January 30, 2020 -At the moment the SMMC annual report of 2016 is available online.SMMC had on its website the annual reports of 2010 till 2014. Before SMMC removed these annual reports from their website, we analyzed the development of the annual financials of the SMMC. We have here a graph based of the figures we found in these annual reports.
We can see in the graph below how the operational expenses of SMMC annually have increased since 2012. From 2012 SMMC started to show deficits caused by reduced revenues generated. Since 2015 SMMC started to show surpluses based on substantial revenues received.
The figures presented by SMMC are much lower than the figures presented by SZV in its annual accounts. Let us take for example whatSMMC reported for the year 2014
- total income 29.9 million ANG. (compared to 27.9 million ANG for 2013)
- operational expenses 35.4 million ANG (compared to 6 million ANG for 2013)
SZV management reported in the 2014 SZV annual reports that the TOTAL COST of hospital care was 42,4 million ANG. But how can the total costs of hospital care reported by SZV for 2014 be 42.4 million ANG, whereas SMMC self is reporting its total revenues (including SZV advances) to be 29.9 million ANG? How to explain this huge difference of 12.5 million ANG between what SZV has to pay for hospital care in 2014 and what SMMC is reporting as total income received?
SZV MUST EXPLAIN AND GIVE ACCOUNT FOR WHAT THEY REPORTED.
SZV management wrote as explanation for the higher amounts in their 2014 annual report that final declarations of the years 2011 till 2014 were included in the 42.5 million ANG. But the same SZV management wrote also that “Parties agreed to have an independent party to do an investigation on the final declarations of the year 2013 and 2014”, which may lead to corrections and an agreement between parties. When this independent investigation took place?
- In the 2016 SZV annual report SZV management reported that the Final settlement For the calendar years 2013, 2014, 2015 and 2016 between SZV and SMMC for the care provided to patients insured under the ZV/OV fund, did not yet take place.
- In other words no accurate total costs yet for these years passed.
- SZV management reports in the same 2016 annual report that in 2016 a 3.9 million ANG advanced payments to SMMC regarding a final settlement for the years 2013, 2014, 2015 and 2016.
- In other words even though there was no agreement achieved between parties about final declarations of 2013, 2014, 2015, 2016 SZV management still agreed with SMMC and we quote them:“to settle the outstanding years for the ZV/OV fund, taking into account a reasonably increased budget payment to compensate for the years of underfunding.
We discovered that the latest annual report of SMMC of 2016 which was published online last year in 2019 is not approved by the independent accountant BDO. In this annual report SMMC management reported that the 2016 revenues consist of 1. fees for medical treatments chargeable to patients and insurance companies and 2. budgeted amounts as agreed with SZV and other social security institutions.
As Consumers Coalition we have therefore the following questions:
- Why SMMC could not report charged fees for services provided to SZV card holders and other social security institutions three years after the book year?
- Why SMMC could not report its income from SZV funds based on approved final declarations and is still reporting advanced budgets not accounted for?
- Why SZV management cannot make SMMC charge the funds with corrected declarations?
- Why SZV management gave this extra advance for years passed and for non approved annual declarations of SMMC? SZV management wrote “to facilitate SMMC to become again a sustainable organization, to give SMMC a realistic chance to cover its expenses and to invest in the ongoing improvement of quality and service level”.
- Which article in which law authorizes SZV management to advance budget monies to a medical institution for passed calendar years?
- Which article in which law allows SZV management to provide advances for unapproved declarations of services provided in years passed?
In our meetings with SZV management as Consumers Coalition we will request more detailed explanations, and repeat our request for them to provide corrected annual accounts for each fund separate. With the Prime Minister, the Minister of VSA and the Minister of Finance we will discuss these findings and questions we have, so that an appropriate reaction and correction can be demanded from SZV and SMMC.