Medscheme’s bid to halt Bonitas’ administration transition has been delayed after procedural lapses and unresolved interlocutory issues forced the matter off the urgent roll.
Bonitas, Medscheme, and PHA trade accusations as court papers, whistleblower claims, and a CMS probe intensify the battle over medical scheme contracts.
The CMS frames the judgment as necessary to protect members, emphasising the scheme is compliant, operational and under close oversight.
The scheme and the regulator say a narrowly focused investigation will not halt the transition – but members should brace for some operational changes.
Bonitas’ decision to change administrators comes amid a CMS investigation and High Court proceedings involving its former service provider.
The comment comes amid a growing standoff between organised labour and GEMS after the scheme announced a 9.8% contribution increase for 2026.
In Circular 48, the CMS signals tougher enforcement against exempted insurers, warning that non-compliant branding and failure to notify regulators will attract decisive action.
Discovery Health has abandoned recovery action against more than 16 500 members, agreeing to absorb up to R170 million in overpaid ATB claims after sustained pressure from MediCheck,
Discovery Health is engaging affected members individually after a processing error led to some pharmacy claims being paid beyond Above Threshold Benefit limits during 2025.
The 2024 Industry Report highlights rising utilisation, ageing membership, and persistent under-pricing as the key forces reshaping medical scheme sustainability.
Broker service fees made up 17.65% of medical schemes’ directly attributable insurance service expenditure in 2024.
An accelerated 19% contribution increase is designed to correct historic under-pricing and shore up reserves.
After concluding its section 43 inquiry into Bonitas, the CMS has determined that the allegations merit a further forensic investigation.
Medihelp says it will challenge the judgment while the cost of Elaprase awaits a final decision by the CMS Appeal Board.
The Council for Medical Schemes’ latest annual report shows a decline in registered complaints – continuing a three-year downward trajectory.
The Council for Medical Schemes has approved two savings plans that will be marketed from 1 November.
Two new CMS studies highlight the growing strain of chronic diseases and soaring out-of-pocket healthcare costs.
