Hospital groups Netcare and Medi-Clinic have denied presenting inflated invoices to medical-aid schemes.
”Medical schemes are not forced to pay inflated costs — to the contrary, private healthcare delivered in South Africa has been benchmarked internationally within the top five for value for money and quality,” Netcare said in a press release on Wednesday.
The groups were responding to a report in the Star newspaper in which the head of the Board of Healthcare Funders’ (BHF) benefit and risk department, Rajesh Patel, alleged that private hospitals inflate device and materials invoices when presenting them to medical-aid schemes.
Hospitals then receive off-invoice discounts of rebates that schemes are not aware of, a BHF conference was told.
While Netcare does negotiate for and receive discounts from suppliers, allegations these are improper are ”misconceived and untrue”.
”They are not illegal or unethical,” the company said.
Netcare said it does not request suppliers of devices and materials to inflate their invoices. ”Suppliers set the prices for devices and materials, which form the list prices charged by Netcare to medical schemes.”
Medi-Clinic said in a statement that it had removed all rebates and discounts on pharmaceutical and surgical items when it adopted a transparent pricing system in 2002. ”This model provides no incentive whatsoever for Medi-Clinic to inflate invoice prices,” it said.
Earlier, the Democratic Alliance said the estimated R2-billion alleged overcharge of medical-aid schemes this year is outrageous. Gauteng health spokesperson Jack Bloom said the overcharge needs to be tackled by addressing lack of competition in the private healthcare market.
Bloom said between 2000 and 2006, 22 out of 50 applications for private hospital licences were turned down. ”If they had been approved, competition would have been much enhanced by the addition of 2 192 extra beds and 68 operating theatres in Gauteng.”
He has referred the matter to the Competition Commission and said an investigation might open up the private healthcare market to new players. ”This would drive costs down and avoid rip-offs in order to gain business in the industry,” he said. — Sapa