THE results of a survey conducted by the South African Medical Association (Sama) indicate there is a significant risk that doctors will have no choice but to opt out of treating workers injured on duty if the Compensation Fund proceeds with recently published regulations.
The regulations, gazetted on 19 October and open for public comment, will force doctors to deal directly with the Compensation Fund to be paid for treating injuries on duty (IODs).
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Currently, doctors and other medical service providers use third party pre-funders or administrators due to the fund’s chronic dysfunctionality and the high risk of non-payment of invoices.
While 76% of doctors who completed the survey treat patients who are injured on duty, 82% said that if the regulations take effect, they will have no choice but to stop treating these patients.
Sama and its members are calling for the regulations to be immediately withdrawn, and have joined employer representatives, unions, and groups representing injured workers in opposing the proposed regulations.
Sama chairperson Dr Angelique Coetzee said 93.15% of all those surveyed want to see the Compensation Fund withdraw the regulations with immediate effect so doctors and medical service providers can continue working with efficient third party administrators and
pre-funders.
‘This is the only part of the entire Compensation Fund process that works, so it is utterly incomprehensible that the commissioner would even think of meddling with it.
‘These regulations are a travesty, not only for medical practitioners, but most importantly for vulnerable injured workers who need to be able to access the best care when they are hurt at work.
‘Any regulation that threatens workers’ ability to access medical care when they most need it, should be rejected outright.’
Third party pre-funders or administrators critical
When Sama asked respondents what their main reason was for using a third party pre-funder or administrator, more than 87% said they don’t have the time or resources to navigate the Compensation Fund’s cumbersome and unreliable system, and said claiming directly from the fund results in years of non-payment.
‘The only way a medical practice can remain viable is when it is paid for the critical services it renders,’ said Coetzee.
Pre-funders also ensure medical service providers are paid upfront, which provides critical cash flow and alleviates the negative financial impact of waiting up to two years for the Compensation Fund to settle their claims.
‘Doctors legally cede their invoices to the pre-funders and receive cash upfront. The pre-funding mechanism allows them to manage their practices’ cash flow and ensure their sustainability.’
‘It is critical to note that Sama will continue to engage the Department of Labour and Employment to find ways to improve the system for all stakeholders, specifically the medical professionals who we represent, the patients who stand to take the brunt of the proposed changes.
‘Sama understands that these changes will affect all stakeholders interacting with the COID system. Our survey clearly shows that patients will suffer directly if these regulations are approved,’ she concluded.
