Cabinet Approves New Emergency Patient Coverage Rules
Thailand's cabinet approved new emergency patient coverage rules requiring hospitals to provide immediate critical care without payment conditions, with costs covered under the Universal Coverage for Emergency Patients scheme for the first
On September 15, 2569, at Government House, Deputy Government Spokesman Ploythale Laksameesongsuncharn announced that the cabinet had approved criteria, procedures, and conditions for determining costs in treating critical emergency patients under the Universal Coverage for Emergency Patients (UCEP) scheme, as proposed by the Ministry of Public Health.
The key points of the UCEP guidelines are:
1. Hospitals must provide immediate treatment to critical emergency patients to prevent life-threatening danger according to professional standards and hospital capabilities, without conditioning treatment on payment collection. Hospitals must promptly notify the patient's insurance fund or relevant agency. Any legal action to avoid this obligation or waive the patient's rights is prohibited by law.
2. Hospital operators must arrange for professionals to assess emergency severity levels and provide care in priority order. If diagnosis difficulties arise, consultation with the National Institute of Emergency Medicine (NIEM) is required. Patients who disagree with the triage assessment may appeal to NIEM within 90 days of receiving the assessment notification. NIEM must decide the appeal within 60 days of receipt, with possible extension up to 30 days if necessary. If the appeal determines the patient qualifies as a critical emergency, the hospital must refund all charges within 30 days of notification.
3. Hospitals must continue treating critical emergency patients until they stabilize and address the underlying cause for up to 72 hours from admission. Patients may be transferred to another facility only if the hospital lacks capacity, the patient has stabilized, or the patient requests transfer.
4. Hospitals will be compensated for costs incurred during the first 72 hours of critical emergency care according to attached fee schedules. Costs within 72 hours are billed to the Universal Coverage Scheme, while costs after 72 hours are billed to the patient's relevant insurance fund, other agencies, or the patient according to hospital rates.
5. The Universal Coverage Scheme must verify costs and notify relevant insurance funds or agencies within 30 days of billing.
