Bulgarian healthcare fund monitoring implementation

The Bulgarian Medical Union (BMU) initially called for the implementation of a real-time monitoring system for public healthcare funds. The union argued that current retrospective audits were insufficient to prevent the misuse of resources and proposed a preventive mechanism to ensure the National Health Insurance Fund (NHIF) only pays for actual medical services and dispensed medications.

Following these concerns, the NHIF launched a real-time digital control system via the National Health Information System (NHIS). This system monitors the Global Trade Item Number (GTIN) of medicines paid for by public funds to identify discrepancies between physical packaging and reported products. The measure was prompted by investigations involving the State Agency for National Security and the Ministry of Interior, which uncovered over 1 million euros in unjustified expenditures.

Under the new protocol, pharmacy software scans 2D codes to automatically reject transactions if a mismatch is detected. This real-time verification replaces previous methods that relied on retrospective audits, which often identified errors months after payments were made. The system ensures that if a discrepancy is detected, the transaction is blocked at the pharmacy counter before the sale is finalized. Dr. Vladimir Daskalov, manager of the NHIF, described the measure as a proactive approach to prevent abuse, noting that compliant pharmacies should not experience changes to their workflow.