Law & Regulations

Law - Arabic
Insurance Law No11 of 2013
Executive Council Resolution No. 7 of 2016
UAE Law for Narcotic, Controlled and Semi Controlled Drugs – Ministerial Decree 888 of 2016
Executive Council Resolution No 1 of 2018 – Ambulance Service Fees
Executive Council Resolution No 2 of 2016
Ministerial Decree 680 for 2017/ Exemption of articles in Resolution 888 for 2016
Executive Council Resolution No. 16 of 2013 – Health Insurance for Dubai Government Employees
Executive Council Resolution No. 7 of 2019
Resolution No. 17 of 2018
Updated list of Semi controlled medications - Ministerial Decree 49 of 2021
Decree No. 8 of 2022
Law - English
UAE Law for Narcotic, Controlled and Semi Controlled Drugs – Ministerial Decree 888 of 2016
Ministerial Decree 680 for 2017/ Exemption of articles in Resolution 888 for 2016
Regulations - Arabic
Regulations - English
Policy Directives
PD 01-2014 Complaints handling (rev 1)
PD 02-2014 Compliance with minimum benefits
PD 03-2014 Healthcare Provider Pricing
PD 02-2015 Top-up policies
PD 01-2016 Insurance coverage for emergency cases and DHA price list
PD 01-2017 Medical Facilities for Hatta Population
PD 02-2017 Emergency Definition
PD 01-2018 Patient’s treated or transferred by Ambulance
PD 02-2018 Patient Support Programs – BASMAH
PD 03-2018 Patient Support Programs – HCV
PD 05-2018 Updated TOB for the Essential Benefit Plan
PD 06-2018 Basmah Initiative – Fund structure
PD 07-2018 Updated TOB for the Essential Benefit Plan
PD 01-2019 Claims Audit and Recovery in the Emirate of Dubai
PD 03-2019 Settlement of Payment for Emergency Services
PD 02-2020 Telehealth Services
PD 03-2020 Elective Surgeries for insured patients
PD 04-2020 Co-Payments of emergency cases transferred by ambulance
PD 05-2020 Elective Surgeries for insured patients
PD 06-2020 Elective Surgeries for insured patients
PD Medical Facilities for Hatta Population_24-11-2020
PD Compliance with Essential Benefits Plan updates and top-up policies_24-11-2020
PD Complaints Handling_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 Elective surgeries_24-11-2020
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
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 05-2014 Enforcement of fines and penalties
GC 02-2015 Patient drug safety checks
GC 05-2015 HIP status results 2015
GC 06-2015 Enforcement of the Law through Visa applications
GC 07-2015 Communication protocols
GC 04-2015 Online health insurance - Project Full Sweep EoI
GC 08-2015 HIP status results 2015
GC 09-2015 Coding Standards
GC 10-2015 PI applications and renewals for 2016
GC 01-2016 HIIP status of intermediaries
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 05-2016 HIIP status of intermediaries
GC 06-2016 Member Register
GC 07-2016 The eClaimLink eAuthorization Initiative
GC 08-2016 Mandatory Member Information and Final Deadline
GC 09-2016 Premium Refunds
GC 01-2017 Member Register Validation with GDRFAD
GC 02-2017 Member Register Failed Uploads
GC 03-2017 DRG Implementation – Phase II of Shadow Billing
GC 04-2017 Violation of Standards Notice 01 of 2017 and its consequences
GC 05-2017 General updates and clarification of frequent misinterpretations
GC 01-2018 DRG Implementation – Phase II of Shadow Billing
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 10-2018 Cessation of Direct Billing Paper Claim Form
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 03-2019 Iranian Hospital Dubai eClaimLink Accounts Reinstatement
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 07-2019 Ethical Standards of Business Conduct
GC 08-2019 Previously Issued Circulars from Health Funding Department
GC 09-2019 Member Register
GC 01-2020 General Updates and Clarifications
GC 02-2020 Treatment of Novel Corona Virus (2019-nCoV)
GC 03-2020 Upgrade of ICD-10-CM, CPT and HCPCS Code Sets to Version 2018
GC 04-2020 Full DRG Implementation
GC 05-2020 Settlement of Outstanding claims and Update of claim payments cycle
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 08-2020 Covid-19 patients
GC 09-2020 Teleconsultation DSL Codes
GC 10-2020 Medical Coding for COVID-19
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 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 20-2020 - Postponement of Upgrade of ICD-10-CM, CPT and HCPCS Code Sets to Version 2018
GC 21-2020 - Full DRG Implementation Updates
GC 22-2020 - Coverage of Covid-19 PCR tests
GC 01-2021 - Elective Surgeries for Insured Patients
GC 02-2021 - Essential Benefit Plan Formulary
GC 03-2021 - Elective Surgeries for Insured Patients
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 07-2021 - Announcement of 2022 PIs
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 04-2022 - Excluding Public Hospitals under the Government of Dubai form Emergency Factor 1.3
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 06-2022- Electronic Claim submissions for Dubai related Policies
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 01-2023 - Health Insurance Data compliance by health insurance companies licensed by DHA
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 05-2023 - Vaccination Influenza
GC 06-2023 - Notification on the launch of the new E-Claim system
GC 07-2023 - The New Online Complaints System
GC 08-2023 - Circular / Email Notification for 2024 INVs
Standards' Notices
SN 01-2014 Facilitation agreements
SN 01-2015 Single Point of Contact
SN 02-2015 Standards for health insurance intermediaries
SN 03-2015 Standardised claims records
SN 04-2015 Marketing standards
SN 01-2017 Intermediary Remuneration on LSB products
SN 01-2018 Health Insurance Claims records
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 01-2014 PI 2015 submissions
PN 03-2014 Provider price regulation
PN 02-2014 Health insurance certificates
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 01-2017 Member Register uploads
PN 01-2018 PHIR Register
PN 01-2019 Patient Support Programs (BASMAH & HCV)
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