# North Macedonia to implement new medical leave regulations

> Live situation record from CLSTR: https://clstr.news/situations/north-macedonia-medical-leave-regulation-reforms
> Updated: 2026-09-29T08:13:03.000Z. Sources: 23. Developments: 3.

North Macedonian authorities are moving forward with stricter regulations to combat the abuse of medical leave, with new rules set to take effect on December 1. A central component of the reform is reducing the period during which primary care physicians can independently authorize sick leave from seven days to five. For longer absences, stricter electronic documentation and medical commissions will be required.

The Health Insurance Fund (HIF) reported a significant rise in medical leave usage, noting that while the number of patients increased by 6.7% between 2021 and 2025, the number of open medical leaves rose by 33.4%. To address this, authorities are exploring electronic data exchange with other institutions to monitor whether individuals on leave are crossing national borders.

Specific provisions have been established for certain conditions: leave for influenza, acute respiratory infections, viral enteritis, and specific gynecological conditions may extend up to 15 days subject to laboratory analysis. Additionally, medical leave following a successful IVF procedure can last up to three months. Certain groups, such as hospitalized patients, the severely ill, those receiving treatment abroad, and companions of children under three, will be exempt from requirements to appear physically before a doctor or commission.

While the HIF has denied that new controls will amount to “house arrest,” the measures include unannounced home visits to verify prescribed rest. These reforms follow reports of individuals using sick leave to travel abroad, attend social events, or work secondary jobs, with previous audits showing irregularities in approximately 37 percent of cases.

## Claims

- Between 2021 and 2025, the number of patients increased by 6.7%. (corroborated by 3 sources)
- The number of open medical leaves increased by 33.4% between 2021 and 2025. (corroborated by 3 sources)
- Family doctors can issue medical leave without a specialist's confirmation for a maximum of 5 days. (corroborated by 3 sources)
- Medical leave for specific diagnoses like influenza or acute respiratory infections can last up to 15 days with laboratory analysis. (corroborated by 3 sources)
- Following a successful IVF procedure, medical leave can extend up to 3 months. (corroborated by 3 sources)
- Authorities are considering electronic data exchange with other institutions to monitor if individuals on medical leave cross borders. (corroborated by 3 sources)

## Timeline

### 2026-09-29: North Macedonia to implement new medical leave regulations

North Macedonia will implement new medical leave rules on December 1, limiting family doctors' ability to issue leave without specialist approval to five days.

5 sources. https://clstr.news/cluster/north-macedonia-to-implement-new-medical-leave-regulations

### 2026-09-23: North Macedonia to tighten controls on medical leave abuse

North Macedonia is tightening controls on medical leave to prevent fraud, including reducing physician-issued leave to five days and conducting home inspections to stop abuses in public and private sectors.

15 sources. https://clstr.news/cluster/pane-tokovski-calls-for-concrete-implementation-of-european-values

### 2026-09-14: Health Insurance Fund proposes stricter sick leave controls

North Macedonia's Health Insurance Fund proposes reducing the maximum sick leave days issued by primary doctors from seven to five to prevent abuse and strengthen financial controls.

5 sources. https://clstr.news/cluster/health-insurance-fund-proposes-stricter-sick-leave-controls

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Cite as: North Macedonia to implement new medical leave regulations. CLSTR, https://clstr.news/situations/north-macedonia-medical-leave-regulation-reforms