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Rare Diseases South Africa

@rarediseasessa

We're bridging the gap to improved quality of life, for a better tomorrow, for the #1in15 South Africans affected by rare diseases.

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linkhttp://www.rarediseases.co.za calendar_today27-02-2013 13:50:06

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J Swanepoel asks specifically where in the Scheme ruses it states it won’t include provisions for PMBs to which Adv Kromhout responds that he would need to check. #DeWetVsMedihelp Break for brief adjournment.

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Medihelp argues the Scheme rules must be considered, but J Swanepoel is asking why its relevant if the MSA overrides the scheme rules. #DeWetVsMedihelp

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This is a matter of law. The reasons we are here for re-consideration are because Zachary is receiving donated doses of Elaprase WHICH HE ONLY RECEIVED when Medihelp stopped complying with the Millar’s order.

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The affidavit confirming that Zach does not ordinarily qualify for compassionate stock, and has only been granted this approval as an exception. #DeWetVsMedihelp

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Medihelp first argued that Millar’s order only was in effect until will we “filed a complaint,” and then subsequently changed to “excludes part B” of the process.

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Judge Munzelele gave an order affirming J Millar’s order, and Medihelp then chose to appeal that decision, and that became the basis to not comply with J Millar’s order. #DeWetVsMedihelp

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The fact of their non compliance of J Millar’s order is the reason for Zachary getting access to compassionate stock. #DeWetVsMedihelp

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#Polmed ruling did not deal at all with issue raised by Medihelp in the current matter. J Millar confirmed that it was not relevant to this matter. Yet, Medihelp argues that this is RDSA / DE WET ”creating an impression“ at this court.

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It Is because PMBs are a matter of public policy states that whatever Scheme Rules say, must exclude PMBs Provisions are mandatory. #DeWetVsMedihelp

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If we find ourselves in a situation where a Medical Aid is no longer mandated to fund PMBs based on Solvency, we will find ourselves in troubled waters #DeWetVsMedihelp

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The CMS Code of Conduct is NOT law, Nor is it a regulation. Medihelps reliance on the Code of Conduct and its development by “major stakeholders” is irrelevant. #DeWetVsMedihelp

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RDSA requested an undertaking from Medihelp asking them to cover the other PMB costs, outside of Elaprase, going forward whilst this matter continues, which was then declined by Medihelp. #DeWetVsMedihelp

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The legal principle is quite clear: you can not request a reconsideration of an order that is currently not being complied with. #DeWetVsMedihelp

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Adv Kromhout is citing the instances where RDSA / De Wet have “creating an impression” with order J Millar, and reiterates it is Medihelps understanding. No quote confirming our use of word ‘Funding’ is given,merely only us using ‘accessible,’ ‘treated with’ etc #DeWetVsMedihelp

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Adv Kromhout now dealing with the payments - J Swanepoel directly asked Medihelp to show what has actually been paid for. #DeWetVsMedihelp