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Medical schemes back new tariffs

Aug 15 2012 18:07 Sapa

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Johannesburg - New health tariffs will help to stabilise medical costs and provide certainty to medical schemes and patients, the Board of Healthcare Providers said on Wednesday.

"We feel that this is a much-needed first step in bringing about certainty to medical schemes and their members," BHF managing director Humphrey Zokufa said in a statement.

"Nowhere else in the world is there a situation where healthcare providers do not have a pricing guideline to work off."

Zokufa said medical scheme providers had been prohibited from discussing tariffs with healthcare providers due to a Competition Commission ruling in 2005.

He said a reference price list had been ended by a High Court order in 2010 and no guidelines had existed to replace them until the new tariffs were proposed.

"There has been no tariff or pricing guideline on healthcare provider charges, therefore allowing for opportunistic charging by some healthcare providers, and putting severe strain on the pockets of patients," Zokufa said.

The Health Professions Council of SA (HPCSA) announced the new guidelines on Tuesday. The council hoped the new regulations would promote transparency and end billing surprises.

The tariff guidelines were a yardstick and practitioners could charge more than stipulated, provided there was consent from the patient or a relative.

The BHF said it supported patients having to be consulted by the healthcare provider if the fee exceeded HPCSA tariffs.

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