WORKING GROUP ON THE FIGHT AGAINST FRAUD THE PROMOTION OF AN ANTI-FRAUD CULTURE IN LITHUANIAN NATIONAL HEALTH INSURANCE FUND Jurgita Šilinaitė - Šermukšnienė Simona Adamkevičiūtė LITHUANIAN NATIONAL HEALTH INSURANCE FUND UNDER THE MINISTRY OF HEALTH Berlin, 2019
THE CONTENT • Corruption Perception Index • Basic anti-corruption legislation in Lithuania • Committee on corruption prevention in HIF • The HIF Anti-Corruption Program: objectives and measures • Summary 2
CORRUPTION PERCEPTION INDEX: LITHUANIA 3
LITHUANIA – A LITTLE BELOW OF SCORE SCALE AVERAGE OF THE CPI OF WE AND EU LITHUANIA IN 2008: RANK 58/180, SCORE 4,6/10 LITHUANIA IN 2018: RANK 38/180, SCORE 59/100 The Corruption Perceptions Index (CPI) is a measure of the country's perception of corruption by state and municipal officials and politicians. This index is based on business surveys and other expert studies. The CPI scores are on a 100-point scale where 100 points for a very transparent state and 0 for a very corrupt state. Experts emphasize that the perception of corruption in a particular country should be focused on the scores of the CPI, not on the list of countries. Both scores and position can be adjusted by changes in the research methodology as a whole. CPI is one of the world's most renowned corruption perceptions research, showing how countries around the world manage to control corruption. 4
BASIC ANTI-CORRUPTION LEGISLATION IN LITHUANIA 5
BASIC ANTI-CORRUPTION LEGISLATION IN LITHUANIA The law on Whistleblower Corruption balancing Protection Law Prevention public and Law private (in action since 1 January 2019) interests The National Anti-Corruption Program Goverment and The Interinstitutional Action Plan for the years 2015-2025 The Healthcare sector Anti- MoH Corruption Program for the years 2017 – 2019 The HIF Anti-Corruption Program NHIF for the years 6 2017 – 2019
BODIES AGAINST CORRUPTION/INSTITUTIONS FIGHTING CORRUPTION IN LITHUANIA Institutions and their fields of activity: Special Financial Crime State Tax All other public Prosecutor‘s Investigation Investigation Inspectorate institutions Office Service Service • control of all • organized • large-scale • criminal • participate in taxpayers crime, corruption activities the national corruption against the anti- State financial corruption system program according to their field of activity 7 COOPERATION NETWORK – ROUNDTABLE DISCUSSIONS
ROUNDTABLE DISCUSSION IN STATE TAX INSPECTORATE 8
ENTITIES FOR PREVENTION OF CORRUPTION IN THE INSTITUTIONS SPECIAL COMMITTEE ONE SINGLE PERSON OF PERSONS WITH DIVISION* with functions only for DIFFERENT FUNCTIONS* prevention activities* *THE SOCIAL INSURANCE FUND; *STATE TAX INSPECTORATE; *HIF; HOSPITALS MoH 9 DRUG CONTROL SERVICE
COMMITTEE ON CORRUPTION PREVENTION IN HIF 10
A POLICY OF INTOLERANCE FOR CORRUPTION IN HIF open to the public encouraging the use of electronic services do not tolerating the conflicts of public and private interest following principles of selflessness, transparency and openness in their activities do not tolerating any form of corruption and any kind of bribery or nepotism and misuse of duties encouraging employees to deepen their knowledge of corruption prevention 11
IN ORDER TO IMPLEMENT THE POLICY GOALS AND FEATURES OF ANTI-CORRUPTION PROGRAM IN THE HIF: 1) special Committee for Prevention of Corruption is established: persons from different fields of activities 5 2) one person from Personnel Administration Department for monitoring the declaration of public and private interest of employees is appointed 1 12
THE COMMITTEE ON CORRUPTION PREVENTION: res esponsib ible le for or prep eparation of of cor orruption-prevention program as well ell as for th the e mon onit itoring and coo oordin inating of of th the e im imple lemen entation of of th the e tasks of of th that t program Specia ial acti ctivit ities of of Co Committee to o in increase employee in interest t in in anti ti-corruption: Encouraging em employees to o participate in in various anti ti-corruption in init itiatives Con onsulting em employees and acc ccepting in information about pos ossible corruption Dis istributing in information rel elated to o th the e prevention of of cor orruption to o th the e em employees and public Organizing th the com ommemorations of of th the In International Anti ti-Corruption Da Day In Investigating complain ints regarding cor orruption Ca Carries ou out preventive measures assigned to o th the com ommission, etc. c. Organized the special quiz and the competition on creation of NHIF‘s anti -corruption 13 symbol in in 2017
Election of NHIF anti-corruption symbol THE WIN INNER 14
THE HIF ANTI-CORRUPTION PROGRAM: OBJECTIVES AND MEASURES 15
THE HIF ANTI-CORRUPTION PROGRAM FOR THE YEAR 2017 – 2019 OBJECTIVES OF THE PROGRAM: EVALUATE THE IMPROVE THE ENSURE TRANSPARENT PROBABILITY OF CORRUPTION AND OPEN PUBLIC CORRUPTION PREVENTION CONTROL SERVICES OCCURRING TO DEVELOP ANTI- CORRUPTION EDUCATE AND INFORM AWARENESS AND THE PUBLIC INTEGRITY OF EMPLOYEES 16
ALL PROGRAM MEASURES ARE IMPLEMENTED BY: Management board All employees of the NHIF and THIFs (the director and his deputies, heads are involved of departments and divisions) 17
THE HIF ANTI-CORRUPTION PROGRAM FOR THE YEAR 2017 – 2019 Main activities to implement objective: • Rotation of commission members and IMPROVE leading person is foreseen THE • A quarterly report on the implementation CORRUPTION of the plan is prepared PREVENTION • The effectiveness of the program annually CONTROL is evaluated 18
THE HIF ANTI-CORRUPTION PROGRAM FOR THE YEAR 2017 – 2019 Main activities in order to implement objective: IMPROVE THE TRANSPARENCY OF OPERATIONAL PROCEDURES AND ENSURE TRANSPARENT AND OPEN PUBLIC SERVICES Transfer more HIF • waiting list management for endo-prosthetics is fully automated • waiting list management for dental prosthetics is fully automated services to • residents can check by themselves what kind of healthcare services and prescriptions they have received through the e-government gates (IS) and Information the amount paid from the CHIF budget for them. About 20,000 people check that information annually. About 7,000 more people apply to THIF Systems: for such reports. More and more data • CHIF budgeting principles • NHIF financial data is being opened: • health care financial and statistical data HIF ‘s legislation is being • of behavior in the event of a collision with corruption improved to ensure zero • on whistleblower protection tolerance for corruption among • on gifting behaviour employees by setting rules: 19
THE HIF ANTI-CORRUPTION PROGRAM FOR THE YEAR 2017 – 2019 Main activities in order to implement objective: • anti-corruption evaluation of drafts of legal acts and of already valid legal acts is performed on the daily basis CONDUCT AN (examples of the types of legal acts that shall be evaluated EVALUATION from an anti-corruption perspective: in public OF THE procurement, in human relation management and PROBABILITY administration fields, in the area of control of economic OF units field) CORRUPTION • The probability of corruption in selected areas of activity is checked annually and risk elimination plan is prepared 20
THE HIF ANTI-CORRUPTION PROGRAM FOR THE YEAR 2017 – 2019 Main activities in order to implement objective: TO DEVELOP • The trainings for the employees are organised ANTI- CORRUPTION • The NHIF annually carries out an anonymous survey in order AWARENESS to assess the change in intolerance to corruption of the AND INTEGRITY employees OF EMPLOYEES The main questions in anonymous survey for employees are: What kind of behaviour do they considered to be corruption? Do they know how to behave if they faced with the corrupt practices at work? Whether they considered health insurance funds as corrupt institutions Which fields of activities of health insurance funds do they considered as the most corrupt? Whether they have been ever offered a remuneration for a favourable decision, Whether they themselves have given a bribe in the last calendar year et ctr. Employees were asked to solve certain situations / tasks in order to find out if they recognize corrupt behaviour. 21
THE HIF ANTI-CORRUPTION PROGRAM FOR THE YEAR 2017 – 2019 Main activities in order to implement objective: • Ways of informing: • Announcements on Health Insurance Funds websites; EDUCATE • media (press, radio, TV) AND • On social networks: FB, Instagram, Flicr INFORM THE • Leaflets, posters, information messages, educational videos on TV monitor in medical institutions PUBLIC • Cooperation with non-governmental organizations is being developed • Information in public transport • Meetings with target groups – in order to inform about current issues 22
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