Three Koshi Hospital Employees Dismissed for Misusing Health Insurance Funds

Kathmandu – Koshi Hospital has dismissed three employees after an internal investigation confirmed their involvement in misusing health insurance funds. The employees, including two pharmacy assistants and one office assistant working on a contract basis, were found guilty of committing irregularities in the hospital’s pharmacy unit.

According to details released by the hospital, the employees had been supplying fewer medicines than prescribed while charging higher amounts, billing expensive drugs not recommended by doctors, and recording inflated quantities of medicines in patients’ names. Their actions resulted in undue deductions from the national health insurance program.

Hospital Information Officer Gajendra Prasad Yadav confirmed that the temporary employees were immediately removed from service. “The administration itself decided not to renew their contracts after the investigation revealed misuse of insurance funds,” he said.

The malpractice came to light after a cancer patient filed a written complaint, stating that his insurance account had been charged for a month’s supply of medicines while the doctor had prescribed only a week’s dosage during his emergency treatment. Following the complaint, the hospital formed a probe committee, which reviewed past billing records and confirmed the irregularities.

Although the hospital had received verbal complaints in the past, this was the first documented case, which provided solid evidence. Based on the committee’s findings, the hospital administration terminated the employees, calling it a serious breach of trust and financial misconduct.

Koshi Hospital, which serves around 1,000 patients daily, treats more than half of them under the health insurance program. In the fiscal year 2081/82 alone, 123,983 out of 317,718 patients received treatment through insurance coverage. Most insured patients were chronically ill, suffering from conditions such as hypertension, asthma, diabetes, gastritis, and neurological disorders, among others.