Minister proposes interim framework for collective healthcare tariff-setting
The Board of Health Funders has ‘serious reservations’ about giving the Department of Health the power to manage the block exemption negotiation process.
CMS
Discovery vs RAF: CMS executive says High Court got it wrong
A regulatory expert believes the judgment misinterpreted key legal principles in its ruling on the RAF’s obligation to reimburse medical schemes.
Court hears case on low-cost benefit options for medical schemes
The case raises questions about whether LCBOs will expand access to affordable private healthcare or threaten the rollout of NHI.
New chief executive and Registrar appointed for the Council for Medical Schemes
Dr Musa Gumede steps into the role of Registrar of the CMS, succeeding Dr Sipho Kabane, whose tenure was marked by significant challenges and critical industry reforms.
Bestmed defends 12.75% 2025 contribution hike as industry faces cost pressures
Bestmed states pending rules for low-cost benefit options have further complicated efforts to reduce costs for members.
CMS aims to release long-awaited report into racial profiling by year-end
Launched in 2019, the inquiry sought to investigate allegations of racial profiling by medical schemes. As 2024 draws to a close, the CMS is still battling objections and technical reviews to finalise the report.
Rise in complaints about medical schemes clawing back losses allegedly linked to fraud and waste
Schemes and healthcare professionals are at odds over whether these recoveries are justified, says the Council for Medical Schemes.
As medical schemes announce hikes, members brace for tough choices amid rising costs
With major medical schemes reporting average contribution hikes exceeding 9%, members face tough choices in an increasingly unaffordable healthcare landscape.
Discovery announces 2025 contribution increases: average hike of 9.3%
Discovery Health Medical Scheme’s contribution adjustments will be more evenly distributed across its members, highlighting the widespread effects of increasing medical inflation on contribution rates.
Will medical schemes adhere to an inflation-linked tariff hike?
The Council for Medical Schemes has advised medical schemes to limit their contribution increases for 2025 to 4.4% plus ‘reasonable’ utilisation estimates.
Medical scheme placed under statutory management as reserves plummet
The deterioration in Sizwe Hosmed’s reserves is attributed to ‘benefit under-pricing and historically unreliable budgetary and forecasting processes’.
Another setback for CMS in legal battle over LCBO documents
The signing of the NHI Act does not mean the BHF is letting up in its fight for regulations on low-cost benefit options.
CMS invites BHF to collaborate, criticises ‘forum-shopping’ tactics
The BHF’s canvassing of key policy issues in the public domain via a ‘deliberately leaked’ lawyer’s letter indicates the organisation ‘has run out of creative ideas’.
Council mulls outsourcing appeal adjudication amid BHF accusations
The CMS asserts that medical schemes have frequently disregarded the existing appeals procedures, exploiting them to the detriment of members’ interests.
CMS denies it is sabotaging medical schemes to boost NHI
The regulator comes out swinging in its response to the Board of Healthcare Funders’ claims of bullying and curatorship abuse.
CMS seeks reconsideration after court dismisses appeal on LCBO documents
The Supreme Court of Appeal’s dismissal of the Council for Medical Schemes’ appeal against providing documents to the Board of Healthcare Funders on low-cost benefit options marks the latest development in the ongoing legal dispute.
Medical schemes regulator flags ‘extravagant’ AGM expenses
Council for Medical Schemes urges investigation into ‘worrisome’ AGM costs as new research report reveals disparities within the medical scheme landscape.
