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

He says that now he is in a state of mind to stop treatment under insurance. The financial crisis is increasing as the insurance board does not pay the amount for a long time. Lamichhane said, "We have reached a state of mind to stop insurance treatment by calling an all-party meeting." 30 percent of patients are insured. Of the 700 patients receiving services daily, more than 200 are covered by insurance,'' he said, adding, 'Operation, ICU and other costly treatments have also been done through insurance.

Lamichhane says that because of lack of funds, suppliers of medicines and health materials are not getting paid. 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?" He said, "How to do if the goods are not available?" The patient may die. Lamichhane said that despite correspondence with the insurance board with information about the problems of the establishment and warnings given by drug suppliers, they were not serious about paying the amount.

Chemicals and Medical Supplies Association Dang and Nepal Pharmaceutical Wholesalers Association Dang submitted a memorandum to the establishment on February 13, saying that the amount of money supplied by the professional organizations affiliated to the association for the supply of materials needed for healthcare including medicine, lab chemicals, x-ray, etc. has not been paid for a long time. Balkumar Gharti, President of Chemical and Medical Supplies Association, says that despite submitting a memorandum warning that the amount will not be paid on time, there has been no response so far.

'Small businesses are unable to supply health supplies. Now if payment is not received, there is no option to stop the supply," Gharti said, "We cannot buy goods on credit and supply them. Even though there are sensitive materials from the point of view of health, the situation has come to a point where the businessmen are drowning.''On February 14, the foundation wrote a letter to the board and informed them that there is a compelling situation in which they cannot run the health insurance program if the health insurance amount is not paid. The foundation said that the remaining amount of 30.7 million 29 thousand 787 rupees for the financial year 079/80 and 10.5 million rupees for the current financial year is yet to be paid.

The foundation says that the board is responding to the delay in payment due to lack of staff to process documents. Executive Director of the Board Dr. Damodar Basoula was removed by the government twice and was reinstated by the court order. 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 Health Minister. 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.

Omkumari Kandel, the information officer of the insurance board, said that while accepting the delay in sending the health insurance amount, 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 we are ready to send it soon.'' "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. Even after making a claim, if the required documents are not submitted, the amount will not be paid.'