Bulgarian hospital fraud going unchecked despite patient digital verification app
The app was launched to curb fake hospital admissions and financial abuse in the healthcare system.
As of the end of 2024, only 160,000 citizens had requested and obtained access to their e-health records via the 'eZdrave' smartphone app, and even fewer - just 80,000 (1.5%) - had actually used it.
Bulgaria has 5.7 million insured citizens (87% of the population), while the remaining 13% are only entitled to emergency care under national law due to non-payment of contributions.
In early 2024, the Ministry launched the free eZdrave app to provide citizens with access to their digital health records and those of their underage children. The app sends real-time notifications for all medical services received.
'By accessing their e-health records, citizens can help safeguard the system from abuse and public fund theft. If services appear in their file that were never provided, they can report it to the authorities,' the Health Ministry told Euractiv. Low oversight fuels hospital fraud
A ruling by the Constitutional Court in 2024 stripped the National Health Insurance Fund (NHIF) of some of its key tools for hospital spending control, leading to an unchecked rise in admissions. In just one year, hospitals reported 200,000 more admissions than planned, resulting in over €200 million in overspending.
In June 2025, the government announced it would begin sanctioning hospitals and doctors for claiming payments for medical services that were never performed. Still, the system relies on citizens to verify these services - a task they appear largely uninterested in.
Calls for legislative changes to improve oversight have gained little traction.
In May, an opposition MP from the liberal Democratic Bulgaria party proposed a bill requiring the NHIF to send citizens an SMS every time they are admitted to a hospital, enabling them to detect fraud if false admissions are made in their name. The governing majority, led by the centre-right GERB party, rejected the proposal.
'This is an effective prevention mechanism. If hospitals know that patients will be notified, they will stop misreporting. But we cannot verify how widespread the fraud is, as offenders use real ID data. If victims don't report it, it's impossible to uncover,' the bill's sponsors from the Democratic Bulgaria told Euractiv. Insufficient funding's part
Alexander Simidchiev, a member of the parliamentary health committee, added that chronic underfunding in Bulgaria's healthcare system incentivises hospitals to simulate excessive hospitalisations to balance their books.
During parliamentary debate, GERB MP Lachezar Ivanov countered that citizens already have access to all their health data via the eZdrave app and warned that SMS notifications for all admissions would impose a significant financial burden on the NHIF. The opposition, however, estimated the cost of such a system at no more than €500,000.
Euractiv's reporting suggests that the app's limited reach means digital access alone cannot ensure effective citizen oversight in a healthcare system plagued for years by misuse and corruption. In 2025, Bulgaria's parliament approved a record healthcare budget exceeding €4.6 billion, almost half of which is allocated to hospitals.
[Edited by Vasiliki Angouridi, Brian Maguire]
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