South African Medical Association

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PP4U: DSPs Undesirable Business Practices

 
 
 

DSPs Undesirable Business Practices

Dear General Practitioners and Specialists in private practice.

Several of you have expressed grave concerns about the undesirable and detrimental practices of medical schemes with regard to designated service providers (DSPs), Co-payments etc., affecting your practices and patients.

We have the opportunity to air these directly and formally with the Council for Medical Schemes (CMS).

In terms Circular 39 of 2017 on 13 June the CMS has invited written submissions on undesirable practices as per the attached link: http://www.medicalschemes.com/files/Circulars/Circular39of2017.pdf.

The Council has been ordered to undertake this process following a successful appeal by the Independent Community Pharmacy Association (ICPA) in 2016 in which the association challenged the medical scheme practise of appointing closed DSPs and then charging penalty co-pays on services obtained outside of these closed DSPs.

The period for response is only 21 days so please consider this urgently. Please do circulate widely for commentary from any practitioners who are affected as negatively by these practices as pharmacists.

Please send ALL your comments through to shelleym@samedical.org by Tuesday 27 June 2017 so we can collate a thorough submission in time for the deadline.

We would really appreciate specifics in terms of schemes, disease areas, plan types and DSP selection processes which you believe to be particularly problematic.

We look forward to our inputs

 

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