Data Cross-Check Reveals Flaws
Authorities uncovered the irregularities through automated matching of two national databases: real-time casino entry logs, mandated by Bulgaria’s gambling laws, and hospital admission records. Licensed venues must scan government-issued IDs at every entry, with timestamps relayed to tax servers in real time. Operators also report financial activity tied to registered accounts, creating a trail.
This infrastructure enabled investigators to pinpoint over 22,000 instances where patients’ casino visits overlapped their hospitalization periods. NHIF has now increased scrutiny, vowing to recover illegally claimed funds and enforce compliance with treatment protocols. Cross-agency coordination is also underway, though officials stress findings are still inconclusive.
Officials Urge Caution Amid Probe
Bulgarian health authorities have cautioned against premature conclusions regarding potential fraud, despite identifying the overlap between casino visits and hospital stays. NHIF Deputy Governor Momchil Mavrov stressed that while biometric casino logs and hospitalization records show “indisputable evidence” of physical presence, responsibility remains unproven.
“The data was given to us by the NRA,” Mavrov clarified, explaining that the six-month collaboration pinpoints mismatches but not intent. He acknowledged scenarios where patients may have left hospitals undetected, evading institutions’ control.
The cases under review involve BNG7 million in treatment reimbursements, with ancillary medical costs still being quantified. Mavrov emphasized the need for thorough inspections before labeling stays as fraudulent, noting the probe could expose gaps in patient monitoring.
Uncovered Discrepancies
Bulgaria’s hospital audit now spans over 90% of contracted care providers, excluding only low-admission facilities. Preliminary findings reveal a direct relationship between higher patient volumes and discrepancy rates, suggesting systemic patterns rather than isolated incidents. Notably, flagged cases include treatments for severe conditions where leaving medical facilities would be implausible, such as intensive care stays.
Authorities reiterated that identified mismatches, while significant, require investigation rather than being labeled as confirmed violations. NHIF pledges transparency, vowing to disclose sanctions and recovered funds after audits.
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