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Palestine: Financial regulator brokers agreement between insurers and hospitals

Source: Middle East Insurance Review | Sep 2018

The Capital Market Authority (CMA) has mediated an agreement between the Palestinian Insurance Federation (PIF) and the Federation of Private Hospitals to resolve outstanding issues between the two parties.
 
Under the agreement, the hospitals would resume accepting insurance of patients and to start dialogue with insurers to resolve their outstanding differences.
 
Dr Nitham Najib, the head of the Doctors Association said it has agreed to hold constructive dialogue between the association and representatives of private hospitals, on the one hand, and insurers, on the other, according to a report by the news agency Wafa.
 
Dr Najib said the dialogue aims to reach a comprehensive and clear agreement for the benefit of the public, stressing that the private hospitals did not stop for a moment providing health service to patients, but there had been a change in some procedures for accepting insurance cards.
 
The Federation of Private Hospitals had announced in July that it would not accept insurance cards issued by local insurers, a move which forced patients to pay first for the medical treatment themselves and then claim reimbursement from insurers.
 
The director general of Medical Services at the Ministry of Health Osama Najjar called for continued dialogue between the PIF and all health service providers so as to ensure that the delivery of health services remains smooth without disruption.
 
Dispute over prices of medical treatment
In July, the Federation of Private Hospitals called for a boycott of health insurers, and for hospitals not to receive patients with health insurance cards as of 1 August 2018.
 
The association cited the failure of insurers to respond to its demands for more than a year to adjust the pricing of medical services.
 
Another complaint of medical institutions is that they have to seek approval from insurers for medical procedures, especially those that are highly specialised. Hospital sources said the approval or rejection of the medical procedure by insurers is usually determined by a person who is unable or less qualified than specialists to determine the importance or priority of the procedure, and there are some cases where the delay in approval forced the patient to go for treatment at his own expense.
 
On the part of insurers, PIF chairman Anwar Al-Shanti said that about eight months ago, hospitals formed a group which began to address the insurers on raising and standardising the pricing among all hospitals without taking into account the operating amounts or the size or potential of hospitals. He added that a dialogue session was to have been held between the two sides on 1 August, but the hospitals pre-empted that by carrying out a boycott of insurers on that date. 
 
Last November, he pointed to some shortcomings in dealings with medical practitioners that have led to large losses for insurers. These include complicity among some lawyers and doctors in a number of claims cases.
 
Mr Al-Shanti expressed his readiness to study the proposals on raising prices, but is wary that hospitals and doctors may perform unnecessary or repeated medical procedures, with the increase in costs borne by insurers.
 
He stressed that any price hike in the current political and economic conditions in the Palestinian territories will negatively affect the public.
 
There are eight insurers registered with the PIF that insure around 140,000 people. M 
 
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