Portugal's Health System Faces Challenges Over Billing Foreign Patients

Health Billing Responsibility in Portugal

Susana Cavaca, the president of the Shared Services of the Ministry of Health (SPMS), emphasized that the billing for services provided by the National Health Service (SNS) to non-resident foreigners lies with local health units (ULS). This statement was made during a session in the Assembly of the Republic, addressing inquiries from Chega and PS regarding the treatment of foreign citizens.

System Capabilities

Cavaca noted that the SNS's information systems are capable of handling billing, but the responsibility falls on the ULS, which must manage the reception of patients, regardless of their nationality. She clarified, "It is not due to a lack of system that billing does or does not occur."

Data Management and Analysis

She explained that while the SPMS manages and maintains information systems, they do not possess all the necessary data. The data is available to the Central Administration of the Health System (ACSS) and the Executive Directorate of SNS. Cavaca assured that the systems are outdated yet allow for data cross-referencing, such as with Social Security or Tax Authorities.

Billing Challenges for Non-Residents

António Gandra d'Almeida, the SNS executive director, mentioned that billing for foreign patients is managed by ACSS, and the SNS does not interfere in this process. He remarked on the complexity of identifying situations where non-residents use the SNS and the potential involvement of organized networks, stating that this is not within the Ministry of Health's investigative scope.

Legislative Actions

A recent report by the General Inspectorate of Health Activities (IGAS) revealed that 102,182 non-resident foreigners received emergency care from SNS hospitals in 2023. In response to concerns about abusive usage of the SNS by non-residents, the PSD and CDS-PP have proposed a bill aimed at amending the Basic Health Law. The PS has indicated opposition to this bill, although Chega may support it.