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Published On: Sun, Jan 11th, 2015

Doctors drag medical aid bosses to court

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Doctors have begun taking legal action against medical aid societies over US$14 million in outstanding consultation fees.

Although court records were not immediately obtainable, it is understood the doctors won some cases and lost others.

The court action follows disagreements over medical tariffs.

Zimbabwe Medical Association (Zima) secretary-general Dr Shingi Bopoto said: “Our members – in their own capacity – have approached the courts. We, as an association, are considering taking the same step, but are, at the same time, still confident that the regulator will solve the problem.”

Association of Healthcare Funders of Zimbabwe (Ahfoz) chief executive Mrs Shylet Sanyanga declined commenting.

The impasse between doctors and medical aid societies has remained unresolved for nearly three years.

At one point, medical practitioners wanted initial consultation fees of US$50, but health funders promptly shot down this proposal.

The Ministry of Health and Child Care then intervened and gazetted new tariffs in May 2014.

General practitioners’ consultation fees were pegged at US$35, up from US$20.

Special service tariffs were increased from US$80 to US$120.

However, the standoff has continued with Ahfoz arguing that the new charges are too steep.

In October, the association instructed all its members to pay US$25 for initial consultations and US$18 for reviews. Doctors responded by asking patients to settle the difference.

Figures compiled then showed that medical aid societies owed US$23 million to health service providers; US$14 million of which belongs to doctors.

Healthcare funders are regulated by the Ministry of Health and Child Care in terms of the Medical Services Act. Section 16A (c) (ii) of the Medical Services Regulations of 2000 compels all doctors and hospitals to abide by gazetted tariffs.

Experts contend that medical aid societies should be treated and regulated as full-fledged insurance companies.

Zimbabwe Insurance and Pensions Trust general manager Mr Martin Tarusenga told The Sunday Mail recently that: “The problem with health insurance companies is that they have been operating according to their own terms without subscribing to how premiums must be charged.”

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