Frauds within the medical system cannot be completely eliminated, but they can be significantly reduced through digitization, checks, and sanctions for those who break the rules. Most often, these refer to the unjustified reporting of services, unnecessary hospitalizations or other practices through which public funds are improperly used. The subject was discussed during parliamentary hearings on the execution of compulsory medical assistance funds for the year 2025, reports IPN.

Asked about fraud in the medical system and the measures taken to combat it, the director of CNAM, Ion Dodon, stated that such cases will continue to exist, but institutions must minimize the waste of public money. “There are frauds and, excuse me, there will be. We must fight to significantly reduce the level of these frauds as much as possible”, Ion Dodon affirmed.

According to him, one of the main tools is the digitalization of the medical system, which allows authorities to almost real-time track reported medical services and more easily detect any irregularities. The CNAM director specified that the institution also checks the quality of the medical act, penalizes providers when deviations are found, and alerts law enforcement agencies if there are indications of fraud.

The head of CNAM has also provided examples of irregularities detected in the system. According to him, there have been cases where patients were kept hospitalized longer than necessary or situations where a doctor prescribed medical services for himself. He pointed out that such cases are isolated, but they demonstrate the need for constant monitoring.

Another topic addressed during the hearings concerned complaints that patients are forced, in some hospitals, to buy out of their own pocket consumables such as cotton, syringes or other medical materials that should be provided by health institutions. The director of CNAM described such situations as unacceptable and said that all medical institutions must ensure essential consumables. He urged patients who are asked to procure such materials, to keep the receipts and file a petition with CNAM, and the institution will force the hospitals, in confirmed cases, to reimburse the expenses incurred. According to Ion Dodon, in recent years several hundred thousand lei have been returned to patients as a result of such reports.

At the same time, during the hearings, the CNAM management presented the results recorded in 2025. Over 17 billion lei were spent from the compulsory health insurance funds, almost 10% more than in the previous year, and additional funding allowed the expansion of access to medical services. According to Ion Dodon, the waiting lists for cataract surgery and prosthetics of the locomotor apparatus were reduced by increasing the volume of contracted services, and the implementation of the e-Prescription system and other digital tools contribute both to simplifying patient access to treatment and reducing fraud in the system.

The members of the Parliamentary Committee for Social Protection, Health and Family appreciated the financial results presented by CNAM. During the hearings, they insisted on the need to orient the medical system towards measurable results, with an emphasis on prevention, primary medicine, and the evaluation of the impact of investments on the population’s health.