Seventeen medical aid societies are operating on temporary licences as Government tightens the screws on those failing to remit payments to health service providers.
Ordinarily, authorities review medical insurers’ licences yearly to check whether their operations conform to standing regulations.
However, it emerged last year that quite a number of the medical insurers were flouting stipulations, prompting the Health and Child Care Ministry to give them six-month permits that expire in June 2016 and will only be renewed if they revise their modus operandi.
Chief among the medical aid societies’ transgressions is failure to remit claims within the stipulated 60 days, to produce audited financial statements, not having a health insurer’s constitution and notice of management change.
Secretary for Health and Child Care Dr Gerald Gwinji told The Sunday Mail that conditional licensing would induce compliance.
He would not be drawn into revealing culprits’ names.
“The bulk of medical health insurance companies are on conditional licensing, and this was done to improve compliance with Government regulations.
“Failure to remit claims within the stipulated timeframe is one of the reasons why most of them were given temporary licences. Some have exceeded 100 days without remitting claims!
“I should point out, however, that a temporary licence doesn’t necessarily mean a certain medical aid society will be struck off the register. No. Striking them off can only be done if they fail to own up. Only one has already provided evidence of compliance.”
Association of Healthcare Funders of Zimbabwe Chief Executive Mrs Shylet Sanyanga declined commenting, referring all inquiries to the parent ministry.
The association comprises 31 medical aid societies with 1,2 million subscribers.
Medical aid societies are granted operating licences on the strength of their ability to manage members’ contributions and remit payments to service providers.
They are regulated by the Health and Child Care Minister whose mandate, among others, is to monitor their activities, including financial performance and fiduciary responsibility.
Over a week ago, Government gave Cimas, one of Zimbabwe’s largest health insurers, a seven-day ultimatum to pay claims, failure of which would lead to revocation of its operating licence. The firm has been allegedly cherry-picking medical institutions instead of allowing its members to approach service providers of their choice as provided for by Statutory Instrument 330 of 2000.
Last Friday, Cimas applied for a High Court interdict to stop cancellation of its licence, but authorities maintain it is not yet off the hook.
Health and Child Care Deputy Minister Dr Aldrin Musiiwa told our sister paper The Herald: “We have been served with (court) papers in which they are asking for an interdict to stop the ministry from cancelling their licence.
“We had not cancelled their licence, but signalled our intention to do so in the event that they do not comply with the law.
It seems they do not want to regularise, but that will not save them.”
In an earlier update to members, Cimas Managing Director Mr Roderick Takawira had said: “We believe that the outcome of the audit (Cimas has instituted) should determine whether or not Cimas resumes direct payments to Corporate 24 (hospital).
“It is our expectation that engagement with authorities will lead to resolution of this matter as member interests remain paramount to us.”
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