In brief

  • The annual fee paid by health services evaluators rises from 200 to 840 lei. The amount is paid in a single instalment, between 1 and 31 January, is not refundable and covers attendance at the annual refresher course. Those who have already paid 200 lei for 2026 still owe 640 lei, due by the date on which they confirm their attendance at the course. The figure of 200 lei had been set in November 2016 and was still in force for 2026.
  • The evaluator’s certificate becomes annual and is lost if the mark falls. The document expires on 31 January of the following year, whatever the date on which it was issued. To keep it, the evaluator has to pass the refresher course with at least 8.00 and to gather, within one calendar year, at least 30 theoretical continuing education points and 7 practical ones. Points do not carry over from one year to the next.
  • Training moves to the National Authority for Quality Management in Healthcare and costs 1,960 or 2,520 lei. The course runs for at least 56 hours, the written examination has 40 questions in 60 minutes, and the pass average is 8.00. The certificate of completion does not automatically confer the right to evaluate: entry in the register is limited to the number of places available, in descending order of averages.
Act: Order of the President of the National Authority for Quality Management in Healthcare no. 136/2026 approving the normative framework for the health services evaluators of the National Authority for Quality Management in Healthcare
Published: Official Gazette of Romania, Part I, no. 810 of 24 September 2026, page 31, and no. 810 bis of 24 September 2026, pages 3-105
In force from: 24 September 2026, the date of publication, because orders of the heads of central public administration bodies are not subject to the three-day period laid down for laws and ordinances

The National Authority for Quality Management in Healthcare has rewritten, in a single order, every rule by which the people who walk into hospitals to check whether they deserve accreditation are trained, certified and disciplined. Order no. 136/2026 was published on 24 September 2026 and replaces five older acts, three of which had never appeared in the Official Gazette of Romania. It comes three weeks after the third edition of the hospital accreditation standards, that is, after the set of requirements the evaluators will be applying on the ground.

The first figure that catches the eye is the fee. Annex no. 3, Article 10, sets it at 840 lei a year, payable between 1 and 31 January, in a single instalment, with no possibility of a refund. The previous order, no. 651/2016, published in Official Gazette of Romania no. 902 of 9 November 2016, had set it at 200 lei, and Article 7 of the new order confirms that this was still the 2026 rate. The difference is 640 lei, that is, a 4.2-fold increase after ten years in which the amount had not moved. Evaluators who have already paid the 200 lei for 2026 pay the rest by the date on which they confirm their attendance at the refresher course.

The order has 10 articles and five annexes: the training methodology, the methodology for assessing performance and for refresher training, the methodology for managing evaluators, the Code of Conduct and the rules of the committee that investigates misconduct. The annexes appeared separately, in the bis edition of the same day, and run to 103 pages.

What it changes in practice

From 24 September 2026, to stay in the „Evaluatori activi” section of the register, the section of active evaluators, an evaluator has to meet four conditions at the same time: to have paid the fee, to have passed the annual refresher course with at least 8.00, to have gathered in the previous year at least 30 continuing education points for theoretical training and at least 7 for practical work, and to have updated the data held in the CaPeSaRo application within no more than 15 working days of any change. If a single one of them is missing, the certificate is revoked and the evaluator moves to the „Evaluatori inactivi” section, that of inactive evaluators.

The refresher course is held every year between 1 September and 31 December, over at least three days, with four hours of instruction a day. It ends with a multiple-choice test of 30 questions in 60 minutes, and the pass mark is 8.00. Anyone who fails is entitled to a single re-examination in the same year, organised within no more than 15 working days of the result being communicated and in any event no later than 31 December. Appeals may be brought only against the written paper, within two working days, and are settled within another two working days.

For those coming in from outside, joining the body of evaluators has a price and a timetable. The course fee is 1,960 lei for anyone who already holds the certificate of completion of the Quality Management of Healthcare Services course and 2,520 lei for anyone who also has to take that module. The basic course runs for at least 56 hours, of which 50 of theoretical instruction and 6 of practical instruction, while the additional module runs for 14 hours, 12 theoretical and 2 practical. The two examination papers are marked from 1 to 10, the minimum mark on each paper is 7.00, and the pass average has to be at least 8.00. On the practical paper, a case study discussed in a group, the score is split into 7 points for applying knowledge, 2 for the manner of presentation and 1 for teamwork.

The certificate of completion guarantees nothing beyond that. Article 19 of Annex no. 1 states expressly that entry in the register is made on application, within the limit of the places announced for the intake, in descending order of averages. Graduates who do not secure a place land straight in the „Evaluatori inactivi” section, from which they can be called back only when the authority needs people.

The Code of Conduct lists 35 acts that constitute misconduct, from carelessness in drafting reports and systematic delays to recommending consultancy firms to the unit being evaluated. The consultancy ban runs for at least two years before and two years after the evaluation process is completed. There are three sanctions: loss of membership of the committee for the evaluation under way, suspension of the right to take part in evaluations for six months, and loss of the status of evaluator, with revocation of the certificate. The last one is final: anyone who receives it can never register again.

What has changed compared with the previous situation

Training is no longer outsourced. Under the original form of the 2016 order, the courses were organised by the National School of Public Health, Management and Professional Development in Bucharest or by other bodies recognised by the authority, and the certificate of completion was issued by them. Now the authority trains its own evaluators, with its own trainers or with external lecturers appointed by order of the President, and it is the authority that issues the certificate.

The certificate changes its lifespan. The original form of the 2016 order granted it „as a rule for 3 years from the moment of issue”, with annual endorsements and a re-evaluation test every three years. The new order drops the endorsements and the three-yearly re-evaluation and ties the certificate to a single fixed point: 31 January of the following year.

The register loses one section. In the original 2016 form, the register had three sections, „Evaluatori activi”, „Evaluatori inactivi” and „Evaluatori excluși”, the last being excluded evaluators. Two are left now, plus the subsection of suspended evaluators, and exclusion has turned into loss of the status of evaluator, with a ban on registering again. In exchange, the records are organised in three professional categories, doctors, nurses and other professions, and anyone holding certificates for both specialisations, hospitals and outpatient care, has to choose a single register in which to be active.

The seniority requirement is levelled out. The original form of the 2016 order required five years of uninterrupted seniority from a principal nurse and two years from graduates in related fields. Now every candidate proves the same uninterrupted seniority of at least two years, in the public administration of healthcare or in the hospital sector, or in the health services sector for outpatient care evaluators.

The threshold of continuing education points falls. In the original 2016 form, the order required at least 40 points in the twelve months following the last endorsement, of which no fewer than 30 theoretical and no fewer than 7 practical. The new order keeps the two partial thresholds but drops the total of 40, so the effective minimum comes down to 37 points per calendar year. One rule is added that did not exist before: points do not carry over, and the supporting documents have to be uploaded within no more than 60 working days of being issued, otherwise they no longer count.

Advantages and disadvantages

What it improves

  • For the first time, all the rules sit in a single act published in full. Three of the five repealed orders, among them the model of the register and the model of the certificate, had never appeared in the Official Gazette of Romania (Monitorul Oficial), so neither the evaluators nor the hospitals could read them.
  • The entry criteria are written down, with deadlines: five working days for examining the applications, one working day for appeals, publication of the anonymised results on the website, and separation by the mark on the practical paper in the event of a tie.
  • Each evaluator’s performance is assessed after every visit, on a form that also gathers the view of the healthcare unit evaluated, and the evaluator has five working days to reply in writing or to lodge an appeal.
  • The fee covers the refresher course, so the evaluator no longer pays separately for compulsory training.
  • The investigation of misconduct gets rules of its own, with a five-member committee, substitutes, written notice at least five days in advance and the right to put forward a defence.

What remains a problem

  • The annual cost quadruples overnight, with no intermediate step and no explanatory statement published together with the order.
  • The fee is not pro-rated. Anyone entering the register in December pays 840 lei for a certificate that expires on 31 January, then pays another 840 lei to carry on.
  • The time limit for reporting misconduct runs from the date of the act, not from the date on which the authority discovers it, even though the main instrument of discovery, the activity analysis form, is only drawn up after the documents have been formally received.
  • The annual timetable for refresher training, that is, a plan approved by 31 July and courses between 1 September and 31 December, could no longer be met in 2026, because the order entered into force on 24 September.
  • The annual performance mark becomes a threshold of professional survival, without the order saying how the criteria that make it up are weighted.

Practical advice

  1. If you are an active evaluator and you paid 200 lei for 2026, get the remaining 640 lei ready: they have to be transferred by the date on which you confirm your attendance at the refresher course, and that confirmation is due within three working days of the intake being announced.
  2. Check the data in your CaPeSaRo account now, not in January. A change of name, address or workplace not reported within 15 working days brings suspension, and suspension blocks you from sitting on committees.
  3. Upload your diplomas and certificates to your personal account within no more than 60 working days of their issue. After that deadline they no longer count towards points, even if the activity did take place.
  4. If this year you took part in no evaluation visit and in no voluntary work, for reasons beyond your control, gather 37 theoretical points, not 30: the 7 practical points can be made up only with additional theoretical points.
  5. If you enrol on the training course, ask in writing for the number of places available in the register, not just the number of places on the course. The certificate of completion does not give you the right to evaluate if the places have been filled ahead of you.
  6. If you receive an order imposing a sanction, read first the date on which the authority says it became aware of the act. The time limit for issuing the order is written differently in two annexes of the same order, and the difference can exceed ten days.

Frequently asked questions

What does it cost now to be a health services evaluator?
The annual fee is 840 lei and is paid in a single instalment, between 1 and 31 January. The amount covers attendance at the annual refresher course and is not refundable. For entry into the profession, the course fee is added: 1,960 lei for anyone holding the Quality Management of Healthcare Services certificate and 2,520 lei for anyone who also has to take that module.
What happens if I do not pay the fee on time?
Failure to pay by 31 January leads automatically to the „Evaluatori inactivi” section, the certificate is revoked and you can no longer attend the refresher course for that year. Inactive evaluators are exempt from the fee, but they cannot serve on evaluation committees. Coming back is possible only when the authority announces that it needs evaluators, and it means paying the fee in full.
How long is the evaluator’s certificate valid?
Annex no. 3 gives two answers. Article 1(4) describes it as a document valid for 12 months, while Article 9(2) and (3) says that it expires on 31 January of the following year, whatever the date on which it was issued. The second rule is the detailed one and it fits the mechanism of the fee, but the contradiction remains in the text.
Can I be an evaluator for hospitals and for outpatient care at the same time?
You can complete both training programmes and you can receive a certificate for each, but in the „Evaluatori activi” section you can be entered in only one register. The choice can be changed later, with the approval of the President of the authority and depending on how many evaluators are needed.
What happens if I get a low mark in the performance assessment?
The mark on the activity analysis form is itself the number of practical points you receive for that year, and the compulsory minimum is 7. An annual average below 7.00 means you do not meet the condition and you move to the „Evaluatori inactivi” section. Making the points up with additional theoretical points is reserved for those who took part in no visit and no voluntary work at all.
How long is there to sanction an evaluator?
A report or an own-initiative finding may be made within no more than 30 working days of the date of the act. The investigation and its settlement have to be completed within 12 months of that same date. The time limit for issuing the order imposing the sanction is, however, written in three different ways in the same order, and the difference between them changes the date on which the order becomes open to challenge as out of time.

Errors and inconsistencies in the published text

  • The time limit for issuing the order imposing a sanction is written in three different ways, with two different starting points. Annex no. 4, Article 54(1), says that the order „se emite în termen de 30 (treizeci) de zile lucrătoare de la data luării la cunoștință de către ANMCS cu privire la săvârșirea abaterii”, that is, within 30 working days of ANMCS becoming aware of the misconduct. Annex no. 5, Article 33(1), says that the President determines the sanction by order „în termen de 30 (treizeci) de zile calendaristice de la data luării la cunoștință despre săvârșirea abaterii”, that is, within 30 calendar days. Annex no. 5, Article 21(2), says that „emiterea și comunicarea ordinului de sancționare se realizează în termen de cel mult 30 (treizeci) de zile de la data înregistrării Raportului de cercetare prealabilă”, that is, within 30 days of the preliminary investigation report being registered. Thirty working days means 42 calendar days in a stretch with no public holidays, so twelve days more than the calendar version, while the third text moves the starting point altogether, from the date the act became known to the date the investigation report was registered. The time limit decides whether the order imposing the sanction was issued inside or outside the statutory period, that is, whether the sanction can be annulled as out of time.
  • The rule that says where and within what time the sanction may be challenged refers to a law that does not exist, and the official text still carries the printed correction note of a private legal database. Annex no. 5, Article 33(2)(e), provides that the order sets out „termenul în care poate fi contestat și instanța competentă, potrivit Legii nr. 554/2005 privind contenciosul administrativ”, that is, the time limit for challenging it and the court with jurisdiction, under Law no. 554/2005 on administrative litigation. Administrative litigation is governed by Law no. 554/2004, published in Official Gazette of Romania no. 1154 of 7 December 2004; there is no law numbered 554 of 2005 governing this field. The parallel text in Annex no. 4, Article 54(2)(e), is published in the form „potrivit Legii nr. 554/2005 (Erată G&G: Legii nr. 554/2004) privind contenciosul administrativ”, on page 85 of the bis edition: the bracket is not normative text but the correction note of a private legislation provider, taken over together with the text and left in the official edition. The correct number appears twice in the same order, in Article 57 of Annex no. 4 and in Article 2(1)(e) of Annex no. 5. The reference is itself a rule, because the time limit for a challenge and the court with jurisdiction depend on it.
  • The validity of the certificate is laid down twice, differently, in the same annex. Annex no. 3, Article 1(4), defines the certificate as an „document electronic emis de către ANMCS în condițiile prezentului ordin, valabil 12 luni”, an electronic document issued by ANMCS under the order and valid for 12 months. Article 9(2) and (3) of the same annex says that the certificate is issued on registration „și este valabil până la data de 31 ianuarie a anului următor, indiferent de data la care a fost emis”, and is valid until 31 January of the following year whatever the date of issue. For an evaluator registered in October, the first rule gives a certificate valid until October of the following year, the second stops it on 31 January. The certificate is the document that confers the right to sit on evaluation committees, so the difference decides whether a committee was lawfully constituted.

Editorial analysis

The order solves a real and long-standing problem. Until now, the regime of the evaluators was scattered across five acts, three of which, the model of the register, the model of the certificate and the rules of the misconduct committee, had never been published in the Official Gazette of Romania. A hospital that wanted to know the rules by which the person coming to evaluate it is judged had nowhere to look. Now it has 103 pages and a single body of text, and that matters more than it seems, because accreditation has contractual consequences for the hospital.

The part where the order stays brief is precisely the part that decides an evaluator’s career. The threshold of 7 points for practical work is in fact a pass mark: Annex no. 3 says, in Article 16(6)(a), that „nota din FAAE reprezintă numărul de PFC practice obținute pentru anul respectiv”, that the mark on the activity analysis form is the number of practical continuing education points obtained for that year, and the annual minimum is 7. In other words, the annual average of the activity analysis forms has to be at least 7.00, otherwise the evaluator drops out of the active section, however many courses they have attended. Making the points up with theoretical ones, provided for in paragraph (7), is expressly reserved for those who took part in no visit at all, so it does not help the evaluator who did take part and scored 6.50. The methodology says instead that the form is filled in for every visit, on the basis of six sources, among them the feedback of the healthcare unit evaluated, but the weightings are left to be set later, by another order of the President. A pass mark therefore exists before the way it is calculated is public.

The second place where the text leaves an asymmetry is the timetable. The evaluator is given short, precise deadlines: three working days to confirm attendance at the course, five working days to upload proof of payment, 15 working days to update personal data, 60 working days for the documents behind the points. What is left to the authority are deadlines it controls itself, and in 2026 it could not even meet them: the annual refresher training plan is approved by 31 July, the courses are held between 1 September and 31 December, and the order entered into force on 24 September, three weeks after the window opened. The order lays down no transitional rule for this year, apart from the one saying that certificates issued after the course are valid until 31 January 2027.

On money, the increase arrives all at once and in full. The 840 lei are paid in their entirety, in a single instalment, whatever the month in which the evaluator enters the register, and the amount is not refundable. The original form of the 2016 order at least had a release valve, Article 9(7), which required payment in proportion to the period of activity during the year in the event of suspension; there is nothing equivalent in the new text. Add that the certificate expires on 31 January „indiferent de data la care a fost emis”, whatever the date of issue, and an evaluator registered in December pays 840 lei for at most two months of the right to evaluate, then another 840 lei to carry on. Set against hours, the training fee looks just as uneven: the 56 hours of the basic course cost 35 lei an hour, while the 14 hours of the additional module, the 560-lei difference between the two fees, cost 40 lei an hour.

What should be changed

  • A single time limit for issuing the order imposing a sanction, with a single starting point. As things stand, the evaluator who wants to plead that it is out of time and the authority that wants to avoid that plea read three different texts in the same order. A one-sentence amendment, saying „30 working days from the date on which ANMCS became aware of the act”, would make the date on the order verifiable by anyone, without interpretation.
  • Correcting the reference to the administrative litigation law, no. 554/2004, and removing the database annotation from the official text. The practical effect: the person sanctioned would know from the act itself, not by deduction, which court to turn to and within what time. For now, the only correct mention in Annex no. 5 sits in the list of acts at the start of the rules, not in the provision that directly concerns them.
  • The validity of the certificate written down once. The definition in Article 1 should also say „until 31 January of the following year”, not „12 months”. Otherwise an evaluation committee set up in November with an evaluator certified in October of the previous year can be challenged on the ground that the certificate had expired, and the hospital evaluated has a free argument against the report.
  • A pro-rated fee for registrations in the second half of the year. Payment in full for one or two months of activity bears no relation to the cost of the refresher course that the fee covers, because that course is held between September and December. A pro-rating rule, like the one the 2016 order had for suspension, would remove the situation in which the same person pays 1,680 lei over two consecutive calendar months.
  • The time limit for reporting misconduct should run from the date of discovery, not from the date of the act. The 30 working days from commission are often used up before the activity analysis form is drawn up, because that is done within 15 working days of the formal receipt being completed, and the receipt comes after the visit. In practice, the 12-month limit for the investigation is left without object for the very misconduct that the authority’s own evaluation system brings to light.
  • Publishing the grid of weightings for the activity analysis form together with the methodology, not afterwards. The mark on the form decides whether the evaluator stays active, so its criteria and weightings are a rule with direct effect, not a detail of internal procedure. Published, they would turn the appeal provided for in Article 6(7) into a right that can be exercised on arguments rather than on impressions.

Original text of the legal act

The text below is reproduced in Romanian, the official form of publication.

The full text, as published in the Official Gazette of Romania

Official Gazette of Romania no. 810 of 24 September 2026 32 pages PDF, 208 KB the act starts on page 31

Open the official PDFDownload the PDF

The other editions cited: nr. 810 bis/2026

The viewer is not shown on small screens. Use the buttons above to open or download the file.

This article is for informational purposes only and does not constitute legal advice. For specific situations, consult a licensed attorney or tax advisor.