RSSB delays settling invoices giving healthcare a headache

Wednesday September 21 2022
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Some of the pension schemes under RSSB include old age lumpsum benefits, survivors' lumpsum benefits, invalidity pension, and survivors' pension. PHOTO | FILE | NMG

By Ange Iliza

Delays in settling invoices from health centers are taking a toll on patients and nurses who have to operate without funds for weeks or months. Patients are the hardest hit when pharmacies run out of stock and require them to fund their own medicines.

Nurses say this dampens service provision to citizens. Ideally, health centers are required to record every expense made and service provided to citizens with health insurance schemes under Rwanda Social Security Board (RSSB) such as Mutuelle de Sante.

At the end of every month, health center staff and RSSB clerks at every center review the inquiries, agree on the expenses, and submit the electronic invoice for payment.

Contracts signed between RSSB and health facilities state that payment shall be completed by RSSB within 30 days from the day the invoices are raised by both parties as being definitively accepted.

Heads of health facilities told Rwanda Today that payments sometimes take weeks and months. For instance, Kimonyi health center in Musanze district sends invoices every 5th day of the month of a minimum of Rwf2.5 million. The funds are used to purchase hospital equipment, essential medication, electricity, and pay wages and other bills.

District pharmacies that provide medication and other medical equipment also rely on RSSB monthly payments. When payments are delayed, Beatrice Furaha who heads the health center says operations come to a halt.


Negative impact

“It is difficult. Sometimes the money comes when we have a pile of arrears from months back. It affects our health services because we are basically broke, short on medication, equipment, and workers are not paid,” Ms Furaha said.

Kimonyi’s challenges reasonate with many other health facilities. The Auditor General reported that between 2020 and 2021, some 44 invoices totalling Rwf10 billion from eight health facilities were delayed for a period of up to 82 days while 36 others amounting to Rwf6.4 billion from nine health facilities delayed for up to 56 days.

The report observed that “delays in verifying invoices and payments negatively impact the availability of cash for health facilities to buy drugs and other medical tools to deliver services”.

The issue was put before the RSSB by the parliamentary Public Accounts Committee during the annual hearings. RSSB explained that the system that was used to verify invoices was faulty but has been rectified.

In an interview with Rwanda Today, Valens Muhakwa, chairperson of the committee said the committee recommended “that RSSB separate invoicing systems for different health insurance schemes.

Mutuelle de Sante would have its own system and verification process as well as other schemes. That way, invoices would be less overwhelming and faster to process,” Mr. Muhakwa said.

RSSB serves 13 million Rwandans who are either enrolled in the Community-based Health Insurance scheme known as Mutuelle de Sante, receive pension fees, or are part of Ejo Heza long-term saving scheme.