Tag: health insurance companies

Outpatient doctors do not want to accept the offer of Všeobecná zdravotná poisťovňa (General Health Insurance Company). Current contracts are valid only until the end of the month. Slovak Medical Chamber, Association of Private Doctors and Association of General Practitioners for Children and Adolescents, which together represents about 70% of outpatient doctors, are asking the insurance company for increasing of payments on the level of 20%. Insurance company, however, only offers the resources from the reserve. Associations therefore advise doctors not to sign the contracts.

President Ivan Gašparovič signed the amendment to the Act on Health Insurance, which introduces the new mechanism of risk-adjusted premium redistribution. This step should bring additional almost €30 million annualy to state Všeobecná zdravotná poisťovňa (General Health Insurance Company). This will be paid by the private insurance companies Dôvera (almost €22 million) and Union (€8.7 million). New re-distribution scheme will enter into force in July. 

Patients may have to pay out of pocket for the treatment in the outpatient clinics. Všeobecná zdravotná poisťovňa (VšZP, General Health Insurance Company) and insurance company Union were not able to make an agreement with doctors on new contracts from July 1st. VšZP offers 6.5% increase of monthly payments to general practitioners and 5% to specialists, while doctors are asking for 20%. Insurance companies claim that requirements of doctors do not meet their resources.

Health insurance companies will refund to policyholders more co-payments for pharmaceuticals than before. This is the result of the extension of so called "protection limit on co-payments for pharmaceuticals". For first quarter the health insurance companies will refund the co-payments in amount of € 1.4 million to 64 043 policyholders. About two thirds of them are retired, the rest are handicapped. In last quarter of 2011 the amount of €87 592 was refunded to 5 834 people. 

According to the common statement of private physicians the prices, which were offered by the health insurance companies, are not acceptable for health care providers. Costs of private outpatient clinics, which arose also by increasing of salaries of nurses and doctors, are not included in the proposals of new contracts with Všeobecná zdravotná poisťovňa (General Health Insurance Company) and private insurance company Union. The representatives of Slovak Medical Chamber and civic association of private physicians Zdravita will meet on Monday June 25th and will agree on further proceeding. 

The intention of Všeobecná zdravotná poisťovňa (VšZP, General Health Insurance Company) to reduce the costs of hospitals on pharmaceuticals and medical devices has failed. Hospitals are spending even more. This results from the analysis of the costs of hospitals made by VšZP. During February and March hospitals should have reduced their average monthly costs on pharmaceuticals, dietary supplements and medical devices by 7%. Based on this VšZP increased from February the amount of finances for discharges, specially paid health services and outpatient care. Hospitals, however, failed to meet their commitment.

Health insurance companies will make an annual accounting also for policyholders, who are expected to have overpayment. Act, withal, does not require this from insurance companies. Všeobecná zdravotná poisťovňa (General Health Insurance Company) despite the fact that the act on health insurance does not consider these groups, will make an annual accounting also in the cases, when health insurance company does not have to, but may make an annual accounting because it will result in overpayment. Insurance companies Dôvera and Union will proceed similarly.  

Všeobecná zdravotná poisťovňa (General Health Insurance Company) will increase payments for hospitals by €3.8 million monthly. The amount will be divided into particular hospitals after separate negotiations with each of them. It will depend on the individual impact of increased wages of doctors and nurses on hospital's costs. Increase is covered from €50 million governmental reserve in the state budget. 

Všeobecná zdravotná poisťovňa (General Health Insurance Company) suspects Dôvera from unfair acquisition of policyholders. VšZP is therefore preparing the suggestion to the Healthcare Surveillance Authority. This should examine several cases from recent days, when private health insurance company Dôvera allegedly did not act correctly. The latest case comes from Trnava. If the errancy in the process of sale is proved, Dôvera will according to the spokeswoman consider the adoption of corrective action.

Minister of Health chose Adam Hlôška for the position of the head of Pharmacy and pharmaceutical policy section. She also installed him into the function of President of Categorization Committee for Pharmaceuticals. In this position he was in 2008-2010 and then he returned to the pharmaceutical company Abbot Laboratories. Former Minister of Health Ivan Uhliarik points to a possible conflict of interests. Spokeswoman of the Ministry claims that in the case of any suspicion of favouritism of some pharmaceutical company, Minister will intervene immediately.