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Private health providers refuse to accept medical aid, govt says move illegal
23/05/2016 00:00:00
by Anna Chibamu
 
Premier Service Medical Aid Society is not paying service providers
 
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PRIVATE doctors, hospitals and other health providers will, with effect from July 1, stop treating patients on medical aid schemes due to non-payment of claims, the Zimbabwe Medical Association (ZIMA) has said.

The association says its members are struggling to cope as the Zimbabwe Revenue Authority (ZIMRA) is still demanding and collecting tax whether or not the insurance schemes have paid out on claims.

The development means patients on health insurance schemes will, beginning July, have to pay upfront for treatment.

However, government immediately said doctors would be breaking the law if they refuse to treat patients.

“The law requires doctors to render services to members of the public,” said deputy health and child care minister Dr Adrian Musiiwa.

“When a patient produces a medical aid card, they’re expected to treat them and be paid by medical aid societies’ within a period of six months. If they don’t accept that they’re breaking the law.”

ZIMA claims to be owed more than $220 million by various health insurance firms with the association’s Secretary General, Dr Shingai Bopoto, saying almost half of the amount was owed by a single medical aid society.

“Medical aid societies are not paying claims and some have gone for three years without paying service providers resulting in doctors looking for funds elsewhere to pay their tax,” he said.

Deputy Minister Musiiwa said government would force the health insurers to pay up.

“It’s a complicated situation that is being created by medical aid societies that are not honouring their obligations,” he said.

“Zimra is chasing doctors for tax yet they have not been paid. The only way we can solve this is to push the medical aid societies to pay up.

The row over failure to pay claims by health insurance firms has raged for some time with health service providers even appealing to Parliament as well as the Competition and Tariffs Commission.

ZIMA gave the health insurers up to July 1st to pay up, failing which the association would refuse to treat their members without payment upfront.

Premier Service Medical Aid Society (PSMAS), which is run by government and largely caters for civil servants, has been struggling to pay service providers with bosses at the organisation accused of looting the company.



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Deputy Minister Musiiwa told NewZimbabwe.com that people need to know the law and also understand agreements they get into with medical aid societies.

Musiiwa said most patients were being prejudiced of their hard-earned cash by some medical aid societies because they lack knowledge on the law and their rights.

“People need to understand the law and also know their entitlements,” he said.

“Medical aid societies should communicate with clients and not dictate to them. Things like booklets to show a client’s limits should be issued by the medical aid society to avoid problems.

“The law is clear. Statutory Instrument 330 of 2000 is very clear and this should be followed.”


 
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