Mongkutwattana Hospital has stopped treating outpatient referrals under the universal coverage healthcare card, or gold card scheme, to help contain financial losses.
Maj Gen Dr Riengthong Nanna, the hospital's director and owner, said the hospital stopped receiving gold card outpatients from last Friday. The cards are issued under the scheme run by the National Health Security Office (NHSO).
The NHSO, he said, had not kept its promise to pay outstanding debt incurred in referred outpatient cases since March. The accumulated cost is 44 million baht. "If Mongkutwattana Hospital continues to provide services to the referred outpatients, we will not be able to survive," he said, adding the hospital had a similar problem in 2020, running up a debt of 13.2 million baht. The hospital at the time filed a lawsuit against the NHSO with the Administrative Court.
No progress has been made in the case, so the hospital has decided not to accept outpatients from clinics referring patients, unless the patients agree to pay or until the NHSO clears its debts, he said. He added the hospital might end its contract with NHSO next year.
The NHSO, however, insists it is not in debt to the hospital. Atthaporn Limpanyalert, deputy secretary-general of the NHSO and NHSO spokesman, said NHSO has a budget to pay hospitals. However, in the case of Mongkutwattana, the situation is complicated.
The first debt of 13.2 million baht is an outstanding debt from a clinic which Mongkutwattana Hospital was the referring hospital for. However, the clinic's contract with the NHSO was scrapped to an incorrect budget disbursement in 2020.
The clinic lost its status as a contracted service unit with the NHSO and no longer receives a budget. By law, the NHSO has no authority to use the National Health Security Fund to pay the debts of private clinics to referring hospitals. For another 44 million baht slab of debt, the NSHO has yet to pay Mongkutwattana Hospital because outpatient data in Bangkok is being investigated.
Some clinics have sought a probe into payment data worth 2.1 billion baht. In addition, an investigation is under way into a central reimbursement budget worth 1.2 billion baht. The NHSO will postpone the payment of both budgets until the work is complete, he said.
For these reasons, Dr Atthaporn said, payments to the referring hospital cannot be made for now. However, to solve the hospital's liquidity problem, the NHSO board decided to approve an advance payment to the hospital and transferred 60 million baht to Mongkutwattana Hospital on Nov 6.
In the event Mongkutwattana Hospital stops providing outpatient referral services, the NHSO will ask other hospitals to accept patients for further treatment, such as Chulabhorn Hospital and Phaet Panya Hospital.