NFZ Overhauls Specialist Clinic Financing with New Regulation Signed by President
The President of the National Health Fund has signed a new regulation ending quarterly over-limit settlements for specialist clinics in Poland, introducing retroactive application from July 1, 2026....
The President of the National Health Fund has signed a new regulation ending quarterly over-limit settlements for specialist clinics in Poland, introducing retroactive application from July 1, 2026.
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End of Previous Rules in Specialist Clinics
The President of the National Health Fund has officially signed a new regulation that changes the existing rules for financing medical care in Poland. Over-limit services in specialist clinics will no longer be settled quarterly. Although the regulations enter into force overnight, the new rules will apply retroactively from July 1, 2026, though key exceptions have been introduced for some services.
End of Quarterly Over-Limit Settlements
Published on Wednesday on the National Health Fund website, the order by the NFZ President introduces significant modifications to the financing system for outpatient specialist care. According to the new guidelines, over-limit services in specialist clinics will no longer be settled quarterly, but only after the end of the full settlement period.
Although the document formally enters into force on the day following its signing—July 23—the financing rules specified in the regulation will apply to services provided starting from July 1, 2026.
Modifications After Consultations Involving Over 80 Entities
The draft changes aroused immense emotions in the medical community. During public consultations, opinions from over 80 medical entities were submitted to the Fund, pointing to potential risks related to financial liquidity, work organization, and the daily functioning of facilities.
The NFZ partially addressed these objections, adding procedures and outpatient care from emergency indications to the catalog of services settled on preferential terms after the quarter in which the excess occurred.
7 Key Exceptions Where Payments Remain Unchanged
The new regulations cover a wide range of ambulatory specialist care, but the NFZ decided to exclude the group of most vulnerable patients and procedures. Quarterly settlement of over-limits will continue to apply in seven areas.
Goal of Changes: Long-Term Financial Stability
As emphasized in the official justification for the ordinance, the amendment aims to ensure the long-term financial stability of the Polish healthcare system. Shifting settlements to the end of the period is intended to translate into greater efficiency in managing public funds allocated for health services.