Claire Elshot and Raymond Jessurun.
~Lee, SZV: Solution being worked on ~
MADAM ESTATE–St. Maarten Anti-Poverty Platform and St. Maarten Consumers Coalition are calling on authorities to speedily address a concern brought to their attention that Social and Health Insurance SZV cards for civil servants are at risk of not being accepted by some family doctors, and monies paid for medical services abroad will not be reimbursed if government fails to consistently settle its debt to SZV.
In an invited comment on the matter, Health Minister Emil Lee said SZV and government have been working together to find interim and long-term solutions on the issue of payment of premiums; while SZV Senior Communications Advisor Charonne Holder said SZV is trying to work on a structural solution.
Consumers Coalition said at a press conference on Thursday it is very much concerned about the matter. According to the platform, two weeks ago, a teacher informed them that SZV staffers had indicated that as long as government does not pay SZV, insured will not be reimbursed for medical bills paid for abroad. The teacher had declared the bill since December.
“The teacher started to worry even more when the home physician told the teacher that their… consultations have to be paid for in cash, because the doctor card of government workers will not be accepted anymore, because government owes the health care providers for months now,” it was stated at the press conference.
“Based on this complaint… Consumers Coalition immediately sent an email to the management of SZV to inquire if the information received from the teacher was correct. Until today we have not received any answer or update from SZV management, nor has the customer of SZV been contacted by SZV to address her reimbursement. It was the management of SZV that two weeks ago in a press release said they had an open-door policy. Well, apparently, the door is closed this time.
As Consumer Coalition, we also sent an email to the Minister of Public Health, Social Development and Labour requesting his attention and urgent mediation to resolve any payment issue between government and SZV for the medical care of civil servants and teachers, if there exists such a problem. Until today no response from the Minister of VSA,” it was stated at the press conference.
“As Consumer Coalition, we also asked for an urgent meeting with the Platform of Health Care Providers to get first-hand information from them concerning the issue of not being paid by SZV and government for medical care to civil servants and teachers and if refusal of the doctor cards can be prevented or postponed. We think that health care providers should be paid what is owed to them based on services rendered. With the liquidity support received from the Netherlands, why can’t the health care providers be paid yet? We publicly appeal to the Minister of General Affairs (Leona Romeo-Marlin), who is responsible for personnel affairs and thus also to guarantee continuity of medical care services for its employees. Also, PP-card holders might be affected if the doctor card is refused by health care providers. We therefore publicly appeal to Minister of Public Health, Social Development and Labour who is responsible to guarantee the continuity of medical care for the PP-card holders.”
The Coalition also called on Finance Minister Perry Geerlings to release the necessary funding for the payment of health care providers for services rendered to civil servants, teachers and PP-card holders. “By the way, was it not the Minister of Finance who just a few weeks ago announced that the government revenues were higher than expected? In other words, why can’t this money pay the bills declared by the health care providers?”
Working on solutions
Lee said he and colleagues in government are aware of the status of payments by government towards the OZR fund. “SZV brought this situation to the attention of the government several years ago, and it is a point of concern of the CFT (Committee for Financial Supervision) also. This was again brought to the attention of the Council of Ministers, including the Minister of Finance two weeks ago by SZV and by the Minister of VSA. All parties are now waiting for measures to be taken by the Minister of Finance.” Lee said.
Payments are being made and SZV has agreed to execute payments based on what is available. “The agreements on this are amicable and with respect to the fact that SZV, as a result, would have a delay in the processing of payments to insured, etc. The minister said government is also in conversation with health care service providers, who are bearing the burden, to which we are hoping to come to a resolve at soonest. “It is not the intention of government that medical services to patients be disrupted by this situation. Payments are being made and SZV has been flexible in the matter. There are no absolute solutions yet, but we are all working on this together at the moment,” the minister made clear.
Trying to resolve structurally
SZV said it executes the administration and management of the OZR Fund on behalf of the government of Sint Maarten. The government of Sint Maarten is responsible for providing the funds to SZV that are deposited in the OZR Fund. The objective of the OZR Fund is to cover the cost of medical treatment, nursing or other related medical expenses that are provided to its insured, the civil/public servants and/or government officials.
“SZV and government have been in consultation on the matter of the backlog in the payments towards the OZR Fund. Together we are looking at the state of affairs and structural resolutions. The result of the backlog is a delay in the transfer of payments to health care service providers for executed services and payments to OZR insured for approved medical reimbursement and dental requests. Both health care service providers and OZR insured are notified of this – pending liquidity of the fund, payments are transferred. Together with government, we are in consultation with the health care service providers who have expressed their concerns on the matter. We are trying to work on a solution to resolve structurally,” Holder said.
“Government has been forthcoming in the payment of monthly instalments towards the backlog. Payment transfers are reliant on the allotting of funds by the Sint Maarten government to the OZR Fund. The usual reimbursement period of six weeks, in some cases may be delayed. When payment is delayed, OZR insured are informed of this.”
Regarding the complaint of the teacher, Holder said that due to SZV’s privacy policy, it is unable to comment in detail on the case of the teacher in question to the media. “However, we can comment that on February 6, we did receive an e-mail from Consumer Coalition regarding the status of reimbursement of OZR claims, and inquiries regarding the reimbursement of an insured. The e-mail from Consumer Coalition will be replied to, however, we will be contacting the insured directly to address their complaint on the information provided regarding the status of the reimbursement request. As is customary, we will do this according to our complaint procedure, which we highly recommend that all our customers make use of directly,” Holder said.
Source: The Daily Herald https://www.thedailyherald.sx/islands/85090-consumers-group-concerned-about-refusal-of-szv-cards-non-reimbursement-of-bills
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