Apparent confusion about whether or not practitioners are allowed to disclose a patient treatment record to his or her medical scheme was cleared by Health Professions Council of SA (HPCSA) registrar, Dr Raymond Billa, at the IPAF Mini-Conference in Durban last week when informing delegates that doctors were required by law to release this information.

In terms of Regulation 15J(2) of the Medical Schemes Act Regulations, he noted, 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: “This is in terms of a contract entered into under regulation 15A.”

Stressing, however, that such information may not be disclosed to any other person without the express consent of the beneficiary, this entitlement, Billa added, was 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 under the aegis, in turn, of the HPCSA.

“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.”