PSMAS forensic audit starts
A FORENSIC audit has started at Premier Service Medical Aid Society (PSMAS) as the regulator of Medical Aid Societies seeks to establish if it is operating under its core mandate.
The Government says that the equivalent of US$5 million a month it pays towards civil servants contributions must be used to retire debt and ensure that civil servants can access medical care with PSMAS cards.
The Government says that while it is paying an equivalent of US$5 million per month to PSMAS towards civil servants’ contributions, they are struggling to access healthcare as their medical aid cards were being turned down due to non-payment to service providers.
Issuing a statement on PSMAS and the Premier Service Medical Investments yesterday, Vice President and Health and Child Care Minister Dr Constantino Chiwenga said access to healthcare was one of the most important non-monetary benefits extended by the Government to its employees.
VP Chiwenga said the facility was being extended through PSMAS, which was started in 1930 by civil servants under the name Public Service Medical Aid Society.
“The core business of PSMAS is, therefore, to serve the health needs of civil servants,” he said.
“Government supports each employee who chooses to become a member of PSMAS by paying 80 percent of their subscription to the Society.
“An amount of US$5 million equivalent per month is paid by the Government as employer contributions to PSMAS. This translates to US$60 million dollars equivalent annually.
“In view of the size of that commitment to the welfare of its workers, the Government has a weighty responsibility to ensure that PSMAS continues to attend effectively to its core business of providing unimpeded access to healthcare for its workers, the majority of whom are public sector workers.”
VP Chiwenga said the Government maintained active contact with PSMAS to ensure that the significant outlay made from Treasury to guarantee efficient and effective healthcare services were availed when needed.
“From time-to-time, PSMAS draws the attention of the Government to changes in the environment in which it operates, particularly as it pertains
to changes in consultation fees and other healthcare tariffs that may necessitate adjustments in subscription rates,” he said.
“The regulator of Medical Aid Societies has informed both Government and the PSMAS board that he has ordered a forensic audit of PSMAS in order to satisfy himself that the society is operating properly and in keeping with its mandate.”
VP Chiwenga said while awaiting the outcome of the forensic audit, the Government will continue to support PSMAS in order to enhance its ability to provide healthcare, maintain credibility with service providers and in the process ensure that its workers get access to health care services.
The support will extend to Premier
Service Medical Investments to pay its workforce and procure adequate medical drugs consistently.
VP Chiwenga said recently, the attention of the Government was drawn to serious challenges being faced by its employees when they seek medical attention on the strength of their PSMAS membership cards.
“In many instances, service providers are refusing to honour the card, citing non-payment of claims submitted to PSMAS,” he said.
“This has resulted in members being required to make payments up front, often in foreign currency.
“Where PSMAS medical aid cards are accepted, significant co-payments are also required, both in respect of consultation fees and the purchase of prescription drugs.
“PSMAS has since confirmed to the Government that the Society had accumulated significant debts with service providers.”
The Government urged PSMAS to use a significant proportion of the money from Treasury to retire the debt owed to service providers in order to restore the integrity of the PSMAS medical aid card.
VP Chiwenga said the restoration of trust will also remove the distress caused by huge shortfalls to service providers that would require civil servants to find the money for co-payments.
“In further engagements, Government sought information from PSMAS, as well as from Premier Service Medical Investments, the arm through which PSMAS provides direct healthcare to members through its hospitals, clinics, laboratories and pharmacies on the amounts required, on a monthly basis, to provide healthcare to its members,” he said.
“In addition, the amounts would be used to pay their employees and to purchase medical drugs.”
The Government has committed additional financial resources on a monthly basis ensuring viability of PSMAS and PSMI to deliver on their core mandate, said VP Chiwenga.
The funds are targeted to retire the debt to PSMI and other third-party service providers.
The move will, in turn, restore the confidence of service providers in PSMAS and it will also benefit Government employees and their dependants.
“The Government will therefore take measures to support PSMAS and PSMI and this will place PSMAS in a position where its word will be respected by service providers as it negotiates the restructuring of its debts,” he said.
“As the major stakeholder which, with its employees, provides over 90 percent of the total funding to PSMAS, the Government has a duty to ensure that the core business of the society is not crowded out by other preoccupations that do not contribute to the core mandate of the Society.
“Cases in point include investment in micro-finance, the buying and selling of gold, extending the Society beyond our borders and creating additional institutions that draw funds from the Society’s core business of health care service provision.
“This is the position of the Government as a whole and not by isolated components of Government. The position of the Government is to support PSMAS and PSMI as they concentrate solely on their core business of providing healthcare to members.”