Tunisia: Pharmacists resume 3rd-party payments from health fund
Source: Middle East Insurance Review | Feb 2017
An agreement has finally been reached between the national health insurer, Caisse Nationale d’Assurance Maladie (CNAM) and the Union of Pharmacists of Tunisia (SPOT), to resume third-party payments for medicine sold at pharmacies. The resumption took effect on 29 December last year.
The agreement, signed at the offices of the Ministry of Social Affairs, is for a transitional period of one year. It follows measures taken by the authorities to ensure regular contribution of funding to CNAM, which will help to improve its cashflow and allow it to better meet its commitments, the union said in a statement.
Last October, SPOT suspended the payment arrangement with CNAM because of the months of delay by the social health insurance fund in settling amounts due to community pharmacies.
The decision forced registered citizens to pay the full cost of the medication to the pharmacist who would then give them an invoice to obtain a refund from CNAM.
SPOT had said then that pharmacists cannot shoulder the financial burden of the social health insurance system alone.
In October, the amounts owed by the CNAM to pharmacies totalled about TND50 million (US$21.4 million).
In its statement, SPOT said that the agreement is also dictated by the need to take into account the difficult situation of the country, and to facilitate access to medicine by citizens.
In the wake of the suspension of the third-party payment system, the Consumer Protection Organisation had argued in October that it was not legitimate for health insurance deductions to be made to the fund from the salaries of workers if they continued to be deprived of their rights in obtaining medication.
TND1 = US$0.43