The Lithuanian government has approved a significant legislative shift aimed at eliminating illegal surcharges and financial malpractice within the country’s healthcare system. Under the new proposal, clinics and pharmacies found to be charging patients unauthorized fees will face substantial financial penalties, marking a transition from simple restitution to a punitive deterrent model.
Currently, the Lithuanian healthcare oversight mechanism primarily requires institutions to return illegally obtained funds to the patient or the state budget. However, health officials argue that this “repayment-only” approach has failed to prevent repeat offenses. The proposed amendments to the Law on Healthcare Institutions and the Law on Health Insurance seek to change this by introducing a tiered system of fines designed to protect the most vulnerable citizens.
Ending the Cycle of Repeat Violations
The move comes as a response to persistent reports of patients being asked to pay “top-up” fees for services that should be fully covered by the Compulsory Health Insurance Fund (PSDF). According to Skirmantas Krunkaitis, the Vice-Minister of Health, the current measures are insufficient to discourage providers from engaging in exploitative practices.
“The changes aim to manage cases where harm is done to socially and financially vulnerable individuals—the sick,” Krunkaitis stated. He emphasized that while the current system forces providers to compensate for the damage, it does not provide a meaningful financial consequence that would make such violations unprofitable in the long term.
A New Tiered System of Financial Penalties
The proposed legislation introduces specific formulas for calculating fines based on the nature and severity of the violation. This structured approach is intended to ensure transparency and fairness in how penalties are applied across the sector.
For violations where a patient has been charged an illegal surcharge, the fine will be set between 5 and 15 times the amount of the unauthorized fee. This represents a massive escalation in risk for providers who might previously have viewed such fees as a low-risk revenue stream.
In cases where the violation results in direct damage to the PSDF budget—such as through fraudulent billing or misrepresentation of services—the fine will range from 20% to 100% of the total damage caused. For other types of regulatory breaches that do not involve direct financial loss to patients or the state, penalties will be calculated based on “basic social benefits,” a standard economic unit used in Lithuania for administrative fines.
Safeguarding the National Health Insurance Fund
Beyond simple overcharging, the government is also targeting systemic fraud. The new rules will allow for significant fines if a healthcare institution is found to have submitted forged documents to obtain or maintain its operating license. Furthermore, if an institution’s license is suspended due to regulatory violations, additional financial penalties may be applied to ensure that the disruption of service carries a heavy price for the owners.
To ensure consistency, the specific amount of each fine will be determined using the same rules applied to damage against the state or social insurance budgets. Authorities will consider mitigating and aggravating circumstances; for instance, multiple mitigating factors would result in a minimum fine, while repeated or severe aggravating factors would trigger the maximum penalty allowed by law.
Path to Implementation and Patient Rights
While the government has signaled its clear intent to protect patients from hidden costs, the new regime will not take effect immediately. The draft laws must still be debated and approved by the Seimas (the Lithuanian Parliament). If the legislative body grants its approval, the new regulations are scheduled to come into force on November 1, 2026.
This lead time is intended to give healthcare providers and pharmacies sufficient opportunity to audit their internal billing processes and ensure full compliance with the law. For patients, the move represents a long-term commitment to a more transparent healthcare system where the cost of care is predictable and protected by law. By shifting the financial risk onto the providers, the Lithuanian government hopes to foster a culture of integrity within the medical community that prioritizes patient welfare over illicit profit.
Source: ELTA
/linkComments