Board of Health Care Funders wins copyright infringement case

The Board of Healthcare Funders of Southern Africa (BHF) has won its court battle against Discovery Health Medical Scheme and Discovery Health Administrators in a copyright infringement case that had the potential of inflicting chaos within the area of payment of claims by medical schemes to health service providers and health facilities.

The North Gauteng High Court held on 15 May, 2012, that Discovery Health Medical Scheme allowed its administrator, Discovery Health Administrators to make use of BHF's intellectual property without authority. It did so to attempt to build an in-house system of its own.

BHF owns the copyright

The court held that the BHF owns the copyright in the Practice Code Numbering System (PCNS), which is the system used since the 1960s to generate and maintain practice numbers for health care practitioners and facilities. Used by all medical schemes and health care providers across the private health care industry, the PCNS ensures uniformity of claims and assists in protecting medical scheme members against potential fraud.

The BHF administers the allotting and maintenance of health care provider practice numbers through the PCNS system under strict conditions set out by the Council for Medical Schemes, one of which is that all users of the system contribute to funding it, and another is that the system is not for profit.

The potential liability of practices

"It is of utmost importance that the Boards of Trustees of medical schemes are aware of the potential liability of practices that they allow, either knowingly or unknowingly, not to pay the annual PCNS user fees," said Dr Zokufa, MD of BHF. "A cornerstone of their duties is to protect the scheme and the members of the scheme, and it is the members of the scheme who will ultimately have to pay the costs," he said.

Discovery Health Medical Scheme and Discovery Health Administrators have been interdicted from using the PCNS, and directed to deliver up all data bases, records and/or documents that incorporate the PCNS, which are in their possession or under their control. Discovery Health Medical Scheme and its administrator have also been instructed to pay royalties to BHF for the period 1 January to date, as well as the legal costs of the case.