Georgiev, Todorov & Co has successfully defended the interests of Multi-profile Hospital for Active Treatment Doverie against Bulgaria's National Health Insurance Fund in a dispute involving payment for medical care provided by the hospital to health-insured persons above the limits set by the NHIF.
According to Georgiev, Todorov & Co, “the Sofia City Court ordered the NHIF to pay MHAT Doverie the due remuneration for medical care provided on clinical paths over the monetary limit set in the agreement by the NHIF for 2017, along with the statutory interest until the final payment of the amount. The court’s decisive reasoning centers on the constitutional provisions according to which the formation and implementation of the health policy is an obligation of the state. According to the court, proper internal budget planning is an obligation of the defendant NHIF as a compulsory health insurance authority. A deviation from the planned uniform spending of the budget does not limit NHIF`s obligation to pay the providers of hospital care services for all actually performed and reported medical care to health-insured persons. The hospital owes provision of medical care to all health-insured persons, who have requested it. Therefore, the contract between the hospital and the NHIF cannot be interpreted that if the hospital performed medical activity above the set monthly limits, it should be at its own expense. The medical services provided above the limits set by the NHIF, which the hospital was obliged to carry out, are subject to payment.”
The Georgiev, Todorov & Co team was led by Lawyer Mariya Derelieva.