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Premier Service Medical Aid Society members will now have to fork out cash when they visit service providers after the society instructed them to demand cash upfront as part of a strategy to avoid further litigation.PSMAS is being sued by service providers for defaulting on settling claims.

Members, who will visit the more than 30 health service providers who have been instructed not to accept the society’s medical aid packages, will then have to apply for reimbursement.

The health service providers sued PSMAS for defaulting on settling claims, but the medical aid society said stopping them from treating patients on its medical aid was part of its strategy to avoid further litigations at a time it was facing grounding liquidity challenges.

PSMAS interim manager Dr Gibson Mhlanga yesterday confirmed the move and revealed that the society faced about $8 million in litigation since December last year.

This has been necessitated by failure by member organisations to remit subscriptions to the institution timeously.

Dr Mhlanga said the embargo was only aimed at service providers who sued the society.

“We are trying to limit our litigation because if they continue to take us to court we have no defence, so they will come and attach our properties,” he said.

“What we want to avoid is for them to continue going to court and getting judgments against us. So, we only sent those letters to about 30 general practitioners, optometrists and medical laboratories who sued us since December 2014.

“The service providers seem to have understood our position, so we haven’t had any complaints from them or our members.”

Dr Mhlanga said Premier Service Medical Investments and other health service providers continued to attend to PSMAS members.

“These ones have understood our challenges and we are putting other mechanisms in place both in the short-term and long-term to ensure that we don’t short-change our members,” he said.

“The problem is if other service providers hear that some of them are refusing to attend to our members it puts pressure on them. But we are doing everything possible to make sure we also address their concerns.”

The health service providers have been filing their applications at the High Court separately since December last year.

Patients have been complaining that PSMAS’ health institutions are always congested and it takes long and even days for one to be admitted at Bains Hospital in Harare, the society’s major hospital.

PSMAS chief operations officer Dr Farai Muchena wrote to some of the institutions on March 26 this year instructing them to request cash from its members.

He said given the fact that member organisations failed to remit subscriptions to PSMAS on time due to liquidity challenges, the society was unable to settle health service providers’ claims timeously.

“We note that you are not prepared to bear with the society during this difficult period and have resultantly taken legal action against it in order to recover what it owes you,” said Dr Muchena.

“Whilst the society is trying its best to settle its indebtedness to you, and indeed to all service providers, every single claim that you submit to the society will add to the financial predicament and hence create room for further litigation.

“It is in this background that the society has taken the decision that until its financial position improves to an extent that it is able to settle your claims timeously, you STOP attending to its members with IMMEDIATE effect.

“Refer any of our members who may have problems with this decision to our offices. Indeed, you can ask any of our members who insist on getting service from yourselves to pay cash and thereafter approach our offices for the necessary refunding processes.”

The majority of the society’s clients are civil servants.

Finance and Economic Development Minister Patrick Chinamasa recently said the liquidity challenges facing the country resulted in Treasury failing to remit PSMAS subscriptions.

Apex Council team leader and Zimbabwe Teachers Association president Mr Richard Gundani yesterday called for dialogue between Government, PSMAS and health service providers to find a lasting solution to the problem.

Apex Council is the top representative body for all civil servants.

“All the stakeholders involved in the health care provision including Government, PSMAS and health service providers must sit and come up with an agreement on how to provide service to members,” he said.

“They are there to ensure there is health provision, so they should come up with a solution.”

PSMAS’ problems have been largely blamed on the mega salaries which were being awarded to ousted chief executive Dr Cuthbert Dube and his executives.

Dr Dube was taking home more than $500 000 in salaries and allowances each month, at a time when the medical aid society was failing to pay health service providers and was accumulating the debt.

Source : The Herald