The Capital Market Authority (CMA) has issued the regulations for the compulsory health insurance scheme (Dhamani) due to be rolled out in the sultanate.
The regulations, captioned as Decision 78/2019, enshrine the guidelines for mandatory health insurance in Oman. They were compiled in collaboration with entities tasked with preparing the legislative and regulatory infrastructure for the Dhamani scheme which is for employees of the private sector, residents and visitors to Oman, according to Oman Observer citing a CMA statement.
Mr Abdullah bin Salem Al Salmi, CMA executive president, said the issuance of the decision represents an advanced step in preparations for the legislative infrastructure and legal framework of Dhamani.
The rules regulate the business of health insurance in Oman by specifying the obligations of the parties in the insurance relationship, ie, insurer, TPA, health services provider, the worker and employer.
The health insurance regulations cover general provisions governing health insurance market, licensing requirements to carry out the business, obligations of stakeholders and dispute resolution.
On the key features of the health insurance rules, Mr Al Salmi said that insurers licensed to carry out the business, health service providers, TPAs and others will be obliged to implement an electronic link called the ‘Dhamani Platform’. The purpose of this electronic platform is to digitalise the private healthcare system and health insurance services, as well as enhance the monitoring of the overall system in Oman.
The CMA is aiming for a mid-2020 timeframe to launch the e-healthcare system. This indicates that the compulsory health insurance scheme will be launched in the middle of next year.
The regulations will restrict insurers from retaining more than 40% of the insurance premiums in Oman. M