Bupa Malta has said prices charged by St Philip’s Hospital for medical treatment are more than 50% higher than the rest of the market, after it announced a new list of “participating hospitals” in which patients will have full insurance cover.
Last week, the director of St Philip’s Hospital, Dr Frank Portelli, criticised Bupa Malta’s decision not to honour in full claims for treatment in other private hospitals not included in the insurance company’s list of participating hospitals.
Portelli accused Bupa Malta of “stealing” if clients who have a full hospital insurance cover with Bupa only get 80% of the claim for private hospital treatment.
On 21 July, Bupa Malta sent a letter to all subscribers announcing it had reached an agreement with the St. James Group, which comprises Saint James Capua Hospital in Sliema, Saint James Hospital Zabbar and Saint James Clinic in Mosta.
In its letter, BUPA Malta stressed that “wherever possible, treatment should be received in a BUPA participating hospital”.
However, if subscribers choose to receive their treatment in a “non-participating hospital”, benefits for pre-authorised treatment would be paid at 80% of eligible costs.
Moreover, direct settlement with a non-participating hospital would not be possible.
In a comment to MaltaToday, Bupa Malta said its members can receive treatment in any of the private hospitals and clinics on the island. “This gives them freedom to choose the facility of their preference, and focus on getting well without worrying about the cost,” a spokesperson said.
“Bupa Malta has had a good relationship with St Philip’s Hospital for many years, and we are keen for that relationship to continue. However, most of the prices proposed by the hospital in its new tariff for treating Bupa Malta members are more than 50% higher than the rest of the market.
“Bupa Malta is not prepared to agree to these prices because they would drive up medical inflation on the island resulting in higher insurance premiums not just for Bupa Malta members, but for all health insurance policyholders on the island.”
St Edward’s clinic has also filed a judicial protest claiming Bupa was behaving in a way that did not allow a level playing field by informing clients to choose only those clinics or hospitals forming part of its approved list.
St Edward’s Clinic complained that it was suffering as a result of the agreement struck by BUPA with the private hospitals and clinics in order to feature on the approved list. The clinic called on BUPA to withdraw its directive to its clients.
Apart from the Saint James Group, the BUPA private hospital scheme currently includes Da Vinci Hospital in Birkirkara, St Mark’s Health Clinic in Msida, and Family Health Services in Rabat.
BUPA Malta said it hoped to conclude “similar agreements with other providers for the mutual benefit of our clients and private medical entities”.
Last week Portelli said Bupa Malta was an agency of Bupa UK and had no statutory role in setting standards or approve hospitals or clinics. “Bupa Malta has approved clinics whose standards I personally would not have approved – such as for instance the re-sterilizing of disposable instruments. Some instruments are designed to be used once and then to be thrown away after use – obviously this raises costs,” Portelli said.