deadline it set for the medical insurers to pay up service providers owed in excess of 60 days.
Many service providers are turning away patients because their insurers are defaulting on payments with others going for 12 months without paying instead of 60 days.
Health and Child Welfare Deputy Minister Dr Douglas Mombeshora said; “There are some societies which never contacted the regulator about their progress in clearing the debts and we are definitely not going to give them licences. These societies are Access and GreenCard medical aid societies.”
Dr Mombeshora said his ministry would send notices informing the medical aid societies that they were not fit to operate as they failed to clear their debts with service providers.
He said some of the societies such as Public Service Medical Aid Society negotiated with the regulator for payment plans, while others had their plans rejected.
“We are going to look into their plans and advice accordingly on the way forward.
“It is not every plan that we are going to accept.
“We want a plan which is feasible and realistic,” he said.
He said if the nine remaining societies fail to come up with feasible plans, Government would have no option but to withdraw their operating licences.
There are 26 medical aid societies in the country.
Meanwhile, Government has strongly warned all medical aid societies against coming up with their own regulations to govern the industry.
“They are not regulators, yet they come up with all sorts of laws in the event disadvantaging the patients. If any society wants a particular law to be reviewed they should contact the ministry, which is the regulator,” Dr Mombeshora said.
He said the Association of Healthcare Funders and the service providers have also been given a further two-week ultimatum to come up with an agreed tariff, failure of which Government will impose one.
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“We have realised that the medical discipline is too broad and it requires several months to agree on a common tariff for all services and procedures.
“We have, however, categorised them and what we want as a matter of urgency are tariffs for basic services such as consultations for general practitioners and specialists,” Dr Mombeshora said.
These decisions were reached during a Joint Advisory Council chaired by Dr Mombeshora last Friday.
JAC is made up of all stakeholders in the health sector including representatives of medical aid societies, service providers and consultants.
The decision to ban non-compliant societies is meant to ensure all patients holding a valid medical aid card are treated at any provider of their choice.



