Law & Regulations Law - Arabic قانون رقم (11) لسنة 2013 بشأن الضمان الصحي في إمارة دبي قار المجلس التنفيذي رقم (7) لسنة 2016 باعتماد الرسوم والغرامات الخاصة بالضمان الصحي في إمارة دبي قرار وزاري رقم (888) لسنة 2016 في شأن ضوابط وقواعد وقواعد وصف وصرف الأدوية المخدرة والمراقبة وشبه المراقبة قرار المجلس التنفيذي رقم (2) لسنة 2016 بشأن استيفاء بدل مالي نظير خدمة نقل المصابين بحوادث المرور. قرار مجلس إدارة هيئة التأمين رقم (9) لسنة 2011 م بشأن تعليمات ترخيص شركات إدارة مطالبات التأمين الصحي وتنظيم ومراقبة أعمالها القانون الاتحادي لحماية البيانات الشخصية قانون اتحادي رقم (2) لسنة 2019 في شأن استخدام تقنية المعلومات والاتصالات في المجالات الصحية قانون اتحادي رقم (15) لسنة 2020 في شأن حماية المستهلك قرار رقم (8) لسنة 2022 بشأن تطبيق قانون الضمان الصحي داخل مدينة دبي الطبية. قرار إداري رقم (78) لسنة 2022 بإصدار اللائحة التنفيذية للقانون رقم (11) لسنة 2013 بشأن الضمان الصحي في إمارة دبي. قرار المجلس التنفيذي رقم (6) لسنة 2017 باعتماد مراحل تطبيق الضمان الصحي في إمارة دبي. Law - English Law No 11 of 2013 Concerning Health Insurance in the Emirate of Dubai (“Dubai Health Law”) Executive Council Resolution No. (7) of 2016 Approving Health Insurance Fees and Fines in the Emirate of Dubai Ministerial Decree No. (888) of the year 2016 regarding the controls and rules for prescribing and dispensing narcotic, controlled and semi controlled drugs Executive Council Resolution No. (2) of 2016 Concerning Collection of a Fee for Transporting Persons Injured in Traffic Accidents Resolution No. (8) of 2022 Concerning Application of the Health Insurance Administrative Resolution No. (78) of 2022 Issuing the Implementing Bylaw of Law No. (11) of 2013 Executive Council Resolution No. (6) of 2017 Approving the Health Insurance Implementation Phases in the Emirate of Dubai Insurance Authority Board Resolution No. 9 of 2011 Concerning the Instructions for Licensing Health Insurance Third Party Administrators and Regulation and Control of their Business Federal Decree by Law No. (45) of 2021 Concerning the Protection of Personal Data Federal Law No. (2) of 2019, Concerning the Use of the Information and Communications Technology in Health Fields Federal law No. (15) of 2020 – consumer protection law Regulations - Arabic Regulations - English Policy Directives PD 02-2015 Top-up policies PD 02-2018 Patient Support Programs – BASMAH PD 06-2018 Basmah Initiative – Fund structure PD Medical Facilities for Hatta Population_24-11-2020 PD Compliance with Essential Benefits Plan updates and top-up policies_24-11-2020 PD Claims Audit and Recovery_24-11-2020 PD Patient Support Programs_24-11-2020 PD PSP Program_Basmah Guidelines_24-11-2020 PD Telehealth services_24-11-2020 PD PSP Program_Hepatitis C Guidelines_24-11-2020.pdf PD Insurance coverage of Emergency cases_24-11-2020 PD Healthcare Providers' Price Regulation_24-11-2020 PD 01-2021 Updated TOB for Essential Benefit Plan PD 01-2023 Maternity and New Born Coverage Policy PD-01-2025 Ethical Standards and Conflict of Interest PD-02-2025 Data Governance and Records Management PD-03-2015 Emergency Coverage PD-04-2025 Insurance Complaints Management General Circulars GC 01-2014 Communication protocols GC 02-2014 Self-funded and EBP compliance GC 03-2014 Employer Information Pack GC 04-2014 TPA activities GC 02-2015 Patient drug safety checks GC 06-2015 Enforcement of the Law through Visa applications GC 07-2015 Communication protocols GC 09-2015 Coding Standards GC 10-2015 PI applications and renewals for 2016 GC 02-2016 Internal Coding Elimination and Coding Standards in eClaimLink GC 02-2016 Special Needs Members GC 03-2016 Marketing or Advertising Medical Insurance GC 04-2016 Mandatory Insurance Deadline GC 07-2016 The eClaimLink eAuthorization Initiative GC 09-2016 Premium Refunds GC 01-2017 Member Register Validation with GDRFAD GC 02-2017 Member Register Failed Uploads GC 05-2017 General updates and clarification of frequent misinterpretations GC 02-2018 Collection of DRG Negotiation Factors GC 03-2018 The eAuthorization Initiative – Update GC 04-2018 The ePrescription Initiative – Update GC 05-2018 Updating eClaimLink User Details GC 06-2018 Denial Code Updates GC 07-2018 DRG Implementation – Exempted Hospitals GC 08-2018 Clarifications on Collection of DRG Negotiation Factors and Reporting Requirements of DRG Financial Parameters in Phase II of Shadow Billing GC09-2018 Prescriptions for VIP Patients in the Emirate of Dubai GC 11-2018 New Member Register Structure GC 12-2018 The Dubai Drug Code (DDC) List and eClaimLink System GC 01-2019 Unnecessary medical treatments, diagnostics or medications at medical providers GC 02-2019 Pro rata refund of premiums for individually sponsored members GC 04-2019 Addition of Comment Field to the Remittance.Advice Schema GC 05-2019 Healthcare Professional Licensing Information GC 06-2019 Healthcare Professional Licensing Information - MOHAP GC 01-2020 General Updates and Clarifications GC 02-2020 Treatment of Novel Corona Virus (2019-nCoV) GC 04-2020 Full DRG Implementation GC 05-2020 Settlement of Outstanding claims and Update of claim payments cycle GC 10-2020 Medical Coding for COVID-19 GC 16-20 Postponement of Full DRG Implement GC 17-20 Postponement of Upgrade of ICD-10-CM, CPT and HCPCS Code Sets to Version 2018 GC 18-2020 Revised Unified Prices Institutional Isolation GC 19-2020 - Postponement of Full DRG Implement GC 21-2020 - Full DRG Implementation Updates GC 22-2020 - Coverage of Covid-19 PCR tests GC 02-2021 - Essential Benefit Plan Formulary GC 04-2021 – Day Case Admissions GC 05-2021 - Rolling out 3M Software New Version (IR-DRG V3.3 Codefinder / Grouper) and Adding the Fixes of Current Version (IR-DRG V3.01) GC 06-2021 – Fund Transfer for Hepatitis C and B Patient Support Program GC 01-2022 - Patient Support Program – New workflow process GC 02-2022 - New System to Issue and Pay Annual Fees GC 03-2022 - DRG Phase II GC 05-2022 - Prescriptions Covered by Health Insurance and Discounts GC 07-2022 - Compliance with Authenticating the Personal Data of the Beneficiaries of Healthcare Services GC 08-2022- Updating the Data of the Insured Members in the 'E-Claims' Portal - Member Register GC 10-2022 - DRG Implementation for Eye Hospitals and Eye Centers GC 09-2022 - Patient Support Program Awareness Sessions GC 11-2022 - Expansion of Patient Support Program CoE to private providers GC 02-2023 - Full DRG Implementation – Year 3 GC 03-2023 - The contractual relationship between the healthcare providers & insurance companies of the health insurance system in the Emirate of Dubai GC 04-2023 - Upgrade of ICD-10-CM, CPT and HCPCS Code sets to version 2021 GC 06-2023 - Notification on the launch of the new E-Claim system GC 07-2023 - The New Online Complaints System GC 08-2023 - Email Notification for 2024 INVs within the health insurance system in the Emirate of Dubai GC 02 2024 - Treatment of renewal premiums of existing insured members GC 03 2024 - Updated Table of Benefits for Essential Benefits Plan GC 05-2024 - Enforcement against Yas Takaful Company for issuing Health Insurance GC 06-2024 - Announcement of Participating Insurers (PIs) Permitted to Offer Essential Basic Plan for Low Salary Band Members for the Year 2025 GC 01-2025 Customer Experience Maturity guidelines GC 02-2025 Cancellation of Previous Circulars Related to Covid-19 GC 03-2025 Notification of Enforcement Action Against Yas Takaful Company GC 03-2025 (V2) Notification of Enforcement Action Against Yas Takaful Company Circular to rescind flu vaccine - GC 04-2025 GC-04-2025 DHIC Issuance of Updated Regulations Superseding Previous regulatory documents (1)n Standards' Notices SN 01-2014 Facilitation agreements SN 01-2015 Single Point of Contact SN 02-2015 Standards for health insurance intermediaries SN 04-2015 Marketing standards SN 01-2017 Intermediary Remuneration on LSB products SN 01-2019 Series of key performance indicators to measure services delivered by Third Party Administrators SN 02-2019 Use of Remittance Advices and Denial codes SN 03-2019 Claim Cycle Standardisation SN 04-2019 Member Register Procedural Notices PN 04-2014 PI renewal for 2015 PN 05-2014 Registration of health insurance intermediaries and their representatives PN 01-2015 HIP applications 2015 PN 02-2015 v1.4 Fraud, waste and abuse return PN 03-2015 Price Regulation PN 01-2016 v1.1 Health coverage certificates PN 02-2016 Price Regulation for 2017 PN 03-2016 PI Status Submissions for 2017 PN 04-2016 PI Status Renewal Submissions for 2017 PN 01-2018 PHIR Register PN 02-2019 Clarification of Index Rate for 2019 PN 03-2019 BASMAH Fund Transfer PN 02-2020 Member Register Uploads PN 01-2020 Claim Cycle Standardization PN 01/2021 Procedural Notice Participating Insurer submissions and renewals for 2021 Enforcement Bulletins EB 01-2015 Health Insurance Law Enforcement Measures EB 01-2017 Notice of Suspension of HIIPs EB 02-2017 Notice of Suspension of HIIPs (To Replace EB 01-2017) Enforcement Bulletin EB 01-2018 EB 01-2019 Notice of Suspension of an HIP EB 02-2019 Notice of Suspension of an HIP EB 01-2020 Notice of Suspension of an HIP EB 02-2020 Notice of Suspension of HIPs Archive of Older Documents PD 01-2014 Complaints handling GC 03-2015 Registration of health insurance intermediaries (rev 1) GC 01-2015 Antenatal care protocols PD 01-2015 Maternity coverage PD 04-2018 Pregnancy Declarations PD 02-2019 New Born additions PD Maternity Coverage and New Born Additions_24-11-2020 GC 08-2020 Covid-19 patients PD 02-2014 Compliance with minimum benefits PD 03-2014 Healthcare Provider Pricing PD 01-2017 Medical Facilities for Hatta Population PD 03-2018 Patient Support Programs – HCV PD 05-2018 Updated TOB for the Essential Benefit Plan PD 07-2018 Updated TOB for the Essential Benefit Plan PD 01-2019 Claims Audit and Recovery in the Emirate of Dubai PD 02-2020 Telehealth Services PD 03-2020 Elective Surgeries for insured patients PD 05-2020 Elective Surgeries for insured patients PD 06-2020 Elective Surgeries for insured patients PD Elective surgeries_24-11-2020 GC 05-2014 Enforcement of fines and penalties GC 05-2015 HIP status results 2015 GC 04-2015 Online health insurance - Project Full Sweep EoI GC 08-2015 HIP status results 2015 GC 01-2016 HIIP status of intermediaries GC 05-2016 HIIP status of intermediaries GC 06-2016 Member Register GC 08-2016 Mandatory Member Information and Final Deadline GC 03-2017 DRG Implementation – Phase II of Shadow Billing GC 04-2017 Violation of Standards Notice 01 of 2017 and its consequences GC 01-2018 DRG Implementation – Phase II of Shadow Billing GC 10-2018 Cessation of Direct Billing Paper Claim Form GC 03-2019 Iranian Hospital Dubai eClaimLink Accounts Reinstatement GC 08-2019 Previously Issued Circulars from Health Funding Department GC 09-2019 Member Register GC 03-2020 Upgrade of ICD-10-CM, CPT and HCPCS Code Sets to Version 2018 GC 06-2020 Postponement of Full DRG Implement GC 07-2020 Postponement of Upgrade of ICD-10-CM, CPT and HCPCS Code Sets to Version 2018 GC 09-2020 Teleconsultation DSL Codes GC 11-2020 Postponement of Full DRG Implement GC 12-2020 Postponement of Upgrade of ICD-10-CM, CPT and HCPCS Code Sets to Version 2018 GC 13-2020 Announcement of unified Covid-19 Rates GC 14-2020 COVID-19 DSL Code GC 15-2020 COVID-19 DSL Codes for Mandatory Prices of Procedures GC 20-2020 - Postponement of Upgrade of ICD-10-CM, CPT and HCPCS Code Sets to Version 2018 GC 01-2021 - Elective Surgeries for Insured Patients GC 03-2021 - Elective Surgeries for Insured Patients GC 07-2021 - Announcement of 2022 PIs GC 05-2023 - Vaccination Influenza PN 01-2014 PI 2015 submissions PN 03-2014 Provider price regulation PN 02-2014 Health insurance certificates PN 01-2019 Patient Support Programs (BASMAH & HCV) PN 01-2017 Member Register uploads GC 04-2024 - Influenza Vaccination GC 07-2019 Ethical Standards of Business Conduct GC 04-2022 - Excluding Public Hospitals under the Government of Dubai form Emergency Factor 1.3 GC 06-2022- Electronic Claim submissions for Dubai related Policies GC 01-2023 - Health Insurance Data compliance by health insurance companies licensed by DHA GC 01-2024 - The contractual relationship between the Healthcare Providers & Insurance Companies SN 03-2015 Standardised claims records SN 01-2018 Health Insurance Claims records PD 01-2014 Complaints handling (rev 1) PD Complaints Handling_24-11-2020 PD 01-2016 Insurance coverage for emergency cases and DHA price list PD 02-2017 Emergency Definition PD 01-2018 Patient’s treated or transferred by Ambulance PD 03-2019 Settlement of Payment for Emergency Services PD 04-2020 Co-Payments of emergency cases transferred by ambulance
