Insurance Board Hospital Payment Clears Backlog to Chaitra 2081
Insurance Board Hospital Payment
5th November 2025, Kathmandu
In a major move to stabilize the operational finances of health facilities nationwide, the Insurance Board has recently paid a significant portion of outstanding arrears owed to hospitals.
Insurance Board Hospital Payment
Executive Director Dr. Raghuraj Kafle confirmed that the Board successfully cleared the backlog of hospital dues up to Chaitra 2081 (March), covering claims dating back as far as the fiscal year 2077/78.
This critical payment provides substantial financial relief to hospitals participating in the health insurance program. The Board actively reviewed and scrutinized documents submitted by hospitals over the past several years to ascertain the exact extent of the liabilities.
Dr. Kafle stated that the immediate focus was on clearing the old payments to ensure that hospitals can sustain their service delivery without undue financial strain.
Commitment to Regular Payment Cycles
Executive Director Kafle emphasized that this clearance is part of a broader strategy to regularize future payments and avoid the accumulation of arrears moving forward. He mentioned that the total backlog up to Ashoj (September) was recently calculated following the review of documentation.
“We have cleared the amount owed to hospitals until last Chaitra (March),” Dr. Kafle stated. He further confirmed that the remaining outstanding dues, covering the period from Baisakh (April) to Ashoj (September), will be processed and paid to hospitals within the current month of Kartik (November).
This commitment signals a strong effort by the Insurance Board to establish a predictable financial cycle for its service providers.
The Scale of the Program and Financial Liabilities
The outstanding amount for the period of Baisakh to Ashoj is substantial, standing at approximately Rs 11 billion. Dr. Kafle confirmed that the Board has proactively requested these necessary funds from the Ministry of Finance to ensure the pending amount is settled promptly within the promised deadline.
The health insurance program remains one of the largest public welfare initiatives in the country, currently boasting an affiliation of 9.4 million insured beneficiaries.
Annually, the Board successfully collects Rs 3.72 billion in contributions from these affiliated members. However, the Board’s total annual expenditure related to the health services provided significantly exceeds this collection, amounting to approximately Rs 26 billion per year.
Health Insurance Program Structure
The Health Insurance Program provides comprehensive health service facilities for families of up to five members in exchange for an annual contribution of Rs 3,500. This contribution covers a wide array of medical services, emphasizing primary and essential care.
The infrastructure of the program is extensive, designed to maximize public accessibility. It operates through a network of 377 First Point of Service Health Institutions across the country, serving as the initial contact point for beneficiaries.
Additionally, there are 98 Referral Health Institutions providing specialized and advanced care, ensuring patients receive continuous and comprehensive treatment as needed.
The decisive action taken regarding the Insurance Board Hospital Payment plan aims to secure the continuity and quality of these essential services for all affiliated members.
For more: Insurance Board Hospital Payment
