The Ministry of Health cannot properly audit!

In response to what Al-Akhbar published entitled “Hospitals that loot public money …” (May 9, 2020), we note that the audit currently underway at the Ministry of Health is based on a small sample of invoices that are chosen at random instead of checking each invoice, and of You have no medical record, have not examined the patient, or are in contact with the treating physician, so how can you decide if laboratory and radiological examinations were necessary or not? How can you know if the symbol of medical work done by the doctor is correct or not? How can you decide whether to cancel checks or change the code?

We recall that the scrutiny of the hospital bills went until the reception of the former Minister of Health, Dr. Jamil Jibak, through private TPA companies commissioned by the Ministry, then Minister Jbak issued a decision to cancel it, so it was made impossible to know the truth of the admission of each patient to the hospital, the quality of the analyzes and the processes to which he was subjected, No data included in his file. And the Ministry’s audit unit, represented by an insufficient number of medical observers, was unable to carry out a proper and scientific audit of hospital admission and discharge transactions after it was signed. Hospitals suffer from unfair random discounts applied to their bills by the Ministry of Public Health.
Therefore, we requested the reassignment of specialized companies for the audit, since the hospital rates currently in force were approved according to a study carried out by the Ministry of Health with the World Bank 20 years ago, and we have asked for years to amend them because they are not consistent with the actual cost. For example, the hospital stay fee does not exceed $ 20 per day, and includes nursing care, electricity, heating and cooling, the use of sterilization tools and the means of protection and prevention, and the increase in price. The dollar has doubled the prices of medical and non-medical items that hospitals use to be a knockout. (…)
Given the assumption that there are some abuses by some hospitals, why should appropriate legal action not be taken against them without prejudice to the reputation of an older sector that is struggling to maintain its position, using investments to care for patients and securing job opportunities for approximately 25,000 people, in addition to its importance that it has earned well in the national economy, with courageous individual initiatives, is far from any incentive it is supposed to provide.
Union of Private Hospital Owners in Lebanon

Editor’s Response:
In its response, the union focuses on ineligible physicians who observe the procedure for a proper and adequate audit, while noting that the auditor (ie, employees in the audit unit) “does not have the medical record or the one who examined the patient, “questioning the employee’s eligibility to determine the nature of the medical abuse. The quotient It was absent from the union that the Ministry’s audit unit contacted a number of” few “patients whose telephone numbers were recorded in the files of Health reports sent by some hospitals were validated, and he obtained responses that highlighted a clear contradiction between the alleged file and the statements of the patients.
Similarly, the union asks: “How does he (the auditor) decide if the laboratory and radiological examinations were necessary or not?” But the union does not answer a basic question: how can a patient file be free of reports and examinations of image results?
In addition, it was noted that the union remembers its “injustice” in the discounts that the Ministry of Health makes on its bills, at a time when it demands a clarification on the looting and waste of public money from some hospitals. It did not discuss the discovery of the “disappearance” of files from the affiliated audit unit to patients affiliated with the Ministry of Health or the violations monitored by the ministry in terms of some of them benefiting from the bill of insurance companies and the ministry at the same time, and opted for the subsequent review of “injustice” due to the high dollar price indicated by the low price »For the hospitalization fee two decades ago (knowing that it is no secret to anyone that hospitals no longer meet a standard rate).
The greatest irony remains in the union’s statement that there are supposed to be inquisitive abuses “Why not take appropriate legal action against them without prejudice to the reputation of an old sector that struggles to maintain its position (…) and employs approximately 25 thousand people (…) ». In other words, hospitals say they may be wrong, but we have to deal with their excesses more “gently” because they are “guardians of grace” for some 25,000 people!