A police operation currently underway across several locations in Skopje, Tetovo, and Kumanovo concerns suspected financial misconduct regarding the billing of medical services at a private healthcare facility.
According to reports, the investigation centers on allegations that certain medical services were billed twice, once to the Health Insurance Fund (HIF) and again to the patients themselves, at private rates.
The suspicions relate to instances where the Fund had already covered the costs for specific packages of medical services, yet patients, in addition to the legally mandated co-payment, allegedly paid further amounts.
Unofficial information suggests the investigation involves financial transactions totaling over MKD 260 million, or more than EUR 4 million.
Unofficially, the case concerns a private, specialized eye hospital in Skopje backed by Turkish investors. The facility has been in operation since 2011 and, at the time of its opening, was presented as one of the major foreign investments in the healthcare sector. The hospital spans over 4,000 square meters and specializes in ophthalmological services. The investigation also examines how the funds were recorded and utilized in the ongoing operations of the healthcare institution, as well as whether a portion of these funds was integrated into regular financial transactions and spent for various business purposes.
The police operation involves reviewing documentation and financial records across several locations; the investigation aims to determine whether, and to what extent, legal regulations were violated.
Unofficially, the primary suspect is Den Donchev, the former director of the Health Insurance Fund (HIF) during the tenure of the SDSM-led government. Other suspects include: RidvanAsani, former Chairman of the HIF Management Board; VesnaKjamilova, former manager of Sante; SalihBozgurt, former owner and authorized representative of the hospital; Selma Amet, the current manager; GerianaArapi, former director of the hospital; CvetenSerafimovski, former Head of the Control Department at the HIF; ZhaklinaStamenkova, former director of the HIF Skopje regional unit; and Irena Popovska, the current head of the HIF Skopje regional unit.