Romania’s new national digital health platform, e-Sănătatea Mea, became operational nationwide on September 1, with authorities noting that its services will be introduced gradually over the coming days and weeks, according to Business Review.
Developed by the National Health Insurance House (CNAS), the platform is designed to bring patients’ medical information, prescriptions, referrals, reimbursed healthcare services, and eventually online medical appointments into a single digital portal. It will include 12 modules and sub-modules, which will become operational progressively.
Among the planned features are access to medical history, prescription records, reimbursed consultations and investigations, information on healthcare providers contracted by CNAS, and online appointment scheduling.
The appointments component is expected to be among the first services rolled out nationally.
CNAS president, Horațiu Moldovan, said the launch would not create immediate new obligations for doctors, hospitals, or other healthcare providers. Many currently use third-party software, which will have to be updated to interface with the new system, while CNAS plans to provide technical specifications, training, and support during the transition.
The rollout also does not make Romania’s new electronic identity card mandatory for accessing healthcare services from September 1. The existing national health card can continue to be used, while the requirement to validate services using the card has been suspended for another month to avoid disruption during the transition. CNAS has also released updated middleware allowing systems to work with both the national health card and the electronic identity card.
Horațiu Moldovan noted that the gradual rollout was intended to reduce the risk of technical disruption after years in which Romania’s health insurance IT infrastructure was affected by repeated outages. According to CNAS, the underlying hardware and software infrastructure has already been replaced and upgraded through the National Recovery and Resilience Plan (PNRR).
“Nothing will be different tomorrow compared with today, because we will not require anyone to use new facilities or new platforms before the necessary training takes place,” Horațiu Moldovan said, adding that the new functions would be introduced into production progressively.
The platform is part of the broader modernisation of CNAS’s Integrated Health Insurance Information Platform, or PIAS, and marks a shift towards giving patients direct access to information that has until now largely remained within healthcare providers and the public insurance system.
Over the past five years, the National Health Insurance House (Casa Națională de Asigurări de Sănătate – CNAS) has found itself at the epicenter of Romania’s broader public health policy debates. Managing the Single National Health Insurance Fund (FNUASS)—which channels tens of billions of lei annually into primary care, hospitals, pharmaceuticals, and specialized treatments—CNAS has operated under intense pressure to modernize its operations, address chronic funding deficits, and improve patient access across urban and rural divides.
The period spanning 2021 through 2026 was marked by post-pandemic operational recovery, aggressive legislative adjustments to the Framework Contract (Contractul-Cadru), and an urgent drive toward full digital integration.
Key Operational and Financial Pillars (2021–2026)
| Focus Area | Policy Direction & System Shift |
| Primary & Outpatient Care | Shifted financial incentives toward family medicine and early diagnosis to reduce avoidable hospital admissions |
| Digital Infrastructure | Overhauled the Health Insurance IT System (SIUI) and scaled mandatory electronic prescriptions and billing |
| Pharmaceutical Budgeting | Expanded cost-volume contracts and revised the clawback tax mechanism to ensure access to innovative therapies |
| Fiscal Governance | Tightened audit mechanisms for medical leave reimbursements and streamlined hospital contract settlements |
Core Drivers of Transformation
The trajectory of CNAS over the last half-decade has been defined by three primary catalysts:
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The Modernization of the Digital Ecosystem: The aging and historically prone-to-outages SIUI framework underwent crucial server upgrades and architectural re-engineering. The push toward cloud-based record integration and seamless digital validation reduced administrative friction for family doctors and pharmacists nationwide.
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Rebalancing Fund Allocation: Recognizing that hospital-centric healthcare systems are fiscally unsustainable in the long run, CNAS adjusted its payment formulas to channel higher point values and budget percentages into primary healthcare and outpatient ambulatory care, incentivizing preventive medicine.
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Budgetary Pressures and Clawback Calibrations: As demand for advanced oncology treatments and rare-disease therapies surged, CNAS recalibrated its financial agreements with pharmaceutical manufacturers. Through refined cost-volume-result agreements, the institution managed to introduce dozens of new innovative molecules onto the list of compensated medications without exceeding fiscal ceilings.
Persistent Structural Challenges
Despite operational progress, CNAS continues to navigate significant systemic headwinds:
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Demographic Deficits: With a shrinking base of formal contributors relative to the total number of beneficiaries (including pensioners, children, and chronic disease patients), FNUASS relies heavily on state budget transfers to cover its annual liabilities.
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Bureaucratic Overhead for Providers: Healthcare practitioners continue to voice concerns over rigid reporting requirements, delayed reimbursements for medical leave, and strict volume caps on diagnostic imaging and laboratory tests.
Romania races to complete 4,500 PNRR projects before August deadline
