Tunisia's private hospitals have called for urgent intervention to settle their outstanding dues with the National Health Insurance Fund (CNAM), which have been delayed for eight months. The Tunisian Private Hospitals National Union issued a statement on September 24, 2026, warning that the continued delay in payments could threaten their ability to operate and impact the continuity of healthcare services provided to insured individuals.
The union stated that the delayed payments have exacerbated the financial difficulties faced by private hospitals, with some struggling to meet their obligations to suppliers and pay employee salaries. They warned that if the situation persists, some hospitals may be forced to cease operations. Despite these challenges, private hospitals continue to provide services to insured individuals professionally and without discrimination.
The union noted that transactions with CNAM account for 30-70% of each hospital's total transactions, depending on the hospital and location. They argued that CNAM's continued issuance of healthcare coverage letters, while failing to pay outstanding dues, has further complicated their financial situation. The union called for urgent action to ensure regular payments and maintain the continuity of healthcare services.
Private hospitals also highlighted the ongoing issue of outstanding financial claims from the Libyan state since 2016. They emphasized that these debts, which have been audited on several occasions, have caused significant financial damage and impacted their financial balances.
In another matter, private hospitals expressed their rejection of being required to pay social contributions for private sector doctors who practice within their facilities, particularly radiologists and anesthesiologists. They argued that considering these doctors as employees is not based on the current legal and regulatory framework.
The union explained that these doctors practice under their own names and responsibilities, receiving fees directly from patients or through cooperation agreements with hospitals. As such, they are required to pay their own social contributions as self-employed individuals within the social security system for non-salaried workers.
The union reported that discussions with CNAM's general management have led to a proposal to conclude an agreement with the concerned doctors, taking into account their independent practice and enrollment in the social security system for non-salaried workers.
Key points
- Private hospitals in Tunisia demand payment of outstanding dues from CNAM
- Delayed payments have exacerbated financial difficulties faced by private hospitals
- Hospitals warn that continued delays may force some to cease operations
