Settlement of medical leave

Emergency Ordinance (OUG) 74/2021 for the amendment and completion of the Government Emergency Ordinance no. 158/2005 on holidays and social health insurance benefits, for the amendment of article 299 paragraph (4) of Law no. 95/2006 on the reform in the field of health, as well as for establishing measures regarding the granting of medical leave was published in the Official Gazette (Part I) no. 645 of June 30, 2021.

Thus, the recently published normative act will increase the sanctions applied to employers who do not pay the indemnities due to the employees within the legal term, unjustifiably refuse to pay the indemnities, erroneously pay the indemnities, do not manage the number of days of medical leave for each insured and each disease. the disposition of the control bodies of the health insurance houses the justifying documents and the necessary evidence documents in order to verify the way of determining the indemnities borne from FNUASS (Single National Health Insurance Fund).

We specify that these increases of fines provided by OUG 74/2021 will be applied after August 1.

We mention that OUG 74 also aims at changes related to the obligations of employees related to medical leave. Thus, from August, sanctions will be introduced for those who work for more than one employer and who, during the same period, carry medical leave certificates only for one of them, still working for the other employer or employees. Those who do so will risk fines of up to 2,000 lei, from August 1.

Moreover, from next year, the refund requests accompanied by the supporting documents must be submitted within a maximum of 90 days from the date of receipt, otherwise, the amounts will be definitively rejected from payment and will no longer be settled from the FNUASS budget.

There is still an obligation for applications for reimbursement of allowances to be submitted within 90 days, but no penalties or sanctions are provided for non-compliance with this deadline. The same term is provided for remedying the causes that led to a rejection by the social insurance houses of the applications submitted by the employers.

Exceeding the 90 days will lead to the final rejection of applications. It is important to mention that the term is calculated starting with the 25th of the month following the one for which the health insurance indemnities (insured persons) are due.

The normative act stipulates that if the employers have not submitted a new refund request by August 1, 2021, accompanied by the documents proving the remedy of the problems that led to the initial rejection of the compensation refund requests, they will have time to do so until December 31. 2021.

The amounts registered in the refund requests that will be submitted after this date will be definitively rejected from the payment and will no longer be settled from the FNUASS budget.