New regulations on reimbursement of contributions and financing of health services – what is changing?

The new 2025 law introduces significant changes to the publicly funded healthcare system. These changes include simplifying reimbursement procedures for treatment abroad, introducing Rare Disease Expert Centers, and improving cooperation with European Reference Networks. Significant changes to the regulations regarding the reimbursement of social security contributions, the financing of healthcare services, and the organization of services for individuals with high-risk mental disorders will take effect in 2025. The amendments cover both administrative procedures and financial settlements.

In 2025, the Polish healthcare system underwent a major overhaul aimed at improving access to healthcare services and streamlining administrative procedures. One of the key changes is the streamlining of treatment reimbursement rules in EU, EEA, and UK countries . The new regulations allow for faster reimbursement in urgent medical cases and allow for documentation of opinions from foreign specialists.

Another important element of the Act is the establishment of Expert Centers for Rare Diseases (OECR) . These specialized units provide diagnostics and treatment for patients with rare conditions, collaborating with other centers in Poland and international reference networks. OECR status is granted for five years and requires meeting specific criteria, such as the number of patients, staff qualifications, and clinical trials conducted.

The amendment to the Act implements the provisions of EU Regulation No. 883/2004 and Directive 2011/24/EU , which aim to protect patients' rights in cross-border healthcare. This allows patients to count on more transparent procedures and faster access to highly specialized healthcare.

Thanks to the changes introduced, the Polish healthcare system is becoming more accessible, effective, and patient-friendly, especially for those struggling with rare diseases, for whom rapid diagnosis and access to treatment is crucial.

One of the key changes is the introduction of an automatic mechanism for refunding overpaid contributions. ZUS will be obligated to refund amounts exceeding ten times the cost of a reminder issued in ex officio enforcement proceedings after the contribution payer submits their annual settlement. In the absence of a bank account number, the refund will be made upon an electronic application submitted in the ZUS system, using a qualified signature, a trusted signature, or other forms of electronic authorization.

Additionally, the amendment specifies that overpayment amounts that do not exceed ten times the costs of the reminder will be settled in the contribution payer's account by the end of the tax year, which streamlines the handling of small overpayments and reduces formalities.

The Act introduces changes to the financing of healthcare services for individuals posing a threat to the life, health, or freedom of others. Provincial branches of the National Health Fund (NFZ) will finance services provided within the voivodeship only by entities that have contracts with the Fund. The amendment also clarifies the liability of owners and employees of pharmacies and healthcare entities affiliated with the NFZ .

The possibility of concluding contracts for an indefinite period of time for primary health care (except for night and holiday care) has also been introduced, which is to ensure the stability of services.

The new regulations clearly state that individuals placed in such facilities do not have the right to choose their healthcare provider; these decisions are made by the facility's director. Services that cannot be provided in the facility are provided by healthcare providers for detainees, with the costs covered by the state budget.

Additionally, the head of the centre decides on the need to provide services in emergency situations, and the provisions on referral for treatment under the National Health Fund do not apply in these cases.

The Act requires laboratories to continuously participate in external quality assessment programs for laboratory tests, both domestic and international, to ensure high-quality medical diagnostics. Laboratories must also conduct internal quality control of all tests performed.