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National Framework Contract for Medical Activities 2023-2025. https://www.nhif.bg/bg/nrd/2023-2025/medical", "country_ids": [ "BGR" ], "coverage_domains": [ "autonomy", "decision_rights", "governance", "market_structure", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "Националния рамков договор", "institution": "National Health Insurance Fund and Bulgarian Medical Union", "locator": { "locator_type": "web_sections", "source_word_anchor": "Националния рамков договор", "source_word_count": 3 }, "material_id": "material:b3e53c04a2e1e86d2c34d1c6", "notes": [ "Keep this expired contract period separate from later contracting arrangements." ], "origin": "country-evidence-improvement-sources", "period": "2023-2025 contract period, amended 13 June 2025", "publication_date": null, "publication_year": 2025, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "90ff4e04c48d30e38f88d290fa296792e63de608ba9deaadbd8cf6aef733e78e" }, "statement": "NHIF states that the national framework contract sets the health-economic, financial, medical, organizational, information and legal-deontological framework for contracts with medical-care providers. This supports contractual governance, not proof of observed referral completion or service use.", "tags": [], "territory": "Bulgaria, NHIF contracting framework", "title": "National Framework Contract for Medical Activities 2023-2025", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.nhif.bg/bg/nrd/2023-2025/medical" }, { "kind": "resolved_document", "source": "single-country score-improvement acquisition", "url": "https://www.nhif.bg/upload/28002/%D0%94%D0%9E%D0%93%D0%9E%D0%92%D0%9E%D0%A0%20%E2%84%96%20%D0%A0%D0%94-%D0%9D%D0%A1-01-2-3%20%D0%BE%D1%82%2022%20%D0%BC%D0%B0%D0%B9%202025%20%D0%B3.%20%D0%B7%D0%B0%20%D0%B8%D0%B7%D0%BC%D0%B5%D0%BD%D0%B5%D0%BD%D0%B8%D0%B5%20%D0%B8%20%D0%B4%D0%BE%D0%BF%D1%8A%D0%BB%D0%BD%D0%B5%D0%BD%D0%B8%D0%B5%20%D0%BD%D0%B0%20%D0%9D%D0%A0%D0%94.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health of the Republic of Bulgaria. National Health Information System. https://his.bg/en", "country_ids": [ "BGR" ], "coverage_domains": [ "facility_data", "networks", "referral_design", "reform_history" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "National Health Information System", "institution": "Ministry of Health of the Republic of Bulgaria", "locator": { "locator_type": "web_section", "section": "National Health Information System", "source_word_anchor": "National Health Information System", "source_word_count": 4 }, "material_id": "material:af8aa5faae5b11b113bd2a06", "notes": [ "Keep a technical platform separate from observed clinical coordination or digital inclusion." ], "origin": "country-evidence-improvement-sources", "period": "Official portal checked 2026-08-15", "publication_date": null, "publication_year": 2026, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "655c3f21031baba9d12251bcd88ab2e374ad6903d8e1359b0a8154225498b84a" }, "statement": "The Ministry's National Health Information System portal documents the national digital-health platform. Its existence supports an information-network mapping, but the portal alone does not prove complete interoperability, referral completion or patient adoption.", "tags": [], "territory": "Bulgaria, National Health Information System participants", "title": "National Health Information System", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://his.bg/en" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health of the Republic of Bulgaria. National Health Strategy 2030. 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It supports a time-bounded policy commitment, not a finding that the planned organizational changes have been completed.", "tags": [], "territory": "Bulgaria, national policy framework", "title": "National Health Strategy 2030", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://old.mh.government.bg/bg/politiki/strategii-i-kontseptsii/strategii/nacionalna-zdravna-strategiya-2030/" }, { "kind": "resolved_document", "source": "single-country score-improvement acquisition", "url": "https://old.mh.government.bg/media/filer_public/2024/05/10/rns_-_nzs_2030.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Organisation for Economic Co-operation and Development. Overview of Bulgaria's Health System. OECD Reviews of Health Systems: Bulgaria 2026. https://www.oecd.org/en/publications/oecd-reviews-of-health-systems-bulgaria-2026_aeb810ee-en/full-report/overview-of-bulgaria-s-health-system_4bd8bbf2.html", "country_ids": [ "BGR" ], "coverage_domains": [ "actors", "authoritative_review", "autonomy", "decision_rights", "facility_data", "governance", "hospital_organization", "market_structure", "networks", "ownership", "primary_care" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "reported", "excerpt": "Healthcare providers are autonomous and self-governing", "institution": "Organisation for Economic Co-operation and Development", "locator": { "locator_type": "web_lines", "section": "Overview of Bulgaria's health system", "source_word_anchor": "Healthcare providers are autonomous and self-governing", "source_word_count": 6 }, "material_id": "material:a08517814a98e7cb6045a03c", "notes": [ "Keep provider autonomy distinct from NHIF price and volume negotiation, and do not generalize ownership categories to every facility." ], "origin": "country-evidence-improvement-sources", "period": "OECD review published 2026; institutional description current to its evidence cut-off", "publication_date": null, "publication_year": 2026, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "review_literature" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "5911f7ac662c9267ed318f1f1afa5fb00c8fb8747dc69f30a13f7b9085b344e2" }, "statement": "The OECD review describes NHIF as Bulgaria's single purchaser of statutory insurance activities, providers as autonomous and self-governing, predominantly private ambulatory delivery, state-only emergency and specified hospital services, and split state-municipal responsibility for district hospitals.", "tags": [], "territory": "Bulgaria, national system review", "title": "Overview of Bulgaria's Health System", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.oecd.org/en/publications/oecd-reviews-of-health-systems-bulgaria-2026_aeb810ee-en/full-report/overview-of-bulgaria-s-health-system_4bd8bbf2.html" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "National Health Insurance Fund. Patient Rights and Obligations. https://www.nhif.bg/bg/people/rights", "country_ids": [ "BGR" ], "coverage_domains": [ "decision_rights", "governance", "referral_design" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "задължителен за НЗОК, РЗОК и за изпълнителите", "institution": "National Health Insurance Fund", "locator": { "locator_type": "web_section", "section": "Национален рамков договор", "source_word_anchor": "задължителен за НЗОК, РЗОК и за изпълнителите", "source_word_count": 7 }, "material_id": "material:f2d0488bd64d412f90a7ed73", "notes": [ "The page does not establish identical terms for all individual provider contracts." ], "origin": "country-evidence-improvement-sources", "period": "Official patient-information page checked 2026-08-15", "publication_date": null, "publication_year": 2026, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "fff3672bc3ebd162aafa3d0b18092a6d1c040dca09c4eca336b2274e5a0754b7" }, "statement": "NHIF's patient-information page states that the national framework contract is binding on NHIF, regional health insurance funds and providers. The page describes a formal contracting framework, not a complete patient route through primary, specialist and hospital care.", "tags": [], "territory": "Bulgaria, NHIF, regional health insurance funds and contracted providers", "title": "Patient Rights and Obligations", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://www.nhif.bg/bg/people/rights" }, { "kind": "resolved_document", "source": "single-country score-improvement acquisition", "url": "https://www.nhif.bg/upload/14733/%D0%A5%D0%B0%D1%80%D1%82%D0%B0%20%D0%BD%D0%B0%20%D0%BA%D0%BB%D0%B8%D0%B5%D0%BD%D1%82%D0%B0%20%D0%9D%D0%97%D0%9E%D0%9A.pdf" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health of the Republic of Bulgaria. 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This administrative description does not establish a municipal provider-management function.", "tags": [], "territory": "Bulgarian districts covered by Regional Health Inspectorates", "title": "Regional Health Inspectorates", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://old.mh.government.bg/en/ministry/secondary-authorizing-officers/regional-health-inspectorates/" } ] }, { "analytical_mapping": {}, "annotation_status": "open", "authors": [], "availability": {}, "citation": "Ministry of Health of the Republic of Bulgaria. Rules of Organization of the Regional Health Inspectorates. State Gazette No. 6, 18 January 2011. https://dv.parliament.bg/DVWeb/showMaterialDV.jsp?idMat=43059", "country_ids": [ "BGR" ], "coverage_domains": [ "actors", "decision_rights", "facility_data", "governance", "government_responsibilities" ], "display_status": "shown_in_full", "document_type": null, "evidence_mode": "formal", "excerpt": "осъществява държавната здравна политика", "institution": "State Gazette of the Republic of Bulgaria", "locator": { "locator_type": "legislation_sections", "source_word_anchor": "осъществява държавната здравна политика", "source_word_count": 4 }, "material_id": "material:891386d80ae2c121099866d0", "notes": [ "Do not extend the Inspectorates' public-health and registration powers into ownership or routine management of providers." ], "origin": "country-evidence-improvement-sources", "period": "Regulation published 2011; current applicability requires legal-status confirmation", "publication_date": null, "publication_year": 2011, "record_kind": "country_improvement_source_lead", "record_kind_label": "Country Improvement Source Lead", "screening": { "previous_boundary_detected": false, "previous_visibility": "previously_not_projected" }, "source_layers": [ "official" ], "source_system": null, "source_version": { "detected_media_type": "text/html", "response_sha256": "e262ed3e114015db4643973c4cb86821209894320f229e0f64df07a2b1694286" }, "statement": "The regulation establishes the Regional Health Inspectorate as a budget-funded legal entity under the Minister of Health. It assigns district public-health policy, health control, provider registration and health-information functions, with directors appointed through a ministerial process.", "tags": [], "territory": "The corresponding Bulgarian administrative district for each Regional Health Inspectorate", "title": "Rules of Organization of the Regional Health Inspectorates", "urls": [ { "kind": "url", "source": "not supplied", "url": "https://dv.parliament.bg/DVWeb/showMaterialDV.jsp?idMat=43059" } ] }, { "annotation_status": "open", "authors": [], "availability": {}, "citation": "World Bank Documents and Reports. Bulgaria - Deposit Insurance Contingency Financing Project. 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Bulgaria - Deposit Insurance Strengthening Project. 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