Qatar’s National Vision 2030 sets out the Qatari government’s (the Government) goal of improving the health of Qatar’s population by developing a world class and integrated health care system. In furtherance of this goal a national health insurance scheme named ‘Seha’ is currently being implemented (Seha). Seha will be accessible to all citizens, residents and visitors. Seha was enacted by Law No 7 of 2013 concerning the Social Health Insurance Scheme (the Health Insurance Law) and is regulated pursuant to Resolution No 22 of 2013 of the Minister of Public Health Issuing the Implementing Regulations for Law No 7 of 2013 concerning the Social Health Insurance Scheme (the Regulations). Article 5 of the Health Insurance Law tasks the Supreme Council of Health (the SCH) with supervising and developing Seha. Article 19 of the Health Insurance Law tasks the National Health Insurance Company (the NHIC) with implementing and managing Seha, and the powers of the NHIC are listed in Article 20. The NHIC is a government-owned entity with a board of directors including representatives from various ministries and two members from the private business sector. The NHIC has appointed Al Khaleej Takaful as its third party administrator and Aetna and GlobeMed as exclusive subcontractors of the third party administrator. Implementation The Regulations ‘Basic’ and ‘Additional’ healthcare services Accredited health insurance companies will be entitled to offer insurance cover for Additional healthcare services only. It is not clear whether the NHIC will participate in offering Additional healthcare service insurance. Health insurance premiums Premiums will be paid in accordance with the Regulations pursuant to Article 12 of the Health Insurance Law. Under Article 13 of the Health Insurance Law, the Government is responsible for paying Premiums for Qatari nationals. Employers and sponsors are responsible for paying Premiums for their employees (and their families) and sponsored persons, respectively. Employers and sponsors are prohibited from recovering Premiums from employees or sponsored persons. SCH Circular No 7 of 2013 introduced a moratorium on price increases for health care services offered by private health care providers until Seha is fully implemented to avoid potential price increases during the implementation phase. Note: all Qatari Laws quoted in this article are issued in Arabic and there are no official translations. For the purposes of drafting this article Clyde & Co has used its own translation and interpreted the same in the context of Qatari laws, regulations and current market practice. |
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