Bulgaria | Cam-Regulation


Summary of the country's general legislation of CAM.

Go directly to legislation of specific CAM therapies in Bulgaria:
Acupuncture – Anthroposophic medicine – Ayurveda – Chiropractic – Herbal medicine/Phytotherapy – Homeopathy – Massage – Naprapathy – Naturopathy – Neural therapy – Osteopathy – Traditional Chinese Medicine (TCM) – Other treatments (if found in legislation)

Bulgaria became a member of the European union in 2007 (11) and has been a member of
the Council of Europe since 1992 (12).

The legal and regulatory status of CAM and CAM practices

The Health Law, effective from 1 January 2005, includes regulation of Complementary and Alternative Medicine in Chapter Six, Articles 166-173 (58). Article 166 quotes:
“(1) The Minister of Health shall control the application of non-conventional methods for favorable impact on individual health, including:

  1. The use of non-pharmaceutical products of organic origin;
  2. The use of non-pharmaceutical products of mineral origin;
  3. The use of non-conventional physical methods;
  4. Homeopathy;
  5. Acupuncture and acupressure;
  6. Iris, pulse and auricular methods of testing;
  7. Dietetics and curative hunger.

(2) The use of non-conventional method for favorable impact on individual health other than those under Paragraph 1 shall be prohibited” (58).

Except for homeopathy, eligible to practise under art.166.1 are holders of

  • A master’s degree in the professional area of medicine, dental medicine or
  • A specialist’s or bachelor’s degree in the professional area of health care.
  • A secondary education diploma and a certificate of completed training of at least
    four semesters at a higher medical school under terms and conditions set out by the
    Minister of Health and the Minster of Education and Science.

Eligible to practise homeopathy are holders of a master’s degree in the professional areas of medicine or dental medicine (58). We interpret the educational level “Master’s degree in medicine” to be equivalent with “medical doctor”.

According to the health law article 170, practitioners shall register at the regional healthcare center (RHC) in the region where they operate (58). The regional healthcare centers manage a public register for non-conventional providers (58).

In the health law article 173 patients of alternative medical practitioners have to be registered in the “visitor’s journal”. The visitor’s journal is managed by the regional healthcare center (RHC). Advertising for alternative treatment methods shall be prohibited according to article 169 (58).

The governmental supervision of CAM Practices

Registered non-conventional practitioners are subject to supervision according to the health law 2005, Chapter six, articles 168-173 (58).

The reimbursement status of CAM practices and medicinal products

Alternative treatment is paid out-of-pocket by the patients themselves (61). The health insurance act, article 45 describes the treatments and medical care which are covered.

Article 51 says that no other health service than those mentioned in art. 45 are covered. It is unclear if alternative treatment is covered according to those articles (62).


11. EUROPA. Gateway to the European Union; member countries. Brussels EUROPA
Communication department of the European Commission; 2011 [cited 2011 November 3]; Available from: http://europa.eu/about-eu/countries/index_en.htm.

12. Council of Europe. Council of Europe. Strasbourg: Council of Europe; 2011 [cited 2011
November 7]; Available from: http://www.coe.int/lportal/web/coe-portal.

58. Solicitor Bulgaria. Bulgarian Health Act, part 2 Section, Promulgated, SG No. 70/10.08.2004, effective 1.01.2005, Chapter Six, Non-conventional methods for favourable impact on individual health Sofia: Copyright 2011 by SOLICITOR LTD; 2011 [cited 2011 November 2011]; Available from: http://solicitorbulgaria.com/index.php/legislation/health-law:45.

61. Georgieva L, Salchev P, Dimitrova R, Dimova A, Avdeeva O. Health Systems in Transition: Bulgaria: Health system review. In: Avdeeva O, Elias M, editors. Copenhagen: WHO Regional Office for Europe, on behalf of the European Observatory on Health Systems and Policies; 2007. p. 1-156.

62. Health insurance act, New, SG No107/2002 with amendments, (2002).

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