All Thais can still access free COVID-19 health services despite its label as an 'endemic disease'
 
The National Health Security Office (NHSO) revised the reimbursement guideline for COVID-19 health services. Under the new guideline, all Thais can still access free services.
 
Since July, COVID-19 has been labeled an endemic disease in Thailand, prompting the NHSO to revise its reimbursement guideline to ensure the financial sustainability of universal health coverage.
 
The guideline revisions, approved by the NHSO board on Jul 4, highlight the shift of COVID-19 health services from emergency care to general healthcare services.
 
This means some COVID-19 health funds and fast-track reimbursement systems set up during the pandemic will be revoked.
 
This financial mechanism provided extra funds to health providers, ensuring they would not go bankrupt while providing free services to COVID-19 patients.
 
On the other hand, patients can access the treatment without fear of expensive medical costs.
 
As the health crisis has subsided, providing health providers with extra funds is unnecessary as the number of COVID-19 cases has drastically declined.
 
It will also lead to overspending, affecting the financial sustainability of the Thai healthcare schemes.
 

The NHSO Secretary-General Dr Jadej Thammatacharee said that the major revisions include:
 
1) The NHSO will not act as a clearing house for all healthcare schemes.
 
During the pandemic, the government assigned the NHSO to reimburse  COVID-19 health service fees to health providers, regardless of the registered healthcare schemes of their patients.
 
Having a single organization acting as a clearing house helped speed up the transaction and accelerate financial resource mobilization to tackle the health crisis. 
 
The guideline revision will shift the reimbursement of the COVID-19 health service fees to the existing system, in which each healthcare scheme operator proceeds the reimbursement and transaction regarding the healthcare fees incurred by its beneficiaries.
 
Thailand’s main healthcare scheme operators are the NHSO, which manages the Universal Coverage Scheme, Social Security Office and Comptroller General's Department overseeing Social Security Scheme and Civil Servant Medical Benefit Scheme, respectively.
 
2) The NHSO will cancel the special fund covering healthcare fees for mild-symptom COVID-19 patients regardless of their registered healthcare schemes.
 
They can still get free healthcare services under the existing system, in which their healthcare scheme manager reimburses the costs for health providers.
 
3) The NHSO will cancel the actual-cost reimbursement for hospitals providing transportation to COVID-19 patients.
 

These hospitals also received extra funds for vehicle cleaning and PPE used during the trip.
 
Instead, the NHSO will cover the transportation cost based on mileage only.
 
4) The NHSO will cancel the actual-cost reimbursement for hospitals providing renal replacement therapy to COVID-19 patients, plus PPE used when performing the treatment and transportation if patients require inter-hospital transfers.
 
Instead, the NHSO will reimburse only the cost of renal replacement therapy in lumpsum or 1,500 baht per case.  
 
5) The NHSO will revoke the specific-purpose fund covering the treatment for COVID-19 vaccine recipients with adverse effects.
 
They will still be treated under the fund for outpatient and inpatient services.
 
Dr Jadej emphasized that these changes will not affect people’s access to COVID-19 health services.
 
He added that beneficiaries of the Universal Coverage Scheme can still access benefits including free antigen test kits and medications.
 
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