Strict warning to them service providers healthwho do not comply with the terms and obligations deriving from the contract they have signed with EOPYY, the Organization addresses. As he emphasizes, the collection of any additional fee from the insured is expressly prohibited and results in the termination of the contract with EOPYY.

In a statement, EOPYY states that it is being done addressee complaints either by patient associations or by individual insured persons, regarding cases of refusal to carry out referrals of the Organization or demands for the collection of additional charges for the services provided, beyond the legal participation of the insured person.

“We address strict recommendation for the faithful observance of the terms and obligations deriving from the contract you have signed with the Organization regarding the execution of opinions and referral medical procedures of the EOPYY and for the proper fulfillment of your contractual obligations“, emphasizes EOPYY.

As he adds, “the participation of the Organization’s beneficiaries in the cost of diagnostic tests – medical procedures is not affected by the clawback and rebate mechanisms nor by the application of the Weighted Average Normalization Index (M.D.E.), it is valid, and, as stated in referential.

In particular, as pointed out in no. 26084/24-10-2024 announcement, the Weighted Average Normalization Index is not a ceiling per referral patient – beneficiary or per patient – beneficiary.

The Index is used to calculate the Maximum Allowable Submission Amount (MSA) per provider, which varies per month, provider and submission. For the determination of the M.E.P.Y, the totality of the patients – beneficiaries of the submission is used as a basis and in no case is a ceiling established per referral or beneficiary”.

The Organization underlines that, according to the terms of the EOPYY contracts, “the collection of any additional fee from the insured or his relatives for supplementing or substituting the state invoice is expressly prohibited. As a consequence of this violation, the contract with EOPYY will be terminated.

Also, according to article 69 of Law 5102/2024 (Government Gazette 55 A/2024) the refusal to provide services or execute referrals to beneficiaries of EOPYY care leads to the automatic termination of the contracts with the Organization».

The EOPYY calls on the providers to faithfully observe the above in order to avoid similar incidents in the future, which may lead to the imposition of sanctions for non-contractual behavior and the automatic termination of the contracts with the Organization.