Kazakhstan Orders Transfer of Social Health Insurance Fund to Ministry of Finance
Astana, The Gulf Observer: Kazakh Prime Minister Olzhas Bektenov on Friday ordered the transfer of the Social Health Insurance Fund under the authority of the Ministry of Finance, the Government’s press service reported, as part of efforts to strengthen budget discipline and improve the efficiency of healthcare spending in line with President Kassym-Jomart Tokayev’s directives.
The decision follows a comprehensive review launched on December 18, 2025, when Prime Minister Bektenov instructed the Ministry of Finance to conduct an in-depth analysis of the Fund’s operations to enhance the effectiveness of budget expenditures in the healthcare sector.
Minister of Finance Madi Takiyev informed the Government that despite healthcare spending increasing to 2.4 trillion tenge in 2026—an increase of 1 trillion tenge compared to 2020—the efficiency of the Social Health Insurance Fund has not improved. He noted that while the Fund’s investment income rose sharply to 588 billion tenge, these resources were largely accumulated in the Fund’s assets rather than being directed toward financing medical services for citizens.
An IT audit of healthcare information systems conducted by the Ministry of Finance revealed a range of systemic violations. These included fictitious patient billing, where payments were collected for registered patients who did not actually receive treatment; the provision and reporting of inappropriate or unnecessary medical services; double funding of the same services through both private insurance and the state fund; and abnormal volumes of services recorded within unrealistically short timeframes. The audit also uncovered so-called “ghost” billing for deceased citizens and excessive prescriptions, including cases in which more than 1,000 medications were prescribed to a single child in one day.
In parallel, tax authorities carried out desk audits of the heads of medical organizations, examining their income and asset acquisitions. The audits established that between 2024 and 2025, 1,465 executives purchased more than 5,000 real estate properties, while 912 individuals acquired 1,416 vehicles. According to the findings, some directors of private clinics acquired between 52 and 124 properties and 14 to 24 vehicles each within a two-year period.
The review also identified inconsistencies between the information systems of the Social Health Insurance Fund and the Ministry of Healthcare, as well as shortcomings in the regulatory and legal framework. The lack of a unified database for patients and medical organizations has resulted in regulation that focuses on the functions of individual institutions, such as the Fund and SK-Pharmacy, rather than on healthcare outcomes for the population.
Furthermore, while initial checks of the material and technical base, equipment, and staffing of medical organizations are conducted, subsequent oversight is largely absent. Preventive control mechanisms have not been established, limiting the authorities’ ability to prevent the misuse of funds allocated under the State-Guaranteed Benefits Package and the Mandatory Social Health Insurance system.
The system was also found to lack incentives for cost savings, as there are no mechanisms to return unspent funds to the budget, encouraging spending rather than efficiency. Additional issues were identified in tariff setting, with more than 3,000 tariffs currently in use, significantly complicating administration and oversight.
Following the review, Prime Minister Bektenov instructed the Ministry of Finance to submit all identified violations to law enforcement agencies for procedural decisions. He also ordered the transfer of the Social Health Insurance Fund to the Ministry of Finance to ensure comprehensive control over financial flows, the full digitalization of healthcare business processes based on the Ministry’s information systems, and the termination of unjustified financing by revising the parameters of the Fund’s investment strategy and the use of its investment income.
