The Ministry of Finance has reiterated its commitment to maintaining strict verification and monitoring procedures to prevent overcharging and abuse of the Government’s Free Medical Scheme. The statement comes as the Public-Private Partnership (PPP) Free Medical Scheme continues to provide critical health services to eligible Fijians through a network of 49 general practitioners, dental practitioners, and medical laboratories, with 64 branches nationwide.
According to the Ministry, payments to medical providers under the PPP arrangement are processed only after independent verification is carried out by FijiCare Insurance Limited, ensuring that claims are accurate and only pertain to services rendered within the scheme. Additionally, the Ministry monitors payment claims to further prevent overcharging, indicating a proactive stance on maintaining accountability.
While most practitioners have received timely payments, the Ministry acknowledged that anomalies and instances of overcharging have been identified. In these cases, payments may be withheld until claims are thoroughly reconciled. Generally, when claims are clear of discrepancies, payments are processed within a span of 10 to 14 days. However, delays may occur if service providers do not respond quickly to requests for clarification.
This verification process is deemed essential for safeguarding public funds and maintaining the integrity of the Free Medical Scheme while ensuring that services rendered to patients adhere to agreed-upon terms and conditions. The Ministry has begun releasing payments for August and is expediting further disbursements for September. Additionally, meetings are being arranged with participating doctors and clinics to reinforce the payment timelines and terms of the PPP agreement.
Importantly, the Government has issued a stern reminder against any medical practitioners refusing to treat patients under the scheme. Such actions are deemed unacceptable and will be addressed in accordance with the PPP agreement.
Moreover, similar reports have surfaced surrounding the challenges faced by patients under the PPP medical scheme, with some individuals experiencing difficulties accessing private clinics due to alleged delayed payments from the government. Patients in Suva have reported being turned away from clinics, accompanied by statements from affected patients who understand the situation due to the financial pressures on healthcare providers.
Dr. Atonio Lalabalavu, the Minister for Health and Medical Services, has acknowledged these challenges, linking them to the historical complexities of the PPP model and its implementation during the COVID-19 pandemic. He emphasized the necessity for effective communication and management within the healthcare system to ensure sustained access to medical care.
In light of these ongoing issues, government officials remain optimistic that proactive measures will contribute to improved service delivery and healthcare access for all Fijians. The Ministry appreciates the collaboration of participating practitioners in upholding transparency and accountability within the scheme, emphasizing a collective effort towards enhanced healthcare services.
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