The head of Egypt Healthcare Authority is meeting with the Health Insurance Authority and the Specialized Medical Boards to discuss the management of the transition to <> Universal health Insurance System> in the experimental operating departments of the system.
Head of Egypt Healthcare Authority: Replacement of the health insurance and treatment systems at State expense with the progressive transfer of the >> Universal health Insurance>> to the experimental operating departments of the system within two months.
Chairman of Egypt Healthcare Authority: Preparation of a manual to define the experimental operating policies of Universal health insurance in dealing with the health insurance and treatment systems at State expense. It stresses the importance of making citizens aware of universal health insurance registration and of making full use of its comprehensive and differentiated treatment services and programs.
Chairman of Egypt Healthcare Authority: Standing Committee to review and settle claims between "health care" and "health insurance" in the experimental operating departments of the system now and later. Studying the establishment of a central settlement committee with "specialized medical boards and ending patient waiting lists".
Dr. Ahmed El-Sobky, President of Egypt Healthcare Authority, Assistant Minister of Health and Population, General Supervisor of the Universal health Insurance Project, held a meeting with Dr. Mohammed Dahi, President of the Public Health Insurance Authority, Dr. Hader Sultan, Deputy Head of the Department of Specialized Medical Boards, Dr. Abdullah Gomaa, Director-General of the General Administration for Travel and Citizens Treatment, as well as a number of leaders and directors of the central and public departments of Egypt Healthcare Authority, at the headquarters of the Authority in Nasr City.
The meeting discussed how to manage the transition and the gradual transition from the health insurance and treatment systems at State expense to the new Universal health insurance system in the pilot departments of the South Sinai, Aswan and Suez system, in preparation for the launching of the formal operation of the system in those governorates, and reviewed the results of previous coordination meetings between the above-mentioned entities on this matter.
The meeting discussed the policy of the Public Health Care Authority with the Public Health Insurance Authority, as well as the policy of the Public Health Care Authority with treatment at State expense, reviewing the services provided at primary care centers and units, hospital medical specializations and samples of the lists of medicines provided to patients.
During the meeting, Dr. Ahmed El-Sobky directed the preparation of a manual to define the experimental operating policies of the Universal health insurance system in dealing with the health insurance and treatment systems at State expense, which includes the establishment of fixed administrative, financial and technical rules for its operation during the gradual transition and the formal operation of the Universal health insurance system in the current and subsequent pilot departments of the system, respectively with the rest of the Republic governorates, thereby guaranteeing the right of citizens to receive Universal health care in the Universal health insurance system during the transitional period.
Dr. Ahmed El-Sobky stressed the importance of sensitizing citizens to the experimental operating departments of the system by registering the new Universal health insurance system, making full use of its services and comprehensive and differentiated treatment programs, and raising awareness of the forms and methods of delivery of services and how to access health care at the three levels of the "first, secondary and tertiary" service, which led to agreement on the accreditation of the primary care centers and units of the Public Health Care Authority as equivalent and complementary comprehensive clinics to the Universal health insurance clinics during the transition period, which will last two months.
The meeting discussed the cycle of collection of revenues and claims for health insurance and treatment at State expense for the provision of health services in the new Universal health insurance system in accordance with the financial regulations of both sides. It also discussed the working methods of the medical committees and the transfer and a mandate of personnel. Dr. Ahmed El-Sobky and Dr. Mohammed Zahi decided to establish a standing committee to review and settle claims between the two existing bodies in the pilot operating departments of the former or subsequent system and with the extension of the system to the rest of the Republic governorates, respectively, after the briefing and approval of the governing body of the two bodies.
The meeting discussed the proposal to establish a central settlement committee with specialized medical boards and to end waiting lists for patients. Dr. Ahmad El-Sobky suggested that the hospital codes of Egypt Healthcare Authority be linked to the specialized medical boards.
Dr. Ahmed El-Sobky stressed the importance of networking and electronic networking within the health-care facility with health insurance and treatment at State expense during the experimental operation period, and of reviewing the availability of strategic stocks of medical supplies and medicines to ensure the optimal operation of the new Universal health insurance system.
Dr. Ahmed El-Sobky stressed the importance of this coordination meeting between the three agencies for the final and ready preparations for the replacement of the health insurance and treatment systems at State expense with the pilot operating departments of the new Universal health insurance system, for its full reliance on it and its comprehensive and differentiated treatment programs, and for ensuring its optimal operation after the system pilot phase is confirmed, with a view to completing the digitization of health services to reach the overall quality level, facilitating citizens easy and easy access to services and achieving the highest health indicators that will satisfy the users of the universal health insurance.
The meeting was attended by Dr. Hani Rashed, Vice-President of the Board of Directors of the Authority, Dr. Amir El-Telwany, Executive Director of the Authority, General Hesham chende, Director of the Directorate-General for Information Systems and Digital Transformation, Dr. Jamal Ratba, Financial Adviser and Director-General of the Finance Department of the Authority, Dr. Ahmed Hamad, Director-General of the Technical Office of the Chairman of the Authority, Dr. Mohamed Ibrahim, Director-General of the General Directorate of Legal Affairs, Dr. Hussein Al-Tawil, Rapporteur of the Authority Revenue Cycle Committee, Professor Khalid Sayed, Director of the Financial Claims Department, Dr. Marwa Mowafe, Director of the Medical Department of the General Department of Secondary and Third Care and General Supervisor of the Medical and Medical Committees, Dr. Heba Abd-elaziz, Member of the Technical Office of the Chairman of the Authority, Dr. Ahmed Jalal, Head of the Documentation and Publishing Unit and Director of the Monitoring and Evaluation Department, and Professor Mahmoud Zaki, Member of the General Administration of Finance.
Reference should be made to the decision of the Prime Minister No. 4236 of 2022, approving the transfer of 141 health facilities from the various agencies of the Ministry of Health and Population to Egypt Healthcare Authority, with a view to launching the pilot operation of the new Universal health insurance system in the provinces of Aswan and Suez, as well as the admission of some health facilities to the Universal health insurance system in the governorates of South Sinai and Ismailia, which are to be joined by the system.
