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Social health insurance in Qatar by 2014
Source: Clyde & Co , Author: David Salt and Michael Earley
Posted: Wed May 16, 2012 5:35 pm

QATAR. The rapidly increasing population coupled with continuing advancements in hi-tech medical technology and pharmaceutical innovations has started to put pressure on the financial and infrastructure capacity of the health care sector in Qatar.

Pursuant to the goals set out in the Qatar National Vision 2030, the State of Qatar has been working to implement a social health insurance scheme (SHIS) to provide universal health care access by 2014 in order to strengthen the health care infrastructure of the country.

The Supreme Council of Health (SCH), the governmental entity responsible for the development and implementation of the SHIS, last month revealed initial details regarding the way in which the scheme will be implemented.

Currently the draft law that will implement the SHIS is under consideration with the Council of Ministers.  Although the draft law has not been circulated for wider consultation, several key details have been released by the SCH local newspapers and media statements. 

According to these sources, the draft law provides that the government will pay the health insurance premiums for Qatari nationals while employers will be responsible for the premiums of their expatriate workers.

Once the draft law has been approved and comes into effect, the government plans to require all residents and visitors of Qatar the country to have insurance coverage by the end of 2014.

The SHIS will be mandatory for residents and will be linked to the processing and granting of residence permits for expatriates. However the position with respect to the coverage of expatriates who are not sponsored by an employer remains unclear. 

In preparation of the implementation of the draft law, the government has initiated the establishment of the National Health Insurance Company (NHIC) which will be wholly owned by the SCH. The NHIC will ultimately launch and regulate the SHIS by coordinating between insurance providers and the beneficiaries of the SHIS.

The scheme will be further supported by a third party administrator responsible for establishing a provider network and processing claims. 

The SHIS will be rolled out through a series of five phases. On 12 April 2012 the SCH announced that the pilot programme of the SHIS will be launched around November of this year, followed by additional phased programme rollouts to be completed by the end of 2014.

The pilot programme will initially provide cover to approximately 75,000 Qatari women aged 15 years and above. Among the services to be covered by the programme are maternity, obstetrics and gynecology with more services becoming available at a later date.

The second stage of the SHIS is planned for July 2013 and will extend the scheme coverage to include all Qatari nationals and provide access to primary healthcare facilities and certain private sector participants. In October 2013 the third stage will be implemented entitling all Qatari nationals to basic services from all healthcare providers in Qatar.

By May 2014 the fourth stage will extend coverage of all Qatari nationals under the SHIS to all services in the private sector and half of the services available on an out-patient basis. 

The final stage, earmarked for the end of 2014, will extend SHIS coverage to include all residents of Qatar with the majority of those covered eligible for the basic package of benefits of healthcare services at both primary and secondary levels.

Whilst it is likely that there are quite a few challenges to face before the SHIS will effectively be implemented, it appears that Qatar is progressing the scheme at a pace that may well see its complete implementation prior to 2015.

All Qatari Laws (save for those issued by the Qatar Financial Centre (QFC) to regulate its own business) are issued in Arabic and there are no official translations, therefore for the purposes of drafting this article we have used our own translation and interpreted the same in the context of Qatari regulation and current market practice.

Should you have any questions in connection with this article or the legal issues it covers, please contact the authors, David Salt or Michael Earley  at Clyde & Co LLP.

You can access related articles on the Clyde & Co website at www.clydeco.com.

Disclaimer: The views set out in this article do not constitute legal advice and readers are urged to seek specific legal advice in relation to any particular issues which arise from the subject-matter of the article.

© 2012 Clyde & Co LLP. All rights reserved

 

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