Audit sent at the NHIH in Bucharest

The Court of Auditors started an audit at the National Health Insurance House in Bucharest, as per the request of the president of the pertinent state institution, who discovered significant differences between the numbers of health insurance beneficiaries in the NHIN data base and the number of those who claimed for the refund of prescription charges.

The Court of Auditors sent one of its teams to examine the National Health Insurance House.

NHIH president Lucian Duță said that there were three million insurance beneficiaries prior to enforcing the centralized version of the IT system and, at present, the number of registrations is reduced by half.

Lucian Duță is aimed at finding the main responsible for this significant difference and announces that audits will also be made all over the country.

The head of the NHIH assures that the enforcement of the centralized version of the IT system will establish the actual number of health insurance beneficiaries.

‘Till the first quarter of 2010, the centralized version of the IT system had not been used in Bucharest. I issued an ordinance by which the enforcement of this system became mandatory’.

The following months of 2010, there has been noticed a decreased number of patients and, as a result of implementing the SIUI, we noticed that the patients became two, even three times more numerous.

It is obvious that the system used prior to the SIUI allowed family doctors to double or the triple the number of their patients’, Lucian Duță stated.

Doctors put the blame on Health Insurance Houses

Family doctors question these accusations and claim that their activity implied the utilization of a computerized system prior to introducing the Integrated Unique Information System (SIUI).

President of the National Society of Family Medicine Rodica Tănăsescu also believes that responsibility is to be assumed by health insurance houses.

‘The moment I register a patient and enter his personal information into the system, although the patient is registered with other family doctors, the health insurance house has the responsibility of erasing that specific patient from other systems.

Technically speaking, I don’t see this being possible, therefore we do not have the answers. Health insurance companies must deal with these issues’, Rodica Tănăsescu stated.

The Court of Auditors issued no official statements and, therefore, the duration of the audit remains unknown.

The activity of the NHIH and of the territorial branches of the institution has become a highly debated subject.

The Ministry of Health considers the possibility of taking the institution under subordination.

Translated by: Mihaela Grigoraş
MA Student, MTTLC, Bucharest University