WHILE officials are still uncertain of when the National Health Insurance regulations will be finished or when the primary care phase will be rolled out, the government yesterday released a global request for proposals to invite bidders to manage NHI’s public insurer.

This release of the request for proposals (RFP) has raised several questions about the feasibility of the Christie administration’s time line to implement the first phase of NHI and about whether the government stuck to its budget in carrying out the groundwork to usher in the primary care phase.

Asked to reveal the cost of using the services of KPMG, one of the government’s lead consultants, NHI Secretariat Permanent Secretary Peter Deveaux-Isaacs said the figures would be made public in due course.

Officials were also asked to give an idea of when the regulations for NHI would be complete, but could give no concrete response and neither could they clearly state if it was possible to have the public insurer in place by January 2017.

And despite continuous criticism that the government has not incorporated much of the input of the local insurance industry, Damara Dillett, the Secretariat’s in-house lawyer, said the government made decisions that were in the best interest of Bahamians.

NHI legislation was passed in the House of Assembly last Monday and then agreed upon unanimously in the Senate three days later. It has since been sent to Governor General Dame Marguerite Pindling for the assent and will be later gazetted as the NHI Act.

“At this particular juncture we are waiting for the NHI Bill to officially become an NHI Act so that we can meet with our policy makers and make those critical decisions and advise the public right away,” said Ms. Dillett.

“You would know that before now we would have absolutely no authority. NHI did not exist on the books. Now that we have that legislative power we’re able to make the critical decisions that are necessary.

“It gives us the opportunity to strategise as it relates to the time line having regard to the first step which is the passing of the NHI legislation.”

Regarding the recommendation from local insurers into the RFP, she said: “They did share their concerns with respect to the public insurer. However, the government has taken the opportunity to make the decision that is in the best interest of the Bahamian public.

“We’ve taken a look at models around the world and realised the public insurer is a critical and vital component to NHI implementation roll out. I don’t know that there is a scheme that exists or a plan that excludes a public insurer.

She added: “We are working very hard towards completing the regulations. We have internal deadlines. We’re trying to ensure that framework is put together in such a way that we can go out and engage with the stakeholder industry to get their input on the regulations. The regulations process is very detailed and we want to make sure that all of the details with respect to the regulations are accurate and the only way we can ensure that that happens is we get the technical skills and expertise that already exist in country through our stakeholders.”

RFP
According to the target schedule, the responses to the RFP are due no later than October 7 and the government expects to select the preferred bidder by October 28.

The contract negotiations and execution of the third party contractor are expected on November 25 and the week of November 28, respectively.

Under the new NHI structure the public insurer would be a wholly government-owned entity registered as a long-term insurance company carrying on sickness or health insurance business with the Insurance Commission of the Bahamas and as the public insurer with the National Health Insurance Authority.

The government is seeking a third party management company or a third party contractor with the level of experience and expertise necessary to provide comprehensive management, administration and wellness services to the public insurer.

This third party contractor will have responsibility for several aspects including claims and case management; health risk management, wellness, management services, beneficiary and provider relations and data security.

They should also have at least 10 years experience as of June 30, 2016 providing services similar to those outlined in the RFP.

Those who wish to submit an RFP can only submit one proposal and will be required to register beforehand by completing and returning the registration form. A non-refundable $10,000 fee to be paid to the Public Treasury by draft or wire transfer must accompany this form.

“The contract for the public insurer will contain a number of responsibilities,” Ms. Dillet said.

“Inclusive in that will be claims and case management, handling and processing requests for payment, health risk management, wellness management services, beneficiary and provider relations in ensuring that there is sufficient support in that regard, data security, which is of paramount importance, communications with and education of beneficiaries and providers and fiduciary management of the NHI fund.”

A selection committee, to be formed by the government, will review the proposals submitted and make a recommendation for the preferred bidder to Cabinet for approval.

An evaluation of this preferred bidder also will be included and consist of three phases, including a compliance phase, pricing analysis, and technical analysis.

The full RFP can be found at http://www.nhibahamas.gov.bs.

By Khrisna Virgil, Tribune Deputy Chief Reporter

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