Risk of stopping treatment due to non-payment by health insurance

He said that now he is in a state of mind to stop the treatment under the insurance. The financial crisis is increasing as the insurance board does not pay the amount for a long time. Now we don't have the money to buy the necessary health supplies,' he said, 'now we have reached a state of mind to stop the insurance treatment by calling an all-party meeting.' 30 percent of patients are insured. Out of the 700 patients receiving services daily, more than 200 are covered by insurance, he said, "Insurance has also provided surgery, ICU, etc., which cost a lot of treatment." He said that due to the lack of research for a long time, it is not possible to get treatment.' Due to this, the suppliers have already warned that they will stop giving the material, he said. What to do if the supply of goods such as kidney dialysis is stopped? The patient may die.'

Lamichhane said that despite correspondence with the insurance board with the information about the problems of the establishment and the warnings given by the drug suppliers, there was no seriousness in paying the amount.

Chemicals and Medical Supplies Association Dang and Nepal Pharmaceutical Wholesalers Association Dang submitted a memorandum to the foundation on February 13, saying that the amount of money supplied by the business organizations affiliated to the association for the supply of medicines, lab chemicals, X-rays and other necessary materials for healthcare has not been paid for a long time.

Balkumar Gharti, Chairman of Chemicals and Medical Supplies Association, said that despite submitting a memorandum warning that they will not be able to supply health materials if the amount is not paid on time, there has been no hearing. Small businesses have reached a situation where they cannot supply health supplies. If payment is not received now, there is no option to stop the supply," Gharti said. "You cannot supply by buying goods on credit. Even though it is a sensitive material from the point of view of health, it has become a situation where the businessmen are drowning.' The foundation informed that the remaining amount of 30.7 million 29 thousand 787 rupees for the financial year 2079/080 and 10.5 million rupees for the current financial year is yet to be paid.

The board has responded that the payment is delayed due to the lack of staff to process the documents. Executive Director of the Board Dr. Damodar Basaula has been reinstated by the court order for removing him twice by the government. Because of this, the work of the board has not been able to pick up speed.

The then Health Minister Mohan Bahadur Basnet suspended Basaula for three months on October 26. On December 6, the Supreme Court gave an interim order not to implement the decision of the Minister of Health. After that, Basaula, who returned to work, was again dismissed by the government on January 9. The Council of Ministers decided to remove him saying that he could not speed up the insurance board and could not address various problems. He is re-instated by another order of the Supreme Court. Sources claim that due to this, the work of the board could not pick up speed.

Omkumari Kandel, the information officer of the insurance board, admitted that there was a delay in sending the health insurance amount and said that now preparations are being made to send it soon. The establishment has informed us about its problem. We have requested that sensitive services like health should not be stopped," she said. "Due to the delay in receiving and evaluating the documents, the funds have been delayed. Now preparations are being made to send it soon.' She said that the amount up to July has been paid and the balance is only from August.

'The payment of the old financial year is not due. Some claims are rejected without going through the process," she said. There is nothing left of the old one. Even after making a claim, if the required documents are not submitted, the amount will not be paid.'