The Directorate of Health has stated that patients should not pay for additional services in primary care

The Directorate of Health has assessed the practice of general practitioner (GP) contractors and contract appointment medical specialists to charge payment for supplementary services in addition to the funding they receive from the public sector. This applies, for example, to hourly fee or SMS fees, and patient payments for other types of services that are not regulated by the Agreement with public health authorities. The Directorate of Health concluded that it is not allowed to claim this type of additional personal payment from patients, including existing services (such as internet services) and any new services not intended or introduced yet.

The economic conditions for general practitioners and appointment specialists are governed by the Government Agreement between the Government, Association of Local Authorities (Kommunenes Sentralforbund) and regional health authorities (regionale helseforetak) on one hand and the Norwegian Medical Association on the other hand.

The Government Agreement includes three types of funding for GPs and appointment specialists:

• operating grants (driftstilskudd);
• reimbursement tariffs of the National Insurance (refusjoner takster);
• tariffs for patient payment (deductible / self-payments).

This funding covers the services offered by GPs and appointment specialists delivered to the patients. When GP or other specialist have an agreement with the public health sector they are a part of public health system and cannot act in violation of the rules and principles on which public health system is based. One of these principles is that the population should have access to healthcare regardless of the type of private economy they have. The patient's deductions and own payments are governed by, among other regulations, by the National Insurance Act (Folketrygdloven), according to which a public physician cannot charge the patient any payments other than those provided by the regulations. The physician cannot instruct the patient to communicate in certain ways (for example, only via digital channels).

See full details in the Norwegian here.

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