Cimas, Corp 24 get 2-week ultimatum

GOVERNMENT has given medical aid society Cimas and hosptial group Corporate 24 two weeks to resolve their differences following the release of a forensic audit instigated by the medical aid society.

The audit implicates the emerging hospital group in different forms of fraud.

Speaking to The Herald yesterday, Secretary for Health and Child Care Dr Gerald Gwinji said an amicable solution to the rift between Corporate 24 and Cimas was long overdue, considering that it continued to affect patients.

“We created a platform for amicable resolution of the longstanding matter and agreed on a framework for bilateral resolution and I expect feedback in a week or two,” said Dr Gwinji.

He said Government was using the “Cimas-Corp 24” rift as a case study in the medical aid/service provider relationship.

“In essence, we used this as a learning experience in the provider-insurer relationship and their common obligation to the patient,” said Dr Gwinji.

If the parties fail to agree, the matter will be referred to the Attorney-General for final determination.

Although Cimas managing director Mr Vulindlela Ndlovu refused to comment saying he was not at liberty to discuss the rift in the media, the Association of Health Care Funders of Zimbabwe (AHFoZ) said the majority of service providers made legitimate claims and were professionals of integrity.

AHFoZ said some service providers were in the habit of abusing and misusing medical aid funds.

“Generally, patients are expected to be treated by their general practitioners and to use emergency units only for emergencies,” said AHFoZ chief executive officer Mrs Shylet Sanyanga.

“The follow-up care even after an emergency visit should be the family doctor.”

Corporate 24 CEO Dr Mike Joka refused to shed more light on the allegations leveled against his hospital.

He said there was another process taking place, which was being spearheaded by the regulator.

Dr Joka said the forensic audit instigaetd by Cimas was incomplete.

“We cannot comment on the allegations in the forensic audit, but what we can say is that the audit itself is incomplete,” he said.