PESHAWAR: The Khyber Pakhtunkhwa government is set to table a proposed law in the provincial assembly’s next session to ensure the accessibility of health services to the entire population of the province through a predefined package.

According to officials, the programme has offered Rs25 billion worth of free treatment to 1.1 million people since 2015 when it was introduced in the province through an executive order.

They told Dawn that the initiative covered 7.4 million families of the province with each entitled to Rs1 million per year.

The officials said the proposed law was meant to give legal coverage to the programme and the people continued to receive free health services.

They said the proposed Khyber Pakhtunkhwa Universal Health Coverage Act, 2022, which was recently approved by the provincial cabinet, sought health protection for all families in the province.

Govt to table bill in next PA session

The proposed law said it was expedient to provide for health protection of all the permanent resident families through a systematic approach and clear delineation of roles of key stakeholders towards better performance in the health system and to ensure that all the permanent resident families registered with Nadra are guaranteed equitable access to a predefined package of healthcare services.

It added that the Social Health Protection Initiative branded as the Sehat Card-Plus programme was meant to give universal health coverage to its beneficiaries when and where they need them without financial hardship.

“Soon after the commencement of this Act, the government shall, under the auspices of the Policy Board, execute the programme through a third party insurance firm having expertise in the field of health insurance. The policy board to be headed by the health minister will select a third party insurance firm through a transparent bidding process, in accordance with the provisions of the procurement law and rules.

“The board shall make an agreement with the selected insurance firm, covering all matters relating to the execution of the programme, including the basic package, claims management and other ancillary matters.”

The bill said the computerised national identity card of each beneficiary would serve as the basis of eligibility for availing benefits under the programme subject to available budget, all the beneficiaries of the programme would be provided with a basic package of in-patient healthcare services to be determined by the board with the approval of government.

It added that the maximum limit of the basic package, in terms of money, would be fixed by government on the recommendations of the board.

“The insurance firm might, with the approval of the board, offer additional package, which was over and above the basic package, to interested individuals, families and groups on payment of such additional premium, as determined by government. The empaneled hospitals would be paid by the insurance firm for the provision of services in a manner, as may be prescribed by regulations,” it said.

The proposed law said public hospitals would retain, without loss of budget, all of the additional income to be utilised for the improvement of quality of healthcare services and payment of incentives to the hospital staff in line with the regulations.

It added that the policy board would establish a central management information system through a third party to process all information regarding enrolment of beneficiaries, empanelment, admissions and treatment in hospitals, claims data, beneficiaries’ grievances and any other information.

“A chief executive officer will be responsible for day-to-day administration of the affairs and would exercise such powers and perform such functions as prescribed by regulations or assigned to him or her by the policy board.”

The bill said a portion of the fund would be specified as Reserve Fund to be used in the manner, as may be prescribed by regulations, for payment of cost exceeding the basic package limit or to cover cost of those procedures or treatments not covered under the programme, while the accounts would be audited by the auditor general of Pakistan.

It added that the policy board would render all-out support to the Auditor General’s Office while carrying out audit of the programme’s accounts.

Published in Dawn, May 8th, 2022

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