The High Court in Johannesburg has granted urgent interim relief to 3Sixty Health (Pty) Ltd, allowing it to continue operating on the same terms that applied immediately before its accreditation as a managed health care organisation (MHCO) expired on 25 April 2026.
An organisation providing managed care services to a medical scheme must be accredited in terms of Regulation 15B. 3Sixty provides services to Sizwe Hosmed Medical Scheme and the SAB Medical Aid Scheme.
It was common cause that 3Sixty submitted its renewal application to the Council for Medical Schemes (CMS) on 16 January 2026, more than three months before expiry, meeting the timing requirement in Regulation 15B(7). But its accreditation expired by effluxion of time on 25 April 2026.
The CMS indicated its board would decide the renewal application on 29 April 2026.
The judgment, delivered on 30 April, noted that concerns about 3Sixty’s affairs arose during 2024 and 2025, including a KPMG investigation and “reports generated in the context of curatorship and other regulatory oversight”.
As previously reported by Moonstone, Sizwe Hosmed was placed under statutory management in August 2024. The High Court placed Sizwe Hosmed under provisional curatorship in early September 2025 and appointed Lebogang Grace Mpakati as the curator. In February this year, the High Court cancelled Mpakati’s appointment and appointed Ian Fleming in her place.
Read: Sizwe Hosmed: High Court blocks board comeback, new curator installed
The Council for Medical Schemes (CMS) sent 3Sixty a letter dated 19 March 2026 raising concerns about whether it remained “fit and proper” and whether it had the systems, resources, skills, and capacity required for renewal.
In Part A of its two-part application, 3Sixty asked for two forms of interim protection:
- An order compelling renewal, or alternatively an order that would prevent the lapse from stopping it from operating while the dispute was dealt with.
- An order compelling the CMS to provide the material behind its concerns and to allow 3Sixty a meaningful opportunity to respond.
The CMS opposed Part A on several grounds. It said the matter was not urgent (or that urgency was self-created), that the application was premature because the board had not yet taken a final decision, and that 3Sixty had not exhausted internal remedies under the Medical Schemes Act read with section 7(2) of the Promotion of Administrative Justice Act (PAJA).
On disclosure, the CMS argued that 3Sixty was effectively seeking pre-litigation discovery and should use proper mechanisms if it wanted the documents.
What the Court decided
Judge Wilhelmina du Plessis said the urgent decision did not determine whether the CMS’s concerns were correct. The Court’s focus was whether 3Sixty was entitled to fair treatment – particularly disclosure and a real opportunity to respond – before the consequences of a delayed renewal decision took effect.
Regulation 15B(7) requires a renewal application at least three months before expiry. The Court read this purposively: the three-month window is meant to enable the CMS to request further information and to decide before the accreditation lapses, so that an MHCO is not left in a “legal vacuum”. That vacuum arose on these facts because accreditation expired on 25 April 2026, while the CMS scheduled its decision only for 29 April 2026.
Regulation 15B(3) provides that if the CMS considers other information about an applicant “derived from whatever source”, it may do so only if the information is disclosed and the applicant is given a reasonable opportunity to respond.
The Court accepted that the 19 March letter raised concerns but often in a way that did not allow a meaningful response without access to the underlying material.
The Court rejected the CMS’s suggestion that 3Sixty should simply use the Promotion of Access to Information Act, holding that Regulation 15B(3) itself places an obligation on the regulator to disclose the adverse information on which it intends to rely in the accreditation process.
It ordered the CMS to provide the documents and information “reasonably necessary” to enable a meaningful response within 30 days, and then (if still required) to allow 3Sixty an opportunity to respond of up to three months.
The CMS argued 3Sixty had to exhaust internal remedies first. The Court accepted that exhaustion is generally required where a completed decision exists and is being reviewed in the ordinary way. But at the time Part A was launched and argued, there was no final refusal decision to appeal, yet the harm from expiry would occur immediately.
In that posture, the Court held that section 7(2) of PAJA did not prevent it from granting narrow, interim relief to preserve the position while a procedurally fair process runs its course and a lawful decision is made – after which internal appeal remedies remain available.
The Court awarded costs against the CMS, including the costs of two counsel.
