In a survey of its members, the SA Medical Association (SAMA) said 76% of those who work with people injured at work will stop treating these patients if proposed new Compensation Fund rules take effect.
Most medical staff use companies that pay them upfront for treating IOD patients and then claim from the fund on their behalf in a process that sometimes takes more than a year, in some cases, up to 400 days. The Compensation Fund, which receives employer contributions, has a surplus, reports BusinessLIVE, despite receiving more than a decade of adverse audits.
But for two years and using three separate pieces of proposed legislation, the Fund has tried to outlaw the use of these companies, referred to as third-party administrators.
When SAMA asked its members why they used a third-party pre-funder, more than 87% said they do not have the time or resources to navigate the Compensation Fundʼs cumbersome and unreliable system, and said that claiming directly from the fund results in years of non-payment.
“Pre-funders also ensure that medical service providers are paid upfront, which provides critical cash flow alleviating the negative financial impact of waiting up to two years for the Compensation Fund to settle their claims,” Coetzee said.
Hughes said the Fund is frequently hauled to court by third-party payers who have not been paid and who then win their cases in court. He said he does not know why there have been three attempts this year to remove third-party administrators.
The auditor-general in 2021 told parliament it only audits the Compensation Fund as it is required to by law, and would not do so if it had a choice, as it has been unable to audit it correctly for more than a decade, due to missing information.
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