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Medical protocol to curb unsound healthcare insurance practices


Muscat, MARCH 30 - A recent forum spotlighting the imminent rollout of Mandatory Healthcare Insurance (Dhamani) in the Sultanate has underlined the importance of a binding medical protocol due to be put in place by the Ministry of Health with the aim of combating “unnecessary medical tests” — a phenomenon that hurts the insurance industry. The Arab Symposium on ‘Health Insurance and Challenges’, organised by the Capital Market Authority (CMA) in collaboration with the General Arab Insurance Federation, adopted a communiqué featuring nine recommendations for implementation in support of a robust healthcare insurance system in the Sultanate.

The forum stressed in particular the Health Ministry’s role in contributing to a strong framework underpinning a sound health insurance scheme for Oman. It noted the “importance of putting in place a binding medical protocol for all health services providers to be issued by the Ministry of Health specifying the procedures to prevent unsound practices by health service providers in making unnecessary medical tests”. The day-long symposium, which attracted delegates from Oman and the wider region, discussed a number to topics related to digital transformation of the health insurance sector, sustainability of health systems, and investment opportunities unleashed by the implementation of health insurance services in the Sultanate.

Additionally, the communiqué emphasised the importance of standardized contracts for health service providers, costs and prices of health insurance services. “All stakeholders (are encouraged) to follow best practices to limit the increased cost of health insurance services and to support the efforts exerted to avoid inflated private health services sector through implementation of the electronic link for the health insurance scheme,” it noted.

Forum participants, who included representatives of local insurers, health services providers and third party administrators, pledged to “work to collect all the data related to health insurance sector whether from health service providers or insurance services providers to take sound decisions in the implementation process in Oman”.

They also affirmed the importance of putting in place quality control standards for health services in private health institutions to ensure the insured will get best standards of health care. Furthermore, beneficiaries must be made aware of their rights as well as the features of the unified health insurance policy to ensure they get the most out of their coverage.

Jomar Mendoza

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