Management of the Ministry of the Interior Public Health Insurance Fund: partial errors in individual funds, concerning for example public procurement and management of receivables
PRESS RELEASE ON AUDIT NO 23/12 – 17 June 2024
The Supreme Audit Office (SAO) focused on the management of the Ministry of the Interior Public Health Insurance Fund (MoI PHIF) with the funds collected on the basis of the law, especially with the money from the collected premiums for public health insurance, in the years 2020 to 2022. Specifically, the auditors focused on how the MoI PHIF used money from the Basic Fund, the Operating Fund and the Prevention Fund, for which the legislation stipulates what the insurance company can spend the money on. The audited funds included more than CZK 190 million in cash resources, nearly CZK 126 million worth of public contracts and CZK 24 billion in system-level receivables. Within the given sample, the SAO did not find that the insurance company spent funds uneconomically or ineffectively. However, the auditors found partial deficiencies in individual funds.
Under the Basic Fund, the insurance company pays for health services, medicines, medical devices, etc. Financially, this is the most important fund of the insurance company. In 2022, the insurance company drew more than CZK 53 billion from it. During the audit, for example, the SAO found, that the MoI PHIF had claims on defunct payers that amounted to CZK 2.7 million at the end of 2022. Furthermore, the insurance company had also failed to collect outstanding premiums and penalties totalling CZK 5.1 million from other payers.
In 2022, the MoI PHIF drew more than CZK 1.2 billion from the Operating Fund, which is used to finance the insurance company's operations. The shortcomings detected in this fund concerned, for example, public procurement. During the audit of a sample of 13 public contracts, the SAO found that in four cases the insurance company did not follow the correct procedure when awarding public contracts with a total value of CZK 10.4 million by competing them under the wrong regime. This violated the principles of transparency, equal treatment and non-discrimination.
The Prevention Fund is used, for example, to pay for preventive health services over and above those covered by the Basic Fund. The auditors found that the MoI PHIF did not act transparently when it allowed members of the association who did not meet the conditions for inclusion in the programme to draw contributions from the Prevention Fund. In the audited period, approximately CZK 2.5 million was involved.
Communication Department
Supreme Audit Office