Ministry identifies anomalies and overcharging by some of the GPs under Free Medical Scheme

The Ministry of Finance has revealed that while the Public-Private Partnership for the Free Medical Scheme has worked well and most General Practitioners get paid in a timely manner, the Ministry has also identified anomalies and overcharging by some of the GPs.

They say in cases like this where GPs try and abuse the system, the payments are held back and only paid after the claims are reconciled.

The Public-Private Partnership for the Free Medical Scheme was introduced as part of the Government’s health and economic response strategy during the COVID-19 pandemic.

The initiative has since continued, and currently, 49 General Practitioners, Dental Practitioners, and Medical Laboratories, with 64 branches across the country are part of the scheme.

The Finance Ministry says as part of the PPP agreement signed between the Government and GPs, payment is made after an independent verification by a third party (FijiCare Insurance Limited) which verifies that payment claims are accurate and only for services rendered under the PPP scheme.

The Ministry of Finance also monitors these payment claims to ensure there is no overcharging and abuse.

As part of the Ministry’s process, it takes around 10 to 14 days to complete the verification and payment process when claims are free of discrepancies.

However, when anomalies are detected, processing may take longer particularly when GPs do not respond promptly to clarification requests.

The Ministry stresses that this verification process is vital to safeguard public funds, uphold the integrity of the scheme and ensure that services provided to eligible patients are consistent with agreed terms and conditions.

Payments have been released for the month of August and further disbursements are being expedited, including for September.

The Government is also concerned if any GP is turning away patients under the scheme.

It says this is not acceptable and if this is happening, the Ministry will take necessary action in line with the PPP agreement.