Monday, July 1, 2024 at 4:53 PM
Rabat – The Board of Directors of the National Fund for Social Security Organizations (CNOPS) has approved the unconditional certification of the accounts of the AMO-Public Sector in 2023 and called for preserving the acquired rights of the insured and those of the staff of the CNOPS and the Mutuals in the AMO reform projects.
During its 28th session held last Thursday under the AMO-Public Sector, under the chairmanship of Miloud Massid, the CNOPS Board of Directors also adopted the financial report of the Fund for the year 2023 and its activity report, indicates a press release from the CNOPS.
This report, it is added, is marked by several achievements in terms of simplification of procedures and their digitalization, exchange of data with partners to facilitate access to services, and continuation of the fight against fraud, in coordination with mutual insurance companies, in particular after the development of a unique software on a national scale “CNOPS360”.
This software, explains the same source, makes it possible to monitor the consumption of insured persons and healthcare providers and to combat attempted fraud.
Thanks to the CNOPS’s mastery of the AMO-Public Sector indicators, the external auditor has certified, for the 10th time in a row since 2014, the accounts of this scheme without any reservations in 2023, the press release underlines, noting that the external auditors have approved the accounts of the AMO scheme for students since its launch in 2016 and those of the CNOPS-State-National Council for Human Rights agreement for the coverage of former victims of serious human rights violations 1956-1999, as well as the accounts of the common sector and the mutualist clinic.
As a result, the auditors certified, without any reservation, the accounts of all the schemes managed by the CNOPS, which cover 3.8 million people, which constitutes a first at the level of social protection institutions.
Subsequently, the Board of Directors examined the indicators of the AMO-Public Sector for the year 2023, continued the same source, specifying that the number of beneficiaries reached 3,111,030 people and the contributions of the insured amounted to 6.31 billion dirhams, against 6.12 billion dirhams in 2022, an increase of 3%.
In view of this slow progression of contributions, and after the processing of 6 million sickness files, the payment of benefits reached 7.45 billion dirhams in 2023, against 5.86 billion dirhams in 2022, thus recording an increase of 1.59 billion dirhams (27%).
The total payments to policyholders and healthcare providers since the entry into force of the AMO in 2005 amount to 79 billion dirhams, making the CNOPS the leading financier of medical coverage in our country.
According to the CNOPS, the gap between contributions and payments in 2023 generated a deficit of 1.28 billion dirhams, after two years of deficit, in 2022 and 2021, where the AMO recorded deficits of 878 million dirhams and 1.51 billion dirhams respectively, forcing the Fund to buy back 1.6 billion dirhams of its security reserves to honor its commitments to policyholders and healthcare producers and putting the AMO at risk of exhausting its reserves by 2027.
This situation is explained by the continuous expansion of the basket of care, particularly in expensive medicines, without medico-economic studies, the high prices of medicines, medical devices and biological analyses, dental care, etc., the delay in approving the decision to cap the reimbursement of ceramic-metal crowns, as well as the weakness of the system for medical control of health care expenditure, the capping of contributions and the non-revision of their rate since 2005.
This situation is also explained by the increase in the number of people suffering from long-term and costly illnesses and their expenses (3.7 billion dirhams in 2023, or 53% of expenses), the aging of the insured population (the number of retired insured persons increased from 20.8% in 2006 to 38.4% in 2023), as well as the increase in the claims rate from 51.6% in 2022 to 52.9% in 2023.
Accordingly, the Board of Directors approved a decision urging the relevant authorities to take the necessary emergency measures to ensure the sustainability of AMO-Public Sector and restore its financial balance.
The CNOPS Board of Directors also examined the draft law on the merger of AMO schemes, on which neither the CNOPS, as the management body, nor the Mutual Insurance Companies, which have been conducting a unique experience of integrated management of AMO and supplementary coverage with the Fund for 74 years, were consulted, the press release added.
Speaking on this occasion, Mr. Miloud, quoted in the press release, stressed “the full support of the CNOPS and the Mutuelles for the royal project of generalization of the AMO and their determination to put their experience and expertise, recognized for several decades, to contribute to preserving the dignity of citizens and supporting their constitutional right to access to health care”.
However, he considered that the exclusion or marginalization of the CNOPS and the Mutuals from the AMO reforms does not agree with the principle of participation provided for in the framework law 21-09 on social protection, nor with the constitutional dimension of the mutual sector, specifying that the decision to merge the schemes and to examine its financial and management aspects, as well as its impact on the insured, the State, the CNOPS and the Mutuals, fall within the remit of the Interministerial Commission for the steering of the reform of the Social Protection system and the technical committee that resulted from it.
In this regard, the CNOPS Board of Directors urged the government to preserve the acquired rights of policyholders and to protect CNOPS and Mutuelle employees in light of the ambiguous provisions of Bill 54-23 on the merger of AMO schemes which threaten their future and exclude CNOPS and Mutuelle from the scope of AMO.
Finally, the Board of Directors called on the relevant authorities to speed up the approval of the status of CNOPS employees, which has not been revised since 2011.
The delay in approving this status and the uncertainty regarding the future of the Fund and the Mutual Funds are causing a haemorrhage of human resources, captured by institutions working in the field of social protection, deplores the CNOPS.
At the end of the work of this Council, the CNOPS and the Mutuelles reaffirmed their support and their mobilization to contribute to the success of the royal project of generalization of the AMO and guarantee its sustainability thanks to their expertise, their experience and their commitment to the principles of social solidarity and to everything that preserves the rights of the insured and values their achievements.
