Health Insurance Fund proposes stricter medical leave rules

The Health Insurance Fund is proposing regulatory changes to medical leave rules to prevent abuse and strengthen oversight. According to Fund Director Zlatko Perinski, general practitioners may soon be able to issue medical leave for up to five days, a reduction from the current seven-day limit.

To combat irregularities, the Fund will implement stricter controls, including random inspections and investigations triggered by employer reports. If an insured individual is not found at their declared address during a check, they will be required to appear before a medical commission to provide an explanation, with the employer also being notified. The Fund plans to collaborate with the Public Revenue Directorate and the Ministry of Internal Affairs to enhance these efforts.

Recent audits conducted with the Ministry of Internal Affairs revealed irregularities in approximately 30 percent of reviewed cases. The move comes as the Fund manages significant expenditures; in August alone, over 623 million denars were paid for medical leave, including 414 million denars for maternity leave. The Fund anticipates needing approximately 6.45 billion denars for medical leave and maternity benefits by 2026.