NHI Secretariat responds to Nassau Guardian article

Regarding the editorial printed on September 5th, 2016 in the Nassau Guardian, the NHI Secretariat wishes to highlight the facts around the roles and responsibility of the public insurer with the NHI Bahamas plan:

1. All regulated health administrators (RHAs), including the public insurer, will be subject to the same legal and regulatory requirements set forward by the Insurance Commission of The Bahamas, as outlined in in Section 2 of the National Health Insurance Act 2016, Section 1.3.2 and 1.3.3 of the Request for Proposal (RFP) for the Public Insurer and Section 198a and 198b (1) of the Draft Insurance Amendment Bill 2016.

The claim that the Government would serve as both administrator and compliance officer for the public insurer and that the public insurer would not fall under the oversight of the commission that is responsible for regulating the industry is factually incorrect.

2. The public insurer is to be wholly Government owned, but privately managed to drive a more cost-effective, efficient, fair and accountable universal health coverage (UHC) model. This is consistent with global benchmarks in health financing and UHC models.

This model would enable best practices found in the private sector to assist in the monitoring and reduction of medical fraud risk management.

3. There are mitigation mechanisms outlined in the NHI Act 2016 to reduce risk for medical fraud. This includes the duty of every RHA and medical provider to submit reports (Section 30), routine inspections of health care providers (Section 36), strict fines/penalties (Section 40) and termination of RHA and medical provider agreements for producing any false declarations or failing to submit reports on services rendered under NHI Bahamas (Sections 31).

4. The proposed payment models for health care providers, capitation or fee for service, are designed to ensure reimbursements on procedures must be within costs (medical providers cannot over charge for services).

The public insurer, other RHAs and health care providers signed on to provide NHI Bahamas benefits, must agree to a fee schedule set forward by the National Health Insurance Authority. Additionally, patients utilizing health care providers under the NHI Bahamas plan are not expected to exchange money for health care services.

NHI Bahamas is founded on the principles of equity and ensuring that all eligible persons will have access to a modern, affordable and accessible health care system without payment required at point of service. We encourage all eligible persons to register for your NIB Smart Card, as we will soon be transitioning to phase two of NHI Bahamas, enrolment.

For more information on NHI Bahamas, please visit http://www.nhibahamas. gov.bs/.

By National Health Insurance Secretariat