The new National Framework Agreement, under which NHIF will pay for medical care, was signed today by the management of the National Health Insurance Fund and the Bulgarian Medical Association. The agreement will be in force until the end of 2028.
For 2026, an increase in funds for general practitioners and specialists by 4.4% compared to the previous year has been agreed. New prices and volumes of medical activities in primary, specialized and hospital care are also planned.
In primary outpatient medical care, prices are increasing by 4.38%, and in specialized outpatient care the average increase is 4.37%. For hospital medical care, the price increase will be up to 10% on average.
In November, it is planned that the providers of primary and specialized outpatient care will receive a one-time payment for all reported activities performed by them.
The Governor of the National Health Insurance Fund, Dr. Vladimir Daskalov, announced that the preparation of the contract began about a year ago, and in the last two months, negotiations with the Bulgarian Medical Association have been particularly intense. He defined the agreement reached as a balance between different interests and emphasized that patients' rights are protected.
By the end of September, the necessary documents and changes in the NHIF information system must be ready, which will allow the implementation of the new contract.
Among the agreed changes are new rules for the organization of medical care. The simultaneous performance of activities by a general practitioner and his deputy will not be allowed when the holder is on leave. The indications for hospitalization are also changing, expanding the list of diseases for which it can be performed.
The Chairman of the Bulgarian Medical Association, Dr. Nikolay Brunzalov, pointed out as positive solutions the elimination of the electronic prescription book and the creation of two new clinical pathways. According to him, the increased budget for 2026 provides the necessary relief to the system after a long period without an update of the prices of clinical pathways.
The medical union also insists on more precise valuation of the work of doctors and more active participation of doctors in the implementation of the framework agreement.
Health Minister Katya Ivkova emphasized that the negotiation adhered to the budget framework set by the NHIF Budget Act for 2026.
She also presented information on the screening programs for colon cancer and cervical cancer. According to her, the necessary tests have been purchased and have been available for more than a year, and up-to-date information on the places where citizens will be able to get tested is about to be published. The necessary equipment for conducting the screening tests has also been provided.