By Confidente Reporter
IN a bid to get rid of the rot that has engulfed the Public Service Employees Medical Aid Scheme (PSEMAS) claims system, the Ministry of Finance has given notice that it intends to terminate its previous agreements with all health service providers by 31 May.
It was confirmed to Confidente this week that the ministry has given health service providers 60 days’ notice, from 1 April, in order to phase out the old PSESMAS agreements.
The agreements will be available for signing from 1 May.
If health service providers fail or refuse to sign the new agreements by 1 June, PSEMAS members will have to be pay them directly, before claiming their money back from the medical aid scheme.
According to a letter in possession of Confidente, which was written on 30 March by Ministry of Finance Permanent Secretary, Ericah Shafudah, to all healthcare professionals, the new service provider agreements were necessary, in order to align PESMAS to the changes that have taken place in the sector over the years.
Shafudah also highlighted that the ministry was busy reviewing the current benefit structure, rules and agreements, which governed the direct submission and payment of healthcare professional claims, through the PESMAS administrator.
“In terms of Section 12.4 of the (existing) agreement, the Ministry of Finance and PSEMAS, wish to inform all healthcare providers that this agreement will be terminated and wishes to give 60 days’ notice, as from 1 April till 31 May 2017.
“Due to the involvement of all stakeholders, the amended agreement will only be effective from 1 June 2017, and no new agreements will be allocated until the respective date of 1 June 2017, as indicated. The new agreement will be available for signature as from 1 May 2017. Please, take note, that if any healthcare professional doesn’t have a signed agreement, the PSEMAS member must first pay, and then claim,” Shafudah wrote.
Finance Minister, Calle Schlettwein, confirmed on Tuesday that health service providers will have to sign a new contract with PSEMAS.
This comes after N$125 million in claims were submitted to the medical aid scheme in December last year, which led to the ministry instituting an investigation to verify their authenticity.
Confidente recently established that a review com¬mittee, comprising of members from differ¬ent health institutions, had been put in place by the ministry, to audit the claims.
Documents in Confidente’s possession also revealed that the committee will also gauge PSEMAS claim patterns, to identify health service providers with suspiciously high claims.
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