Apr 06, Kathmandu - The Health Insurance Board has warned of strict action against health institutions that charge insureds cash to buy medicines and discriminate against them in services. The board issued a notice on Monday, stating that the agreement with hospitals that send medicines included in the insurance package to outside buyers and discriminate against the insured may be canceled.

According to the board, recently, there have been widespread complaints that some service-providing health institutions have forced insureds to buy medicines and pharmaceutical materials included in the insurance facility from outside drug stores in cash. 'We warn against such acts, if found doing so, strict action will be taken as per Rule 19 of the Health Insurance Regulations, 2075,' the board's notice states.

Similarly, the board has also drawn serious attention to the practice of forcing patients who come to get services through insurance to book appointments in advance and treating them discriminatoryly compared to other patients. The board has warned that if such activities are not stopped, the insurance agreement with such hospitals will be canceled as per Section 12 of the Health Insurance Act, 2074.

The board has also clarified the issue of rates of medicines and services. If the hospital's own rate is lower than that specified in the insurance 'facility bag', then a claim must be made at the hospital's own minimum rate. The board has also directed that all such claims be mandatorily claimed in the Insurance Management Information System through API.