The Ministry of Health has put into public debate the GEO that establishes exceptions to the application of the measure regarding non-payment of the first day of sick leave

The Ministry of Health published, on Friday, the draft of the Emergency Ordinance that establishes exceptions to the application of the measure regarding the non-payment of the first day of medical leave, assessing that, otherwise, repeated reductions of the allowance will be reached for several categories of patients.

The Ministry of Health published, on Friday, the draft for the completion of the Government's Emergency Ordinance no. 91/2025 regarding the establishment of measures within the health system.

“In the current form of the regulation, the reduction of the allowance is applied for each medical leave certificate issued, regardless of whether they are issued for the same episode of illness, successively, according to the medical protocols and the clinical evolution of the patient. This approach leads, in practice, to repeated reductions of the allowance for the same period of temporary incapacity for work, which exceeds the initial purpose of the measure and generates disproportionate effects”the initiators show in the Memorandum.

According to them, this situation affects all categories of insured persons, especially the sick from the following categories:

1. patients with chronic diseases, which require permanent monitoring and medical leaves granted in stages;

2. patients with oncological or hematological conditions, for which the treatments are structured in successive cycles, requiring the issuance of several medical leave certificates for the same condition;

3. patients included in the national health programs, whose treatments are strictly regulated by therapeutic protocols;

4. pregnant women and women on maternity leave, who benefit from a special protection regime, according to national and European legislation.

“The application of the reduction of the allowance for each successive medical certificate leads to repeated financial losses for these categories of people, affecting their financial stability at a time when the costs associated with medical treatment and care are already high. In the case of vulnerable patients, there is a real risk that these losses will determine the abandonment of treatment, postponement of presentation to the doctor or non-compliance with medical indications, with negative consequences on the state of health and on public health”it is also shown in the Explanatory Note.

Regarding pregnant women and those on maternity leave, according to the initiators of the OUG, “the reduction of the allowance goes against the principles of protection of maternity and women's health, enshrined both in national legislation and in European normative acts regarding safety and health at work, as well as equal treatment”.

“A distinct situation is represented by the insured persons who benefit from medical services under continuous or day hospitalization regime. In their case, the medical leave is inextricably linked to the hospitalization period, and the temporary incapacity for work is determined exclusively by the need to carry out medical treatment under hospital supervision. The application of the reduction of the social health insurance allowance for each medical leave certificate issued in these situations generates disproportionate effects, considering that hospitalized patients do not have the opportunity to carry out professional activity and cannot influence the duration or structure of hospitalization, this being established strictly on medical criteria”, it is also shown in the cited document.

According to him, the reduction of the allowance during hospitalization directly affects the financial security of these people, increases the social vulnerability associated with the health condition and can create real difficulties in covering current expenses during the treatment.

“In the absence of an express regulation, there is a risk of non-uniform application of the measure and of affecting effective access to hospital medical services, which necessitates the proposed normative intervention. At the same time, non-uniform application of the provisions regarding the reduction of the allowance has generated administrative difficulties for employers and for health insurance companies, especially regarding the calculation of the allowances and the settlement of the related amounts from the budget of the National Single Health Social Insurance Fund. In the absence of an intervention immediate regulations, these dysfunctions risk being accentuated, disproportionately affecting the vulnerable categories of insured persons, the continuity of medical treatments and trust in the social health insurance system”, it is also shown in the document.

The GEO subject to public debate proposes the amendment and completion of art. II of the Government Emergency Ordinance no. 91/2025, in order to correct the unintended effects generated by the current application of the measure to reduce social health insurance allowances.

According to them, this measure has the effect of:

1. the elimination of repeated penalties for the insured for the same condition;

2. ensuring fair treatment between people in similar medical situations;

3. the correlation of the regulation with the medical realities, in which medical leaves are often released successively, depending on the evolution of the state of health and the therapeutic protocols;

4. reducing the negative financial impact on patients who, by the nature of the disease, require long periods of temporary incapacity for work.

At the same time, the draft emergency ordinance provides for the exemption from the application of the allowance reduction for the following categories of medical leave:

1. maternity risk medical leaves;

2. medical leaves for maternity;

3. medical leaves granted to patients included in the national health programs;

4. medical leaves granted during the periods in which the insured persons benefit from medical services under continuous or day hospitalization regime.

According to the Ministry of Health, the establishment of these exceptions aims to:

1. ensuring an adequate level of protection for pregnant women and those on maternity leave, in accordance with national legislation and European directives regarding maternity protection, health and safety at work;

2. protecting patients with oncological, hematological, autoimmune or other serious diseases, included in the national health programs, whose treatments are usually complex, long-lasting and staged;

3. prevention of the risk of interruption of medical treatments or worsening of the health condition, as a result of the repeated decrease in the income of persons temporarily unable to work.

The proposed changes are necessary to prevent the disproportionate impact on the incomes of vulnerable patients; elimination of dysfunctions arising in the application of the provisions of GEO no. 91/2025; ensuring the continuity of medical treatments for cancer patients and those with chronic diseases; increasing predictability and uniformity in the application of the rules regarding the calculation of social health insurance allowances and avoiding the emergence of social and institutional tensions generated by different interpretations and non-uniform application of the regulations in force.

“Also, by exempting medical leaves granted during hospitalization from the application of the allowance reduction, the aim is to protect patients in situations of severe medical vulnerability, for whom the temporary inability to work is determined exclusively by the need to be hospitalized and to undergo medical treatment under specialized supervision. This measure ensures a proportionate and fair treatment, considering that hospitalized patients cannot influence the duration of hospitalization and do not have the opportunity to carry out professional activity or obtain income from work during hospitalization”says the Ministry of Health.

According to the cited institution, the establishment of a term for the approval of the methodological rules of application is necessary to ensure an immediate, unified and coherent application of the introduced changes.

“The establishment of the 30-day deadline for the approval of the methodological rules is aimed at preventing administrative dysfunctions, ensuring predictability for employers and health insurance companies, as well as guaranteeing the effective access of insured persons to the social protection rights regulated by this emergency ordinance. Through these changes, a better correlation is achieved between the financial sustainability objectives of the social health insurance system and the need to protect the fundamental rights of the insured, especially the categories in vulnerable situations medical”, the Ministry of Health also conveyed.