HIB suspends insurance services in private health institutions

By A Staff Reporter, Kathmandu, May 29: The Health Insurance Board has decided to suspend all insurance services except emergency ones in private health institutions, citing the growing financial crisis.

According to the decision taken by the board meeting, this arrangement will be implemented from May 29, Friday.

A press release issued after the board meeting stated that all insurance services other than emergency ones provided by private health institutions affiliated with the Health Insurance Programme of the Government of Nepal will be suspended until further decision.

“The continuation of service management has become challenging due to financial pressure and increasing liabilities, keeping this decision in mind for the time being,” the release stated.

With the decision, it is seen that general treatment, examination and other non-emergency services available through insurance in private health institutions across the country will be affected. However, emergency health services will continue to operate.

The board has also directed all the concerned health institutions to implement the decision and update the information on the website through the information technology branch.

Meanwhile, the Ministry for Health and Food Safety said that it has been working on the reformation of the insurance programme.  

According to Dr. Bikash Devkota, the Secretary of the Ministry of Health and Food Safety, it has been noted that health insurance services are being utilized not only by individuals who genuinely need them but also by those who do not.

“There has been double use of insurance services or, in some cases, misuse of insurance. The government, however, is currently trying to provide services targeting only those who are in need. Along with this, the government is planning to improve insurance services,” said Dr. Devkota.

Secretary Dr. Devkota added that the government also initiated efforts to clear dues for insurance services to various hospitals.

The decision was made following a discussion last week between MPs from the health sector across various political parties, health experts, and senior government officials.

In the discussion, most speakers suggested that the health insurance programme was being used unnecessarily and was not in the reach of the target group. They also suggested that appropriate solutions should be found to address the financial burden this programme has to bear, as the Ministry of Finance had already declared that it couldn’t support the programme with additional funds.

In the meantime, various large health institutions have already stopped providing insurance, setting an ultimatum to clear the dues.

Currently, the insurance programme, which covers nearly 10 million Nepalis, is in uncertainty due to the government’s inability to pay hospitals billions of rupees in outstanding claims.

According to the latest information from the Health Insurance Board, the amount owed to health service-providing institutions has exceeded 16 billion rupees. These institutions receive daily insurance claims totaling about 80 million rupees.