WITH DEFICIENCES OF VIEW
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The Court of Accounts of the Republic of Moldova (CoARM) presented on June 7, within the Public Finances Control Committee and the Social Protection, Health and Family Committee, the results of the Financial Audit Report of the Government Report on the execution of the state social insurance budget (SSIB) in 2022 and the Financial Audit Report of the Government Report on the execution of the mandatory medical assistance insurance funds (FAOAM) in 2022.
Sergiu Știrbu, Member of the CoARM, and the audit team reported on the most relevant findings of the audit that were the basis for formulating the general conclusions, as well as the submitted recommendations.
Through the public social insurance system, the state guarantees citizens the right to social protection in order to ensure the risks that occur during life (old age, unemployment, illness, disability), through social payments such as pensions, allowances and other social insurance benefits, which are a source of livelihood for the beneficiaries of this system.
The revenues from contributions and transfers from the state budget, which totaled more than 33 billion lei, were audited. Thus, state social insurance contributions, which hold the maximum share of total revenues, totaled 18.3 billion lei, which is 54.2%. They also increased by 2.1 billion lei compared to the previous year.
With reference to general purpose transfers, the audit found that they have increased four times in the last five years, from 1.1 billion in 2018 to 4.4 billion lei in 2022.
In this context, the Court of Accounts mentioned that the evolution of general purpose transfers, as well as the obligations towards the beneficiaries, can affect the sustainability of this budget and increase the burden on the state budget.
In order to cover the temporary cash gap and to honor the obligations towards the beneficiaries, in the year 2022, after using the amount planned to cover the deficit, the National House had to take out 2 loans from the state budget, in the total amount of 690 million lei, which were repaid by the end of the management year.
Another audit finding related to the process of awarding, checking and paying social and cold season benefits, which is fragmented and leads to inconsistency of data at all stages and levels. This directly influences the SSIB indicators and generates the non-refund of amounts paid improperly. Thus, for the period of 2017-2022, improperly paid payments were found in the amount of 11.7 million lei and a low index of restitution at the level of 53.4% of these amounts, thus determining unjustified expenses of over 5, 4 million lei.
During the meeting, reference was also made to the pensions for the age limit, disability, successor and anticipated, these being established according to the legal framework. At the same time, the delayed receipt of information regarding the death of the beneficiaries caused unjustified expenses in the amount of 1.2 million lei. This was caused by the systemic process of exchanging beneficiary death data and entering death information with a delay of up to 1 year.
Finally, the Court of Accounts mentioned that 21 audit recommendations were submitted, some of them being reiterated as a result of non-implementation or partial implementation.
With reference to the Financial Audit Report of the Government Report on the execution of the MMAIF in 2022, the CoARM’s team presented the most significant findings, which were the basis for formulating the audit opinion.
In the opinion of the Court of Accounts, the Government Report on the execution of the MMAIF in 2022 provides, under all significant aspects, a correct and faithful picture, with the exception of the possible effects of some aspects exposed on the basis of the audit opinion, being issued the qualified opinion.
Concerning the expenses reported in the subprogram "Hospital medical care" in the amount of 3 billion 254 million lei, the audit was unable to evaluate them. This situation was caused by the fact that the hospital medical services reported by the medical institutions cannot be delimited in those paid by NMIC versus those performed by the medical institutions, but not paid by the Company. It was found that 52 medical institutions over-contracted in 16,364 treated cases, in the amount of 152 million lei that were not paid. The NMIC as well as medical institutions do not have monitoring measures and exact delimitation of the amount of hospital services reported and paid.
The processes for the provision of medical services in 2022 continued to attest to deficiencies, which are expressed through:
- non-regular preparation of the Urgent List of patients requiring surgical interventions. Thus, 1515 people were sent urgently to receive surgical interventions, which does not provide comprehensive information with reference to the assessment of all persons on the general waiting list who require emergency medical interventions;
- in the case of 171 people from the waiting lists, it was indicated that they performed the intervention against payment. The exposed situation reveals that the waiting time to benefit from surgical interventions is long, which led people to go to medical institutions on their own and pay the cost of the services, which amounted to about 1 million lei;
- 730 people had surgery before being placed on the waiting list;
- 1269 people benefited from the intervention, although the audit did not have information regarding the fact that NMIC sent the list of these people to medical institutions for the intervention.
Regarding the medical prophylaxis services required to be provided within the dental medical assistance, it was found that the medical institutions in the audit area, which were contracted by NMIC, they did not ensure the mandatory annual dental medical examinations of all children in kindergartens, general and professional secondary education institutions. The district and municipal dental centers were contracted in the amount of 28 million lei for the provision of dental medical assistance, which also covers the annual prophylactic examinations. As a result of the evaluations, it was found that the institutions did not provide annual preventive dental services for 80,900 children, although the medical institutions were paid for this.
The Court of Accounts concluded that NMIC should strengthen internal controls, as well as undertake the necessary measures to ensure the use of the MMAIF funds according to the needs of the insured persons.
