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OBA warn of possible unexpected consequences from health insurance bill

Government and the Opposition traded blows over health insurance legislation, accusing one another of political posturing.

Both sides agreed in principle to the intent of the legislation to remove up-front payments to healthcare providers.

The Health Insurance (Health Service Providers and Insurers) (Claims) Regulations 2012 was approved by the House on Monday evening.

However, One Bermuda Alliance argued it could have unexpected consequences as written.

Healthcare providers will be asked to pay the insurers’ share of costs up-front when the legislation comes into effect on August 1. It will also require insurance providers to pay claims within 30 days.

Health Minister

Zane DeSilva said that the bill is intended to make sure the most vulnerable members of the community can afford medical treatment.

OBA Seniors spokeswoman

Louise Jackson said that while she has long pressed for up-front fees to be removed, the legislation would lead to doctors turning away patients based on their insurance provider.

She called the bill a sign of political posturing.

In response, Government Minister

Glenn Blakeney said her own statements were the epitome of political posturing.

“This legislation has nothing to do with politics,” Mr Blakeney said. “It has to do with the social impact of up-front fees.”

The legislation actually remedies the concerns voiced by Mrs Jackson by forcing insurers, including Government schemes such as HIP, FutureCare and GEHI, to pay for claims in a timely manner, he said.

Government backbencher

Walter Roban meanwhile stressed that the Health Ministry had met with stakeholders to create an inclusive solution but was forced to legislate after some parties refused to budge on the issue.

“It started with guidelines, not to be punitive, not to require by law to do this but clearly there were other issues,” Mr Roban said.

“Private providers were not following guidelines. We might not be here if these guidelines were being followed.”

Grant Gibbons, of the OBA, repeated the Opposition’s stance that it supports the intent of the bill, but the legislation could cause problems as written.

He said most private insurers pay claims quite quickly, but Government schemes, particularity GEHI, routinely take three months and in some cases as long as 18 months.

Mr DeSilva said that healthcare providers need to be paid on time in order to keep their businesses afloat.

He shouted: “Welcome to the world of business. Welcome to the real world.”

Dr Gibbons also expressed concern about an “opt-out” clause in the legislation insurers unable to meet the turnaround time demanded by the legislation can opt out, allowing healthcare providers to charge up-front again.

He then claimed that the Implementation Committee set up by the Ministry of Health to deal with the issue is not on-board with the legislation.

Mr DeSilva refuted that statement. He said that while there may have been one or two committee members who opposed the legislation, the majority were in favour.

Dr Gibbons continued: “This does not solve the problem. It does not achieve the objective, but does increase bureaucracy and cost.”

Also approved on Monday was the Health Insurance Amendment Act 2012, which transfers responsibility for licensing health insurers from the Bermuda Monetary Authority to the Bermuda Health Council.

It also increased the penalty for submitting a false insurance claim from $250 to $2,000 among other smaller changes.

Both Mrs Jackson and Dr Gibbons expressed some concern about the act granting the Health Council the ability to demand information from insurers, including potentially confidential information about patients.

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Published March 21, 2012 at 9:46 am (Updated March 21, 2012 at 9:45 am)

OBA warn of possible unexpected consequences from health insurance bill

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