Fund paid over 138 thousand euros in Turkish hospital for the patient, who passed away and failed to carry out the marrow transplant.

The 10-year-old patient (known name for proofreading) diagnosed with Leuke Akate had applied for treatment in Turkey at the Medical Park Hospital under the Public Institution Training Programme at the end of 2019. The application was accepted by the Programme Executive Board on 13 August 2020 in the amount of 138,135 Euro, writes Schneta newspaper.

The paper has secured all documentation for the case from sources, though F The SSH has not allowed access to the documents for more than a month after the request.

In the Consiliar report released by three doctors and the former director of the Clinical Clinic at QKUK, it was said that the patient needs “urgent treatment abroad: Chemo therapy and radio therapy and bone marrow transplant” These services were included in the parent's procurement taken from the Turkish hospital.

The patient had stayed for about eight months at the Medical Park Hospital where she had passed away and failed to undergo intervention for bone marrow transplants. In the course of treatment, in addition to the amount approved by the program, the hospital had asked the parent for 19 thousand euros to provide a drug, money provided with family self - financing.

After a 10-year-old change in life and having failed to perform the transplant operation, the hospital Medical Park had issued a receipt worth 138,135 Euros.

The parents of the deceased had sent a letter to the Health Insurance Fund, which is led by Fatmir Plaqiqiqi, protocol on the date 11,06.2021, where he had announced that although the bone marrow donor was involved in hospital service, the latter had told him they could not provide him because of the situation with Codvis-19. Although this intervention was not possible, the parent had agreed to offer as a donor to his daughter.

In this letter he also announces F. The SSH that the girl has passed away and that she has paid 19 thousand euros in medicine insurance.

After that letter, the 10-year-old subject had again gone into review by the Board of Executive Programme, which was then headed by Petrit Brucie and had four other members. In spite of that, about two weeks after the letter received on 28.06.2021 Fund paid the sum under the bill issued by the Turkish hospital, worth 138,135 Euro, writes Schneta newspaper.

Three more chemotherapys were placed on the bill than were meant to justify the final price. And for that, during the review, the Program Executive Board had requested clarification from the Medical Park City Hospital on why the chemotherapys 5, 6 and 7 were put in place, which were not meant to be carried out in preemptive procurement. The hospital had reasoned that the patient's condition had deteriorated, and complications could not be predicted.

However, the Executive Board after reevaluating and reevaluating the course in 14,07.2021 makes a decision that amount of 138,135 Euro to be reduced to 49 thousand Euros. But the payment was already paid according to the approved amount in the EU's first decision.

For this abolishing the first decision and reducing the approved amount, The EU had announced the Fund on July 15th, which was said to have only approved services that were performed in line with the USKKUK's profat, bill and conservative opinion. This announcement also required that the subject be stopped for further procedures. But until this announcement was written, the money had already been transferred from Kosovo's budget to the Turkish hospital account.

Fund insists on arguing on first board executive decision

Despite the parent's announcement that the girl had passed away and that the deceased had failed to perform the bone marrow transplant, officials at the Health Insurance Fund carried out the payment according to the hospital bill whose price was justified with additional chemotherapy.

FSSH officials in an answer to the Shneta Journal have insisted on arguing for payment, with the first decision by the Board of Foreign Training Programme. They did not explain why the payment was paid, although two weeks earlier they had accepted the parent's announcement that the girl died and failed to perform the transplant.

The course wage was made when it was completed and approved by the Executive Board (BE) of Medical Treatment Out of Public Health Institutions ( TMJISEP, according to the UA criteria of 03/2017. As for the patient's letter to the patient's family, this letter involved the claim that, apart from the amount of 138,135.00 (many who had been approved by the EU of TMYISHP) it was not included in the amount of $19,000.00, which, according to the parties, have been forced to pay the patient's own family (paid by family for services not approved by the EU). We followed this letter to EU for TMJI The EPS, who were informed that this payment has been executed, despite not having been presented to us any testimony from the side regarding the payment made for services approved by the EU, have also not received on the basis of additional information they have requested from the hospital themselves, The EU has abolished the preliminary decision by making a new decision”, the FSF's response said.

Although they paid the bill and reasoned with the EU's first decision, the FSSH says they are considering the possibility of bringing back the amount of money they have paid.

“On one side we have payment with all evidence for the cost of TMYISHP's EU approved health service, 2. The party's claim to pay no evidence, 3. The annulment of the decision by the EU on TMISHP and the making of a new decision, we as the Fund have addressed this subject to the financial equalisation commission with the Private Health Institutions (ISHP) and is currently in the process of financial equality with this hospital. The moment this process closes following the definition of the correct sums, if we have lower costs than the payment, the hospital is ordered to return the vehicle”, it says.

But this does not turn out to be the only case that pays bills, though patients die in treatment. FSSH officials themselves claim this.

There are many payments, but the payments are made according to spending bills for the share they've received until the moment they've passed away, with preliminary approval from the EU of TMISHP”, said the FSSH response.

A request for the return of vehicles from the Medical Park Hospital had been issued by the Executive Board on August 11, 2021, to the Health Insurance Fund, but so far it has not happened.