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Public Hospitals losing an estimated $300M to insurance companies

Published:Wednesday | July 19, 2017 | 6:02 PMErica Virtue

Already struggling and under-resourced, public hospitals are losing an estimated $300 million to insurance companies from individuals with health coverage who are preying on public hospitals where services are 'free'.

Under the no-user-fee policy, hospitals are entitled to receive fees from insurance companies where a policy holder uses the public-health facilities. However, patients were not disclosing their status, which was giving the ministry a headache.

This issue was discussed at yesterday's sitting of the Public Administration and Appropriations Committee (PAAC) of Parliament when the Ministry of Health and sector agents were guests of the PAAC.

Committee member Leslie Campbell, an attorney, read the regulations to the committee which said that the hospitals were entitled to demand and collect information from patients despite the no-user-fee policy.

"If it is costing you $2 billion a year and these insurers are having a windfall as it were, it is something that you ought to pursue," Campbell suggested.

Permanent Secretary Sancia Bennett Templer said that the matter had been noted and a discussion is to be had with the Attorney General's Department for a full interpretation on procedure. Hospitals collected $338 million between April 2016 and March 2017, according to Bennett in response to committee member Franklyn Witter.


But collections could be much more.

"It's almost double what we are collecting now that we estimate," said Howard Lynch, director of policy in the ministry.

Officials have met with the insurance providers, and difficulties were acknowledged in collecting without card information. Remedies are being sought by way of policy through Cabinet submission.

"We are at present preparing the necessary Cabinet submissions to get the necessary legislation amended to enforce the collection once there is knowledge that the individual has health insurance," Lynch explained.

The submission is expected to be made by August.

Fitz Jackson, member of the PAAC, said that the insurance companies were the biggest beneficiaries because they were collecting the premiums but were not making the payouts.