An opportunity was given to the Audit Chamber (AC) by the designed volume to implement the complete assessment of the maintenance of purposeful, expenditure efficiency and saving principle of the programme Medical Aid of Socially Insecure Persons and Separate Groups, and the reached certain proofs did not form sufficient basis to conclude that the measure expenditures were carried out by preservation of purposeful, expenditure efficiency and saving principles. At the joint sitting of the NA Standing Committees on Financial-Credit and on Health Care, the Head of the Seventh Department of the RA Audit Chamber Khachik Papazyan, presenting the current conclusion of the Audit Chamber on the results of audit implemented towards the medical aid of the socially insecure persons and separate groups in the Ministry of Health.
Khachik Papazyan noted that the main record refers to the restriction of the information necessary for the audit of the medical aid services of the socially insecure persons and separate groups, as a result of which, the Audit Chamber had a serious problem connected with providing information. Restricting the framework of information, they resulted in the impossibility of the assessment of the issues set for the performance audit. According to him, particularly information on the identification of the beneficiaries that made use of the services within the framework of the programme and the cases recorded in the electronic health ARMED system, as well as the passes provided to the citizens were not provided by the Ministry, as a result of which, it was not possible to compare the indices on the basis of financing of the beneficiaries and the services rendered to the latter and their reliability.
Though prices for medical aid and services with free and privileged conditions guaranteed by the state were set and applied by the order of the Minister of Health, but no information on any methodology set for their formation and accounting was not provided to the Audit Chamber, as a result of which it was not possible to assess the cost efficiency.
There were no clinic guidelines approved by the authorizing body for the majority of the more than 300 narrower specialized diseases involved in the individual conducting procedure of the cases, as well as, there was no appropriate number of specialists with narrow professional qualification in the staff. As a result, in case of absence of the majority of clinical guidelines and appropriate doctors with narrower professional qualification activities of individual conducting, assessment and accepting reports of the cases and payment for them were carried out.
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During the period including the audit the inner audit function was not done in the Ministry. As a result, the during the period including the audit the inner control system did not fully function in the Ministry.
In the deputies’ opinion, we shall understand the reasons of not providing or fully not providing information by the Ministry.
The Chair of the Standing Committee on Health Care Narek Zeynalyan, answering the question noted that part of not providing information by the Ministry implies medical secret, and it is distinctly set who can reach that information, and if the Ministry provides it then will violate the law. According to Narek Zeynalyan, there is legislative problem, a decision must be made if that information shall be provided to the Audit Chamber or not.
Presenting the bases of the external state audit function, the Chairman of the Audit Chamber Atom Janjughazyan touched upon the task put before the structure and what is expected. “In fact, the task that is put before the AC is to promote the improvement of the public property and the public finance management in the RA,” he noted. According to Atom Janjughazyan, that information also should be accessible, otherwise the situation will be continuously repeated, thus it is designed to solve that very problem by the package of the proposals put in circulation.
The co-rapporteur, the Deputy Minister of Health Armen Nazaryan, thanking the attendees for the detailed audit, noted that some voiced problems had already been included in the agen da items. Regarding the fact of not providing information the Deputy Minister documented that the legislative regulations do not allow providing personified data to the Audit Chamber. “The data contain medical secret, and can be passed only by the consent of the patient or his/her representative,” he noted.
The Chair of the NA Standing Committee on Financial-Credit and Budgetary Affairs Garegin Papoyan voiced about the fact of not having clinic guidelines approved by the authorizing body for the majority of the more than 300 narrower specialized diseases. The Deputy Minister Armen Nazaryan mentioned that every year dozens of guidelines are being worked out in big rates, but their volume does not meet the expectation and the threshold that they will overcome. He assured that as this year, in the coming years also, there will be guidelines on the main part of more frequently existing diseases.
National Assembly of the Republic of Armenia
