Bulgarian healthcare professionals challenge National Framework Agreement in court

The Bulgarian Association of Healthcare Professionals (BAPZG) has officially mandated its president, Diana Georgieva, to legally challenge the National Framework Agreement (NFA) for medical activities covering the 2026–2028 period.

The association alleges a violation of Article 54, Paragraph 1 of the Health Insurance Act. BAPZG claims the Bulgarian Medical Union (BLS) failed to include them in negotiations regarding activities performed by nurses, midwives, and associated medical specialists. While the NFA was signed in September 2026 between the National Health Insurance Fund and the BLS, BAPZG argues that the interests of approximately 50,000 specialists and their patients were ignored.

Potential impacts on patient care include restricted access to certain services, such as postnatal and newborn home care, which may now only be covered by the National Health Insurance Fund if a primary care physician has an explicit contract with a midwife or nurse. The Bulgarian Medical Union maintains that the law was followed, asserting that relevant parameters were negotiated before the regulatory changes requiring BAPZG's involvement were finalized.