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Charity asks Govt for relief to seniors hit by FutureCare shortfall

Helping is at hand: Executive Director of Age Concern, Claudette Fleming

Seniors advocacy group, Age Concern, is calling on Government to review FutureCare legislation and provide financial assistance to eligible seniors following revelations of a glitch in the system which led to overpayments to healthcare providers.“We have to question whether the Future Care programme is doing what it was created to do, that is, eradicate the financial hardship that the elderly were experiencing, as a result of expensive healthcare coverage,” said Age Concern Director Claudette Fleming.“The current situation is not good and is not a reflection of our understanding of the programme’s initial intent.”Ms Fleming was reacting to yesterday’s story in this newspaper which reported that a “system implementation error” had led to the scheme reimbursing doctors 100 percent of their costs for certain procedures done at the local hospital, instead of 75 percent.The error was corrected in April this year, and going forward doctors now have to bill their patients for 25 percent of the cost of certain procedures they do at the local hospital something that seniors did not have to be concerned about since the scheme’s inception in 2009.Clients and doctors believed that the benefits policy for such procedures was 100 percent coverage.FutureCare administrators failed to directly inform healthcare providers and their clients of the error and its correction with Health Minister Zane DeSilva saying that policyholders are not informed every time the automated system is “tweaked” as that constitutes “routine configuration and maintenance”.And because of a lag in claims processing, at least one doctor’s office was not aware of the change when contacted by The Royal Gazette but was able to confirm that they were no longer receiving 100 percent reimbursements when they checked their records.Another doctor’s office said they noticed the reduction in reimbursement and questioned the Health Insurance Department repeatedly but as of last week had not received a clear explanation.“In light of the lack of an immediate alternative, Age Concern would support a review of the legislation to include 100 percent coverage as a long-term solution, and the offer of financial assistance to those persons who would undergo further financial hardship as a result of the 25 percent coverage shortfall in the short term,” Ms Fleming continued.And she called on FutureCare clients to register their experience with her organisation “so that cases are properly documented, in order that decision makers have a good understanding of the degree to which individuals are being personally impacted.“To expect that seniors should ‘bear this and grin’, is unreasonable, especially considering all that they have already contributed to this island.”The Opposition One Bermuda Alliance has criticised the Government for not properly informing seniors about the benefits available under the programme, a claim robustly denied by Minister DeSilva.Shadow Health Minister, Senator Michael Dunkley last night issued this statement in response to the news.“My colleague Louise Jackson has raised legitimate concerns about the Government not properly informing seniors of their financial obligations under FutureCare.“This morning’s story in The Royal Gazette reveals the Government has more work to do to make sure seniors and even doctors are properly informed about FutureCare coverages.“The reported implementation last April of a 75-25 co-pay to replace 100 percent coverage for procedures performed at the hospital without any kind of notification to the people affected is astonishing.“That the Minister said policyholders were not typically informed when the system was “tweaked” is an unacceptable response.“That the Minister blamed it on a ‘system implementation error’ is a weak attempt to somehow spin blame to something beyond people control.“We urge the Minister to take responsibility and get this programme’s act together. It appears to be disconcerting the system, the people it was designed to help and their families, all of whom are on the line for the anticipated and unanticipated costs of seniors’ healthcare.”Government is yet to respond to additional queries from this newspaper seeking information as to the size of the overpayments, whether other benefits have been affected by the system implementation error and who, if anyone, will be made accountable for the error.