Paidamoyo Chipunza Health Reporter—
Government has directed service providers not to charge co-payments and shortfalls on patients and warned medical aid societies that they risk being de-registered if they do not reimburse doctors using newly-gazetted medical tariffs. Defiant medical aid societies, will in the next two months, be de-registered.
Addressing private hospital officials at their annual general meeting in Harare recently, Health and Child Care Deputy Minister Dr Paul Chimedza said medical aid societies were “hiding behind the finger” by claiming that existing legislation did not compel them to reimburse service providers at the newly-gazetted rates.
He instructed the service providers to file a formal complaint with his ministry should medical aid societies refuse to reimburse them at the gazetted rates within the stipulated 60-day time frames.
Deputy Minister Chimedza said upon notification from service providers, Government would write to the societies and if they fail to reimburse the required amounts within 14 days, then they would be de-registered.
“As far as the new tariffs are concerned, please put on your (claim) forms the money that was gazetted and claim that,” he told the service providers at the annual general meeting.
“If they do not pay, look at the statutes – what do they say and we take it up from there.”
Dep Minister Chimedza’s remarks followed a new impasse between service providers and medical aid societies who insist on using the previous rates for reimbursement.
Medical aid societies through their association recently published and wrote to their members that Section 16A(c)(ii) of the Medical Services (Medical Aid Societies) Regulations, 2000 quoted in the relevant Government Gazette, entailed doctors and hospitals to abide by the gazetted tariffs, but was silent on what medical aid societies should do.
This resulted in medical aid societies sticking to reimbursing general practitioners the old tariff of US$20 a visit and US$80 for specialist services.
The newly gazetted tariff for general practitioners is US$35 per visit, while specialists should charge US$120.
Doctors had no choice but to pass on the burden to patients whom they were asking for co-payments and shortfalls, rendering medical aid useless.
“We were shocked that the funders (also known as medical aid societies) said Government gazetted medical tariffs, but they are not obliged to pay the new tariffs. It is very unfortunate that they chose to do that and maintained the status quo.”
He said there were only two types of tariffs that were recognised in terms of the law – tariffs agreed by both parties or those that were gazetted by Government.
In this case, both parties failed to agree on a tariff, resulting in Government stepping in with a common tariff, which saw a 70 percent increase.
“As a ministry, we do not get in the ring to fight providers or medical aid societies,” said Dep Minister Chimedza. “We are a referee.”
Association of Healthcare Funders of Zimbabwe chief executive Mrs Shylet Sanyanga yesterday said she had nothing to say on the matter and would not entertain questions.
AHFoZ is made up of medical aid societies and has since made it clear that its members would not abide by the newly gazetted tariffs.
Dr Chimedza also spoke against ‘medical tourism’ that sees patients seeking from other countries, treatment that could be offered locally.
He said the practice was not good for the economy.
“We might need to sit down and interrogate our systems and see how best we can treat our people locally for procedures that can be done here,” he said. “If we do not adapt and adjust we will be extinct like dinosaurs.”
He said Government was looking at ways of reviving Natpharm to ensure that both private and public institutions got drugs at a cheaper price.
Zimbabwe’s health system is facing a myriad of challenges ranging from drug unavailability, obsolete equipment, depleted human resources and high costs of medical care.