Did medical schemes fail members during pandemic? – BHF denies CMS assumption

Last week the CMS shared their concern that a significant number of schemes, which account for nearly half of the medical scheme population, have not applied for exemptions to regulations from the Council. “Medical scheme beneficiaries have been denied of this relief despite extreme COVID-19 conditions and their schemes seem not to be acting in their best interests. As such, the CMS will continue to monitor this inaction in the interest of protecting medical scheme members,” a CMS circular reads.

Following the release of the circular, the Board of Healthcare Funders (BHF) said the CMS accusation that its members were “denying beneficiaries relief despite extreme Covid-19 conditions” was incorrect and unfair. In an interview, Dr Katlego Mothudi Board MD of BHF spoke to eNCA on what medical schemes are doing to help their members and to mitigate the impact of the pandemic, in light of the rise in the number of Covid-19 infections that poses such a big challenge for healthcare providers.

In the interview Dr Katlego Mothudi explains the organisation approached the CMS at the beginning of the pandemic to ask for a payment holiday or a blanket exemption for its members. “The CMS’s response was that the schemes should rather approach them on a case by case basis,” Mothudi responded. As a result only some schemes applied, “while others looked at their scheme rules to establish areas in which they could provide support without making the applications to the CMS, given that members needed an immediate solution”. He specifically stresses that schemes’ decisions not to apply for exemptions did not mean they were denying members assistance.

Click here to view the interview.

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