NAMS institutions entered the medical guarantees program without proper preparation. What consequences did the audit of the Accounting Chamber reveal?
On July 8, the Accounting Chamber adopted a Report on the materials of the compliance audit on the topic "How the institutions of the National Academy of Medical Sciences of Ukraine are prepared for the transition to the program of state guarantees of medical care for the population". Responsible for the audit is the Head of the Accounting Chamber, Olga Pishchanska.
The purpose of the audit is to assess the compliance of the process of integrating the NAMS institutions into the medical guarantees program with the requirements of current legislation.
As a result, the audit revealed numerous facts of managerial inaction: preparation for the transition was formal in nature and did not ensure the real readiness of the institutions. The Academy did not implement most of the recommendations provided to it on these issues by the relevant committee of the Verkhovna Rada, the Cabinet of Ministers and the Ministry of Health. The lack of timely decisions and organizational measures on the part of the Academy's management made it impossible to fully prepare the institutions for the new financing conditions.
As a result, 28 institutions of the Academy entered the medical guarantees program at the beginning of 2025 unprepared - that is, they did not meet the requirements of the National Health Service for concluding contracts, in accordance with medical packages. Without concluding relevant contracts and starting to provide services under them, institutions risked being left completely without funding from the NHSU.
In order to financially support them during the transition period, the Government has provided for a separate package of services for additional financial support in the 2025 medical guarantee program. These funds compensated for the difference between the required funding level in 2024 and the actual payments to institutions from the National Health Service for the medical services provided.
At the same time, in 2025, some institutions of the National Academy of Medical Sciences had difficulties in concluding contracts with the National Health Service for medical service packages. Two institutions did not submit proposals to the National Health Service at all, and in one the contract was terminated due to the inconsistency of the number of medical personnel with the requirements. Thus, in general, as of 01.06.2025, the total value of the concluded contracts amounted to only 36% of the level of funding in 2024.
«There are risks that in 2026 the volume of financial resources of the Academy institutions will be lower than in 2024. This will require a solution to the issue of reorganization of individual institutions and may have negative consequences for the quality, volume and accessibility of medical services for the population of Ukraine," emphasized the Head of the Accounting Chamber, Olga Pishchanska, in her report on the audit results.
One of the key problems was the lack of proper justifications from the Academy regarding the high-tech, unique and complex nature of the medical services provided by its institutions. Because of this, the NHSU had no reason to apply adjustment coefficients to tariffs, which directly affects the amount of funding for institutions. In addition, the NAMS did not provide any justification at all regarding the need to compensate for the costs of treating the so-called "thematic patients" — patients participating in scientific research.
There was also no proper transfer of medical information to the Electronic Health Care System (EHS),which made it impossible for institutions to enter full data on the services provided. Given that these data are the basis for calculations by the NHSU, this situation directly affected the amount of funding for institutions. The Academy formally assessed the medical information systems used by institutions for this purpose — without checking their ability to transmit data. Control over the registration of medical personnel in the Unified State Register of Medical Personnel has not been established.
At the same time, the Head of the Accounting Chamber noted the assistance and understanding of the audit results from the new leadership of the NAMS.
The Accounting Chamber provided the Cabinet of Ministers of Ukraine and the National Academy of Medical Sciences with a number of recommendations aimed at eliminating shortcomings.
- The Academy was recommended to ensure that subordinate institutions comply with the requirements of the National Health Service of Ukraine, as well as to organize the registration of all medical workers providing services in the Unified State Register of Medical Records and the mandatory entry of medical records in full by them. It was separately emphasized the need to prepare a justification for the costs of treating "thematic patients" and the high-tech, uniqueness and complexity of medical services provided by its institutions for reviewing tariffs and applying correction coefficients. It was also recommended to determine clear criteria for selecting "thematic patients".
- The Government was recommended to instruct the Ministry of Health and the National Health Service of Ukraine to provide appropriate methodological and advisory support to the institutions of the National Academy of Medical Sciences of Ukraine, in particular on issues of tariff regulation.
Minister of Health Viktor Lyashko, who took part in the discussion of the issue, agreed with the proposals provided by the Accounting Chamber, emphasizing that managerial and organizational decisions should be made in order to eliminate the shortcomings identified by the auditors. In turn, the President of the National Academy of Medical Sciences of Ukraine, Vasyl Lazoryshynets, reported that the current policy of the institution is aimed at cooperation with the Government, the Verkhovna Rada, the Ministry of Health and the National Health Service, and the received comments have already begun to be processed in order to eliminate them.
The report on the audit results will be sent to the Government and the Verkhovna Rada of Ukraine and will soon be published on the website of the Accounting Chamber.
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