KATHMANDU, March 31: The Health Insurance Board (HIB) has yet to pay Rs 16 billion to service provider hospitals. When confirming the claims made by the service provider hospitals within the month of Chaitra (mid-March to mid-April), it was revealed that there is still Rs 16 billion pending, said HIB chairman Chandra Bahadur Thapa
According to the HIB information officer, Bikesh Malla, this outstanding amount is expected to be paid within the current fiscal year 2024/24. He stated that as the number of insured individuals has increased, the government has allocated a smaller budget, which has caused delays in making payments on time.
According to Malla, the government has been allocating Rs 7.50 billion rupees for health insurance over the past three years. He mentions that while the number of insured individuals has been increasing, the decrease in the government grant budget has disrupted financial balance. “The number of insured individuals has increased every year, but the budget allocation has remained the same,” he said.
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According to the HIB, the government has increased the budget by Rs 3 billion for the current fiscal year following a special request. However, even this amount will not be sufficient to make the insurance payments within this fiscal year. By the end of the current fiscal year, it is expected that Rs 2 billion will be collected from the insured individuals. Even with the total of Rs 5 billion, it will still fall short for the required payments.
After HIB failed to make timely payments to service provider hospitals in the past, a few months ago, the Teaching Hospital had even suspended its insurance services. After the HIB made some payments, the hospital resumed providing services. Malla mentioned that delays in payments to service providers affect the internal budgets of hospitals, leading to management difficulties. He added that if payments could be made on time, ideally within one to two months, this issue would be reduced, though no immediate solution seems to be in sight.
“If payments are made on time, patients will receive faster services,” he said. According to ministry's Policy and Planning Division chief Dr Krishna Chandra Poudel, due to a shortage of funds in the HIB’s fund, the government reduced the budget of the Ministry of Health and Population by Rs 2.5 billion and transferred it to the HIB. With the government's decision, the budget under the Ministry of Health has been reduced, he said.
The health budget was already limited, and with this further reduction, other programs are expected to be automatically affected, said Chief Poudel.
HIB Chairman Thapa stated that both the HIB and the government need to play a role in resolving the ongoing issues that have been persistent for several years. Thapa stated that in the coming days, the HIB is preparing to make health insurance mandatory for citizens in the formal sector, including employees and entrepreneurs.
“We are working with the plan to strengthen the fund after making insurance mandatory for all entrepreneurs and employees,” he said. He also suggested that for a sustainable solution to the fund, the government needs to gradually increase the budget scope in accordance with time.
