Issues related to unpaid bills to the Health Ministry’s hospitals by insurance organizations was discussed at a meeting attended by top officials recently, said Dr. Mohammad Aqajani, deputy minister of health.
The meeting aimed to address the contentious matter between hospitals and insurance companies and propose practical solutions to resolve the pressing problem, the Persian language newspaper ‘Iran’ quoted Aqajani as saying.
First Vice President Eshaq Jahangiri, head of Management and Planning Organization of Iran (MPO) Mohammad Baqer Nobakht, head of Central Bank of Iran (CBI) Valiollah Seif, ministers of health and cooperatives as well as insurance officials were present.
Two important decisions were taken. First, the Social Security Organization (SSO) and the Iran Health Insurance Organization (IHIO) were ordered to pay $285 million within a week from the total debt of more than $1.2 billion owed to hospitals, Aqajani said.
Second, it was decided that the debts should be paid using banking resources and lending facilities, and that the banks coordinate the transactions between the hospitals and insurance firms.
Jahangiri instructed the head of the CBI to form an expert committee with the representatives of relevant organizations to ensure the smooth transfer of payments.
Aqajani said clearing the debts by insurance organizations will be beneficial to the healthcare system.
Coverage for Infertility
He also announced the ministry’s plan to increase insurance coverage for infertility treatment.
Health insurance is a significant tool in medical care as it finances healthcare and provides equal access to health services for the people. But the tug-of-war between hospitals and insurance organizations imposes extra burden on the patients, often causing financial losses and infringing upon their rights.
The SSO is a social insurer whose members mostly include wage-earners, the salaried class, retirees as well as self-employed persons.
A non-government organization, the SSO is solely financed by premium contributions (7% by employees/workers, 20-23% by their employers and 3% by the government). At present, more than 40 million people in the country are under the SSO umbrella.
SSO Director General Taqi Nourbakhsh, said this year (started March 21) the organization’s budget is $27 billion, which he said “is equivalent to 40% of the country’s annual budget,” and it is independent of government resources.
The public sector IHIO was established in 2014 to cover up to 90% of a patient’s medical bills in state hospitals. It provides coverage to those lacking health insurance, such as women heads of households, the unemployed, the poor and disabled, who account for over 10 million of the population.
