Ramed: The changeover to the CNSS relying on the amendment of the law

Planned from July, the changeover of holders of the Ramed card (health insurance for the poor) to compulsory health insurance managed by the CNSS (National Social Security Fund) could be delayed. The operation requires an amendment to Law 65-00 on medical coverage, except that the text has still not been introduced into the legislative circuit, which risks slowing down the pace of generalization, in particular for beneficiaries of the Ramed scheme. Exceeding the deadlines set in the “social protection” calendar is not ruled out. Until then, the stated goal is to complete, towards the end of the current year, the generalization of medical coverage to move in 2023 to that of family allowances, then in 2024-2025 to the generalization of retirement benefits. The amendment of the law on medical coverage and the implementing texts which should follow will, among other things, make it possible to establish the operational plan for the changeover to an insurance system and to answer the questions of the persons concerned: will the beneficiaries of the Ramed scheme pay for care services provided by the private sector? Will they benefit from third-party payment? How will the care take place… In any case, nearly 5.5 million people are waiting for answers and visibility concerning the changeover to the AMO (Compulsory Health Insurance) managed by the CNSS. For the time being, one thing is certain: the arrival of this vulnerable population at the CNSS will be made through a contribution which will be borne by the Government: 6.37% of the minimum wage (Guaranteed Minimum Wage). Nearly 9 billion dirhams will be devoted to that purpose annually. This population will also benefit from a basket of care identical to that of private sector employees. Started in 2021, the extension of medical coverage to self-employed workers and vulnerable people must be completed before the end of this year. For now, tight management of the different categories is planned. Ultimately, 8.5 million policyholders and 22 million beneficiaries will join the AMO scheme, which will result in a significant increase in CNSS activity. The number of policyholders should increase from 3.5 million to 11 million people, while that of beneficiaries will be multiplied by 4, moving from 7 to 29 million. As for the number of disease files, it should reach 80,000 to 90,000 files per day versus nearly 20,000 today. This is an increase in terms of workload for which the CNSS has been preparing for several months. Its information system has been adapted to support a different population of employees and to strengthen its capacity to process a large flow of data. The Caisse has also reviewed its organization and processes. In the new organizational chart, a cluster is dedicated to compulsory health insurance. It has three directorates, including one for medical affairs. The latter will manage partnerships in particular with the medical profession. “We must establish a permanent dialogue with doctors in the interest of the plan and our policyholders. We must also keep a close eye on medication, therapeutic protocols, and medical procedures. We must invest in monitoring so that we can be a source of proposals” , declared Hassan Boubrik, Director General of the CNSS during the Club de L’Economiste event organized last June (see L’Economiste 
No 6284 of 16/06 /2022). The CNSS has also invested in digitalization, and a large part of the procedures can be carried out remotely. The CNSS is also planning  totally paperless processes and the implementation of the electronic care sheet. Internally, it has set up a Resources & Digital Transformation division. It has cross-functional “functions”: Finance & Purchasing, Human Capital as well as a Digital Transformation & Organization division. A Data & Analytics department in charge of data architecture and management has been set up.
Khadija MASMOUDI