Iceland
In Iceland EHFCN has one member:
Icelandic Health (SJUKRA)
Icelandic Health (SJUKRA)
Sjúkratryggingar (Icelandic Health) is the universal health insurance agency for Iceland, providing mandatory health insurance for all residents in Iceland. The main task is to contract and pay for all health care covered by the insurance. Main roles and responsibilities include:
- Contract for services with health care providers, including hospitals, primary health care, nursing homes, medical specialists, dentists and others healthcare professionals.
- Maintain specialised payment models and pay for health care services that are required by law or by contracts.
- Purchase of goods and services, i.e. drugs, and therapeutic and other appliances.
- Monitor the quality and effectiveness of health care services.
- Managing patient insurance and certain accident insurance schemes
| Priority | Action Areas | Category | Example |
|---|---|---|---|
| 1 | Detection | Compliance to regulations | Data access, legal aspects, tools, .. |
| 2 | Medical Check | Avoid waste/overconsumption | Overutilization of services – no medical evidence |
| 3 | Action | Compliance to regulations | All types of action once fraud is detected |
| 4 | Financial Check | Avoid waste/overconsumption | Overly expensive services |
| 5 | Prevention | Compliance to regulations | Both soft and hard |
