Government Emergency Ordinance No. 91/2025 on establishing measures within the healthcare system

On 31 December 2025, Emergency Ordinance No. 91/2025 on establishing measures within the healthcare system was published in the Official Gazette No. 1223.

Control of medical leave certificates

A new provision introduces the possibility for CNAS and the local health insurance authorities to verify the legality and validity of medical leave certificates, either on their own initiative or upon employers’ requests.

The authorities will review the documents underlying the issuance of the certificate, the justification for the duration of the medical leave, the accuracy of the information recorded in the certificate, as well as the alignment

of the diagnosis and the medical recommendations. For this purpose, the authorities may request medical documents and information from the attending doctor or other healthcare providers.

If it is confirmed that a certificate was issued without complying with the legal provisions, the insured person will not be entitled to the medical leave allowance.

The detailed procedure for these controls and the method of applying sanctions will be established through a Government Decision.

The first day of medical leave will no longer be paid

For all medical leave certificates issued between 1 February 2026 and 31 December 2027, the health insurance allowance will be calculated and paid by reducing one day. Consequently, the first day of medical leave will be unpaid.

The employer will pay the allowance for temporary incapacity for work from the 2^nd to the 6^th day inclusive. As an exception, medical leave certificates issued for isolation as regulated by Law no. 136/2020 do not fall under the employer’s payment obligation.

After this period, the payment of the allowances becomes the responsibility of the National Health Insurance Fund (FNUASS), which covers:

• The allowance starts from the day following those paid by the employer, until the end of the medical leave or until the individual is retired.
• Starting from day 2, for those categories of medical leave that, by law, are fully covered by FNUASS.

According to the Ordinance, the day by which the allowance is reduced shall still be considered as insurance contribution period and the individual maintains their insured status.

The detailed procedure for implementing these provisions will be established through a Government Decision within 30 days.

These changes reflect a more rigorous approach to the governance of medical leave and may have a significant impact on both employees and employers, particularly preventing unjustified use and ensuring proper justification of periods of temporary incapacity for work.

For further information, the EY team remains at your disposal.