SAOPA Annual General Meeting – 16/17 November 2021

Planning for the Annual General Meeting and Workshop is underway. The workshops and AGM will be held on the 16th and 17th November 2021, and we request that you start making provision for this in your diary. The final program will be announced once confirmation has been received by our guest speakers and sponsors. Regular updates will follow via our social media platforms to keep you abreast of the program and detail.

Please let us know if you have any specific matters you wish to discuss, or if you would like to become involved as a sponsor and/or workshop presenter.  Any comments can be sent to coo@saopa.co.za

UPDATES
All systems go on the new Membership Management System

The SLA’s have been signed and the development team is putting ‘tekkies to the tar’ to ensure that we reach the go-live goal of 1 November 2021.  With this date coming up on the horizon, we will engage with you during the coming month to keep you informed and excited.  Be sure to join us for the AGM on the 17th November when ProfNet’s representatives will take us on a virtual tour of what the system has to offer.

CMS Appeals Finding

The CMS Appeals Committee recently ruled that it is unlawful for Medical Schemes to appoint device supplying companies as DSP’s.  In case you missed our earlier News Flash, a short summary of the findings as well as the complete published findings can be viewed by following these links:

Summary PDF >>
CMS Published Findings >>

Included in the submission made by the Appellant, is an earlier (April 2021) CMS Notice under which the CMS declared that the appointment of any DSP’s is undesirable where such an appointment is made:

“3.1. …without engaging in a fair procurement process which is fair, equitable, transparent, competitive and cost- effective. The Council shall publish guidelines on selecting Designated Service Providers (DSPs) for Medical Schemes within 180 days of publication of this notice.”

“3.2 Imposing a co-payment in terms of Regulation 8(2)(b) that exceeds the quantum of the difference between that charged by the medical scheme’s designated service provider and that charged by a provider that is not a designated service provider of such scheme. …”

SAOPA CMS Notice >>

Coding Committee 

Due to a lack of understanding or transparency in the coding and billing process, we experience increased scrutiny by funders who are unwilling to authorise or fund many O&P procedures. This has also been brought about by large discrepancies in coding and billing for apparently the same procedures between different practices.  In addition, regrettably there also appears to be over servicing and fraudulent coding and billing practices that needs to be addressed.

As a result, funders have been unwilling to address tariff increases until there is a greater understanding and transparency in our treatment procedures.

The committee, under guidance of Grant Monaghan, is currently attending to step 3 of the first stage of the program and are pleased to share this short overview of the project plan.

This is a work in progress and planning, scheduling and priorities will be adjusted as we proceed and learn about the process.

Coding Prjoect Plan Summary >>
Your profession needs you!

The SAOPA Executive Committee remains committed to working tirelessly in representing the needs and interest of our members and the O&P profession at large – but we cannot do it alone.

We are again asking for your support and putting your hand up to form part of special interest committees to be established in the weeks to come.  See elsewhere in this newsletter the work already performed by a dedicated Coding Committee…but new members always needed and welcomed.

If you have not done so already, please complete our 2-minute questionnaire to let us know how you want to help.

GEMS Strategic Meeting -14 September 2021

The SAOPA Executive committee recently attended the second bi-annual GEMS & associated Medscheme Strategic Meeting.

GEMS is clamping down on fraudulent activities with payments being suspended and legal action taken against O&P’s defrauding the medical schemes. Reductions in tariffs and exclusion of codes are partly in response to these fraudulent activities, which continue to be to the detriment of the larger profession. We respectfully ask practitioners to heed the warning and ensure you and your practice remain beyond reproach.

SAOPA strongly urged for engagement prior to scheme rule changes that affect the profession, which was positively received by representatives.  The NEC has recently received proposed changes for comment and technical input.  The outcome, or if need be, the extent of further consultation will be shared in due course. Medical schemes want to engage with professional bodies on technical and patient care advise, but understandably require a majority representation through membership.  SAOPA membership is therefore crucial, and we need your support in, not only continuing your own membership and becoming involved in our specialist committees, but all importantly advocating to colleagues who might not yet share in the benefits and shared responsibility that our association bring to the profession.

Standing up for the safety and dignity of our women & girls

Gender-based violence – which disproportionately affects women and girls – is a profound and widespread problem globally.   South Africans are by no means excluded from these widespread human rights violations, impacting almost every aspect of life as it undermines the health, dignity, security and autonomy of its victims – all whilst mostly shrouded in silence and shame. With one in three women that is estimated to experience physical or sexual abuse in her lifetime, chances are someone in your immediate circle may be quietly hurting.

Addressing this scourge is complex, requiring multi-faceted responses and commitment from all stakeholders, society and everyday people.  SAOPA does not have a mandate to act on reports coming to our attention.  Other than offering empathy and reference to the proper authorities and support systems, as health care professionals, we condemn in the strongest sense possible, any violation of another human’s basic right to safety and dignity.  Do not look away…

EVENTS

Webinar (CPD) – 27 September 2021 

“Making sense of the ethical challenges of today”

Ms Cynthia Schoeman is the Managing Director and Chief Ethics Activist at Ethics Monitoring & Management Services and still finds time to Chair the Ethics Practitioners’ Association.  We were honoured that she could fit us into her schedule to present a very informative and thought-provoking webinar on key ethical issues to be considered as we navigate the current context and reality towards a more ethical future.

In her own words: “Our current context, shaped by the systematic corruption of State Capture and the widespread moral collapse evidenced in the recent looting, is characterised by many high-profile and very undesirable ethical examples. So too does the pandemic present many ethical challenges. Together these factors can have a negative effect at a personal, professional and business level, fueling ‘lowest-common-denominator’ behavior and eroding the culture of organisations.”

Please keep an eye open for future events as we would like to welcome Ms Schoeman back in future to take us further into this and other ethical related topics. Details on our October webinar event will be posted on social media in due course.