Dubai Health Authority (DHA) has fined 25 health centres, clinics and insurance brokers and companies for violating the Dubai Health Insurance Law, while referring six clinics to prosecution for potential fraudulent activities.
The violations were found during routine inspections conducted by the authority’s Health Funding Department as well as spot checks based on member complaints.
Dr Haidar Al Yousef, Director of the Health Funding Department at DHA, said the fines imposed ranged from Dh10,000 to Dh80,000.
“Some healthcare providers and insurers didn’t comply completely with the Health Insurance Law and the circulars issued by the Health Funding Department,” he said. “We found this out through inspection visits, compliance meetings and complaints from different parties involved in the system. Therefore we have resorted to fining them to avoid such acts in the future.”
Dr Al Yousef revealed that the violations included but were not limited to healthcare providers altering the diagnosis to get claims paid, submitting claims for non-performed services, submitting partial case details to get coverage
and get claims settled; abuse by beneficiaries; the ordering of medically unnecessary services and laboratory services; healthcare providers submitting invoices and receiving payment before the services are fully delivered, for example, dental and physiotherapy sessions; delays in insurance companies issuing health insurance cards or activation of the Emirates ID; non-compliance of insurance companies in providing the required level of customer satisfaction, especially the front desk and employees handling call centres; insurers marketing or advertising wrong information without verification from DHA; insurers practising health insurance in Dubai without a DHA/HFD licence; and insurers dealing with unlicensed companies providing health insurance in Dubai market without DHA/HFD licence.
Dr Al Yousef said violating facilities received a warning, which was then followed by a fine and some were referred to prosecution and might face criminal punishment for potential fraudulent activities.
The fines were based on the violation and the number of times it was repeated in line with Law No. 7 of 2016 issued by His Highness Shaikh Hamdan Bin Mohammad Bin Rashid Al Maktoum, Crown Prince of Dubai and Chairman of the Executive Council. The law aims to protect the rights of individuals by ensuring they are covered by health insurance.
Employers and sponsors who fail to provide mandatory health insurance are now liable to a fine of Dh500 a month. Apart from the fine, no new visa will be granted and no existing visas renewed without health insurance.
