When Penkov, Markov & Partners was established in 1990 it was one of the first law firms in Bulgaria. At present it has approximately 50 partners, associated members and external legal advisers and ten trainees, as well as 20 assistants and other staff, and offices all over the country. The firm publishes its own newspaper Lega Interconsult News, circulation 2200, available on its website. It is the Bulgarian member of Lex Mundi and FLI Net and is the first law firm in Bulgaria certified under the ISO 9001:2000 and later recertified under ISO 9001:2008 standards by Bureau Veritas Certification. Main Areas of Practice: Commercial & Business, Privatisation, Project Finance, M&A, Real Estate, Energy and International Work.

Mr. Vladimir Penkov:
“The foreign nationals are guaranteed equal rights with the patients from Bulgaria and EU”

Mr. Penkov, which are the most important conditions that have to be guaranteed, in order a foreign national to be medically treated in Bulgaria?

Most of all available should be sufficient capacity for conduct of medical treatment, quality medical service to be guaranteed, as well as facilitated access to Bulgaria to patients from Oman through relieved visa regime when travelling for medical treatment. Guaranteed should be also the access to the medical institutions through information campaigns and appropriate logistic support, including transport, when needed.

How are these conditions guaranteed in Bulgaria?

These conditions are guaranteed bythe Bulgarian legislation in a reliable manner. Thus, for instance between Bulgaria and Oman applies visa regime under the common visa policy of EU, but the treatment in Bulgarian medical institution provides ground for obtaining of entry visa and short-term stay in Bulgaria with possibility for obtaining of permit for prolonged stay (up to 1 year).

The foreign nationals are guaranteed equal rights with the patients from Bulgaria and EU. Applicable in our country a number of medical standards for the separate medical specialties, the liability of medical specialists is strictly regulated, where the observance of these conditions is accurately monitored by the Ministry of health. The medical institutions are subjected to registration, respectively authorization, regimes and in events of violations their registration or authorization may be revoked. The effective legal framework in Bulgarian in the healthcare sector, such as the Health Act, the Medical Institutions Act, the laws for medicinal products, for medical devices, for transplantation of organs, tissues and cells (the latter entirely aligned with the European regulations and directives), provide for an indeed good ground for qualitative health servicing and favour the choice of Bulgaria as health treatment destination. The specific Regulation on the terms and conditions for rendering medical care to foreigners that do not enjoy rights of Bulgarian nationals, namely from non-EU countries, guarantees medical care to foreign patients not only in emergency cases, but also in events of planned treatment.

All these positive conditions regulated in our laws have decisive importance for the quality of medical services and for the reasoning ofincreasing number of foreign patients from non-EU countries to choose medical treatment in Bulgaria.

It is still recommendable the visa regime to be relieved in events of planned treatment in Bulgarian hospitals, to facilitate the access of patients from abroad. The terms for obtaining of visa are not always short and the patients sometimes need to obtain permit for prolonged stay. While in some events, for instance for non-complicated procedures, rehabilitation, balneo-treatment, etc., a short-term stay in country (up to 90 days) would be sufficient, for operation procedures with longer recovery period for instance, a permit for prolonged stay might be needed. Of course, thesereliefs should be in the frames of EU requirements.

What should a foreign national consider to come for treatment in Bulgaria?

First of all should obtain visa for the period of the specific treatment. For facilitating the visa applicants established are outsourcing centers, including in Sultanate of Oman, city of Masqat. A number of documents are required for the issuance of visa, including certificate from medical institution with pointed plan of treatment and recovery, proof of sufficient funds for support during the term of stay in Bulgaria, etc. It is recommendable all these procedural issues and necessary documents to be considered and arranged in advance with appropriate consultant, in order to avoid impediments at the time of visit to the country and to the medical institution.

The foreign patient should also consider the necessary expenses for the medical treatment and for the stay in the country. The equal treatment of patients-foreign nationals guarantees also equal access to all Bulgarian medical facilities – private or state-owned, but as a rule patients from non-EU countries have to pay the expenses for theirown treatment at prices, determined by the respective medical facility. This is due to the fact that the foreign nationals do not have health insurance in Bulgaria or EU and because of this their treatment may not be paid by the health funds of these countries.

In spite of this, the conditions for medical treatment in Bulgaria are extremely attractive, since the prices of medical and health services in Bulgaria are considerably lower than the prices in the other European countries and the access to high-skilled specialists is easy, which makes possible the holding of consultations, examinations (including complex ones) and treatment in considerably shorter terms. Bulgaria has the highest number of hospital beds on percentage of population – six beds on each 1000 citizens, according to the statistics. Our country disposes with exceptionally competitive medical institutions, not only private clinics and hospitals, but also a number of state-owned ones, which are famous with the high level of expertise and specialists, working in them.

Which main legal stipulations regulate the relations between Bulgaria and the other countries in the healthcare sector?

These relations are regulated differently with each country. In EU the relations are settled in accordance with the Rulesforcoordinationofsocialsecurityschemes, in view of the membership of our country in the union. The relations with countries, not from EU, are regulated by virtue of bilateral agreements. Bulgaria is a party to 13 bilateral agreements in the healthcare sector, concluded with non-EU countries. These agreements encompass mainly the emergency medical care, in some cases also treatment of members of diplomatic missions, treatment to a level sufficient for home return, of persons on business trips to a certain amount, etc., and almost all agreements explicitly exclude from their scope the visit of foreign nationals to the country with the aim of medical treatment. No agreement is concluded between Bulgaria and Oman in the healthcare sector.

Mr. Penkov, what should Bulgaria and Oman develop from administrative and legal aspect for realization of so-called “health tourism”, exchange of health professionals and medical education?

As a first step, stimulated should be the exchange of information about the possibilities for medical treatment, as well as negotiations to be initiated for relieving the formalities in the conduct of treatments. The reaching of bilateral agreements is appropriate way for stimulating the relations between the two countries, including in the so-called “health tourism” sphere. A government level agreement may significantly facilitate the use of medical services by nationals of Oman in Bulgaria. Discussed could be the possibilities for the payment of medical interventions or part of them by the health funds of Oman. A bilateral agreement for exchange of medical specialists will be beneficial for both parties.

An easier step for realization that does not require state intervention is the holding of advertisement-information campaigns, as the current initiative, for presenting for instance the conditions for balneo-treatment in Bulgaria, Bulgarian rehabilitation and spa-centers. Participation of Bulgarian medical institutions will significantly contribute for recognition of the achievements and the possibilities of the Bulgarian medicine and its distinguishing in Oman. This is a good potential which would benefit not only the Bulgarian clinics, hospitals and doctors, but also the foreign patients minding the qualitative, fast and cheaper medical service they will enjoy when choosing medical treatment in Bulgaria. Bulgaria should also not be underrated as place for business and investments, since it is a member of the European Union and has established good tax and other investment conditions.

For Contact:
Penkov, Markov & Partners
1113 Sofia-Bulgaria
13B Tintyava Str.,Fl.6
Ph.+359 2 971 3935
E-mail: lawyers@penkov-markov.eu
Website: www.penkov-markov.eu