Medical Schemes Corporate Governance on-line programme

We have many examples of failings in corporate governance and their negative impact on any business, its clients and partners. Medical schemes are no exception. The medical scheme industry collects over R170 billion annually in contributions and is a not-for-profit business that needs to be managed in the “best interests of members”. The high number of medical schemes placed under curatorship is but the tip of the iceberg of an indication of corruption within the industry.

This online programme provides guidance as to what the rights and responsibilities of all the parties in managing a medical scheme are, ensuring that you are not on the wrong side of the law.

This course is for anyone working in the medical scheme administration and managed care environment who require understanding of governance requirements, including:

  • Trustees
  • Principal Officers/CEO of medical schemes
  • Fund managers
  • Managed care employees
  • Brokers

Each module will take about one hour to complete

Total cost for the eleven modules: R4 000.00 excluding VAT

Download  the registration and once complete email it to info@ihrm.co.za

Debbie Pearmain has developed this course in collaboration with IHRM. She has worked in the health care industry for over 20 years. She has a BA LLB from WITS and an LLD in health law from the University of Pretoria. She has worked in the private hospital industry and the medical schemes industry. She also worked at the National Department of Health for a number of years and was responsible for the drafting of various health legislation. She lectures at the WITS Business School on corporate governance for medical scheme trustees. The Minister of Health has at various times appointed her to the Council for Medical Schemes, the medicines pricing committee and the Ministerial Advisory Committee on National Health Insurance. She was the legal advisor to the Minister of Health before starting her own consultancy five years ago. She is the co-author of the textbook Foundational Principles of South African Medical Law and the author of the Law of Medical Schemes in South Africa.

FPI CPD Hours:

FPI Approval No. FPI19060063

11 CPD Hours (9 CPD Points/hours | 2 Ethics & Practice Standards CPD Points/hours) 

Module 1 – What is a medical scheme?

  • What a medical scheme is
  • What are requirements for registration
  • The governing body of a medical scheme
  • Medical Schemes Amendment Bill
  • Appointment and election of trustees under the MSA

Module 1 can be done free. Download the registration form here and email it to info@ihrm.co.za

Module 2 – Business of a medical scheme

  • Business of a medical scheme analysed and discussed
  • Comparison of a medical scheme to a company
  • Accountability of medical schemes, boards of trustees and CEO/PO
  • Introduction to the Registrar and Council for Medical Schemes
  • Introduction to King IV and accountability
  • What is a fiduciary duty?

Module 3 – The Council for Medical Schemes and the Registrar

  • What is the Council?
  • Functions of the Council
  • Powers of the Council
  • The Registrar of Medical Schemes
  • The relationship of the Registrar to the Council

Module 4 – The King IV Code

  • Introduction
  • The six capitals of business
  • Apply and explain
  • The founding values of corporate governance
  • The seventeen principles of King IV

Module 5 – The Medical Schemes Act

  • The specific duties of Boards of Trustees
  • The general duties of Boards of Trustees

Module 6 – What does “fit and proper” mean?

  • The Medical Schemes Act
  • The nature of the roles
  • What is “fit and proper”?

Module 7 – The nature and importance of Medical Scheme rules

  • What the rules must contain
  • The nature of the contract
  • Termination of membership

Module 8 – The rights of medical scheme members

  • The right to benefits
  • Judgements on Appeals
  • Termination of membership

Module 9 – Medical scheme relationship with brokers

  • Definitions
  • References to the Medical Schemes Act and Regulations
  • The provisional report of the Health Market Inquiry

Module 10 – Medical schemes relationship with healthcare providers

  • Designated service providers
  • The nature of the relationship
  • Judgements on appeal

Module 11 – Prescribed minimum benefits

  • What are the PMBs?
  • Review of PMBs by CMS
  • Management of PMBs
  • Judgements on Appeals

Training Date: 5/27/2019

Date: 5/27/2019