TU Teaching Hospital, Manmohan Hospital resume health insurance scheme

Thousands of patients in Nepal are breathing a sigh of relief as two major hospitals, Tribhuvan University Teaching Hospital and Manmohan Cardiothoracic Vascular and Transplant Centre, have reinstated services under the government's health insurance scheme. These crucial services had been suspended since January, leaving many poor and ailing individuals without access to affordable care.

The suspension occurred because the government failed to reimburse long-pending dues to the hospitals. This forced patients to pay out-of-pocket, seek treatment elsewhere, or forgo medical attention altogether. The hospital administrations had also voiced concerns about the Health Insurance Board approving only half of their submitted claims and demanded a review of service prices.

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We have been informed that Tribhuvan University Teaching Hospital and Manmohan Cardiothoracic Vascular and Transplant Centre have resumed indoor services under the government health insurance scheme.

Bikesh Malla, an information officer at the Health Insurance Board, confirmed the resumption of indoor services, noting that outpatient services had restarted a few weeks prior. He stated that outstanding dues until January have been settled and service prices revised. However, the financial sustainability of these rates remains a concern for some healthcare providers. Officials at other hospitals outside the Kathmandu Valley have also resumed services, though some, like Shahid Gangalal National Heart Centre, are only offering outpatient care, citing the current rates as insufficient for hospital operations.

The halt in services had drawn significant criticism, including from within Parliament, and raised questions about the government's commitment to providing free basic healthcare as guaranteed by the constitution. The board has since reimbursed Rs25 billion in hospital dues accumulated until January, with the government allocating Rs10 billion in the last fiscal year's budget and an additional Rs15 billion to facilitate the resumption of services.

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We cannot run and sustain our hospital if we provide services at the rates set by the Health Insurance Board.