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Ministry of Health signals the renewal of 4 PPP concession contracts, after the expiration of deadlines

Ministry of Health signals the renewal of 4 PPP concession contracts, after the

Public Private Partnership (PPP) concessions in the health sector widely criticized for high cost versus efficiency seem to be renewed after the deadline.

The Ministry of Health recently released for consultation the 10-year strategy until 2030 for the progress of policies and funding in the sector.

The PPP concession for basic population control started in 2015 and ends in 2024, but in the government plan for the next 10 years the service will continue until 2030 and aims to extend the age of beneficiaries which is now 35-70 years old.

The other PPP concession for the sterilization of surgical rooms started in 2015 and ends in 2024, but the Ministry of Health has announced that the services will continue until 2030.

The Dialysis service concession became active in 2016 and ends in 2025, but the service will continue at least until 2030.

The laboratory services concession started in 2019 and ends in 2028, but will continue at least until 2030 according to the new plans of the Ministry of Health. The Ministry of Health announced that the costs for these concessions will be the same even after the conclusion of the contracts.

"The cost of receiving services such as basic medical examination for the 35-70 age group, the expansion of the network of laboratories in university and regional hospitals, the increase of access for citizens who benefit from the dialysis service package throughout the country and the continuity of use of sterilization kits in the public hospital service is calculated until the year the contract is completed. For expenditures until 2024, expenditures are set according to MTBP 2022-2024. While the expenditures after 2024 are decided taking into account the expenditures foreseen for 2024, according to the MTBP 2022-2024 ”, it is stated in the official document of the Ministry of Health.

The budgetary impact of concessions on health becomes more difficult due to the fact that reports from the Ministry of Finance from year to year vary both for the full value of contracts or even for annual payments. Other values ​​have the contract announced in the Public Procurement Agency, other values ​​in the register of concessions and other values ​​reported by the Ministry of Finance on the effects of the payments it makes. Among other things, the Supreme State Audit Office noted that the VAT payments that the government makes to PPP concessions on health are illegal.

”Konstatohet se, edhe për vitin 2020, vijojnë të pranohen dhe likuidohen faturat tatimore mujore të Check-Up, lëshuar nga koncesionari, në vlerën totale 322 milionë lekë, në të cilën përfshihet edhe TVSH në masën 20% mbi vlerën e shërbimit shëndetësor, ndërkohë që ky shërbim duhet të trajtohet si Furnizim i Përjashtuar nga TVSH. Praktika vazhdon bazuar edhe në interpretimin e DPT, e cila ka referuar shërbimin si të tatueshëm”, raportoi Kontrolli i Lartë i Shtetit në Kuvendin e Shqipërisë.

Nga auditimi për dy nga tre kontrata koncesionare, “Check-Up” dhe “Sterilizimi”, rezultoi se aplikohet Tatim mbi Vlerën e Shtuar, në masën 20 % mbi çmimin e kontraktuar. Ndërsa për shërbimin e “Hemodializës”, ky tatim nuk aplikohet. Megjithëse të tre shërbimet e sipërcituar janë pjesë e zinxhirit të ofrimit të shërbimit shëndetësor ndaj pacientit nga institucione shëndetësore të licencuara, si dhe faturojnë njëlloj shërbimin drejt institucioneve shtetërore prej dhe nga paguhen, mënyra e faturimit të tyre ndryshon.

Although KLSH has continuously advised to change the way of billing for the "Check-Up" service, the situation has not changed, but it continues in the "Sterilization" concession. This way of billing the health service has not been opposed by the Authority, or initiatives have been taken to clarify the spirit of the law with the MFE, to resolve the deadlock, which continues to burden public finances./ Monitor

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