Health Insurance services suspended in private hospitals amid financial crisis
Dhangadhi: The government has suspended health insurance services provided in private hospitals.
Citing a serious financial crisis in the health insurance program, the Health Insurance Board has decided to halt all insurance services in private hospitals except for emergency care.
According to a notice issued by the board on Thursday, health insurance services delivered through private health institutions will be discontinued from June 16 until further notice. The decision was made during a board meeting held on June 11.
With this move, services such as OPD consultations, diagnostic tests, surgeries, medicines, and other routine treatments accessed by insured citizens at hundreds of private hospitals and medical colleges affiliated with the program across the country will be affected. However, the board has clarified that emergency services will continue as usual.
The health insurance program, introduced by the government to ensure access to healthcare for all citizens, is now facing growing criticism, with concerns that it has reached a crisis point due to financial mismanagement, mounting arrears, and administrative weaknesses. Sources indicate that the board was compelled to cut services after payments worth billions of rupees to private hospitals remained unsettled for years.
According to the board, approximately 16 billion rupees is still owed to service providers. Health experts warn that the sustainability of the program is at risk due to inadequate financial management, insufficient focus on service quality, and lack of long-term planning.
Private hospitals have long raised concerns about delayed insurance payments, pending claims, and increasing procedural complexities. Some institutions had already warned that they would stop admitting insured patients. With the board’s decision to suspend services, the health insurance program has effectively entered a phase of contraction.
