For the first time in more than 10 years, the Department of Health has received a qualified audit for the 2021-2022 fiscal year – due, apparently, to a wrangle over financial records for the COVID-19 vaccination programme.
A qualified audit signals the Auditor-General is not satisfied that an entity has properly accounted for the money allocated to it. The department has, for the past decade, received a clean audit. It last got a qualified audit in 2010/2011.
Business Day reports that the department procured COVID vaccines for the entire population and established a programme allowing people to obtain free shots at either public or private sector sites, regardless of their medical scheme status.
A complex reconciliation process has ensued, with the state claiming payments from medical schemes for members who received jabs at public sector sites, while private sector providers have sought reimbursement from the department and medical schemes.
Auditor-General Tsakani Maluleke said she was unable to obtain sufficient audit evidence for R2.079bn in accrued revenue the department had attributed to vaccines for 2021/2022.
“The systems of internal controls they implemented were not always adequate for the recording of some transactions and events relating to the recoupment process of the COVID-19 vaccine programme,” she said, “and I could not confirm accrued departmental revenue by alternative means.”
The department is “extremely disappointed” with the Auditor-General’s conclusion, said deputy director-general for National Health Insurance Nicholas Crisp, who heads the vaccination programme.
The financial reconciliation of the programme was complicated, partly because the payment for each shot was determined by a person’s medical scheme status on the date they received their vaccine.
He said the AG failed to appreciate that the medical scheme population was in constant flux, and it was thus inappropriate to reconcile records drawn on different dates. Individuals switched schemes, resigned, ceased to be dependants or took up membership for the first time.
He told Parliament last month that private providers have so far submitted R2bn in claims for shots administered to people who did not belong to medical schemes, while medical schemes have paid the government R1.3bn for members who had received their shots at public health facilities.
“In the beginning we were more worried about vaccinating people than who would pay,” Crisp said.
Discovery Health’s chief commercial officer, Ronald Whelan, said the reconciliation of payments due to the government for medical scheme members vaccinated at public sector sites is relatively straightforward, but the reimbursement of private sector providers for state patients is more complicated. Claims have to be validated against the electronic vaccination data system, the quantity of vaccines delivered to sites, and the medical scheme status of vaccinees.
“Each of these elements is complex, but we are collectively working to get these reconciliations as accurate as possible. There is good collaboration … and all the checks and balances are in place,” he said.
BusinessDay PressReader article – Health department disputes qualified audit (Open access)
See more from MedicalBrief archives:
Auditor-General on DoH’s vaccination-spend: Some teething issues but quick footwork
Provincial health departments’ audit outcomes criticised
Crisp: Private sector is to blame for much of SA’s wasted healthcare spend
Procurement scandal is the ‘ugly face’ of Gauteng Health — Premier