Doctor will check doctor – hospital sick leave control reformed in Ukraine

As previously reported by the "Judicial and Legal Newspaper", the Cabinet of Ministers adopted Resolution No. 657, which introduced changes to the procedure for verifying the validity of sick leave certificates and medical conclusions on temporary disability (MCTD).

Thus, as explained by the Kyiv City Health Department, the changes were developed taking into account proposals from the medical community and updated legislation in the field of mandatory state social insurance. The main goal is to make the verifications clearer and unbiased.

Checks will be conducted by doctors

From now on, the assessment of the validity of medical conclusions will be carried out by authorized doctors, not officials of the Pension Fund. At the same time, the Pension Fund of Ukraine (PFU) will have the right to initiate a verification.

Thus, a doctor's decision will be evaluated by another practicing doctor with appropriate professional training, who must consider clinical features and specifics of medical practice.

The principle of extraterritoriality is introduced

An authorized doctor for verification will be selected automatically through the electronic health system. The principle of extraterritoriality will apply – the verification will be conducted by a specialist from a different region than the one where the medical conclusion was issued.

The government believes that this approach will help minimize conflicts of interest and ensure impartiality of verifications.

Verifications will be conducted using depersonalized data

After the implementation of the technical capability, verifications will be carried out using depersonalized data in the Electronic Health System (EHS).

Authorized doctors will have access only to the information necessary for conducting the verification, without access to patients' personal data.

Doctors will be informed about verification results

According to the changes, medical institutions will be obliged to inform the doctors who issued the sick leave certificate about the verification results.

Previously, only the institution's management received the corresponding report.

Possibility of administrative appeal provided

The resolution also clarifies the mechanism for pre-trial appeal of the Pension Fund's compensation claims.

Administrative appeal will be carried out in accordance with the Law of Ukraine "On Administrative Procedure".

Most doctors will have no new obligations

The government notes that the changes do not affect clinical practice and do not change the procedure for issuing medical conclusions on temporary disability.

Doctors, as before, must enter electronic medical records regarding patients' temporary disability into the EHS.

Who will be able to conduct verifications

The list of authorized doctors will be formed by the Pension Fund of Ukraine in agreement with the National Health Service of Ukraine (NHSU).

Only specialists who:

• work in a medical institution or as a private entrepreneur with a medical practice license;
• are registered in the EHS registries;
• have at least two years of medical practice experience;
• have completed specialized training on issuing MCTD and sick leave certificates and received the corresponding certificate.

Subscribe to our Telegram channel t.me/sudua and to Google News SUD.UA, as well as to our VIBER and WhatsApp pages on Facebook and Instagram to stay informed about the most important events.