DOHA: Two resident were recently arrested after they used citizen's personal cards to benefit from treatment in private hospitals under the health insurance system. Work was also suspended with a health service provider because of false invoices and QR5m had been recovered. The cases of fraud and forgery in medical bills were revealed by the Minister of Public Health HE Abdullah bin Khalid Al Qahtani in a joint press conference with acting CEO of the National Health Insurance Company Dr Faleh Hussein.
He further said that the National Health Insurance Company, in cooperation with the Supreme Council of Health, has established a consultative committee consisting of doctors from both the public and private sectors, and another committee of specialists for a second medical opinion, under the supervision of the Council.
The Minister underlined that the Health insurance system is an urgent necessity to contain health care costs, reduce the burden on the public health sector, give an opportunity to the private sector for growth and expansion in the services because of its important role in increasing the capacity of health services in the state, and give the opportunity to citizens and residents to choose a service provider, and thus enhancing competition among suppliers to improve the quality of health services.
Concerning health services prices in the insurance system, the Minister said that each disease is subjected to the package of expenses, and each treatment under the insurance system is offered with the same price in all hospitals and clinics joining the insurance system, and therefore the bills cannot be manipulated as each package of treatments or illnesses have a specific price fixed in advance.
For his part, Assistant Secretary General for Policy Affairs at the Supreme Council of Health and Acting CEO of the National Health Insurance Company Dr Faleh Hussein said that wrong treatment by health services providers requires the return of the fee to the Health Insurance Company.
He noted that the audit system in the company is very strict where the bills are subject to audit before and after the payment.
He added that medical costs applied by the company is defined by the Supreme Council of Health not by service providers. The prices schedule has been prepared by two independent advisory bodies that are recognized internationally. The companies worked closely with the Supreme Council through a study that took nearly a year to be completed.
He noted that the prices schedule is being revised periodically in coordination with the Supreme Council of Health on the basis of the data received through the claims and expectations and changes in the prices of services in the sector in order to achieve a fair price for all parties.
The Peninsula
