~ SZV stopped guaranteeing payment 11 months ago ~
PHILIPSBURG–The Health Care Providers Platform has given government an additional two weeks to resolve outstanding payment arrears owed since last year.
The Health Care Providers Platform, which consists of house doctors (general practitioners), physio-, occupational and speech therapists, dieticians, dentists, psychologists, pharmacies, paramedics, and laboratories had been waiting for 10 months already for government to resolve the matter after sending its first letter on the issue in April last year and sending an additional three since then.
Platform member Dr. Mike Mercuur, who is also Secretary of St. Maarten Medical Association (SMA), said in March 2018 that SZV “abruptly announced” on its internal healthcare providers webpage that OZR (“Overheid Ziektekosten Regeling”) health insurance guarantee card payments were on hold until further notice. OZR cards are for government civil servants.
Social and Health Insurances SZV still issues OZR health insurance “guarantee” cards to civil servants, but health care providers have not been paid.
“In response, physio-, occupational and speech therapists, dieticians, dentists, psychologists, pharmacies, GPs [general practitioners – Ed.] and laboratories united in a Platform and sent four letters to government demanding standard 30-day payment. Some providers are (partially) paid, the majority have around six months outstanding,” Mercuur said on behalf of the platform.
The healthcare providers had their first meeting with Health Minister Emil Lee and Finance Minister Perry Geerlings on the matter on Tuesday, February 12. “It was a frank and open meeting and some commitments were made,” Mercuur explained. “These have yet to materialise. The Platform decided to evaluate the final outcome of these commitments after two weeks.”
Prior to the meeting with the two ministers on February 12, the Health Care Providers Platform also met with St. Maarten Consumers Coalition and Anti-Poverty Platform, which wanted to be informed and offer advice on actions to take regarding the outstanding arrears.
“The healthcare providers explained that legal actions easily take two years, carry high legal fees, and if successful, lead to a lien that cannot be placed on a government that needs to borrow money to survive. But the court case can also be lost, because SZV did warn that the OZR guarantee cards are no guarantee for payment,” Mercuur said. “So, parties agreed legal action is no viable option.
“It was also agreed that after waiting for a year, the healthcare providers were no longer able and therefore could no longer be expected to finance OZR healthcare. The healthcare providers pointed out that OZR patients’ right to free access to healthcare was denied when SZV stopped guaranteeing payment for care in March 2018. Premium-paying OZR patients could quickly easily regain their free access to healthcare with a guaranteed OZR card by Kort Geding court case.
“Furthermore, previously, the healthcare providers recently convinced the Consumers Coalition and the Anti-Poverty Platform that, without rate increase for healthcare providers’ services, it is impossible for their employees to get a cost-of-living adjustment (COLA). Some OZR and SZV rates are more than 20 years old. It was agreed that all employees are entitled to COLA and therefore health care providers’ rate increases are inevitable.”
Mercuur said the Healthcare Providers Platform, the Consumers Coalition and the Anti-Poverty Platform look forward to fruitful future cooperation based on agreements made.
After the meeting with the Consumers Coalition and the Anti-Poverty Platform the healthcare providers had their first meeting with Lee and Geerlings.
The Consumers Coalition and Anti-Poverty Platform have expressed concern that health care providers might stop accepting government medical cards and cardholders might have to pay cash upfront for medical services.
The Consumers Coalition and Anti-Poverty Platform first raised the issue two weeks ago after a teacher said they had been informed by SZV staffers 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 in December 2018. The teacher was also told that they would have to start paying upfront for medical services, as cards for government workers will also not be accepted soon.
In an invited comment at the time, Lee had said he and colleagues in government were aware of the status of payments by government towards the OZR fund. He said SZV had brought this situation to the attention of government several years ago, and it is a point of concern of the Committee for Financial Supervision also.
“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.”
Lee had also said that 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,” he made clear at the time.
SZV executes the administration and management of the OZR Fund on behalf of government, which is responsible for providing the funds to SZV that are deposited to 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, 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,” SZV had told this newspaper recently.
Source: The Daily Herald https://www.thedailyherald.sx/islands/85288-health-care-providers-give-govt-2-weeks-to-resolve-payment-arrears
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