The Chairperson of the Medical Practitioners’ Group (MPG), Dr Anthony Sibiya, has confirmed that medical service providers will terminate their contracts with BOMAID on January 23rd 2012 since the Botswana Medical Aid Society (BOMAID) indicated that it is either the service providers charged their prescribed fees or cut ties with them.
The silent pricing war between Medical Aid schemes and the Medical Practitioner’s group intensifies as BOMAID and the MPG failed to find a compromise when deciding on tariffs for the year 2012.
The resolution made at the MPG’s last Annual General meeting to adopt the balanced billing method has not helped the situation as BOMAID is adamant that they will not allow any of their contracted doctors to adopt the balanced billing method.
“BOMAID negotiates tariffs with the service providers on behalf of its members,” stated Constance Matabiswana, the General Manager ÔÇô Operation of BOMAID. Matabiswana also indicated that they have put their offer on the table to all their contracted doctors and those who decline this offer would therefore no longer be a contracted service provider to BOMAID patients.
While BOMAID argues that their interest lies solely in protecting their member’s funds, members of the MPG also feel that they too have an obligation to provide quality services to their patients which comes at a cost and should be paid by the medical aid schemes.
Dr Sibiya, however, stated that the idea behind the tariff negotiations was to come up with a fee that is “mutually beneficial.” He further stated that operational costs had sky rocketed due to increased cost of supplies, labour, property and the depreciation of the pula. Sibiya also stated that despite the current situation, the MPG is still open to negotiate further until they find a compromise.
At the centre of this controversy is the balanced billing method which Matabiswana stated could not only lead to exploitation of their members but is also financially unsustainable for their members who will be paying premiums and will still be expected to pay extra when receiving medical attention.
Although BOMAID indicates that the tariffs are decided taking in to consideration the regional rates, the MPG stated that tariffs in Botswana are way below the regional rates and have recommended an increase in 20 percent.
In addition to implementing the balanced billing method in February 1st 2012, they also intend to embark on a massive debt collection drive where they are “Planning to collectively engage Medical Aid Service providers on debts owed to doctors.”