Medical societies to slash benefits• Row over tariff hikes cited • General schemes to be affected

medical instrumentsPaidamoyo Chipunza Health Reporter
The dispute between medical aid societies and doctors over medical care charges has escalated with medical aid societies yesterday saying they will not pay for visits to general practitioners’ rooms by members on general schemes and will only cater for hospitalisation and emergency cases if Government insists on implementing new medical tariffs.
Doctors have threatened to take legal action against health funders for not complying with the Government directive.

If the proposal sails through, medical aid societies will downgrade members on general schemes to council clinics and Government hospitals.
Recently, service providers through the Zimbabwe Medical Association (ZiMA), wrote to 31 medical aid societies expressing their displeasure over non-abidance by existing tariffs gazetted by the Government in May this year.

Government gazetted US$35 as consultation fees for general practitioners in May.
Health and Child Care Deputy Minister Dr Paul Chimedza yesterday refused to comment on the issue, referring all questions to Minister David Parirenyatwa, whose mobile phone went unanswered the whole day.

Interviewed medical aid societies representatives said if Government failed to revise downwards the new tariffs, they would be left with no option but to downgrade current benefits enjoyed by their members.

“Most of our budget is consumed by claims from general practice and that will be likely the first benefit to be cut off as we encourage our members to seek services from council clinics and Government institutions,” said an official from one medical aid society.

Asked what would be the purpose of medical aid, he said it would only be covering hospitalisation and emergency cases such as accidents.
“Employers are telling us that they cannot afford an increase of contributions from their employees. In fact many companies are cutting down salaries, so where will that money come from. The only option is to downgrade if members still want to see a general practitioner, or will be at their expense,” said the source.

Although law experts say its illegal to downgrade members’ benefits, the service providers are taking advantage of the difficult economic situation and are threatening to close shop if put under pressure.

The Association of Healthcare Funders of Zimbabwe (AHFoZ) chief executive officer, Mrs Shylet Sanyanga, could not shed light on the latest developments saying they had since responded to ZiMA.

AHFoZ represents the interests of all medical aid societies in Zimbabwe.
“The Association of Healthcare Funders of Zimbabwe responded to the letter from the Zimbabwe Medical Association on behalf of all the AHFoZ members in that regard,” she said in her written response yesterday.

She, however, declined to disclose what they told ZiMA.
In a letter dated August 19 directed to one of the medical aid societies, ZiMA said it was concerned by the society’s failure to abide by the Minister’s order.

“The ZiMA has obtained evidence (with great concern) from the generality of our membership that you are reimbursing medical claims at a rate that is lower than that set in General notice 59 of 2014, published by the Minister of Health in the Government Gazette on 23 May 2014.

“Be advised that you are in violation of the general notice above. ZiMA will thus be compelled to notify the industry regulator, who is the Minister of Health and Childcare of such a violation,” reads the letter.

ZiMA national treasurer, Dr Billy Rigava, said the letters were sent to 31 medical aid societies as well as AHFoZ.
“So far we have received five responses,” said Dr Rigava but declined to disclose their contents.

The College of Primary Care Physicians has also written to several societies warning them of their non compliance to existing regulations.
The College of Physicians said it was treating the failure by societies to comply with the new tariffs as shortfalls and failure by the societies to pay up would result in them instituting legal action.

“Please would you immediately instruct your relevant department to comply fully with general notice 159/2014. In that regard we demand that such an instruction be issued by not later than close of business on the 29th August 2014, failure of which legal proceedings will be instituted,” reads the letter by the physicians.

Since 2008, there has been an impasse between medical aid societies and service providers with regards to costs of medical services rendered.

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