Medical scheme access to clinical records

In terms of Regulation 15J(2)© of the Medical Schemes Act Regulations, a medical scheme is entitled to access any treatment record held by a managed health care organisation or health care provider and other information pertaining to the diagnosis, treatment and health status of the beneficiary in terms of a contract entered into pursuant to regulation 15A. However such information may not be disclosed to any other person without the express consent of the beneficiary. This entitlement is subject to the prescribed requirements for disclosure of confidential information.

Council advises practitioners to further obtain written consent from their patients to disclose confidential information.

Guidance provided here is not exhaustive and practitioners are advised to approach Council for further advice by directing an e-mail to Professionalpractice@hpcsa.co.za  for guidance on ethico-legal matters. 

Council commits to a turnaround time of 10 working days to respond to any request for advice and/or guidance through the e-mail provided above.