SAMA Coding

Verification of practice cost studies and 2010 RPL process 

According to the Department of Health (DoH) briefing session on Friday 6 February 2009 in respect of the disciplines/groups that were accepted following the 2008 cost studies, groups are now subjected to the verification process. The Department of Health has since entered into a Confidentiality and Non-Disclosure Agreement with KPMG in this regard to conduct the verification process that will also inform 2010 Reference Price List (RPL). Senior DoH officials have indicated that there is no need for an additional agreement between individual medical practitioners and KPMG or DoH. The National Department of Health explanation is that the Government is automatically bound by existing legislations on Confidentiality and Non-Disclosure agreements (NDAs) regarding the information they get from individuals in the course of the specific Government department's work. This implies that it may thus be superfluous to get individualised NDA's for each person, in this case each medical professional who provides information for the practice cost studies. While that is the DoH considered view based on input from the State Attorneys, concerned medical professionals are at liberty to either directly, or via their legal representative, engage with the DoH's attorneys on this issue. However, failure to participate in the verification process will delay the process and that will be to the detriment of specialists and general practice groups on developing alternative reimbursement and procedure coding models.

Also, of note is that each medical practitioner taking part in the Practice Costs Studies is specifically made aware that they may be selected for the audit and or verification process. Finally, medical practitioners are hereby reminded that these are "Practice-cost"-, NOT "Practice-income"-studies.

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