THE PROMOTION OF AN ANTI-FRAUD CULTURE IN LITHUANIAN ... · THE PROMOTION OF AN ANTI-FRAUD CULTURE...
Transcript of THE PROMOTION OF AN ANTI-FRAUD CULTURE IN LITHUANIAN ... · THE PROMOTION OF AN ANTI-FRAUD CULTURE...
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
WORKING GROUP ON THE FIGHT AGAINST FRAUD
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
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 expertstudies.
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 befocused 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.
LITHUANIA IN 2018: RANK 38/180, SCORE 59/100
LITHUANIA IN 2008: RANK 58/180, SCORE 4,6/10
4
BASIC ANTI-CORRUPTION LEGISLATION IN LITHUANIA
5
BASIC ANTI-CORRUPTION LEGISLATION IN LITHUANIA
The National Anti-Corruption Programand The Interinstitutional Action Plan
for the years 2015-2025
The Healthcare sector Anti-Corruption Program
for the years 2017–2019
The HIF Anti-CorruptionProgram
for the years2017–2019
WhistleblowerProtection Law
(in action since 1 January2019)
MoH
NHIF
Goverment
The law on balancing public and
private interests
CorruptionPrevention
Law
6
BODIES AGAINST CORRUPTION/INSTITUTIONS FIGHTING CORRUPTION IN LITHUANIA
State Tax Inspectorate
• control of all taxpayers
Prosecutor‘s Office
• organized crime, corruption
Special Investigation
Service
• large-scale corruption
Financial Crime Investigation
Service
• criminal activities against the State financial system
All other public institutions
• participate in the national anti-corruption program according to their field of activity
Institutions and their fields of activity:
7COOPERATION NETWORK – ROUNDTABLE DISCUSSIONS
ROUNDTABLE DISCUSSION IN STATE TAX INSPECTORATE
8
ENTITIES FOR PREVENTION OF CORRUPTION IN THE INSTITUTIONS
ONE SINGLE PERSONwith functions only for prevention activities*
*STATE TAX INSPECTORATE;MoH
DIVISION*
*THE SOCIAL INSURANCE FUND; HOSPITALS
SPECIAL COMMITTEEOF PERSONS WITH
DIFFERENT FUNCTIONS*
*HIF;DRUG CONTROL SERVICE
9
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 prevention11
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
12
2) one person from Personnel Administration Departmentfor monitoring the declaration of public and private interest
of employees is appointed
1
THE COMMITTEE ON CORRUPTION PREVENTION:responsible for preparation of corruption-prevention program as well as for the monitoring and
coordinating of the implementation of the tasks of that program
Special activities of Committee to increase employee interest in anti-corruption:
Encouraging employees to participate in various anti-corruption initiatives
Consulting employees and accepting information about possible corruption
Distributing information related to the prevention of corruption to the employees and public
Organizing the commemorations of the International Anti-Corruption Day
Investigating complaints regarding corruption
Carries out preventive measures assigned to the commission, etc.
Organized the special quiz and the competition on creation of NHIF‘s anti-corruption symbol in 2017 13
Election of NHIF anti-corruption symbol
THE WINNER
14
THE HIF ANTI-CORRUPTION PROGRAM: OBJECTIVES AND MEASURES
15
THE HIF ANTI-CORRUPTION PROGRAM FOR THE YEAR 2017–2019
OBJECTIVES OF THE PROGRAM:
IMPROVE THE CORRUPTION
PREVENTION CONTROL
ENSURE TRANSPARENT AND OPEN PUBLIC
SERVICES
EVALUATE THE PROBABILITY OF
CORRUPTION OCCURRING
EDUCATE AND INFORM THE PUBLIC
TO DEVELOP ANTI-CORRUPTION
AWARENESS AND INTEGRITY OF EMPLOYEES
16
ALL PROGRAM MEASURES ARE IMPLEMENTED BY:
Management board
(the director and his deputies, headsof departments and divisions)
All employees of the NHIF and THIFs are involved
17
THE HIF ANTI-CORRUPTION PROGRAM FOR THE YEAR 2017–2019
Main activities to implement objective:
• Rotation of commission members and leading person is foreseen
• A quarterly report on the implementation of the plan is prepared
• The effectiveness of the program annually is evaluated
IMPROVE THE
CORRUPTION PREVENTION
CONTROL
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
• waiting list management for endo-prosthetics is fully automated
• waiting list management for dental prosthetics is fully automated
• residents can check by themselves what kind of healthcare services andprescriptions they have received through the e-government gates (IS) andthe amount paid from the CHIF budget for them. About 20,000 peoplecheck that information annually. About 7,000 more people apply to THIFfor such reports.
Transfer more HIFservices to
InformationSystems:
• CHIF budgeting principles
• NHIF financial data
• health care financial and statistical data
More and more data is being opened:
• of behavior in the event of a collision with corruption
• on whistleblower protection
• on gifting behaviour
HIF‘s legislation is being improved to ensure zero
tolerance for corruption among 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 ofalready valid legal acts is performed on the daily basis(examples of the types of legal acts that shall be evaluatedfrom an anti-corruption perspective: in publicprocurement, in human relation management andadministration fields, in the area of control of economicunits field)
• The probability of corruption in selected areas of activity is checked annually and risk elimination plan is prepared
CONDUCT AN EVALUATION
OF THE PROBABILITY
OF CORRUPTION
20
THE HIF ANTI-CORRUPTION PROGRAM FOR THE YEAR 2017–2019
Main activities in order to implement objective:
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.
• The trainings for the employees are organised
• The NHIF annually carries out an anonymous survey in order to assess the change in intolerance to corruption of the employees
TO DEVELOP ANTI-
CORRUPTION AWARENESS
AND INTEGRITY OF EMPLOYEES
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;
• media (press, radio, TV)
• On social networks: FB, Instagram, Flicr
• Leaflets, posters, information messages, educational videos on TV monitor in medical institutions
• Cooperation with non-governmental organizations is being developed
• Information in public transport
• Meetings with target groups – in order to inform about current issues
EDUCATE AND
INFORM THE
PUBLIC
22
INFORMATION CONTENT FOR PUBLIC
1. Guarantees provided by Compulsory Health Insurance: free services, access to health care services funded from the CHIF budget, patients' rights and responsibilities, etc.
2. Reminders to the public not to pay for goods and services that hadalready been paid from the CHIF budget
3. Information that patients can check for themselves how much the CHIF budget has paid for their treatment
4. Guarantees provided by European Health Insurance Cards
5. Preventive health check-ups for children
ETC
23
EXAMPLES OF INFORMATION DISCLOSURE:
24
THERE IS FOLLOW-UP TO ALL THE ACTIVITIES FORESEEN
• A quarterly report on the implementation of the plan isprepared
• The ongoing corruption prevention program is continuous -every three years the program shall be updated in the light ofthe results
• The effectiveness of the program annually is evaluated: the effectiveness of the program is assessed on the basis of the annual employee survey results
25
SUMMARY
26
SUMMARY
TAKING PART IN INTERINSTITUTIONAL COOPERATION –ROUNDTABLE DISCUSSIONS;
RAISING EMPLOYEES AWARENESS IN THE FORM OFENTERTAINMENT;
EMPLOYEES AWARENESS MEASUREMENT – SURVEYS;
PROFESSIONALY PERFORMED INVESTIGATIONS FOR DETECTINGPROBABILITY OF CORRUPTION
27
THANK YOU FOR YOUR ATTENTION