Kazakhstan prevented 234 billion tenge in financial losses over nine months of tightened controls in the mandatory social health insurance system, infohub.kz reports. Authorities are also seeking the return of more than 79 billion tenge illegally paid to healthcare providers as part of criminal cases.
After the Social Health Insurance Fund was placed under the ministry's control, the priority became stopping funding leaks and ensuring that money is used for its intended purpose. According to the ministry, the identified leak channels have been closed, and the preserved and recovered funds have been directed toward paying for medical care.
New tools, including artificial intelligence-based anti-fraud systems, are being used to prevent unjustified payments. They make it possible to detect signs of violations before money is transferred.
The Finance Ministry reported an increase in funding limits for medical organizations. Hospitals can now pay for services after care is provided. There is also a gradual move away from restrictions on the volume of care through the use of a linear scale.
According to the ministry's assessment, these changes expand the capacity to provide planned care and help reduce hospitals' accounts payable.
The fund has also moved from tracking the total amount of debt to analyzing the causes of its emergence at each troubled clinic. There are 68 medical organizations in the country with overdue accounts payable. A financial recovery plan has been developed for each of them together with local executive bodies.
By the end of 2026, overdue debt is projected to be reduced from 17 billion to 10 billion tenge. To achieve this, the ministry plans to increase clinics' revenues and adjust the volumes of funded care where unmet demand for treatment has been confirmed.
The ministry expects that as the results take hold, patients will be able to receive the care they need more quickly.
According to the Finance Ministry, the tasks set for the first stage by the head of state have been fulfilled. Work to prevent violations and recover funds continues.
The next stage envisages the introduction of insurance mechanisms: assessing the expected need for treatment and the cost of obligations, planning how to cover them, and forming reserves. Payment methods should take into account the complexity of each case and the outcome of treatment.
Financing is to be built around the patient's entire journey — from diagnosis to treatment, rehabilitation, and follow-up. Payment mechanisms should support continuity between medical organizations, timely treatment, and the prevention of complications.
The Finance Ministry intends to assess the results of further changes by the accessibility of necessary care and the sustainability of its financing.
Earlier, Kursiv wrote that in January Olzhas Bektenov ordered the Social Health Insurance Fund to be transferred to the Finance Ministry's control after systemic violations were identified, including fictitious appointments, services provided to deceased patients, and double financing. Already by the end of the first half of the year, the anti-fraud system had prevented unjustified payments worth more than 4 billion tenge before the money was transferred to medical organizations.