HSA expects billing freedom

The Health Services Authority expects it will be allowed to set its fees in the future without first having to get government approval, Acting CEO Lizzette Yearwood has confirmed.

Under the Health Services (Fees) Law, any changes to HSA fees must be legislated for and approved by the Legislative Assembly. The LA last approved a fee increase for the statutory authority in 2002.

‘We anticipate repeal of this law in the future to allow the HSA to adjust its fees according to market conditions, [the] rate of inflation, costs of goods and services etc.,’ Ms Yearwood wrote in an emailed response to questions from the Caymanian Compass.

In May, Health Minister Anthony Eden told the LA a new fee regime for the HSA would come into effect 1 July. At the time, Mr. Eden said the new fees would include a ten per cent across-the-board fee increase, with a new charge master to follow that would include some 4,000 new services that the authority currently does not charge for.

But as the Cayman Observer reported 25 October, the 10 per cent fee increase didn’t materialise. Last week, Ministry of Health and Human Services Chief Officer Diane Montoya confirmed the fee increase is expected to be presented to the Legislative Assembly during its November sitting.

Mrs. Montoya said the delay was caused by incompatible codes in the revised charge master the HSA planned to introduce. The incompatible coding was discovered when the charge master was sent to insurance companies for their review, she explained.

Ms Yearwood said the new charge master is expected to come into effect in the 2008/09 financial year.

It is not clear how long it will take for the HSA to implement the 10 per cent fee increase once it passes the LA.

Budget documents indicated the fee increase and new charge master would generate $22.8 million over the 2007/08 financial year. Four months of the financial year have now passed.

Speaking after a Cabinet press briefing Thursday, Health Minister Anthon Eden conceded the delay in introducing the fee increase will affect the HSA’s bottom line for the present financial year, but he could not say by how much.

Ms Yearwood said the new charge master will allow the HSA to charge more accurately for the services it provides, facilitating a move towards financial independence from government.

‘With the implementation of the charge master, which will repeal the Fees Law, the HSA will have the authority to charge for the true cost of healthcare services to patients,’ she wrote.

‘The new charge master fee system brings the HSA on par with global healthcare practices and coding for healthcare services.’

The delayed fee increase comes at a time when the rising cost of providing health care is outstripping inflation in many parts of the world.

Referring to the problem in an address to the LA 22 June, Mr. Eden said it was unsustainable for government to continue to subsidise healthcare at present levels.

‘If we continue to be reliant on the current healthcare model it will cripple the Government financially,’ he said at the time.

The HSA has previously pledged to become financially independent of government by July 2009.

It is not clear whether the delayed fee increase will affect the authority’s timetable for financial independence.

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