Secondary

Prescribed Minimum Benefits to be Extended?

Intentions by the Department of Health to amend regulations concerning prescribed minimum benefits in terms of the Medical Schemes Act were challenged by Genesis in court on 18 June 2015, asking that the regulations be reviewed and set aside.

TimesLIVE reports:

The Department of Health is intending to change the regulations that ensure that certain diseases are paid for no matter what the cost to medical aids.

Currently the Medical Schemes Act ensures that prescribed minimum benefits cover 26 chronic diseases, 270 other conditions and life-threatening emergencies, which have to be paid for “in full” by schemes. This protects scheme members and ensures that they do not run out of benefit funds halfway through the year.

Medical aid scheme Genesis asked a court yesterday to review and set aside regulations imposed by Minister of Health Aaron Motsoaledi in terms of the Medical Schemes Act.

Genesis argued that the minister does not have the power to impose the regulations and cannot dictate how medical schemes pay for treatment.

Motsoaledi was cited as a respondent in the court case but has indicated that he will not oppose the Genesis application.

Department spokesman Joe Maila said the amendments would be open to public comment.

He would not detail the amendments.

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