The contracts are overseen by the MOH Director of Medical Services, assisted by the department of hospital care in the MOH, and supervised by the Director General of the MOH. They must be approved by the regulatory authorities and General Accounting Office of government, and signed by the minister and the hospitals. Contracts cover almost all personal health care services for outpatients and inpatients, and nothing of public health or primary care services, although many hospitals participate in MOH preventive initiatives including immunization, patient education, and screening (diabetes, various cancers, among others).
More recently, in an effort to curb excessive utilization and billing, the MOH assigned a medical auditor for a group of hospitals to manage daily patient requests and approve invoices. This role includes the following:
- Ensuring identity of patients
- Approving admissions
- Approving use of expensive diagnosis and treatment
- Receiving patient complaints and taking them up with the hospital
- Ensuring emergency cases are given priority
- Reviewing medical records to ensure proper billing
The work of these medical auditors is checked by MOH medical inspectors, and the MOH does a random 10 percent audit of invoices against medical summaries, correcting where required before sending on to the MOH finance department for payment.