CNAS: Contracts with public and private hospitals remain unchanged in the new draft

The President of the National Health Insurance House (CNAS), Horațiu Moldovan, has stated that the draft order currently under public consultation — concerning the reimbursement of medical services under national health programmes — does not alter in any way the existing contracts between CNAS and public or private hospitals. According to him, the document is intended solely to implement the provisions of the Health Law and to establish a common methodology for contracting new private providers in areas where the public network is unable to meet patients' needs.

The official explained that the draft had been misinterpreted in public discourse, giving rise to the unfounded concern that it would restrict patients' access to diagnosis and treatment, or that it would change the rules for units already under contract with the House.

"There is nothing new here. This order has indeed caused a great deal of anxiety in public discourse, because it was based on the mistaken notion that it would block patients' access to diagnosis and treatment in certain areas of healthcare, specifically within health programmes. There is nothing new. It is simply a matter of applying the law. Law 95 has stated very clearly, for many years, that national health programmes are carried out in public health units, and that private health units may enter into a contract with the Health Insurance House only where the capacity of the public system has been exceeded," said Horațiu Moldovan, at the Medika TV and Profit.ro Marathon "Who decides where the patient is treated?", as quoted by News.ro.

He noted that the new document introduces uniform evaluation criteria, so that all applications are assessed according to the same rules, regardless of county.

Existing contracts are unaffected

The CNAS President stressed that the measure has no effect on contracts currently in force, nor on the way in which national health programmes are funded.

"The money effectively follows the patient, and the patient, whether treated in a public or private facility, will receive the same reimbursement under the national health programmes. The budgetary impact of this measure is zero. It is about appropriate territorial organisation, through a unified methodology, by which we aim to ensure transparency and introduce objective criteria on the basis of which the exceeding of public system capacity is assessed," the official explained.

Moldovan emphasised that the current contractual relationships between CNAS and healthcare providers remain unchanged: "All contracts currently in place with public hospitals and private hospitals remain in force, and this technical regulation allows for an increase in the number of providers. We are talking about private providers, because public providers are included automatically, as provided for by law."

Patients retain their right to choose

The head of CNAS assured that patients will continue to be able to choose between treatment at a public or private hospital, in accordance with the legal provisions. The new methodology would identify, county by county, the areas where the public system is unable to meet demand for medical services, allowing private providers to participate in national health programmes wherever a shortfall exists.

"Private providers will have the opportunity, going forward, to have an accurate map of healthcare service needs across national programme areas. This will also assist them in making investment decisions regarding clinics and healthcare units, as they will be able to see precisely where shortfalls exist, through a transparent method rather than an arbitrary one," the CNAS President added.

The draft order, currently under public consultation, sets out the rules by which private providers may enter into a contract with CNAS to deliver national health programmes in situations where the capacity of the public system is insufficient.