Guidance on obtaining consent of patients

Council and the Professional Boards under its ambit has noted that the guideline provided to practitioners by Council in fulfilments of its mandate in terms of section 15A(h) of the Health Professions Act in August 2017 has caused confusion to practitioners in terms of the requirement of obtaining consent from patient to release their treatment records to the medical schemes. Council views the conduct by Medical schemes of using the HPCSA as a tool to threaten, coerce and harass practitioners into signing settlement agreements as unlawful.

Through this revised guide, Council wishes to clarify the issue of obtaining consent from patients as follows:

Access by a medical scheme to the member’s clinical records held by a practitioner

In terms of Regulation 15J(2) of the Medical Schemes Act Regulations, a medical scheme is entitled to access any treatment record held by a managed health care organization or health care provider and other information pertaining to the diagnosis, treatment and health status of the beneficiary in terms of a contract entered into pursuant to regulation 15A, but such information may not be disclosed to any other person without the express consent of the beneficiary. This entitlement is subject to the prescribed requirements for disclosure of confidential information in terms of section 14 and 15 of the National Health Act 61 of 2003 and Ethical Rules of Conduct for Practitioners registered under the Health Professions Act, 1974 as published under Government Notice R717 in Government Gazette 29079 of 4 August 2006. Practitioners are therefore required by law to disclose or release the treatment records of their patients to the medical scheme without having to obtain the written consent of their patients.

Prosecution of practitioners involved in fraudulent activities

In terms of Section 66(2) of the Medical Schemes Act, a practitioner registered under the Health Professions Act may not be prosecuted under the Medical Schemes Act as an act of unprofessional conduct by practitioners registered with the HPCSA is punishable under the Health Professions Act. Section 16 of the Medical Schemes Act places an obligation for the Council for Medical Schemes to report cases of improper or disgraceful conduct (Unprofessional Conduct) to a medical scheme by practitioners registered with HPCSA to the HPCSA as the statutory body which has jurisdiction over practitioners registered under the Health Professions Act. Where an offence has been committed, the Council for Medical Schemes is obliged to refer such a matter to the National Prosecuting Authority. The medical schemes cannot discipline or prosecute health practitioners for unprofessional conduct but may report practitioners to HPCSA for unprofessional conduct or report any offence to the South African Police Services.

Section 34 of the Prevention and Combating of Corrupt Activities Act 12 of 2004 requires that anyone in position of authority or an entity (medical schemes, HPCSA, etc.) that suspects or has knowledge that a practitioner has been involved in a fraudulent activity that involves an amount of R100 000 or more to report such knowledge or suspicion to the South African Police Services. Failure of such a person or entity to comply with this provision of law constitutes an offence under the Act mentioned above.

Practitioners are advised that those found guilty of unprofessional conduct involving fraud amounting to R100 000 or more will not only be subjected to penalties imposed in terms of Section 41 of the Health Professions Act but Council will also report such practitioners to SAPS in terms of the Prevention and Combating of Corrupt Activities Act.

Recovery of benefits paid bona fide to a practitioner who was not entitled to receive such benefits

Section 59(3) of the Medical Schemes Act empowers the medical scheme to recover any amount which has been paid bona fide to which a practitioner is not entitled to or any loss which has been sustained by the medical scheme through theft, fraud, negligence or any misconduct which comes to the notice of the medical scheme.

The question is: How does the medical scheme recover such an amount?
a. by deducting such amount from any benefit payable to the health practitioner. Council advises practitioners that the agreements they reach with the medical schemes should be as prescribed in terms of this section of the Medical Schemes Act.
Or
b. Through any other lawful arrangement made with a practitioner to reimburse the scheme.

Legal status of payment arrangements made between health practitioners and medical schemes

The payment arrangements between practitioners and the scheme are legally binding if they are lawful. An example of an unlawful agreement is one which is reached with a condition that the medical scheme will not report a practitioner to any organ of state, including the HPCSA on a matter that such an organ of state has jurisdiction over. Although Medical Schemes may exercise their choice in terms of reporting unprofessional conduct to the HPCSA, they have a duty in terms of common law and section 66 of the Medical Schemes Act to report practitioners to the HPCSA.

Withholding of claims due to practitioners by medical schemes

In terms of Section 59(2) of the Medical Schemes Act, the scheme should pay a claim either to the member or practitioner within 30 days of receiving the claim. According to Regulation 6 of the Medical Schemes Act Regulations, if a medical scheme is of the opinion that an account, statement or claim is erroneous or unacceptable for payment, it must inform both the member and the relevant health care provider within 30 days after receipt of such account, statement or claim that it is erroneous or unacceptable for payment and state the reasons for such an opinion and the member or health practitioner has sixty days to correct and resubmit such account or statement. Where the medical scheme has failed to either notify the member or health care provider within 30 days that an account/statement/claim is erroneous or unacceptable for payment, OR fails to provide an opportunity for correction and resubmission, the medical schemes bears the onus of proving that such account/statement/claim is, in fact, erroneous or unacceptable for payment when there is a dispute. Practitioners are advised to report medical schemes who unlawfully withhold claims due to them to the Council for Medical Schemes.

Conclusion

Council and the Professional Boards under its ambit do not condone any form of fraud and as a result, the investigation of complaints of alleged fraud by practitioners registered under the Act has been intensified to fulfil Council and the Professional Boards’ function of maintaining and enhancing the dignity of the relevant health professions and the integrity of the persons practicing such professions.

https://www.health24.com/PartnerContent/bleeding-gums-what-it-means-and-why-smokers-need-to-be-extra-careful-20181015 

Bleeding gums: What it means and why smokers need to be extra careful!

2018/10/15 3:57:06 PM

Did you know that 80% of all teeth lost in the mouth is due to gum disease? Scary stuff if you consider that bleeding gums are the first sign of gum disease.  

But there’s a silver lining to this shocker. “The dental field is lucky as we know exactly what the cause of oral diseases like tooth decay and gum disease are and that is plaque,” Angelique Kearney, president of the Oral Hygienist Association of South Africa, explains. 

Why do gums bleed?  

Healthy gums do not bleed! If you have bleeding gums when brushing or flossing your teeth, you have gingivitis or gum infection, according to Kearney. Although infection of the gum surrounding the tooth is the most common reason why gums bleed, there are other conditions that can also cause bleeding gums.  

“Recent research supports the findings that bleeding gums and an unhealthy mouth has a link with uncontrolled diabetes, high blood pressure, premature birth weight of babies and cholesterol,” Kearney says.  

According to Dr Welgemoed, a professional dentist at Longbeach Dental Noordhoek, other reasons for bleeding gums can include:  

·         Hormonal changes during pregnancy and adolescence 
·         Side effects from medication 
·         Malnutrition 
·         Ulcers  
·         Dental Abscess 
·         Oral Cancers 

What can happen if bleeding gums stay untreated? 

If gingivitis is not treated, the infection of the gums can spread to the bone surrounding the teeth. This is called periodontitis and is more difficult to treat. Untreated periodontitis leads to bone loss around the teeth, resulting in teeth getting mobile or loose which in turn leads to the early loss of healthy teeth, according to Dr Welgemoed.  

Why smokers are at risk of periodontal disease 

“Patients who smoke don`t usually experience bleeding gums because of the constriction of the blood vessels of the gums due to the heat,” explains Kearney, who is also an associate lecturer at Wits University. However, that doesn’t mean smokers have dodged the bullet of gum disease.  

On the contrary, smokers are at a very high risk of developing periodontal disease, according to Kearney. Without experiencing the symptom of bleeding gums, smokers need to regularly check the state of their teeth and gums to make sure they don’t have gingivitis.    

How to treat bleeding gums  

Prevention of gingivitis comes down to maintaining a basic, daily oral care routine of brushing twice a day, flossing once a day and rinsing with mouthwash. Adding an antiseptic mouthwash like to your routine twice daily can further reduce your risk of gum disease.  

It’s also important to consult your dentist or oral hygienist when you notice any difference in the appearance of your gums. “Your oral hygienist can determine your plaque and bleeding index and help you to reduce the levels for optimal oral health,” says Dr Welgemoed. 

“Whereas the general recommendation is for you to visit your dental professional every 6 months, it’s advisable that smokers and patients with periodontal disease make an appointment every 3 to 4 months,” Kearney advices.  

Angelique Kearney and Dr Janel Welgemoed are both members of theDental Academy.  



This post is sponsored by , produced by Brandstudio24 for Health24.

https://www.health24.com/PartnerContent/old-toothbrushes-and-4-other-things-that-are-eating-away-your-teeth-20181010 

 4 Things you're doing wrong when taking care of your teeth!

Using the incorrect dentalcare products.  
A wide range of toothpaste and mouthwashes are available on the market but it’s important to choose products specifically for your oral and dental needs. Dr Welgemoed explains for example that someone with a high risk of developing cavities will use different toothpaste than someone with gum disease. Since brushing alone only removes 25% of the bacteria in your mouth according to Listerine, it’s important to choose the right mouthwash for your needs. “Dental mouthwashes prevent tooth decay and gum disease because the essential oils in the mouthwash kill plaque bacteria and remove bacteria effectively while rinsing,” Dr Welgemoed, who is also a member of the Listerine Dental Academy, says.   

Your oral hygienist or dentist will be able to recommend the best products for you to keep your mouth healthy and disease free. 

This content was sponsored by Listerine and produced by BrandStudio.24 for Health24

Whoop whoop!!!

Heres to many more years of providing excellent info and to bringing Oral Hygienists together and to communicate under 1 umbrella.

And to the individuals who tirelessly devote their time so we can reap the benefits.

It is much appreciated.

Regards,

Anisa 

Happy 40th birthday OHASA! May we grow from strength to strength.

Best wishes

Keshree Naicker

Happy 40th anniversary Ohasa,work well done over the yrs . Looking forward to many more fabulous years.

Lots of love Natalie Taft.

Congratulations on the 40th Birthday OHASA! Well done for what you have accomplished in these years.

May we go from strength to strength.

Sanet

Happy 40th Birthday OHASA! Colgate wish you the happiest ever year!

Happy 40^th Anniversary!

Regards

Lynette Jacobs

Dear Practitioner 

TO: ALL ORAL HEALTHCARE PRACTITIONERS
(Dental Specialists, Dentists, Dental Therapists, Oral Hygienists and  Dental Assistants)

REGISTRATION OF UNQUALIFIED BUT EXPERIENCED DENTAL ASSISTANTS

The Professional Board for Dental Therapy and Oral Hygiene made recommendations to the Minister of Health that would allow for unqualified dental assistants, who have experience, to register with the HPCSA. The Minister of Health subsequently promulgated these Regulations on the 07 April 2017.

In terms of these regulations an experienced but unqualified dental assistant may apply to the HPCSA to be registered for a period of two years. The period of registration will be from the date of promulgation of the regulations and close six months later (07 April 2017 – 07 October 2017). Thereafter no new applications will be accepted, and any unqualified dental assistant will be required to complete a qualification via an accredited University of Technology.

It should be noted that this registration is limited to a period of two years, from date of initial registration. During this time the registered dental assistant will be expected to pay an annual fee, and to comply with CPD requirements. A requirement of such registration is that the dental assistant must, within a period of two years from date of registration, successfully complete a board exam. Failure to complete this exam will result in the registration of the dental assistant lapsing.  Dental assistants registered in this category will be afforded four opportunities to complete the exam. The Board has arranged that there will be four examinations a year, and that these examinations will be made available in all nine provinces.

An appeal is made to you to please share the information with all dental assistants, in light of the limited remaining three-month period.

The procedure for registration, and examination, is as follows:

Regards

Dr TA Muslim