Rwanda: RSSB to Assess Rising Medical Bills

17 February 2019

The rise in the money that the Rwanda Social Security Board (RSSB) pays to cover health care costs is not proportionate what people contribute to its medical insurance scheme, a trend that is has raised concerns, its Director General; Richard Tusabe has said.

Tusabe made the revelation on Friday during a press conference on the Fund's performance for the six month period covering July 2018 through December 2018.

For instance, he said that the expenditures that RSSB projected were estimated at Rwf95bn in the financial year that will end on June 30, 2019, or about Rwf47 bn in a six-month period.

However, the half-year expenses alone came to Rwf54.2bn, meaning that it used 14 percent more funds than expected.

The unexpected expenses are attributed to the rise in medical care bills.

Paid benefits were at about 98 percent in Pension scheme, 112 percent in the medical scheme, and 126 percent in Community Based Health Insurance Scheme - Mutuelle de Santé.

"If you compare the trend in the number of subscribers and the amount of money we spend, you realise that there is a huge gap," he said estimating that the former might be growing at between two and three percent against the latter's 20 percent.

He said that preliminary information suggests that there are instances when doctors have prescribed many drugs to a patient so that they can benefit from the high medical bill.

Normally, a doctor prescribes medicine, or records treatment(s) to a patient - subscriber to the scheme - and takes the bill to RSSB which covers 85 percent of the cost.

He said that the measures to respond to that concern should be tactful because it involves the lives of Rwandans, and partners like pharmacies, hospitals.

"What we are doing is to look at which health facilities had higher bills than others, and enter the details to establish whether it is in consultations, drugs (medicine) or other aspects," he said.

He said that the evaluation will help the institution to establish the underlying factors for the rising questions.

"This is an issue of concern for us. We need to know whether it's true that Rwandans had [more] treatments, which is also possible, but we should take a grip on the reality of the numbers growing disproportionately and its root cause," he said adding that a report on these issues might be made available within three months.

Meanwhile, he disclosed that there are people who might be conniving with some RSSB employees to produce fake documents or certificates asserting that they are the next of kin to a deceased person [who was a subscriber to the social security scheme] so that they get undue benefits, yet they did not contribute to the scheme.

He cited a recent case in which some RSSB employees were suspected of this fraudulent act in Northern Province, but fled before they were arrested.

"We are searching for them through Interpol and other means. We are working with all concerned organs to tackle this problem of individuals who are misappropriating public funds," he said.

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