Medscheme says the Council for Medical Schemes (CMS) has expanded its investigation into Bonitas’s procurement processes to include the medical scheme’s most recent appointment of Momentum Health as administrator and Private Health Administrators (PHA) as its managed-care provider.
Bonitas, on the other hand, has labelled this as “misinformation”.
“The Council for Medical Schemes has not contacted the scheme regarding any formal expansion of the scope of its section 44 investigation,” Bonitas said.
The announcement came as the Medscheme withdrew its High Court application seeking to halt implementation of those appointments, saying it had accepted the CMS’s written assurances “in good faith” that the information and evidence it had submitted in the litigation, together with the latest procurement processes, would now form part of the regulator’s investigation.
Until now, the CMS’s section 44 investigation had centred on two earlier procurement processes – Bonitas’s 2022 appointment of PHA to administer its BonCap option and the 2024 award of its marketing, sales, and distribution contract to Agile Business Solutions. Both the CMS and Bonitas had previously said the later appointments of Momentum Health and PHA fell outside the scope of that investigation.
According to Medscheme, the CMS has now provided written assurance that it has “expanded its current investigation relating to prior tenders to include the most recent tender processes”.
However, in response, Bonitas noted that although the CMS investigation into earlier 2022 and 2024 tenders remain ongoing, both the regulator and Bonitas have previously confirmed that the more recent appointments of Momentum Health and PHA fall outside that investigation’s original scope.
“Despite the impression that may have been created, Bonitas is not aware of any change in the regulatory status. Bonitas remains fully committed to co-operating with the CMS with respect to all lawful regulatory matters,” Bonitas said.
Medscheme launched the High Court application in December last year, seeking to prevent Bonitas from implementing the new administration and managed-care contracts until the CMS had completed its investigation. The transition nevertheless went ahead on 1 June while the litigation remained unresolved, after which Bonitas, Momentum Health, and PHA dealt with significant operational challenges during one of the largest administrator transitions in South Africa’s medical scheme industry.
Having accepted the CMS’s assurances, Medscheme said it would now allow the regulatory process to take its course.
“We now look to the CMS to speedily conduct its investigation and to apply appropriate sanctions, should this be aligned with its findings,” the administrator said.
How the dispute reached this point
The CMS launched its section 44 investigation in late 2025 after a preliminary inquiry into Bonitas’s procurement processes. Initially, the investigation focused on two earlier procurement decisions – Bonitas’s 2022 appointment of PHA to administer its BonCap option and the 2024 award of its marketing, sales, and distribution contract to Agile Business Solutions.
Around the same time, Medscheme approached the High Court seeking an urgent interdict to preserve the status quo by preventing Bonitas from implementing its newly awarded administration and managed-care contracts until the CMS had completed its investigation.
When Moonstone asked the CMS in February whether the investigation should delay those appointments, the regulator drew a clear distinction between the two processes. It said the investigation related to the earlier procurement decisions and did not consider it appropriate for Bonitas to postpone appointing new service providers while the investigation continued.
Read: Bonitas’ dispute with Medscheme heads to court
Bonitas likewise maintained that the appointments of Momentum Health and PHA resulted from a separate procurement process that fell outside the scope of the section 44 investigation.
The litigation itself, however, soon encountered delays. In March, the application was removed from the urgent roll by agreement between the parties after becoming bogged down in procedural disputes, with the expectation that it would later be specially allocated for hearing once the outstanding interlocutory issues had been resolved.
As a result, the case was never heard on its merits before the planned implementation date.
Read: Bonitas-Medscheme court battle stalls as application removed from urgent roll
Bonitas said the application had never been genuinely urgent, noting that it was removed from the urgent court roll in March 2026 and that, once the transition to the new service providers was implemented on 1 June, the interdict sought by Medscheme had become moot. The scheme described Medscheme’s withdrawal as a “capitulation”, alleging that the administrator was unable to produce evidence of the alleged wrongdoing in the court proceedings.
Bonitas also questioned Medscheme’s motives, arguing that it was seeking to protect its commercial interests after losing contracts worth about R1.8 billion a year. The scheme said the litigation had resulted in unnecessary legal costs borne by members and that it would seek legal advice on recovering those costs.
A difficult transition
Even while the litigation remained pending, Medscheme said it accelerated planning during April for a responsible wind-down of its services should Bonitas proceed with the transition.
Bonitas proceeded with the transition on 1 June, ending Medscheme’s 44-year role as administrator. The changeover was followed by widespread operational disruption, with members reporting difficulties obtaining hospital and specialist authorisations, accessing chronic medication, reaching support channels, and using digital platforms. At the time, Medscheme said it had repeatedly warned against a “clean-cut” transition, while Bonitas attributed many of the problems to unresolved legacy matters and data anomalies identified during the handover.
Read: Bonitas members caught in service disruption after administration switch
Read: Medscheme rejects Bonitas’s explanation for post-transition disruptions
The transition also prompted further engagement from the CMS. In response to Moonstone’s questions in June, the regulator confirmed that it had engaged with both Bonitas and Medscheme regarding the operational challenges. It said Bonitas had submitted a recovery plan and indicated that “the plan appears to be bearing fruit”.
Read: CMS reviewing Bonitas complaints, says recovery plan appears to be bearing fruit
This week, Medscheme said it had anticipated the complexity of what it described as South Africa’s largest administrator transition and had recommended a phased approach to ensure authorisations and claims payments continued uninterrupted, arguing this would have been in the best interests of Bonitas’s members and healthcare providers. It said Bonitas rejected the proposal and proceeded with the transition on 1 June without explaining its reasons.
Responding to criticism of the post-transition difficulties experienced by some members, Bonitas said operational stability has now been achieved. It said additional capacity has been deployed across key service areas and that backlogs in claims processing, oncology authorisations, and medical savings account refunds have been cleared.
Attention shifts to the regulator
Meanwhile, attention increasingly shifted from the court proceedings to the CMS investigation.
According to Medscheme, the CMS initially decided to pause its investigation while the court application was under way because it did not wish to become involved in what it regarded as a commercial dispute.
The administrator said it wrote to the regulator, emphasising that the court application was intended to preserve the status quo pending the CMS investigation and that the two processes were complementary rather than mutually exclusive.
The parties exchanged further correspondence throughout June. According to Medscheme’s timeline, the CMS confirmed on 19 June that a regulatory enquiry and inspection remained under way.
Medscheme subsequently wrote to the regulator recording its understanding that the investigation would include the 2025 procurement process, before the CMS confirmed on 30 June that the information already provided by Medscheme was being considered as part of its assessment.
By then, however, the contracts had already taken effect. Medscheme said the written assurances it had received from the CMS meant it would withdraw the litigation and allow the regulatory process to continue.
The dispute now moves to the regulator
Although the transition to Momentum Health and PHA has already taken place, the procurement and governance questions that gave rise to both the litigation and the CMS investigation remain unresolved.
The High Court never reached the stage where Medscheme’s allegations of procurement irregularities, governance shortcomings and conflicts of interest could be tested. Bonitas has consistently rejected those allegations, maintaining that the procurement process was independently conducted and lawfully concluded.
“Medscheme’s evidence-backed allegations against Bonitas and PHA remain unanswered. This evidence has not been examined or challenged in court,” the administrator said.
According to Medscheme, however, the work done during months of litigation will not be lost. It says the written assurances from the CMS mean that the information and evidence assembled for the High Court proceedings – including affidavits, supporting documents, and other material relating to the procurement processes – will now be considered as part of the regulator’s ongoing investigation.
Rather than starting afresh, Medscheme says the CMS will be able to build on the material already before it. The administrator said this “paves the way for the CMS to continue to pursue its investigation to the fullest extent” and added that it is “encouraged that the CMS has the authority and power to examine Bonitas’s records and internal documents to the fullest extent it deems necessary”.
Bonitas reiterated this week that every decision relating to the appointment of Momentum Health and PHA was taken in the best interests of members and in accordance with its procurement processes.
It said independent reviews had been conducted to provide additional oversight and added that its 2025 annual financial statements were approved without qualification. According to Bonitas, its auditors also conducted a value-for-money review of the new contracts and confirmed that they had been concluded at arm’s length.
Moonstone has asked the CMS to confirm whether the scope of its section 44 investigation has formally been expanded to include the procurement process that resulted in the appointments of Momentum Health and PHA.
As a member I have been extremely disappointed with the transition. The reports and their content are normally longer as informative as before and certain key information is missing in the new member zone. All the means of communication telephone; WhatsApp and email queries are almost impossible to get a satisfactory response from.
Value for money review stands out. Who benefited from the changeover. It definitely wasn’t the members. We are still trying to come right.
Medscheme was a nightmare for me who was suspended monthly because my account that was always in arrears. I was in contact telephonical and emails with Medscheme administrators monthly and they had to lift my suspension. When Momentum took over I found I was actually in credit of one month. Also never received a monthly Statement from Medscheme where as now with Momentum I received it monthly. I still have all correspondence as evidence.
My claim was forwarded since 2024,not settled yet. Am still waiting. So exhausting. I’m hoping it will be settled soon.
Suddenly my mother’s payments can’t be found in the system, even though we have proof of the payments..
Bonitas/Momentum has suspended her membership… she’s been a member for over 15 years.
We’ve tried everything to no avail
Bonitas sucks as well as the recent letter published by it’s head honcho. Blah, Blah, Blah, all hot air just like several of the South Afican politicians. It will take a miracle at least for this company to ‘come right’
This is a transition that could have taken place in stages or option by option. This is a total nightmare. Paying members now have to protect their good names by doctors and hospitals for unpaid bills due to this transition. Their WhatsApp lines and telephone lines are a nightmare you hold on for hours WhatsApp Dr B can only answer certain questions what a total waste of time for paying members. Pathetic, ridiculous that we as members have to go through this because Bonitas didn’t do their homework for a smooth transition. Get more staff and get those bills paid of members!!! Chronic baskets cancelled and we have to fight to get service. Members are put on chronic meds for a reason so should patients loose their lives first .
WHY WAS WE AS MEMBERS PAYING FOR A SERVICE NOT INFORMED….THIS IS SO UNPROFESSIONAL GOING 2 CHANGE, PAY NEARLY R6000 ONLY FOR ME AS MAIN MEMBER, FOR WHAT…WAS WITH BONITAS, WENT OVER TO DISCOVERY, NOT GOOD, BACK TO BONITAS, NOW IT IS A JOKE (💩 SHOW)‼️‼️‼️
I must say IWork for medschdme as well and as staff we had a direct line it was better always available and queries was resolved now you ask for information you don’t get it I ask for the chronic medicine list still waiting no response
I was recently admitted and had an emergency operation. Both the surgeon and the physician have not been paid in full. What happened to Bonitas’ 100% hospital cover? The statement shows that some of the hospital treatment was deducted from my daily savings account. Why? Doctors are going to turn us away with this nonsense you’ve created for us. Please fix this.
I must be in the 0,3% with a claim not dealt with stipulated times? Now a month since I first submitted it, I resubmitted 11 working days ago. I’ve followed up to claim queries and keep setting reference numbers but the claim does not appear under my claim history. Yesterday I got a rate the service mail for that query… I rated it 1 out of 10 as zero had happened with it.
I phone Bonitas more than a month back to get authorisation for a Cpap machine for my husband. They say wait 2 weeks, its already more than a month. No feedback.
If we can just get feedback or a mail from Bonitas to tell us whats going on with this medical aid. We pay our medical aid but are in the dark when you go to doctors and received bills that medical aid not paid.
As clients we need not to be treated this way
Bonitas is becoming the worst medical aid. For severs provider’s is nightmare to work with. Claim’s not paid not to mention to get hold of them and if you speak to agent it is speaking to a child they can’t help you or understand you after holding on for ours on the phone. I work for a practice of 10 Doctors and we Really need help it can’t go on like this our Bonitas patients are very very angry.Bonitas are going to loose all their clients and it’s very sad they was very good medical aid.
The transition to the new administrative is really bad Hospital is 100% with the new administrative everything is payed for the saving Why? And when you do complain it falls on deaf ears.
Medical aid savings upon change of medical aid promised by end May 2026… to date, zilch took place!
A serious mess that must resolved ASAP.
Concerned member
I had a fremure operation on 11/6/26
.I need homecare assistance.Bonitas asked me a referral from the Orthopaedic.It was sent to them on 8/7/26.but to no avail.I urgently need a physiotherapist and pain care.
Working in the industry for years, the administrator that takes over are dependant on the data provided as part of the take on. If I had to analize the situation, I suspect the data to continue the process was provided too late and incomplete to the new administrator…Just my opinion.
I am very upset. When I went to clicks they inform me that I haven’t ha ve any day to day funds.
I did receive June statement that show I have 11000 still available
What happen to my funds?
I called requesting a letter confirming we are on medical aid as we were traveling overseas for 2 weeks.
I was told a specialist would call me within 2 days and I should look out for the call.
I am back 2 weeks and to date no specialist called me.
Previously when we travelled out of the country, I would call , gave the information on the phone and I would receive an email confirming we belong to the medical aid.
My colleagues are all complaing about their claims.
I am a member since 1999
ĹI called requesting a letter confirming we are on medical aid as we were traveling overseas for 2 weeks.
I was told a specialist would call me within 2 days and I should look out for the call.
I am back 2 weeks and to date no specialist called me.
Previously when we travelled out of the country, I would call , gave the information on the phone and I would receive an email confirming we belong to the medical aid.
My colleagues are all complaing about their claims.
I am a member since 1999
Since the 1 st of June I did not get any feedback if and when any claims of mine were processed ! I queried it several times and every time got an automated reply with a reference number and promise of feedback within a specific time period.
Needless to say that none of this is happening !
Now , a couple of days after treatment, I do get notifications of claims processed and or paid ! It though does not state whether it was paid from my savings account or in case of chronic medication from the other benefits . How does one ensure if it is being paid correctly as there is no way to tell ?
How does one make sure that no false or incorrect claims are being processed ? I never had this problem with Medscheme, They were punctual and effective.
Will this ever come right ?
I am also very disappointed with Bonitas at this moment. I claim was submitted for the 16th and for the 25th of May has not been paid to service provide and yet they sent her remittance sometime before the end of June for the paying but no payment was made into her account my statement. I have been going to this lady since February not once has she ever called me about not being paid and funds were available and you insist she was paid why would she start lying now. Your app does not help much you can’t even see how much you have left, phones never get answered you hold on forever and when you get through you are told a specialist will get back to you and no specialist got back to me. You also denied a hospital authorisation at some point it had to be requested by the Dr again . I regret that I did not change medical aid last year even worse changed from primary to standard I could kick myself right now.
Really emotionally drained over the way Bonitas has made decisions .
We worked hard for this brand and put it on the Map.Blood sweat and tears and then discarded without a second thought.
Our hearts still bleed for this brand💔
I feel sorry for Bonitas members, it’s going to be a bumpy ride from now on, I know this because my current medical aid was at the same position.
It is virtually impossible to contact Bonitas with any request.
I requested ” Detailed Tax Report by Beneficiary “, in order to balance/ verify the details on the Bonitas Tax Certificate, to answer any SARS efiling queries.I ask and receive this document every year. I am now told that this document is not available and that’s that. I tried to open my Bonitas app to obtain further info. Totally without success. It is virtually impossible to speak to anyone at Bonitas by telephone- you are on hold for hours , even days ( if you have enough airtime) and still are not answered.Still waiting to talk to the agent you are being put through to.
The Principal Officiers lengthy article is a complete fabrication- nearly everything positive thing he Says is actually the opposite experience.!!
FRUSTRATED MEMBER.
I am also going through hell with Bonitas over a refund that has been approved and I am still waiting for. Yet no one offers any suggestion on how and when thousands of us affected by this shocking service or lack of service from Bonitas will be attended to. CEO and management still earning a whack whilst we get whacked financially. Can someone tell us how our issues will be resolved and when. They have taken our money, they must be held accountable.
This is disgusting,unprofessional,lack of consideration,and a HELL of a MESS we as members has to first DIE!!!! For the lack of communication of this supposedly PROFESSIONALS MY FOOT!!!…I have been a member with Prosano for plus minus 25years with no
Problems when this Bonitas took over.. and slowly I noticed tiny changes taking place but gave them the benefit of the doubt..Another 15yrs plus with Bonitas and THIS HAPPENS..I too sent them an email 8working days for some info on my savings was given a ref.No: and a “Specialist” will contact me in 3days Time it’s 5days over due and am urgently need to speak to an competent person if any..the way it goes on now if ever..I will give it one more shot at it….then wait and see…HAD TO LET MY WIFE HELP YOU WITH THE TRANSITION SHE IS GOOD AT IT..She sold three houses and she looked and bought another no hiccups..amongst all the many succeful transitions she made in our
55 yrs of marriage…Sending another URGENT email tomorrow.