Cimas to lose operating licence

GOVERNMENT has given Cimas Medical Aid Society a seven-day ultimatum to honour all outstanding claims or lose its licence.

Sunday Mail reported that Cimas has more than 30 000 members, and has allegedly been trying to direct them to use particular service providers. Use of service providers not approved by Cimas, it is alleged, means subscibers pay cash.

Government had told Cimas to allow subscribers to use their medical aid cover when accessing services at institutions of their choice.
The society was directed to settle outstanding claims as stipulated by Statutory Instrument 330 of 2000.

SI 330 of 2000 and SI 35 of 2004 make it illegal for medical aid societies to direct members to particular service providers.
But Cimas has for months refused to cover subscribers who access Corporate 24's services.

In February, Secretary for Health Dr Gerald Gwinji wrote to both Cimas and Corporate 24 imploring them to resolve the issue.
Last week, Health Deputy Minister Aldrin Musiiwa told The Sunday Mail Cimas would lose its operating licence if it fails to comply.

"We will revoke the temporary licence that we had given to Cimas if it fails to settle claims not only to Corporate 24 but to all other companies that include Zimbabwe Medical Association and other pharmaceutical companies in the next seven days. We gave them enough time to settle their claims but they seem to forget who the regulator is. As the supervisory body, we would like all members to give their sides of the stories and see how best we can reach an agreement that satisfies all sides. But when this happens we will exercise our authority to save medical aid subscribers from a further prejudice. We have since had a series of meetings with officials from Cimas to persuade them to comply but they seem not respect that," said Deputy Minister Musiiwa.

Cimas' provisional licence expires in June 2016.

Musiiwa said, "We had initial success in mediating the Cimas-Corporate 24 wrangle and no one has the right to backtrack from the decision we reached earlier as there will be repercussions this time around. (Cimas) cherry-picked some service providers they wanted to pay citing some unclear claims which they said should be revisited.

‘‘We ordered them to look back at those which were straightforward but they didn't."

Last year, Cimas also had run-ins with the National Physicians Association of Zimbabwe, the Zimbabwe Hospital Doctors' Association and the Retail Pharmacists Association of Zimbabwe over various matters.

In 2000, Cimas was locked in a similar dispute with laboratory group Lancet and the matter spilled into the courts. It took Government intervention to break the impasse.