UAE: New data-sharing system to cut health insurance fraud
Source: Middle East Insurance Review | Apr 2016
A new data-sharing scheme should help to cut health insurance fraud, as Dubai’s compulsory medical insurance scheme nears full coverage of the population, officials at Dubai Health Authority (DHA) said.
Medical professionals will be given secure log-in credentials to access electronic health records – enabling the DHA to track the source of breaches, reported The National newspaper.
“We will be able to see who is ‘doctor shopping’ and who is doing unnecessary MRI scans,” said Dr Mohammad Al Redha, Director of Health Data and Information Analysis at the DHA. “This model will save a lot of money.”
Each complaint of fraud is fully investigated. Penalties can vary, from a notice letter to a licence being revoked or a facility being closed.
However, Ms Alisha Moopen, Executive Director of Aster Hospitals and Clinics, said that patients in the UAE were still understanding where and how they could make best use of the benefits of health insurance, so it was still a learning curve for many.
“In my opinion, it is not always fair to call it an abuse of the system. There is a tendency for doctors to do everything they can for the patient to cover all necessary checks, before progressing to the next level of treatment.”
By 30 June this year, all employees, their spouses, dependents and domestic workers will have joined Dubai’s compulsory health insurance scheme.