Norwegian doctors criticise health authority over new documentation rules

A letter sent by Norway’s Health Economics Administration (Helfo) to general practitioners last week, clarifying documentation requirements for state-funded consultations, has sparked outrage among doctors who call the move hypocritical and threatening.

According to a report by Dagbladet, fastlege (GP) Mozzie Marvati took to Facebook to condemn the letter, writing: “Spare me the hypocrisy. You can’t praise us with one hand and choke us with the other.” He told the newspaper that while controls are necessary, the letter felt like a “threat hanging over GPs who are already in crisis.”

Helfo stated the letter aimed to “clarify what is expected” in documentation but acknowledged the message “did not resonate with everyone.” Anette Randeberg, director of treatment reimbursement at Helfo, said feedback would be considered for future communication.

The letter outlined four documentation requirements: proof that care was medically necessary, details of what was done, the reason for the treatment, and justification for the billing codes used. Marvati questioned how GPs could know Helfo’s definition of “medically necessary” and called the guidelines vague, offering no concrete examples of sufficient record-keeping.

Geir Gilje, a GP and union representative in Sandnes, echoed the criticism, arguing the system lacks clear standards. “The method is so unclear that even honest practitioners get penalised,” he said. Both doctors warned the rules could push GPs to underbill or focus more on documentation than patient care.

Under Norway’s reimbursement system, GPs must document consultations to Helfo’s standards or risk repayments and losing their right to state funding—a move that would effectively end their practice. Helfo selects doctors for audits based on high reimbursement claims, but critics say the criteria remain unclear.