28 January 2013

Zimbabwe: Pay Up or Else, Govt Orders Medical Aid Societies

MEDICAL aid societies that have arrears with doctors and hospitals of more than 60 days have been given a two-month ultimatum to pay up or have their licences revoked, Health and Child Welfare Deputy Minister Dr Douglas Mombeshora has said.

He said all non-compliant societies have been given temporary licences to last only up to February 28 but those that have been complying had their licences renewed for one year as usual.

"We want medical aid to work so that no one holding a valid card is turned away. We have given each society that has not been complying with existing regulations a temporary licence and they are all aware of what they are supposed to sort out," said Dr Mombeshora.

Although Dr Mombeshora could not be drawn into naming the non-compliant societies saying they would only reveal the information after February 28, information gathered indicates that more than half of the 26 registered societies have temporary licences.

Dr Mombeshora said some societies were using the bulk of member's contributions in hefty salaries thereby failing to pay up service providers within the agreed timeframe.

The 60-day timeframe is a legal requirement agreed on by both societies and service providers in 2004 and is supposed to result in all card-holders accessing treatment at a provider of their choice.

The same legal requirement also stipulates that both parties should come up with an agreed tariff so that members do not make a co-payment or incur shortfalls. But medical professionals and societies have been failing to agree for the past nine years, resulting in societies directing their members to particular providers -- a clear indication that they might never agree.

For that reason, Government has also given them the February 28 deadline to come up with a position, failing which Government would also impose a tariff.

The Association of Healthcare Funders of Zimbabwe chief executive officer Mrs Shylet Sanyanga said their members were in the process of putting their houses in order.

"We are aware of the deadline and all our members are making efforts to have cleared outstanding arrears by February 28," said Mrs Sanyanga.

She said the main reason why some societies were failing to pay up in 60 days is that some companies were not remitting members contributions.

The Joint Advisory Council - a council comprising of all players in the health sector is expected to meet in the first week of March and announce names of societies licenced to operate.

Some medical aid societies are reportedly facing collapse due to late remittances of contributions, low subscriptions and escalating costs of medical services.

Late payment for services has also resulted in specialists such as anaesthetists, orthopaedics, neurologists and physicians demanding cash up front from patients even those carrying valid medical aid cards.

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