Neelam Rahim | neelam@radioislam.co.za

3-minute read
13 August 2024 | 16:22 CAT

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The Department of Health has clarified the recent claims regarding delayed payments to independent pharmacies for their contributions during the COVID-19 vaccination programme. The Department says there is no doubt that independent pharmacies have been vital partners in ensuring vaccine accessibility across South Africa.

Health Departmental Spokesperson Foster Mohale told Radio Islam International that the role of Independent Pharmacies is crucial, and collaboration is essential for the envisioned success of the National Health Insurance, which aims to provide equitable healthcare access to all citizens.

“The story around pending invoices remains two sided and many issues stem from non- compliance by some pharmacies with established government financial practices, despite repeated guidance and support efforts. All entities must adhere to the same financial regulations, and the Department has communicated this to the Independent Community Pharmacy Association (ICPA),” the Department of Health stated.

Private pharmacies process claims through ‘switches’ to verify a beneficiary’s insurance coverage at the time of service, a process not managed by the Department. Pharmacies were required to work with a private company and contribute to the administrative costs of this system. The switch rejected some claims due to mismatches with the EVDS data used to determine the provided benefits. Common reasons for rejection included missing information such as ID numbers, incorrect vaccine details, incorrect vaccination dates, and incorrect intervals between doses. Unfortunately, many of these rejected claims were not reconciled or corrected by the affected pharmacies at the time, leading to ongoing disputes.

One issue identified is that some pharmacies received free vaccine stock from certain sites but still billed the Department for both the vaccines and the administration of vaccinations. This practice was not permissible, and the separation of the fee components is being addressed.

A significant challenge arose when some pharmacies ordered large quantities of vaccines when public demand declined. As a result, these pharmacies were left with expired vaccines. Through a collective effort to reconcile these doses, the Department obtained permission to credit the pharmacies for the legally disposed stock.

“Out of the 168 private pharmacies and facilities contracted, only 28 have vaccinated a significantly higher number of uninsured patients compared to private patients. The remaining pharmacies owe the Department for the vaccines provided but have not made payments, citing unresolved disputes as the reason,” the Department of Health said.

Listen to the full interview on The Daily Round Up with Moulnana Junaid Kharsany and Health Departmental Spokesperson Foster Mohale here.