Competition Act, 1998 (Act No. 89 of 1998)

Notices

Notice in terms of Section 10(7) of the Competition Act, 1998 (As Amended): Day Hospital Associaiton - Conditional Exemption Granted

Annexures

2. Conditions
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2.1. Transformation Conditions – Ownership; Enterprise and Supplier Development; and Skills Development

 

2.1.1. The DHA Members shall commit to taking active steps in achieving overall transformation including, but not limited to, the transformation of ownership structures to enhance participation of HDIs in the market for Day Hospitals.
2.1.2. The DHA members shall commit to procuring a proportion of their centralised procurement spend from BBBEE entities in line with the targets set out in Table 1 below.
2.1.3. The DHA members shall mobilise resources for expanding the existing human capital pool through investing in people, employment equity, skills development and institutional transformation in line with the targets set out in Table 1 below.

 

N1977 Annex 1 Table 1

 

2.2. Dual Membership

 

2.2.1. Each member of the DHA participating in the Exemption as granted, must cease all affiliation and membership from the NHN by 31 December 2022.

 

2.3. Collective implementation of prices, collective bargaining and global fee negotiations

 

2.3.1. There shall be no co-ordination or information exchange in relation to prices charged or price increases between DHA members. All information required to be shared will be submitted individually and directly to DHA.
2.3.2. When entering into global fee arrangements the DHA will ensure that:
2.3.2.1. All carve-outs or exclusions in relation to this ARM method shall be limited and global fees are to be negotiated on the premise of full risk sharing between the medical aid schemes and administrators and the providers of healthcare services.
2.3.2.2. The negotiation of global fees agreements shall specifically incorporate clearly defined quality and performance metrics which shall be transparent, and evidence based.
2.3.2.3. The DHA shall, as part of its general annual reporting condition below, report on all global fees that were negotiated annually.

 

2.4. Annual Submission of Information

 

2.4.1. The DHA is required to submit a report to the Commission by the end of June annually, commencing at the end of June 2023. This will enable the Commission to monitor the impact of the measures taken to meet the objectives relied upon and to assess whether the DHA is meeting those objectives on an on-going basis. The information to be submitted to the Commission in respect of each member of the DHA may be in table format and must include the following:
2.4.1.1. Prices negotiated and agreed with medical schemes and medical scheme administrators;
2.4.1.2. Data regarding centralised procurement of products and/or service. The data must include inter-alia, products and/or service procured, list of service providers utilised including the percentage of service providers which are
(i) SMMEs; and
(ii) firms owned by HDIs appointed as part of the centralised procurement leg of the exemption and in line with the Transformation Condition in 2.1 above;
2.4.1.3. Full details on the number of global fee arrangements the DHA has entered into. This must include but not be limited to the following: the parties to the agreement; the structure of the agreement; details on risk sharing between medical schemes and service providers; the carve-outs or specific exclusions from the global fee arrangement as well as justification for why the carve-outs are necessary; clearly defined quality metrics which are applicable to the agreements; and copies of all agreements;
2.4.1.4.The number and identity of new members who joined the DHA within the preceding year;
2.4.1.5. The annual turnover of each DHA member, accumulated within the preceding year;
2.4.1.6. The number of employees of each DHA member;
2.4.1.7. The number of DHA members that qualify as Historically Disadvantaged Persons (“HDP”) in terms of section 3(2) of the Act;
2.4.1.8. The number of DHA members that qualify as small businesses in terms of the National Small Business Act 102 of 1996 (“NSB”). This includes DHA members who meet each individual requirement and DHA members who meet the collective requirements;
2.4.1.9. The steps taken and milestones achieved towards attaining the overall transformation goals as set out in 2.1.1 above;
2.4.1.10Full details on the number on the milestones achieved and objectives reached in line with the targets for Skills Development as set out in 2.1.3 and Table 1 above;
2.4.1.11The number of new facilities opened by each DHA member and / or expansion through an increase in the number of hospital beds;
2.4.1.12The number of DHA members that are part of any Designated Service Provider arrangements concluded with medical schemes / administrators; and
2.4.1.13The expansion of product / service offerings to patients by each DHA member and the name of the product or service.

 

2.4.2. In addition to the above, DHA must during the period of the exemption, implement competitive strategies aimed at providing additional services to its members outside of the collective bargaining process. The purpose of this condition is to provide ongoing support to members, in order to improve their competitiveness in the market. The services to be provided to the aforementioned members must include but not be limited to:
2.4.2.1. High level feedback providing insight into industry trends and economic factors which may affect the operation of the member facilities;
2.4.2.2.Detailed feedback on Alternative Reimbursement Models (“ARMs”) entered into with the medical aid schemes and the constitution of such ARMs enabling member facilities to better manage the costs of the procedure and maximise profits;
2.4.2.3.Feedback and training on the tools available to assist in managing facility(ies) optimally;
2.4.2.4.Assistance and training on submission of claims and support on technical claims issues;
2.4.2.5. Detailed feedback and training on managing cost efficiencies and quality control measures including benchmarking; and
2.4.2.6. Operational meetings held with medical schemes and/or administrators in which problem areas and / or trends are identified and discussed and approaches to resolve any issues are concluded.

 

2.4.3. The above mentioned services are to be provided to members through one or combination of the following platforms:
i. Regular workshops hosted by the DHA;
ii. Information manuals provided to members;
iii. Onsite training sessions held at the facilities of the members;
iv. Newsletters produced by the DHA; and
v. Email and telephonic support made available to members and their staff members.

 

2.4.4. The DHA must implement measures to track the number of members whose competitiveness has improved as a result of the implementation of the aforementioned exemption and conditions. These documents and/or information must be submitted to the Commission by the end of June annually, commencing at the end of June 2023.

 

2.4.5. The compliance report(s) must be submitted to the following email address [email protected]