An inclusive revised medical services tariff could soon be finalised, with implementation set for July, The New Times has learnt. The development, officials say, could save healthcare facilities from counting substantial losses, and at the same time ensure sustainability of quality healthcare provided to patients. ALSO READ: Private health facilities body appeals for review of medical tariffs For context, the current tariffs were set in 2017 (for all private health facilities) and they were subject to be reviewed after one year — in 2018, however, despite the commitment, no review has been carried out since then. A facility like Ndera Neuro-Psychiatric Teaching Hospital told a Public Accounts Committee (PAC) on Tuesday, April 30, during the ongoing hearings, that it had counted losses amounting to over Rwf100 million in the fiscal year that ended June 2023. This, the hospital’s Director General, Charles Nkubili, said was largely attributed to the fact that some of the funds claimed from insurance providers were rejected. Most of the services are not tailored to the current market prices, he said. In some instances, Nkubili explained, patients who seek medical services at Ndera Hospital have unique challenges, whose bills vary from one disorder to another. “We need support from the health authorities to review these tariffs so that they are tailored with the current market prices,” he said during a PAC hearing, for which the hospital’s management had appeared to respond to the irregularities in public asset management raised by the report of the Auditor General for the financial year 2022/2023. He added; “When we share these invoices with respective insurance providers they are rejected, based on the current tariffs.” Valens Muhakwa, the Chairperson of PAC, maintained that it was not the first time private medical facilities are voicing their concerns over the current tariffs. He also noted that the Lower House had previously requested the Ministry of Health for a roadmap to expedite the review of health service tariffs for all health facilities by taking their categories into account, to reflect price increase in medical products. “While Ndera Hospital can be categorised as a unique case, members of parliament have previously raised this to the Ministry of Health and we should have explanations of why it has taken long to expedite.” According to Ndera Hospital, 98 percent of the claims rejected are by the Rwanda Social Security Board (RSSB). In an earlier interview, the Rwanda Private Medical Facilities Association (RPMFA) Executive Secretary Christian Ntakirutimana told The New Times that a biochemistry analyser — medical equipment used to analyse some components of the blood with intention to diagnose different medical conditions —cost about Rwf11 million in 2017, but its price rose to Rwf14.5 million in 2023. “Yet, the price of a test carried out using that machine [biochemistry analyser] did not increase,” he said. Again, Ntakirutimana said that salaries of staff in private medical facilities increased – in some cases doubling since 2017, for the facilities to be able to retain qualified medical personnel. Lack of adjustments of medical tariffs to reflect those changes make health facilities incur losses, he pointed out. Health Ministry reacts Reacting to the concerns, Zachee Iyakaremye, the Permanent Secretary at the Ministry of Health, pointed out that the review is undergoing, and that results could soon be made public. “To be finalised with this year and implementation to start with the next fiscal year starting in July 2024,” he told The New Times. Iyakaremye however warned that several medical facilities are forging documents to claim funds that were not used from the insurance providers. He said there are cases where hospitals are duplicating invoices, overbilling services and encountering metric errors, under the disguise of tariffs.
