The Dubai Health Authority (DHA) has begun initiating Healthcare Reform across Dubai. These changes are intended to ensure that all individuals have a health insurance plan and to change the way healthcare is managed in Dubai. This is intended to not only shift the burden of healthcare costs from the public to the private sector, but to also encourage a more open market which will hopefully attract more investment, quality care, and innovations within the sector.
Dubai’s new Health Insurance Law is very much in line with a trend that has been seen across the GCC in regards to healthcare reform. The new Health Insurance Law will be a requirement which all residents and visitors to Dubai must adhere to. At present, the obligation will fall to employers to provide coverage for their staff but while it will be encouraged, employers are not required to provide coverage for dependents. If the employer chooses to not cover employee’s dependents, the responsibility will then fall to the employee.
To ensure that all parties involved in the healthcare sector are up-to-date on all information, the DHA has been releasing circulars that detail all information regarding new changes, requirements and policies. In September, four new circulars were released which can be found here.
The First Circular
Released on September 4, 2014, this discusses the four main types of communication in which the DHA will release information to those involved in the industry:
- A Policy Directive, which refers to a policy that all residents must adhere to such as minimum benefit levels or complaint handling procedures.
- A Standard Notice, intended to set standards for the industry in terms of customer service, business conduct etc.
- A Procedural Notice, to provide specific details on the steps which certain procedures must follow.
- A General Circular, which will provide further communications of a more broad and informative nature.
The Second Circular
Also released on September 4, 2014, the second circular reiterates that self-funded schemes are not allowed and that only certain participating insurers are able to provide policies to lower salary band employees (LSB). All existing self-funded schemes will need to be transferred to a fully insured scheme by the defined deadline, which will be based on the next renewal date.
The reason for stopping self-funded schemes is to protect employers from the risk of catastrophic claims as well as to ensure that employees have access to a good standard of care. In addition, there will also be certain minimum levels of benefits that all plans must adhere to. The DHA is reiterating this information again to stress its importance to insurance providers, TPAs, and intermediaries and to ensure these parties stop encouraging employers to establish a non-compliant scheme before the deadline.
The Third Circular
The third circular, released on September 21, 2014, sets a standard as to how all health insurance providers, distributors and management companies should act in relation to handling complaints. The DHA now requires all complaints to be logged with a minimum requirement of data and to be reported monthly to the Chief Operations Officer of the company, and annually to the DHA Health Funding Department.
These reports must provide a range of information including turn-around times, number of complaints, outcomes, etc. The circular also includes requirements as to how complaints should be handled. For example, every complaint must now be assigned to an individual member of staff and there must be a clear reporting line to ensure that a complaint is handled promptly and appropriately.
The Fourth Circular
Released on September 24, 2014, the fourth circular provides the latest deadlines for when all insurance policies must become compliant. The new deadlines are as follows: any new policies written after January 1st, 2015 will have to be compliant. For those members with existing policies, plans may need to be updated at the time of renewal. For policies which have an upcoming renewal date before July 1st, 2015, the deadline to transition to a compliant plan will be the following renewal date in 2016. Lastly, policies which have an upcoming renewal date after July 1st, 2015 will have until the next 2015 renewal date.
As the healthcare industry adapts and transitions to the new policies and requirements, the DHA will continue to release further circulars and updates. Please contact us if you require any more information or have any further queries that have not been covered above.