Kathmandu, July 4: The Health Insurance Board has directed hospitals and health institutions to provide continuous, quality healthcare services to citizens without disrupting treatment for insured beneficiaries.
In a directive issued on Friday, the board instructed all health institutions participating in the Health Insurance Programme to ensure uninterrupted healthcare services in accordance with the programme’s prescribed standards.
“Please provide continuous, quality health services in accordance with the prescribed standards under the Health Insurance Programme without creating any obstruction or difficulty in the treatment of insured service recipients,” the board said in a statement.
The board also urged health institutions to promote the responsible use of health insurance services. It asked doctors and healthcare workers to avoid prescribing unnecessary tests or treatments and called on insured beneficiaries to use the programme appropriately. The board stressed that all stakeholders have an important role in ensuring the long-term sustainability and effectiveness of the Health Insurance Programme.
Rs. 23.44 billion paid to health institutions
According to the board, it has disbursed a total of Rs. 23.44 billion to hospitals and health institutions during the current fiscal year, covering insurance claims submitted up to mid-December 2025.
The board said it has fully cleared all pending claims of affiliated health service providers up to that period. It added that discussions are ongoing with the relevant authorities to secure the budget required to settle claims submitted after mid-December 2025.
The board acknowledged that delays in claim payments in recent months were caused by the absence of a fully established sustainable financing mechanism for the Health Insurance Programme. It said the delays had created difficulties for both healthcare providers and insured beneficiaries.
Despite limited financial resources and structural challenges, the board noted that thousands of insured citizens continue to receive healthcare services through the programme every day. It said the programme plays an important role in reducing out-of-pocket medical expenses and protecting citizens from financial hardship.
The board said it will continue coordinating with the concerned authorities to ensure proper budget management and establish sustainable financial resources for future claim payments.
As payment processing continues, the board has urged all participating hospitals and health institutions to maintain uninterrupted, quality healthcare services in line with the programme’s standards while ensuring that insured beneficiaries face no obstacles in accessing treatment. #nepal
