CMS research points to urgent need for chronic disease and cost-of-care reforms
Two new CMS studies highlight the growing strain of chronic diseases and soaring out-of-pocket healthcare costs.
CMS
High Court confirms curatorship of medical scheme
The Court ordered Sizwe Hosmed’s principal officer to personally pay legal costs after dismissing the scheme’s attempt to overturn the provisional curatorship.
Discovery delays 2026 contribution increase to April
Leading open medical schemes have announced increases above the CMS’s guidance, underscoring the tension between regulator calls for restraint and schemes’ funding needs.
Provisional curator to advise on future of medical scheme
The curator will assess Sizwe Hosmed’s finances and recommend whether it should merge, be liquidated, or continue.
Medical scheme hikes: CMS calls for restraint, but will schemes listen?
The Council for Medical Schemes recommends capping 2026 contribution increases at 3.3% plus “reasonable utilisation estimates”, yet past trends show schemes often push far higher.
Panel upholds findings of racial bias in medical scheme fraud investigations
Statistical analysis found that black healthcare professionals were multiple times more likely than their white peers to be investigated and found guilty of FWA.
Medihelp’s solvency dips again, but scheme says recovery plan is working
Medihelp says its recovery plan is on track, with strong cost controls, younger members, and CMS-approved funding measures set to restore financial stability by 2026.
CMS will issue a new circular on appointment of healthcare brokers
A significant ruling by the Appeal Board rendered the processes outlined in the circulars published in 2022 invalid.
Major setback for medical schemes in legal battle over low-cost options
The Board of Healthcare Funders says it will appeal after the High Court dismissed its application on procedural and substantive grounds.
CMS extends exemption for primary healthcare policies
Insurers are allowed to offer primary healthcare policies for an additional two years pending the finalisation of a framework for low-cost benefit options.
Medical schemes push ahead with case over Covid test pricing
The Competition Tribunal has dismissed key objections from major pathology laboratories, moving the medical schemes closer to having their damages claim heard in the High Court.
Sanlam’s split with Bonitas paves the way for exclusive Fedhealth partnership
After months of speculation, Sanlam has officially partnered with Fedhealth as its exclusive open medical scheme provider.
Health Minister signals opposition to low-cost benefit options for medical schemes
In its long-awaited report, the Council for Medical Schemes says its preferred recommendation is not to introduce LCBOs.
BHF slams CMS report on LCBOs as flawed and politically motivated
The Board of Healthcare Funders questions the timing and content of the CMS’s report, claiming it ignores stakeholder input and the opposition to low-cost benefit options is politically motivated.
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.
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.
