Slovakia has from now a new broader list of diseases. The amendment of the Act on health care entered into force that spread the present. The modification of the list was the needed for the introduction of a new way of rewarding hospitals – DRG system. The legal standard also regulates the medical terminology according to current standards and practices. The amendment was pushed by Richard Raši of Smer-SD. He pointed out that in Slovakia was no revision of the International Classification of Diseases and Related Health Problems (ICD-10) since 1993. Since 2011 ran the preparation of revision of current version and expansion of new diagnoses or groups of diagnoses. Preparation of introducing a new way of rewarding hospitals is not under the original plan, the introduction is expected in 2016.
By next year, the health sector should get over 1.3 billion euros from the state budget. As is clear from the state budget, most of this amount, nearly 1.21 billion euros should be payments for state-insured. According to the current draft, state plans to pay less for its policyholders next year. The rate should be at a basic level guaranteed by law – four per cent of the tax base. The proposal does not like the Health Insurance Association, Association of hospitals of Slovakia, Slovak Medical Chamber, Slovak Chamber of Nurses and Midwives and Medical Trade Union.
Health insurance companies submitted for the first half of this year nearly 140-thousand proposals to conduct enforcement on premium payers. At the end of June, they managed to recover 64.8 million euros together. The General Health Insurance Company (VšZP) registered at the end of June this year 314.675 defaulters who unpaid the premiums of over two hundred million euros. Compared to the same period last year, the number of defaulters fell by 13 per cent. In the health insurance Dôvera is the list of debtors for the first half of 2013 nearly 60-thousand clients. Unpaid premiums reached 15.3 million.
The biggest public health facilities also face executions of nearly 600 thousand euros.
Health care facilities owed the end of July the insurance Social Insurance over 70 million. Since last year their assets increased by € 21.3 million. Claims on state medical facilities have reached the end of July € 43.02 mil. Per month assets increased by more than 4.4 million euros.
The European Commission has ordered Slovakia to verify the payment of over 2.8 million, which were intended for healthcare. Failure to do so will lose money. The reason is probably misconducts in public procurement. The April audit on Operational Programme Health was focused just on the competition. The Ministry of Health will now have to refute the doubts of Brussels within six months. The resort of Zuzana Zvolenska did not specify what errors Brussels revealed. Healthcare is not the only area that faces the negative decision of Brussels. At the beginning of the year were also suspended funding of projects under the Operational Programme Transport. The reason should be the fundamental error of the Ministry of Transport under the leadership of Jan Figel.
The Ministry of Health has been delayed three quarters of the year with the adoption of legislation, which is a condition to implement the new payment mechanism for hospitals, the so-called DRG (Diagnoses Related Groups) system. Originally, the ministry should have approved a decree which provides a list of medical procedures necessary for the further progress of the project in October last year. The term could not be observed, because the list of performances has not been finished. In February, the Healthcare Surveillance Authority, which covers the process of introducing DRG, announced that the list is ready. However, the Ministry has not approved the decree till today. According to Authority, the decree is prepared and its estimated force was established on October this year.
Medical facilities owed to Social Insurance Company at the end of April 2013 on unpaid premium over € 61.5 million. Since the end of last year is it an increase of more than 12.8 million euros. Receivables of state medical facilities have reached the end of April more than € 35.9 mil.; i.e. 58.4 per cent of the total receivables. Compared with the previous month it increased by 4.5 million. Despite the fact, their debts were paid by State at the end of 2011. Transformed health care facilities owed to Social Insurance Company more than € 25.5 million. Compared with the previous month, debts increased by 1.4 million. Spokeswoman of Ministry said that the Ministry of Health monitors the development of the debt in Social Insurance Company.
Association of Hospital in Slovakia (AHS) has recommended to hospitals which associate to not sign the contracts with health insurance company Union. Association attitude will change only if the smallest private health insurance company Union raises payments to hospitals for five to ten per cent. This condition is based on the attitude of the state General Health Insurance Company (Všeobecná zdravotná poisťovňa – VšZP), which stated that if the amount of the payments by competitor will not be the same, the company will withdraw contracts with hospitals. Lower payments to hospitals currently give only health insurance company Union. General Health Insurance Company (GHIC) submits a proposal for new terms and conditions to AHS. In it is included the condition that if hospital will have a contract with an insurance company competitive with lower prices for finished hospitalization than is paid by General Health Insurance Company, GHIC will pays only the price of competition.
By June 1, 2013 is it 10 years after the introduction of "20 and 50 crown" fees in health care, so-called „zajacovky“. Anniversary commemorated at a press conference former members of the reform team of Minister Rudolf Zajac, who now operate in Health Policy Institute (HPI). According to Director of HPI Peter Pažitný, the main reasons for introducing of fees a decade ago were: to limit excessive demand for health care, to increase patient co-responsibility for own health, to reduce corruption. Although the objectives of the introduction of fees were fulfilled, unpopularity made them the subject of political struggle. After elections in 2006, the government runs down the most of the fees. If the fees were reintroduced at the same rate today, it could bring overall more than € 115 million per year into the health care sector. Nowadays, outpatient doctors who charges fees, do not use cash registers and how much they earn by fees no one knows.
Debt in health care (measured as overdue liabilities) reached at the end of last year € 213 million. Liabilities of state facilities amounted 141.7 million euros, representing an increase of 72.3 million. The largest part of the debt and generate teaching and university hospitals, with the exception of hospital in Nitra. Health care facilities transformed into joint stock companies, which do not show any overdue liabilities. According to estimation by Health Policy Institute (HPI), at the end of the year 2013 may debt exceed amount of 300 million. €. From previous experience, HPI consider this limit from the view of suppliers’ patience as critical. Therefore HPI assume that in 2014 will be needed another debt elimination of hospitals.
Hospitals, which will do more surgery, will get more money. For each patient after surgery in 18 selected surgical disciplines should get hundred euros extra. This is new philosophy of funding by General Health Insurance Company (VšZP) which should be valid from April this year. This new way of funding is relevant for all university, teaching and general hospitals. The aim of this measure is to decrease the waiting times. State General Health Insurance Company also wants to check the evidence for waiting lists in hospitals. If it finds that some patients are preferred or there is mess in evidence, hospital receives a fine. If hospital fails to dispose patient from evidence, at first notify the provider and after repeated warnings, the hospital may not gets paid for the surgery or gets paid only part of it.