Physician, how do you defend yourself against unfairly imposed penalties for determining the degree of reimbursement?

The issue of so-called "undue reimbursement" became notorious after the National Health Service began calling on doctors in various parts of Poland to reimburse them for some of their prescriptions for amino acid preparations for children. 

Doctors who fight a human disease at an early stage of development in a manner consistent with the art of medicine cannot be punished. Involving doctors in carrying out the therapeutic process of a child in the best possible way, so that the child can have a chance for proper development, while at the same time imposing administrative duties on medics, distracting the doctor from his priority task, is a kind of trap. The medic then becomes responsible for errors resulting from irregularities in the organization of the health care system in Poland," stressed the doctors gathered at the NIL meeting on whom the NFZ has imposed penalties. 

The medical association has repeatedly pointed out in its appeals that a doctor cannot be held responsible for the consequences of faulty regulations and cannot be punished for them. So far, NIL's efforts to abolish this administrative obligation have led to the organization of a debate in the Senate of the Republic of Poland and the establishment of a team at the Ministry of Health to develop automation of the reimbursement process. 

In order to defend wrongly penalized doctors, an analysis of legal actions that individual doctors can take to challenge the NFZ's imposition of penalties for prescribing a reimbursable product outside of the reimbursement indications was prepared on behalf of the NIL. 

The NIL's legal office also has model pleadings - one of which applies to the situation before the NFZ brings proceedings; the other will find its application in proceedings already underway. 

Source: NIL