PM Bektenov instructs Finance Ministry to take over Health Insurance Fund

In the furtherance of President Tokayev’s directives to tighten budget controls, the Government is consistently analyzing the efficiency of healthcare spending.

On December 18, 2025, Prime Minister Bektenov instructed the Ministry of Finance to conduct a comprehensive analysis of the Social Health Insurance Fund to improve the efficiency of budget spending.

Minister of Finance Madi Takiyev reported that despite healthcare spending rising to 2.4 trillion tenge in 2026 (1 trillion tenge more than in 2020), the efficiency of the Fund is not improving.

While the Fund's investment income soared to 588 billion tenge, analysis shows that these funds are being hoarded in the Fund's assets instead of being used to fund healthcare for citizens.

An IT audit of healthcare information systems conducted by the Ministry of Finance has exposed a series of systemic violations:

• Fictitious patient billing (in cases where 1,000 people are registered, only 500 actually seek treatment, yet payment is collected for the entire registered group);
• Provision of inappropriate medical services (reporting services that were either unnecessary or unrelated to the patient's actual needs);
• Double funding (charging both private insurance and the state fund for the same service);
• Abnormal service volume (recording an implausibly high number of medical procedures performed within extremely short timeframes);
• "Ghost" billing for deceased citizens; 
• Excessive prescriptions. (Cases of over 1,000 medications prescribed to a single child in one day).

Furthermore, tax authorities conducted desk audits on the heads of medical organizations, analyzing their income and asset acquisitions. It was established that between 2024 and 2025, 1,465 executives purchased more than 5,000 real estate properties, while 912 individuals acquired 1,416 vehicles. Notably, some directors of private clinics purchased between 52 and 124 properties and 14 to 24 vehicles each in just two years.

Inconsistency has been noted between the information systems of the Social Health Insurance Fund and the Ministry of Healthcare, as well as within the regulatory and legal framework. The absence of a unified database for patients and medical organizations has resulted in the current regulation being largely focused on the functions of individual institutions, such as the Fund and SK-Pharmacy, rather than on the outcome of providing healthcare services to the population.

After the initial verification of the material and technical base, equipment, and staffing requirements of medical organizations, subsequent oversight is virtually not carried out. Preventive control mechanisms have not been established, which makes it impossible to timely prevent the misuse of funds allocated under the State-Guaranteed Benefits Package and the Mandatory Social Health Insurance system.

In addition, the system lacks incentives for cost savings: there are no mechanisms for returning unspent funds to the budget, which encourages not efficiency but spending allocated financing. Separate issues have also been identified in tariff setting — the system applies over 3,000 tariffs, which significantly complicates administration and oversight.

Following the review, Prime Minister Olzhas Bektenov instructed:

• the Ministry of Finance to submit materials on all the voiced facts to law enforcement agencies for procedural decisions;
• the transfer of the Social Health Insurance Fund under the authority of the Ministry of Finance to ensure control over all financial flows;
• the full digitalization of the healthcare system's business processes based on the Ministry of Finance’s information systems;
• the termination of unjustified financing by revising the parameters of the investment strategy for placing the Social Health Insurance Fund's assets and generating investment income.

As Qazinform previously reported, the Prime Minister ordered to make medical care available for low-income citizens under the compulsory social health insurance system.