Commentary on Law No. (22) of 2021 regulating health care services
The Law of Regulating Health Care Services in Qatar, enacted as Law No. (22) of 2021, represents a milestone in the country’s healthcare sector. Published in the Official Gazette on October 18, 2021, the law sets regulations for managing healthcare services in both public and private sectors. It aims to enhance the quality of services, ensure patient rights, and promote equitable access to healthcare. Scheduled to take effect six months after issuance, the law reflects Qatar’s dedication to public health in alignment with its constitution. This article explores the law’s key features and its impact on healthcare stakeholders.
Introduction to the Law of Regulating Health Care Services
His Highness Sheikh Tamim bin Hamad Al Thani, Emir of the State of Qatar, issued Law No. (22) of 2021, the Law of Regulating Health Care Services.
The law was published in the Official Gazette on October 18, 2021, and defines the controls, procedures, systems, and standards necessary for providing health care services in both government and private health facilities.
The law is set to be implemented six months after its issuance.
This legislation is part of a broader set of health laws that have been established previously. Most notably, it aligns with the rights affirmed by the permanent constitution of the State of Qatar, which emphasizes public health and ensures the provision of means for the prevention and treatment of diseases and epidemics by the law (Article 23, 2004).
The law consists of 48 articles, which are divided into six chapters. The first chapter focuses on definitions and general provisions. The following chapters address the provision of health care services to health card holders, the obligations of parties involved in the insurance relationship, the grievance committee, and finally, the penalties and provisions.
Structure of the Health Care Services Law
Key Definitions and Provisions
In its first article, the law introduces several important definitions. Among these is the clarification of what constitutes health care services. These are defined as a collection of services provided according to the provisions of this law and the regulations, applicable to both governmental and private health facilities.
Additionally, the law defines an emergency situation as a medical condition or injury that threatens a person’s life or the function of their organs and requires immediate medical intervention to save their life or protect an injured organ. This aligns with the Theory of Unforeseen Circumstances to Insured against Sickness, ensuring that individuals are protected and receive the necessary care promptly in critical situations.
Patient Consent and Legal Requirements
The law mandates that patient consent is required to receive health care services. However, the consent of a patient under the age of 18 or one whose will is not considered legally valid is not accepted. In these cases, the consent of a guardian must be obtained. Furthermore, the law defers the discussion of patients’ rights and duties to a decision to be issued by the Minister.
Health Care Services and Mandatory Insurance in Qatar
Health care services in government health facilities are provided free of charge to citizens. Additionally, the Council of Ministers may issue decisions specifying certain categories of individuals who are entitled to benefit from these services, along with the limits of their usage.
Mandatory Health Insurance for Expatriates and Visitors
The law emphasizes the requirement for health insurance for expatriates and visitors. This means that every person in the State of Qatar who is not a citizen, as well as individuals specified by a decision from the Council of Ministers, must obtain health insurance in accordance with the law. This insurance ensures that these individuals have access to health care if they face any health issues.
Regulation of Health Insurance Relations
To regulate the relationships between the parties involved in health insurance, the law mandates the registration of companies wishing to engage in the compulsory health insurance activity. The executive regulations of the law will define the conditions, procedures, and controls required for the registration process.
This law also aligns with the Qatar labour law medical insurance provisions, ensuring that workers and other eligible individuals are adequately covered under the country’s medical insurance policies.
1. Who are the health care providers as one of the parties to the insurance relationship?
Health care providers include:
- Governmental health facilities offering health care services.
- Private health facilities that are licensed to provide health care services under the laws in force in Qatar.
Obligations of health care providers:
Health care providers have several key responsibilities under the Qatar healthcare services law No. 22 of 2021, which ensures the quality and accessibility of services:
- Providing health care services in accordance with established professional and ethical standards, as well as approved treatment evidence by the Ministry of Public Health.
- Adhering to the rules and procedures outlined by the Ministry for delivering health services.
- Maintaining accurate medical and financial records regarding the health care services provided to beneficiaries.
- Not requiring any party other than the insurance company to pay for the health care services, except for co-payment amounts or deductions.
- Emergency care must be provided to beneficiaries without requesting payment until the emergency has passed, even if the service provider is not within the network of providers for the beneficiary. However, this does not waive the health care provider’s right to claim reimbursement from the insurance company, employer, or recruiter.
- Protecting the confidentiality of beneficiaries’ information and data.
- Providing information, data, and documents related to health care services to the competent department, the insurance company, and the claims management company.
- Cooperating with the competent department and providing any information or statistics they request, including access to the beneficiary’s medical file, in line with the medical insurance labour law.
- Any additional obligations that may be specified by regulations or decisions issued following the law.
These obligations are part of Qatar’s comprehensive healthcare system under the Qatar healthcare services law No. 22 of 2021, ensuring a structured and efficient healthcare service delivery for all beneficiaries.
The Recruiter’s Role and Obligations under Qatar’s Health Care Law
The recruiter plays a crucial role in ensuring that expatriates and workers in Qatar receive the necessary health care coverage.
Under Qatar’s health care law, recruiters are responsible for providing mandatory health insurance, ensuring access to basic health services, and complying with regulations.
This article outlines the recruiter’s key obligations.
Who is the recruiter as one of the parties to the insurance relationship?
A recruiter is defined as:
- Any natural or legal person who brings a natural person into the country for the purposes of residence or work.
- This is done in accordance with the provisions of Law No. (21) of 2015, which regulates the entry, exit, and residence of expatriates.
Obligations of the recruiter:
The recruiter must fulfill several important duties to ensure compliance with the Law of regulating healthcare services:
- Paying health insurance premiums to provide mandatory health insurance coverage for basic health care services to those recruited, who are not already covered by insurance from their employer. This must be done from the date of their entry into Qatar, in line with the regulations.
- Providing the beneficiary with a health insurance card once the insurance policy has been issued.
- Ensuring health insurance coverage for the beneficiary when issuing or renewing their residency, providing proof of coverage as required.
- Paying the costs of health care services for beneficiaries in cases where the recruiter fails to maintain valid insurance coverage. The recruiter is prohibited from deducting any part of the cost of these services from the beneficiary.
- Other obligations specified by regulations or decisions issued in accordance with the law.
What are the obligations of the beneficiary?
- Pay the co-payment amounts or the deductions specified in the insurance policy.
- Not to misuse the insurance policy or health insurance card, in any way.
- Any other obligations specified by the regulations or decisions issued in the implementation of this law.
These obligations help ensure the effective implementation of mandatory health insurance in Qatar, providing comprehensive health care services for residents under the health insurance Qatar for Residents system.
Who is the insurance company as one of the parties to the insurance relationship?
Every national insurance company conducts health insurance business in the country per the provisions of the Law of Regulating Health Care Services and its regulations.
The law defines the obligations of the insurance company, the most important of which are:
- Applying the best systems and procedures that guarantee the provision of fast and efficient services in fulfillment of its obligations towards insurance policyholders and beneficiaries.
- Concluding contracts with health care service providers in the country to establish a network of health care service providers by this law and regulation.
- Paying the value of health care services to the providers of those services by the contracts concluded with them and in the manner outlined in the regulations.
- Paying the value of health care services provided to the beneficiary by a health care service provider who is not included in the network of such service providers, in emergency cases.
- Enabling the beneficiary to obtain their rights specified in the insurance policy by all available means and not placing any restrictions or conditions that limit the use of health care services contracted to provide.
- Not refusing any request to contract for compulsory health insurance coverage from an employer, recruiter, or visitor, as long as this request complies with the controls stipulated in this law and the regulations unless written approval is obtained from the competent department, under what is specified by the regulations.
What Are the Obligations of Health Care Providers?
Health care providers must adhere to the following obligations as per the Law of Regulating Health Care Services:
- Providing health care services by established professional and ethical standards, and in line with the treatment evidence approved by the Ministry.
- Following the rules and procedures set by the Ministry regarding how to provide health services.
- Maintaining accurate and regular medical and financial records for health care services provided to beneficiaries.
- Ensuring that no party other than the insurance company is required to pay for health care services provided to the beneficiary, except for co-payment amounts or deductions.
- Providing emergency health care services to the beneficiary without requesting any payment until the emergency is resolved. This applies even if the service provider is outside the network of health care providers for the beneficiary. However, this does not waive the provider’s right to seek reimbursement from the insurance company, employer, or recruiter, as applicable, for the cost of the service.
- Protecting beneficiaries’ information and data and maintaining its confidentiality.
- Supplying the competent department, the insurance company, and claims management companies with information, data, and documents related to health care services provided to beneficiaries.
- Providing the competent department with any additional information, data, or statistics requested, including the beneficiary’s medical file, as required by the provisions of the Law of Regulating Health Care Services and its associated regulations and decisions. Health care providers must cooperate with department employees and allow access to their databases and records.
- Complying with any other obligations outlined by regulations or decisions issued under the law.
What Does the Insurance Contract Between Health Service Providers and Insurance Companies Include?
The medical insurance for Qatar contract between health service providers and insurance companies includes the following:
- Details of the health care services that have been agreed upon for provision.
- The terms and conditions governing the contract, as specified by the relevant regulations.
What Does the Insurance Policy Include?
The insurance policy includes the data specified by the regulation. The policy remains valid even if the insurance company’s registration is canceled. The company is obligated to fulfill the rights outlined in the policy for its holder throughout its validity period.
Who Is a Health Insurance Broker and What Are Their Obligations?
A health insurance broker is any natural or legal person who markets and sells insurance policies in return for financial compensation by the provisions of this law and its regulations. Brokers are committed to:
- Providing accurate information, advice, and recommendations to beneficiaries, employers, and recruits.
- Offering the best insurance coverage and prices available from insurance companies, ensuring complete impartiality and independence.
- Complying with additional obligations specified by the regulations.
The Grievances Committee
The law establishes a Grievances Committee tasked with reviewing grievances submitted by concerned parties against decisions issued by the competent department under this law and its regulations. Key details include:
- The Minister decides on grievances within ten days of submission.
- If no response is issued within this period, the grievance is considered implicitly rejected.
- The Minister’s decision on the grievance is final.
Penalties Imposed by the Health Care Services Law
The Health Care Services Law specifies several penalties for violations:
- A fine of up to QAR 500,000 for private health facilities that refrain from providing health care services in emergency or accident cases.
- A fine of up to QAR 500,000 for unregistered health facilities.
- A fine of up to QAR 30,000 for employers or recruiters who:
- Refrain from providing insurance coverage.
- Fail to pay health insurance premiums.
- Deduct any part of the premium from employees or persons for whom they are obligated to pay. Employers must also refund any amounts deducted.
- The penalty is multiplied by the number of individuals affected by the violation.
Conciliation Clause:
The Minister or their delegate may settle crimes stipulated in this law, except for those outlined in Article 28 regarding the failure of health facilities to provide emergency care. Conciliation can occur during the criminal case or before its final judgment.
In Conclusion
The Health Care Services Law is a comprehensive regulation that defines the duties, obligations, and rights of all groups in society. It ensures the provision of health care services under clear legal frameworks.
Key points to note:
- The law will come into effect six months after its publication in the Official Gazette.
- Primary healthcare institutions will continue to serve health card holders during this transition period.
- Laws No. (7) of 1996 (regulating medical treatment and health services) and Law No. (7) of 2013 (social health insurance system) have been repealed.
This law serves as a cornerstone for ensuring equitable access to health care for all members of society.
Conclusion
The Law No. 22 of 2021 Regulating Health Care Services is a crucial step towards enhancing the quality and accessibility of healthcare in Qatar. By setting clear guidelines for both providers and recipients of healthcare services, the law ensures a balanced and efficient system that upholds the rights of all parties involved. This regulatory framework reflects Qatar’s commitment to improving public health and fostering a sustainable healthcare sector.
If you require expert legal assistance or further clarification regarding this law or other legal matters, Dr. Muna Almarzuki Law Firm in Qatar is here to provide professional and tailored legal services. Our team is dedicated to supporting your legal needs with in-depth expertise and personalized solutions. Contact us today for trusted guidance and representation.
FAQ: Summary of Health-Related Laws
What is the healthcare law in Qatar?
The healthcare law in Qatar is governed by the Law of Regulating Health Care Services, which outlines the duties, obligations, and rights of healthcare providers, insurance companies, and beneficiaries. It ensures access to health services, regulates health insurance, and imposes penalties for violations.
What is Law No. 11 of 1982 Regulating Medical Treatment Institutions?
Law No. 11 of 1982 in Qatar governs the licensing, supervision, and operation of medical treatment institutions to ensure they meet professional and ethical standards for providing health services.
What are the health-related laws in the Philippines?
In the Philippines, health-related laws include:
- The Universal Health Care Act (RA 11223): Ensures all Filipinos have access to quality and affordable healthcare.
- The Tobacco Regulation Act (RA 9211): Regulates smoking and tobacco products.
- The National Health Insurance Act (RA 7875): Provides insurance coverage through PhilHealth.
What is the law in Qatar?
Qatar’s legal framework includes a range of laws addressing different sectors, including healthcare, labor, and business. The Law of Regulating Health Care Services is a cornerstone for ensuring access to healthcare and defining the roles of service providers and insurers.