(1) In determining the tariffs to be paid to health care facilities and the schemes, the Council shall consult the facilities and the schemes.

(2) Payment for health care services rendered by a health care facility shall be made by either of the following systems:

(a) capitation;

(b) fee-for-service; or

(c) any other payment system that the Council may determine.

(3) Capitation means a payment mechanism in a written agreement by which a fixed rate of payment for a fixed period is negotiated with an accredited health care facility to deliver health care services to a person, family, household or a group of persons covered under the terms of the agreement for health insurance services.

(4) For a fee-for-service payment the health care facility and the attending health care personnel shall file the claim in the Form 4 provided in Schedule 1.

(5) Hospitals shall attach Forms 4, 5, and 6 in Schedule I to the clinical records of a patient upon admission.

(6) In the event of admission, the patient shall not be discharged unless the attending medical practitioner and the patient sign or thumbprint the forms provided for under sub-regulation (4).

(7) A claim for payment of health care services rendered under a scheme licensed under this Act shall be filed within sixty calendar days from the date of the discharge of the patient or the rendering of the service.

(8) Except as provided under regulation 54 in respect of district mutual health insurance schemes or except in the case of an emergency, a claim for payment not made within the stipulated period is barred upon the expiry of the period stated in sub-regulation (7).