiveness.

Simultaneously, the National Health Insurance Fund (NHIF) is implementing strict, real-time automated controls on payments to hospitals. This digital reform aims to prevent illegal patient co-payments and optimize hospital spending, which accounts for nearly 47% of the NHIF’s 2026 budget. By integrating the NHIF information system with the National Health Information System, the fund intends to move from a retrospective audit model to an immediate validation model, blocking reports that show duplicate activities, fictitious hospitalizations, or unauthorized fees.