Bulgarian authorities have launched a large-scale review of hospital treatment records after identifying thousands of casino visits made by individuals who were officially registered as hospitalised at the same time. The checks follow data shared by the National Revenue Agency, which raised concerns over discrepancies between medical records and verified physical presence in gambling venues.
The National Health Insurance Fund confirmed that it has begun inspections into cases involving incomplete or non-existent hospital stays. According to preliminary findings covering the first half of 2025, authorities recorded more than 22,000 visits to land-based gambling venues during periods when patients were logged as receiving inpatient medical treatment, the Bulgarian News Agency reported. These visits involved 3,890 insured individuals.
Data Cross-Checks Trigger Nationwide Inspections
The discrepancies were identified by comparing two centralized data sets: mandatory visitor registration records from licensed gambling venues and hospital admission timelines stored in the national health system. Current gambling regulations require every visitor to a land-based casino or gaming hall to present a valid identity document for each entry, with the data transmitted to NRA servers in real time.
Licensed operators must remain continuously connected to these systems and submit activity data on deposits and payouts linked to registered player accounts. This framework allowed authorities to confirm that individuals were physically present in casinos during timeframes that overlapped with recorded hospital stays.
Based on the information supplied, the Health Insurance Fund initiated formal inspections and stated it would take additional control measures within its legal authority. If violations are confirmed, the Fund said it would seek to recover payments made for non-existent hospitalizations or cases where clinical pathways and treatment protocols were not followed. Other relevant institutions may also be notified to ensure coordinated enforcement.
Officials Urge Caution As Investigations Continue
Despite the scale of the findings, officials have emphasized that conclusions about fraud remain premature. Momchil Mavrov, Deputy Governor of the National Health Insurance Fund, urged restraint while inspections are ongoing.
“Let’s not call them fraudulent hospitalisations yet, this is just one version which we’ve been working on with the NRA over the last six months,” Mavrov said.
He explained that the cross-checks provide strong evidence of physical presence but do not yet establish responsibility. “The data was given to us by the NRA. We calculate the duration of the hospitalisations, while our colleagues give us indisputable evidence of the persons’ physical presence in casinos at that time.
“It is undoubtedly proven that people who were supposed to be under a hospitalisation that has a specific start and end date were present in casino halls. This must be further investigated.
“The reason could be that patients voluntarily left a hospital’s premises, overcoming the control measures of the medical institutions.”
According to Mavrov, the hospital treatments linked to the identified cases accounted for payments of approximately BGN 7 million, with additional costs for medical devices and medicines still under calculation.
Scope Of Review And Financial Impact
The inspection covers nearly 90% of medical institutions contracted for hospital care, excluding only facilities with minimal patient admissions. Preliminary analysis shows a correlation between hospitalization volumes and the number of discrepancies identified, pointing to a pattern linked to patient behaviour rather than isolated cases.
Health officials noted that some flagged hospitalizations involve clinical pathways where patients would not realistically be able to leave the facility, including treatments associated with severe conditions or intensive care. Authorities stressed that the data serves as grounds for inspections rather than conclusions of wrongdoing.
The Health Insurance Fund said it will publish details of confirmed violations, sanctions, and recovered funds after the inspections conclude. Officials described the effort as part of a broader push to protect public resources through improved oversight enabled by centralized electronic systems.
