eLearning Programmes and CPD Points
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eLearning Programmes and CPD points
LIST OF PROGRAMMES
1. History of the South African health system and medical schemes – 1.5 CPD points/hours

This programme takes a look at how the South African healthcare system and medical schemes have developed starting in the 17th and 18th centuries to the present. It is interesting to see the impact of apartheid and the move from community rating to risk rating of medical schemes, and then back to community rating. Enjoy the reading, and when finished, complete the assessment and print your certificate.

2. Tax implications for medical expenses 2020/2021 – 1.5 CPD points/hours

This programme will give you an understanding of the tax benefits allowable as per the Income Tax Act related to medical expenses. It includes the tax benefits that a taxpayer can claim as a rebate for medical expenses and medical scheme contributions incurred in the tax year, as well as expenses related to disability.

3. The Healthcare Market and Demarcation Regulations 2019/2020 1 CPD point/hour

This course will assist you in understanding the changes made to the Acts governing health insurance products and medical schemes, the reasons for the changes and the impact of the changes.

4. Medical scheme complaint resolution process 1 CPD point/hour

When you successfully complete this course, you will understand the correct process that must be followed when a member or a provider has a complaint against a scheme. The Act and the Scheme Rules dictate the process that must be followed.

Course outline:

  • Basic principles
  • Model rules
  • Principles of administrative justice
  • Cost-effective dispute resolution

5. The Structure and Functions of Medical schemes – 2 CPD points/hours

This programme is intended to people who would like foundational knowledge on how a medical scheme works. It covers –

  • The difference between a medical scheme and health insurance product
  • What a medical scheme is
  • The medical scheme benefit design
  • Roles and responsibilities of the different role-players
6. Series on the Health Market Inquiry Report Findings and Recommendations – 3 parts – 5 CPD points/hours for the three programmes

These programmes will provide you with an understanding of the Health Market Inquiry Findings and Recommendations for the medical scheme industry. This is the first of such an inquiry in South Africa, and took five years to complete by the Inquiry. It includes important and relevant findings and recommendations. The recommended Supply-Side Regulator is a proposed new body that will have, if implemented, wide powers. The recommendations for changes to medical scheme benefits, includes the proposed changes to the prescribed minimum benefit package and the introduction of a risk adjustment mechanism. Lastly, the governance programme addresses ways to improve medical scheme governance.

  1. Health Market Inquiry Findings and Recommendations on the Supply-Side Regulator of Health – 2 CPD points/hours
  2. Health market inquiry Findings and Recommendations for Scheme Benefits – 2 CPD points/hours
  3. Health Market Inquiry Final findings and recommendations report – governance – 1 CPD point/hour
7. An overview of Employee Benefits 1.5 CPD points/hours

This programme covers what Employee Benefits are, and how they can be structured.

8. The what, why and how of the proposed National Health Insurance Bill – 2.5 CPD points/hours

The Department of Health published in August 2011 the NHI Green Paper on its intention to change the current two-tier decentralised healthcare system to a National Health Insurance system. The 2 White Papers were published in 2017.

In 2019 the NHI Bill was published. This programme will provide you with an understanding of what the National Health Insurance Bill contains and how to interpret it.

9. Evaluating financial soundness of a Medical Scheme 2020 1.5 CPD points/hours

The Department of Health published in August 2011 the NHI Green Paper on its intention to change the current two-tier decentralised healthcare system to a National Health Insurance system. The 2 White Papers were published in 2017.

In 2019 the NHI Bill was published. This programme will provide you with an understanding of what the National Health Insurance Bill contains and how to interpret it.

10. Highlights of the Council for Medical Schemes annual report 2018/2019 1 CPD point/hour

This course is a summary of the Council for Medical Schemes Annual Report 2018/19 and includes statistics on:

  • Scheme number and size
  • Membership, and
  • Financial

11. Medical Schemes Underwriting 2020 1.5 CPD points/hours

This course will give you an understanding of the waiting periods and late joiner penalties that a medical scheme may apply according to the Medical Schemes Act No 131 of 1998 and its Regulations. The course includes examples of how the waiting periods and late joiner penalties are determined.

12. Understanding the Prescribed Minimum Benefits 2020 3.5 CPD points/hours

The Prescribed Minimum Benefits (PMBs) remains a vexing issue for medical scheme funders and providers, despite the recent proposed amendments to Regulations. This course will assist you in understanding the legislative requirements related to the PMBs and the interpretation and application of the law. The programme includes the PMB Review and the Health Market Inquiry Findings and Recommendations for the PMB basket.

13. Understanding the Role of Protocols for medical schemes and their beneficiaries 2020 1 CPD point/hour

At the end of this programme the learner will gain an understanding of:

  • what a protocol is
  • the role of a protocol in managing medical scheme benefits
  • the rights and responsibilities of the scheme in having protocols and making them accessible
  • the rights and responsibilities of the medical scheme beneficiary in providing clinical information to the scheme and the right to lodge a complaint/dispute
  • the impact of protocols on providers and patients

14. Medical Scheme Corporate Governance 11 CPD points/hours

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

FPI Approval No. FPI20060055

11 CPD 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

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.

15. Disrupting Prescribed Minimum Benefits 15 CPD Points/hours

Facilitated 2-day training programme using Microsoft Teams and supported with learning material and assessment on a eLearning platform

IHRM has developed a two-day Prescribed Minimum Benefit programme for call centre agents, brokers, case managers, fund managers, claims assessors, medical scheme trustees and principal officers. The Prescribed Minimum Benefits (PMBs) are a set of nearly three hundred defined benefits to which all medical scheme members are entitled, regardless of the option they have selected. The PMBs were first introduced when the Medical Schemes Act of 1998 was promulgated. The issues around payment and treatment related to PMBs remain vexing and are the source of most complaints received by the Council for Medical Schemes.

All our training is being facilitated via online Teams Meetings and supported by an eLearning platform. Contact us to schedule in-house training on training@ihrm.co.za

PMBs have not achieved what they were intended to do. The PMB basket is under review with a focus on primary healthcare. This programme looks at the current PMB basket, and the impact of the CMS Circulars and finding and recommendations of the Health Market Inquiry Report.

In December 2019 the CMS published Circular 80 informing the medical scheme and insurance industry that no Low Cost Benefit Option products will be allowed beyond 2021. This is in sharp contrast to Circular 18 of 2019 envisaging a low cost benefit package. Circular 82 published in December 2019 stated that no additional exemptions will be granted for the creation of products for the low income market segment.

Programme

Introduction to medical scheme benefit design

  • Benefit design
  • Medical scheme expenditure 
  • Rationale for the introduction of PMBs
  • What are the PMBs?
  • Underwriting in the context of PMBs
  • Exclusions – do they apply to PMBs?
  • The Diagnosis and Treatment Pairs (DTPs)
  • Entitlement to benefits for the DTPs.
  • Identifying ‘Emergency conditions’
  • Examining the Chronic Disease List
  • The implications of PMBs for medical schemes
  • The payment of PMBs
  • Proposed primary health care package
  • Products for low-income market segments
  • Health Market Inquiry – PMB findings and recommendations

Risk management for the PMBs

  • Managed care programmes
  • Standards for managed care
  • Designated Service Provider Networks
  • The PMB Code of Conduct 2017
  • The complaint resolution process to be followed by medical schemes, members and providers 

On successful completion of the online assessment a certificate of attendance will be issued.

CPD Points

The FPI has allocated 15 CPD points in total for this programme for attendance and successful completion of an assessment

FPI Approval number: FPI20030099 01 March 2020 - 01 March 2021

These programmes are on an eLearning platform that can be completed at a time and place that suits the learner. These short online courses are beneficial for people working for medical schemes, medical scheme administrators and managed care companies. It also caters to brokers that require CPD points/hours.


CPD points must be accredited by a professional body and be verifiable. Our programmes are accredited by FPI (Financial Planning Institute). For more information on the CPD cycle and on support material on the Regulatory Examinations.

Change to CPD Cycle due to COVID-19

  • FSCA Communication 9 of 2020 - Impact of COVID-19 on Compliance with various regulatory requirements

The 2019/2020 CPD Cycle - Key individuals and representatives are granted an additional 3 months until 31 August 2020 to meet the CPD requirements for this cycle.


The 2020/2021 CPD Cycle - The CPD requirements for this cycle will start on 1 September 2020 and ends on 31 May 2021. The CPD hours will be calculated on a pro-rata basis

CDP Registration Form 2020

FSCA FAIS Notice 17 of 2020 - CPD Requirements for 2021 CPD Cycle 


The CPD Points/hours have been pro-rated for the 2021 cycle.

  • Regulatory examination preparation for brokers
FSCA COMMUNICATION 9 OF 2020 (GENERAL) - Supervision

Passing the regulatory examination is a requirement for FAIS compliance for all representatives and key individuals. You need to demonstrate knowledge, understanding and application of the FAIS Act. The pass mark is 65%.

IHRM does not provide facilitation for the regulatory exams as there are excellent resources that we have included below. These are free for self-study purposes.


Note: The relevant Board Notices and Legislation per the Financial Sector Conduct Authority (FSCA) Preparation Guide below must be downloaded and studied in preparation for the relevant Regulatory Examinations.

FAIS Act

You should read the Act a few times and reference it when you are studying the preparation guide.


You can access the FAIS Act from the FSCA’s website:

FSCA's Website

FSCA Board Notice 194 of 2017


This board notice sets out updated competency, experience and training requirements.

FSCA Board Notice
FSCA Preparation Guide

This is provided by the FSCA and has proven to be an excellent resource in preparation for the exam. We recommend that this is used as your primary resource in addition to the Act. Please note that the amended services under Supervision exemption was published in December 2018 and comes into effect on 1 February 2019. As a result the exam questions will be slightly affected. Therefore there are two versions of the Preparatory Guide

FSCA COMMUNICATION 9 OF 2020 (GENERAL) - Supervision