We will pay hospitals 100% of non-performance and only 50% of overperformance

The majority of providers (373) operating under the primary hospital health care system reported for 2023 a higher number of billing units than the number of units underlying the lump sum for the period, which was related to covering the increased demand for health care services as a result of the "health debt" created during the covid-19 pandemic.

In the Ordinance of the Minister of Health of September 8, 2015 on general terms and conditions of contracts for the provision of health care services (Journal of Laws of 2023, item 1194, 2186 and 2645, and of 2024, item 339) ,the Ministry of Health proposes adding § 3ba, containing a solution analogous to the regulation contained in § 3b of the aforementioned Ordinance (applicable in 2023.), which will guarantee hospitals whose level of realization of services in 2023 was lower than assumed in the determination of the lump sum for that year, the payment of additional funds ensuring the maintenance of the current amount of the lump sum, and at the same time will oblige the beneficiaries of this instrument to settle the funds thus obtained by working them off, and in the case of failure to achieve the corresponding lump sum surplus in 2024, by repaying the amounts thus unaccounted for.

So the Ministry of Health is unfortunately again proposing to keep hospitals that do not perform the lump sum. It is also known that they will not be able to give back public funds. Unfortunately, neither the explanatory memorandum of the draft nor the draft's OSR indicates the costs of non-performance, or what the costs of overperformance are. This raises serious questions from the point of view of the principles of legislative technique.

Another question is how much money have hospitals given back for 2022 in terms of unperformed hospital lump sums?

Fortunately, in this draft there was a provision to pay for "overcharges in the hospital lump sum."

This is provided for by Article § 3d, which will enable the payment in 2024 of special supplements to the lump sum to health care providers who for the previous billing period (2023) showed so-called "overperformance" of this lump sum. The allowances will be paid in the amount of 50% of the overperformance earned, but with simultaneous consideration of the amounts of the allowances paid in 2023, in accordance with § 3b of the amended regulation; the basis for determining the amount of the allowance for a given provider will be the difference between the number of reporting units for 2023 and the sum of the number of these units forming the basis for determining the amount of the lump sum for 2023 and the number of units corresponding to the amounts earned in this period under the aforementioned provision.

It's just a pity that we are paying 50% of earned overdrafts while funding 100% of non-performance, and I still don't know what funding we are talking about in terms of non-performance and overdrafts. The Ministry also doesn't provide the scale of default and the scale of overexecution, and this is very important data.