DOHA: Implementation of the national health insurance scheme (Seha) for expatriates including domestic workers will begin next year through private insurance providers, the Minister of Public Health H E Abdullah bin Khalid Al Qahtani has said.
In an extensive session with the media on Thursday meant to update on Seha, the minister denied reports that implementation of the scheme has led to wastage of government funds.
Citing data, he refuted recent reports that the total invoices received by the National Health Insurance Company (NHIC) from private healthcare providers amounted to QR10bn. The total medical bills for Qataris under Seha was QR1.285bn since the launch of the scheme in July 2013 until October 21 this year, said the minister. Seha currently covers all Qataris for their basic health needs.
The audited bills for the first fiscal year (July 2013 to March 2014) and second fiscal year (April 2014 to March 2015) amounted to QR894m, in addition to QR391m for the period from April 1 to October 21, 2015.
Assistant Secretary General for Policy Affairs at the Supreme Council of Health (SCH) and acting CEO of NHIC Dr Faleh Hussein was also present at the press conference.
In reply to a question from The
Peninsula, Al Qahtani said, coverage for expatriates will begin next year and private insurance providers will be responsible for that. “NHIC is the insurance provider for Qataris while expatriates will be covered through private companies. A special committee is working on assessing the cost and deciding the basic packages,” said the minister. He said private insurance providers will issue their own insurance cards to expatriates, as in the existing system, while citizens will continue to use their Qatari IDs. The health cards issued by the Hamad Medical Corporation (HMC) to expatriates will continue to exist in the initial phase, but they should be brought under the scheme eventually.
There will be three different basic packages for expatriate workers based on their salary structure. They are broadly classified as white-collar and blue collar workers and domestic helps. Insurance for visitors will cover only emergency services.
The minister said that the NHIC has refused to pay invoices amounting to QR317m from the private health sector since introduction of the scheme, while the recoverable funds were to the tune of QR103m. The company employs controls in paying bills such as preventing service providers from unjustified repeat visits and the unnecessary assignment to other disciplines. There is also a detailed and manual audit for all the claims made by service providers, as well as checking on medical files.
He said that the NHIC, in cooperation with the Supreme Council of Health, established a consultative committee comprising doctors from both public and private sectors, and another committee of dental specialists for second opinion on some cases covered by Seha.
Every treatment under Seha is offered at the same price in hospitals and clinics joining the scheme and, therefore, the bills cannot be manipulated. Each package of treatment or illnesses has a specific price.
On misuse of Seha, the Minister said two expatriates had recently been arrested after they used citizens’ personal IDs to avail of treatment in private hospitals under Seha.
Work was stopped at a private health facility after it submitted false invoices and QR5m had been recovered.
Dr Faleh Hussein said wrong treatment by health services providers requires the return of the price to NHIC. He said the audit system in the company is strict and bills are audited before and after payment.
Medical costs applied by the company are defined by the SCH, not by service providers.
The price schedule has been prepared by two independent advisory bodies recognised internationally.
The companies worked with the SCH on a study that took nearly a year to complete.
He said the price schedule is revised periodically on the basis of data received through claims and expectations and changes in prices.
THE PENINSULA
