Sheba says Maccabi preventing treatment of members

Hospital has set up a free help center to help patients “whose rights have been harmed.”

By JUDY SIEGEL-ITZKOVICH
sheba 88 (photo credit: )
sheba 88
(photo credit: )
An extraordinary feud broke out on Monday between Sheba Medical Center at Tel Hashomer, the country’s largest hospital, and Maccabi Health Services, the second-largest health fund.
Sheba director-general Prof. Zeev Rotstein sent a letter to Health Ministry director-general Dr. Ronni Gamzu, saying that Maccabi has prevented dozens of its members from continuing to receive treatment at the state-owned medical center.
Patients at Sheba, including adults with cancer and heart diseases – as well as children in the middle of treatment – cannot continue receiving treatment, Rotstein alleged.
“[Maccabi] makes difficulties and refuses to issue Form No. 17 referral slips to members who want treatment at Sheba,” he said. He added that the hospital has set up a free help center to help patients “whose rights have been harmed.”
According to Rotstein, some patients have left a deposit of their own money so they can continue to get treatment at Sheba.
The dispute has been going on for weeks, but exploded Monday in the form of dueling press releases issued by both organizations.
At the start of this month, Maccabi closed its longtime service office for its members at Sheba for seven days, Rotstein said. Deeming the act “discriminatory,” Rotstein demanded that Gamzu order Maccabi to cancel its sanctions.
Maccabi Health Services is the owner of the huge new private Assuta Hospital, located near Sheba.
A health fund representative charged that Sheba was turning its patients into “game pieces on an economic field by delaying the discharge of Maccabi patients and freeing up of beds at a time when hospital beds are at a premium.”
Maccabi director-general Dr. Ehud Kokia said the ministry must quickly renew agreements between the hospitals and the health funds on payments and other arrangements.
“[Sheba] misleads the public and harms thousands of patients,” Kokia alleged. During the first 10 days of 2011, Maccabi referred 6,486 members for treatment at Sheba, compared to 5,325 during the same period last year, according to Kokia.
“The figures speak for themselves,” Kokia said, adding that Sheba “ejected on Monday morning, in a pushy and unprecedented act, [some] Maccabi nurses from their office in the hospital. They are coordinators of continued care for patients nearing the end of their hospitalization, and toward transfer to nursing care institutions or their return home.”
A Maccabi spokeswoman said that every patient who needs treatment in Sheba will receive financial commitments without delay, adding that the thousands of patients who have been referred since the beginning of the year can testify to that.
“Sheba has misused its power to take advantage of patients, and charges them private fees by requiring them to sign checks as security if Maccabi does not cover the cost of treatment,” a health fund administrator said.
Asked to comment, the ministry spokeswoman said the health funds are bound to carry out agreements with hospitals that they set for their members. Any change in choice arrangements requires notice by the health fund 60 days before it takes effect, and notification to the ministry.
“Maccabi has not yet informed us about changes in its arrangements, and they are thus forbidden,” she said. “Any member who is harmed is entitled to demand from his insurer the return of any money he laid out. We will not allow patients to be harmed or hooliganistic behavior by any of the sides.”