Medical aid societies face ban

renewed every year.

Ministry of Health and Child Welfare strategy and policy development officer Mr Tonderai Kadzere said yesterday that the rules would ensure no patients were turned away by service providers.

He was speaking at the official opening of the Association of Health Care Funders of Zimbabwe offices in Harare.

Mr Kadzere said the newly formed Joint Advisory Council, chaired by Health and Child Welfare Deputy Minister Douglas Mombeshora, made the resolution when it met recently.

The council is made up of all players in the health sector.
Mr Kadzere said another agreement from the meeting was that service providers should not turn away patients with valid medical aid cards.
“All medical aid societies with outstanding amounts to service providers were directed to pay up,” he said.
“Providers with unpaid bills should compile their figures and submit for payment, if there are issues let them be known. Come 2013, any medical aid society or fund with unpaid debts of over 60 days will not be fit to operate.”

Mr Kadzere, who was representing Health and Child Welfare secretary Dr Gerald Gwinji said the medical aid societies had enough time to settle their bills.
“The economic situation has stabilised and there is no reason why they are failing to pay up if they are collecting subscriptions every month from members,” he said.

Mr Kadzere said most patients were failing to access treatment after contributing to medical aid societies.
He said the next JAC meeting was slated for November 14 and that it would come up with agreed medical tariffs.
“All players have been urged to adhere to the existing regulations governing their business,” he said.
The regulations include acceptance of medical aid cards and timely reimbursement to service providers.

Zimbabwe Medical Association president Dr Enock Tatira said most medical aid societies were failing to honour claims within the agreed 60 days.
“I think making them adhere to rules is the only way forward because we end up compromising service delivery to patients,” he said.
AHFoZ chief executive Mrs Shylet Sanyanga said there were some medical aid societies tarnishing the image of the organisation by not paying service providers. She said forcing such members to pay up was a good idea.

“They are simply implementing provisions of a Statutory Instrument and I think it is fair,” she said.
Mrs Sanyanga said there were two medical aid societies notorious for not paying service providers, but refused to name them. She said the two societies blamed their companies for failing to remit contributions.

“There are very few societies failing to pay service providers and these few behave extremely badly, such that they tarnish the whole image of medical aid societies,” she said.

Some medical aid societies are reportedly facing collapse due to late remittances of contributions, low subscriptions and escalating costs of medical services.
Late payment for services has resulted in specialists like anaesthetists, orthopaedics, neurologists and physicians demanding cash upfront from patients with valid medical aid cards.