TFM Libya - Policy Clarification Note

TFM Libya - Policy Clarification Note

CLIPPED FROM ARTICLE:

Before transporting the first patient to Germany we agreed on the following points with the Libyan Ambassador in Berlin. We are still working together with our counterparts in the Embassy to activate some of the points under this agreement:

The Embassy should designate a single point of contact for the Third Party Administrator (TPA) and TFM to resolve any logistical or procedural issues faced by patients and the accompanying guardians/escorts that require coordination with the Libyan and German authorities.
The Embassy should provide regular updates to the TPA on arrivals of Libyan patients and guardians/escorts (preferably in advance).
The Embassy should maintain accurate records of Libyan patients receiving treatment in Germany and the accompanying guardians/escorts (i.e. date of entry to Germany, visa expiry date, address, contact information of relatives in Libya, etc.) and share these regularly with the TPA.
The Embassy should support the representative and/or committee nominated by the Ministry of Health/TFM to manage the TPA contract in Germany.
The Embassy should provide Libyan patients with information packets and organize social and cultural activities for out-patients and guardians/escorts.
The Embassy should respect and protect patient confidentiality, privacy, wishes and preferences, and German Law.
The Embassy should organize the local Libyan community in supporting patients and accompanying guardians/escorts in a way that complies with privacy constraints.
The Embassy should promote awareness of Libyan patients in the German media and project a positive image of Libyans living in Germany in a way that complies with privacy constraints.
The Embassy should help patients keep in touch with relatives in Libya and keep relatives of the patients informed of clinical developments in a way that complies with privacy constraints.

We have also received great deal of comments addressing the TFM’s per-diem policy, which will now be addressed. Our original policy was to pay out 35 Euros per day per patient. Considering that our contract provides for full room and board for each patient we considered that sum sufficient to cover a prudent but comfortable stay in Germany, under the assumption that a patient would spend on average 4 weeks abroad. We did not anticipate that this would be a large issue, but have already taken the feedback into consideration and are currently rolling out a new policy in Germany: 500 Euros one-time payment for clothing expenses, and 60 Euros per day. We ask for the forbearance of the general public while we apply this new policy in a fair and consistent manner across all patients. Cash-based transactions with individuals are very complicated to manage for the TFM due to our reporting and audit requirements. Please note that we have taken the public’s concerns regarding the per-diem policy to heart and have chosen to apply our new policy to the cases transferred to the Netherlands and all future transfers in Europe.

We encourage the general public to review our contractual framework in Germany (http://tfmlibya.org/en/pdf/Third-Party-Administrator-Agreement-TFM-Almeda.pdf). The contract provides for multiple layers of control. Firstly, there is a TFM appointed contract manager and he has been busy managing the proper evacuation of patients. We have a dedicated 24/7 hotline for patients and hospitals. The reporting requirements in Clause (II.e) on page 3 of the contract are very stringent. The medical and financial data for each patient are accessible in Libya via a secure on-line portal. The service provider is obliged to provide daily, weekly and monthly reports. To ensure the finances are correctly administered and as required by the TFM structures, an independent financial auditor examines all the accounts, checking on hospital invoices, ensuring government approved rates have been charged and most importantly that patients have received the medical care and rehabilitation they need. There is also a medical review and governance board that meets weekly which includes the health attaché, a representative from the Ministry of Health as well as a representative from the TFM as provided by Clause (II.a).

Furthermore we encourage the public to examine the list of hospitals in Germany—published on the Libyan German Community webpage—which includes military hospitals, top-tier university hospitals and the best private clinics. Our first consideration is quality of medical care provided and to that end we have excluded all brokers and intermediaries from the hospital selection process.

Almeda, our Third Party Administrator in Germany, is a fully owned subsidiary of Munich Reinsurance, Europe’s largest and most reputable insurance company with an equity of 23 billion Euros in 2010. Almeda is an ISO 9001:2008 certified medical assistance company and a Third Party Administrator specialized in providing medical assistance for acute cases and for the chronically ill. It has a full-time staff of 39 doctors, 110 nurses, and 75 medical transport specialists, 2 psychologists, and 52 logisticians as well as part-time staff and sub-contractors. Almeda had a turnover of 23 million Euros in 2010 and has 26,000 patients under coverage. Almeda is provider of large-scale managed care solutions, and should not be mistaken for the medical tourism companies that cater primarily for patients from the Arabian Gulf. Munich Health is also a fully owned subsidiary of Munich Reinsurance specialized in health insurance. Under the single brand Munich Health, Munich Reinsurance has brought together all of its global healthcare knowledge in insurance and reinsurance. More than 5,000 experts at 26 locations worldwide benefit from the resulting synergy potentials as they devise innovative healthcare solutions for clients and partners all over the world. Almeda developed the deployment plan for Libyan patients by leveraging Munich Health’s access and expertise.

Finally we request that the public please note that there are currently two kinds of wounded in Germany: approximately 350 case who are under TFM coverage and an unknown number transported by other mechanisms. We reaffirm our commitment to cover any case already in Germany that fits our medical criteria and is willing to abide by our policies. If any member of the public is aware of such a case then we ask them to contact us and inform us of their names and locations. The Global Healthcare Programme’s priority is to ensure that the Libyan wounded receive the best health care and treatment available. Though it is not in the TFM’s power to determine the number of patients a country is willing to accept, the Global Healthcare Programme ensures that where they are accepted their medical and financial costs are met, encouraging countries to take in greater numbers.

As Libyans, the care and welfare of our fellow Libyan wounded is a priority for all of us at the TFM. As such, we welcome the constructive feedback and suggestions of concerned Libyan citizens.
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