Audit office disputes HIO claims over Gesy beneficiaries

The audit office on Thursday disputed claims by the Health Insurance Organisation (HIO), which runs national health scheme Gesy, that said it does not allow health professionals not registered to the system to offer their services to beneficiaries.

These statements “do not correspond to the reality of the situation,” the audit office said in a written statement which quoted a memorandum of understanding co-signed by the HIO, the health ministry and the private hospital association in March.

The memorandum specified that in the case where a private hospital is contracted by Gesy, then staff not registered to the system will still be able to offer their services for a fee, as they will not be considered Gesy services.

According to the audit office, this is also clearly stated on HIO’s website, which says that services offered by professionals not registered to Gesy, regardless of whether the hospital has been contracted by Gesy, will not be eligible for Gesy compensation.

“It is clear that HIO accepts that a Gesy beneficiary, or the private insurance company they will turn to in order to cover their medical bills, will be called to pay for the services they receive at a private hospital,” the statement read, adding that currently the law provides for a universal insurance system meant to ensure the equal treatment of patients.

“This makes the HIO’s responsibility even greater since it is clear that in practice, it is illegally implementing an informal multi-insurance system, such as the one deliberately rejected by parliament” when it was suggested in 2016 by then-finance minister Charis Georgiades.

The statement also said that the HIO “continues to pay private hospitals – which it illegally allows to be financed through Gesy beneficiaries – with non-objective criteria and varying fees for the same services provided”.

With regards to this, the audit office said it has asked the Commission for Protection of Competition (CPC) to investigate and is also expecting a response from the health minister as “this is clearly a waste of public funds”.