Control and Supervision

What are the GHS audit and supervision mechanisms?

The Supervision Commissioner, the Health Insurance Organisation and the Medical Audit Committee carry out controls regarding the manner in which healthcare services are provided.

1. Supervision Commissioner

The Supervision Commissioner is an independent officer with authority to investigate complaints lodged by any person in relation to:
  • Any decision, act or failure of the Organisation in relation to healthcare services covered by the GHS,
  • Any act or failure of the healthcare providers within the framework of the contract they sign with the Organisation,
  • Any decision, act or failure of the Organisation in relation to the healthcare providers.
The Commissioner may examine ex officio any issue of general interest that concerns the effective implementation and operation of the GHS and investigate, following an order by the Council of Ministers, any issue concerning the operation and implementation of the GHS. 

2. Health Insurance Organisation Board of Directors

The HIO Board of Directors establishes committees for the investigation of complaints lodged in virtue of the provisions of the GHS relevant legislation by any person.
The HIO monitors and checks compliance with the terms and conditions of the contract and the performance of the healthcare providers in any manner it deems necessary and effective.
The HIO may suspend or terminate a healthcare services contract it has concluded with any healthcare provider for reasons set out in the contract.
The HIO may prosecute criminally any criminal offence set out in the relevant GHS legislation.
The HIO investigates ex officio or following a complaint/grievance, any violation of any provision of the GHS relevant legislation and may impose administrative fines.

3. Medical Audit Committee

The Medical Audit Committee secures the provision of high quality healthcare services and takes all appropriate measures as regards specific incidents where health providers have not exercised reasonable skill or attention.

4. Other

The HIO is obliged to do the following within the framework of effective governance and its supervision by other bodies:
  • It applies the Fiscal Responsibility and Financial Framework Law to the extent that it applies to all Legal Persons Governed by Public Law.
  • It draws up financial statements in accordance with internationally acknowledged accounting standards and it submits them to the Minister of Health, the Minister of Finance as well as the Auditor General for auditing purposes.
  • It drafts a financial report immediately after the end of the financial year that includes an account of the financial year that has just ended and submits it to the Council of Ministers via the Minister.
  • It submits to the Minister of Health an annual report on the exercise of its authorities during the year that just ended as well as on the policy and programme applied by the Organisation.
  • Every three years, at the very least, it submits an evaluation report on the GHS to the Minister of Health with suggestions for any possible amendments to the legislation as regards, donations, co-payments and contributions as well as the services provided to the GHS beneficiaries and any other data that may be deemed expedient.
  • Every 3 years, it drafts an evaluation report on the efficiency and functionality of the entire GHS and submits it to the Minister of Health who updates the Council of Ministers that may then decide upon any possible amendment of the framework for the improvement of the efficiency and functionality of the System.
  • Following a request by the Minister of Finance and through the Minister of Health, it provides reports, accounts and other information relevant to the ownership and activities of the Health Insurance Organisation.
  • It is audited by the Auditor General of the Republic.  The Auditor General audits the accounts of the Organisation annually and may at any time carry out, at his/her discretion an additional management or other audit.