KIRTIPUR: Health insurance payments, which had become problematic in previous years due to a lack of resources and other constraints, have started to ease.
Following the formation of a new government under the leadership of Balendra Shah, the settlement of outstanding insurance payments from previous years has accelerated.
In the past week alone, the government has transferred Rs 1.3 billion to the accounts of concerned health institutions under the health insurance programme. Of the total amount, 155 government hospitals, 25 community hospitals, and 37 private hospitals have received payments.
As the government continues to release funds to clear arrears owed to health institutions across the country, problems related to delayed insurance payments are gradually being resolved.
According to information made public by the Health Insurance Board, more than Rs 326 million was disbursed to beneficiaries under special assistance programmes two days ago.
Senior Medical Superintendent of the Board, Dr. Pawan Sah, said that while insurance payments had previously been limited to services provided at government hospitals, payments have now also been made for treatments received at private health institutions.
Hospitals receiving such payments include Madhyabindu District Hospital, Bheri Zonal Hospital, Narayani Hospital, Nepal Manipal Teaching Hospital, and Tribhuvan University Teaching Hospital, among others.
Similarly, the government has released insurance payments for patients who received treatment at private institutions, including the National Trauma Center, the BP Koirala Institute of Health Sciences in Dharan, and B&C Teaching Hospital in Jhapa.
The payments cover services such as kidney dialysis, treatment of heart disease, severe head injuries, spinal injuries, and other conditions, in accordance with decisions made by the Health Insurance Board. Payments have been made for claims submitted by health institutions after the required documentation was completed.
To prevent future uncertainty surrounding the health insurance programme due to funding shortages, the government has allocated Rs 15 billion for the current fiscal year. In addition, it plans to adopt measures such as providing insurance services within available resources, strengthening hospital inspections, and closely monitoring procurement practices.
Meanwhile, Health and Food Hygiene Minister Nisha Mehta said the government would continue clearing outstanding payments to ensure that welfare programmes such as health insurance operate smoothly.
She added that the health insurance system would be more strictly monitored and regulated in the future to prevent similar problems from recurring.
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