The Specialist Forum Volume 13 No 11 November 2013 | Page 4

SAPPF

HPCSA fee norm
determination process

A

new process document - Proposed Process for the Determination
of Fee Norms by the Medical and Dental Professional Board appeared on the HPCSA website at the end of October (deadline for comments: 18 November).
It has been just over a year since the HPCSA took it upon itself to
unilaterally determine a tariff for medical practitioners in South African
private practice. You will recall that a flurry of objections forced the
Council to withdraw the two schedules from its website in September
2012; and when it decided to gazette the self-same schedules some
weeks later, SAPPF and others (SA Medical Association [SAMA], SA
Dental Association [SADA]) threatened legal action.
Following a spike in complaints of overcharging against practitioners
in recent years, and lacking an up-to-date cost based schedule of tariffs against which to adjudicate on such complaints, the Council took
its mandate to determine ethical guidelines in terms of Section 53 of the
Health Professions Act to mean that it could set, not a ceiling but a tariff
schedule which is in effect the authority of the Department of Health
(DoH). Nevertheless, given the HPCSA’s role and the stalemate since
the Reference Price List (RPL) was set aside in the high court back in
2010, all stake holders acknowledge that a new schedule of tariffs is
imperative, as well as an all-inclusive process.
A draft process was published for public comment early in 2013,
followed shortly thereafter by an announcement that Shivani Ramjee,
head of actuarial science at the University of Cape Town, had been appointed to assist the Council, and she outlined her approach at a wellreceived April 2013 meeting with affected stakeholders. Two options
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