The National Health Service (NVD) of Latvia, together with the Ministry of Welfare (LM), identified unjustified provision of palliative and hospice care to certain groups of patients. The total amount of unlawfully paid services amounted to 527.6 thousand euros, representatives of the NVD reported at a meeting of the parliamentary commission on social and labor affairs.
Inspections revealed that some patients received services without a decision from a medical council, as required by the procedure for assigning palliative care at home. There were also cases where the service was provided for more than nine months, although it is intended for patients with a predicted life expectancy of up to six months, as well as episodes where patients were simultaneously in hospitals or social centers, which contradicts the rules.
Based on the inspection results, the NVD prepared acts to withhold 128.2 thousand euros for unlawfully provided services. Inspections are ongoing.
Additionally, cases were identified where services continued to be paid for after the patients' deaths — for 96 individuals, two providers received 15.4 thousand euros.
Most violations were recorded in the company Magnum Social & Medical Care — in 2024, 4,474 cases were registered, and in the first half of 2025, 3,753. Fewer violations were found in the companies Med4U (218), Hospiss Māja (80), and Cilvēks (56). A total of 8,581 unlawfully paid cases were recorded over two years.
The Ministry of Welfare plans to change the funding model for palliative care starting April 1, 2026. Instead of payment for each day of service (44.79 euros per day), a fixed amount will be introduced — 2,295 euros for the entire period of patient care, half of which will be paid at the start, and the remaining part upon completion of the service. If assistance is provided for more than 180 days, an additional payment of 13.57 euros per day is provided.
Some organizations, including the Latvian Samaritan Association, criticized the new approach, stating that it "creates a risk of unethical incentives to shorten patients' lifespans."
Particular attention is given to children's palliative care, which, according to specialists, "remains sidelined" and lacks a smooth transition to services for adult patients.
To ensure the palliative care system for the next year, 15 million euros will be required, of which 12 million is currently allocated. If necessary, the Ministry of Welfare intends to request additional funds from the contingency fund.
In the 2026 budget, 10 million euros have already been earmarked for palliative care and 3.2 million euros for social rehabilitation.
