IRDAI Standards and Benchmarks for the Hospitals in the provider Network

Last updated: 24 July 2021

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The IRDAI has extended the compliance deadlines for certain standards and benchmarks for hospitals within their provider networks by one year. This extension is a direct response to the ongoing COVID-19 pandemic. The modified guidelines apply to existing network providers, while new entrants must still adhere to the original timelines.

Insurance Regulatory and Development Authority of India

Ref: IRDAI/HLT/REG/MISC/199/07/2021

23^rd July, 2021

All Insurance Companies and Third Party Administrators

Sub: Standards and Benchmarks for the Hospitals in the provider Network

1. Reference is invited to IRDAI Circular ref: IRDAI/HLT/REG/CIR/199/07/2020 dated 24th July, 2020 on the captioned subject.

2. In partial modification of the captioned guidelines, taking into consideration the prevailing COVID-19 pandemic, the timelines for complying with the standards and benchmarks specified at clause (a)(i) and (ii) of Chapter IV of the Guidelines on Standardisation in Health Insurance under Section I of Master circular ref. IRDAI/HLT/REG/CIR/ 193/07/2020 dated 22nd July,2020 (hereinafter referred as Chapter IV ) stands extended for a further period of one year for all the existing network providers as on the date.

3. The norms specified at Clause a(iii) of Chapter IV shall continue to be applicable for all the new entrants.

4. There is no change in other norms specified therein.

5. This Circular is issued in terms of Regulation 31(e) of the IRDAI (Health Insurance) Regulations 2016.

6. This has the approval of the competent authority.

Sd/-

(DVS RAMESH)

GENERAL MANAGER (HEALTH)

FAQ :

The notification concerns the standards and benchmarks for hospitals within the insurance provider network.

The timelines for complying with specific standards (clause (a)(i) and (ii) of Chapter IV) for existing network providers have been extended by one year.

The extension has been granted due to the prevailing COVID-19 pandemic.

Yes, the norms specified at Clause a(iii) of Chapter IV continue to apply to all new entrants.

No, there are no changes to any other norms specified in the original guidelines.

Notification No : IRDAI/HLT/REG/MISC/199/07/2021
Source : https://www.irdai.gov.in/admincms/cms/whatsNew_Layout.aspx?page=PageNo4530&flag=1

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