The main mechanisms used to ensure the availability of economic justification

177. The main mechanisms used to ensure the availability of economic justification for the project include: device management reviews, audits and claims, and monitoring subscriptions, and inspections of clinical, screening and the main categories of claims service providers. Most of interventional procedures and reviews the relevant control and are today manually, a method is not only costly in time and human resources, but it is also likely that efficient in terms of costs with respect to returns. It will be the implementation of the Information Management System modern and efficient point of payment from doing these activities more effective manner. The main objectives with respect to sub-optimal use of resources and include the following: organized fraud and illegal acts of service providers and users, and behaviors of exaggerating the health services offered by service providers to maximize their income, which, poor medical practices. There are also other potential benefits, such as improving administrative efficiency and monitor adherence to the payment of contributions.
178. project investments – occur once fully implemented – impact on all areas that cause problems, as we discussed earlier. It is unrealistic in any case expect to solve all the problems completely, because many countries still enjoy much greater expertise in monitoring spending on health services suffer from these problems, albeit to a lesser degree.
a thousand. Manipulation, fraud and poor distribution of resources so the caller
179. There are different forms of manipulation, fraud and behaviors illegal ranging from business affect the entire system and colludes in which several members of both sides and users of service providers for the purpose of financial gain or get other benefits from the system and practices fraudulent service providers at the individual level in the range but it frequently is limited. It is also likely that there will be other types such as these behaviors, but the evidence of the practice of manipulation and fraud are not easily identifiable.
180. General Authority for Health Insurance has been able to present through revisions and manual checks computational claims submitted her from revealing the behavior of manipulation and fraud, such as claims for non-medical items. Despite the absence of further evidence methodology at the level of manipulation and fraud in Egypt for lack of a good system to provide management information, refer evidence from countries like the United States where there is also a fragmented health financing system to a large extent – that manipulation and fraud level in the billing It may range from 3 per cent to 10 per cent of total health care expenditures. In countries that have anti-manipulation and fraud programs are less developed significantly and information systems of lower quality and management, although it is the structure of health insurance by the regulations may vary but there are – beyond any doubt – manipulation and fraud and then poor distribution of financial resources, and perhaps they were approaching the level of the maximum estimated at 10 per cent.
181. The environment lacks a system for the management of claims electronically means that the anti-manipulation and fraud is one of the things that beset by problems, however, such a system along with the basic programs to combat manipulation and fraud should occur, an effective impact, since they may Ihbtan nearly 25 per cent manipulation of existing activities. And therefore making it difficult to confirm until the introduction of such electronic systems. Assuming that the potential for fraud percentage is 10 per cent of total health care expenditures, the resulting combination of claims management systems and software anti-manipulation and fraud, case work with them after three years, for example, for providing 2.5 per cent of total health care expenditures, or about 123 million dollars a year.
B. Exaggerating the health services offered by service providers to maximize their income by
182. percentage of service providers will actively looking for ways to manipulate their payment in excess of the entry system, based on the current and future nature of this system. Of course, this is to be expected, but if they are not combat it could lead to higher costs and then departs from that complies with best practices. It is difficult to assess the extent of these activities in Egypt because of the lack of data, but it is logical to assume that these activities may represent 10 per cent of total expenditure.
183. If our means to control such activities are in close and systematic monitoring of the process to take advantage of services and identify the emergence of behaviors are not acceptable, and then modifying the regulations and rules of repayment to curb these activities. We must make some effort in both operating and management information system, which will be provided through this project and the process of institutional capacity, which coincides with the work by the Egyptian government to Atsidia of this issue building. It is expected that this type of behavior that is resistant to change, but it is necessary to work to reduce these behaviors by about 20 per cent – the equivalent of 2 percent of total health care costs, or about $ 98 million annually.
Jim. Bad medical practices
184. The measure of good medical practice is extremely difficult for a number of reasons, including the disparity in the identification of best practices. The assessment of the health care technology – a special field to analyze the quality of health care, and the field to develop a standard policy for health care – is applied to a growing application in the OECD countries in the economic field. However, this assessment literally requires access to high quality data, which will be strengthened when developing project investments place of execution. Regardless of the lack of evidence in the beginning on the occurrence of medical errors in Egypt, it would be reasonable to conclude that 20 per cent at least a portion of all health costs related to medical treatments is not the best practice.
185. Judging by the evidence available at the international level on clinical practices and ways to address the glitches it is reasonable to assume that the combination of the information that will be provided through this project and the process of institutional capacity building and the development of programs that will be carried out by the Egyptian government system – will lead to reduce the financial impact of bad practices by 10 per cent, representing 2 per cent of total health care costs, or approximately $ 98 million annually.
D. Increase administrative efficiency
186. Evidence derived from different health care systems indicate that the administrative costs of health care can be high. For example, select a percentage of estimated administrative costs in the health system in the United States at 30 per cent. And it operates the fragmented nature of the system of the United States and the Egyptian regime – both – to pay these costs to increase as a result of what was happening in the past from economies of scale and duplication management systems. On the other hand, show evidence derived from systems with more compact purchasing systems bodies there are administrative costs that the general system of between 10 per cent and 12 per cent, much less than the fragmented systems.
187. The replacement of claims management system is based on the paper more efficient electronic system will lead to a significant reduction in cost per transaction – ideally less than one US dollar per claim. In addition, the introduction of links to service providers to enable them to file claims electronically to reduce the rate of rejection of claims, which is associated in the habit cost increase for the service provider to the point of payment will result.
188. difficult to determine line numbers for transaction costs and rates based on claims rejected because of the current system based on the use of paper documents and the organizational structure of the General Authority for Health Insurance that lead Doreen: hand payment service provider. However, it is possible to compare a new push anti-organized with or without use of management information system. At the international level, often the cost of processing paper claims is $ 7 per claim in exchange for almost one dollar to demand processed electronically. It is also reasonable to assume that the applicability of the relative difference in costs over Egypt. While acknowledging that the expected volume of claims outpatient clinics in Egypt is 460 million claims a year, it is clear that even then reduce the cost per transaction to US $ 1 will lead to the provision of US $ 460 million annually.
189. At a time when the potential savings in the administrative aspects associated with using a single purchaser of services is equipped with modern technologies trained cadre of managers and administrators – is a big saving and whatever, there are many factors that may limit the ability to achieve this administrative savings, such as the complexities involved in implementing the program organizational restructuring of this magnitude. Therefore, a very conservative estimate of the savings in the administrative aspects ranging from 1 per cent to 2 per cent of the total spending on health care services, or about US $ 73 million annually.
E. Summary
190. The new entity will be Almtkvlh to pay the health insurance system – enhanced development project costs of health systems – in a position to face the issues of accountability and transparency very important connection with the financing of health services and provide them in Egypt. But the project will contribute specifically to build the capacity of management and technical capacity Alehioatin in this side with the continuation of reduced administrative costs.
191. The following table summarizes the combined effects of these benefits on the total expenditure on health care in the year.
A summary of the effects of the project
The problem effectiveness of the program estimate the total impact
Manipulation and fraud 10% 25% 2.5%
Overstate the cost of services to maximize income 10% 20% 2%
Bad practices 20% 10% 2%
Administrative efficiency 10% 10% 1%

GDP at the national level of 7.5%
US $ 370 million a year
Total project (in the three pilot provinces) of US $ 111 million a year
Note: World Bank staff estimates based on international and national evidence.
192. based on the total annual revenue of US $ 370 million a year above the national coverage and health care spending estimates. It may also have been an analysis of the total annual revenues are also the three pilot provinces which will run Health Insurance Systems Development Project. Based on current data on the level of health care expenditures in the three provinces where the project is implemented as a share of total spending on health care, and in the light of the evidence shows that per capita health care spending in this higher than the national average provinces, any conservative estimate will explain that

Provide government funding to hold the verification and validation

• Provide government funding to hold the verification and validation, and will recover the amount of the loan as soon as it enters into force, in order to facilitate the choice of checking the company and authentication in a timely manner to contribute to the final selection of the package the main systems and the subsequent development of the package necessary equipment for the project pilot provinces.
• expected when choosing a verification and validation that the company is working closely with procurement staff unity of implementation of the project under the supervision of the Chief of the General Authority for Health Insurance Administration.
160. In addition to the already mentioned above more immediate measures to mitigate the risk of procurement, with respect to more sustainable capacity building; Panel recommends encouraging the procurement staff of the General Authority for Health Insurance workers main center in Cairo to participate in external training and the training of purchases on-the-job offered to them Technical support Office, in connection with the procurement manual guidance and accountability of the World Bank in order to comply with aspects related to procurement contained the loan agreement.
161. The overall risk of the project in connection with the procurement big risks, and that after the implementation of risk mitigation measures.

169. economic and financial benefits for investment arise in the development of health insurance systems through a number of channels project. Which include the efficiency and effectiveness of the remedial management point of payment such as monitoring the levels of use of services and anti-manipulation and fraud, administrative efficiency and effectiveness of medical practices on the part of health care providers. They will show benefits over time, especially during the period of implementation of the pilot project in the governorates, and the period after the project at the national level, which of course depends on the mainstreaming of the project across the country. It follows that the expectations of the benefits is subject to a number of assumptions regarding baselines, effects, and timing. But it is possible to estimate the benefits of conducting various types of analyzes, and eat later, including specifically the duration of the project and experimental provinces breakeven caller analysis, and analysis of the net benefits of the pilot provinces on the basis of a conservative estimate of the expected effects.
170. can enter claims-efficient environment based largely on paperwork that enormous effects occur in a wide variety of areas, management systems, and not only with regard to the administrative aspects of the point of payment, such as: reduce the cost of claims processing, improve claims filed accuracy; so as not to be forced by their sponsors to be resubmitted as often happens, and reduce the cost of paper claims processing, and can also be monitoring the levels of use of treatment services on practicing medicine the same affect. Examples include: unnecessary duplication of tests laboratory, low internal bed occupancy at the hospital or the failure to use equipment to some sites, poor provision of care services Coordination rates resulting in patient hospital entry without the need for, and the waste of medicines and pharmaceuticals because of poor management, and medical errors, such as interactions adverse drug, and unjustified disparities in medical care, poor follow-up of chronic diseases, resulting in poor health outcomes and higher final cost.
171. It may be difficult to estimate the financial benefits that come from dealing with these issues, let alone access to a number that represents the basis of the current line of the body. Therefore, the following calculations are based on a subset of the benefits in the areas of: (a) anti-manipulation and fraud, (b) monitor the levels of use of services, (c) clinical practices, (d) administrative efficiency.
172. Based on the types of analysis described above, we find that the potential opportunity to increase the efficiency and effectiveness of investments in the project is that even under a relatively modest set of assumptions regarding the benefits listed above, the project is able to recover its costs through a geographical and limited space of the three pilot provinces . Benefits that are likely to bear fruit by the investment in the project to provide a potential equivalent to about $ 111 million per year and may lead (pilot governorates), or 7.5 per cent of total current expenditure on health care.
173. Moreover, to reach the break-even point of the project recovers any initial investments amounting to US $ 75 million costs, it should lead to the provision equivalent to 2.7 per cent only.
Second. Elements of the project and estimate revenue
174. spends Egypt to health services is about $ 85 per person per year, or about 6 per cent of GDP, which is equivalent to as much income and other medium-sized countries, but estimates indicate that the rate of increase will be faster than the economic growth rate of about 10 percent. Indicate the fact that spending on health care has a growing share of total spending – the need to strengthen control of the financing system the cost of the capacity, which may be difficult to achieve because of the fragmented nature of the health system now, because it can not any single entity to implement the necessary mechanisms for management and administration . For example, the General Authority for health insurance expenses list has seen an increase faster than its revenue increase over the past decade, leading to exposure to a permanent disability in the operation. And it refers actuarial recent analysis government requested conducted in order to strengthen the expansion of the social health insurance system process – that the Social Health Insurance Fund will face considerable pressure to increase spending, using a reasonable set of assumptions that relate to coverage, levels of use, and the benefits of this analysis. It will be the main driver for this is the assumed usage levels of health services by beneficiaries subscribers.
175. The Health Insurance Systems Development Project will be able – through his investment in a job point of paying an effective and uniform – to contribute to the response to this challenge by developing a business model proved its usefulness backed technology-based management system and would allow the buyer tools and health information services required.
176. increasing the national and international levels to provide the evidence and the evidence of the lack of efficiency of health care services, and the manipulation and fraud and improper use of resources. At a time when the only evidence of a small amount from Egypt are not available, and it basically as a result of the problem of lack of information and management designed this project to solve systems, there are strong grounds to believe that the interventions of the project will contribute to the reduction of total health care expenditures by an estimated 6 to 7 per cent, or the equivalent of about US $ 365 million to US $ 420 million a year, once the preparation and implementation of activities in all parts of the country. These are just a conservative estimate based on reasonable assumptions, it shows high overall economic rate of returns.

The project holds the independent stores for all its goods records

a. Recieved goods subject to the review of the inspection committee, which will consist of technical and financial personnel and procurement officers from the headquarters of the General Authority for Health Insurance and recipient governorate office.
B. The project holds the independent stores for all its goods records.
C. Goods entering the stores after its acceptance of the inspection committee and is a manager of the store contained a receipt for goods that are recorded then stored in the notebook (3 Book Store). It must be recorded each of the receipt of goods, books and detailed its information, as the number of the item number and the envelope.
Dr. Given a copy of the invoice, and the inspection report, the approved contract as well as any other necessary documents to the storekeeper that records incoming goods Bsgelath (4 store books) and match them regularly store employee records.
e. Review the manager of the store receipt goods received and adopted.
And. Over-expenditures store based on the approved applications submitted by the recipient site, and the intervention of goods store location final recipient in the manner described above itself.
G. Receive and project implementation unit stores weekly reports that show all the items added and items distributed to each of the sites. Based on these reports, clutching CFO of the Project Implementation Unit record of the assets of Microsoft’s Excel program format shows all goods related to the project and its location and the Secretary of warehouse information. This record will be part of the interim financial reports prepared by the project every six months and sent to the World Bank.
H. The CFO of the project management unit every three months random scans of goods stored and goods supplied to make sure that the information recorded asset mismatch.
I. A committee of the General Authority for Health Insurance and a representative of the CAA annual physical census of all the items added to the stores and the outgoing ones. The document will include the powers and terms of reference for the project this census revision process to also performed by the external auditor in charge of reviewing the project accounts, and records, and equipment that are purchased.
J. Part of the document includes the powers and terms of reference of the external auditor for the project as well – a physical census of selected sample of items added to the stores and the outgoing ones process.
K. All the General Authority for Health Insurance stocked items are insured against fire.
143. flow of funds: Due to the inclusion of the project on only one component of a limited number of payments required to have large amounts of contracts, will use direct exchange and obligations of the way. The loan will be paid direct exchange manner. And it retains the Finance Division unit implementation of the project with all the documents and supporting documents for payments disbursed and provide copies of these documents to the World Bank at the direct request of exchange. And a flow of project funds as follows:

Payments by the World Bank directly

144. external audit: choose independent auditor from the private sector to do annual audits of the project. The show will document the powers and terms of reference for audits clearly the nature of the project and its specific needs in connection with the distribution and management of equipment, it must be reviewed and authorized by the Financial Affairs Specialist of the World Bank. And This document should be mentioned include an examination of the physical equipment stores received the General Authority for Health Insurance and the final locations where the supply of goods to the provinces. The review covers the costs of the loan proceeds. It leads the auditor’s report and point of view of financial data for the project, accompanied by a letter from the administration. It must This report is submitted to the World Bank in a period not exceeding six months from the date of closure of the financial year and that includes all the components of the project and its activities “as a whole”, according to the loan agreement. We must review process in line with the audit requirements of the World Bank and the International Standards on Auditing.
145. supervision of the World Bank: In view of the limited number of components of the project and its contracts, it has been rated the degree of credit risk after following mitigation procedures set out above as a medium degree; therefore will visit the financial management team of the World Bank project at least twice in order to make sure to keep financial management arrangements satisfactory. . Initially supportive of the Project Implementation Unit is available for you to complete financial management arrangements agreed upon, then have oversight thereafter every six months and review the adequacy of the financial management arrangements for the project.
146. Corruption can manipulation, fraud and corruption at the project resources affects. It would reduce the credit arrangements mentioned above, including the chapter for the purpose of protection measures and arrangements for reporting and auditing, reasonably the risk of corruption from the technical point of view through credit arrangements, but will not be effective in the case of collusion.
147. financial management in the proposed system to work hand payment covers the proposed system “functions such as finance and accounting, human resources, payroll, and legal affairs, and fixed asset management, communications, and management of documents. In addition, the system will support the collection of subscriptions process insurance, registration and management, as well as debts and obligations related “to the purpose of the governance structure consists of a two-tier offices in terms of payment at the national and provincial levels (see document project Appraisal, Appendix 4). The financial transparency and the fight against manipulation and fraud issues at the heart of increasing the efficiency with which we expect to derive from Egypt to develop this system and use it. It is expected to hold the main systems and contract verification and validation to win their tenders providers with expertise in the field of financial controls that apply to the health insurance systems. It is worth noting an important difference here, namely that the World Bank would not be the body that reviews the adequacy of these systems but it would be the General Authority for Health Insurance and National Health Insurance Organization themselves. We’ll measure the results based on indicators agreed outcome and that also includes efficiency standards.

Appendix 8: procurement arrangements
 The Egyptian Arabic Republic

Health Insurance Systems Development Project

a thousand. Public

148. The implementation of the procurement process for the purpose of the proposed project in accordance with the guidelines of the World Bank: “Guidelines: Procurement guide in the framework of World Bank loans for Reconstruction and Development and Credit IDA” dated May / May 2004 and revised in October / October 2006, and a guide “Guidelines: Selection World Bank borrowers to consultants and use “, dated May / May 2004 and revised in October / October 2006, the provisions contained in the legal agreement. The following is a general description of the items included in the various categories of expenditure.
149. The different procurement routes or methods of selection of consultants, and the need for pre-qualification, estimated costs, and the requirements of prior review, and the time frame has been formulated all in final form in the procurement plan has been agreed upon between the borrower and the World Bank in the negotiations, and in respect of each contract financed by the loan. It will be updated procurement plan at least annually or as needed; to reflect the needs of the actual implementation of the project and improvements in institutional capacity.
150. Purchase Information Management System: The project is the purchase of information consists of the following units management system package: Managing the affairs of the beneficiaries, and the benefits package, claims management, and case management, in addition to monitoring the levels of use of services and reporting procedures. And made purchases using brochures Specifications Standard Terms and Conditions of the two-stage bidding for the World Bank on the supply of information systems in accordance with the procedures of international competitive bidding. These brochures have been prepared in good prior period, is scheduled to be reviewed by the World Bank management (Review Committee procurement procedures) and adopted in accordance with the procedures prior purchases due to the need for a long advance period to prepare the specifications required for the package to buy a complex management information system.
151. buy goods: Goods that are purchased in this project of the equipment needed to run a pilot program for the management information system of the three governorates and the National Center consists. Conducts purchasing and procurement process using brochures Specifications and standard conditions of tender of the World Bank with regard to all international competitive bidding.
152. choose advisory bodies: The basic contract advisory services to be entered into under this project – except for the external audit of the project – is a holding company that will provide the technical verification and validation services to the General Authority for Health Insurance. It is expected that the conclusion of this basic contract by March / March 2010 to provide services throughout the duration of the project. If the need arises to acquire additional advisory services it could be considered short-lists of advisory bodies which provide services estimated to cost less than the equivalent of US $ 200 thousand per contract; to include (lists) fully consulting national points in accordance with the provisions of paragraph 2.7 of the Consultant Guidelines Manual.
153. operating costs: The World Bank will not be funded by the proposed project operating costs, but the government-funded paid by the General Authority for health insurance as a body implementing the project.
154. will cause procurement and supply brochures and specifications and standard conditions of the tenders which will be used with all manner of methods of procurement procedures, as well as model contracts, the Plan of Implementation of the project before the expected date.
B. Assess the body’s ability to carry purchases
155. rests with the General Authority for Health Insurance responsibility renovation activities procurement in the proposed project, and this body was established under Presidential Decree No. 1209 of 1964 and is managed by an administrative council, which is empowered to administer all health insurance matters, including aspects related to procurement and supplies. This class and help of autonomy from the Ministry of Health in maintaining the necessary independence and a reasonable degree of transparency in dealing with this relatively large amount of purchases that bear responsibility.
156. The specialists purchases at the World Bank in September / September 2009 an assessment of the ability of the executive body (the General Authority for Health Insurance) on the implementation of the Procurement and Supply project-specific procedures, where accept this assessment organizational structure to implement the project and the interaction between the project staff of the General Authority for Health Insurance responsible for procurement and the central unit of the management and funding of the ministry’s relevant. Moreover, there was an additional assessment of the ability of the technical support of the Ministry of Health’s office in early October / October 2009, which was assigned – even the establishment of a project implementation unit – responsible for prior purchases of package software activities as a setting pamphlets specifications and standard conditions of tender Two-Stage Private the project, which has already carried out.
157. Established technical support office in the context of health reform, which was funded by the World Bank, which recently reached end of the project, but the mission and scope of its services has persisted in support of other donors such as the EU under the supervision of the Ministry of Health. It is characterized by the helpdesk staff technicians and Aitmanyen highly qualified, including procurement staff, and from this perspective it is cooperating closely with the Ministry of Health Management Team in the processing of the first two decades of the three contracts that will be funded in the development of health insurance systems project preparation processes, with some support on health insurance reforms of external consultants provide their reports to the Ministry of Health. It features an office and procurement unit consists of four specialists Purchases (first and 3 employees less degree than employees), all of whom are familiar with procedures for procurement and supply of the World Bank and in force in the projects, which serve a good purpose of these temporary arrangements between the sectors that aim to mitigate risks on procurement activities financed by the World Bank.
158. been identified and risks the major issues relating to procurement for the purpose of implementing the project, and the results show that the General Authority for Health Insurance since its inception in 1964, did not deal with any international competitive bidding or procurement with the World Bank’s instruction manual. The limited body of experience in the field of purchases on the Egyptian Law on the organization of tenders and auctions 89 and before Law No. 9. In addition, the staff of the Procurement Authority limited experience in procurement procedures and other donor community. And related risks and other important purchases, including whether it can design and technical specifications comprehensive and strong determination enough to get in the end on a sufficient range of tenders comparable artistically, and then to make them able to choose the lowest bid responder Rated Provider (mainly based on price alone in stage second) for the supply of key systems package.
159. mitigate the risk of procurement and supply measures: The degree of risk classification procurement project is high, especially in the initial stage of its implementation, if there is any delay in signing the verification and validation of the proposed company. The evaluation recommends the General Authority for Health Insurance to take the following measures to mitigate the risks of purchases:
• Include procurement activity as one of the core activities of the sole responsibility of the Office of Technical Support until the establishment of a project implementation unit, which will then in close collaboration with the consulting firm to verify and authenticate with the technical aspects and management of the contract.
• General Authority for Health Insurance of the helpdesk advantage to start the contracting process with verification company and validation and end (the preparation of the powers and competencies, and letters of intent, condensed list, and RFP, technical and financial evaluation, and the signing of contracts).
• start in this activity immediately prior purchases according to the World Bank procedures, knowing that this along with pamphlets terms for the bidding package of major systems contract is already setup.

The organizational structure of the Project Implementation Unit

The organizational structure of the Project Implementation Unit and internal controls
129. The organizational structure of the Project Implementation Unit and internal controls: Tracking and Project Implementation Unit General Authority for Health Insurance in organizational terms, the government covers the full coverage of their employees’ salaries.
130. The unit will consist of project implementation team of the unit manager, director of procurement, procurement staff, and Chief Financial Officer, who will report to both the project manager and director of the Finance Department of the General Authority for Health Insurance. In addition, it will allow the financial director of the Health Sector Reform Project, which was closing in March / March 2009 – support and training for the new financial director during the period of 12 months from the life of the project to ensure the transfer of knowledge from the projects financed by the World Bank.
131. be entrusted to the Chief Financial Officer of the Project Implementation Unit as soon as his appointment and before the date of the project shall enter into force – a process of renovation Administration Guide Finance with the support of the financial director of the Project Health Sector ending repair work done, as is the person who originally prepared this guide which will explain what will be applied in the project of controls in addition to the accounts, authorization agenda, session and documentary, and review cycle.
132. reserves and project implementation unit of the documents and the documents all have financial manager of the project responsible for preparing monthly settlement document with the site “link collaborators” with the World Bank, where the Director of the Finance Department of the General Authority for Health Insurance reviewing this document and adoption.
133. preparation of reports and registration: The project applies the cash basis accounting method, where the purchase is simple automated accounting system and use it to support the registration work and the preparation of budgets and reporting project to develop health insurance systems.
134. CFO of the Project Implementation Unit shall be responsible for the registration of all accounting operations and reporting. In addition, this is Chief Financial Officer and tracing paper monthly obligations which each of the project manager and director of the Finance Department in the General Authority for Health Insurance reviewed and approved.
135. must be a management information system, which will purchase the project able to produce the required financial reports, including the sources and uses of funds, cash withdrawals, cash and expectations. As has been discussed during the mission, it will prepare the financial director of the project reports and the project manager and director of the Finance Department in the General Authority for Health Insurance reviewed and approved.
136. Based on the instructions of the World Bank directory, you must prepare the following reports in this project:
137. Every six months: the project must prepare interim financial reports half-yearly and brought to the World Bank within the framework of the progress report to the project or independent as reports. This consists of the following reports:
a. Statement of sources and uses of funds by project component, including references to funds received from various sources – if any – cash and expectations, and report expenses compares actual expenditures and planned by activity – if that is true – and the data allocated to the settlement of accounts.
B. List of contracts: include all contracts, clarify the amounts committed and disbursed in each contract in the history of the preparation of the report.
C. Is a list showing when signing a contract supplies of goods received (by type and location) on the date of preparation of the report and distributed.
138. These reports must be sent to the World Bank within 45 days of the end of the half year, according to the project loan agreement.
139. annually: the financial manager of the project implementation unit annually prepare financial statements for the project and that the cash basis method of accounting will follow them, and then decline and then submitted to the World Bank within six months of the end of the year. The consolidated financial statements of the project and include the following:
Dr. A statement on the sources and uses of funds, shows the funds received and expenses of the project sources
e. Appropriate tables classified project expenses by component, and describes the annual and cumulative balances
And. Settlement allocated – accounts if applicable – which explains the settlement between the opening balances and balances at year-end data
G. Statement for the project links, any unpaid balances depending upon what is out of the question the contracts signed for the project.
H. Placement of the equipment received and distributed at the end of the year
140. Budgeting. The chief financial officer of the project implementation unit of the project a year to prepare budgets and plans Exchange reflect the cash requirements for the project every three months. The initial plan shall be based on the initial procurement and implementation schedules and courses discretionary payments plan, and then revise afterwards. The budget will be utilized as a monitoring tool for the disparity and cash management analysis. It is the responsibility and unity of the implementation of the project, the General Authority for Health Insurance responsible for updating of the annual budget.
141. Posting inventory control and assets on the central and provincial levels: All project assets being purchased through your inventory system at the General Authority for health insurance and that they should retain disease inventory is based on the manual registration system entry. Based on the equipment that will be purchased for the purpose of this project scope, the will of the General Authority for Health Insurance installing a system that facilitates the equipment management, which will be purchased and also facilitate the distribution, so that the hold separate records for the purpose of recording the information, maintain and relating with equipment distributed by location, including the number of equipment received in the various offices of the three governorates and kind. It was also agreed to take additional measures during appraisal to ensure the sound management of the project assets.

The project implementation unit and its resources

The project implementation unit and its resources
113. Unit will be implementing the project, which are created for the development of health insurance systems within the framework of the structure of the General Authority for Health Insurance Project, the main counterpart to the World Bank in the process of implementation of project activities, including administrative and fiduciary aspects (financial management and procurement). It is expected to begin its work within a period not exceeding one month from the date of entry into force of the start of the project.
114. The project implementation unit functions include:

• General Manager of the project implementation unit. Be responsible for personnel management and supervision of the daily activities of the unit during the administration of the process of implementing the Health Insurance Systems Development Project. And raise the general manager of the unit reports directly to the Minister of Health through the Assistant Secretary for Health Insurance, which will make it easier to resolve any technical or delay in implementation issues.
• Purchasing Manager. Be responsible for overseeing all aspects of the procurement process for contracts financed by the project, including procurement plan preparation and monitoring, and documentation powers and competencies, and requests for the World Bank’s approval, and the organization of conferences bidders and evaluation of bids, and oversee the implementation of contractual obligations, ect. The Purchasing Manager in collaboration with the Unit Director of implementation of the project staff and other periodic reports on the progress made in the procurement and brought to the party or to the concerned authorities.
• Director of Finance Department. Financial Management Specialist tasks include the preparation of the budgets of the annual project, monitoring, and reporting on the status of the project accounts and disbursement of funds, and the link with the external auditor, and to deal with project funds flow (payments directed to consultants and suppliers, and withdrawals from the project account).
• monitoring and evaluation specialist. Be a specialist in procurement, financial management and technical staff Affiliates of the General Authority for Health Insurance or National Health Insurance Organization in charge of implementation of the project and specialist monitoring and evaluation, in coordination with the Division General Director of implementation of the project, all of whom are responsible for the preparation of periodic reports on the progress of the project, including the progress report work in the public execution, procurement, project financial affairs, and the progress of the project in exchange for the agreed upon performance indicators.

115. be the PIU headquarters in the General Authority for Health Insurance, and can be transferred to the National Authority for health insurance when they are created, subject to the completion of any additional assessments World Bank may need to be carried out within the framework of due diligence procedures.
116. The unit will form part of the implementation of the project management of social health insurance program team and reports directly to the Minister of Health by Assistant Secretary for Health Insurance regarding the implementation of the project and any issues requiring decisions at the management level. As for the technical aspects of the project and operational whereupon the PIU in close coordination with law enforcement officials from relevant departments of the General Authority or the National Authority for Health Insurance: information and financial management systems, management etc. These employees will not fall within the PIU team but their managers chosen to be the chief technical specialists to the project to develop the health insurance systems. Technicians and specialists will work closely with members of the unit project implementation team in specific tasks related to the project, such as the preparation of technical specifications, evaluation of bids technically, ect.
117. The project implementation unit is full of self-government, which is passed to the Ministry of Health funding resources.
Second. The relationship between the General Authority for Health Insurance and National party payment only new
118. Government commissioned by the Ministry of Health to be the body implementing the Health Insurance Systems Development Project funded by the World Bank. And is currently being introduce legislation to the new system of social health insurance, which would create a new body, the National Authority for health insurance to be the point of the only national payment. If the government decided that this new body is the most appropriate body to become the implementation of the project it has been transported to the responsibilities of project implementation body. The mechanism has been integrated in the project documents to allow this if the World Bank has agreed to this as acceptable.
Thirdly. Governance and public administration system structures
119. formed a steering committee for the system of social health insurance members participate at the level of the Council of Ministers and the ministries of health, finance, social solidarity and other ministries and chaired by the Egyptian Prime Minister, in order to guide the development of a comprehensive system of social health insurance reform process. In addition, the government will form a steering committee for the project between the ministries by the Ministry of Health in order to help overcome any bottleneck in the implementation of the project may face and requires coordination between various ministries.
120. When founded the National Organization for health insurance, it is also expected that the unit implementing the project, a project to develop the health insurance system – is responsible for reporting to the board of this body, where the main task of this project is to develop processes and management systems of the body in question. In addition, the Board of the National Authority for Health Insurance Administration will be the party concerned a different point of payment policies, standards, such as decisions concerning the objectives of monitoring the levels of use of services, and methodologies payment service providers format, and will be, the party concerned to ensure the dissemination of improved labor regulations in the pilot provinces projects to all parts other country.
Fourthly. The relationship with the World Bank
121 will be the project implementation unit is the interface interfaces Home of the World Bank with the General Authority for insurance, in all matters of the project, including the stomach reports on project status, and applications for the World Bank’s approval of the documents and papers procurement, and disbursement of loan funds, ect.
122. The PMU prepared the following project reports and submit them to the World Bank:
• progress reports every six months: contains a summary of the physical and financial progress to the project, and explanations of the differences between physical and financial progress and forecasts, and a description of the issues encountered by the project, and a summary of actions are under consideration or have been taken to address these issues, and updates the implementation and outcome indicators.
• interim financial reports half-year results: Financial Manual will coordinate separates these reports and their content.
• consolidated annual reports: the information available to incorporate in the semi-annual reports and describes the actions recommended measures to ensure the implementation of the project effectively and achieve its objectives.
• the annual financial statements of the project: It will detail the financial evidence of these reports and the coordination of their content.