Bulgaria has recently launched a large-scale medical record review after discovering a surprising phenomenon in data cross-checking: thousands of casino visit records coincided exactly with patients' hospital stays. This nationwide inspection was triggered by data shared by the tax office, and preliminary results have already revealed potential loopholes in the health insurance system.
Data cross-checking reveals nearly four thousand "doppelgänger" patients
According to reports by the Bulgarian National News Agency, in just the first half of 2025, authorities recorded over 22,000 visits to physical casinos during periods when patients were supposed to be hospitalized. These visits involved 3,890 insured individuals. This discovery stemmed from a mandatory comparison of two central databases: the national medical system's hospitalization timeline and the real-time identity registration records of all licensed casinos. Currently, Bulgarian regulations require casinos to register each visitor by their real names, providing a precise basis for tracking individual physical movements.
Seven million Bulgarian levs of health insurance payments at risk of recovery, officials call for cautious qualification
Although the data comparison provides strong physical presence evidence, Momchil Mavrov, the deputy director of the Bulgarian National Health Insurance Fund, emphasized that it is premature to categorize these as "fraudulent hospitalizations." He suggested that the patients might have left the hospitals on their own, breaking through the medical institutions' control. However, the related hospital treatment costs have already reached about 7 million Bulgarian levs (approximately 28 million Chinese yuan), with additional costs for medical equipment and drugs still being calculated. The health insurance fund has initiated a formal inspection and stated that it will take additional control measures within the legal authorization scope. Once the violations are confirmed, the payments made for these false hospitalizations will be recovered.
The review covers 90% of medical institutions, pointing to a systemic behavioral pattern
This review covers almost all medical institutions contracted for hospital services, excluding only those with very few patient admissions. Preliminary analysis shows a correlation between the volume of hospitalizations and the number of data anomalies, suggesting this might be a behavioral pattern rather than isolated incidents. Health officials specifically noted that some of the marked hospital cases involved intensive or critical care treatments, theoretically making it impossible for patients to leave the facilities. This necessitates a more in-depth investigation. For more information on global regulatory dynamics and compliance cases, industry professionals often refer to the professional analysis on the PASA official website.
Regulation shifts towards technology-driven, transparency becomes the future direction
This incident highlights the great potential of central electronic data systems in enhancing the efficiency of public resource supervision. The Bulgarian Health Insurance Fund stated that after the review is completed, it will publish detailed information about confirmed violations, disciplinary measures, and recovered funds. This marks a shift in its regulatory approach towards a more technology-reliant and transparent mode, aiming to protect public interests more effectively through modernized oversight means.
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