The Industry Codes of Good Practice with standards exist to foster a culture of lawful, honest, cost-effective and ethical commercial activity in the private health sector for the benefit of patients. Furthermore, to prevent, detect, deter and mitigate losses to the medical schemes due to fraud, waste and abuse. Lastly, the mutual understanding of rules of engagement, including rights and responsibilities of all stakeholders.
Time | Topic | Speaker | Session |
10:00 – 10:10 | Opening and Welcome | Ms M. Mpshane | 10 minutes |
10:10 – 10:20 | Fraud, Waste and Abuse in context | Dr M. Makiwane | 10 minutes |
10:20 – 10:40 | Purpose of the FWA Webinars | Dr S. Kabane | 20 minutes |
10:40 – 11:00 | Recap of FWA Charter and Definitions | Dr T. Phaleng | 20 minutes |
11:00 – 11:10 | QnA and discussion | Ms M. Mpshane | 10 minutes |
11:10 – 11:50 | Introducing the Industry Codes of Good Practice & Standards | Mr M. Willie | 40 minutes |
11:50 – 12:00 | QnA and discussion | Ms M. Mpshane | 10 minutes |
12:00 – 12:35 | Codes of Good Practice: Healthcare provider’s perspective | Dr M. Kwinda | 35 minutes |
12:35 – 12:45 | QnA and discussion | Ms M. Mpshane | 10 minutes |
12:55 – 13:00 | Closure | Dr M. Makiwane | 10 minutes |
The Office of the Tribunal exists to effectively resolve disputes arising within the medical schemes industry, between members of the medical schemes, service providers, and any other relevant stakeholder and medical schemes on the other. The Tribunal will act in the best interests of all the parties, taking both sides into consideration and considering the merits of each case carefully. The Council will be responsible for the appointment of Tribunal members and elected by a majority vote of the Council.
10:05 – 10:10 | Welcome and Introduction | Ms M. Mpshane | 5 minutes |
10:10 – 10:25 | Code of Conduct for Medical Scheme members (SADAG rep) | Ms C. Chambers | 15 minutes |
10:25 – 10:35 | QnA and discussion | Ms M. Mpshane | 10 minutes |
10:35 – 11:05 | Introduction to Dispute Resolution Mechanisms | Mr J. Letsoalo | 30 minutes |
11:05 – 11:20 | QnA and discussion | Ms M. Mpshane | 15 minutes |
11:20 – 12:05 | FWA Tribunal: Legal Mandate, Powers, Ethos & Interpretation | Mr J. Letsoalo | 45 minutes |
12:05 – 12:20 | QnA and discussion | Ms M. Mpshane | 15 minutes |
12:20 – 12:50 | HPCSA Role in FWA Tribunal | Adv P. Khumalo | 30 minutes |
12:50 – 13:05 | QnA and discussion | Ms M. Mpshane | 15 minutes |
13:05 – 13:20 | Future Prospects for FWA and Closure | Dr S. Kabane | 15 minutes |