By Patience Nyangove
MEDICAL service providers claimed around N$125 million in less than two weeks in December from the Public Service Employee Medical Aid Scheme (PSEMAS), a move that has prompted the Ministry of Finance to launch a forensic audit into a majority of the claims it suspects are not legitimate Confidente has learnt.
Confidente is also informed that one medical doctor claimed as much as N$1.2 million from PSEMAS in December which appears to have led to the Ministry of Finance to hold on tightly to its purse until it completes its investigations into the authenticity of the claims.
Confidente is told as well that on average the Finance Ministry monthly releases about N$55 million to PSEMAS and never in the history of the medical aid scheme have there been monthly claims that have surpassed N$55 million.
Finance Minister Calle Schlettwein Tuesday told Confidente that his ministry was currently looking into whether the medical aid claims are legitimate or service providers inflated their rates to fleece Government.
“They are a number of issues we are looking at and we will have a press conference later this week to clarify some issues. It’s a complex issue. There is serious price escalation being looked at on whether it’s legitimate or its possible medical aid fraud which I can’t comment on now,” the Finance Minister said.
Confidente is informed that a meeting was held on Monday at the Ministry of Finance between health service providers affected by the current late payments of money by PSEMAS and Ministry of Finance officials.
“With each payment run PSEMAS gets about N$55 million to pay everyone. However for the first time in 22 years, the claims in December, the quietest period, went up to N$125 million. This was obviously way above the N$55 million they are used to. Some providers we are told claimed as much as N$1.2 million during this quiet period, more than what they do during busy times like June and July. Obviously that’s a serious anomaly. As a result some of the providers’ staff is undergoing forensic audits because quite frankly, fraud is suspected sadly,” high ranking sources close to the matter who spoke to Confidente on condition of anonymity said.
The sources also told Confidente that reports that PSEMAS was bankrupt were not factually correct.
“In short there is money and money will keep being released but because claims in just 11 days of the quietest period of the year trebled from what they’re used to paying, PSEMAS managers had to now wait for senior staff to come back from the December holiday to ask for more money. They won’t be money withheld for payment to members. Money will be allocated as it gets released as usual. They were first looking at updating everyone and making sure everyone is covered up to the last day of December.
“So going forward, we agree to work closely with PSEMAS to ensure that there are no more delays. In the interim they asked that we help PSEMAS clients, as they are working at resolving the situation. There’s no money permanently kept in the PSEMAS kitty. Money gets released monthly and they simply allocate it. What was also mentioned was: the minister had a meeting with PSEMAS officials this past week and they’re working on different strategies and models to ensure they bring everyone up to date with payments. They unfortunately can’t say when but we did our best to indicate how bleak the situation is, and what effects it would have. We won’t pay suppliers, they won’t pay manufactures, business will collapse, and we will have to retrench people,” the sources revealed.
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