North Macedonia
North Macedonia's interior ministry: eight arrested over eye-surgery scheme costing Health Insurance Fund €1.7 million
A criminal complaint targets 11 people and a private clinic in Skopje suspected of billing the same services to both the fund and patients.
By ANN Newsroom · Newsroom
October 29, 2026, 16:50 · Updated 18:43 · 1 min read
In brief
- Police seized about 50,000 euros in cash and mobile phones during the operation.
- The suspects include current and former officials of the Health Insurance Fund and a citizen of Albania.
- According to the complaint, about 3,000 to 4,000 patients were harmed by double billing.
North Macedonia's Interior Ministry on Thursday released details of a police operation against a group suspected of illegally profiting from eye surgeries. Eight people were detained, and about 50,000 euros in cash and mobile phones were seized, Portalb reports.
The operation was carried out by the Department for Combating Organized and Serious Crime, together with the Basic Public Prosecution for Organized Crime and Corruption. According to the ministry, the group's members include current and former officials of the Health Insurance Fund (FSSH).
How the alleged scheme worked
The criminal complaint covers 11 people, one of them a citizen of Albania, and a private health institution in Skopje accused of money laundering. Two fund directors in 2020 and a clinic representative allegedly signed an agreement in breach of procedures. The clinic allegedly entered false data into the fund's electronic system and issued fictitious invoices, billing the same services to both the fund and patients.
Patients, according to the complaint, paid a private fee on top of the legal co-payment, without knowing the fund was being billed at the same time. The allegations also cover officials who allegedly failed to pass on reports of irregularities and delayed inspections.
The figures
The damage to the fund from fictitious invoices is estimated at 104.8 million denars, about 1.7 million euros, plus 525,000 denars in unpaid contractual fines. The clinic's alleged illegal gain in 2022–2025 is put at about 261 million denars, roughly 4.25 million euros. All of these are allegations in the complaint and have not been proven in court.
