Casino Cures All: ‘Sick’ Patients Miraculously Spotted at Slot Machines

_{At the slots. (Image: imagebroker.com/alamy)}

Bulgaria’s National Health Insurance Fund (NHIF) has launched an investigation after the tax authority flagged that nearly 3,900 people recorded as being in hospital were instead detected making 22,000 visits to land-based casinos in the first half of 2025.

The findings stem from revised gambling regulations that require all casino visitors to provide valid ID, which is uploaded in real time to the National Revenue Agency’s (NRA) system. That same ID data was compared with hospitalisation records, revealing thousands of cases where people listed as admitted in hospital appeared to have been at gambling venues.

Cross-Referencing Data Between Casinos and Hospitals

The NHIF suspects that some patients or third parties used fraudulent personal information to claim fictitious hospital stays and draw healthcare payments. The NRA’s tracking system provided indisputable evidence, said NHIF Deputy Governor Prof. Momchil Mavrov.

 “Let’s not call them fraudulent hospitalisations yet,” Mavrov said. “It is undoubtedly proven that people who were supposed to be under a hospitalisation … were present in casino halls.” 

He added that patients may have voluntarily left hospital premises without permission, rather than committing deliberate fraud. Still, the agency confirmed the total cost of the suspect hospital stays reached BGN 7 million, around £3.1 million.

Bulgaria’s Tightened Gambling Laws Enable Monitoring

Bulgaria’s gambling laws were overhauled in 2025 after nearly a decade. Licensed casinos must now stay connected to the NRA’s servers 24/7 and report all visitor IDs and financial activity in real time. This system made it possible to cross-match data and flag anomalies between medical and casino records.

The NHIF is working alongside the NRA to identify whether healthcare providers or intermediaries also played a role in fabricating hospitalisation records.

Could a Casino-Linked Fraud Case Happen in the UK?

While the UK has strong counter-fraud safeguards via the NHS Counter Fraud Authority (NHSCFA), the specific mechanism used in Bulgaria, where gambling venues upload visitor data to a central government system, does not exist in Britain.

UK hospitals do monitor patient admissions and discharges, but there is no system to track where those patients go once they leave. Nor is there a legal mandate to share gambling attendance data with health authorities.

Still, the NHS is no stranger to fraud. The Department of Health and Social Care’s own estimates suggest fraud costs the NHS over £1 billion a year, with common abuses including forged sick notes, false treatment claims, and misuse of NHS funds.

The NHSCFA investigates and prosecutes these offences but depends heavily on whistleblowers, audits, and tip-offs, not real-time cross-sector data matching like in Bulgaria.

What This Means for the Gambling and Healthcare Sectors

The Bulgarian case highlights how digital tracking in the gambling industry, often criticised for surveillance, can be a powerful tool against fraud when properly regulated. It also raises the question of whether public institutions like the NHS could benefit from tighter data integration with other sectors.

But for the UK to replicate such oversight, it would need to overhaul data privacy laws and develop cross-agency systems that currently don’t exist, a complex and politically sensitive challenge. For now UK patients will not be at the slots when they should be in a hospital bed.